Powerful senator fighting merger

Mar 5, 2009

Florida Health News--March 4, 2009

By Christine Jordan Sexton

Last year, Senator Durell Peaden was Gov. Charlie Crist’s health-care point man. He was primary sponsor of the Cover Florida Health plan and helped the governor in other ways.

But Peaden, who chairs the Health and Human Services Appropriations Committee, won’t be carrying the ball for the governor this year. A retired physician from Crestview, Peaden has vowed to work against Crist’s attempted merger of the Department of Health and the Agency for Health Care Administration.

“It’s just like with my little brother,” Peaden said of his relationship with Crist. “There are some things me and my little brother don’t agree on, and I tell him sometimes in four-letter words.”

Crist’s staff confirmed last week in background briefings that the governor seeks the merger for administrative efficiency and would try to accomplish it over the next two years. The consolidation would affect thousands of state employees.

But when the filing deadline came late Tuesday, no bill merging the departments was publicly available. Instead, what was available was SB 2390. Peaden is calling it the merger “thwart bill.”

It mandates that the AHCA Secretary be a “licensed health practitioner.” That would mean that current Secretary Holly Benson, an attorney, would have to step down.
The bill also revises the requirement that the DOH Secretary, also known as the State Health Officer, be a medical or osteopathic physician. Instead, the agency would have to be headed by a “licensed health practitioner.”

“I don’t want them to get health care people out of the whole thing,” Peaden said of AHCA, which currently administers the Medicaid program and licenses health facilities, such as nursing homes and hospitals. “An agency like that should not be run by lawyers; they are not health care people. That kind of lends credibility to the insurance companies and the managed care controlling those entities.”

Joining Peaden in the anti-merger effort is a doctor in the House. Rep. Ed Homan, R-Temple Terrace, chairs the House Health and Family Services Policy Council.
Homan, like Peaden, says the departments have separate missions.

The lion’s share of AHCA’s job is administering Medicaid, the joint state and federal insurance program for the poor, elderly and disabled. DOH is in charge of public health activities, including disease prevention and investigation of outbreaks, and the licensure and discipline of health care professionals.

AHCA’s budget, $17.6 billion, dwarfs that of DOH, at $2.9 billion. Peaden, Homan and others Florida Health News interviewed for this story said they were told in conversations with the governor’s office that a merger would save no more than $3 million. That’s million, not billion – 1/1,000th of the DOH budget.

“Where’s the savings?” Homan said. “It doesn’t make much sense to anyone who is in the Legislature.”

While doctor/lawmakers are leading the charge against the merger attempt, the state’s largest physician lobby is fine with the deal so long as certain conditions are met. Florida Medical Association General Counsel Jeff Scott said his group would not oppose a merger as long as the combined agency was called Department of Health and was run by a medical or osteopathic physician.

Scott said FMA has no objection to Benson continuing to run things during the two-year transition. He said, “We have a tremendous amount of confidence in Holly.”