HOUSE OF REPRESENTATIVES STAFF ANALYSIS
BILL #: CS/HB 1501 Health Care Innovation
SPONSOR(S): Health Care Appropriations Subcommittee, Gonzalez Pittman
TIED BILLS: IDEN./SIM. BILLS: SB 7018
REFERENCE ACTION ANALYST STAFF DIRECTOR or
BUDGET/POLICY
CHIEF
1) Healthcare Regulation Subcommittee 17 Y, 0 N DesRochers McElroy
2) Health Care Appropriations Subcommittee 14 Y, 0 N, As CS Aderibigbe Clark
3) Health & Human Services Committee 18 Y, 0 N DesRochers Calamas
SUMMARY ANALYSIS
CS/HB 1501 creates the Health Care Innovation Council, a 15-member council within the Department of Health
(DOH) to facilitate public meetings across the state to lead discussions with innovators, developers, and
implementers of technologies, workforce pathways, service delivery models, or other solutions. The bill
requires the council to create best practice recommendations and focus areas for the advancement of the
delivery of health care in Florida, with an emphasis on:
 Increasing efficiency in the delivery of health care;
 Reducing strain on the health care workforce;
 Increasing public access to health care;
 Improving patient outcomes;
 Reducing unnecessary emergency department visits; and
 Reducing costs for patients and the state without reducing the quality of patient care.
The bill creates a revolving loan program within the DOH to provide low-interest loans to applicants to
implement one or more innovative technologies, workforce pathways, or service delivery models in order to:
 Fill a demonstrated need;
 Obtain or upgrade necessary equipment, hardware, and materials;
 Adopt new technologies or systems; or
 A combination thereof to improve the quality and delivery of health care in measurable and sustainable
ways that will lower costs and allow that value to be passed onto health care consumer.
The council will review loan applications and submit to the DOH a prioritized list of proposals recommended for
funding. Loan recipients enter into agreements with the DOH for loans of up to 10-year terms for up to 50
percent of the proposal costs, or up to 80 percent of the costs for an applicant that is located in a rural or
medically underserved area and is either a rural hospital or a nonprofit entity that accepts Medicaid patients.
The bill requires both the council and the DOH to publicly report certain information related to the activities
required under the bill and requires the Office of Economic and Demographic Research (EDR) and the Office
of Program Policy Analysis and Government Accountability (OPPAGA) to evaluate specified aspects of the
revolving loan program every five years.
The bill provides an appropriation of $51,250,000 in recurring and nonrecurring funds to DOH to implement its
provisions, and has no fiscal impact on local government.
The bill takes effect upon becoming a law.
FULL ANALYSIS
This docum ent does not reflect the intent or official position of the bill sponsor or House of Representatives .
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 I. SUBSTANTIVE ANALYSIS
A. EFFECT OF PROPOSED CHANGES:
Background
Challenges of the Health Care System
There are numerous challenges facing the health care system in the United States, including provider
shortages, lack of access for certain populations, affordability, and ongoing challenges with health care
outcomes for certain populations. Compared with other wealthy nations, Americans have poorer health,
lower life expectancy, and less access to health care.1
Health Care Professional Shortages
The United States has a current health care professional shortage. The U. S. Department of Health and
Human Services designates an area, population group, or facility as a Health Professional Shortage
Area (HPSA) if it is experiencing a shortage of professionals. 2 The three types of HPSAs are:
 Geographic HPSAs, which have a shortage of services for the entire population within an
established geographic area;
 Populations HPSAs, which have a shortage of services for a particular population subset within
an established geographic area, such as low income, migrant farmworker, or Medicaid eligible;
and
 Facility HPSAs, which indicate shortages in facilities such as correctional facilities, state or
county hospitals with a shortage of psychiatrists, and other public or non-private medical
facilities serving a population or geographic area designated as a HPSA with a shortage of
health providers.
As of December 3, 2023, there are 8,544 Primary Care HPSAs, 7,651 Dental HPSAs, and 6,822
Mental Health HPSAs nationwide. To eliminate the shortages, an additional 17,637 primary care
practitioners, 13,354 dentists, and 8,504 psychiatrists are needed, respectively. 3
This shortage is predicted to continue into the foreseeable future and will likely worsen with the aging
and growth of the U.S. population.4 Aging populations create a disproportionately higher health care
demand due to seniors having a higher per capita consumption of health care services than younger
populations.5 By 2030, all baby-boomers will be over the age of 65, and by 2034, it is projected that the
number of individuals over the age of 65 will surpass the number of children under the age of 18 for the
first time in U.S. history.6 Additionally, as more individuals qualify for health care benefits, there will
necessarily be a greater demand for more health care professionals to provide these services.
Health care workers may experience an extreme amount of stress due to the demanding work
conditions, including taxing work, exposure to infectious diseases, long hours, and challenging
1 Centers for Disease Control and Prevention, U.S. Health Disadvantage: Causes and Potential Solutions, available at
https://www.cdc.gov/policy/chep/health/index.html (last visited January 9, 2023).
2 U.S. Department of Health and Human Services, Guidance Portal, Health Professional Shortage Areas (HPSAs and
Medically Underserved Populations (MUA/P) Shortage Designation Types (Aug. 1, 2019), available at
https://www.hhs .gov/guidance/document/hpsa-and-muap-shortage-designation-types (last visited January 9, 2023).
3 U.S. Department of Health and Human Services, Health Resources and Services Administration, Health Workforce
Shortage Areas, available at https://data.hrsa.gov/topics/health-workforce/shortage-areas (last visited December 19, 2023).
4 The U.S. population is projected to increase from almost 336 million in 2023 to nearly 370 million in 2080, before
decreasing to 366 million in 2100. See U.S. Census Bureau, U.S. and World Population Clock , available at
https://www.census.gov/popclock/ , and U.S. Census Bureau, U.S. Population Projected to Begin Declining in Second Half of
Century (Dec. 19, 2023), available at https://www.census.gov/newsroom/press-releases/2023/population-projections.html
(both sites last visited January 9, 2023).
5 Id. at 33.
6 J. Vespa, L. Medina, and D. Armstrong, Demographic Turning Points for the United States: Population Projections for
2020 to 2060, United States Census Bureau (Mar. 208, rev. Feb, 2020), available at
https://www.census.gov/content/dam/Census/library/publications/2020/demo/p25 -1144.pdf (last visited January 9, 2023).
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 interactions with coworkers, patients, and their families. 7 Prior to the COVID-19 pandemic, the National
Academy of Medicine found that burnout had reached a crisis level, with 35-45 percent of nurses and
physicians and 45-60 percent of medical students and residents reporting symptoms of burnout. 8
During the pandemic, the high levels of stress and the increased demands for care led to record
numbers of health care workers quitting or planning to quit.9 In 2022, nearly one half of health care
workers reported burnout.10
Florida is not immune to the national problem and is also experiencing a health care practitioner
shortage. This is evidenced by the fact that as of September 30, 2023, there are 304 primary care
HPSAs, 266 dental HPSAs, and 228 mental health HPSAs designated within the state. It would take
1,803 primary care physicians, 1,317 dentists, and 587 psychiatrists to eliminate these shortage
areas.11
According to data from the DOH, by 2035, Florida will need 17,924 physicians, 50,700 registered
nurses, and 4,000 licensed practical nurses to meet the demand in Florida. 12 In the next five years
almost 10 percent of Florida physicians are planning to retire, and in nine counties, at least 25 percent
of physicians are planning to retire.13 Nurses make up the largest segment of Florida’s health care
workforce. Approximately 20 percent of the nursing workforce is over the age of 60 and may leave the
workforce in the next five to ten years.14
Access to Health Care
Access to health care means the timely use of personal health services to achieve the best possible
health outcomes.15 There are several barriers that limit an individual’s access to health care services.
Some lack access because they reside in a medically underserved area or are members of a medically
underserved population, which means that they lack access to primary health care services. 16 Florida
has approximately 130 federally designated medically underserved areas or populations.17
Other factors that play a role in access to health care include health care affordability and the lack of
health insurance coverage.18 Studies show that having health insurance is associated with improved
access to health services and better health monitoring. Additionally, nonfinancial barriers significantly
impact a patient’s ability to access care. Among the most prevalent nonfinancial barriers are the ability
to get an appointment and inconvenient or unreliable transportation.19
7 J. Nigam, et. al., Vital Signs: Health Worker-Perceived Working Conditions and Symptoms of Poor Mental Health – Quality
of Worklife Survey, United States, 2018-2022, MORBIDITY AND MORTALITY WEEKLY REPORT (Oct. 24, 2023), available at
https://www.cdc.gov/mmwr/volumes/72/wr/pdfs/mm7244e1-H.pdf (last visited January 9, 2023).
8 Office of the Surgeon General, Addressing Health Worker Burnout: The U.S. Surgeon General’s Advisory on Building a
Thriving Health Workforce (2022),, available at https://www.hhs.gov/sites/default/files/health-worker-wellbeing-advisory.pdf (last visited
January 9, 2023). “Burnout” is an occupational syndrome characterized by a high degree of emotional
exhaustion and depersonalization and a low sense of personal accomplishment at work.
9 Id. at 14.
10 Supra, FN 7.
11 Bureau of Health Workforce, Health Resources and Services Administration (HRSA), U.S. De partment of Health and
Human Services, Designated Health Professional Shortage Areas Statistics, Fourth Quarter of Fiscal Year 2023
(Sept. 30, 2023), available at https://data.hrsa.gov/topics/health-workforce/health-workforce-shortage-areas?hmpgtile=hmpg-hlth-srvcs
(last visited January 9, 2023).To generate the report, select “Designated HPSA Quarterly Summary.”
12 Presentation before the Florida Senate Committee on Health Policy by Emma Spencer, Department of Health, Florida’s
Physician and Nursing Workforce (Nov. 14, 2023), available at
https://www.flsenate.gov/Committees/Show/HP/MeetingPacket/5979/10504_MeetingPacket_5979_4.pdf (last visited January 9, 2023).
13 Id. Those counties are Glades, Gulf, Hamilton, Madison, Union, Calhoun, Hendry, Levy, and Liberty.
14 Id.
15 U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion , Healthy People
2030, Access to Health Services, available at https://health.gov/healthypeople/priority-areas/social-determinants-health/literature-
summaries/access-health-services (last visited January 9, 2023). (Hereinafter “Healthy People 2030”).
16 Health and Resources Services Administration, What is Shortage Designation?, available at
https://bhw.hrsa.gov/workforce-shortage-areas/shortage-designation (last visited January 9, 2023).
17 See, Heath Resources and Services Administration, MUA Find, available at https://data.hrsa.gov/tools/shortage-area/mua-find (last
visited January 9, 2023).To generate a list of medically underserved areas and populations, select Florida as the search criteria.
18 Centers for Disease Control and Prevention, Division of Heart Disease and Stroke Prevention, Health Care Access,
available at https://www.cdc.gov/dhdsp/health_equity/health-care-access.htm (last visited January 9, 2023).
19 Healthy People 2030, supra, note 156.
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 Health Care Outcomes
Although the United States spends more on health care per capita than other wealthy nations, it has
some of the worst health care outcomes, according to an issue brief published by The Commonwealth
Fund. Compared to other wealthy nations, the U.S. has the lowest life expectancy at birth, the highest
death rates for avoidable or treatable conditions, the highest maternal and infant mortality, and among
the highest suicide rates, according to the issue brief. 20
Sixty percent of adults in the U.S. have a chronic health condition, and 40 percent have two or more. 21
A chronic condition is a physical or mental health condition that lasts more than one year and causes
functional restrictions or requires ongoing monitoring or treatment.22 Chronic health conditions are the
leading drivers of the nation’s $4.1 trillion in health care costs, accounting for nearly 75 percent of
aggregate health spending.23 More than two thirds of all deaths are caused by one or more of the five
most prevalent chronic health conditions: heart disease, cancer, stroke, chronic obstructive pulmonary
disease, and diabetes. Unfortunately, these outcomes are because of the nation’s inability to effectively
manage chronic conditions, which could be achieved by reducing unhealthy behaviors.24
Maternal mortality refers to deaths occurring during pregnancy or within 42 days of the end of
pregnancy, regardless of the duration of the pregnancy, from any cause related to or aggravated by the
pregnancy, but not from accidental or incidental causes.25 In 2021, more than 1,200 women died of
maternal causes in the United States compared with 861 in 2020 and 754 in 2019. The national
maternal mortality rate for 2021 was 32.9 deaths per 100,000 live births. Racial and ethnic gaps exist
between non-Hispanic black, non-Hispanic white, and Hispanic women. The maternal mortality rate of
these groups is 69.9, 26.6, and 28.0 deaths per 100,000 live births, respectively. 26 The overall number
and rate of maternal deaths increased in 2020 and 2021 during the COVID-19 pandemic.27
Although Florida’s maternal mortality rate is lower than the national rate, it has been increasing in
recent years. As of 2021, the maternal mortality rate in Florida is 28.7 deaths per 100,000 live births, an
increase from a low of 12.9 deaths per 100,000 live births in 2016. 28 Similar to the national trend, racial
and ethnic disparities exist in the maternal mortality rates in Florida.
Infant mortality is the death of an infant before his or her first birthday. The leading causes of infant
death are:
 Birth defects;
 Preterm birth and low birth weight;
 Sudden infant death syndrome;
20 M. Gunja, Evan Gumas, and R. Williams, The Commonwealth Fund, U.S. Health Care from a Glob al Perspective, 2022:
Accelerating Spending, Worsening Outcomes (Jan. 31, 2023), available at
https://www.commonwealthfund.org/publications/issue-briefs/2023/jan/us-health-care-global-perspective-2022 (last visited January 9,
2023).Other wealthy nations included in the study are Australia, Canada, France, Germany, Japan, the
Netherlands, New Zealand, Norway, South Korea, Sweden, Switzerland, and the United Kingdom.
21 Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, About
Chronic Diseases, available at https://www.cdc.gov/chronicdisease/about/index.htm (last visited January 9, 2023).
22 W. Raghupathi and V. Rahupathi, An Empirical Study of Chronic Diseases in the United States: A Visual Analytics
Approach to Pub lic Health, INTERNATIONAL JOURNAL ON ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH, 15(3):431
(Mar. 2018), available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5876976/ (last visited January 9, 2023).
23 Id., and CDC, supra, note 22.
24 Id.
25 U.S. Department of Health and Human Services, The Surgeon General’s Call to Action to Improve Maternal Health (Dec.
2020), available at https://www.hhs.gov/sites/default/files/call-to-action-maternal-health.pdf (last visited January 9, 2023).
26 Donna L. Hoyert, Ph.D., Division of Vital Statistics, National Center for Health Statistics, Maternal Mortality Rates in the
United States, 2021 (March 2023), available at https://www.cdc.gov/nchs/data/hestat/maternal-mortality/2021/maternal-mortality-rates-
2021.pdf (last visited January 9, 2023).
27 United States Government Accountability Office, Maternal Health Outcomes Worsened and Disparities Persisted During
the Pandemic (Oct. 2022), avail