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House may shrink Dept. of Health

By Jim Saunders
3/3/2010 © Health News Florida

With one lawmaker describing it as a "dumping ground,'' House leaders are targeting the Florida Department of Health as part of a push to save money and revamp the operations of state government.

House Speaker Larry Cretul and other Republican leaders announced the push Tuesday, as they started a legislative session shadowed by a budget shortfall of as much as $3 billion.
House Health Care Appropriations Chairwoman Denise Grimsley, R-Lake Placid, said the House is not trying to merge DOH and the Agency for Health Care Administration, a rumor that has floated around the Capitol.

But lawmakers could shrink the department. Grimsley said possible moves include shifting management of professional boards from the Department of Health to the Department of Business and Professional Regulation, merging some small boards and eliminating unnecessary advisory groups.

Also, Grimsley pointed to a sprawling department organizational structure that House leaders want to "streamline.'' She said the department has expanded over the years as lawmakers have given it more duties --- describing it as the "dumping ground of the Legislature.''

The House has not released a bill or detailed plan for overhauling the department. But Senate Health Regulation Chairman Don Gaetz, R-Niceville, agreed that the department will face scrutiny during the 60-day legislative session.

"The Department of Health will not be immune from a rigorous examination of unnecessary duplication and triplication,'' Gaetz said. 

On Wednesday morning, DOH Deputy Secretary Kim Berfield told Health News Florida that it's natural for lawmakers to look for cuts in the department's $2.9 billion budget to make up for a shortfall in revenues.  But she noted that DOH's increase in staff has come in response to additional duties imposed by the Legislature.

"We continue to meet the challenges they give us, sometimes without additional people and without additional funds,'' Berfield said.  "We look forward to working with them once we know what they are proposing.''
Health Secretary Ana Viamonte Ros appeared Wednesday morning before the Senate Health and Human Services Appropriations Committee to talk about potential budget cuts in the coming year. Committee Chairman Durell Peaden, R-Crestview, told Viamonte Ros that he views the department as the "backbone" of the health-care system.

"We are the backbone, and we are the safety net in many of your communities,'' Viamonte Ros told senators.

The Florida Medical Association issued a statement Tuesday saying it supports finding ways to save money and "eliminate bureaucratic red tape, with a goal of returning a focus to the patients of Florida.''

But the doctors' group also signaled that it would fight far-reaching steps, such as having another agency take over the department or having a non-physician in charge.

"We will oppose any efforts to change that," said Tim Stapleton, the association's executive vice president. 

Amid the pomp of the first day of the legislative session, Cretul focused on a theme of leaner government. He said, for example, that he wants to consolidate the office of the state auditor general with the Legislature's Office of Program Policy Analysis & Governmental Accountability.

Also, House leaders said they will look at revamping health-insurance benefits for state workers. That could end free insurance for thousands of high-ranking employees and may see some workers moved into a different kind of coverage, such as high-deductible plans with health-savings accounts.
"The fact is, we recognize the current (state insurance) system is not sustainable,'' said Rep. Gary Aubuchon, a Cape Coral Republican who is working on the issue.

House leaders released a five-page outline of possible changes in state government. The Department of Health was the most prominent agency targeted in the outline, though the suggestions of how to make the department more efficient lacked details.

Grimsley and Rep. Matt Hudson, R-Naples, said one possibility would be shifting management of the professional boards to the Department of Business and Professional Regulation, which oversees other industries --- and, in the past, administered the health professional boards.

The boards would continue to be made up of independent professionals. But the state employees who staff the boards, issue licenses and investigate complaints would move. 

It wouldn't save much money, though. DOH's Berfield said most of the big boards generate enough money in licensing fees to cover their costs, although some smaller boards don't.

--Capital Bureau Chief Jim Saunders can be reached at 850-228-0963 or by e-mail