Appropriations Committee on Health and Human Services — Closed Captions

>>Chair Trumbull: EVERYBODY THE APPROPRIATIONS COMMITTEE ON HEALTH AND HUMAN SERVICES WILL COME TO ORDER, ROBIN WOULD YOU PLEASE CALL THE ROLL. >>Chair Trumbull: HERE. >>Vice Chair Davis: HERE. >>Sen. Brodeur: HERE. >>Sen. Burton: >>Sen. Garcia: >>Sen. Harrell: >>Sen. Rodriguez: >>Sen. Rouson: HERE. >>Sen. Sharief: >> A QUORUM IS PRESENT MR. CHAIR. >>Chair Trumbull: THANK YOU ROBIN, EVERYONE REMEMBERED TO SILENCE YOUR ELECTRONIC DEVICES, ANYONE WISHING TO SPEAK BEFORE THE COMMITTEE PLEASE FILL OUT AN APPEARANCE FORM AND SHARE THAT WITH THE SERGEANTS OFFICE. YOU'VE PROBABLY SEEN THE MEMO SENATORS SO WE WILL SKIP TAB ONE, MOVE STRAIGHT TO BILLS AND GO TO SENATOR GAETZ ON TAB EIGHT, RECOGNIZED TO EXPLAIN SENT 1002. >>Sen. Gaetz: THANK YOU MR. CHAIR. THIS STRENGTHENS FLORIDA'S CHILD WELFARE LAWS BY CLARIFYING ENDS OF DRUG ABUSE CAN CONSTITUTE NEGLECT ON APPEARANCE CONTINUED INTOXICATION CREATES AN ONGOING RISK TO A CHILD SAFETY, THE BILL PROVIDES IF AN INVESTIGATION FINDS HARM OR NEGLECT PARTS CAN INTERVENE AND REQUIRE SUBSTANCE ABUSE ASSESSMENT AND TREATMENT. THE BILL MOVES THE FOCUS FROM CHAPTER 751 TO CHAPTER 739 TO DEAL WITH SUBSTANCE ABUSE AND PROVIDE POTENTIAL SERVICES TO HELP THE FAMILY. THE BILL EXPANDS THE DEFINITION OF HARM AND NEGLECT IN A WAY MORE CHILDREN CAN BE PROTECTED SOONER SAFETY, PLANS, SERVICES AND POTENTIAL JUDICIAL INVOLVEMENT, THAT IS THE BILL. >>Chair Trumbull: ARE THERE QUESTIONS OF THE SPONSOR, SENATOR ROUSON. >>Sen. Rouson: THANK YOU MR. CHAIR. WHAT IS YOUR DEFINITION OF CONTINUED ABUSE? >>Chair Trumbull: YOU ARE RECOGNIZED. >>Sen. Gaetz: I THINK THE DEFINITION WOULD BE DETERMINED BY THE JUDGE WHO IS FOLLOWING THE CASE AND INVESTIGATORS WHO ARE FOLLOWING THE INDIVIDUAL. THE PARENT WHO HAS BEEN SINGLED OUT BECAUSE OF HARM AND NEGLECT. THAT WOULD BE MY SENSE, I DON'T BELIEVE THERE IS ANYTHING IN THE BILL THAT ESTABLISHES A PARTICULAR CALENDAR OR TIMELINE. I THINK IT WILL BE A TERM OF ART DETERMINED BY THE JUDGE. >>Chair Trumbull: FOLLOW-UP? ANY OTHER SENATORS, QUESTIONS? SEEING NONE I HAVE ONE APPEARANCE FORM, BARNEY BISHOP FLORIDA SMART JUSTICE ALLIANCE WANTING TO SPEAK, YES, SIR YOU ARE RECOGNIZED. >> THANK YOU MR. CHAIR. MY NAME IS BARNEY BISHOP FOR FLORIDA SMART JUSTICE ALLIANCE AND THANK SENATOR GAETZ FOR PRESENTING THIS GOOD BILL TO PROTECT CHILDREN. WE WOULD TELL YOU EXPANDING THE DEFINITION FROM EXPOSURE AND FROM EVIDENCE FOR BOTH ACUTE AND CHRONIC USE TO A FUTURE THREAT IS EXTREMELY IMPORTANT. I WOULD REMIND YOU OUR PRISONS ARE FULL OF PEOPLE THAT HAVE HAD SUBSTANCE ABUSE ISSUES BUT BUDGETS FOR THE DEPARTMENTS OF CORRECTIONS AND JUVENILE JUSTICE REFLECT THE DANGER AND DAMAGE SUBSTANCE ABUSE HAS DONE TO OUR FAMILIES, TWO ADULTS AND TWO CHILDREN SO THANK YOU VERY MUCH. >>Chair Trumbull: I DON'T HAVE ANY MORE PUBLIC TESTIMONY, WE ARE IN DEBATE. SEEING NO DEBATE SENATOR GAETZ YOU ARE RECOGNIZED CLOSE. >>Sen. Gaetz: I SEN. BRODEUR WAIVE CLOSE. >>Chair Trumbull: ROBIN WOULD YOU CALL THE ROLL. >>Sen. Brodeur: YES. >>Sen. Burton: >>Sen. Garcia: >>Sen. Harrell: >>Sen. Rodriguez: >>Sen. Rouson: >>Sen. Sharief: >>Vice Chair Davis: >>Chair Trumbull: YES, SENATORS BY YOUR VOTE SHOW SENATE BUILT CS FOR SENATE BILL 1002 REPORTED FAVORABLY. >>Sen. Gaetz: THANK YOU. >>Chair Trumbull: MOVING TO TAB 12, SENATOR GRALL YOUR RECOGNIZED TO EXPLAIN SENATE BILL 1630. >>Sen. Grall: THANK YOU MR. CHAIR. 1630 MODERNIZES FLORIDA'S AGING LONG-TERM CARE STATUTES, STREAMLINES SERVICE DELIVERY AND STRENGTHENS GUARDIANSHIP OVERSIGHT ALLOWING THE DO AA AND STAFF TO COMPLETE LONG-TERM CARE ELIGIBILITY SCREENINGS USED BY AGING DISABILITY RESOURCE CENTERS, PERMITS CARE TO RELY ON THE MOST CURRENT COMPREHENSIVE ASSESSMENT ELIMINATING DUPLICATIVE REASSESSMENT. IT AUTHORIZES DOPA TO REVIVE TEMPORARY DIRECT SERVICES DURING DECLARED EMERGENCIES OR AGENCY FAILURES PREVENTING GAPS IN COMMUNITY CARE FOR THE ELDERLY HOME CARE FOR THE ELDERLY AND ALZHEIMER'S DISEASE INITIATIVE SERVICES AND CLARIFIES DOPA AUTHORITY TO RESCIND AREA AGENCIES ON AGING DESIGNATION FOR FAILURES AND ELIGIBILITY DETERMINATION OR MANAGEMENT AND REQUIRES AREA AGENCIES ON AGING TO COMPETITIVELY PROCURE ANY CONTRACT IN EXCESS OF $30,000 AND REQUIRES AREA AGENCIES ON AGING EXPENDITURES TO FOLLOW DOPA GUIDELINES IN APPLICABLE LAW AND GRANTS AUTHORITY FOR AN AGENCY ON AGING TO PROVIDE CORE SERVICES DURING A STATE OF EMERGENCY WITH DEPARTMENT APPROVAL AND WITH REGARD TO COMMUNITY CARE IT ELIMINATES CLIENT COPAYMENTS AND PROVIDING MATCH REQUIREMENTS THAT PROVIDE HARDSHIP AND INEFFICIENCIES AND PRIORITIZES HIGH-RISK REFERRALS FROM PROTECTIVE SERVICES. IT PERMANENTLY ESTABLISHES A FLORIDA ALZHEIMER'S CARE CENTER OF EXCELLENCE IN STATUTE WHICH SUPPORTS AGING IN PLACE THROUGH CARE NAVIGATION AND SUPPORT AND DEMONSTRATED REDUCTIONS IN HOSPITALIZATIONS. WITH REGARD TO HOME CARE FOR THE ELDERLY EXPLICITLY AUTHORIZES FOOD AND NUTRITIONAL SUPPLEMENTS AS ALLOWABLE SERVICES ALIGNING STATUTE WITH PRACTICES AND FINALLY WITH REGARD TO GUARDIANSHIP REFORM ADDS MANDATORY ALZHEIMER'S AND DEMENTIA TRAINING FOR PROFESSIONAL GUARDIANS, EXPANDS TOOLS FOR THE OFFICE OF PROFESSIONAL GUARDIANS INCLUDING FINDS ENHANCED MONITORING AND GRANTS THE OFFICE OF GUARDIANS SUBPOENA POWER TO OBTAIN MEDICAL RECORDS DURING INVESTIGATIONS, THAT IS THE BILL. >>Chair Trumbull: THANK YOU FOR THAT EXPLANATION SENATORS ARE THERE QUESTIONS, SEEING NO QUESTIONS PUBLIC TESTIMONY, KAREN MORELLO AARP WAIVING IN SUPPORT, JASON MAIN AREA AGENCIES ON AGING WAIVING IN SUPPORT AND TYLER JEFFERSON WITH ALZHEIMER'S ASSOCIATION ALSO WAIVING IN SUPPORT, SENATORS WE ARE IN DEBATE, SEN. SHARIEF YOU ARE RECOGNIZED. >>Sen. Sharief: THANK YOU MR. CHAIR. SEN. GRALL, I WANTED TO SAY THIS IS A GREAT BILL BECAUSE IT'S GOING TO HELP SO MANY FAMILIES AND HELP NEEDY CHILDREN AS WELL AS NEEDY ADULTS THAT NEED CARE AND GUARDIANSHIP AND I THOUGHT YOU PUTTING IT FORTH WAS A GREAT IDEA SO I WANTED TO SAY THAT AND I AM HAPPY TO SUPPORT IT TODAY. >>Chair Trumbull: ANY OTHER DEBATE SENATORS, YOU ARE RECOGNIZED. >>Sen. Grall: I WANT TO CALL OUT THE ALZHEIMER'S CENTER OF EXCELLENCE AS AN OUTSTANDING EXAMPLE OF WHAT THE STATE HAS BEEN DOING AND THIS IS A WONDERFUL OPPORTUNITY TO HELP CAREGIVERS DEAL WITH ALZHEIMER'S AND RELATED DEMENTIA SO I KNOW I SIT ON THE ADVISORY COMMITTEE BUT I'VE HEARD THE GOOD WORK BEING DONE HERE SO THIS IS MAKING THIS A PERMANENT INSTITUTION AND PROMOTING ASSISTANCE AND GUIDANCE TO FAMILIES WHO ARE CAREGIVERS, SO IMPORTANT BUT THANK YOU, THIS IS TAKING US TO THE NEXT STEP IN OUR JOURNEY TO MAKE SURE OUR ELDERS, ESPECIALLY THOSE WHO NEED CARE THAT THIS IS GOING TO PROVIDE SO THANK YOU. >>Chair Trumbull: SEEING NO OTHER DEBATE YOU ARE RECOGNIZED CLOSE. >>Sen. Grall: I WILL SEN. BRODEUR WAIVE CLOSE. >>Chair Trumbull: WOULD YOU CALL THE ROLL. >>Sen. Brodeur: >>Sen. Burton: >>Sen. Garcia: >>Sen. Harrell: >>Sen. Rodriguez: >>Sen. Rouson: >>Sen. Sharief: >>Vice Chair Davis: >>Chair Trumbull: YES, SENATORS BY YOUR VOTE SHOW CS FOR SENATE BILL 1630 REPORTED FAVORABLY. SENATOR POLSKY. SENATORS ON TAB 10 LET'S GO AHEAD AND TAKE THAT BILL UP WHICH IS SENATE BILL 1022. >>Sen. Polsky: THANK YOU MR. CHAIR. ESTABLISHED IN 2008 WITH THE SUPPORT OF THEN FORMER HOUSE SPEAKER AND NOW SECRETARY OF STATE MARCO RUBIO THE FLORIDA CHILDREN'S INITIATIVE IS A STATEWIDE MODEL AFTER THE NATIONALLY RECOGNIZED HARLEM CHILDREN'S ZONE IN NEW YORK CREATED TO ADDRESS DISPARITIES FACED BY CHILDREN IN DISADVANTAGED COMMUNITIES OPERATING BY CREATING NETWORKS BRINGING TOGETHER PATIENT HEALTHCARE EMPLOYMENT AND HOUSING SERVICES TO CHILDREN IN THESE AREAS, MANAGED BY NONPROFIT OPERATIONS THESE INITIATIVES ARE SUBJECT TO PUBLIC RECORDS LAWS AND OTHER EXPECTATIONS READ CURRENTLY THERE ARE FIVE ACTIVE INITIATIVES LOCATED IN DUVAL, HILLSBOROUGH AND MIAMI-DADE AT THIS ESTABLISHES TWO NEW PROGRAMS, BAY COUNTY AND IN POMPANO. BOTH LOCATIONS HAVE COMPLETED THE NECESSARY STEPS TO BE ADDED TO THE STATUTES. THIS BILL GIVES CHILDREN A CHANCE TO SUCCEED WHILE HAVING NO FISCAL IMPACT ON THE STATE BUDGET. >>Chair Trumbull: ARE THERE QUESTIONS? SEEING NONE ONE APPEARANCE FORM, BARNEY BISHOP FLORIDA SMART JUSTICE ALLIANCE WAIVING IN SUPPORT, WE ARE IN DEBATE. THANK YOU FOR ADDING BAY COUNTY TO THE LIST, YOU ARE RECOGNIZED TO CLOSE. >>Sen. Polsky: YOU FORGOT TO ASK QUESTIONS, SORRY. I WAIVE CLOSE. >>Chair Trumbull: ROBIN WOULD YOU PLEASE CALL THE ROLL. >>Sen. Brodeur: >>Sen. Burton: >>Sen. Garcia: >>Sen. Harrell: >>Sen. Rodriguez: >>Sen. Rouson: >>Sen. Sharief: >>Vice Chair Davis: >>Chair Trumbull: YES, SENATORS BITE YOUR VOTE SHOW SENATE BILL 1022 REPORTED FAVORABLY. ON TAB 11 WE WILL MOVE TO CS FOR SENATE BILL 1030, SEN. ROUSON WILL PRESENT SENATOR GRUNER'S BILL. >>Sen. Rouson: THANK YOU MR. CHAIR. THERE IS A STRIKE ALL TO SENATE BILL 1030, 633918, CAN WE GO STRAIGHT TO THE STRIKE ALL? >>Chair Trumbull: YES, SIR, I'VE GOT 613988, CORRECT? YOU ARE RECOGNIZED. TO EXPLAIN THAT STRIKE ALL AMENDMENT. >>Sen. Rouson: THE STRIKE ALL STREAMLINES THE REGULATORY FRAMEWORK FOR SUBSTANCE ABUSE AND BEHAVIORAL HEALTH PROVIDERS. IT REMOVES BUREAUCRATIC BOTTLENECKS FOR COMPLIANCE PROVIDERS, PROTECTS PATIENT PRIVACY DURING ADMINISTRATIVE REVIEW AND ALIGNS EMPLOYMENT STANDARDS WITH BACKGROUND SCREENING STANDARDS. THE CURRENT REGULATIONS ARE CREATED UNINTENDED BARRIERS AND INCONSISTENCIES INCLUDING UNPREDICTABLE EXPANSION TIMELINES AND AMBIGUOUS OWNERSHIP RULES. WITH SENATE BILL 1030 AND THE STRIKE ALL THIS CREATES PREDICTABILITY FOR LICENSED PROVIDERS, ELIMINATES PATIENT ADMISSION REQUIREMENTS FOR LICENSE HOLDERS IN GOOD STANDING AND CLARIFIES BACKGROUND SCREENING REQUIREMENTS AND THAT'S THE BILL. >>Chair Trumbull: THANK YOU SENATORS, QUESTIONS ON THE STRIKE ALL? SEEING NO QUESTIONS, WE DO NOT HAVE ANY APPEARANCE FORMS. IS THERE DEBATE? SENATOR HARRELL YOU ARE RECOGNIZED IN DEBATE. >>Sen. Harrell: I KNOW SEN. ROUSON AND I HAVE WORKED CLOSELY ON THESE BILLS RELATED TO TREATMENT AND ALSO SOBER HOMES. THIS IS, I APPRECIATE THE HARD WORK YOU'VE DONE ON THIS WORKING WITH STATE ATTORNEY AL JOHNSON IN OUR AREA AND THIS HAS BEEN A MAJOR ENDEAVOR IN PALM BEACH COUNTY AND I APPRECIATE YOUR HARD WORK AND EVERYTHING THEY'VE DONE. I HAD SOME ISSUES WITH THE BILL ORIGINALLY BUT NOW WITH THE STRIKE ALL I HAVE TO SAY I TOTALLY SUPPORT IT. >>Chair Trumbull: ANY OTHER DEBATE SENATORS, SEEING NONE YOU ARE RECOGNIZED TO CLOSE. >>Sen. Rouson: WAIVE CLOSE. >>Chair Trumbull: ALL IN FAVOR SIGNIFY BY SAYING YEA, OPPOSED NO. SHOW THAT COMMITMENT ADOPTED, ANY QUESTIONS ON THE UNDERLYING BILL, I HAVE ONE APPEARANCE FORM, BARNEY BISHOP, VERY BUSY, FLORIDA SMART JUSTICE ALLIANCE WAIVING IN SUPPORT. DEBATE ON THE UNDERLYING BILL? SEEING NONE YOU ARE RECOGNIZED CLOSE. >>Sen. Rouson: WAIVE CLOSE. >>Chair Trumbull: PLEASE CALL THE ROLL. >>Sen. Burton: >>Sen. Brodeur: >>Sen. Garcia: >>Sen. Harrell: >>Sen. Rodriguez: >>Sen. Rouson: YES. >>Sen. Sharief: YES. >>Vice Chair Davis: >>Chair Trumbull: YES, SENATORS BY YOUR VOTE SHOW CS FOR SENATE BILL 1030 REPORTED FAVORABLY. SEN. SHARIEF, ARE YOU GOOD TO PRESENT DOORBELL? YOU ARE RECOGNIZED TO EXPLAIN CS FOR SENATE BILL 864 ON TAB 7. >>Sen. Sharief: THANK YOU MR. CHAIR. I'M PRESENTING SENATE BILL, SORRY, 864 AND IT IS THE PUBLIC RECORDS EXEMPTION WHICH GOES ALONG WITH MY SENATE BILL 196 FOUR UTERINE FIBROID RESEARCH DATABASE, IT'S JUST A PUBLIC RECORDS EXEMPTION THAT ALLOWS US TO COLLECT THE DATA UNDER THE DEPARTMENT OF HEALTH AND THAT IS THE BILL. >>Chair Trumbull: ARE THERE QUESTIONS, SEEING NO QUESTIONS I DON'T HAVE ANY APPEARANCE FORMS, IS THERE DEBATE? YOU ARE RECOGNIZED CLOSE. >>Sen. Sharief: WAIVE CLOSE. >>Chair Trumbull: CALL THE ROLL. >>Sen. Brodeur: >>Sen. Burton: >>Sen. Garcia: >>Sen. Harrell: >>Sen. Rodriguez: >>Sen. Rouson: >>Sen. Sharief: YES. >>Vice Chair Davis: >>Chair Trumbull: YES SENATORS BY YOUR VOTE SHOW CS FOR SENATE BILL 864 REPORTED FAVORABLY. >> IT IS 864, TAB SEVEN. >>Chair Trumbull: SEN. SHARIEF WE WILL STICK WITH YOU AND I DON'T SEE SENATOR KOLODNY WOULD YET SO WE WILL MOVE UP TO TAB THREE SENATE BILL 36 PROFESSIONAL NURSING TITLES, YOU ARE RECOGNIZED. >>Sen. Sharief: THANK YOU MR. CHAIR. SB 36 IS A STRAIGHTFORWARD COMMON SENSE BILL THAT FOCUSES ON TRANS CURRENCY CLARITY AND RESPECT FOR CREDENTIALS IN OUR HEALTHCARE SYSTEM. THIS ALLOWS LICENSED NURSES WHO EARNED A DOCTORAL DEGREE TO USE APPROPRIATE TITLES WHILE CLEARLY IDENTIFYING THEMSELVES AS NURSES SO PATIENTS UNDERSTAND WHO IS PROVIDING THEIR CARE AND IMPORTANTLY AS DOES NOT EXPAND SCOPE OF PRACTICE CHANGE LICENSURE REQUIREMENTS OR CREATE PATIENT CONFUSION, AND IN FACT DOES THE OPPOSITE BY REQUIRING CLARITY IN IDENTIFICATION AND I'D LIKE TO KNOW THE HOUSE COMPANION HAS ALREADY PASSED ALL THREE COMMITTEES WITH STRONG BIPARTISAN SUPPORT, THAT SPEAKS VOLUMES ABOUT THE NATURE OF THIS BILL AND THE BROAD AGREEMENT THAT TRUTH IN CREDENTIALS MATTER. I HAVE AN AMENDMENT, SHOULD WE TAKE THAT UP? >>Chair Trumbull: YOU ARE RECOGNIZED TO EXPLAIN AMENDMENT 508. >> THIS AMENDMENT PROVIDES CLARITY REGARDING USE OF PROFESSIONAL NURSING TITLES WHILE MAINTAINING TRANSPARENCY AND INJURING REGULATORY OVERSIGHT. THIS AMENDMENT REFINES THE LANGUAGE THAT IN THREE IMPORTANT WAYS, FIRST IT SPECIFIES A LICENSED ADVANCED PRACTICE REGISTERED NURSE WILL HOLD A DOCTOR OF PHILOSOPHY DEGREE FOR DOCTOR OF NURSING PRACTICE DEGREE USE THE TITLE DOCTOR OF PHILOSOPHY AND ABBREVIATION PHD OR DOCTOR OF NURSING PRACTICE AND ABBREVIATION DMT RESPECTIVELY IN A MANNER CONSISTENT WITH THE DOCTORAL DEGREE SUCH PERSON HOLDS, SECOND THE AMENDMENT STRENGTHENS PATIENT TRANSPARENCY PROTECTIONS AND PROVIDES 10 APRN USES A DOCTORAL TITLE IN A CLINICAL SETTING MAY NOT HOLD HIMSELF OR HERSELF OUT AS A DOCTOR TO PATIENTS OR PROTECTIVE PATIENTS IN ADVERTISING PRODUCED BY THE PRACTITIONER INCLUDING IMAGE OR WRITTEN COMMUNICATION USING SUCH TITLE OR ABBREVIATION WITHOUT DENOTING HIS OR HER LICENSE. THIRD THE AMENDMENT ALIGNS THE ENFORCEMENT APPROPRIATELY AND MIXED SUCH VIOLATIONS BROWN'S FOR DISCIPLINARY ACTION UNDER THE BOARD OF NURSING READ THIS KEEPS OVERSIGHT IN THE PROFESSIONAL REGULATORY FRAMEWORK WHERE IT BELONGS AND ENSURES ANY VIOLATIONS ARE ADDRESSED PROPORTIONATELY, THAT IS THE AMENDMENT. >>Chair: QUESTIONS ON THE AMENDMENT. NO QUESTIONS. PUBLIC, APPEARANCE FORMS. JOE PUCKETT FLORIDA ASSOCIATION OF NURSE PRACTITIONERS WAIVING IN SUPPORT. ALLISON CARBAJAL, NURSE PRACTITIONERS NETWORK WAIVING IN SUPPORT. ERIN BALLAST FLORIDA NURSES FOUNDATION IN SUPPORT. AND I DON'T SEE A NAME FOR THIS PERSON, SAYS FLORIDA ASSOCIATION OF NURSE ANESTHESIOLOGY WAIVING IN SUPPORT, THAT IS IT FOR PUBLIC TESTIMONY, IS THERE DEBATE ON THE AMENDMENT? SEEING NONE YOU ARE RECOGNIZED TO CLOSE. >> WAIVE CLOSE MR. CHAIR. >>Chair: WITHOUT OBJECTION SHOW THAT AMENDMENT ADOPTED, ARE THERE QUESTIONS ON THE UNDERLYING BILL? SENATOR BURTON YOUR RECOGNIZED. >>Sen. Burton: THANK YOU CHAIR AND THANK YOU SEN. SHARIEF FOR REVIEWING FOR US WHAT THE BILL DOES. CAN YOU TALK TO US A BIT ABOUT WHY YOU BELIEVE THIS BILL IS NECESSARY? >>Chair: YOU ARE RECOGNIZED. >>Sen. Sharief: YES SENATOR BURTON, EACH YEAR WE TALK ABOUT CLARITY AND USE OF TITLES IN PROFESSIONAL PRACTICE IN TERMS OF CLINICAL SETTING AND CURRENTLY RIGHT NOW FOR NURSES THAT HOLD THEIR PROFESSIONAL TITLES WE WANTED TO MAKE SURE WE WERE SETTING A GOOD STANDARD WITHIN OUR PROFESSION TO MAKE SURE WE ARE PROPERLY YOU KNOW, DISCIPLINING AND PROPERLY EDUCATING OUR NURSES ABOUT USE OF THAT TITLE. SO I DECIDED I WANTED TO BRING THIS FORWARD TO MAKE SURE WE WERE BEING VERY CLEAR AND TRANSPARENT ABOUT WHAT WE COMMUNICATE. >>Chair: ADDITIONAL QUESTIONS ON THE UNDERLYING BILL? WE ARE IN PUBLIC TESTIMONY. NOT IN PUBLIC TESTIMONY, WE DON'T HAVE ANY SO NOW WE ARE IN DEBATE. SEEING NONE SEN. SHARIEF YOU ARE RECOGNIZED TO CLOSE ON THE BILL. >>Sen. Sharief: THANK YOU MR. CHAIR. I WILL WAIVE CLOSE. >>Chair: SEN. SHARIEF HAVING CLOSED ON CS FOR AS PLEASE CALL THE ROLL. >>Sen. Burton: >>Sen. Garcia : >>Sen. Harrell: >>Sen. Rodriguez: >>Sen. Rouson: >>Sen. Sharief: YES. >>Vice Chair Davis: >>Chair Trumbull: >>Sen. Brodeur: >>Chair: YES BY YOUR VOTE SHOW CS FOR SB 346 REPORTED FAVORABLY AND NEXT UP WE HAVE SENATOR CALATAYUD, GOING TO SB 6 YOU ARE RECOGNIZED. >>Sen. Calatayud: THANK YOU MR. CHAIR. THIS IS A SETTLED CLAIM WITH DCF WHICH THE DEPARTMENT HAS AGREED NOT TO OPPOSE TO AWARD $3.8 MILLION TO THE REVOCABLE TRUST CREATED FOR LAYLA ESTRADA SAPPHIRE WILLIAMS, THIS WAS, THIS IS A YOUNG WOMAN, YOUNG GIRL BORN JULY 29, 2019 TO BIOLOGICAL PARENTS WHO GOT INTO A FIGHT IN THE HOSPITAL THAT GENERATED TWO ABUSE HOTLINE COMPLAINTS AT DCF LEARNED THE MOTHER HAD EXTENSIVE CRIMINAL HISTORY BUT UNFORTUNATELY DESPITE THIS EVIDENCE THE CHILD WAS ALLOWED TO RETURN HOME WITH HER PARENTS WITHIN THREE MONTHS SHE UNFORTUNATELY EXPERIENCED A REVOCABLE INJURIES. SUCH AS SHAKEN BABY SYNDROME AND MALNOURISHMENT BECAUSE OF THIS CHILD ABUSE SHE HAS TRAUMATIC BRAIN INJURIES SEIZURES AND CEREBRAL PALSY. BECAUSE OF THESE ISSUES SHE WILL HAVE CHALLENGES HER ENTIRE LIFE AND THIS WILL HELP US SUPPORT THOSE TREMENDOUS NEEDS, THAT IS THE BILL MR. CHAIR. >>Chair: FURTHER QUESTIONS MEMBERS? IS THERE PUBLIC TESTIMONY? IS THERE DEBATE? SEN. CALATAYUD TO CLOSE. >>Sen. Calatayud: THANK YOU MR. CHAIR. WAIVE CLOSE. >>Chair Trumbull: ROBIN CALL THE ROLL ON SB SIX. >>Sen. Burton: >>Sen. Garcia : >>Sen. Harrell: >>Sen. Rodriguez: >>Sen. Rouson: >>Sen. Sharief: >>Vice Chair Davis: >>Chair Trumbull: >>Sen. Brodeur: >>Chair: BY YOUR VOTE SHOW SB SIX REPORTED FAVORABLY. MEMBERS WE DON'T HAVE ANY MORE GUESTS HERE. SO WE MAY HAVE TO STAND IN INFORMAL RECESS UNTIL SOMEONE SHOWS UP SO WITH THAT DON'T GO VERY FAR, WE WILL RETURN SHORTLY. [SILENCE] >>Chair: WE NOW HAVE SENATOR SIMON STRIKING A GREAT GATOR JACKET FOR GATOR DAY. WHICH WE APPRECIATE A GREAT DEAL. SENATOR SIMON ON TAB FIVE, SENATE BILL 778, YOU ARE RECOGNIZED SIR. >>Sen. Simon: THANK YOU MR. CHAIR. FOR THE RECORD IT IS TSC DAY AT THE CAPITAL SO THIS IS TALLAHASSEE STATE COLLEGE BLUE. SO THAT IS MY STORY AND I'M STICKING TO IT. I'M SORRY. I CAN RESPOND. >>Chair: GO AHEAD AND PRESENT THE BILL. >>Sen. Simon: THERE IS NO ORANGE IN MY CLOSET, ONLY FAMU ORANGE THAT IS NOT HURRICANE OR FLORIDA ORANGE. SB 778 IS A STRAIGHTFORWARD BILL THAT IMPROVES BOTH SAFETY AND EFFICIENCY IN OUR STATE FORENSIC SYSTEM. IT UPDATES THE DEFINITION OF HER FORENSIC CLIENTS TO INDIVIDUALS WITH INTELLECTUAL DISABILITIES OR AUTISM WHOSE CHARGES WERE DISMISSED BECAUSE THEY WERE INCOMPETENT TO PROCEED CAN BE HOUSED IN THE SAME SECURE SETTING AS OTHER RESIDENTS UNDER CHAPTER 916. RIGHT NOW THE AGENCY FOR PERSONS WITH DISABILITIES MUST MAINTAIN A PARALLEL STAFFING AND SPACE FOR THOSE INDIVIDUALS EVEN THOUGH THEY REQUIRE THE SAME LEVEL OF SECURE FORENSIC CARE. THIS BILL ALLOWS APD TO CONSOLIDATE THOSE SERVICES REDUCING DUPLICATIVE STAFFING NEEDS AND PRODUCING A POSITIVE FISCAL IMPACT FOR THE STATE WHILE MAINTAINING APPROPRIATE ACTIONS FOR THE VULNERABLE POPULATION AND THE PUBLIC. MR. CHAIR THAT IS THE BILL. >>Chair: THERE ARE NO AMENDMENTS, DO WE HAVE QUESTIONS? SEEING NONE PUBLIC TESTIMONY, BARNEY BISHOP FLORIDA SMART JUSTICE ALLIANCE WAIVING IN SUPPORT EMILY REEVES IN SUPPORT. THANK YOU FOR BEING HERE. ANYBODY ELSE? SEEING NONE WE ARE IN DEBATE. SENATOR SIMON TO CLOSE. >>Sen. Simon: I WAVE CLOSE. >>Chair: CALL THE ROLL ON SB 778. >>Sen. Burton: >>Sen. Garcia : >>Sen. Harrell: >>Sen. Rodriguez: >>Sen. Rouson: >>Sen. Sharief: >>Vice Chair Davis: >>Chair Trumbull: >>Sen. Brodeur: >>Chair: SHOW 778 REPORTED FAVORABLY. NEXT UP TAB NINE CS FOR SB 1016 BY SENATOR BRADLEY. YOU ARE RECOGNIZED TO EXPLAIN THE BILL. >> THANK YOU MR. CHAIR. SENATORS IN 2019 THE LEGISLATURE INCLUDED PROVISO IN THE 2019 APPROPRIATIONS ACT WHICH AUTHORIZED AHCA TO CREATE A WORKING PEOPLE WITH DISABILITIES PROGRAM FOR DEVELOPMENTALLY DISABLED FLORIDIANS RECEIVE SUPPORT THROUGH THE MEDICAID WAIVER PROGRAMS. THE PROGRAM WAS CREATED TO ALLOW DEVELOPMENTALLY DISABLED ADULTS TO ENTER THE WORKFORCE WITHOUT COMPROMISING THEIR MEDICAID BENEFITS. THIS IS ABOUT SUPPORTING FLORIDA'S DEVELOPMENTALLY DISABLED AS THEY SEEK INCLUSION DIGNITY SELF-CONFIDENCE AND SELF-ESTEEM. CS FOR SB 1014 CODIFIES THE WORKING PEOPLE WITH DISABILITIES PROGRAM CREATED IN 2019 ALLOWING ELIGIBLE DEVELOPMENTALLY DISABLED INDIVIDUALS TO OPT INTO THE PROGRAM AND REQUIRING DCF TO PROVIDE WRITTEN NOTICE TO ALL ADULTS WHEN THEY ENROLL IN A WAIVER PROGRAM. THE BILL CODIFIES ELIGIBILITY GUIDELINES AND INCLUDES EXISTING INCOME AND ASSET PROVISIONS IN ORDER TO MAINTAIN MEDICAID ELIGIBILITY. THERE ARE NO AMENDMENTS, THAT'S THE BILL. >>Chair: MEMBERS ARE THERE QUESTIONS OF THE SPONSOR? PUBLIC TESTIMONY, TYLER SUNUNU WAIVING IN SUPPORT. SUMMER PFEIFFER MARKET FLORIDA WAIVING IN SUPPORT. LAURA MINUTELLO, DISABILITY RIGHTS FLORIDA . WOULD LIKE TO COME SPEAK, COME ON UP. >> Chair Trumbull: SARGE WILL HELP YOU OUT IN JUST A SECOND. >> Public Speaker: I THOUGHT THAT PODIUM -- THIS IS ALL RIGHT. YOU CAN HEAR ME, CORRECT? >> OH YEAH. YOU ARE RECOGNIZED. >> Public Speaker: THANK YOU TO SENATOR BRADLEY. AS SENATOR BRADLEY EXPLAINED, THE PROGRAM WAS ESTABLISHED IN PROVISO WITH THE SUPPORT OF FORMER SENATOR BRADLEY AND A NUMBER OF OTHERS TO ALLOW THOSE CURRENTLY ON THE MEDICAID WAIVER PROGRAMS TO WORK. AND THOSE OF YOU WHO HAVE HEARD ME PRESENT OR PUBLIC TESTIMONY ON THIS BILL WILL KNOW THAT I WILL SAY THIS IS ONE OF THOSE BILLS THAT BROOCHES INTO PERSONAL AND PROFESSIONAL. I AM THE PUBLIC POLICY ANALYST, HOWEVER, I AM ALSO A WORKING PEOPLE'S USER AND SO FIRST AND FOREMOST, CODIFICATION OF THIS PROGRAM IS PARAMOUNT. IT HAS BEEN IN PROVISO SINCE 2019 AND THERE ARE A NUMBER OF ADMINISTRATIVE HURDLES AND EFFICIENCIES TAKING IT OUT OF PROVISO AND CODIFYING WOULD ELIMINATE. SUCH AS EVEN DCF STAFF NOT KNOWING ABOUT THE PROGRAM. WHEN I GO THROUGH MY YEARLY REDETERMINATION PROCESS, AS WELL AS MANY OTHERS, I USUALLY HAVE TO WIND UP SITTING DOWN WITH MY REVIEWER AND GOING THROUGH THE DCF MANUAL TO TELL THEM AND EXPLAIN ABOUT THE PROGRAM. I CAN DO THAT. MANY PEOPLE CAN DO THAT. BUT NOT ALL THAT CAN BENEFIT FROM THIS PROGRAM ARE GOING TO NOTE TO DO THAT, AND ALSO, IT SHOULDN'T HAVE TO BE DONE. BUT THIS IS ALSO AN APPROPRIATION STOP. IF THOSE OF YOU WHO HAVE READ THE BILL ANALYSIS WILL KNOW THAT IT SAYS THE BILL HASN'T INDISCRIMINATE POSITIVE FISCAL IMPACT ON PEOPLE WITH DISABILITIES. I'M GOING TO ANIMATE THAT FOR YOU A LITTLE BIT USING MYSELF AS AN EXAMPLE. AND THIS IS NOT ABOUT LAURA, THIS IS REALLY ABOUT A NUMBER OF PEOPLE THIS WILL AFFECT. BUT I AM THE PERSON BEFORE YOU TODAY. FOR ME, THE WORKING PEOPLE'S PROGRAM MEANS I CAN UTILIZE MY DEGREE TO THE FULLEST. MY DEGREES, PLURAL, TO THE FULLEST EXTENT, AND PARTICIPATE IN THE COMMUNITY. AND ACHIEVE A DEGREE OF INDEPENDENCE THAT NOT HAVING THE PHYSICAL MEANS THAT WORK PROVIDES WOULD NOT ALLOW ME TO HAVE. IT ALSO MEANS WILL LIGHT UTILIZE THE PROGRAMS I'M NOT UTILIZING A LOT OF OTHER THINGS HAD I NOT BEEN ABLE TO WORK THAT I WOULD BE UTILIZING. IT'S REALLY A COST SAVINGS AS FAR AS THE STATE FOR SNAP AND OTHER PROGRAMS. SO THERE IS THE ECONOMIC IMPACT AS WELL. BUT FIRST AND FOREMOST, IT REALLY JUST PROVIDES THOSE OF US WHO WANT TO WORK WITH DISABILITIES, AND I'VE NEVER MET A PERSON WITH DISABILITY WHO DOESN'T WANT TO WORK, THE ABILITY TO DO SO. AND THE ABILITY TO CONTRIBUTE IN THE SAME WAY ANYBODY CONTRIBUTES. I PAY TAXES, I PARTICIPATE IN MY COMMUNITY. THOUGH I REQUIRE HELP WITH THAT WOULD TYPICALLY BE AN INSTITUTIONAL LEVEL OF CARE, THAT'S WHAT A MEDICAID WAIVER PROGRAM DOES. UNABLE TO BE IN THE COMMUNITY, UNABLE TO BE BEFORE YOU TODAY. AGAIN, I'M JUST ONE EXAMPLE OF THE MANY PEOPLE WHO THIS HELPS. I HAVE TWO ON THIS NOTE SAY WE ACTUALLY DON'T KNOW AT THIS POINT HOW MANY PEOPLE THIS COULD TRULY HELP BECAUSE DCF HAS NOT BEEN TRACKING THE PROGRAM. THAT'S NOT CONTEMPLATED IN THE BILL, BUT THAT IS SOMETHING AS FAR AS IMPLEMENTATION AND GOING FURTHER WITH THE PROGRAM, WHICH IDEALLY WE WOULD LOOK FOR FURTHER WAYS TO EXPAND OUTSIDE THE WAIVER PROGRAMS TO ALLOW MORE PEOPLE WITH DISABILITIES TO WORK. BUT THAT IS SOMETHING TRACKING AND NOTICING WHO IS USING THE PROGRAM WOULD BE A GOOD FIRST STEP AS WELL. >> Chair Trumbull: THANK YOU VERY MUCH FOR YOUR TESTIMONY. APPRECIATE IT. MICHAEL McCREIGHT. AM I SAYING THAT RIGHT? >> Public Speaker: GOOD EVENING. TECHNICALLY GOOD AFTERNOON. I'M HEADING TO THE AIRPORT AFTER THIS. MR. CHAIR, MEMBERS OF THE FLORIDA SENATE, TODAY I'M NOT ASKING YOU TO SIMPLY VOTE ON A BILL NUMBER. I'M ASKING YOU TO SEE A PERSON. SEE THE YOUNG WOMAN WITH CEREBRAL PALSY WHO WAKES UP EVERY MORNING DETERMINED TO PROVE SHE BELONGS IN THE WORKFORCE. SEE THE MAN WITH AUTISM WHO WORKED TIRELESSLY TO EARN HIS CERTIFICATION. WHO WANTS NOTHING MORE THAN TO JUST CONTRIBUTE, EARN A PAYCHECK, TO BUILD A FUTURE AND SEE THE MOTHER WITH A DISABILITY WHO DREAMS OF SHOWING HER CHILDREN WHAT INDEPENDENCE LOOKS LIKE. AND THEN IMAGINE TELLING THEM THIS. YOU CAN WORK, BUT ONLY IF YOU STAY POOR. THAT IS THE REALITY TOO MANY FLORIDIANS WITH DISABILITIES FACE TODAY. UNDER CURRENT POLICY IF THEY WORK TOO MANY HOURS, IF THEY EXCEPT TO THE RACE, IF THEY CHASE A PROMOTION THEY RISK LOSING MEDICAID. THE VERY MEDICAL ASSISTANCE THAT ALLOWS THEM TO FUNCTION TO STAY STABLE. TO REMAIN IN THE WORKFORCE, THE THERAPIES, THE MEDICATION, THE MEDICAL EQUIPMENT AND SUPPORTS THAT MAKE EMPLOYMENT POSSIBLE. IS SUDDENLY PLACED IN JEOPARDY. SO THEY ARE FORCED INTO AN IMPOSSIBLE CHOICE. -- OR HEALTHCARE? OPPORTUNITY OR SURVIVAL? WORK OR STABILITY? LET ME TELL YOU THIS. THIS IS NOT FREEDOM, THAT IS NOT FAIR AND THAT IS NOT THE FLORIDA WE BELIEVE IN. HOUSE BILL -- SENATE BILL 1016 RESTORE HIS DIGNITY TO THIS EQUATION. IT RECOGNIZES DISABILITY AND PRODUCTIVITY ARE NOT OPPOSITES. IT ACKNOWLEDGES MEDICAL ASSISTANCE IS NOT A HANDOUT. IT IS A LIFELINE THAT ENABLES PARTICIPATION. PEOPLE WITH DISABILITIES WHO WANT TO WORK, THEY WANT TO PAY TAXES, THEY WANT TO CONTRIBUTE TO THEIR COMMUNITIES. THEY WANT TO BUILD THE CAREERS, BUY HOMES, AND PLAN FOR THEIR FUTURES. WHAT THEY DO, NOT ONE, IS TO BE PENALIZED FOR FREEDOM. WE ASK YOU TO PASS IN THE BUILT 16. WE ARE NOT EXPANDING THE PENDENCY. WE ARE EXPANDING INDEPENDENCE. WE ARE STRENGTHENING OUR WORKFORCE. WE ARE EMPOWERING INDIVIDUALS TO MOVE FORWARD WITHOUT THE FEAR SUCCESS WILL COST THEM THEIR HEALTH. THINK ABOUT THE MESSAGE IN THESE CHAMBERS. A YES SAYS WE BELIEVE AND THEY WERE, WE BELIEVE AN OPPORTUNITY, WE BELIEVE IN REMOVING BARRIERS. INSTEAD OF BUILDING THEM WE BELIEVE IN DAY-TO-DAY THAT BELONGS TO EVERYONE. MEMBERS, THIS IS NOT A PARTISAN ISSUE. THIS IS A HUMAN ISSUE. THESE ARE FAMILIES WHO DESERVE TO HAVE MEDICAL HEALTHCARE, ESPECIALLY MEDICAID. AS A PERSON ON THE AUTISM SPECTRUM ON PEOPLE WHO ARE GOOD FRIENDS WITHIN THIS ROOM WORK REALLY CLOSELY WITH SUPPORTED DECISION-MAKING. I AM ASKING YOU TO PLEASE PASS THIS BILL AND MAKE A DIFFERENCE TO EVERYONE IN THIS GREAT STATE OF FLORIDA. THANK YOU. >> Chair Trumbull: THANKS SO MUCH FOR BEING WITH US. I DON'T HAVE ANY MORE APPEARANCE FORMS. WE ARE IN DEBATE. SENATOR HARRELL, YOU ARE RECOGNIZED IN DEBATE. >> Sen. Harrell: FIRST OF ALL, I WANT TO THANK MICHAEL FOR COMING IN SPEAKING. I HAVE WORKED WITH HIM ON MANY ISSUES AND I APPRECIATE HIS WONDERFUL TESTIMONY. HAVING WORKED WITH HELPING PEOPLE SUCCEED IN THE L CENTER FOR AUTISM, I CAN'T TELL YOU HOW IMPORTANT THIS BILL IS TO ENABLE THOSE WITH DISABILITIES TO WORK, BUT STILL MAINTAIN THEIR HEALTHCARE UNDER MEDICAID. THEY HAVE MEDICAL EXPENSES FREQUENTLY IN MANY PLACES THAT THEY ARE WORKING IN THAT THE VARIOUS ORGANIZATIONS ARE ABLE TO WORK, WHICH IS AMAZING. IT'S WONDERFUL. THEY DON'T GET HEALTH INSURANCE AND WITHOUT THEIR MEDICAID, THEY WOULD NOT BE ABLE TO WORK. I THINK THIS IS A VERY IMPORTANT STEP FORWARD TO PUT THIS IN STATUTE. IT HAS WORKED VERY SUCCESSFUL. THANK YOU VERY MUCH FOR THIS GREAT BILL AND I SO LOOK FORWARD. >> Chair Trumbull: SEEING NO OTHER DEBATE, YOU ARE RECOGNIZED TO CLOSE. >> THIS BILL WAS BROUGHT TO MY ATTENTION BY REPRESENTATIVE TANT. IT WAS HER SON WHO HAD A JOB AND THEN THE SYSTEM WASN'T AWARE OF WHAT WAS PUT IN PROVISO IN 2019 AND SHE HAD TO HIRE LAWYERS, DOCTORS THE AGENCIES. IT WAS FINALLY DETERMINED THIS WAS IN PROVISO BUT IT WASN'T CODIFIED IN LAW. IT WAS LOST IN TRANSLATION AND WAS DIFFICULT FOR PEOPLE TO TAKE ADVANTAGE OF THIS PROGRAM. AND I SAID I'M IN, LET'S DO IT, LET'S CODIFY IT. SHE SAID DO YOU KNOW WHO PUT IT IN PROVISO AND WORKED ON THIS ISSUE IN 2019? AND IT WAS THE FORMER SENATOR BRADLEY. SO IT REALLY IS FULL CIRCLE TO COME HERE. I THINK WHEN WE CODIFY IT NOW WHEN YOU ARE ENROLLED IN THE MEDICAID PROGRAM EVERYONE IS NOTIFIED AND THE SYSTEM BECOMES AWARE THAT THIS PROGRAM IS AVAILABLE TO HELP AND LIFT UP OUR DEVELOPMENTALLY DISABLED THAT WANT TO WORK. WITH THAT, BOTH SENATOR BRADLEY'S ASK FOR YOUR FAVORABLE SUPPORT. >> Chair Trumbull: IT TOOK YOU TO FINISH ACROSS GET IT ACROSS THE FINISH LINE. ROBIN, WOULD YOU PLEASE CALL THE ROLL CALL? >> Sen. Brodeur: YES. >> Sen. Burton: YES. >> Sen. Garcia: -- >> Sen. Harrell: YES. >> Sen. Rodriguez: YES. >> Sen. Rouson: YES. >> Sen. Sharief: YES. >> Vice Chair Davis: YES. >> Chair Trumbull: YES. BY YOUR VOTE SHOW CS FOR SENATE BILL 1016 REPORTED FAVORABLY. I DON'T SEE ANY OTHER MEMBERS IN THE AUDIENCE. I DON'T THINK I SEE ANY OTHER ONES. JUST KIDDING. ALL RIGHT. SENATOR JONES WHO JUMPED ME IN THE LAST COMMITTEE. YOU ARE RECOGNIZED EXPLAIN ON TAB SIX SENATE BILL 844. >> Sen. Jones: I HAD A LOT OF QUESTIONS, CHAIR. I'M SO SORRY. IT'S GOOD TO BE WITH YOU ALL THIS AFTERNOON. MEMBERS, SICKLE CELL DISEASE AFFECTS HEMOGLOBIN WHICH IS THE PROTEIN THAT CARRIES OXYGEN IN RED BLOOD CELLS. NORMALLY RED BLOOD CELLS ARE FLEXIBLE ALLOWING THEM TO MOVE EASILY THROUGH BLOOD VESSELS AND SICKLE CELL DISEASE READ MODULES ARE MISSHAPED. CRESCENT OR SICKLE SHAPE DUE TO A GENE MUTATION THAT AFFECTS THE MOLECULE. RED BLOOD CELLS DO NOT BEND OR MOVE EASILY AND BLOCK BLOOD FLOW TO THE REST OF THE BODY. ACCORDING TO THE NATIONAL HEART LUNG AND BLOOD INSTITUTE FOUR THOUSAND PEOPLE IN THE UNITED STATES AND 8 MILLION PEOPLE WORLDWIDE ARE AFFECTED BY SICKLE CELL DISEASE. 90% OF PEOPLE WHO HAVE SICKLE CELL DISEASE OR NON-HISPANIC BLACK OR AFRICAN-AMERICAN WITH ABOUT ONE AND THREE BLACK. ONE IN 13 BLACK BABIES BEATEN BORN. INDIVIDUALS WITH SICKLE CELL DISEASE ROUTINELY REPORT DELAYED CARE AND ADEQUATE PAIN MANAGEMENT AND PROVIDED BY US IN EMERGENCY CARE SETTINGS. WHILE THERE ARE DOCTORS WHO SPECIALIZE IN SICKLE CELL DISEASE, MANY HEALTH PROFESSIONALS RECEIVE LITTLE OR NO FORMAL TRAINING WHICH LEADS TO MISMANAGEMENT OF PAIN AND PREVENTABLE COMPLICATIONS. SB 844 UPDATES FLORIDA LAW TO ENSURE EDUCATION OF SICKLE CELL DISEASE IS INCLUDED IN CONTROLLED SUBSTANCE PRESCRIBED EDUCATION AND INITIAL LICENSURE RENEWAL REQUIREMENTS FOR CERTAIN HEALTHCARE PROFESSIONALS. LICENSED PHYSICIAN AND NURSES MUST COMPLETE A ONE TIME, TO OUR BOARD CONTINUING EDUCATION COURSE ON CARE MANAGEMENT AS PART OF THEIR FIRST LICENSE OF CERTIFICATION RENEWAL. THE COURSE MUST COVER BUT IS NOT LIMITED TO EVIDENCED BASED TREATMENT PROTOCOLS FOR PATIENTS OF ALL AGES, CONTINUING PATIENT AND EDUCATION, PERIODIC CONFERENCE OF EVALUATIONS ANOTHER DISEASE SPECIFIC HEALTH MAINTENANCE SERVICES, PHYSIOLOGICAL CARE, GENETIC COUNSELING AND PAIN MANAGEMENT. THAT IS THE BILL MR. CHAIR. >> Chair Trumbull: THANK YOU VERY MUCH. SENATORS, I DO SHOW SENATOR JONES HAS ONE AMENDMENT. YOUR RECOGNIZED EXPLAIN THE MINUTE BARCODE 6422. >> THIS AMENDMENT ALIGNS THE BILL WITH THE HOUSE VERSION. >> Chair Trumbull: QUESTIONS ON THE AMENDMENT, SENATORS? I DON'T HAVE ANY APPEARANCE FORMS. WE ARE IN DEBATE. YOUR RECOGNIZED THE CLOSE. >> Chair Trumbull: WITHOUT OBJECTION SHOW THAT ADOPTED. SEEING NO QUESTIONS REMOVED THE PUBLIC TESTIMONY. JOSIAH FRIERSON? YOU ARE RECOGNIZED, SIR. >> Public Speaker: HELLO EVERYONE. I APPRECIATE YOU HAVING ME. MY NAME IS PASTOR JOSIAH AND I'M THE SENIOR PASTOR OF [NAME] AND I AM ALSO A SICKLE-CELL PATIENT. I HAVE OF COURSE, YOU ARE BORN WITH THIS. I HAVE DEALT WITH THIS ALL MY LIFE BUT I HAVE ALSO HAD DOCTORS AND NURSES COME ASK ME HOW LONG HAVE I HAD SICKLE CELL DISEASE. I'VE ALSO HAD DOCTORS AND NURSES GO ON THE RECORD WITH ME AND OTHER SICKLE-CELL PATIENT TELLING US THAT THEIR EDUCATION AND THE SCHOOLBOOKS WAS JUST HALF A PAGE. WHILE OTHER DISEASES HAVE SEVERAL CHAPTERS. I'M SAYING THIS TO SAY TO YOU ALL THAT GOING INTO THE EMERGENCY ROOMS, WE ARE OFTEN MET WITH PEOPLE WHO JUST DO NOT KNOW HOW TO TREAT OUR DISEASE. I HAVE A VASCULAR PROCESS. BELIEVE IT OR NOT, AS LONG AS I LOOK, I'M NOT EVEN 40 YEARS OLD. 38 YEARS OLD AND YET I NEED A HIP REPLACEMENT IN BOTH HIPS AND I HAVE NEEDED THIS SINCE THE AGE OF 25 YEARS OLD. BUT YET DOCTORS WILL NOT GIVE ME THAT BECAUSE, AS WE KNOW, THE HIP REPLACEMENT WILL WEAR OUT IN THE FIELD THEY HAVE TO CUT ME OPEN EVERY 10 OR 15 YEARS. LEFT TO STRUGGLE WITH THE PAIN THAT COMES WITH IT. MY REASON FOR BRINGING THAT UP IS TO SAY BECAUSE OF THE LACK OF EDUCATION THAT GOES ON, I'M LEFT WITH A LOT OF HEALTHCARE WORKERS. LIKE YOU SAID, THEY DON'T KNOW HOW TO TREAT US, THEY DON'T KNOW WHAT TO DO. WITH THIS BILL IT WOULD ALLOW EDUCATION TO BE ABLE TO EDUCATE THEM A LITTLE BIT BETTER WITH SICKLE CELL DISEASE. SICKLE CELL WAS FOUND IN EVERY CONTINENT WHEN YOU PROCREATE WITH THE GENES. THIS COULD BE YOUR CHILD, THIS COULD BE YOUR GRANDCHILD. YOUR CHILD CAN PROCREATE WITH SOMEONE THAT HAS THE TRAIT AND THEN YOUR GRANDCHILD PROCREATES AND THIS COULD BE YOUR GREAT-GRANDCHILD WHO COULD HAVE SICKLE CELL DISEASE. I JUST WANT TO BE TREATED LIKE A HUMAN. TREATED THE WAY YOU WOULD LIKE TO BE TREATED WHEN YOU GO TO THE DOCTOR'S OFFICE TO FEEL BETTER. THAT IS WHY I AM ASKING YOU ALL TO PLEASE VOTE YES FOR THIS BILL. >> Chair Trumbull: THANK YOU PASTOR. PAULETTE KNOWLES? >> Public Speaker: GOOD AFTERNOON COMMITTEE. THANK YOU AGAIN. I'M HERE IN SUPPORT OF ASAP. I ALSO HAVE AN ORGANIZATION, JAMAR OR YEARS. JAMAR WARRIORS IS MY BONUS ON WHO PASSED AWAY FROM SICKLE CELL DISEASE AND MARISSA KNOWLES IS MY CURRENT DAUGHTER WHO IS 33, A SICKLE-CELL WARRIOR, SINGLE MOTHER. A REGISTERED NURSE. AGAIN, HER BATTLE OVER THE YEARS HAS BEEN UP AND DOWN. AT AGE 15 THEY TOLD ME TO TAKE MY DAUGHTER HOME AND PUT HER ON HOSPICE TO LET HER PARISH. BUT WITH GRACE AND GOD GIVING US STRENGTH SHE WAS ABLE TO SURVIVE AND CONTINUE TO THRIVE TO THIS DAY. AGAIN, SHE'S A REGISTERED NURSE, A SINGLE MOTHER AND I AM HER CAREGIVER. WE LOVE EACH OTHER, SHE LOVES HERSELF AND SHE WANTED TO SEE THE SAME THING THAT SHE CONTINUES TO THRIVE AND SURVIVE WITH THE EDUCATION SHE WOULD NEED TO BE IN OUR EN. SHE TOO WITH THIS BILL WOULD HAVE TO TAKE THE EDUCATIONAL COURSE TO CONTINUE ON TO BE A HEALTHCARE WORKER HERSELF. AS WELL AS MYSELF. I AM A HEALTHCARE PRACTITIONER. I WORK IN THE INDUSTRY AS WELL. I'M A PHLEBOTOMIST. I HAVE BEEN DRAWING BLOOD FOR 26 YEARS. I AM A COMMUNITY ACTIVIST. I AM A NURSING STUDENT. SO THE HEALTHCARE ARENA FOR ME IS EVERYTHING SPOKEN TODAY ALL FITS CONNECTED TO ME IN SOME FORM OR FASHION. I'M HERE TO SUPPORT ALL THE BILLS BECAUSE I WORK IT, I LIVE IT. I AM A CAREGIVER AS WELL AS A PARENT. MY DAUGHTER HAS SICKLE CELL DISEASE. I'M ASKING YOU ALL TO PLEASE SUPPORT CONTINUED EDUCATION WOULD HELP US ALL. MYSELF AS A HEALTHCARE PRACTITIONER AS WELL AS MY DAUGHTER IS AN RN, AS WELL AS A SICKLE-CELL WARRIOR THAT SHE IS. THIS BILL WILL BE VERY BENEFICIAL TO US AND A WHOLE LOT OF OTHER PEOPLE. THANK YOU. >> Chair Trumbull: ANAYA FERNANDEZ? >> Public Speaker: GOOD AFTERNOON CHAIRMAN, VICE CHAIR AND HONORABLE MEMBERS OF THE FLORIDA SENATE. MY NAME ANAIS FERNANDEZ PROGRESSED AND BEFORE YOU NOT AS A TALKING POINT, BUT AS A LIVING HUMAN BEING, A SICKLE-CELL WARRIOR ASKING YOU TO SEE THE HUMANITY BEHIND THE BILL. I'M HISPANIC AMERICAN OF CUBAN CHINESE DESCENT BORN WITH SICKLE CELL DISEASE. MY PAIN CRISIS THAT HAPPENED JUST THREE MONTHS OLD. BEFORE I COULD WALK, BEFORE I COULD SPEAK, PAIN WAS MY INTRODUCTION TO LIFE. YET THROUGH ALL MY LIFE DESPITE A LONG LIFE DIAGNOSIS, I HAVE BEEN TOLD I DON'T LOOK LIKE SOMEONE WHO HAS SICKLE CELL. I HAVE BEEN TOLD BY MEDICAL PROFESSIONALS THAT I DON'T HAVE THE DISEASE BECAUSE I'M NOT AFRICAN-AMERICAN. A GENETIC CONDITION REDUCED TO A RACIAL STEREOTYPE. SCIENCE IGNORED AND HUMANITY DISMISSED. THIS IS WHY FLORIDA MUST PASS SB 844. SICKLE CELL DISEASE DOES NOT CHECK RACE BEFORE IT ATTACKS THE BODY. IT DOES NOT CHECK INFANCY BEFORE IT CAUSES DAMAGE, CHRONIC PAIN, STROKES OR DEATH. IS GENETIC AND BIAS NOT. I WALKED IN THE FLORIDA EMERGENCY DEPARTMENT, ROOMS WITH UNBEARABLE PAIN. PAIN THAT TAKES MY BREATH AWAY. INSTEAD OF CARE WAS MET WITH SUSPICION. LABELED A DRUG SEEKER. TREATMENT DELAYED, DIGNITY DENIED. THIS IS NOT AN ISOLATED EXPERIENCE IT IS COMMON FOR SICKLE-CELL PATIENTS ACROSS THE STATE AND WHILE CARE IS DELAYED WARRIORS ARE DYING. WE ARE LOSING FRIENDS, WE ARE BEARING YOUNG PEOPLE. NOT BECAUSE MEDICINE DOESN'T EXIST BUT BECAUSE BELIEVE, URGENCY AND POLICY FAILS. THAT IS NOT A MEDICAL FAILURE, THAT IS A LEGISLATIVE ONE. SB 844 IS NOT ABOUT SPECIAL TREATMENT. IT'S ABOUT EQUAL AND INFORMED TIMELY CARE. IT'S ABOUT PROVIDERS, EDUCATION, STANDARDIZED PROTOCOLS AND ACCOUNTABILITY SO NO PATIENT IS DISMISSED. BECAUSE THEY DO NOT FIT SOMEONE ELSE'S NARROW EXPECTATION. I LIVE A WARRIOR LIFE I DID NOT ASK FOR. A LIFE OF HOSPITAL VISITS, CHRONIC PAIN, STRENGTH BUILT THROUGH SUFFERING AND THE GRACE OF GOD I AM STILL HERE AND MANY ARE NOT. SO RESPECTFULLY MADAME CHAIR AND SENATORS, TODAY I ASK YOU FLORIDA LAWMAKERS TO ACT. PASS SB 844. PASS IT FOR THE CHILDREN HAVING THEIR FIRST PAIN CRISIS BEFORE THEY CAN SPEAK. PASSIVE FOR THE PATIENTS WHOSE PAIN IS BEING QUESTIONED ASSISTED TREATED. PASS IT FOR THE WARRIORS WHO HAVE ALREADY LOST. FLORIDA HAS THE OPPORTUNITY TO LEAD WITH COMPASSION, SCIENCE AND JUSTICE. OUR PAIN IS REAL, OUR LIVES MATTER, OUR TIME IS NOW IN TODAY YOUR VOTE CAN CHANGE THE FUTURE FOR EVERY SICKLE-CELL PATIENT IN THE STATE. THANK YOU FOR YOUR TIME AND CONSIDERATION. >> Chair Trumbull: THANK YOU VERY MUCH. [NAME] >> Public Speaker: GOOD AFTERNOON SHARON COMMITTEE MEMBERS. THANK YOU FOR THE OPPORTUNITY TO BE HERE TO SPEAK TODAY IN SUPPORT OF SB 844. I'M PRESIDENT OF ADVANCING SICKLE-CELL ADVOCACY PROJECT. AN ORGANIZATION I HELPED START IN 2015 WHEN MY DAUGHTER TRANSITION TO ADULT CARE FOR PEDIATRIC AND I NOTICED THERE WAS A HUGE DISPARITY. VERSUS HOW SHE WAS TREATED AS A PEDIATRIC PATIENT VERSUS AN ADULT. I ADVOCATE NOT JUST FOR HER BUT MANY COUNTLESS OTHERS IN SOUTH FLORIDA LIVING WITH SICKLE CELL DISEASE. HONESTLY, LIVES ARE QUITE LITERALLY AT STAKE. ARE SICKLE-CELL COMMUNITY IS FIGHTING EACH AND EVERY DAY. NOT JUST AGAINST PAIN AND MEDICAL COMPLICATIONS BUT AGAINST A SYSTEM THAT HISTORICALLY OVERLOOKED AND UNDERSERVED THEM. WE CANNOT PASS THE BATON TO THE NEXT GENERATION WITH THE EXPECTATION THEY MUST BE PREPARED TO TOLERATE THE SAME NEGLECT. SICKLE-CELL WAS THE FIRST DOCUMENTED GENETIC BLOOD DISORDER IN THE US, HOWEVER, IT REMAINS -- AND REMAINS UNDER SERVED. WE TRULY UNDERSTAND SB 844 WILL NOT SOLVE EVERY PROBLEM BUT AS A CRITICAL NECESSARY STEP TOWARD EQUITY AND BETTER OUTCOMES FOR THOUSANDS OF FLORIDIANS LIVING WITH THIS DISEASE. ON BEHALF OF MY DAUGHTER AND EVERY SINGLE PERSON AFFECTED AND ON BEHALF OF A COMMUNITY THAT HAS WAITED FAR TOO LONG, I RESPECTFULLY URGE YOU TO VOTE YES ON SB 844. THANK YOU FOR YOUR TIME AND CONSIDERATION. >> Chair Trumbull: THANK YOU, MA'AM. KIMBERLY FRANCE? >> Public Speaker: GOOD AFTERNOON. THANK YOU CHAIR AND COMMITTEE MEMBERS FOR LISTENING AND THANK YOU FOR TAKING SBA 44 SERIOUSLY. MY NAME IS KIMBERLY FRANCE AND I LIVE WITH SICKLE CELL DISEASE. WHEN MOST PEOPLE HEAR SICKLE-CELL, THEY THINK IT'S JUST PAIN. BUT SICKLE-CELL IS NOT JUST PAIN. IT IS A FULL BODY ORGAN DAMAGING DISEASE. THIS DISEASE AFFECTS QUALITY OF LIFE. BECAUSE OF SICKLE-CELL I HAVE HAD MY GALLBLADDER REMOVED, I'VE HAD MY SURGERY AFTER LOSING VISION IN MY LEFT I, AND TODAY MY RIGHT EYE I STILL BLURRY. SICKLE-CELL HAS CAUSED SERIOUS DENTAL PROBLEMS. SOMETHING MANY MORE YEARS SILENTLY DEAL WITH. AND SURGERY TO REPLACE MY RIGHT HIP AND A HOLE DRILLED INTO MY LEFT ONE TO PREVENT FURTHER DETERIORATION DUE TO A VASCULAR NECROSIS. THIS HAS LEFT ME WITH CHRONIC PAIN WHICH IS HARD TO MANAGE. INSTEAD OF BEING UNDERSTOOD, I HAVE BEEN LABELED A DRUG SEEKER. TOO MANY HEALTHCARE PROVIDERS ARE NOT FULLY TRAINED ON HEALTH SICKLE-CELL AND PACS THE ENTIRE BODY AND MENTAL HEALTH. NOT JUST DURING A PAIN CRISIS. AND THAT IS WHY SB 844 MATTERS. IT'S NOT ABOUT BLAME COMMENTS ABOUT EDUCATION. EDUCATION LEADS TO FASTER CARE. EDUCATION LEADS TO BETTER OUTCOMES EDUCATION PROTECTS LIVES. THANK YOU FOR LISTENING, THANK YOU FOR TAKING THIS SERIOUSLY, AND I RESPECTFULLY ASK YOU TO VOTE YES ON SB 844. THANK YOU. >> Chair Trumbull: I HAVE ONE MORE APPEARANCE FORM. JILL, FLORIDA ASSOCIATION OF NURSE PRACTITIONERS WAIVING IN SUPPORT. SENATORS, WE ARE IN DEBATE. SEEING NO DEBATE YOUR RECOGNIZED THE CLOSED. >> Sen. Jones: I WAS GOING TO WAIVE CLOSE, BUT I DO WANT TO RECOGNIZE PASTOR JOSIAH FOR THE DEDICATION ON ALL THE SPEAKERS WHO HAVE COME UP FROM SOUTH FLORIDA. MR. CHAIR AND MEMBERS, THE ORGANIZATION THAT KIMBA HAS HELPED START, RECENTLY THEY DID A PRAYER BRUNCH. IF YOU COULD HAVE BEEN THERE TO HEAR THE TESTIMONIES FROM THE SICKLE-CELL WARRIORS. THEIR STORIES, STORIES FROM THEIR PARENTS, STORIES FROM THOSE WHO LOST THEIR LOVED ONES TO SICKLE-CELL, THERE WASN'T A DRY EYE IN THAT ROOM. AND SO TO YOU, THANK YOU. CHAIR BURTON FOR GETTING THIS BALL ROLLING AND AM HOPING WE CAN GET THE BILL ACROSS THE FINISH LINE. WE KNOW THIS WILL NOT SOLVE ALL THE PROBLEMS, BUT IT WOULD ABSOLUTELY DO THE EDUCATING NECESSARY FOR THE DOCTORS WHO TREAT SICKLE-CELL PATIENTS. >> Chair Trumbull: HAVE ENCLOSED ON THE BILL, ROBIN, WOULD YOU PLEASE CALL THE ROLL? >> Sen. Brodeur: YES. >> Sen. Burton: YES. >> Sen. Garcia: YES. >> Sen. Harrell: YES. >> Sen. Rodriguez: YES. >> Sen. Rouson: YES. >> Vice Chair Davis: YES. >> Chair Trumbull: YES. BY YOUR VOTE SHOW CS FOR SENATE BILL 844 IS REPORTED FAVORABLY. >> Sen. Jones: THANK YOU CHAIR, THANK YOU MEMBERS. >> Chair Trumbull: TAB FOUR SENATOR GARCIA, YOUR RECOGNIZED TO EXPLAIN CS SENATE BILL 560. >> APPRECIATE YOU. IF IT'S OKAY WOULD >> Chair Trumbull: IT IS NOT A STRIKE ALL, CORRECT? >> NO. LET'S DO THE UNDERLYING BILL. IS THAT OKAY? >> THE BILL BASICALLY STREAMLINED PROCEDURES TO PROVIDE FOR CONTINUOUS PSYCHOTROPIC MEDICATION PRESCRIPTION FOR A CHILD AND LEGAL CUSTODY OF THE DEPARTMENT OF CHILDREN AND FAMILIES PICK STATUTE 39.407 GOVERNING THIS CAN BE OVERLY COMPLEX IN THE WORK DUPLICATIVE, CREATING DELAYS AND CARE AND UNNECESSARY ADMINISTRATIVE BURDENS. THE BILL ADDRESSES INEFFICIENCIES TO ENSURE TIMELY TREATMENT AND CLEAR STANDARDS. THE BILL CLARIFIES WHEN A NEW MEDICAL REPORT AS NEEDED, DOCTORS AND PSYCHIATRIC NURSES ARE TREATED AS ONE PRESCRIBER REDUCING UNNECESSARY DUPLICATE REPORTS. THE BILL MAKES A NEW MEDICAL REPORT NEEDED WHEN THERE IS A CHANGE IN DOSAGE TYPE OF MEDICATION MANAGEMENT OF ADMINISTRATION OR PRESCRIBER. THE BILLS TO MINE STANDARDS THE LICENSING AND CLARIFIES THE EXPERIENCE NEEDED OF EVALUATORS AT RESIDENTIAL TREATMENT CENTERS, THERAPEUTIC GROUP HOMES AND HOSPITALS. EVALUATORS MUST BE A PSYCHIATRIST OR PSYCHOLOGIST LICENSED IN FLORIDA WITH THREE YEARS OF EXPERIENCE IN THE DIAGNOSIS AND TREATMENT OF SERIOUS EMOTIONAL DISTURBANCES IN CHILDREN AND ADOLESCENTS. THE BILL MANDATES CHILDREN IN THE CARE I DEPARTMENT OF CHILDREN AND FAMILIES WERE IN THE CONTINUING CARE OF THE DEPARTMENT AND EXTEND THE FOSTER CARE UNDER 21 WILL NO LONGER NEED REPEATED BACKGROUND CHECKS ARE CUTTING DOWN DUPLICATIVE SCREENINGS. THE BILL CHANGES THAT PHYSICIANS PRESCRIBE INSIGHT BUT PSYCHOTROPIC MEDICATION MUST NOW PROVIDE THE PHARMACY WITH A COPY OF THE PARENT OR GUARDIAN'S CONSENT. INSTEAD OF ASSIGNED AS TEST STATION SIMPLE FIND PROCESS THAT IS THE BILL. >> Chair Trumbull: WOULD YOU BE WILLING TO PRESENT YOUR AMENDMENT ON BARCODE 64074? >> DEFINITELY. WHAT IT DOES IS BASICALLY STRIKES A LANGUAGE THAT EXPANDS THE POST SECONDARY SERVICES IN SUPPORT OF TPSS, WHICH WAS A CONCERN FOR SENATOR HARRELL IN THE LAST COMMITTEE STOP. SO WE CLEANED IT UP AND ARE JUST FOCUSING ON THIS. >> Chair Trumbull: WONDERFUL. ARE THE QUESTIONS ON THE AMENDMENT? I DON'T HAVE ANY APPEARANCE FORMS. WE ARE IN DEBATE. YOUR RECOGNIZED TO CLOSE. WITHOUT OBJECTION SHOW THE AMENDMENT ADOPTED. ARE THERE QUESTIONS ON THE UNDERLYING BILL? SEEING NONE, I HAVE ONE APPEARANCE FORM. GEORGE. HEALTHCARE. WAIVING IN SUPPORT. WE ARE IN DEBATE, SENATORS. SEEING NO DEBATE, YOUR RECOGNIZED THE CLOSE. >> THANK YOU. BASICALLY THE BILL HELPS ENSURE WE CLEAN UP THE PROCESS WELL MONITORED CARE AND PRESCRIBED PSYCHOTROPIC MEDICATIONS AT HAND. THE BILL SIMPLIFIES PROCEDURES, REDUCES REDUNDANCY AND IMPROVES CARE FOR VULNERABLE CHILDREN WHILE MAINTAINING STRONG SAFEGUARDS AND THAT IS THE BILL. >> Chair Trumbull: HAVE ENCLOSED ON HER BILL, ROBIN, WOULD YOU CALL THE ROLL CALL? >> Sen. Brodeur: YES. >> Sen. Burton: YES. >> Sen. Garcia: YES. >> Sen. Harrell: YES. >> Sen. Rodriguez: YES. >> Sen. Rouson: YES. >> Sen. Sharief: YES. >> Vice Chair Davis: YES. >> Chair Trumbull: YES. BY YOUR VOTE WE SHOW CS FOR SENATE BILL 560 IS REPORTED FAVORABLY. SENATORS, THAT DOES IT FOR OUR AGENDA TODAY. DOES ANY SENATOR WISH TO BE RECORDED ON BILLS? >> AFFIRMATIVE ON TAB EIGHT, TAB 12, TAB 10, 1011, THREE AND TWO. >> Chair Trumbull: SENATOR RODRIGUEZ. >> Sen. Rodriguez: I WOULD LIKE TO BE RECORDED IN THE AFFIRMATIVE ON TAB FIVE. >> Chair Trumbull: I'VE NEVER DONE THIS BUT I WOULD LIKE TO BE RECORDED AS VOTING IN THE AFFIRMATIVE ON TAB TWO, THREE AND FIVE. AND WITHOUT OBJECTION WE WILL SHOW THAT MOTION IS ADOPTED. SEEING NO OTHER BUSINESS BEFORE OUR COMMITTEE, SENATOR HARRELL MOVES WE ADJOURN. WITH THAT, THAT MOTION IS ADOPTED.