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Assisted living claims victories in Florida budget, sees promise in future talks

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Assisted living claims victories in Florida budget, sees promise in future talks


(Credit: PM Images / Getty Images)

Senior living industry experts are calling Florida’s $117 billion state budget a mix of hits and misses regarding programs supporting older adults.

Increasing the Medicaid reimbursement rate and personal needs allowance were two wins state associations are celebrating.

The 2024-2025 state budget, which was passed recently by lawmakers at the end of the 2024 legislation session, included a $1.3 million Medicaid increase for Assistive Care Services, which includes services provided by assisted living communities. 

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“We are immensely grateful to the legislature and their collaborative efforts that resulted in a budget that not only addresses immediate needs, but also builds upon a solid foundation for the future of elder care in our state,” LeadingAge Southeast Vice President of Advocacy Susan Langston said in a statement. “From nursing homes, assisted living facilities, home- and community-based services, to affordable senior housing and workforce, these investments reflect a commitment to sustaining programs and services that provide high quality care for Florida’s older adults as they age across the continuum.”

Florida Assisted Living Association CEO Bijou Ikli explained that the ACS increase will help offset some of the costs associated with providing care for low-income residents. That daily rate had been $13.37, which Ikli said wouldn’t cover an hour of child care or even boarding for a pet, let alone coverage for assisting an older adult with activities of daily living. The latest budget increase will bump that daily rate by 15%.

The low reimbursement rate previously led many assisted living providers to forgo acceptance of ACS residents. Ikli said that  a bump in the rate might incentivize others to accept this type of reimbursement and potentially reduce instances of earlier transitions of residents to skilled nursing facilities.

The Florida Senior Living Association said it supported the rate increase.

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“Consistent Medicaid increases are necessary for the future of assisted living,” Jason Hand, FSLA vice president of public policy and legal affairs, told McKnight’s Senior Living. “Each assisted living community in Florida is unique and provides many types of services, and we are grateful for every investment made toward securing the continued future of our amazing communities and their residents.”

Increasing the personal needs allowance

The budget also includes $6.7 million to increase the personal needs allowance for individuals receiving Florida Optional State Supplementation in an assisted living community, adult family care home or mental health treatment center. The OSS program helps qualified low-income individuals pay for room and board in those settings. 

Ikli said that the increase is a significant win, as the personal needs allowance — which allows residents to retain a portion of their personal income to pay for personal expenses such as haircuts, toiletries, clothing and snacks — has remained $54 per month for assisted living residents for the past 20 years. The state budget increase brings that monthly figure up to $160 to match the amount nursing homes residents receive. 

“We thought it was important to address, because we thought it must be an oversight,” Ikli said, adding that many assisted living providers who choose to supplement their residents’ needs faced the prospect of going out of business because they couldn’t maintain those expenses.

Assisted living part of ‘promising’ discussions

One area that didn’t gain traction in the latest legislative session was addressing the statewide Medicaid managed care long-term care wait list, or SMMC-LTC. 

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Individuals are living longer, so many older adults who move into private-pay assisted living are running out of money and have to go through the process of applying for long-term care managed care. Those individuals eventually are placed on the SMMC-LTC waitlist for the communities they once called home.

Ikli said that the system creates a level of unnecessary stress and disruption for residents. Although proposals to rework the system did not make it to the committee level, she said that “promising” conversations have occurred about developing a plan to discuss the issue in a rules setting.

In addition, there also is an effort in the state to free up beds in skilled nursing facilities by transitioning more individuals into the greater community by identifying community-based alternatives. Ikli said that she is excited about that effort and believes it presents an opportunity for assisted living providers to help with some of those transitions. 

“There is a lot of room for assisted living to help with saving the system a lot of money, especially for individuals who can’t be alone but also don’t need 24-hour nursing care, to have a place to go,” she said. 

The key to being successful, she said, is going to be demonstrating the value of assisted living. Ikli said that the sector needs to be able to document its value, show the benefit and work as collaborative partners with various agencies and provider types on the healthcare continuum.

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Florida preacher buys VT campus to build Christian college | Fox News Video

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Florida preacher buys VT campus to build Christian college | Fox News Video


Florida preacher Tommie Zito discusses his mission to transform the abandoned Green Mountain College in Vermont into “Z University,” a Christian college. Zito’s goal is to train future leaders in evangelism, business, government, and music. He plans for the college to be fully operational by August 2027, emphasizing the need for godly institutions to counter current educational trends.



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Cyclosporiasis cases in Florida, US could be undercounted, health expert says

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Cyclosporiasis cases in Florida, US could be undercounted, health expert says


TALLAHASSEE, Fla. – A parasite that causes extreme diarrhea, seen in recent outbreaks across the country, has been documented in over 20 counties in Florida. But experts say there could be more cases than what has been reported.

According to the Florida Department of Health’s Reportable Diseases Frequency Report, 50 cases of cyclosporiasis have been reported in the state since May 1.

“This infectious disease may be hard to monitor due to the nature of the signs and symptoms,” said Dr. Norman Beatty, an associate professor of medicine and hospital epidemiologist at UF Health Shands. “It’s common to get a diarrheal illness at times, and other infectious diseases can resolve on their own, but cyclosporiasis is important to identify right now because there are multiple outbreaks across the country.”

Cyclosporiasis is a gastrointestinal disease caused by the parasite cyclospora, which causes diarrhea, abdominal pain, nausea, fatigue and loss of appetite, according to the U.S. Centers for Disease Control.

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[WATCH: Parasitic infection spreading across states, including Florida]

Once a case is confirmed through testing, a report is sent to the state department of health. But if someone doesn’t seek medical attention, the case could go unreported, Beatty said.

There could be a six-week reporting lag between illness onset and reporting, according to the CDC.

Since May 1, the federal agency has received reports of 1,645 confirmed domestic cases of cyclosporiasis but is aware of more than 5,100 cases that require further analysis, the CDC stated Tuesday.

In Florida since May 1, DOH data shows Lee County has seen the most cyclosporiasis cases with nine, followed by Miami-Dade with six and Broward with five.

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Other counties with cases include: Alachua, Brevard, Collier, Columbia, Duval, Escambia, Flagler, Gadsden, Highlands, Hillsborough, Lake, Orange, Osceola, Palm Beach, Pasco, Pinellas, Polk, Seminole, St. Johns, Sumter and Volusia.

In Alachua County, Beatty said he has seen several cases at UF Health Shands, which doctors believe stemmed from eating produce.

Previous outbreaks in the U.S. have been linked to raw produce, like lettuce and raspberries.

According to DOH data, Alachua County has seen one case of cyclosporiasis in June. But the department’s data is 10 days out of date, according to DOH’s website. The last day cases were uploaded to the report was July 4. And the U.S. Centers for Disease Control’s data on Florida undercounts DOH’s data, with only 11-30 reported sick people in the state.

In most scenarios, people who get cyclosporiasis will recover on their own. But in some cases, people can have persistent symptoms and relapsing infections over time, so any suspected cases should be tested, Beatty said.

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Direct human-to-human transmission is rare, he said, but if infected, people could shed the parasite into the environment, where it could become infectious again within a week or two, contributing to another outbreak.

“It’s a very hardy parasite,” he said.

The outbreak was first reported in Michigan on July 1, with other outbreaks later reported in Ohio, West Virginia and Kentucky, according to the CDC.

While 34 states, including Florida, have reported cases, the source of the outbreak is still unknown.



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Florida Cracker Trail predates America, honors history by annual ride

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Florida Cracker Trail predates America, honors history by annual ride



The trail started in the early 1500s when the Spanish would drop off cattle in Fort Pierce on the east coast and drive them across the state to the Manatee River on the west coast for shipping.

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  • The Florida Cracker Trail is a historic cattle-driving route across the state that predates the United States.
  • Florida’s early cattlemen were called “Crackers” because of the cracking sound made by their long leather whips.
  • An annual cross-state ride is held to honor the trail’s history and the endurance of the original cattlemen.

Editor’s note: In celebration of America’s 250th birthday in 2026, TCPalm/Treasure Coast Newspapers takes a look throughout the year at some of our region’s history and landmarks important to all of America.

The Florida Cracker Trail is older than America.

It started in the early 1500s when Spain owned Florida. The Spanish would drop off Andalusian cattle in what’s now Fort Pierce on the east coast, drive them across the state to the Manatee River on the west coast, then put the cattle on a barge and take them to Mexico.

The 146-mile trail was the only dry route across the state to move cattle, said Mike Harrison president of the Florida Cracker Trail Association.

The Kissimmee River and its floodplains were to the north, and Lake Okeechobee and the Everglades were to the south.

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“Florida was the first state to have cattle drives and the last state to have cattle drives” Harrison said. “They’ve been using the same route for over 500 years.”

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The Florida Cracker Association paraded through downtown Fort Pierce

Hundreds gathered to watch the annual Florida Cracker Trail Ride from Bradenton and ending in downtown Fort Pierce on Saturday, Feb. 25, 2023.

KAILA JONES/TCPALM, Wochit

When Florida became part of the United States in 1821, the wild cattle left behind by the Spanish roamed free. Florida officially became the 27th state in 1845.

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Early settlers would have wild cow hunts using the trail, except for the Manatee River. Instead, they would take cattle to Punta Rassa in Southwest Florida near Sanibel Island to ship to Cuba.

“Every group of people, every color — the Seminoles, the Black people, the freed slaves — all of them at one point were collecting these wild cows and making money off them in Florida,” Harrison said.

They were called cowmen or cattlemen — never cowboys like out West — because they had to hunt the cows on horseback in the Florida swamps, he said.

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They became known as Florida Crackers because they used long bullwhips between 10 and 12 feet long made of braided leather.

“The cows would get bogged down in the wetlands,” Harrison said, “and the Crackers would use the whips to keep them moving.”

The snaps of their whips would break the sound barrier and create tiny sonic booms that could be heard for miles, he said, making a loud crack.

“People knew that the Crackers were coming,” Harrison said.

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Re-enacting that rough ride annually

Every year, typically in February when the weather is cooler, Harrison is part of a group of riders who honor the history of the Cracker Trail with a cross-state ride.

From west to east, the trail follows State Road 64, or Bradenton-Arcadia Road, to a small part of U.S. 17, then County Road 66 to U.S. 98 to County Road 68, then a small part of U.S. 441 before back to C.R. 68, which is Orange Avenue, into downtown Fort Pierce.

It attracts between 60 and 200 riders each year, Harrison said, depending on the weather and the economy, especially gas prices.

The riders camp for over a week on a different ranch each night across the state, ending with a Saturday parade into downtown Fort Pierce.

“It is not a pleasure ride — it is an endurance ride,” Harrison said. “It’s grueling.”

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The ranches have changed over the years and so has the route. The original 146-mile trail is now shortened to about 120 miles starting east of Bradenton because of development, he said.

But they still move slow like the Crackers who didn’t want to overwork the fat cows, going at a grazing speed of about 3 mph across the state.

“When you go on horseback, you’re going to see everything, and you get to really enjoy Florida,” Harrison said. “Now you see a lot more asphalt than you used to, a lot more houses, but there’s still some great ranches.”

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‘Keep some agricultural history alive’

The Florida Cracker Trail Association formed in 1987 and started the annual cross-state ride the following year.

Harrison, who’s been president of the association for over eight years, is the second-longest-running member of the organization at over 35 years.

“We wanted to keep some agricultural history alive,” Harrison said. “We wanted people to remember the Florida Cracker Trail was a route that was used to get Florida on the map. It was the economic development of cattle and this agriculture corridor that brought success to Florida.”

The Florida Cracker Trail was selected as a Community Millennium Trail in 2000, according to its website. Millennium Trails was a partnership between the White House Millennium Council, the Department of Transportation, Rails-to-Trails Conservancy, the National Endowment for the Arts and other public agencies and private organizations.

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The goal was to create of a nation-wide network of trails that protect natural environment, interpret history and culture, and enhance alternative transportation, recreation and tourism.

The Cracker Trail Museum is on the actual trail in Zolfo Springs, according to its website. The Hardee County museum is open 8 a.m. to 5 p.m. from Monday to Friday, but it’s closed for lunch.

The historic Cracker Trail is a reminder of how Florida got its economic start before America was born, Harrison said.

“We knew the development would come, so we wanted people to remember this little corridor,” Harrison said. “These rural communities that we go through, they’re there because of agriculture, not because of Disneyland.”

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Laurie K. Blandford is a breaking news reporter with TCPalm. Email her at laurie.blandford@tcpalm.com.



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