By Mary Mayhew
Following three years of an upending pandemic, Florida hospitals received incredible support from the Florida Legislature in the just-concluded legislative session. Thanks to strong advocacy from the health care community, lawmakers passed a number of bills that will stabilize the health care system, invest in essential services, increase access to coverage, and make Florida a national health care leader. While some of these bills are pending signature by Governor DeSantis, they represent a significant win for Florida health care.
After years of legislative proposals to cut Medicaid hospital reimbursement for care provided to vulnerable Floridians, not only did the budgets not include any proposed cuts, the legislature actually proposed and approved $270 million in additional funding for hospitals to care for Medicaid enrollees. A significant portion of this funding is dedicated to care for children, who comprise the majority of Medicaid enrollees. Complex pediatric care and specialty children’s hospitals will receive a boost in funding. Additionally, the Legislature continued to provide support for and to authorize again the Hospital Directed Payment Program (DPP) that provides $1.4 billion in additional federal Medicaid funding through the use of regional intergovernmental transfers from hospital assessments and contributions to help close some of the gap between Medicaid reimbursement and the cost of caring for Medicaid enrollees. This program must still be annually approved by CMS. Florida is currently awaiting approval of DPP for year three of the program.
Recognizing the critical foundation that health care access plays in the health of Florida’s children and in their future educational attainment, the Legislature also passed legislation to increase eligibility for the Children’s Health Insurance Program (this program is largely federally funded with a 72% federal matching rate). Income eligibility for the decades-old Children’s Health Insurance Program, known as KidCare in Florida, will increase from 200 percent of the federal poverty level to 300 percent, or $90,000, for a family of four.
Through focused advocacy by the FHA, the Legislature appropriated $10 million for the Rural Hospital Capital Improvement Program. Although created in 1999, the program has not been funded since 2008. With this new funding, the program can once again support rural hospitals with grants to acquire, repair, improve, and upgrade their systems, facilities, or equipment and help them continue to care for their communities.
Another critical investment is in the behavioral health system. The Legislature continues to improve financial support for community-based behavioral health care services for children and adults to increase timely access to care. In this recent budget, the Legislature increased the Department of Children and Families’ community mental health budget by 47 percent, including $156 million in block grant funding for community-based mental health services.
Given the magnitude of the healthcare workforce challenges nationally and in Florida, the Legislature again prioritized several pieces of legislation to protect and strengthen the workforce. First, House Bill 825 enhances penalties for anyone assaulting a hospital employee or volunteer anywhere in the facility. This bill sends a strong, unequivocal message that violence against health care workers will not be tolerated.
Second, stand-alone legislation and the state budget make two investments in affordable housing for health care workers and help them to deepen roots in their local community where they work. One is $100 million in renewed funding for the Hometown Heroes Housing Program, which helps law enforcement officers, first responders, nurses, and others who dedicate themselves to serving their communities with a first-time home purchase. The program already has provided more than $89.6 million to more than 6,000 qualifying individuals to help with down payments and closing costs for home purchases. Registered nurses are the second highest group of individuals receiving this loan benefit, with the top group being veterans. The second piece is Senate Bill 102, the Live Local Act, which provides more than $700 million for affordable community housing.
The Legislature invested in an additional aspect of the workforce by appropriating funding to increase the number of nurses and physicians who practice in Florida. Florida faces a projected shortage of nearly 60,000 nurses and 18,000 physicians by 2035. The new funding includes renewed appropriations of $125 million for nursing education and a new funding for graduate medical education that, among other things, will support a new Slots for Doctors Program.
With more than 1,000 individuals a day moving to Florida and many over the age of 65, Florida needs a strong, robust health care system ready to meet health care needs today and into the future. The investments and priorities of the governor and Legislature will help hospitals better serve their patients and communities and create a healthy Florida for all.
Mary Mayhew is President and CEO, Florida Hospital Association.
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