HB 0109 2003
1	A bill to be entitled
2	An act relating to health care; providing a popular name;
3	providing purposes; establishing the Citizens' Health Care
4	Working Group; providing for membership and criteria
5	therefor; providing for term of membership; providing for
6	a chair; requiring public hearings; requiring a report;
7	providing for community health care meetings and for
8	dissemination of recommendations; providing for staff of
9	the working group; providing for travel expenses;
10	requiring a report to the Legislature; providing for
11	termination of the working group; providing an
12	appropriation; providing an effective date.
13
14	WHEREAS, in order to improve the health care system, the
15	citizens of Florida must engage in an informed public debate to
16	make choices about the services they want covered, what health
17	care coverage they want, and how they are willing to pay for
18	coverage, and
19	WHEREAS, although on a national level more than $1 trillion
20	annually is spent on the health care system, 2,100,000
21	Floridians are uninsured, and
22	WHEREAS, insured individuals do not always have access to
23	essential, effective services to improve and maintain their
24	health, and
25	WHEREAS, employers, who provide insurance coverage for
26	nearly 8,000,000 Floridians, find providing coverage
27	increasingly difficult because of rising costs and double-digit
28	premium increases, and
29	WHEREAS, despite increases in medical care spending that
30	are greater than the rate of inflation, population growth, and
31	Gross Domestic Product growth, there has not been a commensurate
32	improvement in our health status as a nation, and
33	WHEREAS, health care costs for just one member of a family
34	can be catastrophic, resulting in medical bills that have the
35	potential to undermine the economic stability of the entire
36	family, and
37	WHEREAS, common life occurrences can jeopardize the ability
38	of a family to retain private coverage or jeopardize access to
39	public coverage, and
40	WHEREAS, innovations in health care access, coverage, and
41	quality of care, including the use of technology, have often
42	come from state governments, local communities, and private
43	sector organizations, but more creative policies could further
44	tap this potential, and
45	WHEREAS, despite our state's wealth, the current health
46	care system does not provide coverage to all Floridians who want
47	it, NOW, THEREFORE,
48
49	Be It Enacted by the Legislature of the State of Florida:
50
51	Section 1.Popular name.--This act shall be known by the
52	popular name the "Health Care that Works for All Floridians
53	Act."
54	Section 2.Purposes.--The purposes of this act are:
55	(1) To provide for a statewide public debate about
56	improving the health care system to provide every Floridian with
57	the ability to obtain quality, affordable health care coverage.
58	(2) To provide for a vote by the House of Representatives
59	and the Senate on the recommendations that result from the
60	debate.
61	Section 3.Citizens' Health Care Working Group.--
62	(1) The Secretary of Health Care Administration and the
63	Secretary of Health shall establish the Citizens' Health Care
64	Working Group, which shall consist of 27 members.
65	(2) Not later than 45 days after the effective date of
66	this act, the Speaker of the House of Representatives and the
67	majority leader and minority leader of the House of
68	Representatives and the President of the Senate and the majority
69	leader and minority leader of the Senate, who shall be known as
70	"leadership" for the purposes of this act, shall each appoint
71	members to serve on the working group in accordance with
72	subsections (3), (4), and (5).
73	(3) The Secretary of Health Care Administration or a
74	designee and the Secretary of Health or a designee shall be
75	members of the working group. The remaining members of the
76	working group shall be appointed as follows:
77	(a) The Speaker of the House of Representatives jointly
78	with the majority leader and minority leader of the House of
79	Representatives, and the President of the Senate jointly with
80	the majority leader and minority leader of the Senate, shall
81	each appoint one member of the working group from the categories
82	listed in subparagraphs (d)1., 7., 10., 11., and 13.
83	(b) Leadership shall jointly appoint members of the
84	working group from the categories listed in subparagraphs (d)2.,
85	3., 4., 5., 6., 9., and 14.
86	(c) Members of the working group from the categories
87	listed in subparagraphs (d)8. and 12. shall be appointed as
88	follows:
89	1. Leadership shall jointly appoint one member from each
90	category.
91	2. Of the remaining members, 3 shall be appointed by the
92	Speaker of the House of Representatives jointly with the
93	majority leader and minority leader of the House of
94	Representatives, and 3 shall be appointed by the President of
95	the Senate jointly with the majority leader and minority leader
96	of the Senate.
97	(d) The categories from which members shall be appointed
98	are as follows:
99	1. Two members shall be patients or family members of
100	patients who, for at least 1 year prior to the effective date of
101	this act, have had no health insurance.
102	2. One member shall be a representative of children.
103	3. One member shall be a representative of the mentally
104	ill.
105	4. One member shall be a representative of the disabled.
106	5. One member shall be over the age of 65 and a
107	beneficiary under the Medicare program established under Title
108	XVIII of the Social Security Act (42 U.S.C. ss. 1395 et seq.).
109	6. One member shall be a recipient of benefits under the
110	Medicaid program under Title XIX of the Social Security Act (42
111	U.S.C. ss. 1396 et seq.).
112	7. Two members shall be state health officials.
113	8. Three members shall be employers and shall include:
114	a. One large employer who employed 50 or more employees on
115	business days during the preceding calendar year and who
116	employed at least 50 employees on January 1 of the current year.
117	b. One small employer who employed an average of at least
118	2 employees but less than 50 employees on business days in the
119	preceding calendar year and who employed at least 2 employees on
120	January 1 of the current year.
121	c. One multistate employer.
122	9. One member shall be a representative of labor.
123	10. Two members shall be health insurance issuers.
124	11. Two members shall be health care providers.
125	12. Five members shall be appointed from the following
126	categories:
127	a. One member shall be an economist.
128	b. One member shall be an academician.
129	c. One member shall be a health policy researcher.
130	d. One member shall be an individual with expertise in
131	pharmacoeconomics.
132	e. One member shall be a health technology expert.
133	13. Two members shall be representatives of community
134	leaders who have developed state or local community solutions to
135	the problems addressed by the working group.
136	14. One member shall be a representative of a medical
137	school.
138	(4) Members of the working group shall not include members
139	of the Legislature or other elected officials from federal,
140	state, or local government. To the extent possible, individuals
141	appointed to the working group shall have used the health care
142	system within the previous 2 years and shall not be paid
143	employees or representatives of associations or advocacy
144	organizations involved in the health care system.
145	(5) Members of the working group shall be appointed for a
146	term of 2 years. Such term is renewable, and any vacancies shall
147	not affect the power and duties of the working group but shall
148	be filled in the same manner as the original appointment.
149	(6) Not later than 15 days after the date on which all
150	members of the working group have been appointed, the Speaker of
151	the House of Representatives and the President of the Senate
152	shall make a joint designation of the chair of the working
153	group. If the Speaker of the House of Representatives and the
154	President of the Senate fail to designate a chair within such
155	time period, the members of the working group shall, not later
156	than 10 days after the end of the 15-day time period, elect a
157	chair by majority vote.
158	(7) The working group may establish subcommittees if doing
159	so increases the efficiency of the working group.
160	(8) Not later than 90 days after the date of appointment
161	of the chair, the working group shall hold hearings to evaluate:
162	(a) The capacity of the public and private health care
163	systems to expand coverage options.
164	(b) The cost of health care and the effectiveness of care
165	provided at all stages of disease, but in particular the cost of
166	services at the end of life.
167	(c) Innovative strategies used by other states to expand
168	health care coverage and lower health care costs.
169	(d) Local community solutions for accessing health care
170	coverage.
171	(e) Efforts to enroll individuals currently eligible for
172	public or private health care coverage.
173	(f) The role of evidence-based medical practices that can
174	be documented as restoring, maintaining, or improving a
175	patient's health, and the use of technology in supporting
176	providers in improving quality of care and lowering costs.
177	(g) Strategies to assist purchasers of health care,
178	including consumers, in becoming more aware of the impact of
179	costs and to lower the costs of health care.
180	(9) The working group may hold additional hearings on
181	subjects other than those listed in subsection (8) if such
182	additional hearings are determined to be necessary. Additional
183	hearings are not required to be completed within the time period
184	specified in subsection (8) but shall not delay the other
185	activities of the working group as specified in this act.
186	(10) Not later than 90 days after the hearings described
187	in subsections (8) and (9) are completed, the working group
188	shall prepare and make available to health care consumers,
189	through the Internet and other appropriate public channels, a
190	report to be entitled, "Health Report to the Citizens of
191	Florida." Such report shall be understandable to the general
192	public and include:
193	(a) Health care and related services that may be used by
194	individuals throughout their lives.
195	(b) The cost of health care services and their medical
196	effectiveness in providing better quality of care for different
197	age groups.
198	(c) The source of coverage and payment, including
199	reimbursement, for health care services.
200	(d) The reasons people are uninsured or underinsured and
201	the cost to taxpayers, purchasers of health services, and
202	communities when Floridians are uninsured or underinsured.
203	(e) The impact on health care outcomes and costs when
204	individuals are treated in later stages of disease.
205	(f) Health care cost containment strategies.
206	(g) Information on health care needs that need to be
207	addressed.
208	(h) Examples of community strategies to provide health
209	care coverage or access.
210	(i) Information on geographic-specific issues relating to
211	health care.
212	(j) Information concerning the cost of care in different
213	settings, including institutional-based, home-based, and
214	community-based care.
215	(k) A summary of ways to finance health care coverage.
216	(l) The role of technology in providing future health
217	care, including ways to support the information needs of
218	patients and providers.
219	(11)(a) Not later than 1 year after the effective date of
220	this act, the working group shall initiate community health care
221	meetings throughout the state. Community meetings may be
222	geographically or regionally based and shall be completed within
223	180 days after the initiation of the first meeting.
224	(b) The working group shall hold a sufficient number of
225	community meetings in order to receive information that reflects
226	the geographic differences throughout the state, diverse
227	populations, and a balance among urban and rural populations.
228	(c) A state health officer may serve as facilitator at
229	each community meeting. At least one member of the working group
230	shall attend and serve as chair of each community meeting. Other
231	members may participate through interactive technology.
232	(d) The community meetings shall, at a minimum, address
233	the following issues:
234	1. The optimum way to balance costs and benefits so that
235	affordable health coverage is available to as many people as
236	possible.
237	2. The identification of services that provide cost-
238	effective, essential health care services to maintain and
239	improve health and that should be included in health care
240	coverage.
241	3. The cost of providing increased benefits.
242	4. The mechanisms to finance health care coverage,
243	including defining the appropriate financial role for
244	individuals, businesses, and government.
245	(e) The working group may encourage public participation
246	in community meetings through interactive technology and other
247	means, as determined appropriate by the working group.
248	(12)(a) Not later than 180 days after the date of
249	completion of the community meetings, the working group shall
250	prepare and make available to the public, through the Internet
251	and other appropriate public channels, an interim set of
252	recommendations on health care coverage and ways to improve and
253	strengthen the health care system based on the information and
254	preferences expressed at the community meetings. There shall be
255	a 90-day public comment period on such recommendations.
256	(b) Not later than 120 days after the expiration of the
257	public comment period described in paragraph (a), the working
258	group shall submit to the Speaker of the House of
259	Representatives, the President of the Senate, and the Governor a
260	final set of recommendations, including any proposed legislative
261	language to implement such recommendations.
262	(13) The working group shall be staffed by employees of
263	the Agency for Health Care Administration and the Department of
264	Health. Sponsoring agencies and organizations shall fund travel
265	and related expenses of their appointed members on the working
266	group. Travel and related expenses of consumer members on the
267	working group shall be reimbursed in accordance with s. 112.061,
268	Florida Statutes.
269	(14) The working group may secure directly from any state
270	department or agency such information as the working group
271	considers necessary to carry out the provisions of this act.
272	Upon request of the working group, the head of a state
273	department or agency shall furnish such information.
274	(15) Not later than 1 year after the effective date of
275	this act, the working group shall report to the Speaker of the
276	House of Representatives and the President of the Senate and
277	make public a detailed description of the expenditures of the
278	working group used to carry out its duties.
279	(16) The working group shall terminate when the report
280	described in subsection (16) is submitted to the Speaker of the
281	House of Representatives and the President of the Senate.
282	(17) For fiscal year 2003-2004, the sum of $200,000 from
283	nonrecurring general revenue is appropriated to the Agency for
284	Health Care Administration and the Department of Health to cover
285	the costs of the working group relating to travel and related
286	expenses of staff, consumer members, and members appointed by
287	the agency or department; the hiring of consultants, if
288	necessary; and the reproduction and dissemination of documents.
289	Section 4. This act shall take effect upon becoming a law.
290