Fla. Department of Health overhaul bill comes under fire
Public health advocates spoke out against a bill aimed at reorganizing the state’s Department of Health (DOH) during its passage in a House health committee today.
Hearing after hearing, public health advocates have called the legislation a ”perilous and costly voyage” that could undermine the role of the state’s Surgeon General as well as a slew of health programs.
While the bill has slowed down in the state Senate, it has been moving quickly through the House. Public health advocates have said that the bill would make “unnecessary changes to the structure of the [DOH],” which could have a “demoralizing effect on employees” in both local and state-level branches of the department.
During a committee meeting today, advocates continued to speak out against the bill.
Paul Erons, a physician and public health professional, called the bill “puzzling” and “troubling.” He said that A.G. Holley Hospital, which would be shut down if the bill were to pass, is an important and unique hospital that treats the “hardest of the hardest cases.”
Erons said that most people at A.G. Holley “are at the end of the line” for treatment and closing the hospital could adversely affect them.
The House sponsor, State Rep. Matt Hudson, said that the hospital is treating an average of 29 patients at any given time, but is costing the state a lot of money. He said the Legislature had been trying to “deal with the issue of A.G. Holley” for years.
House Bill 1263 and Senate Bill 1824 are being described by its sponsors as a way of “streamlining” and “focusing” the work done by the DOH. Hudson, R-Naples, has said he has worked with the DOH to remove “duplicative services” and unnecessary or unfunded programs throughout the department. Hudson has dismissed any claims made during committee meetings that he is making harmful changes to the DOH.
Public advocates that have testified against the bill are warning that it would change the language regarding the role of the Surgeon General. They claim it also removes statutes that set in place important programs throughout the department and removes very important preventative health care language from current law.
Advocates are also greatly concerned about the many deletions the bill makes.
Among the language stricken from DOH statutes is a phrase stating the department must “provide services to abused and neglected children through child protection teams and sexual abuse treatment programs.” In a House appropriations committee meeting this month, advocates raised concerns over whether the bill would eradicate programs aimed at protecting children. Hudson denied that the state would no longer have those programs, mostly because the state budget, so far, restores funding to groups that carry out those programs. ”I am not eliminating child protection teams,” he assured testifiers earlier this month. Today, Hudson introduced an amendment that backed off removing the language, at the behest of “stakeholders.”
Christopher Nuland, the legal and legislative consultant for the Florida Public Health Association, said his organization had a “fundamental difference of opinion” with what sponsors of the bill are trying to achieve in a meeting earlier this month.
“Public health promotion should be a state function,” he said, “and one of the things that this bill does is remove that as a function from the Department of Health.”
“We need a unified public health system in order to address the threats that will affect the state of Florida,” Nuland warned.
Today, Nuland reiterated his concerns and said that, despite slight improvements, the bill remained problematic.
Richard Polangin, Florida PIRG’s Healthcare Policy Coordinator, told committee members earlier this month that the bill, as it was written, removes “very important preventative health care language from current law” and would repeal a number of preventative health programs. Polangin explained that there is no reason to remove some health programs from DOH-related statutes.
“There is no harm in keeping these programs in statutes regardless of funding,” he said. He said that many programs receive money from the federal government and simply require that the DOH act as an intermediary.
According to Polangin, these programs are just “tools in the department’s toolkit” for accessing and preserving public health in the state.
Polangin has also expressed concerns that the bill changes the wording of the role of the State Surgeon General.
The House bill currently strikes out language that says:
The State Surgeon General shall serve as the leading voice on wellness and disease prevention efforts, including the promotion of healthful lifestyles, immunization practices, health literacy, and the assessment and promotion of the physician and health care workforce in order to meet the health care needs of the state. The State Surgeon General shall focus on advocating healthy lifestyles, developing public health policy, and building collaborative partnerships with schools, businesses, health care practitioners, community-based organizations, and public and private institutions in order to promote health literacy and optimum quality of life for all Floridians.
“We don’t understand why this language is being deleted,” he said. Polangin, who said he was speaking on behalf of an advisory board comprised of public health professionals across the state, said that he and the board believe “it is important for that language to remain in law.”
An amendment introduced by state Rep. Mia Jones today would have reinstated the language. Jones’ amendment, which failed, also would have reinstated the Office of Women’s Health Strategy.
Nuland testified in support of the amendment and explained that it “would add no cost” to the state, but would reaffirm the state’s commitment to women’s health.
Jones and state Rep. Elaine Schwartz said the amendment was necessary. Schwartz said ”women’s health is a constant battle that is going on,” in the Legislature, citing numerous bills aimed at limiting legal abortions as an example of why statutes aimed at protecting women’s health need to be enacted.
Although Jones’ amendment failed, she said she will introduce another similar amendment if the bill goes to a final vote on the House floor.
During past hearings, Polangin warned that the bill ”makes unnecessary changes to the structure ” of the DOH and could potentially eliminate the Department of Environmental Health.
He explained that the department oversees the “regulation of septic tanks, drinking water from private wells, [programs that] protect the public from radiation hazards, and [prevent and monitor] the spread of diseases from animals to humans, such as west nile and rabies.” The bill would maintain the services, but disperse them to agencies all over the state. ”There is a reason for these programs to be located together,” he explained earlier this month.
Today he told legislators that “Florida is an environmentally sensitive state” that requires an agency that monitors environmental health exclusively.
During a Senate health committee hearing of the bill earlier this month, Col. Michael Smith testified against the bill’s removal of the Florida Center for Universal Research to Eradicate Disease. He said the Center was one of the few institutions that oversees the state’s biomedical research. Removing the Center, he said, would make it harder for the state to receive federal grants for research. According to Smith, the state is already in poor standing for research grants in comparison to other states like California and North Carolina.
Dr. Landis Crockett, a medical doctor with decades of experience in public health, told a House health committee a few weeks ago that Hudson and Garcia’s bills “embarks us upon a perilous and costly voyage.”
The DOH, as it stands today, was created by a Republican state lawmaker and former medical doctor. Public health advocates have long considered the Department of Health as one of the greatest achievements of Dr. William G. “Doc” Myers.