THE NEWS SERVICE OF FLORIDA: Senate Committee Vote Delayed on Lip Council Elimination

Feb 18, 2009


By News Service Staff

THE CAPITAL, TALLAHASSEE………..A Senate health care panel on Wednesday deferred a vote on legislation that would abolish a hospital-dominated panel that helps decide how $1 billion in Medicaid dollars are spent.

After more than an hour of testimony, the Senate Health Regulation Committee’s Chairman, Sen. Don Gaetz, agreed to postpone a vote on the bill (SB 556), which would abolish the Low Income Pool council. Gaetz, a Republican from Ft. Walton Beach, said he agreed to defer action on the bill out of deference to Senate Minority Leader Al Lawson, D-Tallahassee, who asked that the vote be delayed.

Moreover, Gaetz said there were numerous lobbyists who asked to testify on the bill, adding that there was at least another 90 minutes of testimony if he allowed everyone to speak.

Gaetz, who is prime sponsor of the legislation, said the bill will be the first one discussed when the committee meets again.

The LIP Council is a 17 member panel that includes hospital lobbyists and local government representatives and annually makes recommendations to the Legislature on how the state should spend $1 billion in Low Income Pool money.

Ultimately the final approval on how the money is allocated is made by the Legislature in the final state budget.

Like any Medicaid program, the state must contribute money to draw down matching funds. For LIP and other Medicaid programs, the counties contribute the majority of the dollars. According to Safety Net Hospital Alliance of Florida figures, 20 counties voluntarily contribute more than $800 million for LIP and other Medicaid programs. The local taxes allow Florida to draw down an additional $900 million.

The majority of the matching federal dollars the state draws down have been earmarked for safety net facilities and teaching hospitals located in the counties that contribute to the program.

The Gaetz bill is supported by HCA Healthcare Corporation, business giant Associated Industries of Florida, and the federally qualified health centers. These groups argue that the LIP Council should not be charged with making these recommendations because, they say, many of the LIP Council members have a conflict of interest.
Safety net hospitals such as Jackson Memorial, Tampa General, and a variety of children’s hospitals, among others, oppose the bill. They note that while the majority of the dollars are returned to contributing counties, the LIP Council’s recommendations are broad and have directed money to hospitals in 37 counties that make no local contribution to the program at all.

Safety Net Hospital Alliance of Florida lobbyist Mark Delegal told the Senate panel that counties and taxing districts that contribute the dollars deserve to have a say on how they should be spent.

“If they’re putting up the money, shouldn’t they have a seat at the table?” Delegal said.

AIF President and Chief Executive Officer Barney Bishop said abolishing the LIP council is a top priority for the business group. Bishop maintains that the recommendations on how Low Income Pool money should be spent should be made by the Agency for Health Care Administration and not what he called a special interest-dominated health care board.

“What this comes down to is two words, ladies and gentlemen, you hear it every year all the time. It’s the buzzwords. It’s transparency and it’s accountability…. Nobody is going to get screwed if AHCA and the Legislature (are) doing their job(s),” said Bishop.

The state Agency for Health Care Administration, meanwhile, is staying out of the fight.

AHCA Chief of Staff Tom Arnold said the current system has “done an excellent job. On the other hand if this bill was to pass and the agency did it, we would ensure it was not done wrong,” said Arnold.