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.

The annual “Stuff the Charger Food Drive” campaign is underway, as the Florida Department of Highway Safety and Motor Vehicles (FLHSMV) and the Florida Highway Patrol (FHP) collect food contributions for needy families throughout the state.

“Stuff the Charger” refers to the Dodge Charger vehicles many state troopers use to patrol Florida roadways. The campaign by the agencies is designed to encourage residents to donate nonperishable food that will be donated to local food banks throughout Florida to help feed families during the holidays.

The campaign runs through Nov. 30. The donated items, whether a single can of food or a box of spaghetti, can help Floridians in need. Many of the goods will be delivered to food banks in the neighborhoods of those who contribute.

“Floridians have always shown resilience and generosity, especially in times of need,” said FLHSMV Executive Director Dave Kerner. “By loading our Chargers with food donations, we are delivering hope into Florida homes and helping families embrace the holiday season with dignity and joy.”

The two state agencies team up with local organizations in a partnership that is designed to reduce hunger. The general theme is “no family is left behind.”

“Join us in making a meaningful impact this holiday season by supporting our annual Stuff the Charger food drive,” said FHP Col. Gary Howze. “Your donations are essential in helping provide food to families in need, and together we can ensure that no Floridian goes without during this special time of year.”

The items most in need include:

— Canned goods: canned meats, vegetables, fruits and soups.

— Dried goods: stuffing, boxed potatoes, rice, cornbread mix, grits, cereal and oatmeal.

— Other goods: nuts, peanut butter, evaporated milk, bottled water and broth.

All donations can be made at any local outpost for the FHP and the agency is going to be hosting events for accepting contributions in the next few weeks.

Florida’s public schools are bracing for a new wave of charter school takeovers starting Tuesday, when districts across the state begin receiving formal notices identifying campuses targeted under the expanded Schools of Hope program.

But even as those letters go out, state lawmakers are already working to pull the plug on the program’s most controversial piece: a rule that allows private charter operators to move into “underused” public school buildings rent-free.

SB 424, filed by Democratic Sen. Darryl Rouson of St. Petersburg, would repeal that provision. The measure would remove language in state law that requires school districts to permit charter “Hope operators” to use underused, vacant or surplus facilities without paying rent or covering maintenance and operational costs. If approved, Rouson’s bill would take effect July 1, 2026.

“Constituents and stakeholders from across the state have reached out to my office with concerns about the overly broad Schools of Hope program,” Rouson said in a statement.

“By eliminating language requiring colocation in public schools, we are ensuring schools do not face the unintentional consequence of an unfunded mandate, and that students can continue thriving in their schools without losing access to spaces they need for academic success.”

Critics say the program forces local districts to subsidize private charter operations at taxpayer expense and “represents yet another attack on public education through the systemic defunding of the classrooms” already squeezed by funding that has not kept pace with inflation.

The colocation rule, which took effect with the 2025-26 state budget, opened the program to every district containing an “Opportunity Zone,” which effectively includes all school districts in Florida.

The repeal effort comes as school districts across the state scramble to prevent potential takeovers. 

In Jacksonville, Duval County officials are meeting with members of their legislative delegation after receiving notice that South Florida charter operator Mater Academy seeks to occupy space in more than two dozen schools.

In Broward County, the district is canceling a $2.6 million lease with a local nonprofit to move staff into vacant buildings and block the takeover of 27 campuses also targeted by Mater.

Sarasota County Schools is taking similar steps, drafting a strategic plan to eliminate underused space by selling its district headquarters, relocating staff to school campuses, and reconfiguring or expanding programs to keep classrooms filled.

Supporters of efforts to repeal the program, including the Florida Coalition for Thriving Public Schools and the Florida Education Association, argue that the state’s push to expand charter access has gone too far. They say repealing the rule would restore fairness and give districts a chance to focus on improving their own schools without having to host private competitors in their own buildings.

“Our public schools are already underfunded and stretched thin,” Florida Education Association President Andrew Spar said in the statement. “The Schools of Hope expansion is yet another scheme to strip local control from districts and hand public dollars to private charter corporations.”