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DOH-shrinking bill up Monday

By Jim Saunders
3/19/2010 © Health News Florida

The Florida Department of Health would face a major reorganization that scales back its duties and shrinks the size of its bureaucracy under a proposal released Thursday night by House Republicans.

The proposal, which will go before a House committee Monday, would require the department by Dec. 1 to come up with a plan to reduce its number of divisions and bureaus and limit executive positions. It would limit the role of the state surgeon general, now held by Dr. Ana Viamonte Ros.

It also would focus the role of the department on dealing with issues such as communicable diseases, public-health emergencies, management of vital-statistics and regulation of health-care professions.

Rep. Matt Hudson, a Naples Republican who is the point man on the bill, said he wants the department to have a "boots on the ground'' approach that focuses on providing care. He said he does not have a specific number of divisions or positions that he would like to see remain after the reorganization.

"Our citizens expect a focused mission from their government,'' Hudson said.

But even if he gets his way in the House, there could be tough sledding across the rotunda. Sen. Durell Peaden, Crestview Republican and key Senator on health issues, said he has no desire to reorganize the department and questioned whether it would save much money.

"You need to leave it alone,'' said Peaden, chairman of the Senate Health and Human Services Appropriations Committee. "We've got enough problems. You don't need to create any more.''

The bill would eliminate the department's ability to spend state or federal money on such things as conducting health-education campaigns. Also, it would significantly reduce the job description of the surgeon general, who is the secretary of the agency.

As an example, it would eliminate part of state law that says the surgeon general will be the "leading voice on wellness and disease-prevention efforts, including the promotion of healthy lifestyles, immunization practices, health literacy and the assessment and promotion of the physician and health-care workforce.''

Instead, the proposal more bluntly says the surgeon general shall "manage the department in carrying out'' the revised responsibilities that the Legislature would give it.

Department spokeswoman Susan Smith said in an e-mail this morning that agency officials had "just received the bill and are carefully reviewing it so that we can respond to the Legislature with accurate facts and data as to the impact of the proposal. Our goal at DOH is to continue to protect and improve the health of all Floridians.''

House Republican leaders said early this month that they would target the Department of Health as part of an effort to reduce the size of state government. The bill released Thursday provides the first details.

As an example of the effort to rein in the department, the bill would prevent the agency from starting new programs or changing programs without legislative approval. Hudson said the department in the past has sought federal grants for programs without legislative approval --- and that the programs have later required state funding.

Hudson said the department currently has a mission that is a "little broad and unwieldy.'' It has a budget of about $2.9 billion this year and 17,000 employees.

Along with having to offer a plan by Dec. 1 to reduce the number of bureaus and divisions, the department also would have to provide job descriptions for bureau chiefs and division directors whose positions would be kept.

What's more, the proposal calls for eliminating 11 divisions unless they are reviewed and re-enacted by the Legislature before July 1, 2011. Among those 11 is the Division of Medical Quality Assurance, which includes professional regulatory boards.

But the bill stops short of long-rumored moves such as merging the Department of Health with the Agency for Health Care Administration. It also does not move the regulatory boards under the Department of Business and Professional Regulation, another possibility that was offered earlier this month.

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