Senate Derails House 'Train' Bill On Trauma, Telemedicine, Nurses and Pharmacists

May 2, 2014

With hours left to go before Florida lawmakers are set to finish this year’s legislative session, a major healthcare proposal has been derailed in the Senate.

The move highlights the gulf between the House and Senate when it comes to how to manage trauma centers, telemedicine, pharmacists and nurses, and the Senate is not impressed with a massive healthcare "train" bill sent to it by the House.

The House plan combines a series of healthcare-related issues. It outlines regulations for telemedicine, and puts new rules in place for pharmacists and nurse practitioners. It also attempts to referee a fight between private and non-profit hospitals over specialized trauma centers. But the House’s decision to combine the issues in a single bill to woo the Senate failed—as that chamber began stripping the bill apart with more than 50 amendments filed-and most approved.

Sen. Denise Grimsely, R-Sebring,  also managed to change the bill to settle an ongoing fight between retailers and pharmacists over how many technicians a pharmacist can supervise. An initial compromise on the issue would have raised the number to three—but Grimsley’s amendment lowers it back to where it stands today.

“What the language does...says a pharmacist may supervise a certified pharmacy technician on a 1:1 ratio. Anything above a 1:1 ratio has to be approved by the board," she explained.

Also thwarted: an attempt to give a carve out to Jackson Memorial Hospital to operate a remote telemedicine center. Jackson is one of the hospitals at the center of legal challenges related to trauma centers  that have raged for a few years now. Both chambers want to place a moratorium on new trauma centers until a study is done to assess the need. The fight is between non-profit hospitals and for-profit centers--highlighted in an amendment by Sen. Miguel Diaz de la Portilla, R-Miami.

“This is about saving lives. It doesn’t site a new trauma center. It just allows an existing trauma center to do what its mission is," he told colleagues.

While the idea sounds good, several lawmakers including Senate Rules Chairman John Thrasher took issue with it.

“We’re going to have a study of the entire trauma issue. But here we are on the 59th day adding something I think probably hasn’t been heard in any committee and something we all ought to be concerned about," Thrasher said.

To which Diaz de la Portilla retorted, “This is a floor amendment like any other. Except, it’s been vetted a hell of a lot more than a lot of the things we’re going to vote on today and tomorrow and in the past three days."

Republican Senator Anitere Flores tried to tack on a telemedicine-related issue onto the bill, but later withdrew it, after Sen. Eleanor Sobel, D-Hollywood,  expressed the Senate isn’t taking up telemedicine and had also stripped that language out of the House bill.

“I don’t believe we have a telemedicine bill at this time. I don’t know where it’s at, but it has not cleared all committees, Sobel said.

Also eliminated from the bill was a plan to allow highly trained nurses, called Advanced Registered Nurse Practitioners work independently of doctors and prescribe some medications. The Senate’s partial de-railing of the House’s train bill doesn’t bode well for the proposals fate. It now only covers trauma centers and includes the moratorium language. When it comes to trauma centers, the House is seeking to protect three privately-owned facilities in Pasco, Marion and Bay Counties.