Representatives of Florida's counties say they are concerned about proposed decentralization of the state Department of Health and whether it could mean more responsibility for them without any guarantees that the funding will remain.
Initially, it was the Department of Health that suggested a reorganization via legislation to reduce the number of division from 12 to nine, restates its mission and scope of services, privatize A.G. Holley Hospital for tuberculosis treatments and transfers a student loan forgiveness program for nurses to the Department of Education.
But on Thursday, new language in the form of a proposed committee substitute from the House's Health and Human Services Quality Subcommittee was filed. Under this revision, many Department of Health responsiblities would be shifted to county health departments that would receive lump payments from the state.
Rep. Matt Hudson, R-Naples, the sponsor, said the legislation will allow counties to locally control public health initiatives and tailor them to fit the needs of citizens.
"We're going to now give you flexibility to be able to do the things that are important to your individual community," he said.
But representatives of various counties, including the Florida Association of Counties and the Small County Coalition, said they were concerned about the cost of implementing the changes and whether small and rural counties would be able to offer the same level of service. The measure eliminates 12,000 state jobs, many of which would be shifted to counties.
The Department of Health said it was reviewing the new language in Hudson's bill and its impact on counties. Interim Deputy Secretary Lucy Gee said a feasiblity study should be completed before the Legislature makes a final decision.
The Subcommittee approved the measure, which has two more committee stops. Rep. Ronald "Doc" Renuart, R-Ponte Vedra Beach, voted along with Democrats in opposing the legislation. Renuart, an osteopathic physician, said healthcare doesn't work well within a decentralized system.
"Not all provisions in this bill are bad, but not all can pass the muster, either," he said.