Budget Language OKs Spending Levels, But Also Sets Policy

By Christine Sexton, Florida Phoenix

June 17, 2025

People with developmental and intellectual disabilities (IDD) who rely on Medicaid won’t have to worry about reapplying for services every year.

As part of the budget agreement, legislators agreed to pass SB 2514, which, among other thing,s changes the law so that people with these disabilities don’t have to annually prove to the state they remain eligible for the safety net program for the poor, elderly and disabled.

It’s one of a bevy of health care-related proposals that legislators agreed to pass in budget-conforming bills while meeting in Tallahassee during the extended 2025 session. While the General Appropriations Act or budget is in effect for one year, conforming bills make permanent changes to statutes. Conforming bills include the policy changes legislators say are needed to carry out the intent of the budget.

In addition to the health care conforming bill, there were conforming bills for education, state employees, and the environment.

Tucked away in SB 2514 were priorities for House Speaker Daniel Perez, others for Senate President Ben Albritton, as well as Gov. Ron DeSantis.

Perez on Monday reminded reporters that IDD-related issues were the reason he ran for the Legislature and have been his top priority since getting elected.

“Someone who has been diagnosed as being permanently disabled should not have to recertify as being permanently disabled every year. Unfortunately, that person isn’t going to be able to move away from that,” the speaker said, while praising Rep. Chase Tramont, a Republican from Port Orange, for championing the issue on behalf of the House.

That change, coupled with a decision to expand statewide a managed care pilot program for people with IDD, are among the biggest accomplishments of the 2025 session, Perez said. The expansion was contained in HB 1103, signed into law earlier this month. The Legislature agreed to earmark the money needed to make the expansion possible in the General Appropriations Act.

“When we look back at the successes of this session, we’ll look back at this pilot program as one of our greatest victories. It probably will never be a headline, it’s probably not anything that most people will fundraise off of, or campaign off of. But what I can tell you, I think for me and when I’m long gone and everyone forgets who I am and the names of many people in this chamber, they will remember that we potentially got rid of the wait list (for Medicaid services for people with IDD).”

Albritton used SB 2514 to make a number of changes to state nursing home laws, including requiring facilities to conduct patient safety and culture surveys at least biennially. These anonymous surveys must be administered by a third party and survey data, including survey participation rates, must be submitted to the state Agency for Health Care Administration.

SB 2514 also requires nursing home facility medical directors to be certified by the American Medical Directors Association or to hold a similar certification by Jan. 1, 2026. The substantive changes are accompanied by $276 million in nursing home rate increases.

Albritton told reporters on Monday the policy changes and spending increases are an effort to make the state’s nursing homes the “envy of the rest of the country.”

“You know, it would be fantastic to get Florida’s nursing home system in Florida so great that people around the country, when they’re thinking about their own relatives, that they first think of Florida. I would love that and that’s really our goal,” he said.

While the Legislature may have been at odds with the governor in recent months over immigration, spending, and tax relief, the Legislature did give the governor aone of his health care priorities by signing off on a plan to fund a new five-year $30 million research incubators for pediatric cancer research and clinical trials.

The bill also establishes parameters for the existing cancer innovation fund and authorizes money for comprehensive community cancer programs, which are typically hospital-based and manage a high volume of cancer cases, plus integrated network cancer programs which involve multiple facilities within a hospital network that offer integrated cancer services.

The Legislature did not, however, sign off on other changes to cancer funding, including diverting cancer funds away from National Cancer Institute-designated centers.

The House and Senate passed SB 2514 unanimously.

Lawmakers changed the definition of a persistently low-performing school, expanding how many traditional public schools could have a charter School of Hope co-located inside of it. SB 2510 expands which schools may be deemed persistently low-performing by including those that have been in the bottom 10% of third grade English or fourth grade math for two of three years. In 2023-2024, there were 51 persistently low-performing schools.

Existing law relies on schools’ overall grade, classifying them as persistently low-performing if it has three years graded lower than “C” during a five-year span.

The idea was floated but was unsuccessful as its own bill during the session. HB 1267 passed the House on party lines; however, the Senate never took it up. And senators weren’t pleased to discover the issue had been included in the budget legislation after voting it down.

Sen. Rosalind Osgood expressed concern about traditional public schools taking on the expenses of the Schools of Hope.

“If I was on the public school board right now, I would kind of feel a little pressure that my funding in other places could disappear if I don’t go along to get along,” Osgood said.

The conforming bill eliminates weighted funding for advanced placement and dual enrollment courses and establishes the Academic Acceleration Options Supplement as a categorical fund, leaving the amount of funding for the courses largely unchanged from current levels.

This would give schools funding based on their student population enrolled in such courses at the same level but through a different mechanism.

The Florida Education Association said the new way to distribute aids in “reducing transparency and potentially restricting district flexibility in how those funds are used.”

Previously, there was a proposal to lower state funding for those courses, but legislators said constituent feedback prompted maintain the funding.

The conforming bill passed the Senate 25-9 and the House 80-24.

Florida A&M University named a new president last month. Her salary has been a point of contention, with the school’s foundation questioning whether it will fund its obligation toward the contract.

Legislators intervened, including in proviso language allowing FAMU trustees to spend money otherwise unavailable for paying the presidential salary. State law otherwise only allows state funds to pay for the first $200,000 of a president’s salary. Marva Johnson, the new president, opposed by many in the FAMU community, is set to make about $840,000 in her first year and up to about $981,000 in her final year of the contract.

Legislators agreed to give state employees a 2% pay raise in the budget and also to not raise state employee health insurance premiums in the coming year. While that will sit well with state employees, there could be a change in the coming year that Florida employees don’t like.

To help keep costs down in the state group health insurance program, legislators also agreed to include in HB 5015 a mandate for the Department of Management Services (DMS) to implement a pharmaceutical formulary, effective for the 2026 policy year, potentially narrowing available medicines.

HB 5015 does make clear that DMS is required to submit its formulary recommendations to the Legislative Budget Commission by Sept. 1. Additionally, that panel must approve the recommendations for them to take effect.

“We can think it’s a good plan and bring it in for a landing or reject it,” Senate Appropriations Committee Chair Sen. Ed Hooper, R-Clearwater, said when asked about the drug formulary last week.

DMS’ recommendations must include a list of prescription drugs and supplies recommended for the formulary and a comparison of the coverage for the 2025 benefit year. The recommendations must contain a list of prescription drugs and supplies that will require prior authorization. Additionally, the DMS recommendations must spell out any proposed “step therapy” requirements for prescription drugs or supplies.

Step therapy is a cost-containment approach that requires people to try more affordable drugs when therapeutically appropriate. The approach is also called “fail first” because patients can’t use more costly alternative prescription drugs unless they try the less expensive medication first and those medications fail.

HB 5015 passed the Senate by a 25-9 vote and the House by a 98-5 vote.

The Florida Phoenix, a nonprofit news site that’s free of advertising and free to readers, covers state government and politics through a mix of in-depth stories, briefs, and social media updates on the latest events, editorial cartoons, and progressive commentary. The Phoenix is part of States Newsroom, a national 501(c)(3) nonprofit supported by grants and a coalition of donors and readers.