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Sustaining community health by supporting Community Health Centers

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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.

___

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


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Bill enhancing anaphylaxis training in schools ready for Senate floor

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The Senate Rules Committee unanimously passed a measure Monday that seeks to improve the safety and preparedness of public and charter schools when responding to medical emergencies like anaphylaxis.

Orlando Democratic Sen. Carlos Smith presented the bill (SB 1514) that is focused on ensuring school personnel are trained to recognize the signs and symptoms of anaphylaxis and administer epinephrine during emergencies that happen on school campuses.

“Students with life-threatening allergies face significant challenges in school settings,” Smith said. “Anaphylaxis for example, is a severe life-threatening allergic reaction which can occur rapidly and can be fatal if not treated immediately, and it’s typically triggered by food allergens, insect stings, medications, even latex.”

Schools would be required to have student emergency action plans accessible at all times during school activities with the aim to proactively manage allergic reactions, especially during extracurricular programs, athletic events, school dances, and before- and after-school programs.

“According to the Florida Department of Health, approximately 76,000 students in Florida have these types of life-threatening allergies,” Smith said. “For these students, the prompt use of an epinephrine auto injector can be lifesaving.”

The State Board of Education would be required to consult with the Department of Health to adopt rules needed to implement the legislation if it passes, including an approved training curriculum for staff.

“Under the bill, both traditional and charter public schools in K-8 will be required to be ready and able to implement emergency action plans for students with allergies at all times, while the student is on school grounds,” Smith said. “It requires an adequate number of school personnel to undergo critical, but simple and straightforward training on the administration of emergency epinephrine, or EpiPens.”

Smith added that free training for anaphylactic events already exists and should not have a large fiscal impact on the state budget.

The bill will now move to the Senate Floor.


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Hope Florida counsel can’t make Thursday hearing. Alex Andrade wants a special Friday hearing to question him.

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The Hope Florida Foundation’s attorney said he likely won’t attend a high-profile House committee hearing. But Rep. Alex Andrade said that may delay his testimony for a day.

Attorney Jeff Aaron told the Orlando Sentinel he could attend on a Wednesday or Friday, but could not go this Thursday. He also stressed health issues within his family.

That’s the day the House Health Care Budget Subcommittee plans to question Amy Ronshausen, executive director of the Drug Free America Foundation, about money received from the Hope Florida Foundation. Lawmakers also want to ask Aaron about that.

“Rest assured that I am willing to testify,” Aaron wrote in an email to the House.

Andrade requested that time be allowed for an additional meeting on Friday to question only Aaron, and he said many statements already made public by the attorney appear to show conflicting direction and advice passed among the involved parties. Namely, the Committee has testimony that Aaron believed grants could be awarded to agencies without Board approval. Still, it advised that the Drug Free America Foundation must request grants from the Board.

Andrade said an ongoing House investigation of the matter requires representatives to get testimony from Aaron.

“If he doesn’t show up, we have got to subpoena him or accommodate his schedule,” Andrade said. “I’ve already requested we have time on Friday for an extra special meeting just for him.”

The controversy around the grants has escalated tensions between Gov. Ron DeSantis and the Florida House this year. Hope Florida has been an initiative driven by First Lady Casey DeSantis, who continues to mull a run for Governor, but the foundation has come under fire over the grants. After receiving $10 million from a Medicaid settlement, the Foundation awarded the money to two anti-drug foundations, which then donated it to a political committee that opposed last year’s marijuana decriminalization amendment.

James Uthmeier, then the Governor’s Chief of Staff, was Committee Chair. Since then, DeSantis appointed Uthmeier as Florida’s Attorney General; he has maintained that there was no wrongdoing surrounding the transfer of money.

Andrade has yet to question Uthmeier, but said he continues to find new revelations about the management of Hope Florida each day. And he said it will not surprise him if federal prosecutors open an investigation into the redirection of funding.

“Our Attorney cannot with a straight face go after anyone for wire fraud or money laundering,” Andrade said.


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House proposes killing all tourist development councils in Florida

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House lawmakers are taking a years-long effort to abolish or defund VISIT FLORIDA, the state’s public-private tourism promotion apparatus, to the local level.

In the most recent iteration of the chamber’s tax package (HB 7033), the House Ways and Means Committee put all 62 tourist development councils in Florida on the chopping block.

Just a single sentence would effectuate the change: “Any tourist development council created pursuant to s. 125.0104 (4) (e), Florida Statutes, as it existed prior to July 1, 2025, shall be dissolved no later than Dec. 1, 2025.”

That targets every tourist development council from Florida’s southernmost county of Monroe to its northwesternmost county of Escambia.

All but five counties in Florida have tourist development councils, and in recent years, the GOP-controlled Legislature has taken aim at them.

In 2023, House leaders proposed cutting state funding for VISIT FLORIDA and filling in the gap with a cut of each county’s tourism tax revenue. Large counties would have contributed 5% of their tourism tax revenues, while smaller, rural counties would have chipped in 2%.

VISIT FLORIDA, in exchange, would have directed 75% of its spending to assist tourism industries in rural counties, state forests and state parks.

Cape Coral Republican Rep. Mike Giallombardo, who sponsored the 2023 proposal, told the Miami Herald at the time that Florida’s wide-open policies during and after COVID — not its tourism marketing — made the state among the hottest destinations in the country.

Jacksonville Democratic Rep. Angie Nixon said the change Giallombardo’s proposal contemplated amounted to “Robin Hooding” funds from large counties to smaller ones.

Lawmakers ultimately decided against the move, instead infusing VISIT FLORIDA with a $30 million funding boost.

Now tourist development councils are in legislators’ crosshairs.

So are county tourism promotion agencies such as the Greater Miami Convention and Visitors Bureau, Visit Orlando and Visit St. Pete-Clearwater — though nowhere near as harshly.

HB 7033 also includes language that would abolish any existing tourism promotion agency, but only if it doesn’t receive approval by its County Commission by Dec. 31, and only for the purposes outlined in a related resolution.

Those purposes must be in accordance with Section 125.012 (25) of Florida Statutes, which state that the objective of such an organization is to “publicize, advertise, and promote the activities and projects herein authorized; to make known the advantages, facilities, resources, products, attractions, and attributes of the activities and projects authorized; to create a favorable climate of opinion concerning the activities and projects authorized; to cooperate with other agencies, public and private, in accomplishing these purposes; and in furtherance thereof, to authorize expenditures for the purposes here enumerated, including meals, hospitality, and entertainment of persons in the interest of promoting and engendering good will towards the activities and projects authorized.”

HB 7033 contemplates several other notable changes, including new considerations for tourism development taxes, affordable housing and how taxes can be levied on parking spaces at RV parks, among other things.


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