Florida
Diagnosis for 5.22.24: Checking the pulse of Florida health care news and policy
Welcome back to Diagnosis, a vertical that focuses on the crossroads of health care policy and politics.
— Anticipation is keeping us waiting—
Two major federal lawsuits dealing with Florida’s safety net health care program and subsidized children’s health insurance programs remain in a holding pattern.
It’s been nearly two weeks since a federal judge postponed a trial challenging how the administration of Gov. Ron DeSantis has removed people from the Medicaid rolls.
The trial was delayed because U.S. District Judge Marcia Morales Howard had a death in her family. A status conference to discuss when the trial can be rescheduled has yet to be held.
The Medicaid lawsuit filed in Jacksonville stems from Florida’s actions after the state resumed determining whether or not people were still eligible for coverage. During COVID-19, the federal government increased funding to states for Medicaid but mandated that the states could not remove people while the emergency was in place.
The Medicaid lawsuit filed in Jacksonville centers on whether or not the administration properly notified individuals about their termination from the safety net health care program. The lawsuit asks a judge to prevent Florida from using its current notice process as well as reinstate to Medicaid those previously removed until a new more detailed process is put in place.
Meanwhile, a key decision is still pending in Florida’s lawsuit against the Biden administration over guidelines for subsidized children’s health insurance programs.
Florida is challenging a federal requirement that requires that children remain continuously enrolled in the program known as Florida Kidcare even if the families have stopped paying premiums. The Joe Biden administration maintains the requirement was mandated by Congress but Florida says federal authorities are misinterpreting the law.
In mid-April Judge William Jung held a hearing on Florida’s request for a preliminary injunction in the case. Jung asked both sides to submit proposed orders on the motion but he has yet to render a ruling.
Last week the Biden administration filed a lengthy response to the initial lawsuit and asked that it be dismissed.
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— Good news —
The number of Americans without health insurance at the end of last year held steady at 7.7% although the data does not fully reflect the number of people who signed up for health insurance coverage during the recent open enrollment period for Obamacare.
Federal authorities late last week released data that showed the number of those without coverage had stayed constant for the final six months of 2023 — a figure that was below the 8.3% uninsured rate for the final quarter of 2022.
Health and Human Services Secretary Xavier Becerra touted the new numbers as proof of successful efforts by the Biden administration to provide health insurance coverage.
The overall national figure is notable given that many states — including Florida — last year began a process of “unwinding” where they were allowed to remove people from Medicaid because they were no longer eligible for the safety-net health care program. States were required to freeze Medicaid rolls during the public health emergency that occurred due to the COVID-19 pandemic.
But the new uninsured rate also does not capture the impact of Obamacare enrollment. A record 4.21 million Floridians signed up for health insurance through the federal exchange during the period that ended in January.
Florida, which has had one of the higher uninsured rates in the nation, led the nation in Obamacare enrollment. More than 21 million Americans obtained insurance through Obamacare during the open enrollment period.
—DeSantis joins RGA letter—
DeSantis joined 23 other Republican Governors signing onto a letter to Biden stating their opposition to proposed amendments on the World Health Organization’s International Health Regulations and a New Pandemic Treaty.
“We, as governors of our respective states, stand united in opposition to two proposed instruments currently under negotiation that would purport to grant the World Health Organization (WHO) unprecedented and unconstitutional powers over the United States and its people. These Proposed changes could drastically change the role of governors in response to their charge as the state health officials,” reads the May 22 letter from the Republican Governors Association.
DeSantis went from a first-time Governor with a year’s experience under his belt, to a nationally recognized name due in part to his response to the COVID-19 pandemic.
While DeSantis was an early proponent of the vaccine and — unlike the federal government — made getting the vaccine to the senior population the No. 1 priority, he pivoted his position, suing the federal government for its vaccine mandate policies.
The letter was signed by 24 of the 27 Republican Governors.
“As governors, we affirm that public health policy is a matter reserved for the states, not the federal government, and certainly not international bodies like the WHO. We are committed to resisting any attempts to transfer authority to the WHO over public policy affecting our citizens or any efforts by the WHO to assert such authority over them.”
—More needs than desires?—
Florida health care regulators earlier this year said the state needed an additional 702 nursing home beds by January 2027.
Two months after making the announcement, the state received nine CON applications from vendors for 560 new community nursing home beds, 269 of which are applications to convert sheltered beds to community nursing home beds.
The applications come at a time when, according to Bloomberg News, nursing home debt default rates in the Sunshine State hit 18%, well above the national 8% average.
Pilar Carvajal, CEO of Innovation Senior Living in Winter Park, told Bloomberg, “We are headed into a train wreck.”
Florida regulates new nursing beds and construction through the certificate of need (CON) program. There are four CON batching cycles annually, two of which are for skilled nursing facilities or new institutions for people with development and intellectual disabilities and the other two for hospice programs.
Lawmakers considered making changes to state tort laws to provide legal protections to assisted living facilities, many of which are part of larger long term care systems with a continuum of providers, but ultimately made no changes.
While the long term care providers may have fallen short on their efforts to alter how claims are filed and litigated, the industry walked away a winner with record-setting double-digit increases in Medicaid reimbursements.
— New dental protections —
Hard-fought changes pushed by the Florida Dental Association (FDA) will soon become a reality after reality this summer now that DeSantis signed SB 892.
The new law puts dentists in the driver’s seat when it comes to their insurance reimbursements, requiring insurers and managed care plans to get dentists’ advance consent to provide ACH payments by Jan. 1, 2025.
A dentist’s consent may be given through an email that bears the electronic or digital signature of the dentist. As an alternative, express consent can be provided by checking a box indicating consent.
Third-party payors that reimburse providers via an Automated Clearing House (ACH) transfer cannot charge a fee to transmit the payment unless the dentist has consented to the fee.
The law also updates Florida’s insurance codes to make clear that once prior authorization is obtained an insurer cannot subsequently deny a claim unless the claim was denied because, among other reasons, another payor is responsible for payment; the claim was submitted fraudulently; or the prior authorization was based in whole or material part on erroneous information provided to the health insurer by the dentist, patient, or other person not related to the insurer or the person receiving the procedure was not eligible to receive the procedure on the date of service.
“This legislation will address a key issue that is affecting too many Florida patients – denial of coverage for dental treatment services that had been previously authorized by their dental plan,” said Dr. Beatriz Terry, president of the FDA. “This new law will help ensure patients receive the dental benefits they are paying for.”
SB 892 was one of a spate of policy victories for the FDA in the 2024 Session which also saw Medicaid reimbursement increases for dentists.
HB 855 which cracks down on orthodontic telehealth, was sent to the Governor Tuesday.
The legislation requires an in-person examination and “a dentist of record to remain primarily responsible for all dental treatments for a patient treated through telehealth.
—Go Gators—
The University of Florida Health has been selected by the Centers for Disease Control and Prevention to lead a program that could reduce the health disparity gap in some Jacksonville communities by connecting patients with community pharmacists for help managing high blood pressure.
Dubbed the Hypertension Pharmacists’ Program the initiative is scheduled to start this summer with the goal of expanding access to blood pressure care for the city’s medically underserved, predominantly Black communities.
Nearly half of American adults are affected by high blood pressure or hypertension.
Blacks suffer disproportionately, data show.
The program aims to increase treatment for high blood pressure by embedding clinical pharmacists within a patient’s primary care team. The effort, facilitated by the UF Health Jacksonville Office of Community Engagement, is a collaboration among the UF Health Total Care Clinic – Jacksonville, the UF College of Pharmacy and Panama Pharmacy, and it will allow patients to see a specially trained pharmacist at a community pharmacy and seek individualized care and education.
The CDC reports that nearly 90% of Americans live within five miles of a community pharmacy, making pharmacists the most accessible health care provider for most people. Community pharmacists can also make medication recommendations and lifestyle adjustments to help patients better manage the disease.
“Hypertension repeatedly shows up in the triannual Community Health Needs Assessment as a significant health factor and concern in our community. Being able to provide health resources through a collaborative effort such as this is a fantastic opportunity for our patients and for the continuum of care,” says Ann-Marie Knight, M.H.A., FACHE, Vice President of community engagement for UF Health Jacksonville.
— Art awards—
The Florida Health Care Association (FHCA) has picked a winner for its 2024 Long Term Care Photo Contest.
Shout out to Sabal Palms Health Care Center in Largo, which took the top spot for its photo “Veterans Wall of Honor,” taken by Sabal Palms Director of Life Enrichment Lauren Evarts.
FHCA gave the facility a $500 contribution for a social event for residents and staff. Evarts will also receive a $50 gift card for her submission.
“We are inspired by the outpouring of submissions we received for this year’s long-term care photo contest,” said FHCA CEO Emmett Reed. “These photos, taken by caregivers, facility staff, and volunteers, capture the unique and special bonds shared in our long-term care communities. The stories shared through the pictures showcase the amazing history and relationships housed in each of our centers across the state. We are overjoyed each year to receive these submissions and learn more about the lives being changed through the kindness cultivated in our centers.”
More than 200 photos were entered into this year’s contest, which focused on the theme “Cultivating Kindness.” The contest is sponsored by Incite Strategic Partners.
The announcement coincided with National Skilled Nursing Care Week.
The second-place winner is “Sharing is Caring” by Island Lake Center in Longwood, submitted by recreation assistant Freida Bratcher. The photo features residents who have been married for 50 years sharing a slice of pizza on National Pizza Day.
Bratcher said the couple “have always been inseparable. I love their love story, and I have always seen how loyal she is to her husband, how his face lights up when he sees her, and how she prides herself on spending time with him every day.”
“100th Birthday Party” by Bridgewater Park Health and Rehabilitation in Ocala placed third in the photo contest. Activity Director Joy Dean submitted the photo of a resident’s 100th birthday party surprise birthday celebration.
“I was inspired to take her picture because I happened to look over and see this normally reserved and humble lady, just positively glowing with happiness and love, and with her crown and sash I thought she looked like a queen and wanted to always keep that radiant memory with me,” said Dean. “I look forward to seeing her every day and I like to think the feeling is the same for her.”
The winning photos will be displayed during FHCA’s 2024 Annual Conference & Trade Show in Orlando. To read more about this year’s Long Term Care Photo Contest, click here.
— RULES —
Stanley C. Haimes, M.D., has petitioned the Board of Medicine asking whether he is allowed to refer requests for an independent medical examination (IME) report and supplied medical records to the entity that paid for the evaluation or is he required to release directly and without delay to the individual being evaluated, copies of the report and supplied medical records. The Board will consider this petition at its June 7 meeting in Tallahassee.
A copy of the Petition for Declaratory Statement may be obtained by contacting: Paul J. Vazquez, J.D., Executive Director, Board of Medicine, 4052 Bald Cypress Way, Bin #C03, Tallahassee 32399-3253, or [email protected].
— LOBBYISTS —
Michael Corcoran, Jacqueline Corcoran, Matt Blair, Will Rodriguez, Andrea Tovar, Corcoran Partners: Florida Community Care and Independent Living Systems.
— ETC —
— The American Medical Association publication, JAMA Network Open, this week published the findings of a new study led by a University of Florida College of Public Health and Health Professions researcher that shows a nexus between high fluoride levels in pregnant women and neurobehavioral problems in their children. It is believed to be the first U.S.-based study to examine associations of prenatal fluoride exposure with parent-reported child neurobehavioral issues, which include symptoms of anxiety, difficulty regulating emotions and other complaints, such as stomachaches and headaches. The findings are based on an analysis involving 229 mother-child pairs living in a U.S. community with typical fluoride exposure levels for pregnant women in fluoridated regions in North America.
— Attorney General Ashley Moody’s Medicaid Fraud Control Unit (MFCU) arrested the owners of A River’s Journey home health care agency, which has residential home care facilities located in Yulee and Jacksonville. Latrena Marie Thomas and Donald Ray Adams II were arrested for allegedly billing Medicaid $1.6 million for 30 patients who qualify for Medicaid under the Medically Needy program. According to the investigation, Thomas and the agency hired employees who were not licensed as certified nursing assistants, several of whom would have failed the Level 2 background screening that is required by the Florida Agency for Health Care Administration, to provide hands-on personal care to Medicaid recipients. Thomas did not have a director of nursing on staff as required by law to provide oversight of the licensed practical nurses and other staff employed, falsified work-related documents, and billed for around-the-clock care. Moody’s MFCU will prosecute the case through the State Attorney’s Office for Florida’s 4th Judicial Circuit.
— In a letter to U.S. Sen. Bernie Sanders and Rep. Brett Guthrie, who chair Committees overseeing the U.S. Center for Medicaid and Medicare Services, CFO Jimmy Patronis warned that the Obamacare Marketplace does not adequately guard against bad actors who switch policyholders’ health insurance plans without consent to collect commission. “Policyholders are getting plans they didn’t want or ask for,” Patronis said. “Thanks to the weak security measures of the Marketplace, Floridians are being signed up for health policies in different states, then getting penalized by the IRS because they made too much to qualify for plans. This fraud can only occur through a Marketplace that’s got more holes in it than a cheap slice of Swiss cheese.”
—A cyberattack on Change Healthcare has representatives in senior-heavy districts concerned for constituents. Reps. Vern Buchanan, a Longboat Key Republican, and Bilirakis sent a letter to Health and Human Services Secretary Beccera detailing concerns about the federal response. Change Healthcare, which supports 14 billion clinical, financial and operational transactions each year, suffered the attack in February. While the Florida lawmakers expressed gratitude the service has worked with health care providers, many still suffer cash flow problems, according to the letter.Mary Mayhew, president and CEO of the Florida Hospital Association, said the attack impacted nearly every hospital in the state, including more than 100 that rely solely on Change Healthcare for billing.
—ROSTER—
Eric Lawson, the CEO of HCA North Florida Regional Hospital, has been appointed to the Gainesville Regional Utilities Authority. held multiple executive positions at HCA over the last 30 years. Lawson earned his bachelor’s degree in accounting from Tennessee Technological University.
Sha Edathumparampil was named the chief digital and information officer at Baptist Health South Florida In this role, Edathumparampil will drive Baptist Health’s digital transformation efforts while enhancing technology support and customer service for physicians, staff and patients. Edathumparampil joined Baptist Health three years ago from American Century Investments, where he was chief data officer and vice president of technology. He has also held technology and digital leadership roles at BMO Financial Group, The Walt Disney Company, Sabre Inc., and Fidelity Investments.
—ICYMI—
In case you missed them, here is a recap of other critical health care policy stories covered in Florida Politics this past week.
“Health care union backs ‘dedicated advocate’ David Richardson for Miami-Dade Tax Collector” via Jesse Scheckner of Florida Politics — A union representing more than 6,200 local health care workers is throwing its support behind former state lawmaker and Miami Beach Commissioner David Richardson’s bid to be Miami-Dade’s next Tax Collector.Richardson’s campaign announced an endorsement from SEIU Local 1991, the exclusive bargaining representation for nurses, physicians and other health care professionals at county-run Jackson Health System.
“Tampa General’s John Couris appointed to Florida’s Healthcare Innovation Council” via Peter Schorsch of Florida Politics — Senate President Kathleen Passidomo appointed Tampa General Hospital President and CEO John Couris to the newly established Florida Healthcare Innovation Council last month.The Council was recently created to address issues facing the health care industry with fresh perspectives from leaders and innovators across the industry. The Council was established by Senate Bill 7018, proposed by the Senate’s Health Policy Committee and shepherded to the finish line by health care champion Sen. Gayle Harrell in the Senate and Rep. Karen Gonzalez-Pittman in the House. The bill passed with overwhelming support from both chambers and was signed by the Governor on March 21.
“Florida Behavioral Health Association: Housing is an integral part of serious mental health treatment,” via Christine Jordan Sexton of Florida Politics — Top DeSantis administration officials appeared in St. Petersburg to tout the significant spending increases Florida has made for mental health fundingThe administration also promoted its successes with housing programs meant to help people with a serious mental health condition successfully live, work and play in the community in which they live. Department of Children and Families Secretary Shevaun Harris said the Legislature has in recent years increased the amount of recurring state dollars spent on housing for people with serious mental health illness. We’ve seen a 308% increase between state Fiscal Year 22-23 and state Fiscal Year 23-24, increasing our funding from $6.1 million to $25.2 million, respectively.”
“Pregnancy, parenting info soon coming to a tax-supported website near you” via Chirsitne Jordan Sexton of Florida Politics — Look for a state supported online pregnancy and parenting resource hub no later than Jan. 1, 2025, under a new law that takes effect July 1.The legislation (HB 415), sponsored by Republican Rep. Berny Jacques, also includes a one-time $466,200 appropriation to cover the cost of for the state to contract with a third party to develop the website. While the money is appropriated to the Department of Health (DOH), the law requires the agency to collaborate with the Department of Children and Families and the Agency for Health Care Administration to work collectively on the development of the website.
—FOR YOUR RADAR—
Aside from coverage by Florida Politics, these stories are worth your time.
“Sarasota Memorial Hospital Board will consider adopting Joseph Ladapo’s anti-vaccine guidance” via Earle Kimel of the Sarasota Herald-Tribune — The Sarasota County Public Hospital Board will weigh a proposal by Board member Vic Rohe that the hospital embrace assertions by Surgeon General Ladapo that COVID-19 vaccinations are risky and inappropriate for human use when it meets at 2 p.m. Tuesday. Federal health officials say Ladapo’s position is contrary to science and potentially deadly. In January, Rohe asked for the proposal — a five-page motion that he said members of the community handed him — to be placed on a future agenda.
“Fentanyl crisis: Overdoses stop rising in Lee County, but challenges remain” via Dan Glaun of the Fort Myers News-Press — The number of fatal overdoses in Lee County appears to have plateaued, even as death rates remain near historical peaks. Overdose fatalities peaked with 296 deaths in 2020. Those numbers declined to 295 in 2021 and 293 in 2022. “Many have cited this as sort of a glimmer of positive news,” said Dr. Denise Torres, an addiction medicine specialist with Lee Physician Group. “The curve has sort of flattened.” But Torres also warned against complacency. In 2015, before fentanyl had saturated the Lee County drug market, there were 86 opioid overdose deaths — less than a third of recent totals. Opioids remain by far the most lethal class of drugs in Lee County, accounting for 90% of overdose deaths in 2022.
“Former SMH Board Chair appointed to fill unexpired term in at large Seat 3 until November” via the Sarasota Herald-Tribune — Former Sarasota County Public Hospital Board Chair William “Bill” Noonan was appointed to temporarily fill the vacant at large Seat 3 position on the Board. The seat has been vacant since mid-April when Britt Riner stepped down to focus on a new role advocating for parents and children statewide. Noonan will hold the seat until the General Election in November, when voters will pick a new Board member in a race set to include Democrat George Davis and the winner of an Aug. 20 Republican Primary between Pam Beitlich and Mary Flynn O’Neill. The Hospital Board sets the strategic direction of the Sarasota Memorial Health Care System. Four seats on the nine-member Board are on the ballot this year.
—PENCIL IT IN—
Thursday
Happy birthday to Sen. Ana Maria Rodriguez!
8 a.m. — 2024 Florida Voices for Health Summit at the Space Coast Health Foundation1100 Rockledge Blvd, Rockledge, FL More information on tickets here.
2 p.m. — AHCA’s Office of Health Information Exchange and Policy Analysis hosts an education session on thow Florida health information exchange works with crisis stabilization units and other behavioral health providers. Register here.
Friday
8 a.m. — 2024 Florida Voices for Health Summit at the Space Coast Health Foundation1100 Rockledge Blvd, Rockledge, FL More information on tickets here.
Monday
Happy Memorial Day!
Tuesday
3:30 p.m. — Rep. Anna V. Eskamani, Geori Seldine, the executive director of Florida’s Children First, and Kyle Johnson, Florida Youth SHINE’s statewide chair and Orlando Chapter member discuss the foster care system in the state of Florida, current programs and services, and ways it can be improved.The event will be streamed on Facebook Live. RSVP here.
Wednesday
Happy birthday to Reps. Daryl Campbell and Kim Berfield!
10 a.m. — The Blood Clot and Pulmonary Embolism Workgroup meets. Register for the meeting here.
11:30 a.m. — The Capital Tiger Bay Club is hosting a 2024 Leon County ‘State of Public Safety’ panel at a lunch program at the Donald L. Tucker Civic Center. Capital Tiger Bay Club member and attorney Liz Desloge Ellis will moderate the panel. Donald L. Tucker Civic Center, 505 West Pensacola St. Tallahassee.
Diagnosis is written by Christine Jordan Sexton and edited by Drew Wilson.
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Gov. Ron DeSantis praised the World Cup for giving visiting fans from other countries a chance to see America directly.
“We do have a really great country. I know there’s a lot of problems. I know we see a lot of things that we wish we could change immediately. And I know there’s a lot of work to do, but I wouldn’t want to be anywhere else,” DeSantis said.
The visitors, he added, have gotten to see “firsthand both the generosity of the American people, but also that this is a good country.”
He is right.
But we’re pointing out these comments not just to show he is right, but also to show how he, like many of our leaders, are directly responsible for painting such a grim picture that leads to people’s negative views of this country to begin with.
DeSantis’ own political brand — the one that got him elected twice, launched a presidential campaign, and made him one of the most influential Governors in the country — is built substantially on the premise that a vast, organized internal enemy is destroying this country.
Teachers and school administrators who discussed gender identity in classrooms weren’t misguided or mistaken, they were “groomers.” Corporate executives who supported diversity programs were carriers of “the woke mind virus.” California is “a civilization in decay” leading “an attack on the American family.”
We could go on. This is not the rhetoric of someone who thinks America is a good country being pulled in the wrong direction. It is the rhetoric of someone who believes powerful forces within it are fundamentally opposed to everything good about it.
Trump has made the same argument in far more extreme terms. On Veterans Day 2023, at a campaign rally in New Hampshire, he declared: “We pledge to you that we will root out the communists, Marxists, fascists and the radical left thugs that live like vermin within the confines of our country.” Not misguided opponents. Not people with different values. Vermin — a word chosen with precision by Trump’s team and consistent with his repeated use of dehumanizing language toward political adversaries.
A month later, he described immigrants arriving in the United States as “poisoning the blood of our country,” a phrase with frightening historic parallels. These were not offhand remarks; they were delivered at rallies, posted to Truth Social, and repeated at subsequent campaign stops. Again, we could go on.
Democrats have found their own ways to corrode the thing they claim to be defending. The “threat to democracy” framing — once reserved for specific and serious institutional attacks — has been applied so broadly and so constantly that it now means approximately nothing. Every Republican appointment is an existential threat. Every policy disagreement heralds the end of constitutional order.
The World Cup has produced, almost accidentally, what American political culture cannot seem to produce on purpose: a setting in which people from wildly different countries interact with actual Americans and discover that the caricature is wrong. Fans from Scotland, Iran, Brazil, Morocco, and Australia arrived with whatever impressions their politics and media had given them, and found something different. They’re acknowledging that this is a good country, DeSantis said.
They are. The more interesting question is when the people who govern it are going to start acting like they believe the same thing.
In the meantime, sit back, have a drink with a stranger, and go Team USA.
Now, it’s onto our weekly game of winners and losers.
Winners
Honorable mention: Largo. Largo Mayor Woody Brown opened the June 2 Commission meeting by reading a Pride Month proclamation — a gesture the city had planned to drop from the agenda entirely before word got out and dozens of residents showed up to object.
Many of them arrived directly from the ribbon-cutting for Horizon West Bay, the $85 million mixed-use development anchored by the city’s new City Hall, and used their public comment time to make clear they hadn’t come just for the building.
That same Commission, it should be noted, recently passed an ordinance creating a new open-container entertainment district in the blocks surrounding that building — a program called “Sip and Stroll” that lets patrons walk freely through designated downtown zones with drinks purchased from approved local businesses.
Abner Morales, who owns Wepaa Puerto Rican Restaurant nearby, is already designing custom branded cups. “That’s awesome because we have like 16 employees. We want to keep running this business,” he said. One Cozy Smoke Shop employee told Fox 13 she sees the district becoming “almost like Bourbon Street in New Orleans.”
So the city is clearly looking to support its citizens. But on the Pride proclamation, the pressure the city was operating under was real.
In a June 1 online chat with residents, Brown explained that new legislation barring local governments from spending on diversity, equity and inclusion-related events and initiatives doesn’t technically take effect until Jan. 1. But with the budget still unsigned, Brown said the Governor could still cut off funding streams Largo depends on, including dollars for stormwater infrastructure.
“We’re trying to keep a relatively good relationship with our state folks,” Brown said, “and they’ve made some rules around that.”
Planning Board Chair Matthew Faustini, who is running for a Commission seat in November, pushed back, arguing a law that isn’t even in effect shouldn’t be tying the hands of local officials.
“You’re not willing to stand up for the residents of this city,” he said directly to Brown.
The most significant moment belonged to Commissioner Michael Smith, who is gay. Smith described spending 28 years of his life in the closet. He said the near-removal of the proclamation felt like “a real slap in the face.”
He acknowledged having considered ending his life when he was younger because of how different he felt. He said he cannot hold his partner’s hand in a restaurant without risking being called names or worse. He spoke of the proclamation as an act of faith toward residents who haven’t yet felt safe enough to be visible.
“There are many that are still afraid to come out and speak,” he said, “and many that are being shamed back into the closet. And that’s just wrong.”
Look, Florida has inserted itself into the center of the vulture war battle under DeSantis. Sometimes, they’ve pushed back against ridiculous things on the Left, but often, Tallahassee has overstepped. This proclamation isn’t hurting anyone and is a small thing in practice. But as Smith explained, it means a lot nevertheless to a significant portion of the community. They shouldn’t be feeling any heat from the state on this.
Largo didn’t do this perfectly — in fact, the city very nearly didn’t do it at all. But pushed by residents and remarks from some in charge, Largo ultimately chose its people over its political relationships.
Almost (but not quite) the biggest winner: Jared Moskowitz. Moskowitz joined forces with U.S. Rep. Anna Paulina Luna, a Pinellas Republican, to file a discharge petition that would force a floor vote on legislation capping federal student loan interest rates at 2%.
The bill does not attempt to cancel existing debt, a choice both Florida lawmakers described as deliberate. Rather, it’s aiming to put limits on future loans.
“There is broad bipartisan agreement that student loan debt is holding Americans back, yet Congress has failed to act,” Moskowitz said in a joint CNN appearance with Luna.
A discharge petition requires 218 signatures — a majority of the House — to force a vote bypassing leadership, and Luna has experience running them. She filed the first discharge petition of the current Congress in January over a remote voting accommodation for members on maternity leave, and it reached the required signatures before being withdrawn when Speaker Mike Johnson addressed the issue through other means.
Luna is a Republican representing a Trump-leaning Pinellas district. Moskowitz is a Democrat whose district includes Parkland. Neither one let partisan nitpicking stop them from addressing this week.
Also this week, Moskowitz hosted the fourth annual Sneaker Day on the Hill. Moskowitz has run the also bipartisan Congressional Sneaker Caucus since his first year in office. And his own connection to sneakers is personal: His late father used to take him to the mall on Air Jordan release days, and he wears them in the Capitol partly to carry that memory through the work.
Whether it’s a fun way yo bring more humanity to Washington, or reaching across the aisle to deal with a difficult policy problem, Moskowitz is making sure to build bridges in Congress in the hopes that it can break through the toxic and often absurd fake fights his colleagues, and the rest of us, spend way too much time on amplifying.
The biggest winner: FDACS. Florida’s agricultural community is already on its knees. Back-to-back freezes from late December through early February delivered an estimated $1.1 billion in damage to the state’s sugarcane crop alone. Ranchers have spent months contending with rising input costs, drought, and the lingering fallout from one of the most destructive winters in modern Florida farming history.
The last thing producers needed was a new invasive pest.
Enter the pasture mealybug, a small sap-feeding insect that specializes on grasses. It arrived in Florida in late May 2026, first detected on limpograss in South Florida. Since then, infestations have spread to multiple counties, with surveys still underway to determine the full extent of the damage.
Heavy infestations can degrade pasture quality quickly, open the land to weed invasion, and leave cattle without reliable forage. For the sugarcane industry, the pest is one more blow in a year that has already produced more blows than the industry can easily absorb.
“The rapid expansion of the infestation coupled with the quick deterioration of crop quality has taken farmers by surprise,” said Jarad Plair, a sugarcane farmer and past president of the Hendry/Glades Farm Bureau.
The situation was complicated further by the fact that as of this week, no insecticides were specifically labeled for mealybug control in pasture systems. Many common pasture treatments barely affect the pest because it spends much of its life cycle buried in thatch and soil, out of reach of conventional applications.
But the Florida Department of Agriculture and Consumer Services (FDACS) wasted no time in acting, urging the U.S. Food and Drug Administration to grant a crisis exemption for the use of the insecticide Sivanto Prime.
The Florida Cattlemen’s Association issued a statement crediting Agriculture Commissioner Wilton Simpson directly. “Thanks to the dedication of Commissioner Wilton Simpson, FDACS is recognizing the importance of protecting herds and lands from invasive pests,” the group wrote. “While a long road lies ahead, we are grateful for the support and decisive action of FDACS.”
Simpson was able to move fast enough even as the ground continues to shift under Florida’s farmers.
Losers
Dishonorable mention: María Elvira Salazar. The 21st Century ROAD to Housing Act is one of the most significant federal housing bills in decades — an expansive bipartisan package that touches more than 50 provisions aimed at expanding the housing supply, cutting red tape and limiting Wall Street investors from bulk-purchasing single-family homes.
Salazar recently took to Facebook to celebrate.
“In South Florida, housing costs are one of the biggest concerns I hear about,” she posted. “That’s why I supported this bipartisan legislation. We need to build more housing, cut through unnecessary red tape, and make it easier for families to achieve homeownership.”
The problem is, she did not vote for it, as she was absent due to the death of her mother.
To be clear, that is an entirely justifiable reason to be absent. In fact, it’s hard to come up with a more justifiable reason.
The problem is the Facebook post, which claimed credit for “supporting” legislation on which her name does not appear in the vote record.
Her Office’s statement tried pointing to her prior support — she voted for the bill in the House Financial Services Committee, twice on the floor to advance it to the Senate, and her own RESIDE Act, the Revitalizing Empty Structures Into Desirable Environments legislation she introduced in September, was incorporated into the final package.
That is a legitimate record. It’s also a different thing from the final passage vote, and using the word “supported” in a public statement about a bill you did not vote on in its final form opened her up to attack, justified or not.
The Democratic Congressional Campaign Committee (DCCC) did not wait long.
“If María Elvira Salazar is misleading her constituents and taking credit for votes she couldn’t be bothered to show up for, then Miamians will replace her with a real leader who will fight for their ability to afford housing for their families,” DCCC spokesperson Madison Andrus said.
The DCCC has designated Florida’s 27th Congressional District as a “District in Play” for 2026 and has been building a file on Salazar for months. Salazar has won her district comfortably in recent cycles, taking more than 60% support in 2024. She is not in immediate danger.
But she has missed 212 of 2,820 roll call votes across her career, a 7.5% absence rate that is well above the median for currently serving House members. That number, combined with a pattern the DCCC has spent multiple cycles highlighting — instances of Salazar touting legislation she either skipped or voted against — could give the attack some credibility in the eyes of voters.
Almost (but not quite) the biggest loser: Brightline. More than 200 people have now been killed in collisions involving Brightline trains since the company began Florida operations in 2017, a milestone the railroad passed this year.
With 17 deaths recorded through late June, the overall unofficial count now sits at 214.
Brightline emphasizes, with some justification, that its safety picture is improving. The company says incidents — defined broadly as any contact a train makes with another object — have declined 30% in 2026 compared to the same period last year.
It is also midway through deploying $55 million in safety infrastructure: $45 million from a federal grant, another $10 million of its own money. The installations include fencing, warning signs and suicide prevention signage. An Orlando Sentinel analysis from late last year found that 27 months after opening, the route from Cocoa north to Orlando through more rural terrain with 6-foot fencing near the tracks had recorded zero fatal accidents.
That’s all encouraging. And perhaps over the long run it will be enough to rehabilitate Brightline’s reputation.
But that reputation remains relevant. Brightline carries the highest death rate per mile traveled of any railroad in the United States. The deadliest stretch is between Miami and West Palm Beach, where trains run through some of the most densely populated corridors in the state. Many crossings fall within “quiet zones” where trains do not sound their horns. Victims include people in vehicles who miscalculate the speed, cyclists, pedestrians walking on or near tracks, and suicide cases.
And Brightline may not have a “long run” to shed its long-standing image. Brightline lost more than $233 million in 2025. The company carries more than $5 billion in debt and interest.
Revenue reached $214 million in 2025, up from roughly $188 million the year before, but average fares in the first quarter of 2026 actually declined compared to Q1 2025. Ridership hit a quarterly record of more than 900,000 passengers, which is encouraging, though credit-rating agencies have concluded the company needs significantly higher fares or ridership volume — likely both — to reach solvency. A proposed Tampa extension remains on the distant horizon.
Will the train company get back on track before it’s too late?
The biggest loser: Tampa Sports Authority. Ye performed for the first time at Raymond James Stadium on Friday night despite weeks of escalating public pressure from politicians, community leaders and Jewish organizations calling on the Tampa Sports Authority (TSA) to cancel both the Friday and Sunday night shows.
As we spotlighted last week, the opposition was bipartisan, with both U.S. Sen. Rick Scott and former Gov. Charlie Crist leading the charge against the shows.
The TSA wasn’t moved, arguing that no taxpayer money is being used to stage the concerts.
That last claim is technically defensible in a narrow sense — Ye’s promoter is bearing the production costs — but it papers over the reality that the stadium itself is a publicly subsidized facility.
Whether the TSA legally could have canceled is a different question than whether it found itself in a bad situation, and the answer to the former is: probably not. The contract governing the shows includes an anti-cancellation clause that legal experts described as unusual and apparently inserted at the artist’s request, requiring either a federal terrorism threat elevated to Level 5 or a major public health emergency before the shows could be called off without triggering significant legal liability.
Clay Calvert, a First Amendment expert at the American Enterprise Institute, said Raymond James Stadium’s status as a public forum means a performer cannot be excluded based on what they have said or might say.
But the TSA signed a contract that locked in the performances under conditions almost impossible to break. A few miles away, the Florida Holocaust Museum announced free admission for three days in response to the concerts.
Ye published a full-page apology for his antisemitic statements in The Wall Street Journal in January. Whether that is sufficient is a question each attendee has to answer for themselves.
What is not a question is that the TSA is already under scrutiny for its governance of the Rays stadium process, and that it will likely spend the coming weeks answering for this decision.
In Switzerland ever since, Ignatavicius has steadily improved with each passing season.
Spending most of the 2025-26 campaign playing against professionals in the National League, he notched 13 points (7G, 6A) in 52 games with Genève-Servette HC. He also suited up in 11 games in the postseason, scoring two goals and dishing out an assist.
During a brief stint in Switzerland’s second-tier league, he was better than a point-per-game player, racking up 11 points (7G, 4A) in eight contests.
“That was a big there,” the 18-year-old forward said of his breakout season. “There we go, and here I am now.”
Catching the attention of scouts across the NHL, Ignatavicius was projected as a possible late-first-round pick by several outlets heading into this weekend.
Making history when the Panthers called his name, he became the fourth Lithuanian to be drafted, joining Darius Kasparaitis, Dainius Zubrus and Andrey Pedan.
“It means a lot to my family and to my country,” Ignatavicius. “It shows little kids that whatever you dream it’s possible. You’ve just got to work for it. When you get your chance, you take it. Don’t give up. Work hard.”
A veteran of 1,293 games in the NHL, Zubrus has been a longtime mentor to his young countryman.
“I’m pretty close with him,” Ignatavicius said. “We text a lot. I’m happy with that and think I can learn a lot from him.”
When it comes to future lessons, he’ll have no shortage of new teachers to work with in South Florida.
Priding himself on playing a physical, relentless style, Ignatavicius models his game after one Panther in particular.
“Matthew Tkachuk,” he said. “I try playing like him, his style. I think he’s a great player and I can learn a lot from him.”
Yet to commit to returning to Switzerland next season, Ignatavicius is still waiting to see where he’ll lace up his skates in 2025-26.
“I’ve just got to focus on my summer and getting better,” he said.
In the immediate future, Ignatavicius will soon board a flight to Fort Lauderdale to participate in his first development camp with the Panthers.
“Florida? Can’t complain much,” he said when asked about his impending trip. “Very happy.”
In between on-ice sessions, maybe Ignatavicius will even find some time to grab a pizza.
If he needs a recommendation, I’m sure Panthers fans will have a few suggestions.
“This is just the beginning,” he said.
A diver who was reported missing near the Fort Pierce Inlet has been found dead, according to the St. Lucie County Sheriff’s Office.
The U.S. Coast Guard received a mayday call around 11:30 a.m. June 27 about the missing diver. The Coast Guard then notified the Florida Fish and Wildlife Conservation Commission, which deployed four boats to assist in the search, according to a social media post by the Sheriff’s Office. The St. Lucie County Sheriff’s Office marine unit also responded.
Friends of the missing diver joined the search, departing from Fort Pierce Inlet around 1 p.m.
The search, which included aerial support from the Coast Guard and FWC, focused on an area about six to seven miles north-northeast of the Fort Pierce Inlet, near Avalon State Park.
Around 4:10 p.m., the group of civilian divers entered the water and located the missing diver at the bottom of the ocean in about 55 feet of water. The diver was recovered and pronounced dead.
The body was transported to Coast Guard Station Fort Pierce. The St. Lucie County Sheriff’s Office Criminal Investigations Division is investigating the incident.
No additional information is available at this time.
This story was created by Colleen Wixon, colleen.wixon@tcpalm.com, with the assistance of Artificial Intelligence (AI). Journalists were involved in every step of the information gathering, review, editing and publishing process. Learn more at cm.usatoday.com/ethical-conduct.
Colleen Wixon is the Indian River County government watchdog reporter for TCPalm and Treasure Coast Newspapers.
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