Yahoo Movies Lawmakers finally tackle Florida’s NICA program. Now, make life better for brain-injured kids | Editorial
The Legislature seems intent on reforming NICA, a Florida program to protect doctors from medical-malpractice lawsuits by limiting compensation for children born with catastrophic brain damage.
That’s good news — and overdue.
Of course, lawmakers didn’t tackle the problems on their own. It took a multipart series, Birth and Betrayal, written by the Miami Herald in partnership with the investigative reporting nonprofit ProPublica, to get this sudden burst of action in the final two weeks of the session. The series detailed the plight of families in the program, with some saying they are forced to plead for medical care and services their children need.
Broward County Democratic Sen. Lauren Book, one of the sponsors of the new measures, said NICA families she spoke with revealed “the utter brokenness of this program.” Co-sponsor Sen. Danny Burgess, a Zephyrhills Republican, said the program “failed families time and time again.”
We agree, and as we have said before: This is a program that needs serious reform. Since the Legislature created the program in 1988, NICA — the Birth-Related Neurological Injury Compensation Association — has amassed $1.5 billion in assets, employing money managers and lobbyists along the way. At the same time, it spent millions of dollars on legal fees to fight parents over claims for their children.
Parents whose children are accepted into NICA receive a lump sum of $100,000 — an amount that hasn’t changed in 33 years — and a promise of lifetime “medically necessary and reasonable” care for their child. They have to give up their right to sue their doctors, which ultimately reduces malpractice insurance premiums, the law’s stated intent.
For some, this is a good program. If they sued, they might lose and bear the entire financial burden of raising a child with brain damage. But for others, the program has devolved into an unending fight over broken beds or too-small wheelchairs — piling misery on misery.
The reforms will help, if the House and Senate pass them. They include creating an ombudsman; covering mental-health costs for parents; increasing the initial lump sum and adding the parent of a NICA child to the board of directors — something that should have been done years ago. Another reform requires NICA to cover medical costs currently shifted to Medicaid.
Those are good ideas that can help some of the state’s most vulnerable families.
Kenney Shipley, the program’s executive director since 2002, says she supports most of the reforms. That’s a turnaround. In 2013 she opposed reforms, telling a lobbyist in an email that, “We are not here or funded to ‘promote the best interest’ of the children.” Those reforms died.
She’s still fighting one of them, though: the provision that would force NICA to stop shifting medical costs to Medicaid. NICA is currently in court in a suit that alleges the program is violating federal law by making Medicaid shoulder hundreds of millions of dollars in reimbursement.
If the program needs more money, lawmakers should consider raising the rates charged to participating doctors: $5,000 a year, the same for 33 years. But first we need a full audit of NICA’s books, as promised by Chief Financial Officer Jimmy Patronis. And we need Shipley, the executive director, to acknowledge the program’s faults rather than blindly defending it.
In addition, administrators should stop making parents work so incredibly hard for every penny they manage to squeeze from the program. A broken bed is a broken bed. If a child has outgrown her wheelchair, then it’s useless. Since the child already is in NICA, why do parents have to prove time and again that the child’s needs are real?
During committee meetings Monday, one parent held up a thick binder of documents that she said was needed to prove to NICA that she’s entitled to reimbursement for her son’s care. She called their lives “exhausting.” Another parent, with a 4-year-old in the program, implored lawmakers to focus the program on the kids: “Not the doctors, not the hospitals … Treat our children, number one.”
That parent, Jayme O’Connell, is right. The public servants who run NICA have gotten things backward. It’s time to “promote the best interest” of these children. Lawmakers, push these reforms through.
