Okaloosa County BOCC — September 3, 2013 — FAC Health & Human Services — reading text

2013 FAC Policy Conference Health & Human Services Policy Committee Meeting Friday, September 20, 2013 8:30 a.m. to 10:30 a.m. Meeting Room: Regency East (DE) Co-Chairs Co-Vice Chairs Priscilla Taylor, Palm Beach County Kathy Bryant, Marion County Karson Turner, Hendry County John Hall, Polk County AGENDA 8:30 a.m. INTRODUCTIONS & OPENING REMARKS • Chairs & Vice Chairs 8:40 a.m. POLICY COMMITTEE ROLES AND RESPONSIBILITIES • Susan Harbin, FAC Staff 8:50 a.m. HOMELESSNESS IN FLORIDA: STATE AND LOCAL EFFORTS 9:20 a.m. MEDICAID UPDATE • Susan Harbin, FAC Staff 9:30 a.m. REVIEW OF DRAFT HHS POLICY STATEMENTS • Susan Harbin, FAC Staff 10:25 a.m. CLOSING REMARKS/ADJOURNMENT Marriott West Palm Beach ♦ Palm Beach County Updated 9/16/13  Health & Human Services Policy Committee 2013-14 Policy Statements Susan Harbin, Legislative Advocate Health Care Email: sharbin@fl-counties.com Phone: 850-922-4300 Fax: 850-488-7501 CONSENT ITEMS Baker Act: SUPPORT appropriate funding as outlined in the existing state capacity formula for crisis mental health and substance abuse beds statewide. SUPPORT increased funding for public receiving facilities and maintaining funding for public facilities if new state general revenue is provided to private receiving facilities. Behavioral Health System: SUPPORT appropriate funding for core mental health and substance abuse services. SUPPORT continued efforts to work through Medicaid reform initiatives to ensure that persons with substance abuse and mental health treatment needs are appropriately served. SUPPORT efforts to increase supportive housing, employment and education initiatives for people with behavioral health issues and/or disabilities. County Health Departments (CHDs): SUPPORT maintaining state general revenue funding for CHDs, and OPPOSE any state reductions to the CHD Trust Funds. SUPPORT efforts to enable CHDs to transition to managed care under the Statewide Medicaid Managed Care Program without impacting service capacity. SUPPORT maintaining a coordinated system of CHDs that is centrally housed within the Department of Health (DOH). SUPPORT preserving the ability of CHDs to provide primary care and direct patient care services, particularly in communities without adequate substitutes or alternative providers for these services. Emergency Medical Services (EMS): SUPPORT ST Segment Elevated Myocardial Infarction (STEMI) legislation that leads to better coordination of care without imposing additional liability or administrative costs on county government. OPPOSE legislation that preempts county authority to regulate use or register distribution of Automatic External Defibrillators (AEDs). SUPPORT a cost recovery mechanism if county provided training is mandated. Graduate Medical Education (GME): SUPPORT efforts to fund GME programs to meet the healthcare needs of the state and its local communities, with a particular 1 emphasis on programs that provide for specialties in need as well as the development of physicians practice in medically underserved areas. Trauma Care System: SUPPORT efforts to maintain and enhance established trauma care funding, including incentives for the development of new trauma centers. OPPOSE any efforts to shift the state’s financial responsibility for the trauma system to counties or divert trauma care funding for purposes other than those intended by the existing legislation. Statewide Medicaid Managed Care Program: SUPPORT including County Health Departments as priority providers within the Medicaid Managed Care Program and protect their ability to deliver primary care services to the communities they serve. SUPPORT carving out the coordinated Transportation Disadvantaged (TD) system to avoid fragmentation, inefficient operation, and costly duplication of TD services. SUPPORT the continuation of the Medically Needy program. NEW AND REVISED ITEMS County Share of Cost for Medicaid Services: FAC SUPPORTS the dissolution of the current county-state Medicaid contributory relationship in a manner that: (1) absolves counties of all financial responsibilities related to the provision of Medicaid services in Florida; (2) eliminates associated administrative burdens for the counties and the state; and, (3) equitably mitigates any potential fiscal impact for all affected parties. However, absent the identification of strategies to achieve the aforementioned goals in the referenced proscribed manner, FAC SUPPORTS retaining the current Medicaid billing system, but only with certain statutory modifications. At a minimum, these modifications should include: (1) allowing counties to review their bills prior to payment; (2) allowing counties to pay from a revenue source of their choosing within a specified time period; and, (3) allowing the state to withhold county revenue sharing for nonpayment within a specific time period; (4) and, requiring the state, in consultation with the counties, to develop an accurate, reliable, and equitable billing process. SUPPORT continued evaluation of the county-state Medicaid cost sharing arrangement, taking into consideration the impacts of state efforts designed to control and/or reduce overall Medicaid costs, including statewide Medicaid managed care and diagnosis related group reimbursement for hospitals. OPPOSE efforts to further shift state Medicaid costs to counties. Explanation: During the 2013 Legislative Session, the Legislature passed SB 1520, which significantly modified the county-state Medicaid cost share relationship to eliminate the monthly billing system in lieu of a fixed formula-based county contribution. For the first two years, county contributions are based on past actual utilization (during 2012-13); however, beginning in FY 2015-16, the formula will begin transitioning to being based on each county’s respective share of Medicaid enrollees. 2 Additionally, the state has adopted policies in recent years that are designed, in part, to stabilize and/or reduce certain Medicaid costs. FAC supports closely evaluating the impacts of these programs to ensure that counties share in any savings derived from the various reforms. Health Care for Veterans: SUPPORT collaboration with the Florida Department of Veterans’ Affairs to steer veterans who are eligible for federal health care benefits into the appropriate federal programs. Explanation: Certain veterans are eligible for federal health care benefits through the U.S. Department of Veterans’ Affairs (VA). It is estimated that thousands of eligible veterans in Florida have not accessed this coverage, and instead remain uninsured or under-insured. FOR DISCUSION PURPOSES Medicaid Expansion: SUPPORT state legislation drawing down the federal funds made available to Florida under the Patient Protection and Affordable Care Act to expand health insurance coverage to certain individuals who earn up to 138 percent of the federal poverty level, provided that such a program does not further shift Medicaid costs to counties. Explanation: Under the federal Patient Protection and Affordable Care Act (PPACA), states have the option to expand Medicaid coverage to all adults with incomes below 138 percent of the federal poverty level, beginning in 2014. The federal government will fully fund the expansion population through 2016, after which the federal share will gradually reduce until it covers 90 percent of costs in 2020 and on. Increasing health care coverage should reduce the costs associated with providing uncompensated care. 3  Susan Harbin, Legislative Advocate Human Services Email: sharbin@fl-counties.com Phone: 850-922-4300 Fax: 850-488-7501 CONSENT ITEMS Community Care for the Elderly: SUPPORT restoration and expansion of state funding for the Community Care for the Elderly Program, which provides cost efficient diversion from nursing home placement for impaired elders. Healthy Families: SUPPORT a continuation of funding for the Florida Healthy Families program. Homelessness: SUPPORT legislation that streamlines current state statutes relating to homelessness and associated programs. SUPPORT a process that would waive the fees related to obtaining personal identification from the state for persons identified as homeless. SUPPORT the implementation of discharge protocols and/or procedures for hospitals and correctional facilities when releasing homeless persons. SUPPORT the development of strategies that would allow local governments to work with the state and federal government to serve target populations: the chronically homeless, veterans, and families and children, with particular emphasis on children aging out of the foster care system. SUPPORT continued coordination with the state's homeless planning council, specifically as it develops policies in support of the new Federal Strategic Plan to End Homelessness. SUPPORT efforts to extend tax credits to businesses that employ the homeless. SUPPORT restoring state funding for programs that serve the homeless. Open Water Life Guards: SUPPORT legislation that would provide for open water lifeguard agency certification in Florida. Smoking Regulation: SUPPORT legislation that repeals the state statutory preemption of smoking regulation by allowing local governments to enact local regulations that exceed state standards. Transportation Disadvantaged (TD): SUPPORT the continuation of a coordinated Transportation Disadvantaged (TD) system. SUPPORT efforts to avoid fragmentation, inefficient operation, and costly duplication of TD services. SUPPORT appropriate and dedicated state funding for the TD program. SUPPORT efforts to protect the TD trust fund. SUPPORT carving out the coordinated Transportation Disadvantaged (TD) system to avoid fragmentation, inefficient operation, and costly duplication of TD services. 4 NEW AND REVISED ITEMS Sober Homes/Recovery Residences: SUPPORT legislation defining and establishing minimum regulatory standards for sober home/recovery residence facilities, while also allowing for local regulation of facilities, in accordance with applicable federal law. Explanation: Although not specifically defined in state law, a “sober home” or “recovery residence” is a residential facility designed to provide a sober living environment for individuals recovering from substance abuse. Functioning under the theory that such living arrangements will foster