Thursday, August 22, 2024

Diagnosis for 08.22.24: Checking the pulse of Florida health care news and policy

By Christine Jordan Sexton on August 22, 2024

Welcome back to Diagnosis, a vertical that focuses on the crossroads of health care policy and politics.

— Defending disenrollments —

Gov. Ron DeSantis' administration is publicly disputing assertions that it improperly removed people from the state's Medicaid rolls even as a federal judge considers the question.

Florida Department of Children and Families (DCF) Secretary Shevaun Harris, during an event on the Hope Florida program held with DeSantis, said Wednesday that it was not "factual" to suggest the state erred when it trimmed the Medicaid rolls as part of the "unwinding" process.

*Ron DeSantis defends his decision to drop thousands of Floridians from Medicaid.*

During the COVID-19 public health emergency, the state could not remove people from Medicaid, the health care safety net program. As a result, the number of people receiving coverage peaked at 5.57 million. In 2023, Congress gave states the go-ahead to begin reviewing whether people should remain eligible or be part of what has been called "unwinding."

Florida's Medicaid rolls tumbled quickly, but some health care advocates contended that was because the state removed people who were still eligible for coverage. The state's move led to a class-action lawsuit that wrapped up earlier this month, and a ruling is still pending.

During the trial, state officials testified that computer errors and problems with companies helping handle the Medicaid system resulted in people losing their coverage, including new mothers. Another issue highlighted during the trial was that DCF blocked hundreds of thousands of callers trying to reach a person to ask questions about Medicaid or the Supplemental Nutrition Assistance Program.

Harris said Wednesday that in the past year, her agency reevaluated the eligibility of 4 million people and that the "vast majority of those individuals (have) maintained coverage."

She added, "We're committed to ensuring that anyone eligible maintains coverage."

The DeSantis administration continues to disenroll eligible children from its state children's health insurance program, called Florida KidCare, for nonpayment of premiums even though federal law bans the state from doing so.

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— Meet the new Board —

This week, DeSantis appointed two new members to the Board of Medicine, keeping two long-standing members, including one who is an adviser to First Lady Casey DeSantis' cancer initiatives.

First, the new members are Dr. Steven Christie and Dr. James "Matthew" Knight.

Christie is an oncological radiologist in Miami. He also is the brains behind Speaking for the Unborn, which was created, according to the website, because "simply knowing that' abortion is wrong' is woefully insufficient to sustain a movement."

*Steven Christie and James "Matthew" Knight are two new faces on the Florida Board of Medicine.*

Christie, an attorney and member of the Florida Bar, created a book and video teaching series designed with talking points that Christie says, "present the truth of abortion — based on science, the law, reason, morality and social justice concerns."

In a book review posted on the website of New York Archbishop Timothy Cardinal Dolan, Christie's work is a "must-read."

Christie also lectures regularly on "marriage, family and the dignity of life," according to the website.

Knight is an Orlando dermatologist who identifies himself on social media as a "physician, dad & husband, author, speaker, entrepreneur." He also says he's "committed to the fight for lifelong wellness and individualism."

He is no stranger to the limelight, appearing on Fox News and submitting opinion pieces to the Orlando Sentinel, including one that detailed why people should abandon shaking hands with one another.

Chris Nuland is a Jacksonville health care attorney and a close watcher of the Board of Medicine. Nuland called Knight a "great addition to the Board."

Having two new Board members means two existing ones won't be coming back.

The Governor's news release did not say which members were being replaced. But three physician members have expired terms: Miami Beach physician Luz Marina Pages, Eleonor Pimentel from Miami, and Zachariah Zachariah, a Ft. Lauderdale physician and well-known Republican fundraising rainmaker.

— Same as the old Board —

While DeSantis appointed two new members, he also reappointed two long-standing members, which Nuland said, "provides much-needed continuity on the Board."

The Governor reappointed Scot Ackerman and Dr. Hector Vila.

Ackerman is the medical director of the Ackerman Cancer Center and served on an advisory Board hand-picked by First Lady Casey DeSantis. The Legislature codified into statute the "Cancer Connect Collaborative" the First Lady created in 2023. Efforts to give members of the collaborative control over how the state allocates $127.5 million in recurring cancer research funds, named in honor of the First Lady, fell short.

*Scot Ackerman and Hector Vila are returning to the BOM.*

Florida currently directs the money to the Mayo Clinic Comprehensive Cancer Center, the University of Miami Sylvester Comprehensive Cancer Center, Moffitt Cancer Center, and UF Health Cancer Center, all of which are recognized by the National Cancer Institute (NCI).

While appearing at Nicklaus Children's Hospital earlier this year, the Governor hinted that the state should consider broadening the list of providers who receive the funds.

Ackerman's term on the Board expired Oct. 31, 2022. Vila's term also expired Oct. 31, 2022. He was first appointed to the Board by former Gov. Rick Scott in 2016 but has never served as its chair.

Vila is currently the managing partner and anesthesiologist at Pediatric Dental Anesthesia Associates.

Similar to Christie, Vila is politically active in the abortion arena. In a challenge to the 24-hour waiting period for abortions, Vila testified for the state, saying he was "not aware of another area of medicine, besides abortion, in which a nonemergency outpatient invasive procedure is performed without a prior visit and consultation."

He stated that the lack of a 24-hour waiting period "would fall below the acceptable medical standard of care."

— Board of Medicine & abortion —

The appointments by DeSantis come just weeks before the November election, where voters will decide whether to approve Amendment 4, an initiative that would guarantee abortion up to the point of viability.

DeSantis is steadfastly opposed to the initiative and calls it "radical." Florida law currently prohibits abortions after six weeks of pregnancy, and the two new appointees reflect the position of the Governor on the topic.

*New members of the Board of Medicine will be able to weigh in on several medical issues — including abortion.*

Florida's Governor enjoys broad administrative power, and DeSantis has already used his power to have the Board investigate the gender-affirming care standard. Before his presidential run and legislative push in 2023 to prevent most teenagers from accessing trans care services, DeSantis pushed the Board to amend its existing standard of care rules to ban access to gender-affirming care.

Akerman chaired the Board while the rules were being developed and passed and appeared before the Florida Legislature to defend the Board's position and explain what it did.

The Board of Medicine has already announced that it's amending its rules and forms regarding the monthly reporting of pregnancy terminations. The changes will reflect what the administration has twice published in emergency rules.

— Simply RISE —

Simply Healthcare Plans announced it's partnering with the Resilience Institute of Strength and Empowerment to promote a better understanding of trauma awareness among Florida health care providers through a new certification program.

Henderson Behavioral Health is the first care provider to participate in the pilot program, which helps providers understand trauma awareness and resilience principles and practices, recognize trauma-related signs and symptoms, create safe and supportive environments for patients, prevent burnout, and improve the overall well-being of staff.

*Henderson Behavioral Health is the first provider to participate in a new program to understand trauma.*

"We are grateful to Simply Healthcare for spearheading trauma awareness across Florida." Steve Ronik, CEO of Henderson Behavioral Health, said in a release. "Through their partnership, Henderson's staff members participate in FSU's 'Organizational Certification in Trauma and Resilience' course. This program is equipping our staff with essential tools for resilience and helping them support patients in navigating traumatic experiences so they can emerge with the resources they need to thrive."

In January 2023, Simply Healthcare Plans earned FSU's Trauma Aware organizational certification in January 2023. To earn the certification, more than 90% of Simply Healthcare's 1,400 employees completed online training on the impact of trauma and the promise of resilience.

"Through training and education with our partners at FSU, we have gained a greater awareness and understanding of trauma and how we can support our members who have experienced it," said Dana Gryniuk, Medicaid President of Simply Healthcare Plans. "Simply Healthcare is proud to extend this opportunity to our care providers through this pilot program. Together, we are building a stronger system that promotes health and wellness." Angi Yoder Maina, director of the Resilience Institute at FSU, said Simply Healthcare's support has been vital in sharing the evidence-based curriculum with health care professionals.

"This empowers providers to guide their patients through trauma prevention and recovery more effectively. By working together, we aim to broaden future training initiatives, making a significant impact on the well-being of all Floridians and fostering healthier communities," Maina said.

Simply Healthcare is an existing Medicaid-managed care provider and was recently awarded contracts across the state after the recent Medicaid procurement.

— RULES —

— The Board of Dentistry proposes amending Rule 64B5-13.005 regarding disciplinary guidelines to make them comply with the law. More here.

— The Board of Dentistry proposes repealing Rule 64B5-2.0152 regarding licenses granted based on the American Dental Licensing Exam from other jurisdictions. More here.

— The Board of Pharmacy proposes amending Rule 64B16-28.802 to clarify language regarding special sterile compounding permits for pharmacies and outsourcing facilities. More here.

— The Board of Speech-Language Pathology and Audiology proposes amending Rule 64B20-2.001 regarding licensure by credentials. More here.

— The Board of Psychology proposes amending Rules 64B19-11.001, 64B19-11.002, and 64B19-11.012 regarding application, endorsement, and licensure forms and to repeal outdated language that has become obsolete. More here.

— LOBBYISTS —

Jacqueline Corcoran, Michael Corcoran, Noah Corcoran, Will Rodriguez, Andrea Tovar; Corcoran Partners: Perfecting Peds

Cory Dowd, Capital City Consulting: Burrell College of Osteopathic Medicine

— ETC —

— The Democratic National Convention isn't the only banger this week. The Florida Behavioral Health Association (FBHA) kicked off its annual conference, BHCon2024. According to the group, more than 1,900 in-person attendees are at this year's conference, making it the largest conference the group has hosted.

"BHCon brings together the best of the behavioral health workforce, providing the space for attendees to reignite their passion for helping and serving those most in need, re-energize their creativity, and re-imagine the future of behavioral health care in Florida," said FBHA President and CEO Melanie Brown-Woofter. "Having a record number of attendees is a testament to the incredible speakers, dedicated sponsors and partners, and tenacious staff of BHCon."

BHCon2024 started Wednesday and will go through Friday, with keynote speeches from Sebastian Terry, Chris and Martha Thomas, and Jimmy Yeary.

— Senior Director of State Government Affairs at Bristol Myers Squibb, Scott Brock and his wife, Suzi Brock, are donating $3 million to their alma mater, Florida State University. The donation to the College of Business partially honors Scott's late father, Hubris A. Brock, a World War II and Korean War Army veteran and longtime friend of former Gov. Reubin Askew, the namesake of FSU's School of Public Administration. The gift includes $1.5 million for Seminole Booster, which supports FSU athletics, and $1.4 million for a pair of new endowments, one for an accounting professorship and the other for an accounting scholarship. "As we developed our estate plan, we wanted to include a gift to Florida State University that would benefit faculty and students academically and athletically for generations," the couple said. FSU President Richard McCollough called their contribution a "remarkable gift" that "reflects the Brocks' devotion to Florida State University and their belief in our students, student-athletes and faculty members."

— ROSTER —

The American Association of Nurse Anesthesiology inducted Jose Delfin D. Castillo III, Ph.D., MSNA, CRNA, APRN, and Jeanne M. Antolchick, Ph.D., CRNA, APRN, U.S. Army Veteran, as 2024 Fellows. Castillo is a member of the Florida Association of Nurse Anesthesiology (FANA) Board; Antolchick is a former Board member.

*Jose Delfin D. Castillo III and Jeanne M. Antolchick are Nurse Anesthesiology Hall of Famers.*

Jorge A. Valdes, DNP, CRNA, APRN, has been named a 2024 Fellow by The American Academy of Nursing. He is the Florida International University Nicole Wertheim College of Nursing & Health Sciences Interim Dean and a former FANA Board member.

— ICYMI —

In case you missed them, here is a recap of other critical health care policy stories covered in Florida Politics this past week.

"Endorsements keep rolling in for adult-use marijuana amendment," via Christine Jordan Sexton of Florida Politics — One of the state's largest unions is throwing its support behind legalizing marijuana for adults. The Florida chapter of the Service Employees International Union (SEIU) is supporting Amendment 3, the group said in a news release.

"Abortion rights advocates lose fight over ballot's financial impact statement" via Gabrielle Rousson of Florida Politics — The Florida Supreme Court has ruled against abortion rights advocates fighting to overturn a controversial financial impact statement appearing under Amendment 4 on the November ballot. Taryn Fenske, a spokesperson for DeSantis, called the ruling "excellent news."

"Ashley Moody warns returning students about fentanyl vapes, fatal pills" via A.G. Gancarski of Florida Politics — Even one pill (or puff) can kill. That's the sobering message from Attorney General Moody, who is calling attention to poison clouds from vape carts and phony medicines that could be pushed on unsuspecting youth as they go back to school.

"Trulieve contributes another $5M to recreational pot initiative" via Christine Jordan Sexton of Florida Politics — Trulieve, one of the state's largest medical marijuana companies, has now contributed nearly $65 million to help get Amendment 3 passed. The latest campaign finance reports show that Trulieve kicked in another $5 million in August to Smart & Safe Florida, the political committee backing the effort to legalize recreational marijuana.

— FOR YOUR RADAR —

Aside from coverage by Florida Politics, these stories are worth your time.

"Florida teacher vacancies are down 13%, state says. Teachers union says there are still 5,000 unfilled jobs" via Travis Gibson of News4Jax — The Florida Department of Education (FDOE) and the state's largest teachers union are at odds over the framing of teacher vacancies in public schools. The FDOE announced Monday that teacher vacancies for the 2024-2025 school year are 13.3% lower than first-day vacancies for the 2023-2024 school year. Schools have reported 1.11 teacher vacancies per school, lower than last year's average of 1.28. This year's 13.3% drop in vacancies follows last year's drop of more than 8% compared to the previous year.

"Florida abortion Amendment 4 means 'end of the pro-life movement'" via Kirby Wilson of the Tampa Bay Times — The opposition to Amendment 4 is getting organized, and DeSantis is leading the resistance. At an event at Jesuit High School on Thursday, DeSantis galvanized opposition to the amendment, which would end most abortion restrictions in Florida. In front of a packed auditorium crowd of a few hundred, Florida's Republican Governor laid out what he said are the stakes in November. "If you care about building a culture of life in this state or this country, them winning in Florida, I think, really represents the end of the pro-life movement," DeSantis said.

"Shock, frustration, anger, desperation: The real-life toll of Florida's six-week abortion ban" via Cindy Krischer Goodman of the South Florida Sun-Sentinel — On a Wednesday afternoon in a Tamarac abortion clinic, Eileen Diamond delivers the same news to the fourth patient in a row: "I am unable to help you here." She tells the woman her ultrasound confirms she is more than six weeks into the pregnancy, and in Florida, the services the patient seeks are no longer a legal option. The woman stares at Diamond. "No, you have to help me," she pleads, "I can't afford another child." Diamond, director of Benjamin Surgical Services International, knows the panic will soon turn to tears, and anger will follow.