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The bill to revamp staffing at Florida nursing homes reaches DeSantis' desk

Virus Outbreak-Medicare-Nursing Homes
Ted S. Warren
The Florida Channel
Leon County Judge John Cooper on June 30, 2022, in a screen grab from The Florida Channel.

Among the other measures awaiting the governor's pen was a proposal that would broaden doctors’ ability to prescribe controlled substances through telemedicine.

With the measure drawing support from the nursing home industry and a veto request from the senior-advocacy group AARP Florida, a proposal that would revamp staffing standards for nursing homes was among 35 bills that landed on Gov. Ron DeSantis’ desk Tuesday.

Among the other measures was a proposal that would broaden doctors’ ability to prescribe controlled substances through telemedicine.

The nursing home legislation (HB 1239) was approved by votes of 80-31 in the House and 28-9 in the Senate, with supporters saying it would provide more flexibility to nursing homes and help with staffing shortages.

“The staffing shortage in long term care facilities has been unprecedented and devastating — with roughly 92% of nursing centers reporting shortages in 2021,” the Florida Health Care Association, an industry group, said in a news release last month that urged DeSantis to sign the bill. “Through that massive shortage, nurses and certified nursing assistants have endured significant physical and mental health challenges, underscoring the critical need for long term care facilities to utilize more specialized help.”

The most controversial part of the bill involves certified nursing assistants, who provide much of the hands-on care in nursing homes.

Current law requires that certified nursing assistants provide a minimum of 2.5 hours of direct care per resident per day. The bill would reduce that to two hours. Also, current law requires that certified nursing assistants and licensed nurses provide a weekly average of 3.6 hours of direct care per patient per day. The bill would keep that 3.6-hour average, but it would allow time spent by other types of workers, such as physical therapists and occupational therapists, to be factored into the calculation.

AARP, the state’s long-term care ombudsman and the Service Employees International Union, which represents nursing home workers, have contended the proposal would result in nursing home staff having to do more with less.

AARP Florida has asked supporters to submit veto requests to the governor’s office, saying the “legislation would cut nursing care in Florida's nursing homes by 20 percent, putting more Florida seniors at even greater risk of receiving poor care in these facilities.”

The measure on telemedicine (SB 312) aims to relax restrictions related to physicians prescribing certain controlled substances for patients. Doctors using telemedicine still would be prohibited from prescribing what are known as Schedule I and Schedule II substances, which include drugs that are considered highly addictive.

Doctors currently are prohibited from prescribing any controlled substances through telehealth unless the prescriptions are intended to treat psychiatric disorders, hospital inpatients, patients in hospice care or nursing homes.

Also, DeSantis received a bill (SB 1950) that would help set the stage for the Agency for Health Care Administration to award billions of dollars in Medicaid managed-care contracts. The agency during the past decade has gone through lengthy processes twice to award contracts to managed-care plans and is expected to begin a third round this year.

DeSantis will have until April 20 to take action on the bills.

Jim Turner - News Service of Florida
Ryan Dailey - News Service of Florida