There is a lot of change happening in health care and government, but there always is. In these ongoing times of uncertainty, programs such as Community Health Centers should be heralded as successes for their return on investment, high-quality outcomes, and fiscal resilience.

However, these same Health Centers are facing a number of challenges related to funding, reimbursement, workforce, and collaborations that threaten current service levels, much less the implementation of any further expansion.

If Community Health Centers are the solution to expanding primary care and cutting health care costs in Florida, why are so many facing difficult decisions regarding workforce capacity and scope of services?

Finding sustainable ideas and initiatives enables individuals and communities to build and improve upon experiences and efforts.

One sustainable program that has become a necessary part of the foundation of health care in Florida is primary care. Community Health Centers are the vehicle for providing and expanding this program throughout Florida.

While you may not be aware of your local Community Health Center, over 700 service locations currently treat 1.8 million patients from all 67 counties, providing a $3.3 billion economic impact.

Services include medical, dental, and behavioral health, along with a variety of additional specialties and support services that differ by site. Patients come from all walks of life — low-income and affluent, employed and unemployed, with or without health insurance, rural and urban.

Community Health Centers are, in fact, a 60-year-old efficient and effective health care program and resource. This sounds like a great resource, vital to any community’s success, right?

While Florida’s Community Health Centers continue to advocate for appropriate federal funding, they are also pursuing an increase in the state Medicaid reimbursement rate.

A recent analysis indicated that the current state average reimbursement was approximately $90 below the average visit cost. No business can sustain such a business model.

Recognizing patients’ increasing needs, health centers have identified and utilized other revenue sources to make up this gap.

One such source is 340B, a pharmaceutical program that allows select providers to realize savings in purchasing and delivering discounted medicine to patients. While Community Health Centers account for a mere 5% of the 340B program nationally, this resource is now under scrutiny, if not outright attack, to further restrict providers’ utilization.

The uncertainty at the federal level has motivated two-thirds of the states, including Arkansas, Kansas, Mississippi, Missouri, Maryland, Minnesota and West Virginia, to implement 340B protections to ensure entities like Community Health Centers have the protection they need to sustain their operations and continue to provide high-quality, affordable health care to everyone.

These financial concerns are simultaneously experienced while patients, payers, and partners assume increased responsibilities, causing Community Health Centers to deplete their reserves to continue providing services and cover day-to-day operational costs.

Health Centers participate in value-based initiatives, are the most transparent providers in terms of quality outcomes and operational data, implement technology, expand telehealth capacity, increase hours of service, and struggle to attract the most talented providers and staff.

So, I ask again, why are there so many challenges to recognizing appropriate state and federal support?

Community Health Centers are much more than “just part” of the health care safety net; they are a cornerstone of everyone’s daily lives.

Shown repeatedly, they enable a healthy workforce while creating savings to the state’s health care system by reducing costs associated with emergency room visits for non-urgent conditions, investing in programs that treat the root cause of a medical condition through nutrition and mental health programs, and making services available to everyone.

Health Centers require and deserve pertinent funding and policy support to preserve effectiveness, increase efficiency, and maintain affordability.

It simply benefits us all.

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Jonathan Chapman is president and CEO of the Florida Association of Community Health Centers (FACHC).

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A measure that would decouple thoroughbred horse racing from certain casino operations, such as slot machines, has cleared its first Committee stop, but not before dozens of speakers voiced their opposition to the measure. 

It was an occasionally heated hearing Tuesday at the Senate Regulated Industries Committee meeting, where Sen. Danny Burgess presented his bill (SB 408), including a strike-all amendment that provided what were intended to be concessions to the thoroughbred horse racing industry and affiliated partners. 

But the change did little to quell fears, mainly among those in the Ocala horse community, including breeders, trainers, veterinarians, feed store owners and more. 

The amendment to the bill, which was adopted, ensures a seven-year window for the horse industry to discuss and establish a plan to ensure its future. The amendment stipulates that race tracks must give at least four years’ notice before ending live horse racing, and that notice, under the bill, couldn’t be given until July 1, 2028, more than three years from now. 

More broadly, the bill would implement what is known as “decoupling,” which would allow thoroughbred horse racing tracks to maintain licenses for slot machines and card rooms without requiring them to also host live racing. 

Other parimutuel facilities were decoupled from ancillary gambling activities under a 2021 law (SB 2A).

Committee Chair Sen. Jennifer Bradley cited the unfairness to horse racing facilities in her support for the bill. Still, she was sure to support those who spoke passionately against the measure. She noted declines in the horse breeding industry, which throws a cloud of uncertainty into not just racing but the horse industry writ large. 

“That uncertainty acts as a cloud to everyone in this room,” she said. 

And committee co-chair, Sen. Jason Pizzo — a rare Democrat holding a leadership post in the Legislature — went even further. He sincerely thanked those who spoke against the decoupling measure, emphasizing the importance of horse racing to Florida and, in particular, the Ocala area. But his South Florida district is home to Gulfstream Park in Hallandale Beach, which is pushing for decoupling. 

At issue is a drop in foal production in the state. In 2002, about 4,500 foals were bred. By last year, that number had dropped to just around 1,000. And last year, the Legislature approved and the Governor signed into law permanent yearly distributions of $27.5 million “to promote breeding and racing horses.”

“That’s not sustainable,” Pizzo said, supporting his “yes” vote. 

“This had to happen today so a conversation is actually had,” Pizzo said, noting that the bill has two more committees to clear before even reaching the Senate floor.

Still, the opposition will be hard to ignore. Several dozen people either spoke or waived their speaking time in opposition. A vet started his own practice under the assumption of a continued thriving horse racing industry in Ocala. There was a brother and sister looking forward to establishing livelihoods. There were trainers who have built their lives around rural farms. All shared a similar message: that if this bill becomes law, it will imperil horse racing and everything it supports. 

According to the American Horse Council, that includes a $3.24 billion economic impact and more than 33,000 jobs. And that doesn’t include the tourism impact horse racing draws, many speakers noted. 

The Florida Thoroughbred Breeders’ and Owners’ Association responded to Tuesday’s vote, arguing “more work” is needed to fight the bill and that it’s “a fight we can win.” The group, through its CEO Lonny Powell, blasted the Legislature’s “prioritizing Canadian gaming interests over Florida’s family farms, small businesses, and horsemen,” a reference to the group that owns Gulfstream Park, the Stronach Group, which is based in Aurora, Canada. 

“Make no mistake, this legislation would strip away jobs, investment, and a $3.24 billion industry, pushing economic opportunities out of the state. Our Thoroughbred industry is deeply rooted in Florida’s agricultural heritage, powering rural communities and fueling local economies. Lawmakers must reject this bill and stand with the hardworking Floridians who keep this agricultural industry and rural Florida thriving,” Powell said. 

Of all the speakers, only one was in favor of the bill. Jeff Johnston, president and partner at the Johnston & Stewart governmental affairs firm, represents Gulfstream Park. The company wants to make necessary improvements to its facility and hopes to attract more attention to its racing activities. He lamented that critics were perhaps not reading the bill, noting that it does not change the number of days tracks are required to race per year. And he doubled down on the industry being “in trouble.” He said Gulfstream subsidizes the sector “to the tune of about $6 million.” 

The conversation is far from over. The Senate bill will next go to the Appropriations Committee on Agriculture, Environment, and General Government and the Rules Committee. 

A house version of the bill (HB 105) originally from Rep. Adam Anderson has cleared both of its committee stops and was amended to include a similar provision to provide more time for the horse racing industry to adapt to change. However, unlike the Senate version, which contemplates a seven-year period before decoupling is put into practice, the House version offers five years. 

Time is ticking on both sides — the Legislative Session is expected to end on May 2. 

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For the next two years, Walter Fajet will have a stronger voice in dictating the future of Miami Springs.

Voters picked him over former City Council member Bob Best to serve as Mayor.

Fajet beat Best with nearly 66% of the vote. Because of the city’s term limit rules, he can only serve as Mayor for a single two-year term.

“I’m happy the residents of Miami Springs had the confidence in me to lead them,” Fajet told Florida Politics, adding that he looked forward to building on the progress he’s made in the past six years.

“We’ve made a lot of changes. We have a new City Manager, a new Public Works Director, a new Chief of Police, we have a positive trajectory for our city, and we’re going to continue that for my final term.”

Joining Fajet on the five-member Council are new members Joseph Dion and Fabian Perez-Crespo, who respectively won the Group 2 and Group 4 seats Tuesday.

Dion took 50.5% of the vote to defeat Irma Matos and MaryJo Mejia Ramos. Perez-Crespo, meanwhile, received more than 64% of the vote to secure victory over Tom Hutchings.

The race marked Perez-Crespo’s first run at public office, and he leaned on his experience fundraising for local scout troops and the Miami Springs Women’s Club.

“I’m used to asking people for donations. Engaging with people was natural to me. But running for office was a whole ‘nother level, and I’m so grateful for the citizens of Miami Springs believing and trusting in me,” he said. “From here on, we’re moving forward to do the people’s work.”

Florida Politics contacted Dion for comment but did not immediately receive a response.

Miami Springs election rules dictate that no matter the number of candidates in each contest, the candidate with the most votes wins. There is no requirement that a candidate receive more than half the votes, and there are no runoffs.

The winners of Tuesday’s nonpartisan election won two-year terms.

Best and Fajet faced off for the right to succeed Mayor Maria Puente Mitchell, who is leaving office due to term limits.

Best, a 72-year old Democrat, is a past Council member who has been out of office since 2013. Fajet, a 52-year-old Republican, has served in the Group 3 seat for three consecutive terms.

A U.S. Air Force veteran, Best worked in the aerospace industry and owned a local landscaping company.

He vowed, if elected, to support targeted development that doesn’t significantly alter the city’s character, protect green spaces, improve local safety initiatives and improve the city’s parking situation — an issue most candidates cited as problematic.

Best told MiamiSprings.com that running for Mayor was “the next logical step” for him, politically.

“I have the experience. I worked with three or four City Managers, three Mayors,” he said. “I’ve got the leadership skills to bring forth certain experience.”

Through March 27, Best raised $3,705, including a $1,000 check from United Teachers of Dade and a $500 self-loan.

Fajet, a charter school principal and Miami Springs resident for more than 40 years, ran on a platform prioritizing increased police funding, lowering the city’s millage rate, halting expansion of Miami Springs’ Overlay District, addressing parking issues and getting more funding for senior services.

He told the Miami Herald that Miami Springs needed to capitalize better on development opportunities while preserving the city’s “small-town feel, beautiful tree canopy and idyllic way of life.”

“My policy platform is rooted in a deep commitment to the City of Miami Springs and the best interest of ALL its residents,” he said in a statement.

Fajet stacked up $40,401 by March 27. His donors included Management Hospitality, the Miami Association of Realtors and the political committees of Miami-Dade County Commissioner Juan Carlos Bermudez, Miami-Dade School Board member Daniel Espino and Florida Highway Patrol trooper Joe Sanchez, who ran for Sheriff last year.

The race to replace outgoing Council member Jacky Bravo in Group 2 featured two Republicans, Dion and Matos, and one Democrat, Mejia-Ramos.

Dion, a 44-year-old process server and small-business owner, had a platform prioritizing crime prevention and preserving the city while embracing “thoughtful planning and sustainable development.”

He told the Miami Herald the most pressing issues in Miami Springs are the city’s high property taxes, crime on 36th Street, traffic and parks accessibility.

Dion carried an endorsement from the Miami Realtors Global and raised $22,670.

Matos, a 69-year-old author, real estate investor and entrepreneur who serves as President of the Wings II Townhouse Apartments Condominium Association, made crime prevention a centerpiece of her campaign.

She hoped, if elected, to support police and combat human trafficking, preserve Miami Springs’ character, clean up 36th Street, attract more businesses to the city and start a campaign called “Save the Children” to combat human trafficking and child predation.

Matos raised $1,025, most of it her money.

Mejia-Ramos, a 55-year-old former University of Miami’s Jackson Health System employee, came to Election Day with an edge in campaign experience. In 2023, she mounted an unsuccessful City Council bid, but lost to Santin. She is also a member and planner of the city’s 2026 Centennial Celebration and a longtime member of the Miami Springs Women’s Club.

Her platform focuses included improving the city’s economic stability, balancing its budget, fostering commercial development on Northwest 6th Street and Abraham Track, and safeguarding the city’s tree canopy.

She raised $9,824, including $3,000 in self-loans. Her donors included the Florida Democratic Party and former state Rep. Robert Asencio, among others.

Two years after losing a race for the Group 4 seat by 20 votes to outgoing Council member Victor Vázquez, 61-year-old Republican Tom Hutchings made another run at it this year.

Perez-Crespo, a 57-year-old with no party affiliation, denied Hutchings victory.

An Emmy Award-winning multimedia pro and life coach, Perez-Crespo will make the jump from civil volunteer to elected official. Before running for office, he served as a member of the Miami Springs Historical Society and Miami Springs Women’s Club.

He promised, if elected, to protect Miami Springs from overdevelopment, strengthen the city’s business corridor, support local small businesses, cut taxes, support police, champion Parks and Rec programs, promote effective parking solutions and further rejuvenate the city’s tree canopy to “reclaim” its “Tree City USA” title.

Perez-Crespo reported raising $7,930, with sizable donations from the Miami Realtors PAC and EB Hotel.

Hutchings, a restaurateur, told MiamiSprings.com he wanted to preserve the city’s “small-town charm” while redeveloping some of its older areas that are in need of modernization.

Reducing crime, cracking down on through-traffic speeders and working with the city’s Parks and Recreation Department to provide more after-school activities to youths are also high on Hutchings’ to-do list.

He raised $6,100, $1,500 of it self-loaned.

Races for two of the Council’s five seats were decided last month, when Group 1 Council member Jorge Santin coasted back into office and Orlando Lamas won Fajet’s Group seat unopposed.

Election Day voting for the 2.9-square-mile municipality of nearly 14,000 residents was held at the Miami Springs Golf & Country Club from 7 a.m. to 7 p.m.

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