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Budget crisis stalls KidCare, mental health, abortion issues

By Gary Fineout
4/1/2009 © Health News Florida

Today, at the midpoint of the 60-day legislative session, a controversial bill that would require ultrasound before abortion looks unlikely to win passage because most political effort and attention are focused on the $6-billion budget crisis.
The same forces have stalled issues that have strong support from consumer advocates: A bill that would streamline the process of signing up for KidCare and a budget shift of funding at Department of Children and Families so that the state can maintain mental health services and substance abuse treatment for thousands of patients.

On the other hand, a public-health bill that wouldn’t be considered in an ordinary year -- hiking cigarette taxes by $1 a pack to generate more money for health programs -- has a good chance now.

“The budget is sucking so much air out of the room,’’ said veteran lobbyist Jon Johnson, whose health care clients include the Florida Hospital Association and the Florida Medical Association. “It’s hard to focus on anything else.’’ 

Health care organizations were relieved that both Senate and House budget committees agreed to use federal stimulus dollars to maintain the state’s Medically Needy program and a Medicaid program that provides help to the elderly and disabled. 

However, the initial Senate budget has deep cuts in funding for both substance abuse and mental health programs. DCF Secretary George Sheldon has predicted that some 5,000 adults would lose mental health services and another 2,200 adults and children would be forced out of substance abuse programs if the cuts were to go through.  

A crackdown on Medicaid fraud, the creation of a prescription drug database, and changes to Florida’s Baker Act are still moving through legislative committees. There are also ongoing attempts to tinker with the Medicaid “Reform” project running in Broward and Northeast Florida. 

One of those, a very different kind of pilot project to create “medical homes,” is being introduced today by Rep. Ed Homan of Tampa, an orthopedic surgeon and chairman of the Health & Family Services Policy Council. (See story on this). 

But Homan says his model, which would use community health centers and medical schools as the treatment network, is opposed by managed care organizations, dimming its prospects.

Homan, R-Tampa, has other bills facing long odds: a mandate for more insurance coverage of mental health benefits and a requirement that establishments serving alcoholic beverages post prominent signs warning about drinking during pregnancy. His measure to require flu vaccines for children in day care was watered down so that now it requires day care centers to provide information about influenza.

“Every year I’m disappointed,’’ Homan said. “I would like to do more every year.’’ 

Lawmakers blame the budget crisis for the failure to move a measure that would streamline the application process for families trying to enroll in the Florida KidCare program. While KidCare advocates contend the changes would not increase the cost of the program, the legislation has not yet been heard in either the House or the Senate. 

Some veteran legislative observers say that the installation of Rep. Larry Cretul, R-Ocala, as House Speaker caused a slowdown in the House. Cretul took over earlier this year when Rep. Ray Sansom, R-Destin, stepped down because a grand jury began looking into money he steered to Northwest Florida College. 

Some health care bills have proven too controversial to move very far this year. A bill to allow optometrists to prescribe certain drugs was voted down by a Senate committee.

GOP legislators opposed to abortion wanted a requirement that women seeking a first-trimester abortion would first have to get an ultrasound showing them an image of the live fetus. Backers hoped that the departure of two GOP senators who voted against it last year meant the measure would pass this session.
But Sen. Andy Gardiner, R-Orlando, has been unable to convince moderate GOP senators to vote the bill out of its first stop, the Senate Health Care Regulation Committee. 

"Sadly, we haven’t been able to get the votes to get it out of that first committee,’’ said Gardiner, who says that makes it unlikely the Senate would consider it even if the House passes it. “I have a pro-life position, but others disagree. If we have to, we will try another time.’’ 

Sen. Don Gaetz, R-Niceville and chairman of the Senate Health Regulation Committee, agreed that the bill appears unlikely to move this year. 

“It’s a very tough lift,’’ said Gaetz, who supports it. “As controversial as the bill is, if (Gardiner) can’t get it through the first committee of reference and get it to the floor the old fashioned way, I don’t think there’s much of a chance it passes.’’ 

--Contact Gary Fineout.