Medicaid Archives - Page 6 of 31 - Florida Politics

Budget signed, LIP deal formalized (sort of), health care done for now

Just hours after Gov. Rick Scott quietly signed a state spending plan into effect, the federal government gave Florida a long-awaited “agreement in principle” letter that all but formalizes an agreement between Florida and the federal government on hospital funding for the next year.

The coveted agreement, which the state had hoped to secure in April so the Legislature could draft a budget before the end of the 2015 regular legislative session, lays out a two-year agreement that expires in June 2017, which is when the underlying Medicaid 1115 waiver that makes Low Income Pool possible expires. The waiver also allows Florida to operate its mandatory statewide Medicaid managed program statewide.

The two-page letter was sent to Deputy Medicaid Secretary Justin Senior and is signed by Centers for Medicare and Medicaid Services Acting Director Vikki Wachino. CMS and Florida have been working closely to reach final agreement on Low Income Pool funding.

Meanwhile, the budget put an additional $400 million recurring general revenue into hospital rates and directs $1 billion in Low Income Pool dollars to a variety of hospitals based on a plan hammered out between the House and Senate.

Jan Gorrie, managing partner of the Tampa office of Ballard Partners and a lobbyist for large urban hospitals around the state, said the “high five” from the federal government and the signing of the budget is good news for Florida hospitals.

However, CMS also indicated next year LIP will be further ratcheted back. “So our work is cut out for us. No rest for the weary,” she said, noting that the Legislature returns to Tallahassee in about two months to begin a round of meetings in preparation of next year’s Session, which starts in January.

And even before the start of the January session Florida will be working on what a new Low Income Pool distribution model for 2016-17 looks like. Wachino’s letter makes clear that the the $1 billion Low Income Pool money in fiscal year 2015-16 will be distributed as outlined in the General Appropriations Act, but that the $608 million for the following year will be distributed based on the volume of provider uncompensated care and in accordance with a new distribution formula.

The letter notes that Florida will have to submit a new formula to the federal government by October 31 and that CMS will work with Florida to approve the new distribution method before December 31, 2015.

“Florida may not claim federal financial participation for LIP payments [in 2016-17] until a new methodology is approved by the federal government,” the letter notes.

6_23_15 Lettter to Florida

Jac Wilder VerSteeg: Jeb Bush’s view of religion knocks off some commandments

I have to believe Jeb Bush when he says he wouldn’t let his priest – or even the pope – dictate his economic policy. In fact, if you take Jeb’s recent statements about religion seriously, an obvious conclusion is that Jeb doesn’t take his religion seriously.

I hope Im not going to get castigated for saying this by my priest back home,Jeb said, but I dont get economic policy from my bishops or my cardinals or my pope.”  He continued, I think religion ought to be about making us better as people, less about things [that] end up getting into the political realm.

With that statement which Jeb uttered in an attempt to sidestep Pope Francisencyclical on climate change Jeb has created a conundrum. We have to identify things that can be categorized as making us better as peoplebut that are not so important that they would be getting us into the political realm.

The first thing to notice is that Congress and state legislatures routinely deal both in criminal and civil statutes with things such as murder, theft, perjury and marriage.

Right away, at least four of the Ten Commandments are in trouble. Dont kill, dont steal, dont bear false witness and dont commit adultery.

Sorry, priests, rabbis and pastors, we dont want to hear your thoughts on those topics any more. Too political.

Its true that some commandments that used to be enforced by the state already have fallen or are falling by the wayside. We dont still put people in the stocks for missing services on the Sabbath, though a dwindling few blue laws remain in effect. Presumably Jeb-gagged priests can continue to preach about such things. But, and this is part of the head-scratcher Bush has posed, those things could not have dropped out of the political realm without some politicians deciding to remove them from statutes.

But leave that catch-22 alone for time being. Try instead to imagine the kinds of things that Jeb thinks would be appropriate for religious leaders to concern themselves with. Get back to that sliding scale with Making us better as peopleon one end and Getting us into the political realmon the other. You can move the slider along the Making us better as peoplerange only until it moves into the Getting us into the political realmon the other. Then you have to stop, Mr. Minister, and abandon the issue to politicians.

However, Im having trouble thinking of an issue that makes us better as people that doesnt quickly get into the political realm in some fashion or other.

Could he be talking about I dont know eating right and exercising? Oh, wait. Hasnt Congress had regular fights about which farm products can be purchased for low-cost school lunches? Hasnt the Florida Legislature mandated periods of physical activity for school children?

Perhaps religious leaders should just talk about the redeeming value of prayer. Certainly prayer never has become a political issue. Oh, wait

What about, love your neighbor as yourself? That sounds just a little too much like what all those sore-loser Florida senators were saying when they castigated House members for failing to expand Medicaid even as they preserved special health insurance for themselves.

Like it or not, nearly everything that is important to religion also is important to politicians. Jebs view seems to be that once politicians pick up a subject, religious leaders have to drop it.

How incredibly secular of him. I guess there is only one thing for religious people to do: Pray Jeb doesnt get elected.

Jac Wilder VerSteeg is a columnist for The South Florida Sun Sentinel, former deputy editorial page editor for The Palm Beach Post and former editor of Context Florida. 

Jac Wilder VerSteeg: Jeb Bush’s view of religion knocks off some commandments

I have to believe Jeb Bush when he says he wouldn’t let his priest – or even the pope – dictate his economic policy. In fact, if you take Jeb’s recent statements about religion seriously, an obvious conclusion is that Jeb doesn’t take his religion seriously.

I hope Im not going to get castigated for saying this by my priest back home,Jeb said, but I dont get economic policy from my bishops or my cardinals or my pope.”  He continued, I think religion ought to be about making us better as people, less about things [that] end up getting into the political realm.

With that statement which Jeb uttered in an attempt to sidestep Pope Francisencyclical on climate change Jeb has created a conundrum. We have to identify things that can be categorized as making us better as peoplebut that are not so important that they would be getting us into the political realm.

The first thing to notice is that Congress and state legislatures routinely deal both in criminal and civil statutes with things such as murder, theft, perjury and marriage.

Right away, at least four of the Ten Commandments are in trouble. Dont kill, dont steal, dont bear false witness and dont commit adultery.

Sorry, priests, rabbis and pastors, we dont want to hear your thoughts on those topics any more. Too political.

Its true that some commandments that used to be enforced by the state already have fallen or are falling by the wayside. We dont still put people in the stocks for missing services on the Sabbath, though a dwindling few blue laws remain in effect. Presumably Jeb-gagged priests can continue to preach about such things. But, and this is part of the head-scratcher Bush has posed, those things could not have dropped out of the political realm without some politicians deciding to remove them from statutes.

But leave that catch-22 alone for time being. Try instead to imagine the kinds of things that Jeb thinks would be appropriate for religious leaders to concern themselves with. Get back to that sliding scale with Making us better as peopleon one end and Getting us into the political realmon the other. You can move the slider along the Making us better as peoplerange only until it moves into the Getting us into the political realmon the other. Then you have to stop, Mr. Minister, and abandon the issue to politicians.

However, Im having trouble thinking of an issue that makes us better as people that doesnt quickly get into the political realm in some fashion or other.

Could he be talking about I dont know eating right and exercising? Oh, wait. Hasnt Congress had regular fights about which farm products can be purchased for low-cost school lunches? Hasnt the Florida Legislature mandated periods of physical activity for school children?

Perhaps religious leaders should just talk about the redeeming value of prayer. Certainly prayer never has become a political issue. Oh, wait

What about, love your neighbor as yourself? That sounds just a little too much like what all those sore-loser Florida senators were saying when they castigated House members for failing to expand Medicaid even as they preserved special health insurance for themselves.

Like it or not, nearly everything that is important to religion also is important to politicians. Jebs view seems to be that once politicians pick up a subject, religious leaders have to drop it.

How incredibly secular of him. I guess there is only one thing for religious people to do: Pray Jeb doesnt get elected.

Jac Wilder VerSteeg is a columnist for The South Florida Sun Sentinel, former deputy editorial page editor for The Palm Beach Post and former editor of Context Florida. Column courtesy of Context Florida.

Lawmakers aimed to build a veto-proof health care budget

Florida’s legislative leaders are trying to make the health care financing decisions they made during the June Special Session veto-proof.

The Florida House and Senate were at odds throughout the 2015 Regular Legislative Session on health care spending and policy. Indeed, the inability to agree on how much additional Medicaid funding to include in the budget was the reason the chamber’s didn’t pass a spending plan on time.

But that was then and this is now. House and Senate leaders not only agreed to $400 million in recurring general revenue dollars for hospital funding, they appear to have agreed to a strategy to buffer their hard-won compromise from a potential veto from Gov. Rick Scott who during the regular Session made clear that he did not support back-filling the loss of any Low Income Pool funding with general revenue.

The Senate’s chief budget writer, Sen. Tom Lee, told reporters that the agreement to Low Income Pool funding was one of the “linchpins” that was able to bridge the House and Senate into working again on the 2015-16 budget.

“Since that was a huge priority to the Senate, and we understand that not everyone supports putting general revenue into back-filling LIP, we wanted to make sure that the critical pieces of that were part of this agreement that brought us together didn’t get unraveled after when we left here for session,” Lee said.

“We have had a priority to continue to stabilize the health care system while we look for long-term solutions. And in the interim we just think it would do irreparable harm to the system to allow the executive branch to go in and unravel that transaction that took place in the legislative process. We tried to do as much as we could to keep that agreement together.”

To that end, buried in the mounds of paper that House and Senate budget chiefs agreed upon was language that stated the two chambers agreed to reference a 53-page document in the General Appropriations Act as well as proviso called the Medicaid Hospital Funding Programs. It is the 53-page Low Income Pool offer the House made to the Senate.

Incorporating the document by reference means that there will be no dollar amount listed by the appropriation. Scott can veto an appropriation in a substantive bill without vetoing the underlying policy. Without a dollar amount, the governor would have to veto the entire bill to eliminate the spending.

The chambers agreed to put language in the conforming bill that notes whether any portion of the General Appropriations Act is unconstitutional then “all other provisions or applications of this act invalid” and that “the entire act shall be deemed to never have become law.”

Though included in the conforming bill, which, is permanent law, the chambers agreed to repeal the language effective July 2016.

Lee said the House knew that hospital funding and stabilizing the health care environment in the aftermath of the loss of $1 billion in Low Income Pool funding was a priority for the Senate. As such, Lee said the House was “accommodating” when it came to including the comfort language throughout the bills.

Matt Hudson, chief writer for the House health care budget, said the language was put in the bills at the behest of the Senate but may unnecessary.

“I think at the end of the day the governor is going to be very pleased with the work we have.”

Marc Yacht: Universal health care access must come to U.S.

The Florida House’s rejection of Medicaid expansion money affects more than just the poor. A recent Tampa Bay Times editorial outlined 25 reasons to accept the federal money.

Because of House members’ rejection, 800,000 low-income Floridians are now shut out of health care coverage. Many working poor who now pay high premiums for Obamacare face high deductibles. One rightly questions the value of insurance without protective subsidies.

Significant numbers of uninsured will continue to use Florida emergency rooms. That pressures insurance premiums and health care costs to rise. A fully insured population would break the cycle of escalating health care costs.

By refusing the expansion money Florida lost $700 million in 2016, and billions more down the road. That loss ripples outward to affect healthcare providers, pharmacies, medical equipment suppliers, the business community and all Florida residents.

Arguments against accepting the money are disingenuous at best and relate solely to the ideological hatred of President Barack Obama. Many who support that bias work against their own interests. The opportunity for comprehensive care will be lost to hard-working families. Federal taxes paid by Florida residents are then sacrificed to Obamacare-friendly states.

In all fairness, Medicaid offers second-tier discounted coverage. Many doctors reject it.  However, it does open the door to a full range of services including primary care, specialty care, and hospitalizations.

Free clinics rarely offer comprehensive services. Placing the Medicaid insured into managed-care models further reduces the options for care because those insurers profit by limiting patient care. That conflict of interest has defined the managed-care model. Also, doctor scorecards unfairly flag physicians for statistically driven increased patient costs. The health care management model can determine what services a doctor may perform.  Yet the physician remains responsible for outcomes.

In spite of all the emphasis on healthcare cost containment, the U.S. significantly exceeds per capita healthcare costs worldwide. Wise efforts should be directed at reducing administrative costs that can consume 20 percent or more of the health care dollar. Such costs result from the fragmentation of insurers, complex billing practices and onerous oversight.

A valid argument exists that Obamacare is too expensive to provide universal coverage. Yet those same critics block every effort to reduce healthcare administrative costs. Naysayers protect not only highly profitable insurers but also protect provider profiteering. And, of course, the uninsured place further pressure on costs.

Whenever the circular arguments vis-à-vis the outrageous costs of health care occur, rarely is there any movement to effectively address excessive charges, administrative costs and fragmentation. Those remain off the table.

That brings up the “Medicare for All” model with administrative costs under 5 percent. Every provider would save significantly because of the simplicity of the coverage. It’s criminal to allow the profiteering to continue while criticizing the lack of resources to provide universal health care to Americans.

Universal coverage would allow all Americans access to needed preventive and episodic care. Chronic conditions would be addressed and no one would have to delay needed care for fear of cost.

We stand alone from wealthy nations that have successfully provided universal health coverage for decades. Those nations surpass us in the overall health and well-being within their countries. Such political confusion regarding affordable healthcare for every American is unforgivable.

 Marc Yacht M.D., M.P.H. is a retired physician living in Hudson. This column courtesy of Context Florida.

Lots added to budget but not more money for Medicaid HMOs

More than $300 million in additional revenue was plowed into the budget late Monday night but, apparently, leaders did not agree to spending any more money on Medicaid.

That’s a disappointment to the managed care plans participating in Florida’s mandatory Medicaid managed care program. They were hoping for an increase of $57 million in “grants and donations” trust funds that could be used to draw down federal matching funds.

In all, it would have been about a $110 million infusion for the plans, about 25 percent of the original $400 million bump in rates the plans requested at the beginning of the 2015 Regular Legislative Session.

The Florida Association of Health Plans President and Chief Executive Officer Audrey Brown said pharmaceutical costs were not properly contemplated in the current rates the HMOs are being paid. Brown said the agency has not properly adjusted the second-year rates — which are in draft form — to accommodate for the costs of name brand drugs.

“We look forward to working with the agency and the Legislature on adequate rates so that we can continue to ensure high quality care for Florida’s most vulnerable citizens,” Brown said in an email statement.

Agency for Health Care Administration Secretary Liz Dudek scoffed at the notion that the 13 plans that participate in the Statewide Managed Medical Assistance Program needed a $400 million increase in current-year rates. In a letter to health plans, Dudek  said that under the current contracted rates with HMOs, the state is saving slightly more than 5 percent compared to prior year’s spending after the shift to statewide Medicaid managed care.

“The $400 million in current year increase demanded by the plans would offset the vast majority of those savings,” she wrote.

Florida Law requires HMOs to maintain solvency requirement in the greater amount of:

  • $1,500,000;
  • 10 percent of total liabilities; and
  • 2 percent of total annualized premium.

Insurance Commissioner Kevin McCarty issued a memorandum to HMOs in May advising that the solvency requirements are in effect at all times, not just the end of each quarterly reporting period.

McCarty’s memo also puts in bold and underlines the message that it’s a felony for any officer of director of an HMO to accept or renew insurance or provider contracts if the officer knew the HMO was impaired or insolvent.

While the health plans were pushing to get money to increase their current rates, Dudek’s agency has shared a draft of proposed rate increases for the upcoming 2015-16 year. The draft rates show the plans could see an average 6 percent increase in rates. That’s far less than the 12 percent increase the plans were advocating.

Steve Crisafulli downplays Senate rejection of House health care proposals

House Republicans earlier this month rejected a Senate proposal to extend health coverage after a bitterly divisive debate that last nearly seven hours.

House leaders such as Rep. Jason Brodeur and House Speaker Steve Crisafulli contended a better way was to fix other problems with the state’s health care laws.

The answer from the Senate?

No debate, no vote. At least not now.

On Monday, Senate Health Policy Committee Chairman Sen. Aaron Bean announced his committee wouldn’t be voting on a number of bills the House sent to the Senate for consideration this session.

The timing comes as legislators are frantically trying to reach a final deal on a new state budget and raised the possibility of another breakdown between the two chambers.

Crisafulli, though, doesn’t see it as a snub. Instead, the Speaker chose a more conciliatory, and perhaps sarcastic, note. “We understand that you cannot force another Chamber to take up legislation,” the speaker said in a statement.

The House of Representatives would not consider the Senate’s proposal to expand Medicaid under ObamaCare. The Senate advanced the plan, dubbed FHIX, as conservative noting that it had prerequisites for eligibility such as work requirements and co-payments. FHIX — and the House’s refusal to bring the issue up during the 2015 regular legislative session — led to a budget impasse during the regular session and, eventually, the special session.

Bean cancelled the Health Policy Committee meeting scheduled for Tuesday. His committee discussed several of the House’s proposals last week but didn’t take a vote on any of the issues.

Bean said in the statement that in the days following his panel’s workshop the consensus view in the Senate is that a 20-day budget special session does not lend itself to a “thorough and proper vetting of foundational changes to our health care delivery system.”

Bean also asked for the creation of a Joint Legislative Task Force on Health Care Policy Innovation that could begin meeting in the interim between the special session and the regularly scheduled 2016 legislative session in January.

Bean said in his release that Senate President Andy Gardiner is open to the idea.

Crisafulli said he “welcome(s) discussions on these bills because much work needs to be done to lower costs and improve healthcare quality and access for all Floridians.”

Spokesperson Michael Williams said the speaker supports the ideas of a joint legislative task force.

Julie Delegal: Health care defeated by politics of personal resentment

State Rep. Mia Jones tried.

In the spirit of compromise, the Democrat from Jacksonville moved right to embrace the health care-expansion plan backed by the Florida Senate: the Florida Healthcare Affordability Insurance Exchange, aka FHIX.

Jones told The Jacksonville Times-Union that she had set aside her doubts about the plan and would “stand on the shoulders” of Florida’s 800,000 working uninsured in her fight to get them covered. She fought for the workers who build our houses in 100-degree heat, clean Florida’s hotel rooms, pour your coffee every morning, and sell you shoes at the mall.

These are able-bodied — for now — adults who, despite working every day, often at multiple jobs, still can’t afford to purchase health insurance. Florida FHIX would have enabled workers who earn up to 138 percent of the poverty level to use federal subsidies — money that Florida taxpayers have already sent to Washington — to buy coverage.

Billed as a free-market solution — as opposed to Obamacare — Florida’s FHIX would have required participants to pay premiums of up to $25 per month and show proof of work, school, or a job search.  Among the plan’s advocates was a John-Thrasher-conservative, Fernandina Beach Republican Sen. Aaron Bean, who was quoted as saying that this was “not your grandfather’s Medicaid expansion.”

The FHIX plan was, instead, innovative in the way that former Gov. Jeb Bush’s Med-waiver program was innovative when it was introduced about a decade ago.

Like Bush’s plan, FHIX would have used Medicaid funds to pay private entities to meet participants’ healthcare needs. Like Bush’s plan, it could have produced a savings that could be put toward something else. And despite the James Madison Institute’s protestations to the contrary, implementing FHIX would not have been mutually exclusive to pursuing other healthcare reforms.

In fact, in passing up FHIX, lawmakers passed up an opportunity to attach meaningful reforms to the package.

Yes, the Medicaid reimbursement rate needs to be raised. But doesn’t that have a better chance of happening if private insurers are in the negotiating room?

Yes, we could stand to roll out some carefully constructed pilot programs in telemedicine. Why not negotiate with the feds to use Medicaid money to do just that?

Why not?

Partisan politics, that’s why not. Specifically, it’s the far right’s reliance on a certain, divisive brand of ideology. My husband, the political scientist, calls it “the politics of personal resentment.”

The politics of personal resentment dictates that no one should ever, ever have something that only I deserve. The politics of personal resentment relies, implicitly, on the notion that some people are simply better than other people.

It defaults back to power structures that endow white people, male people, and wealthy people with a sense of automatic authority. It defers to the most powerful, and faults the least among us for being vulnerable.

The politics of personal resentment uses language like “able-bodied adults with no children” to distinguish those people from “the rest of us.” Conjuring the ghost of Ronald Reagan, dog whistles such as “American values” and “welfare queens” echoing in their minds, lawmakers set out to put themselves above the working poor in Florida. Their ideology, you see, depends on these false hierarchies — depends on being “better than.”

The politics of personal resentment blames poor people for being poor, whether or not they’re working one, two, three, or more jobs to feed themselves and their families. It begrudges a hand-up because it can.

Practitioners of this divisive and ugly brand of rhetoric point accusatory fingers at those who simply want a shot at the American Dream. “You’re not worthy,” lawmakers have told 800,000 Floridians. “You are somehow … less.”

We have already decided that we will not, as a nation, turn people away when they’re in need of medical treatment. We’ve already agreed, on an implicit level, that access to quality health care is, like education, essential to equal opportunity.

We’ve now decided, in Florida, to pretend that we give a damn, using the most inefficient means available: the ER as primary care.

But as we turn our backs on people who need a hand up, we need to face the irony: The same people whose ideological intransigence has them scoffing at the workers who fix their cars, or cook their dinners, or change their sheets in Tallahassee hotel rooms have no problem accepting taxpayer-subsidized health care.

Personally, I resent the hell out of them.

Julie Delegal, a University of Florida alumna, is a contributor for Folio Weekly, Jacksonville’s alternative weekly, and writes for the family business, Delegal Law Offices. She lives in Jacksonville. Column courtesy of Context Florida.

Gary Stein: 6 degrees of health care is no idle game

One of the great advantages of the universe as well as one of its biggest problems is that everything is connected to something. From the forces that act on the tiniest subatomic particle to the most massive of planets, nothing works apart from everything. Nothing exists entirely within a vacuum, completely unaffected by anything around it.

For years, people have been playing games like “six degrees of Kevin Bacon” to prove the fact that anything is eventually connected to everything.

The budget process in Tallahassee is like a game, too. In fact, it is like several games rolled into one. It is one part poker, one part fencing, one part chess and one part big sliding puzzle.

The ultimate goal for everyone in the process is to start with a picture of what they want, and, they hope, to end up with what they need. To win, you have to persuade the other side to make compromises they didn’t even consider until the handwriting appeared on the wall. Just like chess, you have to think several moves ahead. Just like in poker, you have to study your opponent’s nuances to figure out what their last move meant, and what their next move will be. Just like in fencing, it is all in the timing of thrust and parry.

The similarity to a big sliding puzzle is obvious. Pieces and offers slide across an ever-moving landscape until everything settles into their final place and the final vote is taken on the balanced budget. Move one piece at the last minute, and you see again that, even though the categories may have looked separate, altering any piece’s size, shape or color can change everything.

In the House, with its “finite total” approach, the only way to get an increase for the category you think needs it is to take away funding from someone one else who wants it. Players have to consider whether an increase in a pot of money to help get kids necessary technology for education or vocational training could be done by taking it away from an agency like Big Brothers and Sisters or Laura’s Kids. They can be very stressful decisions, and this sliding puzzle sometimes comes with grave consequences to getting the job done.

To ignore any piece of the game as unrelated, and you ultimately lose.

One solid example involves the pieces associated with health care. The big argument at the end of the Session was whether Medicaid expansion and the Low Income Pool funding were truly separate. The governor went so far as to sue the federal government for assuming one isn’t possible without the other.

In part he is right. You can have full LIP funding but not Medicaid expansion. However, it’s like having a car with a half tank of gas and a cross-state trip to make. You can take the trip, but you may not make it to your destination, at least not without getting some gas from someone else, say, a school bus. Just realize that you may get where you have to go, but the kids might not get to school.

Now the Legislature is working with a truncated LIP budget, but with none of the money that could have come from the federal government in that seemingly “disconnected” matter of Medicaid expansion. Thus the health care needs go unmet for more than 800,000 Floridians, many of them working poor.

They are destined to end up in emergency rooms where costs are high and the money from LIP, for the most part, won’t be there. It would have helped the hospital pay for the care needed for those able-bodies, hardworking people because they have no way to pay for their healthcare. Or else they go to work sick or miss their desperately needed hourly pay that pays bills and buys the things, a cycle that keeps our economy sound.

Now that the Medicaid expansion piece has been archived for another session, our lawmakers are working on a budget with missing pieces. The budget can still be made, and they have worked long and hard at the various conference meetings, in the open and behind closed doors. There has been great wailing and gnashing of teeth. Committee meetings, conference meetings and even the Regular Session have been shut down when things went badly.

Many projects and funding needs have hit the budget room floor with no chance of getting picked up again this year. Even the money that conservatives, including the governor, wanted for economic development has been lost. So missing out on the pieces and connections that healthcare provides has even reduced the state’s ability to bring in new jobs and industries that would put more money into the economy and, eventually, the state budget.

It has been said that you shouldn’t sweat the small stuff, even though, eventually, it’s all small stuff. Here’s a corollary: If you don’t sweat the health stuff, you will soon find out that, eventually, it’s all health stuff.

Ignoring the connectivity of the situation has its consequences.

Gary Stein MPH, a native Detroiter, worked for the Centers for Disease Control, landed in the Tampa Bay area to work for the State Tobacco program and is now a health advocate and activist and blogger for Huffington Post. Column courtesy of Context Florida.

Everybody’s working over the weekend, really

Legislative leaders on Friday said the House and Senate budget chairs would continue to work over the weekend in order to bring the General Appropriations Act in for a landing.

The goal is for a copy of the budget to be on lawmakers’ desks by Tuesday so they can wait the mandated 72 hours before voting on the bill. Friday was the initial deadline for Sen. Tom Lee and Rep. Richard Corcoran to “bump” any unsettled issues to Senate President Andy Gardiner and House Speaker Steve Crisafulli for them to resolve.

In a joint news release, though, Gardiner and Crisafulli said the budget chiefs had made tremendous progress and that they would continue to meet during the weekend to hammer out unresolved issues.

“We anticipate one more meeting this evening (Friday) as well as meetings on Saturday and Sunday,” the leaders said in a joint statement. “We look forward to using this last week of the Special Session to finalize a balanced budget and deliver broad-based tax reform legislation. We look forward to an on-time finish.”

Amendment 1 funding remains unresolved though Crisafulli said the House has agreed to no bonding. The Education and Tourism and Economic Development budgets are proving problematic, also. Progress has been made in Criminal and Civil Justice as well as Health and Human Services. A “linchpin” of the budget, the Low Income Pool, was resolved early Friday.

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