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Checking the pulse of Florida health care news and policy

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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.”

Paul Renner spotlights ‘health freedom’ in 2026 campaign, pledging to end mandates and overhaul school nutrition.

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.

Mike Giallombardo renews push for CRNA autonomy, seeking to expand independent anesthesia practice statewide.

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.”

Florida Health Care Association honors Veterans with Dream Flights in WWII-era biplanes during Veterans Appreciation Month.

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.

FSU and TMH clash over hospital Board control, sparking public debate on community oversight and politics.

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!

Congrats to Sam Garrison, who is celebrating another trip around the sun.

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.



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Early voting underway for Miami Mayor’s runoff between Eileen Higgins, Emilio González

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Early voting is underway in Miami as former County Commissioner Eileen Higgins and former City Manager Emilio González enter the final stretch of a closely watched Dec. 9 mayoral runoff.

The two candidates rose from a 13-person field Nov. 4, with Higgins winning about 36% of the vote and González taking 19.5%. Because neither surpassed 50%, Miami voters must now choose between contrasting visions for a city grappling with affordability, rising seas, political dysfunction and rapid growth.

Both promise to bring more stability and accountability to City Hall. Both say Miami’s permitting process needs fixing.

Higgins, a mechanical engineer and eight-year county commissioner with a broad, international background in government service, has emphasized affordable housing — urging the city to build on public land and create a dedicated housing trust fund — and supports expanding the City Commission from five to nine members to improve neighborhood representation.

She also backs more eco-friendly and flood-preventative infrastructure, faster park construction and better transportation connectivity and efficiency.

She opposes Miami’s 287(g) agreement with U.S. Immigration and Customs Enforcement, calling recent enforcement “inhumane and cruel,” and has pledged to serve as a full-time mayor with no outside employment while replacing City Manager Art Noriega.

González, a retired Air Force colonel, former Director of U.S. Citizenship and Immigration Services and ex-CEO of Miami International Airport, argues Miami needs an experienced administrator to fix what he calls deep structural problems.

He has made permitting reform a top priority, labeling the current system as barely functioning, and says affordability must be addressed through broader tax relief rather than relying on housing development alone.

He supports limited police cooperation with ICE and wants Miami to prepare for the potential repeal of homestead property taxes. Like Higgins, he vows to replace Noriega but opposes expanding the commission.

He also vows, if elected, to establish a “Deregulation Task Force” to unburden small businesses, prioritizing capital investments that protect Miamians, increasing the city’s police force, modernizing Miami services with technology and a customer-friendly approach, and rein in government spending and growth.

Notably, Miami’s Nov. 4 election this year might not have taken place if not for González, who successfully sued in July to stop officials from delaying its election until 2026.

The runoff has drawn national attention, with major Democrats like Democratic National Committee Chair Ken Martin, Arizona U.S. Rep. Ruben Gallego and Orange County Mayor-turned-gubernatorial candidate Jerry Demings and his wife, former Congresswoman Val Demings, backing Higgins and high-profile Republicans like President Donald Trump, Gov. Ron DeSantis and U.S. Sen. Rick Scott lining up behind González.

For both parties, Miami’s outcome is seen as a bellwether heading into a volatile 2026 cycle, in a city where growth, climate challenges and governance failures remain top concerns for nearly 500,000 residents.

Higgins, a 61-year-old Democrat who was born in Ohio and grew up in New Mexico, entered the race as the longest-serving current member of the Miami-Dade Commission. She won her seat in a 2018 Special Election and coasted back into re-election unopposed last year.

She chose to vacate her seat three years early to run for Mayor.

She worked for years in the private sector, overseeing global manufacturing in Europe and Latin America, before returning stateside to lead marketing for companies such as Pfizer and Jose Cuervo.

In 2006, she took a Director job with the Peace Corps in Belize, after which she served as a foreign service officer for the U.S. State Department under President Barack Obama, working in Mexico and in economic development areas in South Africa.

Since filing in April, Higgins raised $386,500 through her campaign account. She also amassed close to $658,000 by the end of September through her county-level political committee, Ethical Leadership for Miami. Close to a third of that sum — $175,000 — came through a transfer from her state-level PC.

She also spent about $881,000.

If elected, Higgins would make history as Miami’s first woman Mayor.

González, a 68-year-old born in Cuba, brought the most robust government background to the race. A U.S. Army veteran who rose to the rank of colonel, he served as Miami City Manager from 2017 to 2020, CEO of Miami International Airport (MIA) from 2013 to 2017 and as Director of Citizenship and Immigration Services at the U.S. Department of Homeland Security under President George W. Bush.

In private life, he works as a partner at investment management firm RSMD Investco LLC. He also serves as a member of the Treasury Investment Council under the Florida Department of Financial Services.

Since filing to run for Mayor in April, he raised nearly $1.2 million and spent about $1 million.

Election Day is Tuesday.



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Paul Renner doubles down on Cory Mills critique, urges more Republicans to join him

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Mills was a day-one Byron Donalds backer in the gubernatorial race.

A former House Speaker and current candidate for Governor is leading the charge for Republicans as scandal swirls around a Congressman.

Saying the “evidence is mounting” against Rep. Cory MillsPaul Renner says other candidates for Governor should “stand up and be counted” and join him in the call for Mills to leave Congress.

Renner made the call earlier this week.

But on Friday, the Palm Coast Republican doubled down.

He spotlighted fresh reporting from Roger Sollenberger alleging that Mills’ company “appears to have illegally exported weapons while he serves in Congress, including to Ukraine,” that Mills failed to disclose conflicts of interest, “tried to fistfight other Republican members of Congress, and lied about his party stature to bully other GOP candidates out of primaries that an alleged romantic interest was running in,” and lied about his conversion to Islam.

The House Ethics Committee is already probing Mills, a New Smyrna Beach Republican, over allegations of profiting from federal defense contracts while in Congress. More recently, the Committee expanded its work to review allegations that he assaulted one ex-girlfriend and threatened to share intimate photos of another.

Other candidates have been more reticent in addressing the issue, including Rep. Byron Donalds.

“When any other members have been involved and stuff like this, my advice is the same,” said Donalds, a Naples Republican. “They need to actually spend a lot more time in the district and take stock of what’s going on at home, and make that decision with their voters.”

The response came less than a year after Mills, a New Smyrna Beach Republican, spoke at the launch of Donalds’ gubernatorial campaign.

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Staff writer Jacob Ogles contributed reporting.



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Eileen Higgins brings out starpower as special election campaign nears close

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Prominent Democrats will be on hand at a number of stops.

Former Miami-Dade Commissioner Eileen Higgins is enlisting more big names as support at early vote stops ahead of Tuesday’s special election for Mayor, including a Senate candidate, a former Senate candidate, and a current candidate for Governor.

During her canvass kickoff at 10 a.m at Elizabeth Virrick Park, Higgins will appear with U.S. Senate Candidate Hector Mujica.

Early vote stops follow, with Higgins solo at the 11 a.m. show-up at Miami City Hall and the 11:30 at the Shenandoah Library.

From there, big names from Orlando will be with the candidate.

Orange County Mayor and candidate for Florida Governor Jerry Demings and former Congresswoman Val Demings will appear with Higgins at the Liberty Square Family & Friends Picnic (2 p.m.), Charles Hadley Park (3 p.m.), and the Carrie P. Meek Senior and Cultural Center (3:30 p.m.)

Higgins, who served on the County Commission from 2018 to 2025, is competing in a runoff for the city’s mayoralty against former City Manager Emilio González. The pair topped 11 other candidates in Miami’s Nov. 4 General Election, with Higgins, a Democrat, taking 36% of the vote and González, a Republican, capturing 19.5%.

To win outright, a candidate had to receive more than half the vote. Miami’s elections are technically nonpartisan, though party politics frequently still play into races.



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