September 29, 2012

Can Florida's Medicaid experiment be the model for the nation?

Quietly, over the past six years, an experiment in providing healthcare for the poor has been playing out in Broward and four other counties around the state. Its basic goal is to relieve the financial pressures of Medicaid on Florida’s taxpayers by turning over poor and disabled patients to private companies, a move lawmakers believe will cut costs.

Conservatives love the Medicaid reform program, pointing to an in-depth University of Florida study indicating that the experiment has lowered costs while not raising consumer complaints. The Legislature has already approved a slightly modified model of the reform to go statewide. At least one national think tank believes it should be a model for the entire country.

Liberals decry the effort as a way to build corporate profits at the expense of the poor. Howard Mallinger, a Sunrise retiree, thinks they’re right. He has two adult sons with mental health problems who are in a Medicaid health maintenance organization. The HMO frequently won’t provide their medications, or is slow to approve them, causing their health issues to spiral out of control, Mallinger says.

One son has been involuntarily committed under Florida’s Baker Act 44 times in the past five years, he says. That often means expensive three-day hospital confinements. “The joke is on the taxpayer,” Mallinger says.

More from John Dorschner here.

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September 20, 2012

Census report: Number of Floridians in poverty rose as income gap widens

Florida residents are among the poorest in the nation as median income in the state dropped 2.9 percent in 2011 and the state had some of the broadest gaps in income equality, according to 2011 U.S. Census Bureau data from the American Community Survey released on Thursday.

One in six Floridians lived in poverty last year, and the median income dipped from $45,609 in 2010 to $44,299 in 2011, according to the survey. The national median income is $50,502 and one in five Americans live in poverty.  

The survey also found that the income gap in Florida widened by 3.6 percent in 2011, a reflection of the state’s stagnant unemployment and slow jobs market. The income disparities in the state also remain among the highest in the nation, although they are on par with other states in the Southeast.

Seventeen percent of Florida’s population – 3.1 million people -- lived in poverty in 2011, up from 16.5 percent in 2010 and above the 15.9 percent national average. According to the survey, 48.5 million people had income below the poverty rate in the U.S., 2.2 million more than the year before.

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July 26, 2012

Florida prison vendor agrees to hefty fine in Pa. case

The company awaiting final approval from Gov. Rick Scott's administration to privatize health care services for most Florida prison inmates has agreed to pay a $1.85 million fine in Philadelphia for skirting minority contracting requirements. The vendor, Prison Health Services, now known as Corizon Health, is accused of falsifying official documents and federal prosecutors are looking for evidence of mail and wire fraud.  

News accounts in Philadelphia newspapers report that the city's inspector general, Amy Kurland, as describing the arrangement as a classic "pass-through" in which health care for city jail inmates was subcontracted to JHK Inc,., a female-owned business in Indiana that handled pharmaceutical supplies. The company said it had permission from prison employees for the arrangement.

Philadelphia Mayor Michael Nutter called the city's settlement with the company"a significant moment that sends a very, very strong message to everyone who does business with the city," the Philadelphia Inquirer reports.

As the story was breaking in Philadelphia, Scott's Department of Corrections was formally asking the Legislature for approval to shift $58 million in health care funds across categories so that it can hire Corizon and a second private vendor, Wexford Health Sources, by January 2013. The request for a budget amendment is pending before the Legislative Budget Commission and appears below.

To All Legislative Members:
This Budget amendment is pending approval by the Executive Office of the Governor and requires LEGISLATIVE BUDGET COMMISSION approval. If the Commission chairman elects to agenda this amendment it will be implemented on 8/8/2012.

Budget Amendment Request #:
Requested by:
Department of Corrections
Problem Statement:
The department has requested and received proposals for the statewide privatization of comprehensive health services. In order to award the contracts, budgetary action is needed to transfer funding to the appropriate category.

Agency Request:
The department requests to transfer $57,668,391 in General Revenue to the Inmate Health Services budget entity, Inmate Health Services category from the following categories within Inmate Health Services: Salaries and Benefits  $ 37,535,005 Other Personal Services 12,875,012 Expenses                             6,697,952 OCO                                         199,229 Contracted Services              361,193 Approval of this request will enable the department to move forward with the statewide privatization of comprehensive health care services based on a January 1 implementation date.

EOG Recommendation:
Recommend approval for the transfer of $57,668,391 in General Revenue in the Department of Corrections between various categories within the Inmate Health Services program. The transfer is necessary for the department to move forward with the statewide privatization of comprehensive health services with an anticipated January 1, 2013, implementation date.

-- Steve Bousquet

June 27, 2012

Atwater hopes to reform flawed contracting process by exposing it to sunlight

Florida will spend $47 billion this year hiring outsiders to provide goods and services for the state but hundreds of the contractors will not be required to show they provided services they agreed to and their documentation will be rife with errors.

Those are the conclusions of Chief Financial Officer Jeff Atwater after a sample audit of the 24,000 state contracts at 33 different agencies found that 35 percent were flawed.

At stake, he said: "Hundreds of millions of dollars" of the state's $70 billion budget, 67 percent of which is outsourced. 

On Wednesday, Atwater unveiled a new web site that details most of the state's contracts so the public can determine if they are being held accountable for the services they are offering. The goal, he said, is to put the heat on the flawed contracting system by turning the public into watchdogs and inviting more competitors to the table.

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June 26, 2012

Documents show South Florida gets modest share of incentive grants

Lisa McKerracher might set up a spinal-cord lab in Miami, or she might set it up in Massachusetts. Florida will pay her $83,000 to pick the Sunshine State.

“I’m not sure this is where I need to be,” McKerracher said from her temporary office in Dania Beach. “I’m going up to Boston in two weeks to look at space.”

McKerracher’s quandary captures the high and low stakes involved as Florida uses tax dollars to woo companies that may add jobs in the state. In the last two years, Florida’s economic-development agency pledged about $155 million in rewards for companies planning to add jobs in the state either with new locations or expanding their current ones.

BioAxone Biosciences, McKerracher’s fledgling company, hopes to create a new drug for paralysis victims, making it the kind of research firm South Florida pines for as it tries to move its economy away from depending on tourism and real estate. But McKerracher only plans on hiring 12 people tops for a small lab at the University of Miami’s new commercial research building, representing a tiny win for a region that has lost 134,000 jobs in the recession.

South Florida relied on modest deals like McKerracher’s for the nearly $12 million in pledges from Enterprise Florida, with smaller counties receiving larger grants. Of the 20 largest Enterprise grants since 2011, none were in Broward or Miami-Dade. The biggest was April’s $14 million pledge to Embraer Aircraft in Brevard for a new facility designed to add 650 jobs.

The largest payout in South Florida went to, an online discount site slated to get $1.5 million for moving from Fort Lauderdale to a larger headquarters in Margate. The relocation includes plans for 750 new employees, and prevented the company from accepting offers from other suitors, including San Francisco, said Bob Swindell, president of the Greater Fort Lauderdale Alliance, Broward’s economic development agency.

The incentive numbers were revealed late last week when an official from Florida's Department of Economic Opportunity inadvertently released a confidential database in responding to a public-records request from Integrity Florida, a nonprofit research group in Tallahassee focused on ethics reform. The database showed some pending offers that otherwise would have remained secret. South Florida’s list mostly involved companies already in the area, or moves that had been made public.

Story here by Doug Hanks.

June 21, 2012

Board approves tuition hikes ranging from 9 to 15 percent

The Florida Board of Governors finally settled on tuition increases for the state's 11 universities after more two hours brokering.

The process wasn't pretty, seeming arbitrary and auction-like. At one point, board member Ava Parker put it this way: "There seems to be no method to our madness."

Yet, they continued. And here's the final roundup: 

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June 13, 2012

Haridopolos came to the aid of friend and company on no-bid contract

When a politically connected company was in danger of losing a $9.4 million no-bid contract with the state, Senate President Mike Haridopolos came to the rescue of the outfit — a firm that employs his good friend and political benefactor as a lobbyist.

Haridopolos staved off the threat to the deal with the Department of Juvenile Justice and quietly steered $6 million in additional dollars to the company, despite the vigorous objections of agency leaders and top Republican senators.

The move allowed Evidence Based Associates, a Washington-based probation program, the exclusive contract to handle the state effort to divert at-risk youth from costly prison beds into community programs. The company kept the business despite recent reports that it had failed to comply with key terms of the agreement —– and to the chagrin of a long list of providers who wanted to compete for the work.

The company’s lobbyist, Frank Tsamoutales, is a Brevard County Republican who has been a financial backer of Haridopolos since the Brevard County legislator was first elected to office in 2000. He went to work for EBA in April 2011, earning between $20,000 and $29,000 in the first year, the same year Haridopolos became Senate president.

The investment paid off. Print version here.

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April 17, 2012

Universities push back against governor's suggestion to limit tuition hikes

Gov. Rick Scott's suggestion that the Florida Board of Governors limit universities' tuition increases sent shudders through the higher education world.

"What I've asked our universities and our state colleges is, first, step back and do what Florida businesses have to do," Scott told reporters after the signing Tuesday, amid talk about the Florida College System's tuition increases, which are set at just 5 percent in the state budget. "What costs can we have and what costs don't make sense? I want all our state colleges and our universities to step back and say, are there costs we don't have to have?"

Reporters asked him whether he meant that universities should limit their tuition increases, normally allowed to rise up to 15 percent, to that same 5 percent. Scott said: "I'm very comfortable the Board of Governors will do that sort of review and the right thing will happen."

The Florida Board of Governors quickly put out a statement praising the Legislature for funding some university construction projects and for its cooperation with the board in setting accountability metrics -- even while cutting $300 million from the state university system. The statement included a note for media, saying the 5 percent tuition hike Scott was talking about applied just to Florida Colleges -- not universities.

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Governor cuts $24.8 million in projects from Miami Dade and Broward

Gov. Rick Scott said he used his veto pen sparingly this year when he removed $142.7 million in projects from the state's $70 billion budget. But when it came to South Florida projects, the region sustained nearly one fifth of all the cuts.

From vetoing $500,000 for the Bay of Pigs Historial Museum -- on the 51st anniversary of the invasion -- to rejecting a plan to replace aging trucks for the City of Hialeah, the governor vetoed $24.8 million from Miami Dade and Broward alone out of the $142.7 million in projects he cut.

Left in were projects he deemed worthy because of their economic development potential, such as a $500,000 plan to develop a rowing center in Sarasota. Left unsaid were the projects that remained in the budget because of the governor's relationship with its sponsor or other programs that were rejected because of the governor's disagreements with lawmakers.

Scott approved $1 million for the Boys and Girls Club of Pasco County, the homeown of incoming House Speaker Will Weatherford, R-Wesley Chapel, while he removed from the budget $100,000 for Girls Incoroporated of Sarasota County. Scott said he considers Boys and Girls clubs student focused programs that provide "measurable results."

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Tuition increase to rise 5 percent under new budget; $142.7 m in vetoes

Signaling a newfound commitment to education, Gov. Rick Scott not only signed a budget that partially restores money cut from the budget last year but he approved a 5 percent increase in state and community college tuition after months of warning that he would accept no increase in cost-of-living for Floridians.

The $70 billion budget, approved at Cunningham Creek Elementary School, an A-school in St. Johns County, also dramatically reduces the number of projects vetoed this year. The governor eliminated $142.7 million from the legislature's 2012-13 spending plan, four times less than last year's $615 million in vetoes.

Among the vetoes this year: $500,000 for the Dan Marino Foundation Vocational School for disabled kids, $1.5 million for the Florida Council Against Sexual Violence and $100,000 for the Autism Center of Miami. Scott also vetoed $250,000 to provide security for the Oct. 22 presidential debate scheduled at Lynn University in Boca Raton and $500,000 for the Florida Aquarium. Download Final-Veto-List-4-17-12

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