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Inevitable Tuberculosis Questions Not the Welcome Home Rick Scott Will Want
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A.G. Holley State Hospital and Gov. Rick Scott
For Rick Scott, out of the country is definitely not out of trouble. Somehow, in a matter of less than three days, the governor became a national story -- unfortunately, not for his trip to England.
For tuberculosis. Call it TBgate.
And quite honestly, it is an alarming story that deserves straight answers.
During the 2012 legislative session, citing a decline in tuberculosis cases in Florida since 2010, lawmakers passed a bill to close the state's only tuberculosis hospital, A.G. Holley in Lantana. Gov. Scott quickly and enthusiastically signed the bill.
But on April 5, the Centers for Disease Control and Prevention released a report saying that in Duval County, Florida was suffering one of the largest uncontained TB outbreaks in 20 years. It was also the largest TB spike nationwide. And as a result, 13 people died and 99 others, mostly among the homeless, had contracted the illness. The CDC estimated 3,000 people had been exposed.
Yet, the hospital closed anyway, three months after the federally-issued report -- and six months ahead of schedule. And it all prompted a host of questions: What did the state know? When did they know it? Why was the outbreak kept secret? And how come the hospital was rushed to a close?
Another thing: The Post reported that its repeated requests to see the CDC report fell on deaf ears until reporters showed up in person at the state Department of Health in Tallahassee. Why did it take months to get a report that should have been readily available under Florida's Sunshine Laws?
The fact that Scott and the Florida Legislature would look to eliminate A.G. Holley should come as no great surprise -- though you wouldn't know it judging by the sowse of tuberculosis stories.
In the first place, A.G. Holley was the last TB hospital in the country, not just in Florida. Today protocols and technology exist to treat TB patients in their communities, rather than subjecting them and their families to traveling great distances at great expense to one facility.
In the second place, state officials say A.G. Holley's director is still on retainer with the Department of Health, he's still in the employ of the state, leaving the previous expertise very much in place.
In the third place, shuttering the state TB hospital was an austerity move brought on by the recession, plain and simple. Look what the recession has done to public health: Across the country local and state health departments have shed 52,200 jobs since 2009; they have 20 percent fewer workers than they did four years ago; and according to the National Association of County and City Health Officials, 41 percent of local health departments expect to make even more cuts in 2012.
Was the governor's office aware that the CDC issued a warning about a large outbreak of tuberculosis in time to have stopped the closure of A.G. Holley? In Scott's absense, I asked the governor's press secretary, Lane Wright. In a written statement, he said this:
"The term 'large outbreak' is grossly inaccurate. It was an isolated cluster on one particular strain of TB. There have been approximately 99 individuals diagnosed with that strain of TB over the last eight years. All of them were part of an isolated community and had ... an isolated strain of TB (FL0046, to be specific). This strain is a non-drug resistant strain, meaning it is the easier type of TB to treat."
OK, then, so if the governor was aware of the CDC's warning, why did he accelerate the hospital's closing? If it could have stayed open another six months, why didn't it?
According to the governor's office, while the last patient from A.G. Holley was released on July 2, the actual closure of the campus may take another four to five months. The process of closing a state facility, which requires the closure of records, removal of equipment with the proper safety precautions and moving tenants among other things, can take a substantial amount of time. To meet that deadline, the facility needed to get patients out by July.
The Palm Beach Post story suggests the governor had been actively hiding the CDC report from lawmakers just before they ordered the closing of the state’s sole TB treatment center. Is that true?
Wright says emphatically, "This is outrageous. Right after the CDC had concluded its report, the DOH re-formed the Jacksonville Community Tuberculosis Coalition, which was composed of members from the mayor’s office, the city of Jacksonville, local officials, local hospitals, the sheriff’s office and homeless shelters. The very purpose of the coalition was to protect the homeless population, make sure the cluster was contained, and inform the local community that was affected. The coalition had monthly meetings and the county health department issued a press release in coordination with the first meeting."
Why did it take months for the Post to get the CDC warning, which should have been available under Florida's Sunshine Laws?
Wright referred me to the Department of Health. Though Florida DOH Deputy Secretary for Health Steven Harris, M.D., didn't address the CDC report specifically, he did deny the agency had been hiding information. "Contacting local government officials (in Jacksonville), community organizations and hospitals (which the DOH did) is a clear sign that these actions were conducted with the utmost level of transparency," Harris said.
(See the timeline of the Duval County tuberculosis cluster attached below.)
When Scott returns to his office Thursday, I'm betting it won't matter how much success he had or didn't have recruiting business in England, and it won't matter how good a job his office did in explaining the frenzied mess that TBgate has become. For a while, he's going to be walloped like a tackle dummy with questions on a CDC report that paints a grim picture of Floridians' exposure to a grim disease.
And honestly, a lot of questions are left unanswered.
Reach Nancy Smith at nsmith@sunshinestatenews.com or at (850) 727-0859.
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Comments (14)
That's why in December 2010, his transition team issued a report questioning whether government (and public hospitals) should even be in the business of providing ANY hospital services to people who can't afford to pay.
That's why in 2011 he ordered a study to examine the possible abolition of all government-owned hospitals in Florida, if the state could save money by having privately owned hospitals (like he used to run before all their massive Medicare fraud) begin to care (and get public funds) for providing the care for all uninsured and poor people, a burden usually shouldered by the public hospitals.
That's why he's declaring in advance he won't expand Medicaid in the state that would provide the medical care for additional people who otherwise can't afford to pay for that care.
Yes, Rick Scott is all about good public health care, as long as the public pays for that care with public money to private for-profit providers, even if some fall through the cracks.
No need for a public TB hospital just because of TB, better to let the for-profit private health care marketplace decide whether the homeless get decent, and judging from the desire of some Scott supporter comments on this site, ANY, health care.
Yes, for-profit Medicare fraud CEO Rick Scott would NEVER overlook conflicting facts, now would he, just like when he falsely declared the Department of Community Affairs a "job killer" and abolished it despite virtually all the state economists who spoke out on this issue and former Republican DCA agency heads stating otherwise. They all must be lying, correct.
Rick Scott, the privatize-all-government-no-matter-the-damage Governor.
Someone with experience would have connected the dots, but with our "Throw the Bums Out" mentality, and revolving door among staffers, there was no experienced management personnel to draw upon.
The lower level people probably had the experience to see what was going on, but with the way things are going now, they are afraid to say anything, else they get fired. So we are being ill served by our politicians that don't like reality and hire people that tell them what they want to hear.
Gosh. All of two years of decline. Bean counters don't "get" public health. To them, it's just another place to cut. Florida's dependency on the tourist dollar makes public health a poor choice to cut. Tourists tend to be a skittish lot.
When it comes to contagious outbreaks, the one thing that is constant is the unpredictability of them. Outbreaks tend to come in waves. For example, for most towns in Europe there was not just one Black Plague, there were several and they came years apart. Using the bean counter's model, (and apparently DOH's) towns people would be grateful to God when it mysteriously disappeared, only to be surprised when it returned.
As an aside, I'll bet the new Surgeon General is not very happy to be handed this sandwich.
The belief that money is more important than human life is not just monstrous, but Satanic.
The belief that money is more important than human life is not just monstrous, but Satanic.
Re: The homeless: I have long wondered how many of these unfortunate folks are native Floridians. I have theory that when folks go bankrupt in northern states or, tragically, return from military duty and can't find a job, they head down here where at least they won't freeze to death. Has any ever done a poll?
There is a disturbing level of secrecy coming from this administration, that fuel more than not Scott's problems. From sitting on public records to the legislature calling oppaga reports "working papers" and thus not subject to public records (not Scott's doing but symptomatic of the type of leaders).
If Scott wanted to have a legacy ditch the ideologue mentality and work on evidence based leadership and transparency.
Sound policy is sound politics.
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