Diagnosis for 11.4.24: Checking the pulse of Florida health care news and policy

Voters will decide the fate of Amendments 3 and 4 tomorrow and end two expensive (and wildly contentious) campaigns.

As it stands, it’s unclear whether one, both, or neither will pass — both have been hovering around the 60% threshold in recent polls, with the recreational pot amendment slightly above the mark and the abortion rights proposal slightly below.

If either amendment passes, significant changes will come to the state’s health care laws.

Under Amendment 3, adults 21 and older would be allowed to possess and use marijuana. The amendment would only impact state law, not federal law, which still considers cannabis an illegal substance.

While pot would be legalized at the state level, the Legislature would still have the authority to pass laws regulating when and where it could be used, similar to statutes restricting cigarette smoking. The state would also retain the ability to grant licenses to distribute, sell and cultivate cannabis.

Amendment 4 would expand access to abortion and, by extension, unwind the six-week abortion ban that went into effect in May. The abortion rights amendment has tread a rockier road than Amendment 3.

The Florida Supreme Court voted 4-3 to allow the issue to go before voters. Justices Renatha Francis and Meredith Sasso, who were against putting it on the ballot, are also up for re-election in Tuesday’s election.

In recent weeks, the state has also been actively fighting against the amendment, with DeSantis’ administration sending cease and desist letters to TV stations playing pro-abortion rights ads. At least one media outlet, WINK-TV, took down the ads for five days as TV stations were threatened with criminal prosecution.

 — Major expansion —

The Biden-Harris administration announced a proposed rule to expand contraception coverage under the Affordable Care Act.

The rule would require plans and issuers to cover over-the-counter contraception without a prescription and cost-sharing. When finalized, the rule will extend contraception coverage for 52 million people with private health insurance, which advocacy group Protect Our Care said would be “the largest expansion of contraceptive coverage since 2012 when contraception was first required to be covered under the ACA.”

Protect Our Care praised the announcement while chastising Republicans for “doubling down on their decades-long attacks on critical reproductive health care,” citing the overturning of Roe v. Wade and the advancement of state-level abortion restrictions.

“This is big news for 52 million Americans who will soon have access to over-the-counter contraception at no cost. The Biden-Harris administration is dedicated to advancing reproductive freedom, while Republicans are dead set on ripping it away. This new rule will give millions of Americans peace of mind accessing contraception since the fall of Roe v. Wade tore federal protections for many reproductive services away,” Protect Our Care Chair Leslie Dach said.

“Not only does Donald Trump repeatedly brag about his role in overturning Roe v. Wade, his first goal as President was to repeal the ACA. And when that failed, he sabotaged the law until the bitter end. As a result, millions of Americans lost their health care coverage and access to the critical care they needed to stay healthy. The Republican ‘Project 2025’ blueprint further attacks women’s health care by calling for a total abortion ban and the removal of safe, effective abortion medication from the market entirely. Patients and families deserve access to medication and treatment without political interference.”

More information on the proposed rules is available via CMS.gov.

 — Dragnet —

A recent University of Florida Doctor of Nursing Practice graduate’s research project is helping law enforcement catch human traffickers.

With the help of UF College of Nursing faculty, Baptist Health, and Epic Systems, electronic health records software developer Katelyn Watts developed a screening tool template to identify potential human trafficking victims. The template works in the Epic system and is used by health care workers to assess hospital patients. The information entered in the system raises flags that can identify a victim.

“Observation is a critical component. Noticing how the potential victim acts, their hygiene, what kind of tattoos they have, do they have a cellphone. All these can be clues,” Watts said. “That’s why education is so crucial. Part of the education focused on interacting with the suspected trafficker. We spent a lot of time using scripts and practicing steps to take if things escalated.”

Watts said her project came about after her supervisor at Baptist Health returned from a conference highlighting human trafficking.

“I thought this would be the perfect project to help shed light on such a heartbreaking issue,” she said.

During the project period in late spring, nurses identified five victims, including children, and police arrested three suspected traffickers in North Florida. The screening tool is available in the Epic system for any provider with access.

“This was a rock star project. A D.N.P. project is about the big picture. How do you improve care for the larger group? Katelyn did that and hit it out of the park,” said Rene Love, Ph.D., D.N.P, and associate dean for academic affairs at the UF College of Nursing.

 — ’Mini brain’ —

The Mayo Clinic in Jacksonville is developing a so-called “mini-brain” for people who suffer from Lewy body dementia (LBD), a disease that shares traits similar to Parkinson’s disease and Alzheimer’s disease.

The problem with LBD, according to medical health professionals at Mayo, is that it is more difficult to detect and diagnose because the symptoms are similar to other degenerative disorders that include hallucinations, motion disorders, sleep problems and cognitive issues.

Mayo Clinic scientists have created the “mini-brain” model in a dish that recreates features that replicate conditions of LBD. The mini-brains are called brain organoids and feature cells grown in a laboratory. Using those models, Mayo researchers have also singled out four potential drug compounds that could relieve the condition with no known cure.

“This study suggests that these mini-brain models can effectively mimic disease development, providing a potential platform for testing individualized treatments for patients,” said neuroscientist, senior author and lead Mayo researcher Na Zhao. “The four identified drug candidates, which have the potential to inhibit alpha-synuclein and restore the energy production in neurons derived from LBD patients, could be further refined or modified to develop new treatments for LBD and associated dementias in the future.”

 — Lobbyists —

Jeff Hawes, Corcoran Partners: Eli Lilly and Company, Florida Chiropractic Coalition, Private Care Association of Florida

Aimee Lyon, Karl Rasmussen, Metz Husband & Daughton: Adaptive Biotechnologies Corporation

Jason Maine, PinPoint Results: Seniors First

Carlos Trujillo, James Card, Gangul Gabadage, Continental Strategy: Live Like Bella Childhood Cancer Foundation

Derek Whitis, Whitis Consulting: Parrish Healthcare

 — ICYMI —

“‘More change than usual:’ Big revisions in drug plans and health care benefits ahead for Florida Medicare recipients” via Cindy Krischer Goodman of the South Florida Sun-Sentinel — Big Medicare changes will go into effect in 2025, giving Floridians more reason to sift through plans and make smart choices. The 5.1 million Floridians who qualify for Medicare will have from Oct. 15 through Dec. 7 to choose original Medicare or one of the Medicare Advantage plans offered in their county. Changes to Medicare in 2025 will include a $2,000 limit on out-of-pocket Part D drug costs, an opt-in payment plan for expensive medications, and some potential broad changes in Medicare Advantage plans that could eliminate your current plan or slim your benefits.

“Study: Young people at higher risk for Type 2 diabetes after COVID” via WLRN Public Media — Young people 10 to 19 years old are 1.5 times more likely to be diagnosed with Type 2 diabetes in the six months after having COVID-19. That’s according to a study by researchers at the Case Western Reserve School of Medicine in Ohio published last week. Eileen Marty, a professor and expert in infectious diseases and disaster medicine at Florida International University, says the overall risk is significantly higher when compared to vaccinated children or those infected with a different respiratory virus. “I don’t want to alarm parents and think, ‘Oh, my goodness, my child is definitely going to get Type 2 diabetes if my child gets COVID.’ That’s not true.” … “It’s still a small percentage of the children; it’s just much higher for those who are unvaccinated.” Whether diabetes persists or reverses later in life would need additional study.

“Orlando hospital worker fatally broke newborn’s neck — and facility tried to hide it, suit says” via Julia Marnin of the Miami Herald — The parents of Jahxy Peets, a baby girl who was born prematurely and died months later, are suing an Orlando hospital, saying the facility tried to hide how their daughter’s neck was broken in the NICU. After Gianna Lopera gave birth to Jahxy at Orlando Health Winnie Palmer Hospital for Women & Babies, she was intubated and admitted to the neonatal intensive care unit in June 2022, according to the lawsuit filed Oct. 17 in Orange County. Jahxy was 24 weeks old when she was born. A health care provider at the hospital is accused of breaking Jahxy’s neck when handling her about two weeks later, then returning Jahxy to her incubator with a broken neck without alerting staff, the complaint says. Jahxy’s broken neck resulted in her death a few months later, on Nov. 25, 2022, the complaint says.

“Nurses at two HCA hospitals in Central Florida approve new union contract” via McKenna Schueler of Orlando Weekly — After a contentious round of union contract negotiations, registered nurses at two HCA hospitals in Central Florida — HCA Lake Monroe in Sanford and HCA Osceola Hospital in Kissimmee — have voted to approve new contracts negotiated between their union and their multibillion-dollar employer, HCA Healthcare. According to the union, National Nurses United, the new three-year collective bargaining agreements deliver an average 15% wage increase for registered nurses — the largest guaranteed wage increase ever secured for nurses at both facilities over the life of the contract — plus improvements to nurses’ “floating” policy and the option of adding personal pronouns and preferred names to name badges. Under the new floating policy, RNs can only be temporarily assigned to other units with specialties similar to their normal unit to increase safety.

 — Rules —

AHCA will hold a rule development workshop on Nov. 8 to discuss an amendment to Rule 59G-4.190 that incorporates the Florida Medicaid Laboratory Services Coverage Policy by reference. More here.

AHCA has scheduled a public hearing for Dec. 13 to review recommendations for inclusion or exclusion to the preferred drug list. More here.

 — Pencil it in —

Nov. 6

Noon — The FWC Harmful Algal Bloom Task Force will discuss priority areas of HAB impacts in Florida. The meeting will stream on YouTube. For a copy of the agenda, visit MyFwc.com/research/redtide/taskforce/meeting/

Nov. 7

10 a.m. — The Commission on Mental Health and Substance Use Disorder is meeting to discuss the status of Florida’s behavioral health system of care and opportunities to examine further the current methods of providing mental health and substance use services in the state. Join via Microsoft Teams, or call in via 1-412-912-1530, conference ID: 755 141 498.

Nov. 12

Happy birthday to Sen. Nick DiCeglie!

Nov. 13

Happy birthday to Rep. Sam Garrison!

Nov. 15

Happy birthday to Rep. Michael Gottlieb!

Happy birthday to Rep. Will Robinson!