By Ashley Lopez
Florida Center for Investigative Reporting
On the heels of a mass flush of top-level employees at the state Health Department, one ousted employee sent a 2,900-word e-mail to former colleagues and others, warning that the agency was in decline and being run by “idealogues.”
Health News Florida reports this week that Daniel Parker, operations manager of the Division of Environmental Public Health at Florida’s Department of Health (DOH), sent an email to a long list of contacts he has made during his 14 years at the agency. Health News reports that the email “rips into the administration of Gov. Rick Scott for dismantling the agency, suggesting that the changes were more about politics than sound public policy.”
According to Health News Florida’s report on Parker’s email:
It describes a once-proud department that, he says, “has succumbed fairly quickly to neglect and erratic leadership.” Parker suggests that the turnover level of executive leadership in the department over the last two years may surpass that of the last 10. The last 10, he said, could surpass that of the last 50.
“How did this happen? We are victims of a false portrayal of public services as waste, coupled with a narrow view of what constitutes success in life. A small handful of our colleagues put their own self interest ahead of the agency, a majority of us across the state played it safe and went silent, and leadership simply looks for and installs malleable followers,” Parker wrote.
“Whether it is a purge, a centralization of power, or what other nations call a jihad, the trends are always the same wherever it occurs. When the majority of reasonable people put their heads down and keep quiet, bad things happen.”
In the past few years, there have been significant changes to public health in the state. The trend, so far, has mostly been the privatization of public health in Florida. The privatization of Medicaid, hospitals and prison healthcare in Florida, to name a few, have all been on the table. Proponents cite the mounting costs of public health to the state over time, and in the wake of a persistently troubled state economy, it has been easier for state officials to justify plans to hand over vestiges of public health to private industries.
In short, the role of public health has become, well, less public over the past few years. This would put public health officials in the state — officials who typically work in some capacity with the DOH — in a tough spot.
Rarely, however, has the topic of ideology been publicly mentioned by health officials during these changes.
As Health News reporter Christine Jordan Sexton explains in her article this week, “most of those who have left DOH in recent months have kept quiet, hoping to increase their chances of getting another state job.”
Parker, however, said he felt “those in public service have an inherent duty to speak out for what’s right and to stop unnecessary layoffs and firings without cause.” So he let it be known that there have been changes to the agency he finds troubling — and he’s says the root of many of these changes are philosophical, not budgetary.
An example was a move championed by state Rep. Matt Hudson, R-Naples, the chair of the House’s Health and Human Services Budget committee. Hudson backed a measure requiring all Medicaid recipients, regardless of how much money they make, to contribute $10 a month for Medicaid.
Here is what Healthy State Florida reported about the measure:
Florida leadership would agree that a premium isn’t necessary to shore up the fiscal robustness of the state’s health care program for the poor.
“The Senate proposed these premiums as a way for Medicaid participants to share in the cost of their coverage,” said Katie Betta, spokeswoman for Speaker of the House Dean Cannon (R-Winter Park). “Medicaid reform can be fully implemented regardless of whether or not any premiums are ever collected from Medicaid participants.”
Revenue generated from the premium would not reduce state spending in the program, she added.
n other words, the premium isn’t a necessity in keeping the health care program in tact. Instead, it’s the state’s method of making everyone share in the responsibility of their personal health.
Rep. Matt Hudson, the Republican chairman of the Florida House Appropriations Health subcommittee, told Kaiser Health News: “This is not a budgetary decision – it’s a philosophic stand. Everyone else in society is paying a portion of their own health care, including the military and retirees, so why shouldn’t this segment of the population?”
This “philosophic stand” was eventually shot down by the federal government. A federal health agency told Florida officials that they could not levy a premium on people who simply could not afford it.
Most recently, though, Hudson drafted a bill, which eventually passed and was signed into law by Gov. Rick Scott, making some big changes to the DOH. The bill changed the role of the Surgeon General, and experts say it also undermines a slew of health programs currently carried out by the state health department and repeals all sections of Florida law that direct DOH to promote healthy lifestyles to prevent disease, premature deaths and disability.
Public Health experts sent a letter to Gov. Scott warning that the bill weaken’s DOH ability to protect public health, does not make the state more efficient or cost effective, and does not improve Floridians’ health, among other things.
Months after the overhaul of the DOH was signed, former employees are sounding the alarm and warning that there are serious problems afoot for the agency.
Gov. Scott is the former CEO of a chain of private hospitals. Hudson, when he is not in the Legislature, works in real estate.
The DOH, as it stands today, was created by a Republican state lawmaker and former medical doctor. Public health advocates have long considered the Department of Health one of the greatest achievements of Dr. William G. “Doc” Myers.