LEADINGAGE FLORIDA LEGISLATIVE PRIORITIES
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2021 Legislative Session
Legislative Bulletin
Week Six: April 9, 2021
Joel L. Anderson, Chair | Steve Bahmer, President/CEO
1812 Riggins Rd | Tallahassee, FL 32308 | P: (850) 671-3700 | F: (850) 671-3790
LeadingAge Florida Legislative Priorities
COVID-19 Healthcare Provider Liability Protections
LeadingAge Florida supports reasonable, limited liability protections for long-term care
providers for their extraordinary efforts to offer the best possible frontline care in an ever-
changing environment.
As previously reported, SB 72 by Sen. Brandes (R-St. Petersburg) relating to Civil Liability
for Damages Relating to COVID-19, became law upon being signed by Governor DeSantis last
week. Earlier this week, LeadingAge Florida hosted a webinar, “Florida’s COVID-19 Liability
Immunity Law – Are You Safe?” highlighting the importance of the new law and discussing the
protections outlined in both the business and health care provider provisions. A recording of this
important and informative event is available to LeadingAge Florida members on the COVID-19
page on our website under Members Only Documents.
The new law provides liability protections for both general businesses and health care providers. It
retains the provisions and procedures for civil liability claims in the authorizing statutes for nursing
homes (chapter 400) and assisted living facilities (chapter 429) and layers on the enhanced
liability protections. To the extent that there are any conflicts, the provisions of the COVID-19
liability protections in the bills prevail over chapters 400 and 429. Enhanced liability protections
include a gross negligence standard, particular pleading requirements, affirmative defenses which
provide immunity, and a one-year statute of limitations. CCRCs have also been included as a
health care provider.Affordable Housing Trust Funds
As a member of the Florida Housing Coalition, LeadingAge Florida opposes sweeping any
of the $423 million anticipated for low-income housing to other state priorities and
supports legislative efforts to prohibit the transfer of trust funds for other purposes.
SB 510 by Sen. Hooper (R-Palm Harbor) and HB 13 by Rep. Killebrew (R-Winter Haven)
relating to State Funds prohibit the transfer or use of the state and local housing trust money for
any other purpose. While these bills will not pass the Legislature, the message of prohibiting the
sweep of affordable housing funds for other purposes was heard by legislators and included in a
bill passed this week by the Legislature. SB 2512 by Appropriations Committee relating to
Documentary Stamp Tax Distributions revises the distribution methodology for documentary
stamp funds by diverting some of the funds to sea level mitigation and wastewater programs.
SB 2512 distributes two-thirds of the revenue from the documentary stamp tax paid on all real
estate transactions that currently goes into the Sadowksi Trust Fund to bolster affordable housing
to the newly created Resilient Florida Trust Fund and the Water Sustainability and Accountability
Trust Fund. The remaining one-third would continue to go for affordable housing. In exchange,
there is an assurance that the affordable housing trust funds will no longer be eligible to be
"swept," a practice where unspent money is diverted to general revenue to plug budget holes or
fill other needs.
Medicaid Funding For Nursing Homes
LeadingAge Florida supports continued funding of the recurring inflationary rate increase
contained in the FY 2020-21 budget.
LeadingAge Florida is working to secure the Medicaid funding proposed in the Governor’s
recommended budget as presented to the Legislature. This funding will help ensure Florida’s
seniors continue to have access to the highest quality of care and offset some of the additional
costs that have resulted from the COVID-19 pandemic.
It is now more important than ever that the Legislature retain the nursing home Medicaid
inflationary increase from the FY 2020-2021 budget.
During the COVID-19 pandemic, nursing homes in Florida have been on the front lines
doing everything they can to protect and care for the most vulnerable.
Before the pandemic, Medicaid underfunded the cost of care in nursing homes by $13.79
per patient per day.
Occupancy levels have gone down by 15% since this pandemic hit; but expenses have
increased significantly.
Operating costs for long-term care providers increased substantially this year, including
increased operational fixed costs and increased expenses for personal protective
equipment, infection control supplies, testing and staffing, because of the pandemic.
LeadingAge Florida continues our efforts to retain the inflationary rate increase that was
distributed equally among all nursing homes providers in the FY 2020-2021 budget. We are also
working on efforts for enhanced one-time funding for nursing homes from the American Rescue
Plan. Further, we are requesting a one-year delay in the implementation date of the next phase of
the Prospective Payment System, as it will add still another financial burden to Florida’s high-
quality providers.
The House and Senate health care appropriations bills have passed the House and Senate and
are now in a position to go to the Budget conferences to work out the differences. The House’s
position is to reduce nursing home Medicaid funding by 2% ($31 million in recurring General
Revenue and $49+ million in Federal funds for a total of $80.4 million). The Senate makes no
reductions to nursing home funding.Nursing Home Workforce Shortage – Personal Care Attendant
LeadingAge Florida supports HB 485 by Rep. Garrison (R-Orange Park) and SB 1132 by
Sen. Bean (R-Jacksonville) authorizing nursing homes to hire personal care attendants
(PCAs) if certain training requirements are met. LeadingAge Florida supports making this
program permanent, rather than ending when the COVID-19 State of Emergency expires.
The workforce shortage in long-term care is an ongoing challenge that has been exacerbated by
the COVID-19 pandemic. One initiative designed to help alleviate workforce pressures during the
pandemic, the Personal Care Attendant (PCA) program, was approved by the Agency for Health
Care Administration in March 2020.
Over the past year, this program has become a valuable way to extend and support other nursing
home direct caregivers. The PCA program currently consists of an 8-hour training course (5 hours
classroom and 3 hours hands-on-competency checks) and continued on-the-job training. A PCA
will perform basic resident care procedures to support the CNAs in a community.
HB 485 and SB 1132 allow nursing homes to employ personal care attendants (PCA) and to allow
a PCA to work as a nursing assistant (and count as a certified nursing assistant (CNA) for the
purposes of staffing requirements) for a period of up to four months if the PCA is participating in
the PCA training program established by the Agency for Health Care Administration in
consultation with the Board of Nursing.
As amended in committee, the training program must consist of at least 16 hours of education.
The bills define a PCA as a person who provides care to and assists residents with tasks related
to the activities of daily living and prohibit a PCA from performing any task that requires clinical
assessment, interpretation, or judgment, or from working as a PCA for more than one nursing
home before becoming a CNA. The Agency for Health Care Administration is given rulemaking
authority to implement the program, and is authorized to continue the program currently in
operation if the state of emergency is terminated prior to AHCA adopting rules to implement the
PCA training program.
The House bill, HB 485, specifies that a PCA must complete the 16 hours of education prior to
having any direct contact with a resident.
SB 1132 has one more committee of reference.
HB 485 has been placed on the House Calendar.
Activity on Bills Monitored by LeadingAge Florida
Pandemic Protections/Related Bills
Protecting Consumers Against Fraud
HB 9 by Rep. Zika (R-Land O’Lakes) and SB 1608 by Sen. Bean (R-Jacksonville) relating to
Protecting Consumers Against Pandemic-related Fraud prohibits the dissemination of false or
misleading information relating to personal protective equipment and vaccines and authorizes the
state attorney or statewide prosecutor to prosecute violators. This legislation is intended to guard
against situations such as one that occurred recently where scammers created fake Eventbrite
accounts posing as various county health departments in an effort to get people to pay money for
COVID-19 vaccinations.HB 9 is now on Calendar in the Senate. SB 1608 is in the Senate Rules Committee. House Committee on Pandemics & Public Emergencies – Committee bill on Emergency Management HB 7047, by the Pandemics & Public Emergencies Committee, is a comprehensive bill relating to Emergency Management that amends the State Emergency Management Act to better address the threat posed by pandemics or other health emergencies. The bill also would require the governor to justify closing schools and businesses, require a state-owned stockpile of personal protective equipment, establish an Emergency Preparedness and Response Fund and direct the Department of Health to create a comprehensive public response guide for future crises. The bill incorporates other legislative proposals under consideration this session, including the bills requiring the Department of Emergency Management to maintain an inventory of state-owned Personal Protective Equipment (HB 1353), and limiting the types and duration of any significant emergency order issued by local governments (HB 945). Other provisions give the Governor more flexibility regarding budget decisions during an emergency and make the State Health Officer responsible for reporting the number of cases and deaths. Further, the Department of Health is to create a comprehensive public response guide for future crises. The bill requires that emergency orders, proclamations and rules list the statute or rule that is being amended or waived and post the emergency proclamations and rules online in a searchable format. The legislation seeks to improve state preparation for a pandemic or public health emergency and ensure that the state’s emergency management system and response efforts are as transparent and as accountable as possible. HB 7047 has one more committee of reference. The companion bill, SB 2006 by Sen. Burgess (R-Zephyrhills) has passed all of its committees of reference. The bill has been amended to conform to the House Bill. Provisions included in SB 1924 which, in part ,would require local governing bodies to vote to extend emergency orders after 10 days and give the governor or the Legislature the power to invalidate the orders, were amended onto SB 2006. Personal Protective Equipment HB 1353 by Rep. Yarborough (R-Jacksonville) and SB 1760 by Sen. Albritton (R-Bartow) relating to Personal Protective Equipment requires the Department of Emergency Management to ensure availability of personal protective equipment during a declared emergency caused by infectious or communicable disease and requires such equipment be available for purchase at certain cost by healthcare practitioner. It also prohibits such equipment from being resold at a price that exceeds the purchase price. HB 1353 and SB 1760 are now included in HB 7047 and SB 2006. Emergency Management Powers of Political Subdivisions HB 945 by Rep. Rommel (R-Naples) and SB 1924 by Sen. Diaz (Hialeah Gardens) relating to Emergency Management Powers of Political Subdivisions require that a significant emergency order issued by a political subdivision be narrowly tailored and limited in duration, applicability, and scope to reduce any infringement on individual liberty to the greatest extent possible. The bill also provides that a significant emergency order automatically expires 7 days after issuance but may be extended, as necessary, in 7-day increments for a total duration not to exceed 42 days. Currently, local states of emergency can be ordered for seven days and extended indefinitely in seven-day increments as needed. SB 1924 requires majority votes of local governing bodies to extend emergency orders after 10
days and gives the governor or the Legislature the power to invalidate the actions.
HB 945 and SB 1924 are now included in HB 7047 and SB 2006.
Emergency Preparedness and Response Fund
SB 1892 by Sen. Diaz (R-Hialeah Gardens) and HB 1595 by Rep. Williamson (R-Pace)
relating to Emergency Preparedness and Response Fund create a new pool of money for
emergencies, separate from the state’s “rainy day” fund, in the Governor’s office. The Emergency
Preparedness and Response Fund is to be used as a depository for moneys specifically
appropriated to the fund. The moneys deposited in the fund are available as a primary funding
source for the Governor for purposes of preparing or responding to an emergency that exceeds
regularly appropriated funding sources.
Both bills have passed their committees of reference and are now on Calendar in their respective
Chambers.
Other Bills Of Interest
Assisted Living Facilities
SB 1830 by Sen. Jones (D-Miami Gardens) and HB 1151 by Rep. Buchanan (R-North Port)
relating to Assisted Living Facilities both create a “Medication technician” as an unlicensed
staff person who, after completion of 6 hours of training approved by AHCA, may provide
assistance with a resident’s self-administration of medications and use of point-of-care devices. In
addition, SB 1830 authorizes managed care plans to use funds appropriated by the Legislature to
pay ALFs a rate that reflects the medical acuity and complexity of each resident which must be
based on a three tiered reimbursement payment system for care.
HB 1551 has passed out of its first committee of reference but has not yet been scheduled to be
heard in its second committee of reference. SB 1830 passed its first committee of reference this
week. Given that this is the end of the sixth week of Session, it is very unlikely that these bills will
move any further in the process.
Sales and Use Tax
SB 50 by Sen. Gruters (R-Sarasota) and HB 15 by Rep. Clemons (R-Jonesville) relating to
Sales Tax require retailers that sell above a certain amount of product into Florida through remote
means, such as through an online store, to collect and remit sales tax. SB 50 passed the
Legislature this week.
SB 50, as amended through the process, requires the sales tax from out-of-state retailers to be
collected and deposited into Florida’s Unemployment Compensation Trust Fund annually until the
Trust Fund is replenished to pre-pandemic levels; thereby, avoiding an unemployment tax hike on
businesses. Further, the bill provides that two months after the trust fund reaches $4.07 billion,
the tax rate on commercial real property rentals is reduced from 5.5 percent to 2.0 percent.
Sales and Use Tax Exemption
SB 224 by Sen. Berman (D-Boynton Beach) and HB 81 by Rep. Casello (D-Boynton Beach)
relating to a Sales and Use Tax Exemption exempt from sales and use tax specified items that
assist in independent living.
SB 224 has passed its second committee of reference. HB 81 has not been heard in committee.
Given that this is the end of the sixth week of Session, it is very unlikely that these bills will move
any further in the process.Ad Valorem Tax Exemption for Nonprofit Homes for the Aged HB 571 by Rep. Smith (D) (R-Winter Springs) and SB 1330 by Sen. Rodriguez (A) (R-Doral) relating to Ad Valorem Tax Exemption for Nonprofit Homes for the Aged revise eligibility for the ad valorem tax exemption for property used as a home for the aged by nonprofit corporations to include property owned by a Florida limited partnership where an entity wholly owned by a corporation not-for-profit under ch. 617, F.S. is the sole general partner. Further, the bill reduces the minimum age requirement for the exemption for a unit or apartment occupied by a couple from requiring at least one member of the couple to be at least 62 years of age to requiring at least one member of the couple to be at least 55 years of age. HB 571, as amended in committee, retains the minimum age requirement of 62 years of age. The bill has been reported favorably out of its first two committees of reference. SB 1330 was reported favorably out of its first committee of reference this week. Tax Holidays Earlier this Session,the Senate Finance and Tax Committee approved bills that provide sales tax “holidays” for purchasing back-to-school clothes and supplies and disaster-preparedness needs. House companion bills have not been filed but the Senate and House likely will negotiate on the issue as they work on a budget and tax package. SB 734 by Sen. Joe Gruters, (R-Sarasota), provides for a documentary stamp tax exemption on federal loans made in response to a state declaration of emergency made by the Governor, and provides a sales taxes exemption from May 28 through June 13 on disaster-preparedness supplies such as tarps costing $50 or less; packages of batteries costing $30 or less and portable generators costing $750 or less. The period is geared to the June 1 start of the 2021 hurricane season. A staff analysis said the holiday would reduce state revenues by $20 million and local revenues by $6 million. The back-to-school proposal SB 598 by Sen. Keith Perry (R-Gainesville), provides a sales tax exemption, July 30 through Aug. 8, on clothes costing $60 or less, school supplies costing $15 or less and personal computers costing $1,000 or less. A Senate staff analysis said the proposal would reduce state tax revenues by $51.5 million and local revenues by $15.5 million. Dementia-related Training HB 309 by Rep. Byrd (R-Jacksonville) and SB 634 by Sen. Gibson (Jacksonville) relating to Dementia-related Staff Training create or revise training requirements for all employees of nursing homes, home health agencies, hospices, ALFs, adult family-care homes, and adult day care centers, not just those who have direct contact with individuals with ADRD. HB 309 has been heard in and passed out of its first committee of reference. HB 309 was temporarily postponed in its second committee of reference last week, and has not been scheduled for a hearing in its second committee of reference. SB 634 was amended and passed out of its second committee of reference. It has not been scheduled at this point for another hearing. LeadingAge Florida is working with the sponsors, the Alzheimer’s Association and the other long- term care and other provider associations to address concerns regarding the scope of the bill, increased training-related costs to providers and the need for clarifications on certain provisions. Alzheimer's Disease and Dementia-Related Disorders Education HB 627 by Rep. Salzman (R-Pensacola) and SB 874 by Sen. Brodeur (R-Lake Mary) relating to
Alzheimer's Disease and Dementia-Related Disorders Education require the Department of Health, in partnership with Department of Elderly Affairs & the Alzheimer's Association, to provide specified information relating to creating awareness about Alzheimer's disease & dementia- related disorders to certain licensed health care providers. SB 874 has passed out of its first committee of reference. HB 627 has passed all of its committees of reference and is scheduled to be heard by the House on Thursday, April 15th. PACE HB 905 by Rep. Rommel (R- Naples) and SB 1242 by Sen. Book (D-Plantation) relating to PACE codifies the Program of All-Inclusive Care for the Elderly (PACE) in section 430.84, FS. This program is not currently outlined in statute and has been operating through the annual appropriations process. The bill codifies current practice without making substantive modifications. HB 905 passed the House and has been referred to the Senate Appropriations Committee. SB 1242 has passed out of two committees of reference but has not yet been scheduled to be heard in the third committee of reference. Medicaid SB 1292 by Sen. Bean (R-Jacksonville) relating to Medicaid included a provision amending the nursing home rate setting section to remove a requirement that AHCA report annually to the Legislature the direct and indirect care costs, including average direct and indirect care costs per resident per facility and direct care and indirect care salaries and benefits per category of staff member per facility; however, this provision was removed from the bill. HB 1057 by Rep. Garrison (R-Orange Park) relating to Agency for Health Care Administration is a companion bill to SB 1292; however, it does not include a provision deleting the AHCA annual report requirement relating to the direct and indirect care costs per facility. HB 1057 has passed out of all of its committees of reference and is scheduled to be heard by the full House on Thursday, April 15th. SB 1292 has passed favorably out of its first two committees of reference. Protection of Elderly Persons and Disabled Adults HB 1041 by Rep. Burton (R-Lakeland) and SB 1344 by Sen. Burgess (R-Zephyrhills) relating to Protection of Elderly Persons and Disabled Adults strengthen existing laws relating to protection of vulnerable individuals from abuse as it relates to wills, estates and trusts. HB 1041 is scheduled to be heard by the full House on Thursday, April 15th. SB 1344 has passed out of its second committee of reference but has not been scheduled for a hearing in its final committee of reference. Elder-focused Dispute Resolution Process HB 441 by Rep. Hage (R-Oxford) and SB 368 by Sen. Baxley (R-Ocala) relating to Elder- focused Dispute Resolution Process, offer families with aging loved ones an alternative to court-appointed guardianship to work out conflicts on matters such as housing, finances and healthcare. The bills would allow courts to assign trained coordinators to talk issues out among family members, avoiding the courtroom. HB 441 has passed all of its committees of reference and is on the House Calendar. SB 368 has one more committee of reference.
Broadband Internet Deployment HB 753 by Rep. Clemons (R-Jonesville) relating to Broadband Internet Deployment creates the Florida Broadband Opportunity Program within the Office of Broadband (within the Department of Economic Opportunity) to award grants to applicants who seek to expand broadband Internet service to unserved and underserved areas of the state. The grants are to be used for the installation and deployment of infrastructure that supports broadband Internet service. Recognizing the role broadband Internet service plays in delivering health care services, the bill provides that the Office may prioritize applications that offer new or substantially upgraded service to important community institutions including healthcare facilities. HB 753 has passed its first two committees of reference. SB 1560 by Sen. Ausley (D-Quincy) and HB 1339 by Rep. Goff-Marcil (D-Maitland) relating to Broadband Internet Service require the Office of Broadband within the Department of Economic Opportunity to develop geographic information system maps to illustrate current broadband availability. SB 1560 has passed its first two committees of reference. SB 2004 by Sen. Burgess (R-Zephyrhills) relating to Broadband Internet requires the Florida Office of Broadband’s strategic plan to include short-term and long-term goals for increasing the availability of and access to broadband Internet service in this state and requires the updated plan to be submitted to the Governor, the Chief Justice of the Supreme Court and the Legislature by a specific date. The office is also directed to identify available federal funding for the expansion or improvement of the service. It is reported that, according to the FCC, while Florida's urban areas have broadband coverage rates of 98%, in rural areas, the coverage rate is under 80%. SB 2004 has passed its first two committees of reference. Budget - FY 2021-2022 General Appropriations Act Coming into the final three weeks of the session, the House and Senate passed their budgets and now move to negotiating the FY 2021-2022 budget through the conference committee process. After months of worrying about a big budget hole because of the coronavirus pandemic, state lawmakers anticipate $2 billion more in tax revenue than previously forecast, months after facing the prospects of a major budget shortfall. While economists increased general revenue estimates Tuesday, the state still faces financial fallout from the COVID-19 pandemic such as an increase in Medicaid caseloads and the potential that tourism, particularly from overseas travelers, might not return to “normal” levels until the 2022-2023 fiscal year. On Thursday, the House approved its $97 billion spending plan (HB 5001), a day after the Senate unanimously backed a $95 billion package (SB 2500). The House budget includes $4.4 billion in federal dollars for increased Medicaid costs and COVID-19 response money for the Department of Education. The House health care budget total $42.1 billion, which is an increase of 7.3% in total spending and a 10.9% increase in General Revenue funds from the FY 2020-21 budget. The budget reduces hospital funding and includes a 2% reduction in nursing home funding. There is also $4.1 million to serve approximately 425 additional elders in the Alzheimer’s disease Initiative and community care for the elderly. The Senate budget totals $94.9 billion and does not include the $10 billion in federal relief money. The Senate health care budget is a total of $42.3 billion including $11.7 billion in general revenue, which is an increase of $3.4 billion or 9% over the previous year which goes to the 900,000 new Medicaid enrollees. It reduces hospital rates by 7.5%. The House and Senate have some large differences in the health care and education budgets,
and there will be a lot of discussion during the coming days on how to handle the $10 billion the
state is expected to get from the American Rescue Plan Act, the federal stimulus law. The House
proposal would direct $3.5 billion of the stimulus money for deferred maintenance needs at state
and school facilities. Among other things, it would provide $2 billion to offset revenue losses in the
state transportation trust fund; provide $1 billion to fund a new Emergency Preparedness and
Response Fund in the governor’s office; and provide $630 million for environmental programs that
include beach re-nourishment, resiliency and septic-to-sewer conversions.
The Senate hasn’t detailed plans for the stimulus money, but President Simpson said it could go
into transportation and water infrastructure, along with reserves.
A Week in Review – News from the Capitol
Below is an overview of events that took place at
the Capitol during the sixth week of the 2021
Legislative Session.
Weekly Rundown
Good news arrived this week when the state’s
economists increased the Florida’s revenue
forecast by $2 billion.
Citing a “faster than expected recovery”, most of the additional funds are from higher sales tax
collections boosted by consumer spending and corporate earnings. On Wednesday and
Thursday, both chambers approved their respective budgets, putting them in the posture to begin
work on the final budget proposal. It remains to be seen if the increased revenue will pave the
way for less intense negotiations.
Both chambers advanced legislation prohibiting social media platforms from de-platforming
candidates and establishing large fines for each day of violation. The legislation is a result of
several instances during the 2020 election cycle of platforms censoring users. The bills also
require the platforms to publish their standards on censorship and inform users before changing
them.
Finally, data privacy legislation moved forward in the Senate after the adoption of an amendment
limiting the bill’s scope. The bill now applies to businesses that annually buy and sell the personal
information of 100,000 or more consumers, households, or devices; and derive 50% or more of its
global annual revenues from selling or sharing personal information about consumers. Most
significant was the removal of the provision that allowed for private causes of action.
Copyright 2021 — Publication of LeadingAge Florida
Chair: Joel L. Anderson
President/CEO: Steve Bahmer
Managing Editor: Nick Van Der LindenCopyright Information: Copies of the articles and other information in this publication may be non-commercially
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