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County delegation to tackle state issues

Nursing home reform will be among the most controversial topics state lawmakers will debate this session.

By DAN DeWITT

© St. Petersburg Times, published March 5, 2001


The paths of lawmakers who represent Hernando County will wind through many issues during the 2001 legislative session, including rail service, water conservation and the inspection of septic tanks.

But they will converge on what should be one of this year's most contentious efforts: the reform of nursing homes.

In some ways, this year's session, which starts Tuesday, will be similar to last year's.

In 2000, Gov. Jeb Bush and former Speaker of the House John Thrasher led a well-publicized move to limit the state's role in growth management. After a task force studied the issue for a year -- and found almost nothing to agree on -- the issue will come up again during the 2001 session.

Bush, as he did last year, has promised to control government spending. In his proposed $43.2-billion budget, he has reduced funding requests for some programs, including Healthy Start, which provides maternity and infant care for poor and low-income women.

He has also made plans for $300-million in tax cuts. Those include a proposal to reduce intangible taxes on stocks and bonds: a controversial measure that Nancy Argenziano, R-Crystal River, and David Russell, R-Brooksville, are co-sponsoring in the House of Representatives.

Last year, Sen. Ginny Brown-Waite, R-Brooksville, was one of several lawmakers who pushed for a bill of rights for HMO patients. Though part of it passed -- her proposal to prevent HMOs from damaging patients' credit while payments are in dispute -- another important element failed. Patients were left without a clear right to sue HMOs, she said, and that is a key part of a bill she is sponsoring this year.

Nursing home reform also came up last year. Argenziano, who represents northwestern Hernando County, was part of the effort in the House. So was Russell, who eventually sponsored the House bill to create a task force to study the matter. It was the legislation he was most proud of after last year's session. He now acknowledges, though, that the task force's members failed to reach a consensus.

"The commission came back with a tremendous amount of information to disseminate, but they did not come back with a recommendation," he said.

Argenziano will again be in the middle of the issue, as the head of the House Council for Healthy Communities, a job that gives her oversight of five health-related committees.

She said bluntly that the task force failed.

"They came up with zilch, zero. We paid a lot of money to come up with some solutions, and they didn't come up with anything," she said.

Reaching agreement on the issue is necessarily difficult, said Brown-Waite, who is sponsoring a nursing home reform bill in the Senate, because it involves many powerful political interests.

Elderly voters, and the sons and daughters of elderly patients, want to be sure care is adequate, she said. Trial lawyers want the right to sue. The nursing home companies and their insurance companies want protection from lawsuits that they say are on the verge of driving them out of the state.

"It's like trying to negotiate peace in the Mideast," said Brown-Waite. Partly because of this -- and partly because of the complexity and sensitivity of the issue -- her bill has proved to be extremely time-consuming.

"I just want to be so certain we don't have any unintended consequences of harming elders," she said.

Both she and Argenziano think increased staffing in nursing homes is essential. Brown-Waite's bill would require that aides and nurses not only devote a certain amount of time each shift to each resident, but also document that they are actually spending time giving care and not on other duties.

Brown-Waite favors a cap on awards against nursing homes in lawsuits. Her legislation would funnel most complaints into an arbitration procedure that would pay a maximum of $300,000 per plaintiff. Her bill also includes, however, a clause for the most serious cases, requiring that there be a court hearing, with no limit on damages.

Argenziano has received criticism, especially from the nursing home industry, because she is an outspoken critic of caps on awards.

The best way to limit lawsuits, she said, is for the nursing homes to do a better job of caring for residents. The lawsuits she has seen, she said, have been justified.

"I've asked them to show me the suits, and when they do, the facts are horrendous. Why do you want to cap that?" she said. "There may (eventually) be a cap, but it will be a high cap."

The four legislators who represent the county -- including House Majority Leader Mike Fasano, R-New Port Richey, whose district includes a small section of southern Hernando -- all are involved in another health care issue. Argenziano and Fasano are sponsoring a bill that would make the generic versions of five popular drugs more widely available; Brown-Waite and Russell are co-sponsors.

The bill would allow a pharmacist to substitute a generic drug for a brand-name version, unless the doctor specifies otherwise.

Argenziano also wants to establish a restoration bill for the Withlacoochee River, which would study problems with the river system and provide for a way to pay for solutions to the problems. Brown-Waite, she said, has promised to push the effort in the Senate.

Argenziano, as she did previously, is introducing a related bill that would allow homeowners to clear muck from waterways bordering their property.

She also wants to eliminate a double-inspection system that has the effect of penalizing coastal residents who install better and more expensive septic tanks.

Brown-Waite, as president pro tem of the Senate, will have a variety of duties, including advising new lawmakers, assisting Senate President John McKay and rounding up votes from other senators on issues the leadership considers important.

Add the time she is spending on nursing home reform, she said, and she won't have as many opportunities to sponsor bills as she has in the past. But she has filed several.

She is reviving a bill she first introduced in 1995 that would forbid subdivision deed restrictions from requiring homeowners to plant lawns that need large amounts of water. Another bill would allow prosecutors in domestic violence cases to introduce information from similar, previous cases.

She will also try to get appropriations in the budget for several local projects.

Both the city of Brooksville and Hernando County, she said, have asked for more funding than in recent years. Partly, she said, that is because she and her staff have encouraged them to do so. Among the requests is money to upgrade the Hernando County Fairgrounds, which failed to receive state money in the past, and further improvements to Brooksville's aging utility system.

But, Brown-Waite said, the budget surpluses will be smaller this year than in the last two. And the governor, who has taken a hard line against projects benefiting individual districts, has promised to be even tougher this year, although Brown-Waite's leadership position might help her get some of the money that is available, she said.

"Remember, I said that if you don't ask, you don't get. And unfortunately, they may have waited too long to ask," she said.

Russell and Brown-Waite will be working together on another local issue: creating an enterprise zone in and around Brooksville and south of town.

The zone includes parts of western and southern Brooksville as well as the Airport Industrial Park. It would entitle companies in the zone, especially new or expanding ones, to considerable state tax breaks, many of which depend on the hiring of people who live in the zone.

Russell, in his role as chairman of the House Transportation Committee, will also be seeking money for the improvement of County Line Road.

Before he can do so, he said, the state Department of Transportation must come up with a revised plan with a more reasonable price. The original one called for six lanes at a cost of $119-million.

"We need a four-lane road with a minimum amount of easement, sans the bicycle trail," he said. "What we need to do is move traffic."

Another transportation bill would set up state areas for motorcycles and other off-road vehicles, mostly in degraded areas such as abandoned mining pits. The plan is designed to keep riders out of environmentally sensitive areas such as the Ocala National Forest.

Russell's most high-profile issue will be dealing with the proposed state high-speed rail system. A measure requiring the state to build the system was one of the constitutional amendments voters approved in November.

Because it is a constitutional amendment, the Legislature must try to figure a way to build it, Russell said. It is expected to be tremendously expensive, he said, and he proposes forming a committee to "identify possible funding sources, the possible alignment and the overall viability of the system."

If the task force cannot find adequate funds, which seems probable considering the project's expense, it might recommend that voters be asked how to fund the system, Russell said.

When faced with the prospect of new taxes, he said, residents might rethink their original vote.

"We might have to ask the taxpayer how they want us to fund their mandate," he said.

Government on TV

Beginning this week, Hernando County Government Broadcasting will telecast the Florida Channel's live coverage of the Florida Legislature. The coverage begins each day, Monday through Friday, with Capitol Update, a half-hour of news from the previous day, followed by House and Senate sessions, committee meetings and special features. The coverage wraps up at 5:30 p.m. with a live edition of Capitol Update. On Tuesday, Gov. Jeb Bush's State of the State address will be aired at 11 a.m. It will be replayed at 7 p.m. Tuesday and at 1 a.m. Wednesday. The telecasts are available daily on Time Warner Cable Channel 19 and on a limited basis on Constel Cable Channel 6. For information, call Brenda Frazier, the county's community relations coordinator, at 754-4009, ext. 142.

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