Florida is grappling with an outbreak of hepatitis A but does not have a top health officer at the agency charged with ensuring the public’s health.
More than four months after Gov. Ron DeSantis took office, the Florida Department of Health does not have a secretary. DeSantis’ nominee — Scott Rivkees — continues to serve as chairman of the University of Florida College of Medicine Department of Pediatrics and as physician in chief of UF Health Shands Children’s Hospital, according to UF Health spokeswoman Melanie Ross.
Lt. Gov. Jeanette Nunez, who was charged by DeSantis to oversee health-care issues, appears to be playing a key role in running the department.
Though state law requires that the department secretary be a Florida licensed medical doctor, Nunez is not. She is a former lawmaker from Miami and a one-time hospital lobbyist.
Helen Ferre, communications director for DeSantis, sent a statement to The News Service of Florida that said Nunez has “been at the forefront” with the health department on addressing measles and hepatitis A outbreaks.
Ferre said the Lieutenant Governor also is assisting the department in the statewide rollout of a needle-exchange program. Nunez also played a role in a new webpage for aquatic toxins, including red tide and blue-green algae, according to the statement.
“The goal is to educate, protect and provide appropriate services to residents in Florida,” Ferre said in a statement. “We are making sure that we are not falling through the cracks.”
DeSantis announced April 1 that Rivkees would take over as Department of Health secretary, a job that doubles as state surgeon general. The News Service of Florida reported shortly afterwards that Rivkees had been investigated in the past by the University of Florida for alleged sexual harassment. The probe found that Rivkees made sexually suggestive comments shortly after arriving at the school in 2012.
According to an investigation report, Rivkees was alleged to have repeatedly told people, “If we can’t agree on this, we’ll have to get naked in a hot tub and work it out.” Rivkees acknowledged making the comment “and may have said it more than once,” telling investigators that the pediatric intensive care unit was in “disarray” and that the comment was meant as a joke, the report said.
The Surgeon General is appointed by the Governor and is subject to confirmation by the state Senate. DeSantis defended his choice of Rivkees following the news reports, telling the media: “My thing is, if we have a public health issue, I want somebody that is going to be able to protect the people of Florida.”
Ferre said the Governor still supports Rivkees. Sarah Revell, a spokeswoman for the Florida Department of State, said in an email Wednesday that her agency is working with the Governor’s office on requisite paperwork for Rivkees and that “we will process it as soon as it is complete.”
Ferre didn’t explain why Rivkees has not started the job.
DeSantis struggled to find a health department secretary after he took office in January. It is the only department without an agency head on board.
The vacancy also comes as the state struggles with the spread of hepatitis A.
Florida reported 92 hepatitis A cases last week, bringing the total number of cases this year to 1,129, according to numbers posted on the Department of Health website.
The total is more than double the 548 cases reported in all of 2018.
Ferre downplayed the growing number of hepatitis A cases, as well as measles cases, pointing out the diseases are rising at a national level. “It is only logical that Florida sees an increase as the third largest state in the nation,” she said.
Ferre also said Nunez has been working in close collaboration with the state’s “chief epidemiologist Dr. Carina Blackmore to work in these areas.”
Blackmore doesn’t have a medical degree. She has her master’s degree in veterinary medicine and a doctorate degree in philosophy from Notre Dame.
While Ferre noted that contagious diseases are on the rise nationally, Marc Yacht, a medical doctor who served 20 years as director of the Pasco County Health Department, put some of the blame on Florida’s Republican leadership, both in the governor’s mansion and in the Legislature.
Yacht, who retired in 2007, said physicians were “purged” from county health departments in recent years and were replaced by administrators.
“It’s not a good picture at all. This is just the latest, having a lieutenant governor acting as the head of the health department. That’s just ridiculous,” he said.
By law, the secretary is required to be a Florida licensed doctor with advanced training or extensive experience in “public health administration.”
The Department of Health was created by the Legislature in 1996 with the requirement about it being run by a Florida doctor. Lawmakers tinkered with the law at the behest of former Gov. Charlie Crist to require that the secretary also serve as “state health officer” and have advanced training or extensive experience in public health administration.
The Florida Medical Association was instrumental in the creation of the health department and was adamant that it be run by a Florida physician. Jeff Scott, the FMA’s general counsel and chief lobbyist, said the association still maintains that position.
“I think the FMA’s position is that the head of the Department of Health and state health officer should be a physician,” Scott told the News Service.