- Associated Press - Tuesday, March 25, 2014

Recent editorials from Florida newspapers:


March 22

The Miami (Fla.) Herald on the Department of Children and Families:

What a difference a day makes.

Especially when on that day a newspaper publishes a mosaic of beautiful children. Scores and scores of them with dimpled, smiling, laughing, heartbreakingly happy faces. All of them dead, from brutality, neglect - and even a python. All of them known to the Department of Children & Families, charged with being their salvation.

The agency was anything but.

But after just one day, the lawmakers who for years have, with the blessing of governors past and present, siphoned life-saving funding and oversight from the agency, now declared fixing DCF Job No. 1.

We’ll see.

Absolutely nothing will bring back Ashton-Lynette and Kaleb, Ulysses or Tariji, or the rest of the almost 500 children and youths whose tragic deaths were chronicled last week in the Miami Herald.

And if DCF continues to deny, as Interim Secretary Esther Jacobo has, that DCF is “broken,” then there is no chance that there won’t be hundreds of other children who will be slaughtered one way or another while DCF remains derelict.

Ms. Jacobo, as a temporary chief, has no reason to pull her punches - and she shouldn’t. She knows better, because she is far better - more capable and compassionate - than her predecessor, who didn’t seem to “get it.”

So when she says that DCF is merely “challenged,” she undercuts the devastating seriousness of the agency’s problems - so many of which preceded her tenure. Of course, this is not her responsibility alone.

Solutions, if not easy, are obvious:

. Family preservation must no longer be the one and only priority. How many children were bludgeoned, starved smothered and tortured to death by drug-addled mothers, enraged boyfriends and alcoholic dads who signed a piece of paper DCF handed them and swore they’d morph into Ward and June Cleaver? Children are not property; their safety trumps parental rights.

. Compel troubled parents to get the services they need, and then make sure those services are provided - but first and foremost, get the children who are at risk of being harmed the most out. Child-abuse investigators should be required to file a court petition to order a parent into drug treatment or anger management. Court orders get even a meth head’s attention.

. Training, deep and comprehensive. One egregiously consistent thread that connected so many of these tragedies are the child-protection workers who would accept an addicted parent’s vow to improve. Yes, there are caseworkers who are saving lives because they’re experienced, think critically - and skeptically - to make informed decisions. This needs to be the rule, not the exception.

. Independent oversight has been written out of the picture. The results are clear - there are at least 477 of them. In fact, the Herald unearthed an undercount of reported child deaths, which the agency’s lack of transparency aided and abetted.

. And yes, more money - for caseworkers, better tracking and monitoring technology and services. Money is the one element that has been steadily drained from the child-welfare system. Again, the results were on the Miami Herald’s front page last week.

Republican Senate President Don Gaetz conceded that it will take “tens of millions of dollars” to make DCF whole. But will lawmakers, Gov. Rick Scott and Ms. Jacobo step up and insist on it? Or will more innocents be lost?




March 22

The Tampa (Fla.) Tribune on immigrant children:

The Florida House has taken a compassionate step forward by approving a bill that would grant in-state college tuition to the children of undocumented immigrants, provided the students meet certain conditions.

At the urging of House Speaker Will Weatherford, a Republican from Wesley Chapel, the House voted overwhelmingly Thursday for passage. Now it’s up to the Senate to overcome opposition and pass a similar bill by Sen. Jack Latvala, a Republican from Clearwater, that will put these students on equal footing with their classmates. Current law prohibits the children of undocumented immigrants from getting the cheaper tuition rate.

We think it’s in Florida’s best interest to eliminate a financial obstacle that might keep these students from reaching their full potential. The children shouldn’t be punished for their parents’ choices, and the families have contributed to the state by paying sales taxes and gasoline taxes.

The House bill would grant the cheaper tuition rates to students who attend a middle or high school for four consecutive years, regardless of their parents’ immigration status, before attending college. It would also reduce the cap on annual tuition hikes that universities can impose without legislative approval, dropping it from 15 percent to 6 percent. The Senate bill has differences, including the elimination of the discretionary tuition hike by universities, rather than a drop in the cap level. But it still grants in-state tuition rates to students meeting certain conditions.

Gov. Rick Scott has signaled a willingness to sign a tuition bill, provided it eliminates the discretionary hike by universities.

The Senate should pass a bill that gives these students the academic opportunities they have earned.




March 19

The (Jacksonville) Florida Times-Union on mental health care:

Take every serious issue with the health care system generally and double it when it comes to mental health.

Think fee-for-service is a hindrance for the health care system?

Consider what it does for a patient who needs time and a physician with only 15 minutes to give.

Add in the fact that half of all psychiatrists are rejecting insurance, according to the Cornell Medical College.

And the reality that as aging psychiatrists retire, fewer medical students are choosing that field.

It means that a “perfect storm” is coming, combining numerous mental health issues with too few people to treat them.

Jason Altmire, senior vice president of Florida Blue in Jacksonville, recited some of these challenges to a JCCI study group examining mental health.

He is a former congressman with a background in the health care field whose role now is public policy and community engagement.

Florida is Ground Zero for health care in part due to demographics, Altmire said. In the future, the entire nation will look like Florida does now with its abundance of aging residents.

Florida Blue realizes that the fee-for-service system has to be changed. So the nonprofit is forming partnerships with providers and reimbursing to reward quality and penalize overly high costs.

“That’s a very exciting thing for Florida and the whole nation is watching how we’re doing this,” he said.

“What it means is that for the first time, providers and insurers are aligned on their incentives for the benefit of the health care consumer, the patient,” Altmire said.

This is doubly important for mental illness because it tends to be a chronic condition that needs time and patience.

Both are in short supply in the health care field.

The new health care economy requires market forces that don’t exist.

“Right now when you purchase a health care service, when you’re going to a doctor, you don’t know what you’re getting,” Altmire said.

“You don’t know if it will cost more or less than somewhere else or whether their outcomes are better than somebody else’s. We want to move to a system where that information is right at your fingertips.”

Obamacare did a good job of providing more access to coverage, but not as good a job on cost and quality, Altmire said.

One of the key parts of the access pyramid was expansion of Medicaid, which the Supreme Court shot down.

Now states have an option of taking Medicaid, and Florida is one state that has declined.

About 1 million Floridians would be eligible for Medicaid - but they’re currently denied access to health care

“People will say, ‘They still get treated. They show up in the hospital. So it really doesn’t matter,’” Altmire said.

“Well, it does matter. Because they’re showing up in the emergency room, which is the least cost-efficient setting for health care.”

And everyone with health insurance pays a hidden tax for uncompensated care.

“Your rates are going to go up if we don’t expand Medicaid,” Altmire said.

“And they will go up dramatically if we have 1 million people in this state who don’t have health insurance and they are still getting health care somewhere.”

There is no excuse for leaders in this state to give up $51 billion in federal funding to provide health care for 1.1 million Floridians through Medicaid expansion.

Last year, the state came close.

Gov. Rick Scott reached an agreement with the Obama administration to expand Medicaid in this state.

The Senate went along, but the House resisted.

However, other states with Republican governors and legislatures have worked out compromises.

Why not Florida?

Iowa has a Republican governor, yet it developed a compromise with the federal government that involved privatization.

It will be the third state to adopt a partially privatized version of Medicaid expansion.

And there are good economic reasons to expand Medicaid.

Safety net hospitals like UF Health (formerly Shands Jacksonville) need that federal revenue.

UF Health has been receiving a flat amount from the city of Jacksonville for years. Its efficiency has not been rewarded locally, so funds elsewhere ought to be accepted.

Health care is big business in Jacksonville and Florida.

Business will benefit from this infusion of federal funding.

Besides, when did Florida leaders become so picky about accepting federal funds?

They sure haven’t been fussy about taking money for roads or dredging the river.

Gov. Scott, Senate President Don Gaetz and House Speaker Will Weatherford should visit Washington together and get something done on expanding Medicaid.

If they don’t, it will be a shocking lack of leadership that will go down in history.



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