Senate Bill sb2074

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    Florida Senate - 2003                                  SB 2074

    By Senator Dawson





    29-969-03                                           See HB 109

  1                      A bill to be entitled

  2         An act relating to health care; providing a

  3         popular name; providing purposes; establishing

  4         the Citizens' Health Care Working Group;

  5         providing for membership and criteria therefor;

  6         providing for term of membership; providing for

  7         a chair; requiring public hearings; requiring a

  8         report; providing for community health care

  9         meetings and for dissemination of

10         recommendations; providing for staff of the

11         working group; providing for travel expenses;

12         requiring a report to the Legislature;

13         providing for termination of the working group;

14         providing an appropriation; providing an

15         effective date.

16  

17         WHEREAS, in order to improve the health care system,

18  the citizens of Florida must engage in an informed public

19  debate to make choices about the services they want covered,

20  what health care coverage they want, and how they are willing

21  to pay for coverage, and

22         WHEREAS, although on a national level more than $1

23  trillion annually is spent on the health care system,

24  2,100,000 Floridians are uninsured, and

25         WHEREAS, insured individuals do not always have access

26  to essential, effective services to improve and maintain their

27  health, and

28         WHEREAS, employers, who provide insurance coverage for

29  nearly 8 million Floridians, find providing coverage

30  increasingly difficult because of rising costs and

31  double-digit premium increases, and

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    Florida Senate - 2003                                  SB 2074
    29-969-03                                           See HB 109




 1         WHEREAS, despite increases in medical care spending

 2  that are greater than the rate of inflation, population

 3  growth, and Gross Domestic Product growth, there has not been

 4  a commensurate improvement in our health status as a nation,

 5  and

 6         WHEREAS, health care costs for just one member of a

 7  family can be catastrophic, resulting in medical bills that

 8  have the potential to undermine the economic stability of the

 9  entire family, and

10         WHEREAS, common life occurrences can jeopardize the

11  ability of a family to retain private coverage or jeopardize

12  access to public coverage, and

13         WHEREAS, innovations in health care access, coverage,

14  and quality of care, including the use of technology, have

15  often come from state governments, local communities, and

16  private sector organizations, but more creative policies could

17  further tap this potential, and

18         WHEREAS, despite our state's wealth, the current health

19  care system does not provide coverage to all Floridians who

20  want it, NOW, THEREFORE,

21  

22  Be It Enacted by the Legislature of the State of Florida:

23  

24         Section 1.  Popular name.--This act shall be known by

25  the popular name the "Health Care that Works for All

26  Floridians Act."

27         Section 2.  Purposes.--The purposes of this act are:

28         (1)  To provide for a statewide public debate about

29  improving the health care system to provide every Floridian

30  with the ability to obtain quality, affordable health care

31  coverage.

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    Florida Senate - 2003                                  SB 2074
    29-969-03                                           See HB 109




 1         (2)  To provide for a vote by the House of

 2  Representatives and the Senate on the recommendations that

 3  result from the debate.

 4         Section 3.  Citizens' Health Care Working Group.--

 5         (1)  The Secretary of Health Care Administration and

 6  the Secretary of Health shall establish the Citizens' Health

 7  Care Working Group, which shall consist of 27 members.

 8         (2)  Not later than 45 days after the effective date of

 9  this act, the Speaker of the House of Representatives and the

10  majority leader and minority leader of the House of

11  Representatives and the President of the Senate and the

12  majority leader and minority leader of the Senate, who shall

13  be known as "leadership" for the purposes of this act, shall

14  each appoint members to serve on the working group in

15  accordance with subsections (3), (4), and (5).

16         (3)  The Secretary of Health Care Administration or a

17  designee and the Secretary of Health or a designee shall be

18  members of the working group. The remaining members of the

19  working group shall be appointed as follows:

20         (a)  The Speaker of the House of Representatives

21  jointly with the majority leader and minority leader of the

22  House of Representatives, and the President of the Senate

23  jointly with the majority leader and minority leader of the

24  Senate, shall each appoint one member of the working group

25  from the categories listed in subparagraphs (d)1., 7., 10.,

26  11., and 13.

27         (b)  Leadership shall jointly appoint members of the

28  working group from the categories listed in subparagraphs

29  (d)2., 3., 4., 5., 6., 9., and 14.

30  

31  

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    Florida Senate - 2003                                  SB 2074
    29-969-03                                           See HB 109




 1         (c)  Members of the working group from the categories

 2  listed in subparagraphs (d)8. and 12. shall be appointed as

 3  follows:

 4         1.  Leadership shall jointly appoint one member from

 5  each category.

 6         2.  Of the remaining members, 3 shall be appointed by

 7  the Speaker of the House of Representatives jointly with the

 8  majority leader and minority leader of the House of

 9  Representatives, and 3 shall be appointed by the President of

10  the Senate jointly with the majority leader and minority

11  leader of the Senate.

12         (d)  The categories from which members shall be

13  appointed are as follows:

14         1.  Two members shall be patients or family members of

15  patients who, for at least 1 year prior to the effective date

16  of this act, have had no health insurance.

17         2.  One member shall be a representative of children.

18         3.  One member shall be a representative of the

19  mentally ill.

20         4.  One member shall be a representative of the

21  disabled.

22         5.  One member shall be over the age of 65 and a

23  beneficiary under the Medicare program established under Title

24  XVIII of the Social Security Act (42 U.S.C. ss. 1395 et seq.).

25         6.  One member shall be a recipient of benefits under

26  the Medicaid program under Title XIX of the Social Security

27  Act (42 U.S.C. ss. 1396 et seq.).

28         7.  Two members shall be state health officials.

29         8.  Three members shall be employers and shall include:

30         a.  One large employer who employed 50 or more

31  employees on business days during the preceding calendar year

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    Florida Senate - 2003                                  SB 2074
    29-969-03                                           See HB 109




 1  and who employed at least 50 employees on January 1 of the

 2  current year.

 3         b.  One small employer who employed an average of at

 4  least 2 employees but less than 50 employees on business days

 5  in the preceding calendar year and who employed at least 2

 6  employees on January 1 of the current year.

 7         c.  One multistate employer.

 8         9.  One member shall be a representative of labor.

 9         10.  Two members shall be health insurance issuers.

10         11.  Two members shall be health care providers.

11         12.  Five members shall be appointed from the following

12  categories:

13         a.  One member shall be an economist.

14         b.  One member shall be an academician.

15         c.  One member shall be a health policy researcher.

16         d.  One member shall be an individual with expertise in

17  pharmacoeconomics.

18         e.  One member shall be a health technology expert.

19         13.  Two members shall be representatives of community

20  leaders who have developed state or local community solutions

21  to the problems addressed by the working group.

22         14.  One member shall be a representative of a medical

23  school.

24         (4)  Members of the working group shall not include

25  members of the Legislature or other elected officials from

26  federal, state, or local government. To the extent possible,

27  individuals appointed to the working group shall have used the

28  health care system within the previous 2 years and shall not

29  be paid employees or representatives of associations or

30  advocacy organizations involved in the health care system.

31  

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    Florida Senate - 2003                                  SB 2074
    29-969-03                                           See HB 109




 1         (5)  Members of the working group shall be appointed

 2  for a term of 2 years. Such term is renewable, and any

 3  vacancies shall not affect the power and duties of the working

 4  group but shall be filled in the same manner as the original

 5  appointment.

 6         (6)  Not later than 15 days after the date on which all

 7  members of the working group have been appointed, the Speaker

 8  of the House of Representatives and the President of the

 9  Senate shall make a joint designation of the chair of the

10  working group. If the Speaker of the House of Representatives

11  and the President of the Senate fail to designate a chair

12  within such time period, the members of the working group

13  shall, not later than 10 days after the end of the 15-day time

14  period, elect a chair by majority vote.

15         (7)  The working group may establish subcommittees if

16  doing so increases the efficiency of the working group.

17         (8)  Not later than 90 days after the date of

18  appointment of the chair, the working group shall hold

19  hearings to evaluate:

20         (a)  The capacity of the public and private health care

21  systems to expand coverage options.

22         (b)  The cost of health care and the effectiveness of

23  care provided at all stages of disease, but in particular the

24  cost of services at the end of life.

25         (c)  Innovative strategies used by other states to

26  expand health care coverage and lower health care costs.

27         (d)  Local community solutions for accessing health

28  care coverage.

29         (e)  Efforts to enroll individuals currently eligible

30  for public or private health care coverage.

31  

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    Florida Senate - 2003                                  SB 2074
    29-969-03                                           See HB 109




 1         (f)  The role of evidence-based medical practices that

 2  can be documented as restoring, maintaining, or improving a

 3  patient's health, and the use of technology in supporting

 4  providers in improving quality of care and lowering costs.

 5         (g)  Strategies to assist purchasers of health care,

 6  including consumers, in becoming more aware of the impact of

 7  costs and to lower the costs of health care.

 8         (9)  The working group may hold additional hearings on

 9  subjects other than those listed in subsection (8) if such

10  additional hearings are determined to be necessary. Additional

11  hearings are not required to be completed within the time

12  period specified in subsection (8) but shall not delay the

13  other activities of the working group as specified in this

14  act.

15         (10)  Not later than 90 days after the hearings

16  described in subsections (8) and (9) are completed, the

17  working group shall prepare and make available to health care

18  consumers, through the Internet and other appropriate public

19  channels, a report to be entitled, "Health Report to the

20  Citizens of Florida." Such report shall be understandable to

21  the general public and include:

22         (a)  Health care and related services that may be used

23  by individuals throughout their lives.

24         (b)  The cost of health care services and their medical

25  effectiveness in providing better quality of care for

26  different age groups.

27         (c)  The source of coverage and payment, including

28  reimbursement, for health care services.

29         (d)  The reasons people are uninsured or underinsured

30  and the cost to taxpayers, purchasers of health services, and

31  communities when Floridians are uninsured or underinsured.

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    Florida Senate - 2003                                  SB 2074
    29-969-03                                           See HB 109




 1         (e)  The impact on health care outcomes and costs when

 2  individuals are treated in later stages of disease.

 3         (f)  Health care cost containment strategies.

 4         (g)  Information on health care needs that need to be

 5  addressed.

 6         (h)  Examples of community strategies to provide health

 7  care coverage or access.

 8         (i)  Information on geographic-specific issues relating

 9  to health care.

10         (j)  Information concerning the cost of care in

11  different settings, including institutional-based, home-based,

12  and community-based care.

13         (k)  A summary of ways to finance health care coverage.

14         (l)  The role of technology in providing future health

15  care, including ways to support the information needs of

16  patients and providers.

17         (11)(a)  Not later than 1 year after the effective date

18  of this act, the working group shall initiate community health

19  care meetings throughout the state. Community meetings may be

20  geographically or regionally based and shall be completed

21  within 180 days after the initiation of the first meeting.

22         (b)  The working group shall hold a sufficient number

23  of community meetings in order to receive information that

24  reflects the geographic differences throughout the state,

25  diverse populations, and a balance among urban and rural

26  populations.

27         (c)  A state health officer may serve as facilitator at

28  each community meeting. At least one member of the working

29  group shall attend and serve as chair of each community

30  meeting. Other members may participate through interactive

31  technology.

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    Florida Senate - 2003                                  SB 2074
    29-969-03                                           See HB 109




 1         (d)  The community meetings shall, at a minimum,

 2  address the following issues:

 3         1.  The optimum way to balance costs and benefits so

 4  that affordable health coverage is available to as many people

 5  as possible.

 6         2.  The identification of services that provide

 7  cost-effective, essential health care services to maintain and

 8  improve health and that should be included in health care

 9  coverage.

10         3.  The cost of providing increased benefits.

11         4.  The mechanisms to finance health care coverage,

12  including defining the appropriate financial role for

13  individuals, businesses, and government.

14         (e)  The working group may encourage public

15  participation in community meetings through interactive

16  technology and other means, as determined appropriate by the

17  working group.

18         (12)(a)  Not later than 180 days after the date of

19  completion of the community meetings, the working group shall

20  prepare and make available to the public, through the Internet

21  and other appropriate public channels, an interim set of

22  recommendations on health care coverage and ways to improve

23  and strengthen the health care system based on the information

24  and preferences expressed at the community meetings. There

25  shall be a 90-day public comment period on such

26  recommendations.

27         (b)  Not later than 120 days after the expiration of

28  the public comment period described in paragraph (a), the

29  working group shall submit to the Speaker of the House of

30  Representatives, the President of the Senate, and the Governor

31  

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    Florida Senate - 2003                                  SB 2074
    29-969-03                                           See HB 109




 1  a final set of recommendations, including any proposed

 2  legislative language to implement such recommendations.

 3         (13)  The working group shall be staffed by employees

 4  of the Agency for Health Care Administration and the

 5  Department of Health. Sponsoring agencies and organizations

 6  shall fund travel and related expenses of their appointed

 7  members on the working group. Travel and related expenses of

 8  consumer members on the working group shall be reimbursed in

 9  accordance with section 112.061, Florida Statutes.

10         (14)  The working group may secure directly from any

11  state department or agency such information as the working

12  group considers necessary to carry out the provisions of this

13  act. Upon request of the working group, the head of a state

14  department or agency shall furnish such information.

15         (15)  Not later than 1 year after the effective date of

16  this act, the working group shall report to the Speaker of the

17  House of Representatives and the President of the Senate and

18  make public a detailed description of the expenditures of the

19  working group used to carry out its duties.

20         (16)  The working group shall terminate when the report

21  described in subsection (16) is submitted to the Speaker of

22  the House of Representatives and the President of the Senate.

23         (17)  For fiscal year 2003-2004, the sum of $200,000

24  from nonrecurring general revenue is appropriated to the

25  Agency for Health Care Administration and the Department of

26  Health to cover the costs of the working group relating to

27  travel and related expenses of staff, consumer members, and

28  members appointed by the agency or department; the hiring of

29  consultants, if necessary; and the reproduction and

30  dissemination of documents.

31  

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    Florida Senate - 2003                                  SB 2074
    29-969-03                                           See HB 109




 1         Section 4.  This act shall take effect upon becoming a

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