Transcript Edward Briggs, DNP, ARNP Presentation Slides

LEGISLATIVE UPDATE
ON HEALTHCARE
ISSUES
Implications for nursing practice
Presented by
Edward Briggs MS DNP ARNP-BC
President Florida Nurses Association
objectives
• Review the Florida Legislative process
• Discuss the current Florida Legislative Environment
• Review and discuss legislation being considered by
Florida Legislators that impact on healthcare delivery
• Review and discuss legislation being considered by
Florida Legislators that impact on nursing practice
• Discuss how to impact Florida Legislation that impacts on
nursing practice and mental health services in Florida
Disclaimer
Opinions expressed by the speaker are not intended to
represent those of the Florida Nurses Association, it’s
board, members or affiliate organizations.
I, Edward Briggs, have nothing to disclose or possess any
conflict of interest in this presentation.
A moment of reflection
• “It was the best of times, it was the worst of times!”
• Old Chinese curse…”May you live in interesting times!”
How a bill becomes a law…
Bill has a
house/senate
sponsor
Speaker of
House or Senate
President
assigns
committees
Committee
hearings
including public
comment.
Passes or Dead
60 day legislative
cycle…more
committees = failure
Amendments
or
reconciliation
Floor vote
Passes or
Dead
Governor
signs into law
or vetoes
History and discussion
• Session runs from March 3, 2015 to 5/1/2015
• Budget surplus
• Implementation of Amendment 1
• Not an election year however presidential election in 2016 and talk
of Rick Scott running
• Division between Governor Scott and the Legislative Branch
History and discussion
• Challenges facing Florida’s healthcare delivery system:
• Patient Protection and Affordable Care Act/Medicaid Expansion
• Aging and increase occurrence of chronic illness
• Insufficient availability of primary care providers
• Hospital and Healthcare provider financial constraints
• Healthcare Workforce Innovation House Select
Committee
• Political Realities
• Partisan Political Environment
GOVERNOR SCOTT’S BUDGET
Governors Budget is a guidepost of legislative priorities of the governor.
Governor will present the budget to the Legislative branch for
consideration and action.
Legislative Branch will consider the Governor’s budget and then
develop their own budget(s).
The Governor has the power of the line item veto.
GOVERNOR SCOTT’S BUDGET
$80 million of the budget goes to the Department of Children and Families, with a
focus improving child safety and eliminating preventable child deaths.
Nearly $22.4 million is earmarked for substance abuse and mental health
services
A total of $24.6 million toward improving case practice to protect children in the
states care. That includes the Florida Abuse Hotline and additional attorneys for
DCF to be able to seek injunctions against domestic abusers.
$14 million is allotted for recruiting, training and retaining a high-quality workforce.
GOVERNOR SCOTT’S BUDGET
$2.5 million in funding for criminal justice transitional reentry mental health
services to be implemented under a four county pilot program.
Services will include up to nine months of case management, treatment, therapy,
medication management, and transitional and supportive housing.
The proposed budget also includes $2.4 million to continue and expand
residential substance abuse and mental health treatment for offenders on
community supervision.
GOVERNOR SCOTT’S BUDGET
SFY 2016 Governor’s Proposed Budget – County Funding Highlights
Health and Human Services
1. Funding equal to $382,036,004 for Community Mental Health Services, a
nearly $70 million increase compared to the previous year.
2. Funding equal to $147,343,425 for Community Substance Abuse Services,
an approximate $5 million increase compared to the previous year’s budget.
3. Funding equal to $833,881,705 for County Health Units. (stable)
4. $3M for the Public Safety, Mental Health, and Substance Abuse Local
Matching Grant Program, which supports county programs that serve adults or
youth who are in behavioral crisis and at risk of entering the criminal justice
system (Stable)
5. $2,000,000 in recurring general revenue for Homeless Housing Assistance
Grants, to be distributed to local homeless coalitions throughout the state.
SUMMARY OF BILLS FILED
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List is as of February 24, 2014
Bills have been assigned to committees
Bills without companion is the opposing house will not be heard
Perennial Bills have not been included in the List
 i.e. Bills to outlaw elective terminations of pregnancy, etc.
HEALTH POLICY/MENTAL HEALTH
• HB 141/SB 114 –
• Conceals any identifier for consultants treating impaired providers.
Include family members.
PALLIATIVE CARE BILL
• HB 511/SB 438
Sponsors Placensia/Sobel
• Requires that the Department of Health develop a community
education program regarding the benefits and services of a
Palliative Care Facility/Program
INVOLUNTARY TREATMENT BILL
• SB 474
• Facilitates continuing incarcerated patients on their prescribed
psychiatric medications
MENTAL HEALTH SERVICES
• HB 335/HB 476
• Sets requirements for psychiatric nurse practitioners to have
national certification
• Provides psych ARNP’s with the ability to initiate and rescind a
Baker Act.
HIV TESTING
• HB 321/SB 512
• Defines Community Health Setting versus Healthcare Delivery
Center
• Requires notification of individuals receiving test if test is
confidential or anonymous
• Requires instruction of how data will be handled if confidential
• Requires providing list of available anonymous test sites.
BAKER ACT BILL
• HB 505/SB 514
Sponsors Jacobs/Sobel
• Requires the Department of Health to create a task force to review
current Baker Act criteria/guidelines and to make any
recommendations for change.
MEDICAL MARIJUANA
• SB 528
Sponsor Brandes
• Allows for the Medicinal prescribing of marijuana products to treat
approved conditions
• Creates guidelines for the harvesting/distribution and sales of
Medical Marijuana
CONTROLLED SUBSTANCES
• HB 281/SB 532
Sponsors Pigman/Grimsley
• Allows Nurse Practitioners and Physicians Assistants to “order”
controlled substances in an acute care facility.
EXPERIMENTAL THERAPIES
• HB 269
Sponsors
• Sets requirements for the utilization of experimental medical
therapies in extreme conditions
• Relieves manufacturers from any liability in these cases.
INFECTION CONTROL
• HB 474
Sponsor Edwards
• Allows for an experimental needle exchange program to be
managed from the University of Miami
OVERDOSE RESCUE
• HB 155
Sponsor Pilon
• Allows for the prescribing, sales and distribution of rescue
autoinjectors of Narcan for the treatment of opiate overdose.
ADVANCED PRACTICE NURSING
• HB H47/SB 614
Pigman/Grimsley
Pigman: Allows for advance practice nurses to
practice without a collaborative agreement with a physician,
allows for the prescribing of controlled substances, initiation
of Baker Acts, signing of death certificates, etc.
Grimsley: Allows for the prescribing of controlled
substances by advanced practice nurses.
Sexual Reassignment
• SB204/HB83
• Provides guidelines for sexual reassignment
• Outlaws sexual reassignment surgery/council to anyone
under the age of 18
Obstetrical Services Bills
• SB 161
• Requires that hospital notify obstetrical/gynecologic providers of
the plans to close an OB/GYN unit in advance of closing that unit.
Quarantine Bill
• SB 950 HB 697
• Revises existing quarantine laws and penalties. Allow for
law enforcement officers to enforce any quarantine order
issued by DOH.
Other Bills/Issues being Considered
• “A healthy Florida Works”
• -draw down of Federal Funds
• Other bills
• Other issues
Other Bills/Issues being Considered
• King v. Burwell Supreme Court Ruling
• Does the statement "enrolled in through an Exchange established
by the State” disqualify individuals who purchase health insurance
through federal exchange from receiving subsidies to purchase
health insurance
• If the supreme court upholds this ruling than 8.9 million individuals
in 37 states would lose their health insurance
How to Influence Health Policy
• Step 1
• Become an informed citizen
• Know who your legislators are
• Know what the issues are
• Track bills of interest
How to Influence Health Policy
• Step Two
• Educate your legislators on issues that are vital to you and let them
know where you stand
• (AKA lobbying)
• You can do this by
• Visiting your legislator
• Phone your legislator
• Email
• Letter
How to Influence Health Policy
• Educate your community on key issues
• Letters to the editor
• Educate peers and colleagues
• Blogs or website
How to Influence Health Policy
• Track the responses of your legislators
• How did they vote on issues
• Share with them how you feel about that vote
How to Influence Health Policy
• Participate in your professional organization
How to Influence Health Policy
• http://www.fna4action.com
• A grassroots initiative by the Florida Nurses Association to educate
nurses and the community on important health policy issues.
QUESTIONS