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Florence Snyder: Florida’s opioid crisis, Part 5 – Hey Florida, talk to the hand!

One hour isn’t much time for a Senate subcommittee “confirmation hearing” on the heads of the agencies as important to “health and human services” as the Department of Health and the Agency for Health Care Administration.

But that’s what Health and Human Services Subcommittee Chair Anitere Flores allotted, and not one second longer. So, you’d think that AHCA’s acting secretary Justin Senior and DOH’s Interim Surgeon General Celeste Philip would each get a half-hour of the committee’s time … but you would be wrong.

Senior’s “hearing” was a tongue-bath and tummy rub that consumed most of the hour. To be fair, the feds had just dropped 1.5 billion into the AHCA’s coffers. Maybe Flores & Friends think that cash came Florida’s way due to Senior’s executive brilliance, as opposed to President Donald Trump‘s synergistic bromance with Gov. Rick Scott.

Or maybe they were running out the clock to get Philip safely to the border of Munchkinland and out of Oz altogether before she stumbled over that pesky poppy field.

Delray Beach Democratic Sen. Kevin Rader and large numbers of Floridians want to know why we don’t acknowledge the state’s opioid epidemic and get on with the business of dealing with it. In the minuscule amount of time available for Rader to ask and Philip to bob, weave and weasel her way through an “answer,” viewers got a pretty clear preview of coming attractions on the Opioid Listening Tour, announced last week by Scott and Attorney General Pam Bondi, who are not expected to attend.

Instead, Philip and others with titles, but no actual power, will deploy to four cities in three days for 90-minute “community conversations.”  It will be like watching a Lifetime Cable movie, but with less depth and sincerity.

Florida child welfare providers do more with less, but how much less?

For the community-based care providers that perform the lion’s share of child welfare services in Florida, the proposed 2017 budget is a disappointment.

A press release that accompanied the Jan. 31 release of Republican Gov. Rick Scott’s “Fighting for Florida’s future” budget proposal touts “a  record $632 million to provide core services to children who depend on Florida’s child welfare system.”

“Governor Scott and the Legislature have been exceptionally supportive of the child welfare system and [the Department of Children and Families] is committed to ensuring that all of our resources are directed to be as efficient and effective as possible in serving vulnerable families,” David Frady, press secretary for the Florida DCF, told Watchdog in an email.

But number-crunching done by Florida TaxWatch, a non-partisan taxpayer research group, shows that this statement fails to tell the whole story.

According to TaxWatch’s November 2015 report, real spending on child welfare services has declined since 2008, when inflation-adjusted funding for child welfare providers hit $674.1 million (in 2015 dollars).

At the same time as the effective operating budget of the DCF has been declining, the number of children entering the welfare system has been increasing.

Kurt Kelly, CEO of the Florida Coalition for Children and former state legislator, told Watchdog that there are several factors behind the increased demand for child welfare services.

Part of the growth of children in the system is an outcome of policy changes at the DCF that result in children being removed from unsuitable homes quicker — a good thing, Kelly says.

He added that high turnover rates of child protection investigators affect this process. CPIs investigate claims of abuse and determine if a child needs to be placed into foster care, but the turnover rate means many investigators are new on the job. “Eighty percent of folks making decisions have less than two years experience,” Kelly said. With DCF policies that favor caution and quick action above all else, this might lead to inflated child removal numbers.

The newest threat, Kelly says, is the opioid issue, which is affecting families across the state.  In addition to increased deaths from opioid misuse, CPIs are inclined to remove kids from homes if they see any signs of opioid abuse.

“We saw it in the Sarasota area, which may be the epicenter of the United States in this issue,” Kelly said. “In that area, our removal rate [of children from the family home] in the Sarasota/Manatee area is up 200 percent, which is … unsustainable.”

As of Feb. 28, Florida child welfare services were being provided to 41,707 children.

Underfunded and over-performing

Florida’s child welfare system relies on a community-based care model.

This means that once the DCF investigators have determined that a child needs to be pulled from home, they hand responsibility to regional care organizations. The not-for-profit private organizations administer services to children that enter the foster care system, as well as preventive care services for children that can remain at home, albeit in difficult circumstances.

Seventeen CBC lead agencies operate around the state. These lead agencies, which are spread out around 20 different regions, include Community Based Care of Central Florida and Our Kids of Miami-Dade. They are accountable to the DCF, but operate independently, and subcontract care out to smaller community organizations.

The transition from a more centralized, Tallahassee-administered services model began at the turn of the century. By 2006, the CBC model was operational statewide.

Kelly told Watchdog that Florida’s welfare system now serves as a model for other states. But funding remains a problem.

He estimates that Florida’s child welfare system needs a $49 million budget increase for 2017-18.  DCF requested a $16 million increase for the community care centers.

The current proposal from Scott would allocate a $14.2 million funding increase for Florida’s community-based care providers.

Florida TaxWatch says the system needs another $100 million. The group’s analysis shows that the community-based care providers in particular have been underfunded, while overperforming, for years.

Kelly told Watchdog that the community care providers were allowed access to backup funds several years ago, but quickly went through it. “When I tell you that we’re 20 million in the hole, that’s money that’s being spent right now.”

Decentralization is key

The 2012 Right for Kids Ranking, a report on child welfare systems across the nation, found that Florida has one of the best-performing systems.

Florida ranked fourth in the nation based on measureable outcomes such as adoption rates, family reunification and monthly caseworker visits.

The report found that if all states had welfare programs as effective as Florida’s, the U.S. would have 72,000 fewer kids in foster care per year and find adoptive families for 19,000 more.

Advocates like Florida’s Coalition for Children trace the effectiveness of the Florida system to its decentralization in 1998. Legislation mandated that the DCF contract direct care to private organizations operating at the local level.

Florida isn’t alone in experimenting with decentralizing state child welfare systems.  Kansas initiated similar privatization initiatives in 1995. Although the transition was rockier, a 2010 study by the Casey Family Programs found that “the general public, local communities and stakeholders are more invested in what is happening in Kansas child welfare than ever before,” and that more children were exiting the system into permanent homes.

A 2015 study by the Foundation for Government Accountability, a Naples-based free market think-tank, examined Safe Families, a community-based private child welfare program in Chicago. The FGA report advocated shifting more child welfare power to community organizations.

Increasing the risk

Although the numbers show that the community-based care model has been a success in Florida and elsewhere, no system is free from problems.

Foster Shock, a 2016 documentary that tells the story of children who the Florida system has failed, and suggests that the decentralized, privatized system diverts money away from child services and into organization salaries.

Other dissenters focus less on the whole picture, and more on the individuals that child services has let down. Groups such as Florida’s Children First and firms like Talenfield Law advocate on behalf of the legal rights of children in the system — often, that means lawsuits in the face of the inevitable tragic failures.

“Even when we’re totally doing everything right there’s going to be slips and mistakes made and cracks in the system,” Dominic Calabro, CEO of Florida TaxWatch, told Watchdog. “But when you don’t have the full focus or the full reasonable resources, you just increase the risk. And you have high turnover [of caseworkers]. You just increase the likelihood that something bad will happen.”

Elle Piloseno, Florida TaxWatch researcher and author of the 2015 report, told Watchdog that insufficiently funding the system on the front end has social and fiscal implications for the future.

One of the biggest problems the foster care system faces is retaining caseworkers. High turnover rates mean that children deal with an increasing number of case managers — and that adds to their time in the system.

“Every time that this kid needs to be handed over to a new case manager, that case manager has to be trained, they have to be familiarized with the children that they’re serving, they have to be familiarized with the families and the individual characteristics of that situation,” Piloseno said. “All that time adds up when you’re trading hands a bunch of times, which is why turnover is such a huge issue.”

And as a general rule, the longer a child spends in the foster care system, the worse off they are. When kids age out of the system at 18 before finding a permanent home, pregnancy rates go up. High school diploma rates go down. “A quarter of the youth that are aging out of the child welfare system end up being incarcerated within two years,” Piloseno said.

The TaxWatch study found that in addition to creating poor outcomes for children, workforce turnover adds to the taxpayer burden.

“Florida employs almost 3,800 case managers, of which an estimated 37 percent (approximately 1,400) resign and are replaced within one year.” The study found this costs the state approximately $14 million annually.

Prolonging an individual child’s stay in the welfare system has a significant cost. “Taxpayers could pay up to $70,000 per year to care for one child in out-of-home care,” TaxWatch reports.

“People need to understand there’s a real connection and real consequence when you don’t fund [the system],” said Calabro. “Pay me now, or pay me later.”

If it ain’t broke …

But if the system is performing as well as advocates say it is relative to the national standard with its current funding levels, does it really need more money?

“You didn’t just play the devil’s advocate, you played the legislative advocate,” said Kelly. “That’s exactly one of our problems.”

“We have done so much more for less, which is a good thing … and we did all of that while there wasn’t a dramatic increase of kids coming into the system,” he said. New influxes of kids into the system are straining strapped resources. Moreover, he argues, Florida’s foster system might be doing well relative to other states, but they still have a lot of ways they can improve and better protect kids.

The community-based care providers depend heavily on philanthropy to perform the basic functions DCF has tasked them with, which is exactly the type of local engagement that makes community-based care so effective. However, Kelly says that doesn’t absolve the state of its duty to properly fund the programs.

“The state has a responsibility to provide those resources, because we’re frankly doing the services for the state,” he said.

“They couldn’t do it, we are doing it, and we’re doing a much better job. But that doesn’t mean they don’t have an obligation to make sure that they fund this the right way,” Kelly said.

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Erin Clark reports for Florida Watchdog. Contact her at eclark@watchdog.org and on Twitter.

In Sarasota, Adam Putnam warns GOP of complacency in 2018

Electorally speaking, for two decades now, it’s been a good time to be a Republican in Florida.

But after last fall’s victory by Donald Trump, the Chicken Chard and salmon dill seemed to go down even smoother Thursday night at the Sarasota County Reagan Patriot Day Dinner in Venice.

“Gosh, isn’t it great to be a Republican? Even greater that The Donald is our President,” said longtime Sarasota Republican Cynthia Crowe kicking off the festivities at the Jacaranda West Country Club.

“And isn’t it refreshing that we have a politician who keeps his word?”

“He’s not a politician!” a voice shouted from the back of the room.

Nobody will ever accuse Adam Putnam of not being a politician.

The state’s Agriculture Commissioner has served in public office for nearly half of his 42 years on the planet, and is running hard to succeed Rick Scott as the next Governor of Florida, even though he hasn’t actually declared his candidacy yet.

The keynote speaker for the evening, Putnam has often described his native Florida as a “reward for a life well lived,” which is great if you’re gunning for the over 60-crowd.

However, it isn’t dynamic enough for a general election campaign, something he’s obviously aware of. That’s because he now pivots off that signature phrase to say that the Sunshine State can now be a “launchpad for the American dream.”

“We’re already the envy of the nation,” Putnam says. “Now we can be the envy of the world.”

If Marco Rubio was a champion of American exceptionalism during his ill-fated run for president a year ago, Putnam is running as a champion of Florida exceptionalism.

The state’s Agriculture Commissioner talks about the look in the eyes of out-of-state families when they arrive at a Florida airport for a vacation, and when they depart.

“They have made memories of a lifetime,” he says with the reverence of a child coming back from a week of enjoying theme parks, before stating with pride that “something like two-thirds of all Make a Wish Foundation requests are to come to Florida. That’s our state.” The crowd cheers.

(He asked not to be ‘PolitiFacted’ on that quote.)

Putnam is clearly on Rick Scott’s side in the debate with House Speaker Richard Corcoran over the merits of retaining Enterprise Florida and Visit Florida.

“Coke doesn’t stop advertising. Budweiser doesn’t stop advertising,” he said, adding that the state needs to “invest in telling Florida’s story,” especially if it wants to diversify its economy.

While Florida is a classic Purple State in presidential elections, it’s otherwise awash in red, which is why Republicans have to revert to what it was like in the 1990s when talking about Democratic rule in Tallahassee (Putnam boasted about how crime rates have gone down 45 percent in Florida in the two decades since Republicans began ruling the roost, even though that has been a national trend).

Perhaps that’s why Putnam took aim at New York City Mayor Bill deBlasio instead, saying his policies are making people flee New York for Florida and calling him the best economic developer Florida’s ever had.

“We’re going to make him the honorary chairman of Enterprise Florida. How about that?”

And while Putnam praised the conservative government rule the state has been under for the past two decades, saying that’s why it’s done better economically than states like New York, California and Ohio, his policy prescriptions have tremendous room for growth.

“My strategy for infrastructure is to put up a picture of Atlanta,” Putnam said, decrying traffic conditions in the Georgia capital. But with Florida’s population growing again, traffic concerns are felt in the state’s biggest metropolis like never before.

Putnam ended his half-hour address with a stark reminder of how important it was for Republicans not to be complacent going into next year’s election cycle.

Referring to how the party out of power traditionally does well in off-year congressional elections, (not mentioning the intense grassroots Democratic opposition that manifested itself at town halls this winter and spring), Putnam said the GOP needs to reverse that narrative in 2018.

“We cannot rest on our laurels,” he stressed. “We have to be driven and focused and never take our foot off the gas. We can’t let up,” adding that “Florida has come too far, and America has come too far for us to sit back and become complacent and let the Democrats strip away all the gains we have made.”

So far, Putnam has already raised more than $9 million for the race, even though he’s still not officially a candidate for governor.

Nevertheless, the Democrats are indeed treating him as one, with the Democratic Governors Association requesting a full investigation into Florida Grown PC, a political committee associated with Putnam.

The DGA says that a Miami Herald report and public records show the committee has repeatedly circumvented requirements to reveal the ultimate purpose of a majority of its spending.

Amicus brief to charge Rick Scott with voter disenfranchisement in Aramis Ayala case

A coalition of groups led by the Advancement Project in Washington D.C. is filing an amicus brief charging Gov. Rick Scott with refusing to recognize voters’ will in the State Attorney Aramis Ayala case in the Florida Supreme Court.

The coalition, including Civil Rights, immigration reform and labor groups, is characterizing Ayala as a criminal justice reform state attorney elected by voters of Florida’s 9th Judicial Circuit because of her criminal justice reform platform.

And they’re charging that Scott is rejecting that criminal justice reform platform selected by voters because he does not like the reform she is pursuing – her decision to not pursue death penalty prosecutions.

Scott has stripped Ayala of 23 first-degree murder cases and reassigned them to 5th Judicial Circuit State Attorney Brad King. Ayala on Tuesday challenged Scott’s power to do so in a writ before the Florida Supreme Court and a lawsuit in federal court.

The coalition’s friend-of-the-court entry is in the Supreme Court case, charging Scott is refusing to recognize the will of the voters.

Judith Browne Dianis, executive director of Advancement Project, called Scott’s move “a power grab” in a telephone press conference Thursday announcing the amicus brief.

“We are raising two points in our brief. One of which is the state of Florida is in need of criminal justice reform, and two, that the people voted in a reformer in order to make that happen,” Browne Dianis said.

She said Florida is one of the worst offenders when it comes to a “broken criminal justice system” and that Ayala’s reforms are sought by voters and eschewed by Tallahassee leadership.

“Unfortunately Gov. Scott … didn’t like the policies of Aramis Ayala and decided to step in and usurp the will of the voters,” Browne Dianis continued. “That is unconstitutional”

Ayala never campaigned against the death penalty during her 2016 election campaign, though she did offer herself as a criminal justice reformer.

The coalition, which included representatives of the New Florida Majority, Dream Defenders, the Florida State Conference of the NAACP, Color of Change and the SEIU Florida, also pushed racial aspects of the battle between Ayala, who is Florida’s first African-American state attorney, and Scott, who is white.

Chardonnay Singleton of Dream Defenders, a criminal justice reform organization founded after the slaying of Treyvon Martin in Sanford, said Ayala’s election also can be traced to the cry for criminal justice reform that came from that case..

“The voters have really sought to create an environment where the criminal justice system serves them and not special interests,” Singleton said. “And that’s reflected in the election of Ayala, who is the first black woman state attorney, and that’s a testament of our desire as voters’ across Florida to transform the system to one that is more human, to one that that is more human, one that is more reflective of all of the people in Florida, and one that is more restorative to us as human beings.”

 

Legislature considers proposal to address Florida food deserts

After just three years in operation, retail giant Wal-Mart closed its doors February in the Midtown neighborhood of South St. Petersburg.

It was a blow to the community on a number of levels, not least of which was making it much more difficult for Midtown residents to get access to fresh fruits and vegetables.

Studies have found that lacking access to a vehicle for access to full-service grocery stores creates a situation where people are likely to contract diabetes, diet-related cancers, and liver disease.

A 2014 study commissioned by the Florida Department of Agriculture and Consumer Services identified 100 rural and 100 urban areas of Florida that are so-called “food deserts.”

Food deserts are generally described as geographic areas where residents’ access to affordable, healthy food options (especially fresh fruits and vegetables) is restricted or nonexistent due to the absence of grocery stores within a convenient traveling distance.

A bill now making way through the Florida House and Senate would attempt to remedy that problem.

HB 1083, sponsored by Fort Pierce Democrat Larry Lee (and its Senate companion, SB 1592 sponsored by Fernandina Beach Republican Aaron Bean), creates the “Healthy Food Assistance Program,” to provide funding to the Department of Agriculture for retrofitting small food retailers with refrigeration, display shelving or other equipment — up to a maximum of $7,500 per store.

In addition, funding would be made available for materials for nutrition education and healthy food promotion, as well as funds of up to $2,000 per retailer for an initial purchase of healthy foods, including dairy products and fresh produce.

“Just putting it out there without giving the retailers the training on stock rotation or not giving the customers a reason to buy it, then it’s not going to be effective as it could be in the long run,” says Rivers Buford III, director of government relations at the American Heart Association, which advocates for the legislation.”

“We’re requesting for these little micro-grants, administered by the Department of Agriculture, or somebody they chose to contract with,” Buford says, “so it’s got some government oversight on it to make sure it’s a program that is judicious in nature, and not put funds out there where it doesn’t have some sort of accountability factor associated with it.”

Mari Gallagher Research, which conducted the 2014 study for the Agriculture Department, found that reducing the fraction of the population with insufficient healthy food access in the 200 sites named by the agency by just one single percentage point could prevent nearly 650 premature deaths over a seven-year period. It would also improve the health of over a million Floridians in urban areas and 780,000 in rural areas.

So what qualifies as a small retailer?

According to the House bill, it needs to be in a low or moderate-income area and smaller than 3,000 square feet, such as a corner store, convenience store, small grocery store or bodega which sells a limited number of products.

Mark Landreth, senior director of government relations at the American Heart Association, refers to a statewide version of the New Orleans Fresh Food Retailer Initiative as a program that he’d like Florida to emulate.

Launched in March 2011, the Initiative originally began by awarding low-cost, flexible financing for vendors to open, renovate or expand retail outlets in areas of the city lacking fresh food access. Last month Mayor

Last month, New Orleans Mayor Mitch Landrieu announced the Healthy Corner Store Collaborative, which would provide one-on-one business mentoring with a food retail expert, as well as branding, marketing, and food display materials to expand fresh food offerings into five individual stores in the city.

Another project receiving national attention is the Pennsylvania Fresh Food Financing Initiative, a program that funded 88 grocery stores and improved access for nearly 500,000 Pennsylvania residents.

Although there’s more public discussion of food deserts than ever before, they are still increasing throughout the U.S.

In 2010, there were 8,959 food deserts nationwide. By 2015, there were 9,245 low-income, low-access census tracts, a 3 percent increase, according to the U.S. Department of Agriculture.

A year ago, Gov. Rick Scott signed legislation for a similar request by the AHA, but the funding request was cut from $5 million to $500,000. In 2017, the request is for $1 million.

“I think we should heed the failure of two grocery stores to thrive in the Midtown market,” says South St. Pete activist and magazine publisher Gypsy Gallardo. “This new legislative is one way we can creatively bring healthy food access in neighborhoods. Community leaders in St. Pete are looking at a range of creative and lower-cost options.”

Florida Senate passes budget with limited cut to Aramis Ayala’s office

A Florida Legislature Conference Committee showdown appears likely over how much money will be cut from Orlando’s State Attorney Aramis Ayala‘s office now that the Florida Senate passed a budget package Wednesday that includes a much smaller cut than is being proposed in the Florida House.

Engineered by state Sen. Randolph Bracy, an Oakland Democrat, and Senate Appropriations Committee Chair Jack Latvala, a compromise was inserted into the budget package that would cut $622,000 from the Office of the State Attorney for Florida’s 9th Judicial Circuit, but restore another $569,000 that the Senate initially proposed cutting.

The House of Representatives is still looking at a full $1.3 million cut to Ayala’s office. Under an arrangement put together by Republican state Rep. Scott Plakon, all the money would go to the Judicial Administration Commission, to be redistributed to other state attorneys who get 9th JC cases.

Ayala is under fire from many Tallahassee politicians, mostly Republicans, for her stance to not prosecute death penalty sentences in CD 9. As a result, Gov. Rick Scott has reassigned 23 first-degree murder cases to the neighboring 5th Judicial Circuit. On Tuesday Ayala challenged those reassignments in the Florida Supreme Court and in U.S. District Court.

The $622,000 cut from her office in the Senate budget package would go to 5th Judicial Circuit State Attorney Brad King, to whom Scott reassigned the 23 cases.

Bracy said the money had been allocated last year for human trafficking and domestic violence prosecution programs, and the human trafficking problem is rapidly increasing in the CJ 9 and a top concern for the House Judiciary Committee. Those also were top priorities for Ayala during her election campaign last year.
“I felt for that reason alone she needed the money,” Bracy said.

Bracy is one of the few lawmakers to openly back Ayala. After both the cuts appeared in committees, he pushed to get money restored for her office. Earlier this week he worked out the 45 percent/55 percent split of the original $1.3 million cut with Latvala, the Republican from Clearwater.

Last week Bracy authored an op-ed column in the New York Times in which he conceded he does not necessarily agree with Ayala’s stance on the death penalty, but strongly supports her right to take that stance.

“Although Ms. Ayala’s critics have denounced her actions as dereliction of duty, they cannot point to a single law or statute that she has violated. That’s because she hasn’t,” Bracy wrote in the column. “There are no federal or state laws that say prosecutors must seek death sentences. And the United States Supreme Court has banned all state laws that make executions mandatory for murders.”

On Tuesday Plakon, a strong critic of Ayala’s stance on the death penalty, defended the $1.3 million figure, saying that capital punishment cases are very expensive so the money should follow the cases, that it’s approximately how much extra money the JC 9 office got last year, and that Ayala still has not filled many vacancies in her office, so she’s not spending what she has.

Rick Scott, feds agree to $1.5B commitment for low income pool in Florida

The Trump administration is coming through with $1.5 million in new health care money for Florida, Gov. Rick Scott announced Wednesday as the House and Senate debated their rival spending plans for 2017-18.

The money will finance Florida’s Low Income Pool, which reimburses hospitals that provide charity care.

The infusion would “truly improve the quality and access to health care for our most vulnerable populations,” Scott said in a written statement.

“It is great to have a partner in Washington who is willing to work with us to help our state,” the governor said.

“Florida was on the front-line of fighting against federal overreach under President Obama, and it is refreshing to now have a federal government that treats us fairly and does not attempt to coerce us into expanding Medicaid.”

“This is great news — good news all around,” said Sen. Anitere Flores, chairwoman of the budget subcommittee on health care, who’d included $600 million in LIP money in the Senate budget in hopes the feds would provide it.

“This is a much larger amount of LIP funding than we ever have received. We were not expecting this level of funding. But I think that’s a testament to our congressional delegation being more involved and aware of the importance of this.”

House budget chairman Carlos Trujillo was more circumspect. His committee never counted on the federal money.

“I don’t think there’s a place to spend that much money,” he told reporters.

“It’s good. Florida was punished for years by the prior administration. It’s good that the current administration is recognizing that Medicaid expansion and LIP funding are two separate conversations,” Trujillo said.

The money would allow the House to find other uses for money it would have put into charity care, he said. “We would probably like to use it either for tax cuts or put it straight into reserves, and shore up some more reserves for the out years,” he said.

“From day one, we have been committed to working with our state partners to ensure they have the flexibility they need to make decisions that best reflect the unique needs of their populations,” U.S. Health and Human Services Secretary Tom Price said.

“Today’s announcement reflects that commitment on the part of the Trump administration. We look forward to continuing to work with Gov. Scott as well as governors across the country to make sure Americans have access to quality health care.”

The Obama administration started withholding the money after Florida refused to accept the Medicaid expansion under the Affordable Care Act.

Senate Appropriations Chairman Jack Latvala informed the Senate of the news during debate on the chamber’s $82.3 billion budget for 2017-18.

The House was debating its own $81.2 billion budget Wednesday.

A group of hospitals that spend heavily on charity care welcomed the news.

“The LIP funding helps our safety net hospitals carry out their mission of providing highly specialized, expensive and primary care to all citizens, regardless of their ability to pay,” said Tony Carvalho, president of the Safety Net Hospital Alliance of Florida.

State officials have long complained that Florida draws less than its fair share of federal health care dollars.

“A state like Texas would get almost double what we would get in LIP. This is something that has been needed for a long time,” Flores said. “There has definitely been a disparity.”

It was too early to say how the cash would affect budget negotiations with the House, she said.

“I would hope that, No. 1, that the House would be open to receive this funding,” Flores said.

“Does it open the door for other health care issues? It might. But at the very minimum … it’s for our hospitals. This is great news in a year where, initially, even in the governor’s budget, they had been looking at close to $1 billion in cuts,” she said.

Also party to the announcement were Centers for Medicare & Medicaid Services Administrator Seema Verma and Justin Senior, secretary of Florida’s Agency for Health Care Administration.

“Centers for Medicare and Medicaid Services is working toward a new era of state flexibility and leadership,” Verma said.

“For too long states have been sharing in the cost but have not been allowed to have a meaningful role in decision-making. We want to provide states the flexibility to make health care decisions that best meet their citizens’ unique needs, and support states covering access to health care services.”

“We truly feel like our federal partners are listening to our state and our needs and we know that Florida will have the flexibility we need to run our Medicaid program as efficiently as possible while providing the highest level of care in our state’s history,” Senior said.

Joe Henderson: Rick Scott’s approval rating climbs because the economy trumps everything

The steady increase in Gov. Rick Scott’s approval rating has reinforced the notion that if voters have a job and the economy seems to be humming along, other things don’t matter much.

The latest poll, released this week by Morning Consult, put Scott’s approval number at 57 percent. Considering that he stood at 26 percent in 2012 according to Public Policy Polling, that’s downright miraculous.

That same PPP poll five years ago included a forecast that Scott would lose a then-theoretical matchup with Charlie Crist by 55-32 percent. Scott was declared to be the most unpopular governor in the country.

What changed?

The economy. Duh!

Scott still has the singular focus he brought to Tallahassee as an outsider in 2011. We all remember what the economy was like then as the nation tried to recover from the Great Recession.

Scott’s game plan of offering business incentives to attract jobs has been unrelenting. He has targeted regulations that he says strangle job growth.

While his disregard for environmental laws proved disastrous last summer when guacamole-like runoff from Lake Okeechobee became national news, voters appear inclined to overlook that as long as they have a steady paycheck. That’s how Scott got out of controversies that included the messy dismissal in 2014 of Florida Department of Law Enforcement chief Gerald Bailey. That was handled so poorly that even Agriculture Commissioner Adam Putnam, a member of Scott’s cabinet, claimed he was “misled” by the governor’s staff.

Scott also had to spend more than $1 million in taxpayer money to settle seven public records lawsuits because of his penchant for operating in the shadows.

Even the ongoing battle with Republican House Speaker Richard Corcoran over two of Scott’s major programs for business development and tourism promotion — Enterprise Florida and VISIT FLORIDA — hasn’t hurt the governor. If anything, it seems to have enhanced his standing with voters.

All of this would seem to bode well for his expected challenge for Bill Nelson’s U.S. Senate seat in 2018. Scott’s approval number has inched above Nelson’s, which is significant (maybe).

A lot can happen before that Senate race; remember the poll that said Crist would easily beat Scott for governor. Scott is closely aligned with President Donald Trump, and there is no way to tell how that will impact the race.

And while the economy is doing well and Scott is reaping the benefit now, everyone would be advised to remember another campaign from the dusty past as an example of how quickly things can change.

Republicans circulated a flier saying their candidate for president would ensure “a chicken in every pot and a car in every garage.”

That was in 1928. The candidate was Herbert Hoover. He won with 444 electoral votes. A year later, the stock market crashed, and the Great Depression changed everything. Just four years after his landslide, Hoover lost to Franklin D. Roosevelt, whose electoral college total was 472.

Translation: Things look good now, but don’t get cocky.

Rick Scott brings Visit Florida, Enterprise Florida pitch to Lake Nona

Surrounded by what’s billed as the world’s new center for tennis but yet also almost in the shadow of a failed medical research center, Gov. Rick Scott brought his plea for salvation for Enterprise Florida and VISIT Florida to Orlando’s Lake Nona community Wednesday – urging pressure on the mostly-Republican group of lawmakers set to bring them down.

“When we think about what the state’s doing now with regard to Enterprise Florida and VISIT Florida, we’re missing opportunities, if we’re not in the right place at the right time to make things happen,” Scott said.

Enterprise Florida and Visit Florida, Scott’s prize economic development and marketing organizations, are the targets of fellow-Republican House Speaker Richard Corcoran and others in the Florida Legislature who are convinced the organizations have grown fat and sloppy for years dolling out tax and other financial incentives and marketing efforts without sufficient accountability. Corcoran and other House Republicans are on a path to defund Enterprise Florida and severely restrict VISIT Florida.

So Scott and his economic team including Florida Department of Economic Opportunity Executive Director Cissy Proctor and VISIT Florida President Ken Lawson are on and extended tour of Florida preaching for the organizations’ salvations. They’re meeting with largely bipartisan gatherings of local political and business supporters who also want to keep the state business incentive, recruitment and marketing efforts available, extolling the successes, warning of dire drop-offs in business opportunities without them, and seeking to rally broader support.

This pitch came at the new $70 million USTA National Campus at Lake Nona, home to the United States Tennis Association headquarters and more than 100 pristine courts. The freshly-opened complex has become an Orlando poster child for the kinds of state and local efforts, including financial incentives and marketing and promotion that Enterprise Florida and Visit Orlando use.

The complex, said USTA Executive Director Gordon Smith, was “courted all over the country. The team that came together here including [Orange County] Mayor [Teresa] Jacobs, [Orlando] Mayor [Buddy] Dyer, the city, Visit Orlando, Visit Florida, the governor, worked together in a way that was unique.

“So, we’re bringing tens of thousands of visitors here every year,” Smith added.

For Scott, the facility is a perfect location to warn of the risks of not having an Enterprise Florida or VISIT Florida.

“USTA, they’re a class act. And it’s a significant deal to get USTA here. Let’s all think about this for a second. They’re not going to make a decision like this five times. They’re going to make a decision once,” Scott said. “So we had one opportunity to put our best foot forward… This is not the only place they could go.”

Scott’s latest pitch, however, also came less than two miles directly up Lake Nona Boulevard from the former Sanford Burnham Medical Research Institute, which has become a poster child for the occasional failure and overblown promises of public and private financial incentives. Sanford Burnham pulled out last year despite receiving about $350 million in incentives, and never achieved the levels of job generation, economic development, and technology prestige promised when Florida won a bidding war for it in 2006.

Scott’s voting rallies also include targeting a bipartisan collection of area House members who are voting with Corcoran.

“Here’s who I would like you to reach out to: Bruce Antone, Bob Cortes, Jennifer Sullivan, voted to eliminate Enterprise Florida, eliminate the Florida Defense Alliance, and on top of that to severely restrict the ability for Visit Florida to market our state,” he said. “Jason Brodeur did the same thing. Now, who voted the right way? Kamia Brown, Eric Eisnaugle, Amy Mercado, and Rene Plasencia. Now Mike Miller voted to keep Enterprise Florida but he didn’t vote to support Visit Florida. Carlos Guillermo Smith voted against Enterprise Florida and for Visit Florida.”

Antone, Brown, Mercado and Smith are Democrats; Cortes, Sullivan, Eisnaugle, Plasencia and Miller, Republicans.

Donald Trump taps lawyer involved with Trump U case for federal job

As a top aide to Florida’s attorney general, Carlos G. Muniz helped defend the office’s decision to sit out legal action against Trump University. Now the president is naming him to be the top lawyer in the U.S. Education Department.

President Donald Trump has announced his intent to nominate Muniz to serve as general counsel to Education Secretary Betsy DeVos. The Senate would then consider the nomination of the Republican lawyer.

Emails reviewed by The Associated Press show that in 2013 Muniz, who served as Florida Attorney General Pam Bondi‘s chief of staff for three years, was included in discussions about student complaints alleging fraud with Trump’s namesake real-estate seminars.

Muniz, now in private practice, has also been the lead attorney defending Florida State University in a lawsuit by a former student who said the school failed to investigate after she said she was sexually assaulted by the star quarterback of the Seminoles’ 2013 national championship football team. The player was never charged with a crime by police in Tallahassee, and the state attorney’s office declined to pursue a criminal case against him.

An investigation by the Education Department’s Office of Civil Rights is still underway, presenting a potential conflict of interest if Muniz is confirmed.

Both Muniz and the White House declined to comment Tuesday, referring all questions to the Education Department.

That department did not respond to phone calls and emails seeking comment about the Trump University review or whether Muniz would recuse himself from involvement in the Florida State probe.

AP reported last year that Bondi personally solicited a $25,000 political contribution from Trump as her office was weighing how to respond to questions from the Orlando Sentinel newspaper about whether she would join New York Attorney General Eric Schneiderman in suing the billionaire businessman.

Though both Trump University and the Florida-based Trump Institute had stopped offering classes by the time Bondi took office in 2011, more than 20 consumer complaints had been filed by former students who said they were swindled.

Emails from August 2013 obtained under Florida’s public records law showed that Muniz was copied on discussions about how to respond to the newspaper’s request for comment, though he did not actively weigh in.

Emails show Muniz did help direct Bondi’s public defense on the issue, including rewriting an October 2013 fact sheet distributed to reporters.

Days after Bondi’s office said it was reviewing the Trump U case, a political committee supporting her re-election received a $25,000 check from Trump’s charitable foundation. His daughter, Ivanka Trump, also added $500 more to support Bondi.

Bondi, who endorsed Trump’s bid for president right before the Florida Republican primary, said she was unaware her staff had been asked about the New York lawsuit until a Florida newspaper columnist highlighted the 2013 donation from Trump.

Bondi has repeatedly denied any wrongdoing and defended her decision to accept the contribution, saying her office never seriously considered suing Trump.

Trump’s 2013 check, drawn on an account in the name of the Donald J. Trump Foundation, violated a federal prohibition against charities giving money to political groups. The issue garnered national media coverage last year during Trump’s presidential campaign, and his foundation paid a $2,500 fine to the IRS.

The illegal donation prompted a Massachusetts attorney last year to file a state bribery complaint against Bondi and Trump. A Florida prosecutor assigned to review the case informed Republican Gov. Rick Scott last week of his office’s conclusion that there was not enough evidence to move forward.

A memo about the complaint against Bondi said it was “insufficient on its face to conduct a criminal investigation” and was based almost entirely on media coverage. The assistant state attorney who wrote the memo said the complaint was based on insinuation and there was no evidence Bondi asked for the money in exchange for any official act. There was no indication she interviewed Trump or Bondi before reaching her decision.

Though Bondi’s office took no action against Trump, the president later agreed to settle the class-action case filed by New York and private lawyers, paying his former students $25 million in damages.

After leaving Bondi’s office, Muniz became a partner at the Jacksonville, Florida, office of a large law and lobbying firm. He defended Florida State University in a Title IX lawsuit filed by Erica Kinsman, a former student who said she was raped by quarterback Jameis Winston in 2012.

Kinsman sued Winston in April 2015 in federal civil court, alleging sexual battery and assault, and Winston countersued her one month later, alleging her accusations were false and defamatory. Both civil cases were settled in December under confidential terms. Winston, the No. 1 pick in the 2015 NFL draft, now plays for the Tampa Bay Buccaneers.

Title IX is a federal law that bans discrimination at schools that receive federal funding. The Education Department warned schools in 2011 of their legal responsibilities to immediately investigate allegations of sexual assault, even if a criminal investigation has not been concluded.

Last year, FSU agreed to pay Kinsman $950,000, the largest settlement ever for claims regarding a university’s indifference to a student’s reported sexual assault.

Republished with permission of The Associated Press.

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