Medical marijuana: Health Department must pick up Legislature’s fumble

So much for the Florida Legislature carrying out the will of people when it comes to medical marijuana.

Among the many “up in smoke” headlines was the news the Legislature failed to come up with a law to implement a constitutional amendment establishing medical marijuana in Florida approved by 72 percent of the voters last year.

In the wake of the massive failure, Republican leaders were pointing fingers at each other, marijuana advocates were doing the same and a gubernatorial candidate was calling for a special session.

The lawmakers were not able to compromise on how many dispensaries would be allowed. Now, it is up to the Department of Health to implement the law. It created placeholder rules it published in January into a thriving medical marijuana market that could grow to hundreds of thousands of patients.

The amendment specifies that key regulations be laid out by July 3. The first patients are supposed to get their IDs by Sept. 3 to obtain the drug.

But the department’s proposed rules in January got an earful from critics at town hall meetings who said the state aimed to block patients from timely and affordable access to the medication.

The rules would also restrict physicians in treating their patients and undercut the quality of the product, these critics contend.

The Department of Health issued a statement Monday saying that it took the public comments at five workshops held earlier this year seriously.

“The department is committed to quickly moving through the rulemaking process to create a regulatory structure for Amendment 2,” it said.

The benefits of medical cannabis include relief for chronic pain and muscle spasm. It relieves nausea during chemotherapy treatment for cancer patients. It also has been used for the treatment of Tourette’s syndrome, anorexia, arthritis, migraines, and glaucoma.

But while patients with these ailments wait, Republicans in Tallahassee finger-pointed at each other on Monday.

In an interview with The News Service of Florida, Senate President Joe Negron put the onus on the House for the bill’s demise, while House Speaker Richard Corcoran rejected the blame.

Photo: Creative Commons.

“If I were a voter I would be very disappointed,” said Ray Rodrigues, R-Estero, who sponsored the House bill to legalize the drug told the Tampa Bay Times. “They had a legitimate expectation that we would pass an implementing bill.”

Meanwhile, former U.S. Rep. turned gubernatorial candidate Gwen Graham is calling for a special session to enact the medical marijuana legalization amendment.

“I watched my husband battle cancer and the sickening effects of chemotherapy. So many patients with cancer, AIDS, multiple sclerosis and other debilitating diseases could use medical marijuana as a way to treat their pain,” Graham, Democrat, said in a story by CBS Miami.

“Floridians spent years begging the legislature to take action before taking their case to the voters, but once again, the legislature is ignoring them. If the people of Florida give me the honor of serving as governor, their voices will be heard.”

The two two advocates for medical marijuana in Florida — financial backer John Morgan and United for Care campaign consultant Ben Pollara also turned bitter.

Morgan, an attorney, said Pollara sold out by backing dispensary limits, according to New Times.

Pollara offered his own analysis of the Legislature’s failure in a statement Monday and tried to mend fences with Morgan. He said the House bill was partially drafted by Drug-Free America that banned smokable, edible and vapable forms of marijuana and required a 90-day waiting period.

He said he understands Morgan is angry, but the choices faced were “bad,” “worse” and “the worst.”

Advocates: Disabled take huge hit under GOP health reform

Advocates for the disabled say the House Republican plan to replace the Affordable Care Act seriously threatens some of the most vulnerable Americans.

The website DisabilityScoop reports that advocates say the bill threatens home- and community-based services and other supports that people with developmental disabilities rely upon.

Photo: Joshua Zader/Creative Commons

“The American Health Care Act shows callous and dangerous disregard for the well-being of people with disabilities and their families and erases decades of progress,” said Peter Berns, CEO of The Arc, an organization that service people with intellectual and physical disabilities.

The House passed the bill 217 to 213, allowing President Donald Trump and Republicans to do a victory lap that they had finally succeeded in destroying Obamacare. The measure though was roundly criticized by doctors, hospital and senior groups. It must still pass the U.S. Senate, which gave it a lukewarm response and promised to address its more draconian measures.

While the disabled take a hit, the most wealthiest Americans are big winners with the new legislation as it delivers a big tax cut the would redistribute billions of dollars to the upper tier.

 

How does it hurt the disabled? The many groups who represent them say the bill would institute a per capita cap for Medicaid. This means the federal government would offer a fixed amount of money for each beneficiary.

“These huge cuts and caps will likely put pressure on states to cut home- and community-based waiver services, especially those that are ‘optional,’ like personal care services and therapies,” said Kim Musheno, chair of the Consortium for Citizens with Disabilities, a coalition of disability advocacy groups.

Schools also would be affected by the Medicaid shift because they are currently able to seek reimbursement for a variety of services provided to disabled children to a tune of $4 billion annually. That means money to reimburse schools for speech and occupational therapy, specialized playground equipment, and even wheelchairs is now in jeopardy.

Advocates for the disabled say House Republicans would allow states to no longer consider schools as eligible Medicaid providers.

To read all of the story by DisabilityScoop click here.

 

Congress deals vape industry another blow – but battle far from over

A provision to protect mom-and-pop vape shops from an industry-destroying FDA regulation died in the current budget battle between President Donald Trump and the Democrats.

The Democrats were intent on killing any of Trump’s “poison pills” in the current budget deal, and while most of the attention was on the president’s border wall — you know the one Mexico was going to pay for — the provision to protect the vape industry became collateral damage.

The Cole-Bishop Amendment would have restricted the Food & Drug”s deeming” regulations to e-cigarette products sold as of Aug. 8, 2016 that fails to grandfather in existing products, whether it be devices or liquids. To get FDA approval for each product could cost millions of dollars and put many companies out of business, the industry says.

The Campaign for Tobacco-Free Kids said in a statement that death of Cole-Bishop “delivers critical victories for America’s kids and health over the tobacco industry by rejecting proposals to greatly weaken FDA oversight of electronic cigarettes and cigars and slash funding for the CDC’s programs to reduce tobacco use.”

But while American health officials deride electronic cigarettes, there is little evidence that they are even remotely as deadly as traditional tobacco.

In England, health officials have promoted vaping and electronic cigarettes as an alternative to smoking, but in the U.S. there has been a concerted effort to rein in the hundreds of small businesses that have sprouted up around the industry.

The vaping industry says the reason is clear: they take away profits not only from Big Tobacco, but the pharmaceutical industry peddling cessation patches and gums, as well as the government that heavily taxes cigarettes.

Read the Palm Beach Post’s investigation into whether health officials claims on vaping are legit by clicking here. 

Greg Conley of the American Vaping Industry vows the fight to roll back FDA regulations is far from over.

Greg Conley, president of the American Vaping Industry, says the fight is far from over with a separate bill, HR 1136, sponsored by Democrats that mimics Cole-Bishop.

U.S. Rep. Duncan Hunter, R-Calif., has also introduced HR 2194, The Cigarette Smoking Reduction & Electronic Vapor Alternatives Act.

“This budget is done with, but they need to come back in October and pass the FY 2018 budget,” he said. “The appropriations committees will likely start on that again soon and we will be pushing for Cole-Bishop or similar language to again be included.”

Nick Molina, CEO of Miami-based VaporFi.

In the meantime, Conley warns politicians who carry water for Big Tobacco against the vaping industry. He said if Democrats want to motivate millennial voters to come out to vote against the party, then dare to oppose measures to protect this alternative to traditional tobacco.

Nick Molina, CEO of Miami-based VaporFi, said while last week was disappointing, there are several avenues for the industry to pursue still in Congress.

“In addition to a handful of lawsuits filed against the FDA that are working themselves through the legal system, there is the bill introduced last week by Rep. Duncan Hunter,” he said. “That bill places e-cigarettes in a new category for harm-reduction products to move people off of tobacco-containing cigarettes.”

Polls: Support for Obamacare hits all-time high

Vice President Mike Pence said on Thursday that the Trump Administration will end “America’s Obamacare nightmare.”

But it appears more and more Americans don’t view the Affordable Care Act the same way as Republicans in Washington D.C.

President Trump and Republicans have promised to repeal Obamacare but have been subject to backlash when they head back home to talk to voters at town halls.

The Kaiser Family Foundation, in its latest Health Tracking Poll, found support for the insurance safety net at an all-time high. It’s survey found that 48 percent of Americans view the law favorably, compared to 42 percent — the highest level of favorability measured since the tracking started in 2010.

Voters who say they are registered independents contributed to the boost, half of whom view Obamacare favorably compared to 39 percent who don’t.

FILE - President Barack Obama signs the Affordable Care Act as Marcelas Owens, 11, left, whose mother died lacking insurance, looks on, in Washington, March 23, 2010. The Affordable Care Act has shifted the nation's baseline expectations for how health care should work. With the law on the precipice of repeal, public opinion has suddenly tipped in its favor. (Doug Mills/ The New York Times)
President Barack Obama signs the Affordable Care Act on, in Washington, March 23, 2010.

And the Kaiser poll doesn’t seem to be an outlier. The Pew Research Center found 54 percent of Americans approve of the ACA — which is also the highest level record by Pew.

To read more on the Obamacare polls read CNN’s by clicking here. 

Legislature looks to allow more trauma centers

Another day at the state Legislature and another proposed bill pitting hospitals against each other.

The News Service of Florida reports that SB 746 filed by Sen. Travis Hutson, R-Elkton, would eliminate the caps on the number of trauma centers statewide.

The bill comes on the heels of another proposed law that would get rid of the requirement that hospitals show a community need to expand or add a specialized program.

And like that bill, this one has the blessing of Gov. Rick Scott, a former healthcare executive. Scott has called for getting rid of a limit of 44 trauma centers statewide.

Proponents of more trauma centers argue getting rid of caps will result in less time needed to transport injured people for care. Critics say these facilities require highly trained medical staffs and that adding new centers will siphon patients and staff from existing trauma centers.

St. Mary’s Medical Center and Delray Medical Center — run by Tenet Healthcare — are Palm Beach County’s state-designated Level 1 trauma centers, handling the most extreme cases. Right now the average time to get a patient to one of these centers is eight minutes.

borrego-photo
Dr. Robert Borrego, medical director of the Trauma Center at St. Mary’s Medical Center, says most trauma surgeons would be opposed to lifting caps on the number of trauma centers in the state.

Dr. Robert Borrego, medical director of the Trauma Center at St. Mary’s Medical Center, said it is important that trauma centers have a certain number of patients to remain proficient.

“Can you imagine coming to a center and you have traumatic brain injury and the neurosurgeons only do about 10 operations a year? Are you going to comfortable there or do you want somebody who does 1,000 operations a year?”

Hutson’s bill was introduced after an administrative law judge’s ruling last week that the state Health Department had improperly allowed Orange Park Medical Center in Clay County to open a trauma center in 2016.

Currently, regulations allocate one trauma center to a five-county region of Northeast Florida and UF Health Jacksonville was not keen on the Clay County trauma center.

St. Mary's Medical Center in West Palm Beach, Florida on June 5, 2015. (Allen Eyestone / The Palm Beach Post)
St. Mary’s Medical Center in West Palm Beach is one of two Trauma Centers in Palm Beach County.

Hospital competition in Florida is already at a fever pitch. A trauma center gives a hospital one more way to advertise, attract medical talent and raise its profile — not to mention it looks really nifty on a billboard.

Palm Beach County is hardly immune to trauma drama.

JFK Medical Center in Atlantis filed a letter of intent with the Department of Health on Sept. 30 to establish a Level 2 trauma center that would accept only adult patients.

Tenet, to put it mildly, was not pleased, saying a JFK trauma center would undercut a system in place for 25 years.

“This action threatens the entire care system in our county,” stated the letter on the issue by Tenet.

Ill Iranian boy can’t get to West Palm Beach for treatment after Trump’s ban

Nearly three years ago, President  Donald Trump posted on Facebook photos of himself with two children at Mar-a-Lago. The little children were patients of The Paley Orthopedic and Spine Institute in West Palm Beach. Both sported high-tech braces on their legs.

“We love helping the kids — nothing is more important,” Trump said in the post.

Yet, swept up in the wake of Trump’s immigration travel ban for seven Muslim-majority countries are children trying to get into the United States for life-and-death medical care.

A 4-month-old Iranian girl needing heart surgery was temporarily banned from traveling to Oregon for surgery.

Now, there is a 12-year-old patient of the Paley Institute who is in limbo in Iran. He also seems to be caught up in hospital politics for the institute. which is on the campus of St. Mary’s Medical Center, owned by Tenet Healthcare.

Tenet does not want the story about Mohammad Aref Zarezadeh out even when his delay may have nothing to do with Trump’s controversial travel ban that has been delayed by the courts.

Paley wrote to U.S. Sen. Elizabeth Warren’s office on Friday, saying the boy has a serious birth defect of congenital femoral deficiency.

Currently, the boy has a leg lengthening device with external pins going through skin and bone. He was scheduled for surgery on Feb. 16 and any delay in removing the device could cause infection.

“We were waiting for them to get a visa when this most recent ban was announced last week,” Paley wrote to two aides in the Democratic senator’s office.

Sources in Washington told The Palm Beach Post that visas for the boy and his mother were delayed because some of the problems with the documents the family submitted.

Whether the travel ban did play a role in the boy’s delay remains a mystery. Mother and son have traveled on medical visas in the past for treatment and surgery by Dr. Dror Paley.

Paley also reached out to U.S. Rep. Lois Frankel of West Palm Beach.

The Post received information that Tenet’s lobbyists were in contact with Speaker of the House Paul Ryan.

In an e-mail to Dr. Paley, the father of boy — Ali Zarezdeh — said the family had an interview in Dubai on Nov. 13.

“Exactly, when we sent the passports (Aref and his mother) to stamping the visa by agency, the ban was announced,” the father wrote on Friday. “Unfortunately, three days ago their passports returned without visa.”

Trump’s Jan. 27 executive order halted all refugee admissions for 120 days and imposed a 90-day ban on visitors from Iraq, Iran, Syria, Libya, Sudan, Somalia and Yemen.  A federal judge has temporarily frozen all enforcement of the order’s key parts.

The quandary for his patient may have left Dr. Paley in the awkward position of taking on Trump in the name of his patient. Paley is renowned for his leg-lengthening techniques. In many instances, he is able to save the limb of a child that would have otherwise been amputated.

In that same 2013 posting on Facebook, Paley sits next to Trump and Dr. Ben Carson, the former presidential candidate who is now Trump’s  secretary for the Department of Housing and Urban Development.

In December 2013,  a fundraiser was held at Trump’s Mar-a-Lago that benefited The Paley Institute and Carson Scholar Fund.

Paley responded to an e-mail by The Post inquiring about Aref by asking the newspaper not to report on his patient but he would not say why. “I think we are making headway through some connections via some of our legislators. I am awaiting to hear if the family gets a visa,” he wrote.

In an e-mail obtained by The Post, a Tenet spokesman tells the boy’s mother, Azadeh, not to speak to the press.

“We understand that a reporter from a newspaper in Florida, The Palm Beach Post, has learned about your situation,” writes Dan Waldmann, senior vice president for public affairs for Tenet.

“We do not believe it would be beneficial for Aref’s story to be published in the media before the visas have received and he is in the United States.”

He tells the mother if she is contacted by anyone in the media to not respond and to let Tenet know immediately.

The mother did respond, though, to The Post, saying in an e-mail that she had sent passports for herself and her son to Dubai for a stamping visa two days ago.

“The agency told us the process will take 10 to 15 days,” Zarezadeh “Our main problem is the visa and how responsive will be the staffs of Dubai embassy.”

081111 (Richard Graulich/The Palm Beach Post) West Palm Beach - Towards the end of the surgery, a fixator is assembled on the newly lengthened leg of Demi Reilly at the Paley Advanced Limb Lengthening Institute at at St. Mary's Medical Center Thursday.
A  fixator –similar to the one on the leg of Mohammed Aref Zarezadeh  — is shown in a photo by Post photographer Richard Graulich at The Paley Institute.

Waldmann told the family in his e-mail that Tenet is working on expediting the process but there are no guarantees.

“There are a large number of individual cases for which special assistance is being requested, many of which are being handled by the embassy in Dubai,” he said. “As a result, I can’t provide any assurance that we will be able to get the expedited handling, but we will try.”

Time is ticking for Aref, though.

In a December e-mail to Paley from his father, Ali, he said “Aref has some pain and discharge around his pins. What should he do?”

Doctors want galas moved from Trump’s Mar-a-Lago

Doctors are calling for their charitable galas in Palm Beach to be moved from President Donald Trump’s Mar-a-Lago estate — which is also serving as the winter White House presently.

The news comes on a planned protest at Mar-a-Lago on Saturday when Trump attends the International Red Cross 2017 ball.

It is the height of the ball season on the tony island where the rich and philanthropic don their finery and attend charitable events. And since location is everything, these galas are often either held at Mar-a-Lago or The Breakers resort.

Mar-a-Lago will become the "winter White House" when President Donald Trump returns to Palm Beach as the 45th President of the United States. The front of Mar-a-Lago, January, 31, 2017 in Palm Beach. (Greg Lovett / The Palm Beach Post)
Mar-a-Lago will become the “winter White House” when President Donald Trump returns to Palm Beach as the 45th President of the United States.

The historic Mar-a-Lago Club boasts an 800-seat ballroom and ocean views.

But now throngs of medical professionals are calling on Cleveland Clinic hospitals to cut their ties to Trump in light of the president’s executive order temporarily banning people from seven Muslim-majority countries from entering the U.S.

In a story in The Washington Post today, doctors, nurses and students have signed an open letter pleading with the clinic to condemn the Trump policy and to cancel a fundraiser set for this month at the resort.

More than 1,000 people have also signed a petition demanding a change of venue for the Massachusetts-based Dana-Farber Cancer Institute to cancel or relocate another lavish fundraiser planned for later this month.

It is reported the donors are paying between $1,250 and $100,00o to attend the Dana-Farber event scheduled for Feb. 18.

Dana-Farberr president Laurie H. Glimcher has refused to cancel the fundraiser, saying it was too late to call off the event, according to the Boston Globe.

123116 PBDN Meghan McCarthy Guests dance during the New Year's Eve Celebration at Mar-a-Lago Club.
uests dance during the New Year’s Eve Celebration at Mar-a-Lago Club.

Doctors were lobbying the Cleveland Clinic to cut ties with Trump after a resident at the clinic was denied entry to the U.S. under the president’s executive order. The hospital is trying to get the safe return of the employee.

The Cleveland Clinic says, as well, that it is too late to cancel its ball, but the Ohio-based academic hospital said it would not commit to using the same location for next year’s event.”

The Red Cross ball is the hallmark of the Palm Beach social season and is almost always at Mar-a-Lago.

The Red Cross has not yet signed a contract with a venue for next year’s event, according to a story in Business Insider.

A permit for the Red Cross’s 2016 gala, obtained by The Associated Press, says 500 people were expected to attend. Red Cross estimated the event would raise $925,000 and cost about $400,000 to put on.

The permit also noted a $20,000 in-kind donation — meaning that is what Mar-a-Lago would have charged the Red Cross.

In 2015, according to the same permit, the gala and another Palm Beach event together raised $1.75 million and cost $800,000.

If events are canceled at Mar-a-Lago that would impact Trump’s pocketbook.

This week the department chain Nordstrom announced it no longer working with Ivanka Trump for the fall season and is reducing the amount of Trump merchandise stocked.