Diagnosis for 7.31.24: Checking the pulse of Florida health care news and policy
Welcome back to Diagnosis, a vertical that focuses on the crossroads of health care policy and politics. — More hospitals at home — Four hospitals notified the state this week of their interest in launching hospital-at-home services. Cape Coral Ho…
Welcome back to Diagnosis, a vertical that focuses on the crossroads of health care policy and politics.
— More hospitals at home —
Four hospitals notified the state this week of their interest in launching hospital-at-home services.
Cape Coral Hospital, Gulf Coast Medical Center, Healthpark Medical Center, and Lee Memorial Hospital submitted variances to the state Agency for Health Care Administration this week, asking the state to allow them to deliver acute care services to patients in their own homes.
The acute care at-home program starts with approval from the Centers for Medicare and Medicaid Services (CMS). The Acute Hospital Care at Home program is an expansion of the CMS Hospital Without Wallsinitiative launched in March 2020 as a part of a comprehensive effort to increase hospital capacity, maximize resources and combat COVID-19 to keep Americans safe.
After hospitals receive approval from CMS, they must file a petition of variance that allows the state to waive the requirement that hospitals have "immediate availability of a registered nurse for bedside care of any patient when needed, and have a minimum of one licensed registered nurse on duty at all times on each nursing unit or similarly titled part of the hospital for rendering patient care services."
Four hospitals notified the state they want to launch hospital at-home services.
The Legislature in 2022 passed SB 1222, which allows hospitals to serve patients in their homes through the use of pharmacies, or through paramedics and hospital pharmacies. Specifically, the law authorizes a paramedic to provide basic life support services and advanced life support services to a patient receiving acute and post-acute hospital care at home under a program that has been approved by CMS and AHCA. The law was sponsored by then Sen. AaronBean and championed by Mayo Clinic Hospital Jacksonville Medical Director Michael Maniaci.
Orlando Health Dr. P. Phillips Hospital, Orlando Health South Seminole Hospital, Arnold Palmer Medical Center, Orlando Health Orlando Regional Medical Center, Tampa General Hospital, Cleveland Clinic Florida Martin North Hospital, Cleveland Clinic Florida Indian River Hospital, Cleveland Clinic Florida Weston Hospital, Cape Canaveral Hospital, Holmes Regional Medical Center, Palm Bay Hospital and Viera Hospital all filed similar requests for variances.
I welcome your feedback, questions and especially your tips. You can email me at SextonHealthNewsletter@gmail.com or call me at 850-251-2317.
— Cyberattack threatens blood supply at Florida hospitals —
A hack of one of the top blood suppliers in the state has put dozens of hospitals on the brink of a critical blood shortage.
Florida hospitals have had to cancel optional surgical procedures to help ensure their future blood supply after a cyberattack on OneBlood, the not-for-profit blood center serving more than 250 Florida hospitals.
"We have implemented manual processes and procedures to remain operational. Manual processes take significantly longer to perform and impact inventory availability. In an effort to further manage the blood supply, we have asked the more than 250 hospitals we serve to activate their critical blood shortage protocols and to remain in that status for the time being," OneBlood's Senior Vice President of Corporate Communications and Public Relations, Susan Forbes,said in a statement Wednesday.
Florida Hospital Association President and CEO Mary Mayhew said Florida hospitals started feeling the impacts of the attack Monday. She said there is a significant shortage of platelets, which is "absolutely for some hospitals affecting their ability to do transplants, open-heart surgeries and treatments for oncology patients."
Hackers have endangered the blood supply at myriad hospitals. Stock image via Adobe.
OneBlood said it is working closely with federal, state and local agencies as part of its comprehensive response to the situation. Due to OneBlood's efforts, hospitals on Wednesday were receiving about 60% of their normal blood supply, Mayhew said.
According to a press release, OneBlood experienced a "ransomware event" that has "significantly reduced" its ability to test and distribute blood; they are operating at a significantly reduced capacity.
"OneBlood takes the security of our network extremely seriously. Our team reacted quickly to assess our systems and began an investigation to confirm the full nature and scope of the event," Forbes said. "Our comprehensive response efforts are ongoing and we are working diligently to restore full functionality to our systems as expeditiously as possible."
Jackson Health System has procured additional units of blood from another supplier and currently has enough inventory system-wide "to continue performing the types of complex procedures that Jackson is known for—organ transplants, trauma-related surgeries, heart surgeries, and more," spokesperson Lidia Amoretti said.
"Because we do not know how long this outage will impact our supply chain, our clinical leadership is reviewing every planned surgical case requiring blood in order to ensure the limited supply is distributed appropriately, and putting processes in place to preserve this valuable resource," she said.
Blood centers across the country are sending blood and platelets to OneBlood, and the Association for the Advancement of Blood & Biotherapies (AABB) Disaster Task Force is coordinating national resources to assist with additional blood products being sent to OneBlood, the company said in a statement.
In a statement to Florida Politics, Tampa General Hospital, a level 1 trauma center, said it is taking a "proactive approach to conserve supplies where circumstances allow. "
TGH said it is working closely with state and federal leaders to ensure it has adequate supplies to mitigate the impact on its operations.
"At this time, we are not rescheduling surgeries and are continuing to accept patients at our facilities," a statement from the system said.
Orlando Health also issued a statement saying it was working with OneBlood to "manage the situation so our patients may continue to receive essential blood products."
— What should patients do? —
Mayhew's group has held two statewide calls with hospitals and OneBlood regarding the cyberattack.
Hospitals are working to protect their supplies and OneBlood is working with state and federal agencies. But what, if anything, can patients with upcoming scheduled surgeries do?
Not much.
The good news for UF Health patients: They use LifeSouth.
"Patients need to know that they are going to be communicated with, that hospitals are going to be doing all of the necessary outreach," Mayhew said. "Hospitals are triaging the procedures based upon the level of urgency and the level of dependency, in particular on platelets."
And there's good news for UF Health patients.
According to a spokesperson for UF Health, the system has not been impacted by the OneBlood event. "We work exclusively with LifeSouth for our blood donations. LifeSouth is not experiencing any issues and is fully operational."
—One abortion legal challenge dropped—
The group pushing the proposed constitutional amendment on abortion access is dropping one of its legal challenges over the statement that will appear on the ballot next to the initiative.
Attorneys representing Floridians Protecting Freedom on Wednesday filed a notice with the Florida Supreme Court saying they were voluntarily dismissing their request that the high court overturn an appeals court ruling. The 1st District Court of Appeal said the lawsuit over what is known as the financial impact statement was moot.
Scratch one legal tussle over Amendment 4.
"Upon further review and given the specific facts of this case, petitioners do not believe the decision below expressly and directly conflicts with a decision of another district court of appeal or of this Court on the same question of law, because the conflicts do not appear 'within the four corners' of the decision," states the dismissal notice.
But this doesn't end all the legal wrangling.
Floridians Protecting Freedom's first lawsuit — which has now ended — was aimed at a financial impact statement that was drawn up last year by state economists before the state's ban on abortions after six weeks took effect. A lower court judge sided with the group, but while the lawsuit was pending, legislative leaders directed economists to draw up a new statement.
Amendment backers say legislative leaders did not have the legal authority to authorize a new statement and they are asking the high court to scuttle it.
— Say hello—
It's summertime which, along with sweltering heat and crazy thunderstorms, means changes in leadership positions at statewide associations and lobbying groups.
To that end, two associations this week announced changes in leadership.
Scott Burgess was elected Chair of the Florida Behavioral Health Association (FBHA), Melissa Larkin-Skinner as Chair of the Florida Council for Behavioral Healthcare (FCBH), the association's advocacy arm, and Jean D. Pierre as Chair of FADAA, the association's services arm.
"All thanks to the dedication and leadership of FBHA's chairs, board of directors, and members, we have seen a monumental investment in Florida's behavioral health system, allowing incredible strides toward healing those struggling with mental health and substance use disorders," said Melanie Brown-Woofter, president and CEO of FBHA. "I look forward to continuing these great efforts alongside Scott, Melissa, and Jean. These individuals are forward-thinking innovators who work each day to better everyone around them. I could not be more excited for the future."
Burgess is CEO of David Lawrence Centers for Behavioral Health in Naples and serves on FBHA's Executive Committee and the FBHA Board of Directors.
"I consider it a great honor to have been selected by my distinguished colleagues to serve as chair of the Florida Behavioral Health Association," Burgess said. "I am committed to advancing our mission and ensuring that behavioral health care continues to be available for everyone. Together, we will work to foster healthier communities, support stronger families and empower resilient Floridians."
Larkin-Skinner is the immediate past Chair of FBHA and recently transitioned to a new role as president of Community Assisted and Supported Living in Sarasota. She has 30 years of experience in behavioral health and was previously the CEO of Centerstone Florida for nearly eight years.
"I am excited and energized to work alongside my intrepid colleagues and FCBH board members to create meaningful and powerful change for the well-being of all Floridians," Larkin-Skinner said.
Pierre is the executive vice president and chief behavioral health officer for Community Health of South Florida, Inc. in Miami.
"As I begin chairing FADAA, I am excited for the possibilities ahead," Pierre said. "Together with the FADAA board and our dedicated members, I am eager to innovate and create meaningful change. It is a great honor to serve in this esteemed position, and I am committed to advancing our mission to better serve those most in need."
Five new members have also been elected to the LeadingAge Southeast Board of Trustees. Four of the members are from Florida nursing homes, and the fifth represents a facility in Louisiana, reflecting the association's broader footprint.
The new Board members are: Brad Bodie, Kendall Bryan, Scott Crabtree, Troy Churchill and Susan George. Bodie serves as the executive director at Abbey Delray South Delray South, in Delray Beach. Bryan is executive director at Vicar's Landing in Ponte Vedra Beach. Crabtree is the president and CEO of Lambeth House, in New Orleans, LA. Churchill is the president and CEO of Cypress Living in Fort Myers. George is the executive director at the Edgewater at Boca Pointe, Boca Raton.
"We are thrilled to welcome Brad, Kendall, Scott, Troy, and Susan to the LeadingAge Southeast Board of Trustees," said Steve Bahmer, President and CEO of LeadingAge Southeast. "Each of them brings a wealth of knowledge and expertise that is invaluable as we navigate the rapidly changing landscape of senior living. Their diverse backgrounds, expansive visions, and commitment to embracing advanced technologies will ensure that we remain at the forefront of innovation as we continue to advocate for and serve the aging population in our region."
— RULES —
The Board of Pharmacy proposes amending Rule 64B16-26.2031 to update language regarding the examination required for non-U.S. graduates. More here.
The Board of Nursing proposes amending Rule 64B9-4.00 to provide instruction for a temporary certificate for practice in areas of critical need. More here.
The Board of Osteopathic Medicine proposes amending Rule 64B15-12.005 to implement new statutory provisions of Live Healthy Florida, and to clarify and revise the rule as necessary. More here.
The Board of Osteopathic Medicine proposes amending Rule 64B15-14.0076 for osteopathic physician office surgery registration; inspection or accreditation. More here.
The Board of Osteopathic Medicine proposes amending Rule 64B15-6.003 to incorporate the application for temporary certificates for physician assistants to practice in an area of critical need and to also update the rule text. More here.
The Board of Medicine proposes amending Rule 64B8-9.0091 regarding physician office surgery registration, inspection or accreditation. More here.
The Board of Medicine proposed developing an amendment to Rule 64B8-30.003 regarding the temporary certificate for physician assistants to practice in an area of critical need and updating the rule text. More here.
The Board of Medicine proposes amending Rule 64B8-7.002 to implement new statutory provisions of Live Healthy Florida, and to clarify and revise the rule as necessary. More here.
The Board of Medicine proposes amending Rule 64B8-8.0011 regarding the types of continuing education courses that licensees may take to satisfy disciplinary order obligations. More here.
The Board of Medicine proposes amending Rule 64B8-9.0091 to implement new statutory provisions of Live Healthy Florida, and to clarify and revise the rule as necessary. More here.
— LOBBYISTS —
Courtney Coppola, Christopher Hansen, Ballard Partners: Amneal Pharmaceuticals, ExThera Medical Corporation, K&L Gates.
Michael Corcoran, Jacqueline Corcoran, Matt Blair, Brian Ford III, Will Rodriguez, Corcoran Partners: The Doc App.
Lauren Lange, Johnston & Stewart Government Strategies: Neighborly Care Network.
Tracy Mayernick, Rob Johnson, The Mayernick Group: SalusCare
— ETC —
— PruittHealth–Pinellas, LLC submitted an expedited certificate of need (CON) application to AHCA for the transfer of CON 10732 from PruittHealth-West Central Florida to establish a new 120-bed nursing home.
— ROSTER—
Jeremy Hardegree was named the new Senior Director of Business Development for Health Network One. Hardegree will be instrumental in expanding Health Network One's customer portfolio through the identification of new sales opportunities while fostering current relationships with stakeholders.
Health Network One is bringing on health care veteran Jeremy Hardegree.
The Governor announced the appointment of Wayne Chutkan, Dr. Chris Ghaemmaghami, Matthew Love, and Dr. Michelle Mendez to the Graduate Medical Education Committee. Chutkan is the senior vice president of Finance at Mount Sinai Medical Center. Chutkan earned his bachelor's and master's degrees in accounting from Florida International University. Ghaemmaghami is the executive vice president, Chief Physician Executive, and Chief Clinical Officer of Jackson Health System. He earned his bachelor's degree in chemistry from the University of Miami, his master's degree in health care management from Harvard University, and his Doctor of Medicine degree from the University of Miami. Love is the president and CEO of Nicklaus Children's Hospital. Love earned his bachelor's degree in industrial and systems engineering from The Ohio State University and his master's degree in business administration from Cleveland State University. Mendez earned her bachelor's degree in microbiology from Mississippi State University and her Doctor of Osteopathic Medicine degree from Nova Southeastern University.
— ICYMI —
In case you missed them, here is a recap of other critical health care policy stories covered in Florida Politics this past week.
"State moves quickly to settle Medicaid managed care legal challenges" via Christine Jordan Sexton of Florida Politics — The Agency for Health Care Administration referred legal complaints filed by ImagineCare, AmeriHealth Caritas and Sentara to the state Division of Administrative Hearings on July 26, days before a statutory deadline to do so. Florida administrative law requires that a hearing be held within 30 days, meaning that a trial must start by Aug. 26. AHCA referred the cases to DOAH after Florida's top economists questioned the startup date for the newly announced Medicaid contracts. Medicaid officials targeted a Sept. 1 startup date for a multiphase rollout and a Jan. 1, 2025 date for statewide implementation. The ongoing legal dispute is already causing a bit of a conundrum for economists trying to come up with forecasts that will be used to develop the state's three-year financial outlook.
"Just say no: Florida Sheriffs Association releases resolution opposing recreational marijuana amendment" via Christine Jordan Sexton of Florida Politics — The group that represents Florida's Sheriffs, which has often aligned itself with the state's Republicans, is taking a formal stance against the amendment that would allow recreational marijuana. The Florida Sheriffs Association (FSA) released its resolution spelling out the reasons why it opposes Amendment 3. The Sheriffs voted last week to oppose Amendment 3.
"Legal tussle over disputed Medicaid managed care contracts grows" via Christine Jordan Sexton of Florida Politics — There's growing interest in a Medicaid lawsuit that's been filed in Leon County Circuit Court. Florida Community Care (FCC) filed a motion to intervene in ImagineCare's lawsuit to prevent Agency for Health Care Administration (AHCA) Secretary Jason Weida from executing new multiyear Medicaid managed care contracts until its underlying administrative complaint has been resolved. The lawsuit has been assigned to Leon County Circuit Court Judge Angela Dempsey.
"Jaguars, UF announce new partnership" via Cole Pepper of Florida Politics — The Jacksonville Jaguars and UF have announced a new four-year partnership, signaling a new hospital sponsor of the NFL team. Previously, Baptist Health was the Jaguars' sole hospital partner. Both UF Health and Baptist will remain as Jaguars' partners through the 2024 season. The new arrangement is a marketing partnership that will see Baptist shifting its Jaguars partnership to Wolfson Children's Hospital.
"Top Republican Joe Gruters breaks ranks, supports making pot legal for adults" via Christine Jordan Sexton of Florida Politics — Sen. Joe Gruters, the former Chair of the Republican Party of Florida, is breaking away from Gov. Ron DeSantis and fellow Republicans to endorse a proposed constitutional amendment that would allow the use of recreational marijuana. The Sarasota Republican is a longtime ally of President Donald Trump, who has clashed with DeSantis in the past. Gruters served as the Chair of the RNC Credentials Committee for the convention held earlier this month, and is running for Chief Financial Officer in the 2026 Election. Adding to his conservative bona fides, Gruters was Chair of the state party between 2018 and 2022.
— FOR YOUR RADAR —
Aside from coverage by Florida Politics, these stories are worth your time.
"Regina Hill spent $30K on 'caregivers' for elderly woman. They kept visitors away" via Annie Martin of the Orlando Sentinel – After she seized control of an elderly woman's finances, investigators say suspended Orlando City Commissioner Hill hired a rotating cast of caregivers, including one with a criminal background but none affiliated with home health care agencies, to tend to the woman – and shoo away visitors. Those hires also included a homeless woman who met Hill at a shelter and one who tried to prevent Hill's now 96-year-old constituent from speaking with her pastor and church members who came to her home, records from the agency show. Those details exemplify how investigators say the City Commissioner sought to isolate and failed to provide proper care for the woman, who has no living family members and suffers from memory loss.
"Candidate for Sarasota Memorial Hospital Board dies after battle with leukemia" via Earle Kimel of the Sarasota Herald-Tribune — Englewood resident John A. Lutz, a longtime advocate of patient care who filed in January as a Democrat seeking the at-large Seat 2 on the Sarasota County Public Hospital Board, died July 24 at age 64, following a three-month battle with Acute Myeloid Leukemia. The news of Lutz's death was shared in an email by Sarasota County Democratic Party Chair Daniel Kuether. "John has become a friend to many of us over the last six months, and our hearts go out to his wife, Holly, and his family now," Kuether wrote.
"Rick Scott, Kat Cammack file legislation supporting families using IVF treatment" via Owen Girard of Florida's Voice – Republican U.S. Sen. Scott and Republican U.S. Rep. Cammack filed legislation that supports families as they pay for medical expenses, such as in vitro fertilization, or IVF. The bill decouples Health Savings Accounts, also known as HSAs, from high-deductible health plans and doubles the current contribution limits on HSAs from $4,300 to $8,600 for individuals and $8,550 to $17,100 for families. "IVF is a wonderful thing that enables so many Americans to start and grow their families," Scott said in a statement. "For me and my family, the blessing of IVF is personal, as my youngest daughter is currently undergoing IVF treatments to grow her family."
"Sarasota Memorial Hospital Board reaffirms commitment to keeping facility public" via Earle Kimel of the Sarasota Herald-Tribune – An informal straw poll of Sarasota County Public Hospital Board members reaffirmed their commitment to keep the Sarasota Memorial Health Care System public. The unofficial assessment came about after Hospital Board member Victor Rohe attempted to introduce a motion to require a unanimous vote by all nine members to privatize the health care system. Privatization of the 99-year-old hospital and its network has become an issue on the campaign trail, with four seats on the Board up for election this year and dueling slates of Republicans, as well as a slate of Democratic candidates to face the GOP Primary winners. Members of each slate point fingers at their opponents as champions of privatizing Sarasota's safety net hospital.
— PENCIL IT IN —
Thursday
1 p.m. — The Joint Surgical Care/Quality Assurance Committee meets to discuss proposed changes to its standards of practice for office surgery procedures. Drury Plaza Hotel-Orlando - Disney Springs Area, 2000 Hotel Plaza Blvd., Lake Buena Vista.
Monday
Happy birthday to Rep. Tyler Sirois and Sen. Ed Hooper!
Tuesday
Happy birthday to Rep. Tom Leek!
Wednesday
9 a.m. — State Employees' Health Insurance Expenditures Estimating Conference. Room 117, Knott Office Building.
Diagnosis is written by Christine Jordan Sexton and edited by Drew Wilson.
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