2019 Voting Record

2019 Florida Report and Voting Record on Legislative Issues

Vision

"A society in which all people live with dignity and purpose, and fulfill their goals and dreams."

Mission "AARP enhances the quality of life for all as we age. We champion positive social change and deliver value through advocacy, information, and service."

Special Thanks to AARP Florida’s Advocacy Team:

J ared Jones – Legislative Advocacy Intern Lynn Smith – Senior Program Assistant

Zayne Smith – Associate State Director of Advocacy Dorene Barker – Associate State Director of Advocacy Laura Cantwell – Associate State Director of Advocacy and Outreach Ivonne Fernández – Associate State Director of Advocacy and Multicultural Outreach Jack McRay – Advocacy Manager Odette Bragg - Business Operations Analyst

Jeff P. Johnson – State Director Donna L. Ginn - State President

www.aarp.org/flvotingrecord2019

Introduction

Floridians 50+ saw some big wins in the 2019 legislative session. Legislative accomplishments included bipartisan passage of Prescription Drug Importation, expansion of telehealth services, enhanced patient protections in the healthcare system, and new penalties for texting while driving. During the 60-day session, lawmakers filed 1,675 bills and passed 174 bills. The 2019 legislative Regular Session led to wins and disappointments on issues important to Floridians ages 50+. This Voting Record sets forth summaries of those bills and how legislators voted on them. When the first legislative committee of reference placed on its public hearing agenda a bill significant to AARP’s members and Florida residents 50 years of age and older, AARP notified legislators by email (see p. 99 for an example) that AARP would track the bill and report the votes on that bill, or any successor bill through the entire legislative process.

AARP also provided updates on the status of the bill to its volunteers and stakeholders through the AARP blog and AARP Twitter accounts. Section I of the 2019 Legislative Voting Record provides a complete list of all Florida legislators and their parties, districts, and county legislative delegations. Section II provides a summary of all the bills AARP Florida selected for the final voting record report. The summaries are set forth by subject matter areas (budget, health and supportive services, consumer protections, livable communities and bills of interest that were not selected for vote recording). The summaries identify the pages where readers may review the voting records for each bill. Section III provides appendices that include sample communications to legislators and bills selected for vote recording by date of notice. This document is based on information as of May 24th, 2019.

Two groundbreaking announcements by AARP grabbed headlines during the legislative session. In an effort to develop short- and long- term strategies to meet the health care needs of Florida’s aging population, AARP Florida, the Florida Health Care Association, SEIU, and LeadingAge Florida created the Coalition for Silver Solutions. And, through AARP’s advocacy at the state and local level, Florida became the fourth state in the nation to join the AARP Network of Age-Friendly States and Communities.

Visit www.aarp.org/flvotingrecord2019 to view the electronic version of this 2019 report.

TABLE OF CONTENTS

Introduction Special Thanks to Advocacy Volunteers

6 7 9

Senators

House Representatives

Bill Summaries and Voting Record Tables

Budget Impacts & Bills

23 14 13 14 24 24 24 25 25 25 25 25 26 26 26 27 27 27 27 27 28 28 28

SB 2500 SB 2502

Health & Supportive Services

SB 1088 & HB 897 - Nursing Home Facility Staffing HB 19 & SB 1528 - Prescription Drug Importation Program HB 375 & SB 592 - Prescription Drug Monitoring Program

HB 449 & SB 860 - Alzheimer’s Disease

HB 23 & SB 1526 - Telehealth

HB 843 & SB 7078 - Patient Access to Primary Care and Specialist Providers

SB 716 & HB 465 - Dental Services

HB 813 & HB 843 - Hospital Observation Status HB 7 & SB 1520 - Direct Health Care Agreements HB 559 - Prescription Drug Utilization Management

SB 434 - Ambulatory Surgical Centers

SB 1124 & HB 1115 - Dispensing Medicinal Drugs HB 687 & SB 1170 - Automated Pharmacy Systems

SB 1180 & HB 1363 - Consumer Protection from Nonmedical Changes to

Prescription Drug Formularies

SB 192 - Medicaid Eligibility

HB 5201 - Medicaid

HB 1035 - Patient Access to Records HB 821 & SB 972 - Health Care Practitioners

SB 1620 & HB 885 - Health Care Licensing Requirements

Consumer Protection Bills

67 68 68 68 68 69 69 69 69 69 85 86 86 86 95 96 96 97 97 97 98 98 98 98

HB 409 & SB 548 - Electronic Legal Documents SB 796 & HB 797 - Public Utility Storm Protection Plans

SB 874 & HB 469 - Consumer Finance Loans

SB 1338 & HB 1085 - Guardianship

SB 452 & HB 583 - Elder Abuse Fatality Review Teams HB 651 & SB 1370 - Medically Essential Electric Utility Service SB 1466 & HB 143 - Protection for Vulnerable Investors SB 176 & HB 159 - Tax Exemptions that Assist in Independent Living SB 60 - Tax Exemptions for Diapers and Incontinence Products

Livable Communities

HB 107 & SB 76 - Wireless Communications While Driving

HB 311 & SB 932 - Autonomous Vehicles

SB 844 & HB 305 - Orange Alert

Bills Monitored

HB 1033 & SB 1070 - Continuing Care Contracts

SB 322 & HB 997 - Health Plans

SB 418 - Essential Benefits Under Health Plans

HB 21 & SB 1712 - Hospital Licensure

HB 1349 & SB 1592 - Assisted Living Facilities

HB 999 & SB 1514 - Medical Billing SB 196 - Office of Public Counsel

HB 935 & SB 1560 - Price Transparency in Contracts

SB 202 & HB 51 - Property Tax Exemptions

Appendices

Communication to Legislators on Voting Record Report

99 99

Example Bill Notice

Bills Selected for Vote Recording by Date of Notice

100

Special Thanks to Our AARP Advocacy Volunteers AARP Florida’s 2019 legislative agenda was supported by volunteers across Florida who met with legislators in their home districts and in Tallahassee, sent thousands of letters and emails to legislators, and made countless phone calls to their elected officials. We are grateful to the AARP volunteers who were willing to share their stories and take a stand on critical issues.

AARP is making a difference—whether it's fighting to reform America's health system or protecting vital services for vulnerable Floridians. But we can't do it without you. If you would like to join us in these efforts, contact the Florida state office by calling (866) 595-7678 or send an e-mail to flaarp@aarp.org. There are opportunities to volunteer around the entire state – you don’t have to be in Tallahassee to have your voice heard. La agenda legislativa de AARP Florida del 2019 contó con el apoyo de voluntarios de toda la Florida quienes viajaron a Tallahassee para reunirse con legisladores, enviaron miles de cartas y correos electrónicos e hicieron innumerables llamadas telefónicas a sus oficiales electos. Agradecemos profundamente los voluntarios de AARP que compartieron sus historias y estuvieron dispuestos a tomar una posición en los temas más críticos

FLORIDA SENATE

Name

District

Location by County

Albritton, Ben

DeSoto, Glades, Hardee, Highlands, , Okeechobee and parts of Charlotte, Lee, Polk

Baxley, Dennis Bean, Aaron

Sumter and parts of Lake, Marion

Nassau and part of Duval

Benacquisto, Lizbeth

27 31 32 11

Part of Lee

Berman, Lori Book, Lauren

Part of Palm Beach

Part of Broward Part of Orange

Bracy, Randolph

Bradley, Rob

Baker, Bradford, Clay, Columbia, Dixie, Gilchrist, Lafayette, Levy, Suwannee, Union, and part of Marion

Brandes, Jeff

24 35

Part of Pinellas

Braynon, Oscar II Broxson, Doug

Parts of Broward, Miami-Dade Escambia, Santa Rosa, and part of Okaloosa

Cruz, Janet

18 36 34 39

Part of Hillsborough Part of Miami-Dade

Diaz, Manny Jr.

Farmer, Gary M., Jr.

Part of Broward

Flores, Anitere

Monroe and part of Miami-Dade

Gainer, George B.

Bay, Holmes, Jackson, Walton, Washington and part of Okaloosa

Galvano, Bill

Manatee and part of Hillsborough

Gibson, Audrey

Part of Duval

Gruters, Joe

Sarasota and part of Charlotte

FLORIDA SENATE

Name

District

Location by County

Harrell, Gayle Hooper, Ed Hutson, Travis

25 16

Martin, St. Lucie, and part of Palm Beach

Parts of Pasco, Pinellas

Flagler, St. Johns, and part of Volusia Parts of Hillsborough, Pasco, Polk

Lee, Tom

20 17

Mayfield, Debbie

Indian River, part of Brevard

Montford, Bill

Calhoun, Franklin, Gadsden, Gulf, Hamilton, Jefferson, Leon, Liberty, Madison, Taylor, Wakulla Collier, Hendry, and part of Lee Alachua, Putnam and part of Marion

Passidomo, Kathleen

Perry, Keith

Pizzo, Jason W. B. Powell, Bobby Rader, Kevin J.

38 30 29 37 19

Part of Miami-Dade Part of Palm Beach

Parts of Broward, Palm Beach

Rodriguez, Jose Javier Rouson, Darryl Ervin

Part of Miami-Dade

Parts of Hillsborough, Pinellas Seminole and part of Volusia

Simmons, David Simpson, Wilton Stargel, Kelli Stewart, Linda

10 22 13 40 33 15 14

Citrus, Hernando, and part of Pasco

Parts of Lake, Polk Part of Orange Part of Miami-Dade

Taddeo, Annette Thurston, Perry E., Jr. Torres, Victor M., Jr.

Part of Broward

Osceola and part of Orange

Wright, Tom A.

Parts of Brevard, Volusia

FLORIDA HOUSE

Name

District

Location by County

Alexander, Ramon Aloupis, Vance Jr. Altman, Thad Andrade, Alex Antone, Bruce Ausley, Loranne

Gadsden and part of Leon

115

Part of Miami-Dade

Part of Brevard

Parts of Escambia and Santa Rosa

Part of Orange

Part of Leon

Avila, Bryan Bell, Melony Beltran, Mike

111

Part of Miami-Dade

56 57 10 45 74 40

DeSoto, Hardee and part of Polk

Part of Hillsborough

Brannan, Chuck III

Baker, Columbia, Hamilton, Suwannee, and part of Alachua

Brown, Kamia

Part of Orange Part of Sarasota

Buchanan, James Burton, Colleen

Part of Polk

Bush, James III

109

Part of Miami-Dade

Byrd, Cord

11 89 90 21 43 18 14 13 68 66 80

Nassau and part of Duval

Caruso, Mike

Part of Palm Beach Part of Palm Beach

Casello, Joseph

Clemons, Chuck Sr.

Dixie, Gilchrist, and part of Alachua

Cortes, John

Part of Osceola Part of Clay Part of Duval Part of Duval Part of Pinellas Part of Pinellas

Cummings, Travis Daniels, Kimberly Davis, Tracie Diamond, Ben DiCeglie, Nick Donalds, Byron

Hendry and part of Collier

Drake, Brad

Holmes, Jackson, Walton, Washington, and part of Bay

Driskell, Fentrice DuBose, Bobby Duggan, Wyman Duran, Nicholas

63 94 15

Part of Hillsborough

Part of Broward Part of Duval

112

Part of Miami-Dade

Eagle, Dane

Part of Lee

FLORIDA HOUSE

Name

District

Location by County

Eskamani, Anna Fernandez, Javier

Part of Orange

114 119

Part of Miami-Dade Part of Miami-Dade

Fernandez-Barquin, Juan

Fetterhoff, Elizabeth

26 53 16 78

Part of Volusia Part of Brevard Part of Duval Part of Lee

Fine, Randy Fischer, Jason

Fitzenhagen, Heather

Geller, Joe

100

Parts of Broward and Miami-Dade

Goff-Marcil, Joy Good, Margaret Gottlieb, Mike

30 72 98 54 64 75 73

Parts of Orange, Seminole

Part of Sarasota Part of Broward

Grall, Erin

Indian River and part of St. Lucie Parts of Hillsborough, Pinellas

Grant, J.W.

Grant, Michael J. Gregory, Tommy

Charlotte

Parts of Manatee, Sarasota

Grieco, Mike Hage, Brett Hart, Dianne

113

Part of Miami-Dade

33 61 59

Sumter and parts of Lake and Marion

Part of Hillsborough Part of Hillsborough Part of Escambia Part of St. Lucie Part of Hernando Part of Broward Part of Palm Beach

Hattersley, Adam

Hill, Mike

Hogan Johnson, Delores

84 35 96 88 99

Ingoglia, Blaise Jacobs, Kristin

Jacquet, Al Jenne, Evan

Part of Broward Part of Broward

Jones, Shevrin D. Joseph, Dotie Killebrew, Sam La Rosa, Mike LaMarca, Chip Latvala, Chris

101 108

Part of Miami-Dade

41 42 93 67 25 82

Part of Polk

Parts of Osceola, Polk

Part of Broward Part of Pinellas Part of Volusia

Leek, Tom

Magar, MaryLynn

Parts of Martin, Palm Beach

FLORIDA HOUSE

Name

District

Location by County

Mariano, Amber Massullo, Ralph McClain, Stan

36 34 23 58

Part of Pasco

Citrus and part of Hernando

Part of Marion

McClure, Lawrence McGhee, Kionne Mercado, Amy Newton, Wengay

Part of Hillsborough Part of Miami-Dade

117

48 70

Part of Orange

Parts of Hillsborough, Manatee, Pinellas, Sarasota

Oliva, José R.

110

Part of Miami-Dade

Omphroy, Anika Overdorf, Toby Payne, Bobby Perez, Daniel Pigman, Cary

95 83 19

Part of Broward

Parts of Martin, St. Lucie

Bradford, Putnam, Union, part of Clay

116

Part of Miami-Dade

Glades, Highlands, Okeechobee and part of St. Lucie

Plakon, Scott

29 50

Part of Seminole

Plasencia, Rene

Parts of Brevard, Orange

Polo, Cindy Polsky, Tina Ponder, Mel

103

Parts of Broward, Miami-Dade

Part of Palm Beach Part of Okaloosa

Pritchett, Sharon Raschein, Holly

102 120

Parts of Broward, Miami-Dade Monroe and part of Miami-Dade Flagler and parts of St. Johns, Volusia

Renner, Paul

24 79 71 76

Roach, Spencer Robinson, Will Rodrigues, Ray

Part of Lee

Parts of Manatee, Sarasota

Part of Lee

Rodriguez, Ana Maria Rodriguez, Anthony

105 118 106

Parts of Broward, Collier, Miami-Dade

Part of Miami-Dade

Rommel, Bob

Part of Collier

Roth, Rick

85 32 27 87 51

Part of Palm Beach

Sabatini, Anthony Santiago, David

Part of Lake Part of Volusia

Silvers, David

Part of Palm Beach

Sirois, Tyler

Part of Brevard

FLORIDA HOUSE

Name

District

Location by County Part of Palm Beach

Slosberg, Emily

91 49 28 65

Smith, Carlos Guillermo

Part of Orange Part of Seminole Part of Pinellas Part of Broward Part of St. Johns

Smith, David Sprowls, Chris Stark, Richard

104

Stevenson, Cyndi Stone, Charlie Sullivan, Jennifer

17 22 31 44 60 39

Levy and part of Marion Parts of Lake and Orange

Thompson, Geraldine Toledo, Jackie Tomkow, Josie Trumbull, Jay Valdes, Susan Watson, Barbara Watson, Clovis Jr. Webb, Jennifer Willhite, Matt Williams, Patricia H. Williamson, Jayer Yarborough, Clay

Part of Orange

Part of Hillsborough Parts of Osceola, Polk

Part of Bay

Part of Hillsborough Part of Miami-Dade

107

20 69 86 92

Parts of Alachua and Marion

Part of Pinellas

Part of Palm Beach

Part of Broward

Parts of Okaloosa, Santa Rosa

12 37

Part of Duval Part of Pasco

Zika, Ardian

*Vacant

Calhoun, Franklin, Gulf, Jefferson, Lafayette, Liberty, Madison, Taylor, Wakulla and part of Leon

*Vacant *Vacant

38 97

Part of Pasco Part of Broward

Budget

“Budget policy at the federal, state, and local levels should promote economic growth and stability.” -AARP Public Policy Institute

General Appropriations Act 2019 Senate Bill 2500 & Senate Bill 2502

PASSED

SB2500 - General Appropriations Act 2019, and SB 2502 Implementing the 2019-2020 General Appropriations Act, by Senate Appropriations Committee, PASSED. The bills, respectively, are Chapters No. 2019-115/116 Laws of Florida, effective July 1, 2019.The Florida Legislature passed a $91.1 billion budget for fiscal year 2019-2020, which is $2.4 billion more than the current fiscal year’s budget.

Sponsored by the Senate Appropriations Committee

Voting Record on Pg 17

Impacts from the General Appropriations Act Include:

Statewide Medicaid Managed Care Long Term Care (SMMC LTC): SMMC LTC will receive a funding increase of $344.5 M. The program is designed to provide LTC services to Medicaid-eligible (i.e., low income) disabled adults and elders who need nursing home level of care. SMMC LTC services may include, among others, adult day care, assisted living, caregiver training, hospice services, medical equipment, respite care and various therapies. The SMMC LTC program has a finite number of slots for eligible service recipients. As of March 26, 2019, 55,435 Medicaid applicants awaited slots to open. Community Care for the Elderly (CCE): CCE, a non-Medicaid program, will receive an increase of $2,158,333 in funding to serve an additional 256 slots. CCE provides community-based services to help functionally impaired elders, ages 60+, live in the least restrictive and most cost-effective environments suitable to forestall or prevent nursing home placement. CCE services include: adult day care, adult day health care, case management, case aide, chore, companionship, consumable medical supplies, counseling, escort, emergency alert response, emergency home repair, home-delivered meals, home health aide, homemaker, home nursing, information and referral, legal assistance, material aid, medical therapeutic services, personal care, respite, shopping assistance, transportation, and other community-based services.

Home Care for the Elderly (HCE): HCE will receive no additional funding to serve more elders. HCE provides care in family-type living arrangements for non-Medicaid individuals, ages 60+, who have incomes meeting the Institutional Care Program (ICP) standard and who are at great risk of nursing home placement. These individuals must have living with them approved adult caregivers.

Budget

The Low-Income Pool (LIP): LIP funds help pay for uncompensated medical care costs for uninsured hospital patients, shortfalls in Medicaid funding, and premium payments for insurance products agreed upon by the State and Centers for Medicare and Medicaid Services. To access the full $1.5 billion LIP allotment, local governments must contribute nearly 40 percent of the funds through county and other local tax dollars that are transferred to the state. Alzheimer’s Disease Initiative (ADI): ADI services will receive an increase of $1,769,733 to serve an additional 151 individuals on the statewide waitlist. ADI provides services to individuals with Alzheimer's disease or other memory disorders and to their families. ADI respite services for families include in-home adult-day-care, emergency and extended care (up to 30 days) services. Also, the ADI provides support services that include: case management, specialized medical equipment and supplies, caregiver counseling and support groups, and caregiver training.

Personal Needs Allowance (PNA): Nursing home Medicaid residents will see no increase in their monthly PNA, currently set at $120. The PNA is for clothing, toiletries, personal hygiene products, vitamins or supplements, beauty or barber shop services, co-pays for prescriptions not otherwise covered by insurance, eyeglasses, hearing aids and batteries, etc.

Program for All-Inclusive Care for the Elderly (PACE): PACE organizations provide primary care and social, restorative, and supportive services for Medicaid and Medicare eligible individuals 55 years of age and older who live in PACE service areas. PACE organizations provide care and services in homes, communities, nursing facilities, and in PACE centers. Medicaid enrollees receiving services through managed care plans may not participate in PACE programs. The state will seek federal approval to serve an additional 150 slots in Orange County, at a cost of $4,754,901.

Budget

Public Guardianship Program The Public Guardianship Program will receive an increase of $2,491,326 in funding. The Office of Public & Professional Guardians, housed within the Department of Elder Affairs, provides services for persons who have no willing family members or friends to serve as their guardians and who have inadequate incomes or assets to afford private guardians.

Affordable Housing: The legislature swept $125 million from a trust fund established exclusively for use with statewide affordable housing programs. Funds are down $46,030,000 from last year, for a total of $77,600,000. The State Apartment Incentive Loan (SAIL) program will receive $31,040,000 to fund construction or rehabilitation of rental units for older adults, the homeless, and persons with developmental disabilities. The State Housing Initiatives Partnership (SHIP) program will receive $46,560,000 for emergency repairs and for new construction or rehabilitation of homes. In addition to the sweep, the Legislature allocated $115 million from the Affordable Housing Trust Fund for hurricane housing relief in the Florida Panhandle and $8 million for the Jacksonville Urban Core Workforce Housing Project.

Implementing Bill to General Appropriations Act: Retroactive Medicaid Eligibility:

Section 24 of Senate Bill 2502 directs the Agency for Health Care Administration (ACHA) to seek authorization from the Centers for Medicare & Medicaid Services (CMS) to continue reimbursement for Medicaid services only back to the first day of the month in which an eligible adult applies for Medicaid. This reimbursement restriction applies to adults 21 years of age and older who are not pregnant. Prior to the current year’s budget, Medicaid would reimburse for services rendered to eligible applicants for up to 90 days before application. This section expires July 1, 2020.

Budget

SB 2500 - Appropriations

S enate A ppropriations - 3/27/19

Y Bean

Y Benacquisto

Y Book Y Flores

Y Bradley Y Gainer Y Mayfield Y Rouson Y Stewart

21 Yeas 0 Nays 0 No Votes

Y Brandes Y Gibson Y Montford Y Simmons Y Thurston

Y Braynon Y Hutson

Y Lee

Y Passidomo

Y Powell Y Stargel

Y Simpson

S enate F loor - 4/3/19

Y Albritton Y Berman Y Brandes Y Galvano Y Hooper Y Montford Y Diaz

Y Baxley Y Book Y Braynon Y Farmer Y Gibson Y Hutson

Y Bean Y Bracy

Y Benacquisto

40 Yeas 0 Nays 0 No Votes

Y Bradley

Y Broxson Y Flores Y Gruters

Y Cruz

Y Gainer Y Harrell Y Mayfield Y Rouson Y Stewart Y Wright Y Pizzo

Y Lee Y Perry

Y Passidomo

Y Powell

Y Rader

Y Rodriguez

Y Simmons Y Taddeo

Y Simpson Y Thurston

Y Stargel Y Torres

S enate F loor - 5/4/19

- Albritton Y Berman Y Brandes Y Galvano Y Hooper Y Montford Y Diaz

Y Baxley Y Book Y Braynon Y Farmer Y Gibson Y Hutson

Y Bean Y Bracy

Y Benacquisto

38 Yeas 0 Nays 2 No Votes

Y Bradley

Y Broxson Y Flores Y Gruters

Y Cruz

Y Gainer Y Harrell - Mayfield Y Rouson Y Stewart Y Wright Y Pizzo

Y Lee Y Perry

Y Passidomo

Y Powell

Y Rader

Y Rodriguez

Y Simmons Y Taddeo

Y Simpson Y Thurston

Y Stargel Y Torres

Budget

SB 2500 - Appropriations

H ouse F loor - 4/4/19

N Alexander

Y Aloupis N Ausley Y Brannan

Y Altman Y Avila Y Brown

Y Andrade

107 Yeas 9 Nays 1 No Votes

Y Antone Y Beltran - Burton Y Casello

Y Bell

Y Buchanan

Y Bush

Y Byrd

Y Caruso

Y Clemmons

Y Cortes, J N Diamond

Y Cummings Y DiCeglie Y DuBose N Eskamani

Y Daniels Y Donalds Y Duggan Y Fernandez Y Fischer N Good Y Grant, M

N Davis Y Drake Y Duran

N Driskell Y Eagle

Y Fernandez-Barquin Y Fetterhoff

Y Fine

Y Fitzenhagen Y Gottlieb Y Gregory Y Hattersley

Y Geller Y Grall Y Grieco Y Jacquet Y Killebrew Y Hill Y McClain Y Newton Y Payne Y Plasencia Y Pritchett Y Robinson Y Leek

Y Goff-Marcil

Y Grant, J

Y Hage

Y Hart

Y Hogan Johnson

Y Ingoglia

Y Jacobs Y Joseph Y Latvala Y Massullo N Mercado Y Overdorf

Y Jenne Y La Rosa Y Magar Y McClure

Y Jones

Y LaMarca Y Mariano Y McGhee Y Omphroy Y Pigman Y Polsky Y Renner

Y Oliva Y Perez N Polo

Y Plakon Y Ponder Y Roach

Y Raschein

Y Rodrigues, R

Y Rodriguez, A

Y Rodriguez, A. M. Y Rommel

Y Roth Y Sirois

Y Sabatini Y Slosberg

Y Santiago Y Smith, C Y Stevenson

Y Silvers

Y Smith, D

Y Sprowls Y Sullivan Y Trumbull Y Webb

Y Stark

Y Stone

Y Thompson

Y Toledo

Y Tomkow Y Watson, C Y Williamson

Y Valdes Y Willhite

Y Watson, B Y Williams

Y Yarborough

Y Zika

Budget

SB 2500 - Appropriations

H ouse F loor - 5/4/19

Y Alexander

Y Aloupis N Ausley Y Brannan

Y Altman Y Avila Y Brown

Y Andrade

113 Yeas 2 Nays 2 No Votes

Y Antone Y Beltran Y Burton Y Casello

Y Bell

Y Buchanan

Y Bush

Y Byrd

Y Caruso

Y Clemmons

Y Cortes, J Y Diamond

Y Cummings Y DiCeglie Y DuBose Y Eskamani

Y Daniels Y Donalds Y Duggan Y Fernandez Y Fischer Y Good Y Grant, M

Y Davis Y Drake Y Duran

Y Driskell Y Eagle

Y Fernandez-Barquin Y Fetterhoff

Y Fine

Y Fitzenhagen Y Gottlieb Y Gregory Y Hattersley Y Jacobs Y Joseph Y Latvala Y Massullo Y Mercado Y Overdorf Y Plakon Y Ponder Y Roach Y Santiago Y Smith, C Y Stevenson

Y Geller Y Grall Y Grieco Y Jacquet - Killebrew Y Hill Y McClain Y Newton Y Payne Y Plasencia Y Pritchett Y Robinson Y Leek

Y Goff-Marcil

Y Grant, J

Y Hage

Y Hart

Y Hogan Johnson

Y Ingoglia

Y Jenne Y La Rosa Y Magar Y McClure

Y Jones

Y LaMarca Y Mariano Y McGhee Y Omphroy Y Pigman Y Polsky Y Renner

Y Oliva Y Perez N Polo

Y Raschein

Y Rodrigues, R

Y Rodriguez, A

Y Rodriguez, A. M. Y Rommel

Y Roth Y Sirois

Y Sabatini Y Slosberg

Y Silvers

Y Smith, D

Y Sprowls Y Sullivan Y Trumbull Y Webb

- Stone

Y Stark

Y Thompson

Y Toledo

Y Tomkow Y Watson, C Y Williamson

Y Valdes Y Willhite

Y Watson, B Y Williams

Y Yarborough

Y Zika

Budget

SB 2502 - Implementing the Appropriations Act

S enate A ppropriations - 3/27/19

Y Bean

Y Benacquisto

Y Book Y Flores

Y Bradley Y Gainer Y Mayfield Y Rouson Y Stewart

21 Yeas 0 Nays 0 No Votes

Y Brandes Y Gibson Y Montford Y Simmons Y Thurston

Y Braynon Y Hutson

Y Lee

Y Passidomo

Y Powell Y Stargel

Y Simpson

S enate F loor - 4/24/19

Y Albritton Y Berman Y Brandes Y Galvano Y Hooper Y Montford Y Diaz

Y Baxley Y Book Y Braynon Y Farmer Y Gibson Y Hutson

Y Bean Y Bracy

Y Benacquisto

40 Yeas 0 Nays 0 No Votes

Y Bradley

Y Broxson Y Flores Y Gruters

Y Cruz

Y Gainer Y Harrell Y Mayfield Y Rouson Y Stewart Y Wright Y Pizzo

Y Lee Y Perry

Y Passidomo

Y Powell

Y Rader

Y Rodriguez

Y Simmons Y Taddeo

Y Simpson Y Thurston

Y Stargel Y Torres

S enate F loor - 5/3/19

Y Albritton Y Berman Y Brandes Y Galvano Y Hooper Y Montford Y Diaz

Y Baxley Y Book Y Braynon Y Farmer Y Gibson Y Hutson

Y Bean Y Bracy

Y Benacquisto

40 Yeas 0 Nays 0 No Votes

Y Bradley

Y Broxson Y Flores Y Gruters

Y Cruz

Y Gainer Y Harrell Y Mayfield Y Rouson Y Stewart Y Wright Y Pizzo

Y Lee Y Perry

Y Passidomo

Y Powell

Y Rader

Y Rodriguez

Y Simmons Y Taddeo

Y Simpson Y Thurston

Y Stargel Y Torres

Budget

SB 2502 - Implementing the Appropriations Act H ouse F loor - 4/24/19 Y Alexander Y Aloupis Y Altman Y Andrade Y Antone Y Ausley Y Avila Y Bell Y Beltran Y Brannan Y Brown Y Buchanan Y Burton Y Bush Y Byrd Y Caruso Y Casello Y Clemmons Y Cortes, J Y Cummings Y Daniels Y Davis Y Diamond Y DiCeglie Y Donalds Y Drake Y Driskell Y DuBose Y Duggan Y Duran Y Eagle Y Eskamani Y Fernandez Y Fernandez-Barquin Y Fetterhoff Y Fine Y Fischer Y Fitzenhagen Y Geller Y Goff-Marcil N Good Y Gottlieb Y Grall Y Grant, J Y Grant, M Y Gregory Y Grieco Y Hage Y Hart Y Hattersley Y Hill Y Hogan Johnson Y Ingoglia Y Jacobs Y Jacquet Y Jenne Y Jones Y Joseph Y Killebrew Y La Rosa Y LaMarca Y Latvala Y Leek Y Magar Y Mariano Y Massullo Y McClain Y McClure Y McGhee Y Mercado Y Newton Y Oliva Y Omphroy Y Overdorf Y Payne Y Perez Y Pigman Y Plakon Y Plasencia Y Polo Y Polsky Y Ponder Y Pritchett Y Raschein Y Renner Y Roach Y Robinson Y Rodrigues, R Y Rodriguez, A Y Rodriguez, A. M. Y Rommel Y Roth Y Sabatini Y Santiago Y Silvers Y Sirois Y Slosberg Y Smith, C Y Smith, D Y Sprowls Y Stark Y Stevenson Y Stone Y Sullivan Y Thompson Y Toledo Y Tomkow Y Trumbull Y Valdes Y Watson, B Y Watson, C Y Webb Y Willhite Y Williams Y Williamson Y Yarborough Y Zika 113 Yeas 1 Nays 0 No Votes

Budget

SB 2502 - Implementing the Appropriations Act

H ouse F loor - 5/4/19

Y Alexander

Y Aloupis N Ausley Y Brannan

Y Altman Y Avila Y Brown

Y Andrade

113 Yeas 2 Nays 2 No Votes

Y Antone Y Beltran Y Burton Y Casello

Y Bell

Y Buchanan

Y Bush

Y Byrd

Y Caruso

Y Clemmons

Y Cortes, J Y Diamond

Y Cummings Y DiCeglie Y DuBose Y Eskamani

Y Daniels Y Donalds Y Duggan Y Fernandez Y Fischer Y Good Y Grant, M

Y Davis Y Drake Y Duran

Y Driskell Y Eagle

Y Fernandez-Barquin Y Fetterhoff

Y Fine

Y Fitzenhagen Y Gottlieb Y Gregory Y Hattersley

Y Geller Y Grall Y Grieco Y Jacquet - Killebrew Y Hill Y McClain Y Newton Y Payne Y Plasencia Y Pritchett Y Robinson Y Leek

Y Goff-Marcil

Y Grant, J

Y Hage

Y Hart

Y Hogan Johnson

Y Ingoglia

Y Jacobs Y Joseph Y Latvala Y Massullo Y Mercado Y Overdorf

Y Jenne Y La Rosa Y Magar Y McClure

Y Jones

Y LaMarca Y Mariano Y McGhee - Omphroy Y Pigman Y Polsky Y Renner

Y Oliva Y Perez N Polo

Y Plakon Y Ponder Y Roach

Y Raschein

Y Rodrigues, R

Y Rodriguez, A

Y Rodriguez, A. M. Y Rommel

Y Roth Y Sirois

Y Sabatini Y Slosberg

Y Santiago Y Smith, C Y Stevenson

Y Silvers

Y Smith, D

Y Sprowls Y Sullivan Y Trumbull Y Webb

Y Stark

Y Stone

Y Thompson

Y Toledo

Y Tomkow Y Watson, C Y Williamson

Y Valdes Y Willhite

Y Watson, B Y Williams

Y Yarborough

Y Zika

Budget

Health & Supportive Services

“It is essential to improve healthcare quality and safety, and to raise consumer awareness of these issues, as we continue our efforts to assure affordable healthcare is available for all.” -AARP Public Policy Institute

FAILED AARP Opposed

Nursing Home Facility Staffing Senate Bill 1088 and Companion House Bill 897 The legislation would have eliminated the minimum number of nursing home care hours provided by certified nursing assistants (CNA). It would have authorized “direct care” staffing, but could have included some personnel who do not provide hands-on care to nursing home residents.

Sponsored by Senator Albritton and Representative Roth

Voting Record on Pg 29

AARP argued that this legislation would have put at risk the quality of care and safety of residents in nursing home facilities. The sponsors withdrew this legislation from further consideration and supported formation of the Coalition for Silver Solutions, which is committed to developing short- and long-term strategies to meet the health care needs of Florida’s aging population. Members of that Coalition are: AARP, LeadingAge Florida, the Florida Health Care Association, and Pin Point Solutions.

Prescription Drug Importation Program House Bill 19 and Companion Senate Bill 1528 The legislation establishes two programs to safely import FDA-approved prescription drugs into the state: the Canadian Drug Importation Program and the International Drug Importation Program. For both programs, the legislation establishes eligibility criteria for the types of prescriptions drugs which may be imported and for the entities that may export or import prescription drugs. It also outlines the importation process, safety standards, drug distribution requirements, and penalties for violations of program requirements. The legislation requires federal approval or cooperation before prescription drug importation can begin. The legislation is now Chapter No. 2019-99, Laws of Florida, effective July 1, 2019.

PASSED AARP Supported

Sponsored by Representative Leek and Senator Bean

Voting Record on Pg 29

AARP launched “Stop Rx Greed,” a nationwide campaign aimed at lowering prescription drug prices. The goal of AARP’s campaign is to help drive down drug prices for Floridians and all Americans by advocating for a variety of legislative, executive, and regulatory actions at both the federal and state level. Newly elected Governor Ron DeSantis made prescription drug affordability through importation a centerpiece of his 2019 legislative agenda.

Prescription Drug Monitoring Program House Bill 375 and Companion Senate Bill 592 The legislation provides that prescribers and dispensers of controlled substances for pain control do not have to check the prescription drug monitoring program (PDMP) database before prescribing or dispensing those drugs to terminally ill patients. The legislation is now Chapter No. 2019-70, Laws of Florida, effective July 1, 2019.

PASSED AARP Supported

Sponsored by Representative Pigman and Senator Albritton

Voting Record on Pg 33

Health & Supportive Services

Telehealth House Bill 23 and Companion Senate Bill 1526 The state of Florida is experiencing a health care provider shortage. The provision of health care services through telehealth will increase patient access to health care. The legislation establishes standards of practice for telehealth providers and permits them to deliver health care services pursuant to their respective scopes of practice. The legislation authorizes out-of-state health care professionals to deliver telehealth services to Florida patients if the professionals register with the Department of Health or their respective professional boards, meet eligibility requirements, and pay required fees. The legislation is now Chapter No. 2019-137, Laws of Florida, effective July 1, 2019. Patient Access to Primary Care and Specialist Providers House Bill 843 and Companion Senate Bill 7078 This bill became a legislative healthcare and health insurance “train,” which incorporates language from the following bills: Dental Services SB 716, by Senator Hooper, was amended into HB 843 . The companion bill was HB 465, by Representative Grant (M). AARP supported this legislation. The legislation requires the Department of Health to establish the Donated Dental Services Program. That program will form a network of volunteer dental providers who will provide free dental services to the needy, disabled, elderly, and others who cannot afford necessary treatment but who are Alzheimer’s Disease House Bill 449 and Companion Senate Bill 860 In Florida, there are more than 540,000 individuals living with Alzheimer’s disease. By 2025, it is anticipated to increase by 50 percent. Many patients diagnosed with Alzheimer’s disease require care 24 hours a day, especially in the late stages of the disease. The legislation requires the Alzheimer’s Disease Advisory Committee to submit a report annually by September 1st to the Governor, the President of the Senate and the Speaker of the House of Representatives. That report must include recommendations for Alzheimer’s disease policy, information about state-funded efforts relating to Alzheimer’s disease and updates to the Alzheimer’s disease state plan. The legislation is now Chapter No. 2019-147, Laws of Florida, effective July 1, 2019.

PASSED AARP Supported

Sponsored by Representative Plakon and Senator Stargel

Voting Record on Pg 36

PASSED AARP Supported Sponsored by Representative Yarborough and Senator Harrell

Voting Record on Pg 39

PASSED AARP Supported Sponsored by Representative Rodriguez (AM) and the Senate Health Policy Committee

ineligible for public assistance. Hospital Observation Status

Voting Record on Pg 44

HB 813, by Representative Tomkow, was amended into HB 843. AARP supported this legislation. The legislation requires hospitals to immediately provide patients written notice when the patients are placed on “observation” status instead of “inpatient” status. Only inpatients for at least 72 hours are eligible for post-discharge rehabilitative care covered under Medicare.

Health & Supportive Services

Direct Health Care Agreements HB 7, by Representative Duggan, PASSED. The companion bill was SB 1520, by Senator Bean . Language from this legislation was also amended into HB 843. AARP supported this legislation. Direct primary care (DPC) is a primary care medical practice model that eliminates third party payers from the primary care provider-patient relationship. Through a contractual agreement, a patient pays a monthly fee, usually between $25 and $100 per individual, to the primary care provider for defined primary care services. After paying the fee, a patient can utilize all services under the agreement at no extra charge. The legislation expands the scope of these agreements and allows individuals to contract directly with all licensed healthcare providers, including dentists. Prescription Drug Utilization Management HB 559, by Representative Massullo, was amended into HB 843. AARP supported this legislation. The legislation defines a “step therapy protocol” as a written protocol specifying the order in which certain prescription drugs must be used in order to treat an individual’s health condition. The legislation prohibits an insurer or HMO from requiring a patient to undergo a step- therapy protocol before approving a covered prescription drug if the patient has already been approved to receive the drug through the completion of a step-therapy protocol under previous health coverage in the past 90 days. Ambulatory Surgical Centers SB 434, by Senator Harrell, was amended into HB 843. AARP supported this legislation. The legislation authorizes a patient to stay in an ambulatory surgical center (ASC) for up to 24 hours. Presently an ASC must discharge the patient by midnight of the admission date. HB 843 also does the following: • Hospitals must provide written information on data related to hospital quality to patients upon admission, scheduling of non-emergency care or prior to treatment. • Hospitals must notify a patient’s primary care provider (PCP) within 24 hours of the patient’s admission and discharge from the hospital. • Hospitals must notify a patient of his or her right to request that the hospital’s treating physician consult with the patient’s PCP or specialist. If the patient makes the request, the treating physician must make reasonable efforts to consult with the PCP or specialist when developing the patient’s plan of care. • Requires the Office of Program Policy Analysis and Government Accountability (OPPAGA) to study Florida’s prospective entry into the Interstate Medical License Compact. A report is due by October 1, 2019. The legislation is now Chapter No. 2019-138, Laws of Florida, effective July 1, 2019.

PASSED AARP Supported Sponsored by Representative Rodriguez (AM) and the Senate Health Policy Committee

Voting Record on Pg 44

Health & Supportive Services

FAILED AARP Supported

Consumer Protection from Nonmedical Changes to Prescription Drug Formularies Senate Bill 1180 and Companion House Bill 1363 The legislation would have provided additional consumer protections by requiring a health insurer or health maintenance organization (HMO) to provide at least 60 days’ notice of changes to a prescription drug formulary. The notice would have had to have been in a readily accessible format on the insurer’s or HMO’s website. A treating physician could have requested continued coverage of a prescription drug by submitting information to the insurer or HMO at least 30 days before the effective date of the formulary change and by certifying its medical necessity on the request. prescription drugs received from a Florida-permitted pharmacy and provides a mechanism, either videoconferencing or teleconferencing, by which a pharmacist may counsel a patient at the time of dispensing. The legislation would have authorized community pharmacies to use automated dispensing systems for outpatient dispensing. Automated Pharmacy Systems House Bill 687 and Companion Senate Bill 1170 An automated dispensing system is a mechanical system that delivers Dispensing Medicinal Drugs Senate Bill 1124 and Companion House Bill 1115 The legislation would have authorized licensed prescribers to dispense 48- hour supplies, rather than 24-hour supplies, of drugs to hospital emergency department patients and discharged patients. It would have authorized a licensed prescriber to dispense 72-hour supplies of drugs, during declared states of emergency in their areas.

Sponsored by Senator Harrell and Representative Willhite

Voting Record on Pg 53

FAILED AARP Supported

Sponsored by Representative Willhite and Senator Brandes

Voting Record on Pg 57

FAILED AARP Supported Sponsored by Senator Mayfield and Representative Massullo

Voting Record on Pg 59

FAILED AARP Opposed Sponsored by Senator Bean

Medicaid Eligibility Senate Bill 192

The legislation would have placed into statute a directive to the Agency for Health Care Administration (AHCA) to seek authorization from the federal government to maintain Florida’s current waiver authority modifying the retroactive reimbursement period for services to Medicaid recipients. (See SB 2502, p. 14).

Voting Record on Pg 60

FAILED AARP Opposed

Medicaid House Bill 5201

The legislation would have permanently continued the policy of retroactive Medicaid eligibility to the first day of the month in which a non-pregnant adult applies for Medicaid. (See SB 2502, p. 14).