Week 3 Session 2021

WEEK 3

SESSION 2021

Large Strategies

Health Care

Capitol Update

2021 Health Care BILL Tracking Chart

PA Independent Practice UPDATE

Physician Assistants Independence Considered

Physician Assistants were left out of the autonomous practice bill for nurse practitioners last year, and once again are before the legislature asking for similar independence. But on Wednesday, the Senate Health Policy committee amended SB 894 to remove the autonomous practice language and instead lifted the cap on the number of PAs a doctor can supervise. There was some hesitation from senators who were worried about the quality-of-care Floridians would receive by removing the 4 PA per physician supervisory cap. The measure has two more committees to clear and a similar House bill, HB 431, will be heard on Tuesday in House Professions & Public Health Committee.

The House of Medicine will continue to push for a reasonable number for supervision.

Staff Analysis CS/SB 894

House Proposed Committee Bill

In the NEWS

DEAL REACHED ON COVID-19 LIABILITY PROTECTIONS

via Christine Sexton

Legislative leaders announced Thursday they have an agreement on COVID-19 liability protections for businesses, nursing homes and other health-care providers and that a bill should be headed to Gov. Ron DeSantis’ desk late next week.

Senate President Wilton Simpson, R-Trilby, and House Speaker Chris Sprowls, R-Palm Harbor, said the House would accept a proposal (SB 72) that the Senate amended and passed Thursday in a 24-15 vote along almost straight party lines. Sen. Linda Stewart, D-Orlando, was the only Democrat who voted for the measure.

The bill, sponsored by Sen. Jeff Brandes, R-St. Petersburg, offers protections from liability related to the COVID-19 pandemic to all businesses, from general stores to nursing homes.

The measure would require that all COVID-19 lawsuits be pled with particularity.

In COVID-19 medical malpractice claims or nursing home-related claims, plaintiffs would not need to obtain physician affidavits.

Plaintiffs would have to prove that health care providers’ actions were grossly negligent. Otherwise, health care providers who substantially complied with authoritative or applicable government-issued health standards or guidance related to COVID-19 would have immunity.

The Senate debated --- and shot down --- a number of attempts by Democrats to change the bill. For example, Sen. Perry Thurston, D-Fort Lauderdale, filed amendments that would have changed workers’ compensation insurance laws to include a presumption that a wide range of health-care professionals who test positive for COVID-19 contracted it at work. The amendment would have applied to physicians, nurses, dentists, emergency medical personnel and people who work at clinical labs, doctors’ offices, hospitals and nursing homes.

But Brandes opposed the amendments, saying that the workers’ compensation system is effective and that claims should be considered separately.

Thurston also tried to limit protections afforded to the long-term care industry, saying that the state should not protect facilities that had been sanctioned by the state or federal government in the prior three years.

The House this month approved a bill (HB 7) that would help shield businesses from COVID-19 lawsuits but has dealt with health-care providers in a separate bill (HB 7005). But the Senate’s passage of its combined bill Thursday --- and the announcement of a deal with House leaders --- was a major victory for business and health-care groups.

Florida Senate Seeks To Clarify Pelvic Exam Law

via Florida Health News

A 2020 law that required doctors to obtain written consent before conducting pelvic exams caused confusion last summer among Florida physicians.

The Senate Health Policy Committee on Wednesday took a step to clarify the law by unanimously passing a bill (SB 716) that says the requirement only applies to female patients and that pelvic exams include examinations of the internal reproductive system.

Sponsored by Sen. Laruen Book, D-Plantation, the bill also would make clear consent required only when patients are anesthetized or unconscious.

The bill also would clarify that written consent for pelvic exams may be included in general consent forms that physicians give patients. Moreover, the bill would make clear that one written consent form may be used to authorize multiple health care practitioners or students to perform a pelvic examination.

The bill addresses concerns that physicians and nurses had with the law. Two medical licensing boards were asked last year to issue declaratory statements to settle some of the confusion that occurred.

Sponsored by Book, the 2020 law was in response to media reports that medical students may be performing pelvic examinations on anesthetized or unconscious women without obtaining informed consent.

Florida Lawmakers Consider PPE Stockpile Plan

via Christine Sexton

The bill, approved by the House Pandemics & Public Emergencies Committee, would allow practitioners to purchase personal protective equipment from the state during declared emergencies.

Florida could set up a stockpile of life-saving personal protective equipment and sell it to health-care practitioners at cost, under proposals now moving in the Legislature.

Despite some concern from one lawmaker who cautioned the measure could turn a “government agency into an Amazon,” the House Pandemics & Public Emergencies Committee on Tuesday unanimously approved its version of the proposal (HB 1353), sponsored by Rep. Clay Yarborough, R-Jacksonville.

Committee member Carlos Guillermo Smith, D-Orlando, noted that the state Division of Emergency Management has provided PPE free of charge during the COVID-19 pandemic to health-care practitioners and asked whether there would be a policy switch to require providers to pay for the equipment.

Smith also said he was worried that making PPE available for sale through the state would disincentivize practitioners from having their own contingency plans.

“That’s really my main concern with your bill, that we are turning a government agency into an Amazon when I don't think it’s the appropriate role for the government to be selling it to providers,” he said.

During the early days of the COVID-19 pandemic, personal protective equipment was hard to come by as the United States outsourced production to China. Health-care workers wore garbage bags, and physicians and nurses reused their N95 masks.

Gov. Ron DeSantis in March 2020 temporarily halted all non-essential health care procedures as a way to ensure the PPE supply was adequate.

As of August, the Division of Emergency Management had provided more than 62 million masks; 16.5 million gloves; 2 million face shields; 1.2 million shoe covers; 5 million gowns; 107,000 goggles and 74,000 coveralls to health-care providers. Even then, it wasn’t enough, and providers such as assisted living facilities and homes for people with developmental and intellectual disabilities often were left without supplies.

Also Tuesday, the Senate Military and Veterans Affairs, Space and Domestic Security Committee unanimously approved the Senate version of the proposal (SB 1760), despite worries that it wouldn’t go far enough to protect all Florida businesses and front-line workers who require the equipment.

The bill would allow health-care practitioners to purchase PPE from the state during declared emergencies. To ensure the state has enough respirators, gloves, gowns and masks to cover the potential need, the Division of Emergency Management would be required to complete an inventory of equipment “held in reserve” and procure additional equipment or arrange by contract for it to be sold to practitioners or their employers at cost.

Practitioners would include a wide range of professions, such as physicians, chiropractors, nurses, pharmacists, midwives, speech language pathologists and audiologists, nursing home administrators and respiratory therapists.

Sen. Audrey Gibson, D-Jacksonville, worried that the inventory might not be inclusive. She noted that in her district a coalition was put together to ensure that many minority physicians could get supplies.

The bills are supported by the largest statewide physician association, the Florida Medical Association, and the Florida Osteopathic Medical Association.

TELEHEALTH MEASURES GET GREEN LIGHT

via News Service of Florida

A Senate health panel on Wednesday moved forward with a pair of bills that could help expand the use of telehealth. One proposal (SB 864), sponsored by Sen. Jason Brodeur, R-Sanford, would expand the definition of telehealth to include audio-only telephone calls, which are now excluded from a definition in state law and regulatory rules. Telehealth generally involves health-care providers using technology, such as the internet, to treat patients remotely and has increased in use during the COVID-19 pandemic. The bill, which was approved by the Senate Health Policy Committee in a unanimous vote, also would provide an exemption from registration requirements for out-of-state telehealth providers. That exemption would apply if the services they are providing come in consultation with Florida-licensed professionals who have authority over the diagnosis and care of the patients. The other bill (SB 852), also sponsored by Brodeur, would expand a list of Medicaid-optional services that are covered to include remote patient monitoring services and remote evaluation of recorded video and images. It also passed the committee in a unanimous vote.

Rep Toledo's Human Trafficking bill Clears First Committee Stop

via Florida Politics

HB 523, aimed at helping victims of human trafficking while cracking down on offenders received unanimous support Tuesday in the House Criminal Justice and Public Safety Subcommittee.

The bill would establish a training program for victim advocates.

Also receiving successful passage in

Committee this WEEK

Click on bill to review Legislative Staff Analysis.

SB 0390 Prescription Drug Coverage (Wright)

Committee Substitute filed CS

SB 0130 Mental Health and Substance Use Disorders (Rouson)

SB 0404 Office of Minority Health and Health Equity (Rouson)

SB 0614 Assault or Battery on Hospital Personnel (Rodriguez (A))

SB 1142 Prohibited Acts by Health Care Practitioners (Rodrigues (R))

SB 1442 Substance Abuse Prevention (Boyd)

SB 1934 Health Care Practitioner Discipline (Book)

Bills UP Next Week

(as of March 19 @ 6pm)

MONDAY

HB 0319 Substance Abuse Service Providers (Caruso)

HOUSE On Committee agenda - Criminal Justice & Public Safety Subcommittee, 03/22/21, 3:00 pm

SB 1992 Solicitation of Non-medical Services (Harrell)

SENATE On Committee agenda - Commerce and Tourism, 03/22/21, 3:30 pm

HB 99 Use of Epinephrine Auto-injectors on Public K-20 Campuses (Gottlieb)

HOUSE On Committee agenda - Post-Secondary Education & Lifelong Learning Subcommittee, 03/22/21, 4:00 pm

TUESDAY

HB 1165 Payments for Birth-related Neurological Injuries (Koster)

HOUSE On Committee agenda - Civil Justice & Property Rights Subcommittee, 03/23/21, 9:15 am

HB 183 Office of Minority Health and Health Equity (Brown)