FINAL Legislative update
During the 2013 session of the Florida Legislature, the Florida Nurses Association (FNA) lobbying team tracked more than 200 bills affecting the nursing profession and patients. These bills ranged from access to health insurance coverage and telemedicine to state employee retirement.
The FNA’s biggest victory by far was the defeat of the “doctor title” bill, which would have put limitations on nurses with their doctorate degrees who refer to themselves as “Doctor.”
Below is an outline of key issues from the 2013 legislative session.
Medicaid/Affordable Care Act
One of the more contentious issues of the legislative session was the implementation of the federal Patient Protection and Affordable Care Act (PPACA). Gov. Rick Scott supported the use of federal funds to expand Florida’s Medicaid program to individuals making up to 138 percent of the federal poverty level, but leaders in the House and Senate disagreed on the best approach to accomplish that.
The Senate supported a bill (SB 1816) that would have used $51 billion in federal funding to assist up to 1.1 million uninsured residents with purchasing health insurance coverage. The House had an alternative plan (HB 7169) that would have used state dollars to assist 115,000 people in paying for premiums. That bill included language setting up a task force to consider ways for physician assistants and nurse practitioners to function more independently.
The Florida Nurses Association supported and advocated for the task force, as well as efforts to draw down federal funding for the purpose of providing health insurance access to as many uninsured residents as possible. In the end, no agreement was reached on the Medicaid premium assistance, and the bills died.
The lack of action does not affect Florida’s health insurance exchange, an online marketplace where uninsured residents who make between 100 percent and 400 percent of the federal poverty level can shop for health insurance plans. Some individuals and families may qualify for federal premium subsidies or tax credits. The exchange will go into effect in October.
Related:
· Under SB 1842, the Office of Insurance Regulation will not be responsible for reviewing rate increases for health plans in 2014 and 2015. The bill also requires training, background checks, and registration of “navigators,” which are individuals who will assist others in selecting health plans on the health insurance exchange. The governor signed the bill into law on May 31.
Baker Act, ARNPs (SB 110/HB 9) -- DIED
HB 9 would add nurse practitioners to the list of professionals that could initiate Baker Act proceedings. The bill passed the full House unanimously. The Senate bill (SB 110) by Sen. Anitere Flores was amended and called for a work group to examine the efficiency and effectiveness of Florida’s Mental Health Act and to report findings to the governor and legislative leaders. The bill died in the Senate Health Policy Committee.
Doctor title (SB 612/HB 805) -- DIED
This legislation as originally filed would have required any nurse who uses his/her educational title of “Doctor” while rendering or advertising patient care to state he/she is not a medical doctor or osteopathic physician. An intentional violation would have been a third-degree felony.
In a meeting of Senate Health Policy Committee on March 7, Sen. Denise Grimsley filed an amendment to SB 612 that removed the third-degree felony provision and simply stated that nurses were subject to disciplinary action for introducing oneself with the title of “Doctor” while rendering health care services without orally disclosing that the licensee is a nurse practitioner, doctor of nursing practice, or the appropriate title that corresponds with the person’s license.
SB 612, sponsored by Sen. Bill Galvano, died in its second committee. The House version (HB 805) by Rep. Heather Fitzenhagen never received a hearing in any of its four committees.
Optometry prescribing bill (HB 239) – PASSED
HB 239 passed the full Legislature and was signed into law by Gov. Rick Scott on April 18. The new law represents an agreement between the optometrists and the Florida Medical Association. The bill includes 14 oral drugs that optometrists will be able to prescribe, including certain types of antibiotics and anti-glaucoma drugs. But it also includes limitations, such as barring optometrists from prescribing many types of controlled substances.
The new law requires optometrists to take a course and an exam before prescribing or administering oral drugs and makes clear optometrists would not be able to do surgical procedures.
Patient lifting and handling practices (HB 1383) -- DIED
HB 1383 by Rep. David Richardson requires that hospitals establish an evidence-based policy regarding the safe lifting and associated handling of patients that minimizes the risk of injuries to patients and employees. It did not receive a committee hearing and lacked a Senate companion.
Physical therapists (SB 536/HB 413) -- PASSED
HB 413 by Rep. Travis Hutson authorizes a physical therapist to implement physical therapy treatment plans that are developed by a physical therapist or provided by a practitioner of record or ARNP. Sen. Nancy Detert was the Senate sponsor. The governor signed the bill into law on June 3.
School emergencies (SB 284/HB 369) -- PASSED
The bill gives an option to private and public schools to purchase and store epinephrine auto-injectors, also known as “epi-pens,” on campus. The bill requires schools that possess such auto-injectors to adopt a protocol developed by a licensed physician for the purpose of training school personnel to administer the device in the event of an allergic reaction. Students who are authorized to self-administer may use the school’s auto-injectors.
SB 284 by Sen. Joe Negron was signed into law by the governor on May 30. The House sponsor was Rep. Mike LaRosa. FNA was part of a large coalition of organizations that supported this bill.
Staffing ratios (SB 1732, HB 1397) -- DIED
Called the “Florida Hospital Patient Protection Act,” this legislation requires that hospitals maintain strict staffing ratios of direct care registered nurses to patients in specific units. Neither HB 1397 by Rep. Kevin Radar nor SB 1732 by Sen. Oscar Braynon received a committee hearing.
Surgical Technologists (SB 360/HB 281) -- DIED
SB 360 by Sen. Rene Garcia established certification requirements for surgical technologists. Early versions of the bill placed surgical technologists under the supervision of physicians. The FNA worked closely with Sen. Garcia to ensure that hospital policy would become the default policy, meaning that circulating registered nurses would retain their supervisory role. The bill died in Senate Appropriations. HB 281 by Rep. Matt Gaetz died in Health & Human Services Committee.
The FNA lobbying team worked closely with the Association of periOperative Registered Nurses (AORN) on this legislation.