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13 posts from February 11, 2014

February 11, 2014

Lawmakers to consider expanding telemedicine

The doctors at Miami Children’s Hospital use advanced communications technology to diagnose sick children in Ecuador, Peru and the Dominican Republic.

Helping young patients in remote parts of Florida or other states, however, is not so easy.

For one, insurance companies in Florida aren’t required to reimburse doctors for telemedicine services, meaning physicians aren’t guaranteed payment for Web-based consultations or diagnostic test interpretations. What’s more, many doctors don’t have the licenses to practice in other states or the credentials to practice at other hospitals.

“Because of the regulatory limitations, it is easier for me to care for a child in Colombia than it is for me to care for a child at Broward General,” said Dr. Jacques Orces, the chief medical information officer at Miami Children’s.

The Florida Legislature wants to change that.

Over the next few weeks, state lawmakers will consider creating statewide standards for telemedicine. They will also debate establishing reimbursement requirements, as well as a system for registering out-of-state telemedicine providers in Florida.

“Our goal is to create fertile ground for this kind of technology to be used,” said state Rep. Jose Oliva, a Miami Republican who chairs the House Select Committee on Health Care Workforce Innovation.

The discussion is taking place as the Legislature shifts its focus from Medicaid expansion, which observers consider unlikely in an election year, to less controversial healthcare issues like addressing a shortage of primary care physicians.

Read more here.

Jacobo reports on DCF's revamped focus on investigators

Department of Children and Families Secretary Esther Jacobo appeared before the House Healthy Families Subcommittee and described the agency's focus on improving and expanding the child protection investigators, saying the goal of is to have them work "not faster but better."
Jacobo described how the agency has launched a pilot program to pair two investigators, one more experienced than the other, in Polk and Miami-Dade counties, a recommendaiton made by the Casey Family Foundation which conducted a critical report of how the agency handles at-risk children. The foundation reviewed 40 deaths of children under DCF oversight and concluded that they were a result of inadequate family and safety assessments, inadequate follow-up and inadquate early intervention.

Jacobo said when a call comes into the hotline and they identify risk factors -- such as a child under age 3, a prior DCF history, a boyfriend or paramour involved and mental health or drug abuse history. Investigators go out in a team so they "part of it is we have to look at the whole family dynamic which we havent' been doing thus far."

"It seems like the quality of the investigatoions are getting better and we're making better decisions,'' she said. She said the pilot has worked so well, they plan on implementing it statewide. Gov. Rick Scott has recommended hiring 400 additional child protection staff and Jacobo said that would allow for investigators to work in pairs across the state and provide "two eyes on the case" and also the ability of a mentor to help younger investigators to be more efficient. 

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Poll indicates Crist in line -- and Scott, Lopez-Cantera out of step -- with Cubans, Floridians over Cuba


Large majorities of Floridians, those of Cuban descent and Americans in general support normalizing relations with Cuba, according to a new poll that indicates Charlie Crist's recent stance against the embargo could be a political plus.

Once a hotbed of hardline positions against Cuba, Florida residents are more inclined to want to engage or normalize relations with Cuba compared to the rest of the nation, the poll from the Adrienne Arsht Latin America Center of the Atlantic Council Atlantic Council shows.

As many as 63 percent of Floridians support a thaw in relations with Cuba, compared to 30 percent who are opposed. Nationwide, support for rapprochement with Cuba stands at 56 percent with 35 percent opposed.

“This is a key change from the past: Cuba used to be intractable because Florida was intractable. This poll argues that is no longer true,” Peter Schechter and Jason Marczak, executives with the Latin America center, wrote in an analysis of the poll.

Perhaps most-surprisingly, those of Cuban descent heavily favor normalization or engagement: 79-21 percent in Florida and 73-26 percent nationwide.

More here