Miami-Dade Circuit Court Judge Peter Lopez heard arguments Monday in a fast-moving lawsuit that could reshape Miami’s District 3 runoff election.

A second hearing is set Wednesday, when Lopez expects to issue a ruling.

At issue is a lawsuit filed by three Miami residents, one of whom hopes to take former Miami Commissioner Frank Carollo’s spot on next month’s runoff ballot, seeking to enforce voter-approved term limits.

The measure, which applies retroactively, caps service at two terms as Mayor or City Commissioner. It passed last week with 79% support.

On the same day voters OK’d the change, Carollo — who served on the City Commission from 2009 to 2013 and from 2013 to 2017 — led a crowded District 3 race with about 38% of the vote, advancing to a Dec. 9 runoff against restaurant manager Rolando Escalona.

But the plaintiffs, including third-place finisher Oscar Alejandro, contend the new limits immediately disqualify Carollo, since he served two full terms already. They’re asking Lopez to boot Carollo from the ballot and replace him with Alejandro.

Notably, one of the plaintiffs’ lawyers, former Rep. Juan-Carlos “J.C.” Planas, successfully defended Escalona from an attempt last month to disqualify him in the race due to questions over his residency.

Carollo’s lawyers, meanwhile, countered that the referendum language didn’t specify whether it applies to candidates on the same ballot. They argued that retroactively excluding their client would violate constitutional protections and disenfranchise voters who already cast ballots for him.

The “appropriate mechanism,” lawyer Robert Fernandez said, would be to challenge the outcome of the runoff through standard post-election procedures.

An attorney for the Miami-Dade Supervisor of Elections cautioned that the case could have logistical consequences. Ballots for the city’s 9 runoff, which also includes the mayoral runoff between former Miami-Dade Commissioner Eileen Higgins and ex-City Manager Emilio González, are already being printed.

He said reprogramming and retesting ballots to reflect any changes in the District 3 lineup could delay distribution of mail-in ballots, which are scheduled to go out Nov. 17.

A decision Wednesday won’t likely be the end of the matter, as the losing side could appeal the ruling.

Carollo and Escalona, who took about 17% of the vote in the eight-person contest, are competing to replace term-limited Commissioner Joe Carollo, Frank Carollo’s older brother. Frank Carollo held the seat immediately before him.

Both Carollos and Escalona are registered Republicans. Alejandro, a U.S. Navy veteran, is a registered Democrat.

City races are technically nonpartisan, but party politics are frequently still a factor.

Welcome back to Diagnosis, a vertical that focuses on the crossroads of health care policy and politics.

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— Health freedom —

Former House Speaker and Republican gubernatorial candidate Paul Renner is making “health freedom” a centerpiece of his 2026 campaign, rolling out a sweeping plan to end vaccine mandates, overhaul school nutrition, and push for the repeal of the Affordable Care Act.

Renner unveiled his Florida Health Freedom and Wellness Initiative during a Naples appearance, calling for Congress to repeal Obamacare and for Florida lawmakers to ban “medical vaccine mandates,” including any segregation of patients based on vaccination status. He said the federal health law “caused the costs of health care to skyrocket” and argued that “the solution is not to keep subsidizing.”

Renner’s priorities: protecting medical freedom, strengthening parental rights, improving school wellness and nutrition, and promoting preventive and alternative care options such as naturopathic and nutritional medicine. It also proposes “responsible guardrails” for artificial intelligence in schools, requiring parental consent before use and restricting it to classroom learning.

The initiative mirrors Gov. Ron DeSantis’ opposition to pandemic-era mandates but extends that approach with new provisions on parental authority. Renner said his administration would ensure that “parents and only parents” make medical and mental health decisions for their children, adding that “children get vaccines at too early an age” and should receive them only after discussion with their pediatrician.

Renner also emphasized childhood wellness, promising to partner with Florida farmers to bring fresh, healthy food into school cafeterias and to eliminate harmful additives from meals. Advocacy groups, including Stand for Health Freedom and Parental Rights Florida, praised the plan as a bold step toward “restoring transparency and empowering parents.”

— Anesthesia autonomy —

Rep. Mike Giallombardo is once again seeking to expand autonomous practice for certified registered nurse anesthetists (CRNAs).

The Cape Coral Republican refiled legislation (HB 375) that would allow CRNAs in Florida to work independently, removing the current requirement for written supervisory agreements with physicians in hospitals and ambulatory surgical centers.

Under current law, only specific advanced practice registered nurses — including those in primary care, family medicine, general pediatrics and internal medicine — may practice autonomously. Giallombardo’s bill would extend that same authority to CRNAs, revising state statutes to permit them to administer anesthesia and perform related procedures without direct physician oversight.

The measure builds on similar efforts from the 2025 Session, when the House passed an earlier version (HB 649) in a 77–30 vote, though the companion bill in the Senate (SB 718) stalled in Committee. Critics raised concerns about patient safety and liability in the absence of physician supervision, while supporters argued the change would help close workforce gaps and improve access to care, particularly in rural communities.

The Florida Association of Nurse Anesthetists has long supported the proposal, noting that more than 30 states already allow CRNAs to practice independently and that Florida’s current framework contributes to provider shortages. Opponents, including the Florida Society of Anesthesiologists and the Florida Medical Association, continue to warn of risks to patient safety and the potential for reduced quality of care.

If approved, the measure would take effect July 1, 2026.

— Sky salute —

Last month, the Florida Health Care Association (FHCA) partnered with Dream Flights to honor local Veterans living in Big Bend long-term care facilities with flights in iconic WWII-era, open-cockpit biplanes.

“These Veterans who took to the skies are the model of service to the country,” said Emmett Reed, FHCA CEO. “FHCA and our member centers are focused on enriching the lives of the residents entrusted to our care, and it’s our honor to provide this unforgettable experience to these brave men and women. We’re thrilled to partner with Dream Flights to make this memorable experience possible for them.”

Veteran residents, their families, and team members from the care centers they reside in gathered at Million Air FBO in Tallahassee for the Dream Flight experience. Each Veteran resident received a FHCA challenge coin, a veteran’s service medal from the Florida Veterans Foundation, and additional recognition from the Florida Department of Veterans’ Affairs.

FHCA sponsored the Dream Flights experience to thank Veterans for their service during Florida’s Veterans Appreciation Month. Dream Flyers experienced the freedom of soaring in the same aircraft used to train aviators during WWII.

— ICYMI —

“Community focused or ‘out of touch’? Divide over hospital leadership bursts into open” via Elena Barrera of the Tallahassee Democrat — Tallahassee Memorial HealthCare and Florida State University are clashing over control of a proposed academic medical center’s Governing Board, with TMH insisting on a community majority to prevent political interference in medical decisions. The dispute, long simmering behind closed doors, has erupted publicly through dueling opinion pieces and a controversial text poll from Grow Tallahassee, which TMH called misleading and defamatory. TMH Board Chair James Killius says protecting community oversight is vital to keep health care decisions free from state politics, while business leader Bugra Demirel accuses TMH of blocking progress. City leaders are weighing competing Board proposals that would include FSU, Florida A&M University and Tallahassee State College, as both sides press their visions for the hospital’s future.

“Florida health agency submits application for millions of federal rural health funding” via Kimberly Leonard of POLITICO — Florida’s Agency for Health Care Administration has applied for millions in federal funding through Donald Trump’s One Big Beautiful Bill Act, which allocates $50 billion over five years to improve rural health care. Deputy Medicaid Secretary Brian Meyer told state lawmakers the proposal emphasizes workforce development, expanded access to primary, maternal, dental and mental health services and telehealth technology. The state also outlined plans to promote nutrition and physical activity. Lawmakers voiced frustration over the short Nov. 5 deadline. Still, Meyer said officials will collaborate with the Legislature once funds are awarded on Dec. 31. Grants will be distributed in two phases, with spending restrictions and federal monitoring to ensure Florida meets improvement benchmarks.

“Poll shows most Floridians concerned about U.S. reliance on Chinese medical tech” via Jacob Ogles of Florida Politics — Nearly three-quarters of Floridians say America relies too much on Chinese medical gear. More would vote for politicians who support cracking down on Chinese influence on U.S. health care. That’s according to a poll commissioned by the Protecting America Initiative, which surveyed likely voters on issues related to China’s impact on U.S. medical services. The survey found 72% of Florida voters believe the U.S. is “too dependent” on Chinese-made medical technologies. About 81% support more decisive government action to reduce that reliance. “Florida voters are sending a clear warning about America’s growing dependence on Chinese-made medical technology. They view it as a direct threat to both patient safety and national security,” a polling memo from the group reads.

“Ron and Casey DeSantis announce pediatric cancer research initiative in Florida” via Beth Reese Cravey of The Florida Times-Union — DeSantis announced a five-year funding initiative today to boost pediatric cancer research at four Florida specialty children’s hospitals, including Wolfson Children’s Hospital in Jacksonville. The other facilities are Nemours Children’s Hospital in Orlando, Nicklaus Children’s Hospital in Miami and Johns Hopkins All Children’s Hospital in St. Petersburg. Each will receive $7.5 million each year — a total of $30 million this year — for five years, through the state’s Cancer Connect Collaborative Research Incubator.

“‘We Are TGH Day’: Tampa General, USF Health bring academic medicine to Capitol” via Peter Schorsch of Florida Politics — More than 100 patients, family advocates, medical students, and team members from across Florida gathered at the State Capitol to highlight the academic distinction that defines Tampa General Hospital and USF Health. “As our region’s only true university-affiliated academic health system, we are incredibly proud to provide compassionate, innovative, high-quality, and complex care to millions of people each year across an ever-growing network of seven hospitals and more than 150 care locations statewide,” said John Couris, president and CEO of Tampa General Hospital. “This event is an opportunity for Floridians who benefit from the power of academic medicine at Tampa General and USF Health to share their stories with our state’s leaders.”

— RULES —

The Board of Medicine’s final rule regarding application for licensure and licensure requirements for anesthesiologist assistants goes into effect Nov. 16. More here.

The Board of Medicine’s final rule regarding licensure by endorsement for electrologists and electrology facilities goes into effect Nov. 19. More here.

The Board of Osteopathic Medicine’s final rule regarding application for licensure and licensure requirements for anesthesiologist assistants goes into effect Nov. 16. More here.

The Board of Occupational Therapy’s final rule regarding application by endorsement for occupational therapists goes into effect Nov. 19. More here.

— PENCIL IT IN —

Nov. 12

Happy birthday to Sen. Nick DiCeglie!

10 a.m. — The Florida Association of Health Plans kicks off its annual conference, running Nov. 12-14, at the JW Marriott Grande Lakes in Orlando. 4040 Central Florida Parkway, Orlando.

Nov. 13

Happy birthday to Rep. Sam Garrison!

Nov. 19

8 a.m. — The House Subcommittee on Health Care Facilities & Systems meets. Room 404 H, The Capitol.

8:30 a.m. — Hosted by the Florida Department of Elder Affairs, the summit brings together leaders in health, aging and long-term care to discuss policy and innovation for Florida’s growing senior population. Secretary Michelle Branham will deliver keynote remarks. DoubleTree by Hilton Tallahassee, 101 S. Adams St., Tallahassee.

9 a.m. — The Senate Appropriations Committee on Health and Human Services meets. Room 412 K, The Capitol.

Nov. 20

9 a.m. — The Social Services Estimating Conference will focus on KidCare caseload projections and related health service expenditures. Room 117 K, The Capitol.

Nov. 21

Happy birthday to Rep. Lindsay Cross!

9 a.m. — The Revenue Estimating Impact Conference will review updated data on health-related and general revenue streams affecting state programs. Room 117 K, The Capitol.