A high-profile healthcare bill moving through the Florida House could strip the Miami-Dade County Commission of its authority to make the final decision on labor union contracts at the county’s public hospital system.
The bill originally sought to create new rules for trauma centers, allow skilled nurses to practice independent of physicians, and pave the way for hospitals to use virtual healthcare services.
But last week, a lawmaker from Central Florida added language weakening the role of county commissions in overseeing public health trusts. There’s only one public health trust in Florida: the independent body that governs Jackson Health System.
The county, the hospital system, the Public Health Trust and the healthcare employees’ union all opposed the measure when it was proposed last week.
“Nobody who is involved in this wants this,” said Martha Baker, president of SEIU Local 1991, which represents Jackson physicians and nurses.
Jackson CEO Carlos Migoya said he, too, was caught off guard by the proposal.
“We didn’t know anything about it,” Migoya said. “When it comes to labor agreements, we’ve never had a problem. We felt there was no reason to do this.”
But the provision became part of HB 7113 in a 12-5 vote Thursday. The bill is now poised to go to the House floor.
The provision is not included in any proposals in the Senate, but could be added to a number of bills in the coming weeks. The legislative session ends May 2.
The Public Health Trust of Miami-Dade County is a citizen board that provides independent oversight of Jackson Health System. Its seven members are approved by the Miami-Dade County Commission.
One member also serves in the Florida Legislature: state Rep. Michael Bileca. Bileca, a Miami Republican, did not return calls Monday.
Among other duties, the Public Health Trust negotiates contracts with the hospital’s labor unions. The County Commission has the power to override those agreements.
Case in point: Earlier this year, Migoya reached a deal with the labor unions that would have given employees a “gain sharing payment” or bonus, based on the hospital’s budget surplus from last year. Migoya originally planned to give workers 3 percent. But after facing opposition from one member of the Public Health Trust and Miami-Dade Mayor Carlos Gimenez, he scaled the bonus back to 2 percent.
The process would change if HB 7113 became law.
Rep. John Wood, the Winter Haven Republican who added the provision last week, said he intended to “take politics out of labor negotiations.”
“It’s just inherent in labor negotiations that if you insert politics into a labor negotiation, in my opinion, the result is not going to be as good as a traditional negotiation between management and its workers,” he said.
Wood said Miami-Dade County was not the inspiration for his amendment. He noted that other counties have the option to create public health trusts.
“The public entities that we form are essential to the delivery of healthcare services to our citizens,” he said. “We need to have governance structures that make sense.”
But Miami-Dade County Commission Chairwoman Rebeca Sosa said the proposal was “not proper and not ethical coming from someone from the outside who has never come and talked to the administration of Jackson or SEIU.”
“The employees need a third party to make sure that decisions [on their contracts] are fair,” Sosa said. “And they need a public, open forum where the discussion can take place.”
The five Democrats sitting on the House Health and Human Services Committee made a similar case Thursday.
Rep. Joe Gibbons, D-Hallandale Beach, noted that county commissioners could still influence the members of the Public Health Trust, as they approve members.
“This doesn’t take politics out of anything,” he said.
But Rep. Jimmy Patronis, R-Panama City, made the case for empowering the Public Health Trust.
“The government that is closest to the people best serves the people,” he said.