“A few steps forward, a few steps back,” Rep. Dotie Joseph reviews the 2021 Florida legislative session

Rep. Dotie Joseph shared updates from Florida’s legislative session and looked ahead to the next session at the 2021 Florida State of Reform Health Policy Conference. Rep. Joseph, the ranking member of the House Finance and Facilities Subcommittee, spoke on issues ranging from expanding Medicaid and addressing maternal mortality, to supporting behavioral health, particularly in schools.

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Rep. Joseph says she’s optimistic about the budget, sharing that legislators were uncertertain at first of COVID-19’s impact on state funds. However, the estimating conference assured more funds than legislators had originally expected, along with additional federal funds from the American Rescue Plan Act.

This year, Democrats aimed to pass a number of bills, including CH/HB 899, which calls for managed care plans to codify data based on a patient’s race, age, primary language, and other identifying factors. The bill passed in the House but died in the Senate. Rep. Joseph said:

“That kind of data is going to be the kind of information that helps us address health care disparities.”

HB 1155, which passed the House but died in the Senate, would fine Pharmacy Benefit Managers (PBM) $10,000 if they fail to register with the state. The House successfully passed HB 485, which reforms the training and retention of state Certified Nursing Assistants and allocates funds to expand Medicaid coverage for mothers from two months to a year postpartum.

The state could still improve in some areas, Rep. Joseph said. For example, only one bill, CS/HB 1447, provided support for behavioral health in schools, leaving many school districts to enact those measures on their own.

Additionally, CS/HB 1071, a bill that Rep. Joseph co-sponsored and ultimately did not pass, aimed to expand Medicaid coverage to former fostered youth. Rep. Joseph urged the GOP-controlled legislature to reconsider reasons for not expanding Medicaid.

“I think part of what’s driving this [delay in Medicare expansion] is an inherent disconnect between the needs of the people, versus their personal experiences…[Most legislators] don’t understand the ramifications, financial or otherwise, of having to use your emergency health care system as your primary or maintenance care system.”

Looking ahead, addressing disparities in Florida health care will be Rep. Joseph’s top priority going into the next session. One solution she highlighted would require regular certification benchmarks for providers, to ensure that they are properly addressing implicit bias when assessing patients.

“If you are providing primary or maintenance care, I want to make sure you have the tools you need to understand these little cultural nuances. How certain populations may underreport their pain, or how you might be inclined to overmedicate somebody or undermedicate somebody based on some preconceived notions about pain.”