County health departments face legislative overhaul

Feb 9, 2012

A bill that would shift public-health responsibilities from the Florida Department of Health to the state’s 67 counties is moving through the Florida House. But, as Sascha Cordner reports, opponents believe the public’s health should stay right where it is.

Republican Representative Matt Hudson, the bill’s sponsor, says right now, the county health departments have two bosses, the state’s surgeon general and the county commissioners. He says the locals are better equipped to address the needs of their community:

I can tell you that my counties that I represent, Collier and Broward, they often times ask for more home-rule. They often times want to have less being passed down from the state government and have more control at the local level to address their local concerns and have the ability and the authority do that. This bill gives them that.”

But, Leon County Commissioner Bryan Desloge says while he appreciates the gesture, counties, like his own, have a problem with whether the funding for such an undertaking is going to be there.

“If a year from now, we suddenly we run out of funding, it becomes very problematic for us. And, in Leon County, there’s a 170 employees in our health department. We now would have to take over all the HR and the payroll and all the other issues associated with adding employees. And, we’re a reasonable mid-size county, but some of the other counties are going to struggle with how to manage new employees and that type of thing.”

Acting Deputy Secretary for the Department of Health, Lucy Gee, says her department does not yet have an official position on House Bill 1263 and is currently reviewing the 152-page bill. But, so far, what troubles the department are the thousands of state workers who may be affected by the legislation.

“At a cursory glance, the overall philosophy of the bill is intriguing, but we expect there will be a number of concerns expressed by the counties.  Additionally, in decentralizing the county health departments, the bill would effectively eliminate more than 12-thousand state employee jobs.  We’re working to determine the fiscal impact that would have in terms of leave payouts.”

Hudson’s bill also makes changes to several programs, including the Children’s Medical Services Program. But, Lisa Cosgrove, the President of Florida’s Chapter of the American Academy of Pediatrics, worries about what the change might mean.

“We have been disappointed from the support that we’ve received from DOH in the past, but we believe that if you move the CMS from DOH that it would be a problem. The Pediatric Society does support a concept for provider service networks, but we don’t believe the time is right quite yet.”

Bill sponsor Hudson says that’s not a requirement. It just gives the Department of health an option of having children’s care managed at the local level. Hudson also says what opponents are saying does not make sense:

“One comment that was made that they were disappointed in DOH, but still didn’t think this was the right time to change anything. I find that to be somewhat of a conundrum. We don’t like what we have, but we don’t change anything. Hmmm…weird.”

But, in addition to the public health officials and counties, Governor Rick Scott, so far, does not look like he’s going to support the bill either:

“I’m trying to figure out what it does. Does it improve quality? Does it reduce costs? Does it improve service? If it doesn’t do something that is going to make the lives of Florida citizens better, why would we think about doing that? I haven’t seen anything in the bill that does any of those things.”

The bill passed largely along party lines on a 7 to 4 vote in its first committee stop, with Republican Vice Chair Ronald Renuart joining Democrats in opposition. But, members of the House Health and Human Services Quality Subcommittee, who voted in support, say before the bill moves forward, Hudson should make changes to the legislation. The bill’s next stop is the House Appropriations Committee.