A Report from Gray Robinson on the 2019 Florida Legislative Session

The Legislature adjourned for the 2019 Session – known as Sine Die – on Saturday, May 4, after voting on the 2019-20 fiscal year spending plan. Lawmakers had planned to wrap up their work by Friday but had to extend one more day to give members a mandatory 72-hour review period for the budget, which is required by the State Constitution. Governor DeSantis wields line-item veto power, meaning he can remove individual appropriations from the budget.

The Legislature tackled several major issues this session. The measures that prompted the most debate include an immigration enforcement bill; a bill to implement Amendment 4 – restoring voting rights to felons; and legislation that implements the recommendations of a school safety panel that was commissioned after the Parkland shooting, including a provision that gives school districts the option to train and arm willing teachers.

House Speaker Jose Oliva successfully pursued a number of health care changes that the House believed would reduce patient costs. The Legislature as a whole passed legislation that expands telemedicine, removes certain health provider certifications, increases health care competition, and creates new opportunities to import foreign, less expensive prescription drugs.

Senate President Bill Galvano had identified a series of toll-road projects as one of his top priorities and the Legislature followed through by supporting a multi-year plan to dedicate state dollars toward three major highway constructions or expansions, including bringing the Suncoast Parkway, which starts in Tampa, up to the Florida-Georgia border; and, connecting the Florida Turnpike to Suncoast Parkway.

Thanks to our outstanding lobbying team from Gray Robinson, Mike Huey, Todd Steibly, and Jessica Love, our legislative committee chaired by Dr. Bill Storoe, dentistry and OMS for a very successful session.


Following are the Highlights:

BUDGET & TAX PACKAGE

The $91.1 billion spending plan lawmakers approved Saturday is the largest budget in state history and @2.4 billion more than the current year budget. The final number is closer to Governor DeSantis recommended budget – $91.3 billion – than is to the initial spending plans passed earlier this year by the House and Senate.

Lawmakers provided historic funding for the environment and education in the budget. Per-pupil student spending in K-12 schools, for example, is $243 higher than it was last year. The budget also exceeds the $625 million investment in the Everglades and water quality initiatives that DeSantis requested.

For Hurricane Michael, the Legislature agreed to spend $1.8 billion on relief and recovery. There was little debate over that dollar figure, with most lawmakers criticizing the federal government’s lack of response to the disaster.

The legislature also passed a tax package which will cut revenue by $86 million in the first year and $72 million annually after. The most expensive portion of the package was a reduction in the business rent tax rate, which dropped from 5.7 percent to 5.5 percent. The legislation also includes a 5 day back-to-school sales tax holiday (August 2-6, 2019) and a 7-day hurricane preparedness tax holiday (May 31- June 6, 2019).

HIGH PRIORITY LEGISLATION

Continuing Education for Dentists- PASSED
HB 549 by Rep. Tyler Sirois
SB 648 by Sen. Debbie Mayfield

Legislation which passed during the 2018 Legislative Session (HB 21) required all health care providers who are registered with the Drug Enforcement Agency to take a two-hour continuing education (CE) course on the prescribing of controlled substances. The legislation limited the groups which could provide the course to only those affiliated with a statewide professional association of physicians (s. 456.0301, F.S.), unless a licensee’s practice act requires them to take a two-hour course on safe and effective prescribing of controlled substances, then the licensee is exempt from the requirements of 456.0301.

We approached Representative Tyler Sirois and Senator Debbie Mayfield to file legislation that would insert language into the dental proactive act requiring dentist to complete the two-hour course as part of their required 30 hours of continuing education for biennial licensure renewal. FSOMS worked these bills through the House and Senate committee process without receiving a negative vote. On April 23, the Legislature passed HB 549 which is awaiting action by the Governor, who will sign the bill, let it become law without his signature, or veto it.

This was Representative Sirois’ first bill that he passed as a freshman legislator and we are proud to have worked with him on this issue. We are currently focusing our efforts on the Governor’s Office, advocating that the Governor sign this important legislation to allow dental affiliated groups who understand the specialty of dentistry and oral and maxillofacial surgery to provide these continuing education courses directly.

Dental Therapy- FAILED
HB 649 by Rep. Rene “Coach P” Plasencia
SB 684 by Sen. Jeff Brandes

This legislation would have created a new category of licensees, dental therapists, in Florida. Many educational models recommend two years or less or post-high school education for dental therapist. These bills would have authorized the Department of Health (DOH) to issue a dental therapist license to an applicant who possesses a degree or certificate in dental therapy from an accredited program. The bills authorized a licensed dental therapist to perform remediable tasks under the general supervision of a dentist, and authorized Medicaid to reimburse for dental services provided in a mobile dental unit owned by the health access setting. The Senate bill received only one committee hearing, while the House measure was worshipped by the House Health Quality Subcommittee without going to a vote. We fully anticipate this legislation to be filed again for consideration during the 2020 Session.


OTHER LEGISLATIVE ISSUES

Legislation Which Passed:

Certificate of Need – PASSED
HB 21 by Rep. Heather Fitzenhagen
SB 1712 by Sen. Gayle Harrell

A top priority of House Speaker Oliva, certificate-of-need (CON) repeal, became one of the most contentious pieces of legislation. If approved by the Governor, the bill will eliminate the CON requirement for specialty hospitals in 2021. Earlier this Session, the Senate presented a proposal that would have eliminated CON, but would have imposed additional requirements on any new hospitals, such as mandating that they have an emergency room, accept Medicare and Medicaid patients, and provide a certain percentage of charity care, among other requirements. However, during the last few days of Session, those requirements were removed from the bill, reflecting the House position. The measure, as passed, will also require the Office of Program Policy Analysis and Government Accountability (OPPAGA) to review federal and other state licensure statues regarding tertiary health services and to make recommendations to the legislature by November 1, 2019, regarding best practices as it pertains to the establishment of licensure standards for such programs.

The legislation also includes language establishing the dental student loan repayment program (HB 465), to eligible dentists actively employed in a public health program that services Medicaid recipients and other low-income patients located in medically underserved areas and health professional shortage areas. Each year, DOH may grant up to 10 eligible dentists up to $50,000 in student loan repayment per year for a maximum of five years for a total of $250,000. The bill also requires DOH to establish the Donated Dental Services Programs, a network of volunteer dental providers who will provide free dental services to needy, disabled, elderly, and medically compromised individual who cannot afford necessary treatment but are ineligible for public assistance.

Telehealth – PASSED
HB 23 by Rep. Clay Yarborough
SB 1526 by Sen. Gayle Harrell

Another House propriety, authorizing telehealth services in Florida, passed the legislature this year. The bill established new telehealth practice standards, requires out-of-state practitioners without a Florida license to register with the DOH in order to deliver health care services within their scope of practice to Florida patients, and provides for reimbursement of such services. Providers are defined as licensed physicians, podiatrists, optometrists, nurses, nurse practitioners, pharmacists, dentists, chiropractors, as well as many other professionals, such as acupuncturists, physical therapists, psychologists, behavior analysts and others. These practitioners must maintain an active, unencumbered license issued by another state that is substantially similar to Florida’s license, and must not have been the subject of disciplinary.

IMPORTATION of PRESCRIPTION DRUGS – PASSED
HB 19 Rep. Tom Leek
SB 1452 by Sen. Joe Gruters

This legislation will create a Canadian drug importation program for the state and an international drug importation program for the commercial market. The international program is limited to other counties with similar pharmaceutical standards as the United States.

Documentation of a drug’s manufacturing is required for both importation programs and must be maintained for seven years. This legislation required Federal authorization, and President Trump has directed Alex Azar, Secretary of Health and Human Services, to work with Governor DeSantis on the plan, which must be submitted by July 1, 2020.

ELECTRONIC PRESCRIBING – PASSED
HB 831 by Rep. Amber Mariano
SB 1192 by Sen. Aaron Bean

House Bill requires certain health care practitioners who maintain a system of electronic health records to electronically generate and transmit prescriptions for medicinal drugs upon license renewal, or by July 1, 2021, with a few exceptions. DOH must consult with the Board of Dentistry to adopt rules to implement this language.


Legislation Which Failed:

Department of Health- FAILED
HB 7031 by House Health Quality Subcommittee
SB 188 by Sen. Gayle Harrell

The DOH package once again failed to pass this Session. The bill would have removed language that allows only a “Florida licensed dentist” to grade dental exams for licensure and required dental labs to be inspected once a year in the biennial rather than every year. It also would have required a representation of dental laboratories to consult with a dentist online during a procedure and extended to repeal of the health access dental license from 2020 to 2025.

Opioid Drug Abuse Task Force
HB 875 by Rep. Tyler Sirois
SB 1658 by Sen. Wilton Simpson

This legislation would have established a statewide task force to research Florida’s opioids drug abuse problem. The task force was to be comprised of 25 members, including:

  • One member each from the Department of Education, Florida Department of Law Enforcement,
  • Department of Children and Families, Agency for Healthcare Administration, Department of Corrections, Department of Juvenile Justice, and State Courts Administrator;
  • One member appointed by the President of the Senate;
  • One member appointed by the Speaker of the House;
  • Three members from addiction and recovery associations;
  • Two sheriffs, two police chiefs, two state attorneys, and two public defenders; and
  • One representative each from the Florida Medical Associations, Florida Pharmacy Association, and the insurance industry.

We worked with the House sponsor, Representative Tyler Sirois, to add an oral surgeon to task force, however HB 875 was not heard again in committee. The Senate bill never received a hearing. We will continue to work with both sponsors in the event similar legislation is filed again next year.


NEXT SESSION

The 2020 Legislative Session will begin January 14, 2020, and we expect that committee hearings will begin September 2019. We sincerely appreciate the opportunity of representing FSOMS and comment you for your tireless commitment to the legislative process watch and every Session. Should you have any questions concerning the information provided in this report, please do not hesitate to contact us.