Government & Politics

Florida's Senate president on health, education, and more ahead of the legislative session

WUSF

Published December 18, 2023 at 9:40 AM EST

Senate President Kathleen Passidomo, R-Naples, led efforts to pass a bill to address affordable housing.

With Florida’s 2024 legislative session just a few weeks away, lawmakers will be tasked to address pressing issues affecting Floridians.

Florida Senate President Kathleen Passidomo, R-Naples, spoke about some of these issues Friday with Tom Hudson on The Florida Roundup.

She said she’s focused on a package of proposals called Live Healthy, which promises to “grow Florida’s health care workforce, increase access, and incentivize innovation.”

Passidomo also touched on education bills, home insurance, social media and more.

This Q&A has been edited for clarity and brevity.

Health care

Among the efforts is to require hospitals to help patients who come into the emergency room to get care when it's not an emergency, but go to someplace other than an emergency room. How do you envision this working?

I'm very excited about our Live Healthy series of proposals. That one piece is very important to me, because really, the most expensive real estate in the state of Florida is the emergency room. And there are many people who, for a lot of reasons, do not have primary care doctors — or even if you get sick in the middle of the night, you wake up with an earache or a head cold or something that you feel uncomfortable about. What do you do? You have nowhere to go? You go to the emergency room. And the way it is now, you're in there with people that may have had heart attacks or other serious problems. You may have to wait hours. Why? If there's a place where you can go, that is co-located or adjacent to, or across the street from the hospital's emergency room, wouldn't it make more sense? You'd be seen sooner, you will get efficient and effective service, and you won't take up space in the emergency room. Now, the other thing that's important about it is, what we envision, is to help create a medical home for these patients who don't have one. If you don't have a primary care doctor, you're new in town maybe, that kind of thing.

Going to an out-of-network emergency room can be costly.

What do you mean by a medical home? What does that mean?

So you're seen, they may be prescribe something, they examine you, they determine you may need further care, or not. They take information, they follow up. What we're hoping is that they would follow up with them and make sure they're taking their medication. Create a relationship. You cannot have a relationship with the emergency room doctors because they're too busy.

So it sounds like it's something a little bit different than the current urgent care system that has blossomed in Florida as private insurance companies have tried to move non-emergency cases out of the ER or ED into those urgent care facilities. And a lot of the medical centers have created urgent care businesses.

Well, and honestly, that could be a component. I'm not creating the facility, I'm just creating the opportunity for patients to go somewhere to be seen when they do not need to go into the emergency room itself. The problem with urgent care centers now, unfortunately, is that they're open from, you know, 8 to 5. And particularly with kids — my kids, whenever they got sick, they got sick in the middle of the night.

So what's the state role in either incentivizing or encouraging this kind of development?

Well, that's part of the whole Live Healthy package. We fund hospitals, we are going to provide some additional funding for the federally qualified healthcare centers. Also, again, part of the Live Healthy package, we're working on workforce training, workforce development. So it's not just one single answer. It's just part of everything. It's the state's role to make sure our citizens get quality, affordable health care.

"And we want our constituents, our patients, to know what they're going to be paying for healthcare services. And we want them to be able to pick and choose the best place to provide the services and the care that they need, knowing what it's going to cost."

Kathleen Passidomo

Another piece of that Live Healthy plan is to increase the income limits that allow low-income Floridians to use community-based clinics. A family of four making $90,000 a year would be able to use these clinics free of charge under your proposal as it sits in front of the Senate. Why take this route instead of other types of expansions? For instance, Medicaid.

So here's the problem with Medicaid expansion. Our doctors today don't accept Medicaid. Many don't accept Medicaid. I hear all the time of physicians who are not accepting Medicaid. So why expand a system that the providers are not using? What we're doing here is thinking creatively. There are different ways to skin the cat, if you will. And we have the Health Care Clinic, the FQHCs. We have many of them throughout our state. We have many health clinics throughout our state. Why not utilize those facilities that currently exist, instead of starting off a whole new system? And part of the Live Healthy package is to help those facilities provide care. So as part of our workforce training program, for example, we are looking on some loan reimbursement programs for doctors and nurses and the like. And it's not just saying, we're going to give you your money back. What we're going to say is, we will reimburse you if you agree to volunteer part of your time at these clinics. We will reimburse you if you volunteer at health fairs. So it's a give back to the community for the community that's giving to you.

Could you offer those same kind of loan incentives to caregivers that ultimately open up a practice and accept Medicaid?

Well, sure. Absolutely. Our whole goal is to get as many healthcare providers — from technicians, to brain surgeons and everything in between — in our state. Because the premise of this bill is, right now today in Florida, there are not enough healthcare personnel to take care of the needs of our citizens today. I don't know when the last time you wanted to have elective surgery, did you go in and they told me, 'sure we'll do it, but you got to wait eight months.' That's not the way we want to provide care in our state. So we have such a diverse package of, I think, creative ways of attracting and maintaining healthcare personnel across the board.

One of the other efforts in this package is to get the federal OK to have Medicaid patients get hospital care at home. Addressing that supply side, as you talked about, some Florida hospitals have already been approved and offer this service. Why is state action needed here?

Well, I think part of it is putting together the program. And also, that's part of our Technology and Innovation Program. I talked, for example, Tampa General has a very robust plan of healthcare at home. And they have invested their dollars in putting together that program. But there are many smaller facilities, hospitals in our rural communities, that could never in a million years afford that technology. But we need people who live in our rural communities to be able to get service. So the role of the state is to help some of those rural communities and some of the smaller facilities to be able to afford to put in the technology that they will need to provide those services.

"It is my hope that the parents and the teachers — and my understanding that the parents who are actively involved in their student’s education — have conversations with teachers about their student's progress. But a static rule that if you don't pass a test, you don't advance, is problematic."

Kathleen Passidomo

You have pledged as part of this overall package legislation expanding healthcare price transparency. How are you going to go about doing that?

Well, I think that would be part of the legislation. And that's a separate piece of legislation. And it's very important to the speaker, it's very important to him, it's very important to me. And we want our constituents, our patients, to know what they're going to be paying for healthcare services. And we want them to be able to pick and choose the best place to provide the services and the care that they need, knowing what it's going to cost.

The healthcare providers oftentimes say the price that they've negotiated with a private insurance company like Florida Blue or Humana or Cigna is a trade secret. Do you expect or anticipate trying to address that defense of opacity in health care pricing?

Well, that's the way our committee structure works. We put out the idea and then as the bills will go through the committee structure, those individuals and companies that have issues with it will make suggestions, discussions will be had, changes may or may not be made, and then we hopefully get to the floor with a product that we're all proud of.

Let me ask you one more health-related question. You supported the six-week abortion ban bill, you had supported a 12-week ban with exceptions for rape and incest. Do you have any plans to revisit the abortion issue this legislative session?

I personally do not. Any senator or House member can file a bill. I was very comfortable if we could have passed a 12-week ban with the rape, incest and human trafficking exception. Unfortunately, that was not the bill that was filed. For me, the most important part of the whole debate is the legislation that we had passed in the past did not have the exemption that was most important thing for me.

Education

The Senate Fiscal Policy Committee passed three bills earlier this month aimed at deregulating public schools. Passidomo discussed one of the bills, SB 7004, which would change testing requirements for some students.

One bill has passed out of the Senate Education Committee. It would allow third-graders who do not meet state standards to still graduate, be promoted to the fourth grade, if the parent determines the retention is not in the best interest of the child. The student would be provided with certain assistance. In a memo to lawmakers in November you wrote that, quote, parents are the ultimate arbiter of performance. How do you think this impacts a teacher's ability to assess whether or not a Florida school student is ready for the next grade?

Well, I think that's a different question than the regulation. It is my hope that the parents and the teachers — and my understanding that the parents who are actively involved in their student’s education — have conversations with teachers about their student's progress. But a static rule that if you don't pass a test, you don't advance, is problematic. And the other thing is that regulation that was created in 1999 was created in a vacuum, basically. It was the beginning of a really wonderful program that Jeb Bush had put together. They didn't have the kind of early intervention programs we have today. Students weren't assessed, nobody knew what their progress was. They got to third grade, and they couldn't read and boom, they get to hold them back. Well, now we are spending many, many hours on our VPK programs, on early intervention, on reading initiatives. There are so many programs out there for the early learners. It's really wonderful. And it all is built on Jeb Bush's original ideas. So I believe that if a student can't read by third grade, that's way too late. We've got to find it. We've got to get them earlier. They should be starting to learn to read in kindergarten, first grade and second grade. Some of the other issues with holding a student back in third grade is more problematic from a social standpoint than it would be in kindergarten or first grade.

"We have heard so many horror stories of some of our children that are being influenced by social media posts, tweets and whatever. Suicides and lack of self-esteem and so many things that will impact them in their future. And I think we need to protect our kids. My No. 1 priority is protect our kids."

Kathleen Passidomo

Does the ability to retain a kindergartener, to hold back a kindergartener because of reading deficiency, does that still, under this legislation, stand with the teacher?

That's all part of the whole educational process where they make those decisions. But it's not a statutory requirement. There are testing and evaluations that are done of the early learners and those decisions are made in concert with the principal and you know, everybody participates. It's just that we felt that using third grade is too late.

The bill drops requirements for passing an Algebra 1 test and a 10th-grade English test to graduate. Why do you think these are no longer necessary?

Well, first of all, there's a misunderstanding. We didn't drop the requirement, we just changed it to being a percentage of your grade. Right now, if you don't pass the test, you don't graduate. Now, it's just one of many criteria for how to graduate.

Just for clarification, President. So could a student fail Algebra 1 but still graduate high school in Florida?

If all of their other criteria are successful. They can't fail the course. So they have to have all the other criteria of success. It's just a test.

The EOC, the end of course exam.

Yeah. And if they fail the test, that only counts as 30%. It's being characterized like we've taken away all those requirements. We haven't.

School districts have removed hundreds of books from shelves pointing to the Parental Rights in Education law passed a couple of sessions ago. At least one district no longer recognizes LGBTQ History Month over concerns that it may violate that state law. Others are still recognizing that. Are you satisfied with the way school districts have implemented the two Parental Rights in Education laws passed over the past few years?

First of all, I am not familiar with what all the school districts, how they've been implementing. I know my districts, Collier and Hendry counties, I'm familiar with and I think they're doing a really good job. And I think a lot of the rhetoric is politically motivated on all sides. I stand by my feeling that parents should be involved and have the ability to be involved in what their students read. And I'd like to add something that occurred to me. My children are all older. I mean, my oldest daughter's in her 40s and my youngest is in her 30s. And back in the day, when my kids were in school, I never went into the library. The only time that we parents went to the school was one night, you know, the opening night. And then we went to all their soccer games and the like. I am so thrilled that parents are getting actively involved in their children's education.

Insurance

Home insurance, the governor has proposed a tax holiday for state taxes levied on residential property insurance. He says it'll save about 6%. Do you support this effort?

I do. In fact, I'm just familiarizing myself with the issue. ... There are different buckets of taxes that are assessed on insurance policies. We have to craft it carefully to make sure that the tax savings is passed on to the consumer. So it's a good idea that we have to make sure we craft carefully.

House Speaker Paul Renner announces a proposal that would allow people to carry concealed weapons without licenses.

Immigration

The governor's proposed budget includes $5 million to continue the transportation of undocumented migrants to Massachusetts and California. Is that a program you support?

Well, it's not a priority of mine. I support the governor, I think he's doing a terrific job. He hasn't spent that kind of dollars, so I'm not sure whether that amount is necessary. But I certainly give a lot of respect to his budget items as he has to my initiatives.

Social media

Your colleague across the chamber in the House, House Speaker Paul Renner, one of his priorities is social media. He has said that social media is having a devastating effect on children. Should social media platforms be legally responsible for what they post on their platforms?

Yes. We have heard so many horror stories of some of our children that are being influenced by social media posts, tweets and whatever. Suicides and lack of self-esteem and so many things that will impact them in their future. And I think we need to protect our kids. My No. 1 priority is protect our kids.

Gov. DeSantis’ 2024 presidential campaign

You endorsed the governor's presidential ambitions in May, before he announced his presidential ambition. Do you still support the governor in his White House run?

I do. I do. And I'll tell you why. He has been a good partner to me and the speaker as we've gone through the process. I will tell you that with our Live Local initiative, last session, he was 100% behind it. Very helpful. And in fact, one of our components of our Live Healthy initiative that we're going to roll out soon is a whole mental health initiative, huge deal. And it came from an idea that he threw out on the table one day when we had a meeting. So I feel very comfortable with the way he cares about our state, and I'm going to continue to support him.

Florida GOP chair Christian Ziegler

You've said that you agree with the governor that the Republican Party of Florida Chairman, Christian Ziegler, should resign. He has not. Do you still believe that Mr. Ziegler should quit the chairmanship?

I do.

In absence of him resigning, do you support any kind of action that could be taken by the executive committee of the party to remove him?

Well, it's up to them. It's my understanding that they have an upcoming meeting and are going to make a decision, and I presume it will be the right decision.