Get ready to cough up some answers, Governor. In the words of Ricky Ricardo, you've got some 'splainin' to do. Not that any of the "liberally convinced" in the Sunshine State will believe a word you say.
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 states 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 mayors office, the city of Jacksonville, local officials, local hospitals, the sheriffs 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.
