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Major Health Care Issues Teed Up In Senate

Florida Legislature
Florida House of Representatives
The Florida Channel
Leon County Judge John Cooper on June 30, 2022, in a screen grab from The Florida Channel.

The Senate on Tuesday took up three House health care priorities, teeing them up for votes and potentially clearing the way for public budget negotiations to resume.

But some senators have concerns with the measures and how they would expand the scope of practice for advanced practice registered nurses, arguably House Speaker Jose Oliva’s top priority, and for pharmacists, an issue that has emerged as crucial in the last weeks of the 2020 session.

The Senate’s latest offer on independent practice for advanced practice registered nurses came in the form of an amendment to a House bill (HB 607). The amended bill would allow advanced practice registered nurses to provide primary care independent of physicians and for certified nurse midwives to work autonomously.

To qualify, advanced practice registered nurses would have to take at least 3,000 clinical practice hours in the five years prior to practicing autonomously. The amendment also includes $5 million in recurring general revenue for a loan repayment program for advanced practice registered nurses who work in primary-care health professional shortage areas or county health departments, community health centers, migrant health centers or any other publicly funded health care programs designated by the state. 

“It’s no compromise. That’s a total takeover by the House,” Sen. Gayle Harrell, R-Stuart, said of the amendment the Senate considered Tuesday.

If the bill passes the Senate, it would need to go back to the House for a final vote.

The Senate also took up and amended a proposal (HB 389) that would allow pharmacists to enter collaborative agreements with physicians authorizing them to treat the physicians' patients for chronic illnesses, including arthritis, asthma, chronic obstructive pulmonary diseases, Type 2 diabetes, HIV, AIDS, obesity or “any other chronic condition” adopted in rule by state medical boards.

The measure also would authorize pharmacists to have written protocols with supervisory physicians that would allow pharmacists to treat children for influenza, streptococcus, lice, skin conditions and minor, uncomplicated infections.

“Three-quarters of that bill was never heard in any committee in this chamber,” said Harrell, whose late husband was a physician.

Sen. Tom Lee, R-Thonotosassa, also expressed concerns about the pharmacy bill, saying it “really opens the door pretty wide.”

“It’s gotten very broad. I think that we have all these scope issues that are going on. And I actually give the speaker (Oliva) a lot of credit for having the courage to broach these issues,” Lee said. “But when you do that, you want to make sure you crawl before you walk.”

The Senate could pass the amended pharmacy bill as soon as Wednesday, with the measure then needing to go back to the House.

The Senate on Tuesday also prepared to vote on a bill (HB 599) related to consultant pharmacists, or pharmacists who provide advice on the use of medications to people in community settings as well as nursing homes. The bill would expand the locations where consultant pharmacists can practice to include ambulatory surgery centers, inpatient hospice facilities, hospitals, alcohol or chemical dependency centers, ambulatory care centers or nursing homes within continuing care retirement communities, in addition to nursing homes or home health agencies.

If the Senate passes the bill, it will head to the governor.

Oliva has made clear that health care is his priority for the 2020 legislative session. Though the chambers met over the weekend and early Monday morning, public budget negotiations have come to a standstill as the House and Senate work to hammer out compromises on policy priorities that are important to Oliva and Senate President Bill Galvano, R-Bradenton.

The legislative session is slated to end Friday, but lawmakers already have announced they won’t be able to complete their work on the one must-pass bill of the session: the budget.