As Rents and Housing Prices Spike in Durham, so Does Unsheltered Homelessness

Lack of affordable housing coupled with rising rents appears to have worsened Durham’s homelessness problem, according to an analysis by a Durham non-profit.

In a press conference Wednesday afternoon, Housing for New Hope shared the results of its annual Point-in-Time (PIT) Count, which seeks to estimate the number of people experiencing homelessness (both sheltered and unsheltered) in Durham. The count, conducted earlier this year, saw a 10 percent increase in unsheltered homelessness compared to last year. 

The results suggest that Durham city and county may need to step up services–and confront deeper systemic issues–for a population struggling to find stable housing in one of the country’s hottest real estate markets.

“We are really feeling the loss of affordable housing—particularly deeply affordable housing,” said Russell Pierce, executive director of Housing for New Hope. “There needs to be more units that are publicly controlled so that we are able to address these shortages. There’s funding to get folks housed in many cases. But there just aren’t enough units.”

In its survey in January, Housing for New Hope, which provides a host of social services in Durham, found that the total number of people experiencing homelessness had dropped by 18 percent (from 459 to 375). Yet the number of unsheltered people rose for the third straight year, a 105 percent increase since 2020.

In particular, Pierce said, the non-profit is concerned about the number of families with children living in unsheltered conditions, a trend the group first saw in 2021. This year’s survey discovered 10 such families who lived unsheltered. 

Moreover, African Americans comprise a majority of both sheltered and unsheltered populations. This year, 68 percent of the individuals experiencing homelessness were Black; according to 2020 census data, Black people make up 35.9 of Durham’s population.

Dramatic hikes in both rents and housing prices are making life harder for the homeless. In May 2018, the average apartment rental price in the Durham-Chapel Hill area was $1,034. By May 2022, this figure had jumped to $1,370. Durham’s buying market reflects similar trends. In 2018, the median listing price for a single-family home was about $250,000. Today, those prices have skyrocketed to about $415,000.

Colin Davis, who manages the city of Durham’s efforts to curb homelessness, said that the COVID-19 pandemic—and the ensuing mental health and eviction crises—may also explain the PIT trends.

Durham City Council member Leonardo Williams and County Commissioner Wendy Jacobs both attended Wednesday’s press conference.

Williams said that the city intended to be “as ambitious as possible” in creating more affordable housing in Durham. He referenced recent projects such as the Willard Street Apartments and The Joyce, residences that offer more than 160 affordable housing units combined.

Jacobs spoke to county efforts, such as redeveloping affordable units at 300 East Main Street and creating more educational opportunities and jobs for traditionally underserved populations. 

Nevertheless, Jacobs said, the county must do more. Durham has done little to assist its most vulnerable unhoused residents—those who experience chronic homelessness and battle disabling conditions such as mental illness or substance abuse disorder, she said.

“We have a revolving door that goes from our emergency department to our jail, to our homeless shelters, to the streets, and then repeat,” Jacobs said. “All because they are not able to get the kind of health care that they need.”

Jacobs pointed out that Housing for New Hope is seeking funding for a project at 501 and 531 E. Carver Street that would ultimately provide about 120 affordable housing units and on-site support services for vulnerable residents. The County Commission is considering the request.

The annual Point-in-Time count took place on the night of January 25th. Housing for New Hope intentionally surveys during the coldest time of the year because unhoused individuals who still have connections to family members or friends are more likely to be taken in when cold and wet weather comes, Pierce said. By surveying in the winter, Housing for New Hope can make the most accurate estimate of those experiencing homelessness.

Each year’s count includes people staying in emergency shelters or transitional housing and unsheltered people living in places such as cars, stairways, commercial buildings, and more. 

This year, 150 volunteers canvassed specific areas throughout the county and city, including encampment sites on Holloway and Roxboro streets and parts of Downtown that are known to attract transients. This year’s volunteers included Mayor Elaine O’Neal and Jacobs.

This story was published through a partnership between the INDY and 9th Street Journal, which is produced by journalism students at Duke University’s DeWitt Wallace Center for Media & Democracy. Comment on this story at backtalk@indyweek.com

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My Medicare Nightmare

Sample US Medicare Card (Wikimedia Commons)

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Author’s Note: It’s been a pretty rough couple of years for me health-wise, but thankfully I am still here, having survived the latest close scrapes with death. Indeed, I am wondering when I may eventually run out of ‘cat lives’!  After going off my bike and breaking my hip in March 2021, then surviving a blood clot in my lung (pulmonary embolism) that nearly killed me, and this past year 2022, dealing with an evolving kaleidoscope of strange and troubling systemic symptoms (suspiciously coinciding with my mRNA shots, which at the time I was grateful to get as my lung was still recovering from the embolism.)  And just when I thought I could finally get national healthcare coverage in the USA (I turned 65 in January) the system was confusing and international mail was an issue, so my government health insurance was cancelled. But not before I ran up some horrendous medical bills while in the USA – all the time, being told I was covered, which, thanks to failed communication in a very complex bureaucratic system, turned out to be false! And yet, somehow, I survived – again!

As a retired American living in Asia for over 30 years, I routinely enjoy affordable state-of-the-art healthcare in Thailand, which has included life-saving procedures in some instances. Whenever I travel to the USA, I purchase medicine and medical supplies in Thailand, where the identical products are a fraction of the costs in the USA. Indeed, most travel insurance policies offer health care coverage globally, ‘except in the USA.’ So, when I turned 65 in January 2022, which is the eligible age for US government health insurance Medicare, I was excited to finally have guaranteed healthcare coverage in the USA, like my friends from countries all over the world take for granted.

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The USA is the only industrialized country in the world that does not have some form of government-guaranteed or ‘universal’ healthcare coverage for all of its citizens. More than 30 million Americans don’t have health insurance and millions more are underinsured. 68,000 Americans die every year because they are uninsured or under-insured. Furthermore, even with insurance, medical costs are so high that medical bills cause bankruptcy for half a million people each year in the USA, the number one cause of bankruptcy [1].  Even in Thailand, the government provides universal healthcare through the public health system to all of the country’s citizens. And healthcare costs in Thailand’s private hospitals, which are more like 5-star hotels than hospitals, are significantly less than the costs in the USA [2].

In early February 2022, shortly after I applied for Medicare coverage, I was contacted by the Federal Benefits Unit (FBU) at the American Embassy in Manila, Philippines, which provides services for the SSA and other benefit agencies to customers in over 40 countries in the Asia-Pacific region. They wanted to confirm my mailing address in Thailand, and informed me that all documentation had to be sent by postal mail from SSA headquarters in Maryland, USA. In the past, I have received an annual statement by postal mail from SSA headquarters in Maryland, so clearly, they had my correct mailing address.

By July, I was preparing to travel to the USA for seven months of seasonal work, and I still had not received any information from SSA to explain how my new Medicare coverage worked. I was, however, able to access my online SSA ‘Benefit Verification Letter’ which stated clearly that I was covered under both Part A (hospitalization) and Part B (medical). But even this online ‘verification’ letter made no mention of the required monthly premiums for Part B coverage, nor was there any mention of the 20% ‘co-pay’ responsibility for both Part A and Part B healthcare bills. Only Americans know what a co-pay is. In other developed countries where universal access to healthcare is the norm, this is unheard of! Given the extremely high healthcare costs in the USA, a 20% coinsurance expense can be a substantial out-of-pocket cost. The shocking racist origins of the 20% ‘co-pay’ requirements for Medicare are explained in “The Racist History of American Healthcare” [3] whereby the co-pay was intended to deny access to African Americans, who were deemed unlikely to be able to afford it.

Soon after arriving in the US, I contacted SSA to request information and documentation explaining about my new Medicare coverage, a Medicare card, anything – at which point they told me that my Part B coverage had been cancelled due to non-payment of the monthly premiums. I knew nothing of this – having received no invoices, nor the amount due, how and where to pay, etc. I wondered if this was because of my Thailand address, which was confirmed numerous times by email and telephone with the FBU field office at the US Embassy in Manila. I still, sixteen months later, have not received any documentation from SSA.

But the SSA representative told me not to worry and that Part A would cover any hospitalization, including ER visits (as this would be ‘technically entering the hospital’). Crucially, this advice turned out to be incorrect, and I found out only after I had run up thousands of dollars in ER bills at hospitals in New York and Colorado that this was covered only under Part B.

However, SSA informed me I could back-pay the Part B premiums for all of 2022 which would reinstate my coverage retroactively for the entire year.  SSA cashed my check for $2,000 in October and my Part B coverage was finally reinstated (5 months later!) in March 2023. During this time, I needed some costly diagnostic tests (which I was told only a medical specialist could order – which, of course, added another layer of cost in the ‘for-profit’ American Healthcare System strategy). So, after three months waiting to see a medical specialist, I was told by that office that since my Part B was still not reinstated, I would have to pay the consultation fee of $472 (no testing included) cash up front. I was given the option to reschedule a later appointment when my Part B might be reinstated. But the next available appointment was another three months wait!! Thankfully, I was not dealing with an aggressive cancer – I would be dead, just waiting to get some medical attention!!!

So, after seven rather sickly months in otherwise enjoyable seasonal jobs at YMCAs in upstate New York and the Colorado Rockies, teaching yoga and meditation and supporting the international seasonal staff program as before, I was looking forward to ‘escaping’ from the USA – thanks to my nightmare dealings with the severely under-funded Social Security services [4], the ‘for-profit’ American Healthcare System and the terrifying and outrageously high costs of healthcare there.

Thank goodness I live in Thailand, where I have easy access to efficient and affordable, state-of-the-art healthcare (not to mention no mass shootings, natural, unprocessed foods, low cost of living, a respectful, non-confrontational culture, etc.) So, I left my job in Colorado sooner in order to return to Thailand to get the necessary (and affordable!) health care I needed. I contacted my personal physician in Bangkok who, within a single week or so, had arranged appointments with three top medical specialists, who scheduled the diagnostic tests, follow-up appointments, and treatment. All of this cost far less than the US coinsurance payments I would be responsible for, even after my Medicare coverage was reinstated. Seven months in the USA was more than enough for me. It was time to leave, and indeed a relief to return to Thailand. Though I am still waiting for all of it to be resolved, the SSA employees I have contacted multiple times over these many months have been helpful, given the volume of enrollees. While I was fortunate enough to have had somewhere else to go for healthcare, I can’t help but wonder about the millions of Americans who don’t have any other options.

Sources:

  1. https://chrishedges.substack.com/p/the-chris-hedges-report-show-with-d77
  2. https://www.youtube.com/watch?v=qRDrh-d-UxE&t=16s
  3. https://www.youtube.com/watch?v=49yIskpe1rs
  4. https://www.washingtonpost.com/politics/2023/02/18/social-security-services-degrade-congress/

Please feel free to contact Jim on Facebook or by email at jim_mielke@hotmail.com. 

You can read more about Jim’s backstory,  here and here. 

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Inside the ‘chaotic’ nominating process that could decide whether Trump gets his third nomination

Former President Donald Trump currently appears to be a heavy favorite to win a third nomination for the presidency in 2024, far ahead of his next closest challenger in Florida Gov. Ron DeSantis, who hasn’t yet even formally declared — but there is a long way to go, and the GOP’s primary system could throw a monkey wrench into the process.

On Monday, writing for Vox, reporter Ben Jacobs described the “chaotic, expensive, and widely misunderstood” system Trump will have to navigate — the first time since 2016 he has had to seriously compete with other candidates.

“There are broad parameters set nationally by the Republican National Committee, but outside of that, it’s a free-for-all where each state can make its own rules,” wrote Jacobs. “The result is a cornucopia of contests. States can hold conventions, caucuses, or primaries. Some states are winner-take-all primaries, meaning that the candidate who receives a plurality of the votes gets all the delegates; some are proportional, meaning that delegates are awarded in proportion to what percentage of the vote each candidate receives; and some are mixed, with elements of both. In some states, candidates have to hand-pick and recruit delegates to stand on a ballot as their supporters. In others, the delegates are chosen in entirely different contests, elected by activists, and then assigned to the presidential candidates who emerge from the state’s primary.”

This stands in contrast to the Democratic primary rules, which are much more standardized and straightforward — every state has a proportional contest and uses the same formula for awarding delegates. Once upon a time, so-called “superdelegates,” or unpledged delegates who could vote whichever way they wanted regardless of the popular vote, were an issue in those contests, but a series of reforms after the 2016 election limited their voting powers.

“In advance of the 2020 cycle, the Republican primary rules were changed extensively when the Trump campaign and the RNC worked state by state to make it tougher for gadfly candidates to challenge Trump’s nomination,” noted the report. “In a number of states, the threshold needed for candidates to earn delegates was significantly increased. For example, in Massachusetts in 2016, a candidate only needed to win 5 percent of the vote statewide in order to earn delegates. But in 2020, this threshold was raised to 20 percent and a winner-take-all trigger was added. Coincidentally, the state’s former Republican governor Bill Weld was mounting a long-shot challenge to Trump, and its incumbent moderate governor Charlie Baker had been a vocal Trump critic. Needless to say, this meant Trump won all of the Bay State’s delegates as a result.”

Further complicating matters, noted Jacobs, if a convention doesn’t yield a clean result, delegates can largely do whatever they want and form new alliances, meaning that if the delegate count is close, Trump has to prepare to fight to keep delegates from states he won in his camp.

“The question is how much any of this will matter in 2024. The formal ballot to determine the nominee on the convention floor has long been pro forma. No Republican convention has formally hit a second ballot since 1948,” wrote Jacobs, adding that “For Trump and DeSantis, it is not likely that they will be scrimping for money or media attention in the weeks before the first nominating contest. But building up a delegates operation still matters for them — not just for a potential convention fight, but to demonstrate their strength and viability before the first votes are cast. Voters and donors want to back a winner, and a robust national campaign demonstrates the ability to win not only the nomination but potentially the general election as well.”

ALSO IN THE NEWS: ‘Bastion of wingnuts’: How the MAGA faction has left Georgia’s GOP ‘warped and wrecked’

How can Texas take better care of its Black mothers?

AUSTIN (KXAN) — Patrice Lott felt her appointments were rushed whenever she went in for her prenatal visits. She had deliberately chosen a doctor of color, following a Facebook group recommendation and her own research, and so this was not the experience she was expecting.

“They let me know my appointments coincided with when she got called into the hospital, so we switched it up,” Lott said. “After that, I definitely felt taken care of from top to bottom.”

Black mothers continue to experience health disparities and inequities during and after pregnancy in Texas and across the U.S. To raise awareness on the subject, Black Mamas Matter Alliance created “Black Maternal Health Week or BMHW. The theme for 2023 is, “Our Bodies Belong to Us: Restoring Black Anatomy & Joy.”

Established in 2018, BMHW (April 11 – 17) is a week of awareness, activism and community building intended to deepen the national conversation about Black maternal health in the U.S., center the voices of Black mothers, women, families and stakeholders, and enhance community organizing on Black maternal health.

Also in 2018 in Austin, a maternal health research project quickly evolved into a community organization after Dr. Michelle Roundtree and others who started Black Mamas ATX, or BMATX, realized the need of the women and families they were interacting with.

“Black people in the community are experiencing health disparities in several areas. Maternal health is just one,” BMATX Executive Director Kelenne Blake-Fallon said. “It’s systemic, and the biggest challenge has been that we’ve not been able to push the system to change in a way that allows Black women, Black mothers and Black communities to thrive.”

Kelenne Blake-Fallon is the Executive Director of Black Mamas ATX. She is a former professor at Huston-Tillotson University and a current doctoral student of Public Health at Johns Hopkins University, concentrating in Health Equity and Social Justice. (KXAN Photo/Eniola Longe)

BMATX serves Bastrop, Caldwell, Hays, Travis and Williamson counties providing free doula support, breastfeeding education and mental health support to their clients. Blake-Fallon said she considers this survival work.

“But to really create change, we need that structural work,” she said. “We need to change the systems, we need the health care providers to consider community organizations as partners in the care of their patients, not as threats, not as frustrations or barriers.”

BMATX doulas work with moms from the moment they request a doula and up to one year postpartum providing education, practicing comfort measures, designing a birth and postpartum plan, as well as advocating for the moms when necessary.

Sometime during her pregnancy, Lott started to feel like something was off and complained to her doctor. She seemed to be drained all the time even though she was eating clean. It wasn’t until she ended up in the emergency room she discovered she had a bladder infection and then two weeks later, at a doctor’s appointment, she found out she also had gestational diabetes.

Patrice Lott moved from Minnesota to Texas just before the pandemic. She got pregnant with her daughter, Camilla Joy, and had a difficult time adjusting to a new city especially while being pregnant. (KXAN Photo/Eniola Longe)

“We know something’s not right but we don’t know what it is because we’re not doctors,” Lott said. “We didn’t go to school in order to diagnose ourselves or other people. So, we are allowing that team of people to take care of us and the care is not there.”

Texas Mortality and Morbidity Review Committee

In 2013, the Texas Maternal Mortality and Morbidity Review Committee, or MMMRC, was established to review maternal deaths and release biennial reports on their findings as well as make recommendations on steps to take to actively fight against the high severe maternal mortality and morbidity rate.

The figure above shows a rising trend in general for all women. Black women, represented with the red line continue to experience the worst morbidity rate in Texas (Courtesy MMMRC Joint Biennial Report)

A preliminary review of 2019 Texas data revealed 59 pregnancy-related deaths – those caused directly or indirectly by the pregnancy – from a larger pool of 140 deaths identified as pregnancy-associated – those occurring during a pregnancy and up to one year afterward. The committee determined 90% of the deaths were preventable.

The 2019 numbers also show that non-Hispanic Black women die at twice the rate of non-Hispanic white women and more than four times the rate of Hispanic women. This is a persisting trend since 2013, when maternal mortality data became available.

Racial/Ethnic Severe Maternal Mortality Disparities

In comparison to all other races and ethnicities, Black women consistently experience the greatest risk for maternal death. This trend persists across all levels of socioeconomic status, including women who were married, were at the highest education level, and those women who had private health insurance at the time of their delivery.

High Black maternal mortality and morbidity is not only a problem in Texas, it’s prevalent across the U.S. The U.S. is the only developed country where the maternal death rate continues to rise. According to 2021 national data from the CDC the average mortality rate per 100,000 live births is 32.9. The same data shows the average rate per 100,000 deaths for Black women in the U.S. is 69.9. The Netherlands has the lowest rate per 100,000 live births at 1.2. With a further decrease seen despite the pandemic.

The 2021 American Rescue Plan Act, a direct response to the pandemic, offered a possible solution to a major problem for Texan mothers especially: insurance. As of 2019, Texas was one of the states with the highest number of uninsured women of childbearing age.

With a possible extension from two months to 12 months postpartum coverage under the Act, Texas’ proposal to extend coverage to six months postpartum is currently awaiting federal approval from the Centers for Medicare and Medicaid Service. The latest Kaiser Family Foundation report shows 32 states including DC have adopted a 12-month postpartum coverage extension with six states planning on implementing a full extension and three states including Texas with limited coverage extension proposed.

“As a doula and student midwife, I have witnessed nurses or OB-GYNs not paying attention to Black moms while they’re in labor or ignoring their complaints of what they’re experiencing in their prenatal visits,” a doula with Giving Austin Labor Support, or GALS, Dominique Adeniyi said. “Though there is more than one cause for the mortality rate when it comes to Black women, not being heard or not feeling heard or not being taken seriously are important factors.”

Adeniyi came into this line of work to contribute to the solution after experiencing a near-death situation. During labor, she started experiencing some pain, which her midwife brushed off as a stomach virus. After she said she was ignored for almost two days, Adeniyi left the birthing center she originally planned to give birth at to go to a hospital. It was there she was told her liver was shutting down and that she had developed HELLP syndrome, a life-threatening condition.

“I actually had a great experience at the hospital,” Adeniyi said. “Which is really crazy because you would think that at a birthing center, you’ll get this holistic, one on one, tailored experience, but I didn’t. I got that at the hospital where they took it seriously.”

Training and working as a doula is also an avenue for Adeniyi to work through the postpartum depression she developed after the traumatic experience.

“Helping moms who are in need gives you this sense of fulfillment,” she said. “So although I’m in therapy and still working through the depression, being able to be out in the streets and help people have healthy, positive birth experiences has definitely helped.”

Current Steps

In Austin, the Maternal Infant Outreach Program, or MIOP, an initiative of Austin Public Health, has been providing peer support and advocacy to Austin’s Black and African American women since 2013. MIOP works with these mothers for up to one year postpartum in efforts to address and eliminate the stark racial disparities in maternal and infant mortality. The program has served almost 800 moms since inception.

“This is a direct response to a direct problem, which is the high infant and maternal mortality rate seen in the African American Black diaspora community,” MIOP supervisor Estephanie Olivares said.

Moms are matched with a case worker who makes home visits and is able to connect the mother to any available service she may need.

“Our community health workers (CHW) are the secret sauce to connecting our moms here in Austin, in Travis County, to social services,” Olivares said. “Each CHW has a caseload of moms, and we’re not at full capacity yet.”

MIOP measures success by collecting data on the following metrics – at term births, healthy weight births, breastfeeding, postpartum visit attendance, and intimate partner violence screening. Performance measures are evidence-based and derived from the Healthy Start curriculum. MIOP has seen progress in all measures and is encouraged by the positive outcomes according to a spokesperson.

As part of efforts to raise awareness of their services this week, MIOP put on a screening of Birthing Justice, a feature-length documentary film, capturing the experiences and challenges of Black women, their families, caretakers and advocates, and examines the structures and systems that determine disparate rates of mortality.

Olivares said a lot of the moms who have passed through MIOP continue to attend community events like this one.

“It’s not just service-directed or focused,” she said. “There is a bond of sisterhood that is formed because of the time we spent with them.”

In Texas, statewide initiatives to improve maternal health have included the establishment of the MMMRC and Healthy Texas Mothers and Babies, and the Texas Ten Step Star Achiever Initiative to improve maternity care practices in birthing facilities.

DSHS is the lead coordinating agency to implement the Alliance for Innovation on Maternal Health bundles. The TexasAIM initiative was launched in June 2018. Nearly all Texas’ hospitals with obstetric lines of service are enrolled in TexasAIM. The program provides hospitals with best practices for obstetric hemorrhaging, care for women with opioid use disorder, and severe hypertension in pregnancy using a  “5 R” structure of readiness, recognition, response, reporting & systems learning and respectful care.

To increase family and medical professional awareness about serious pregnancy-related complications and urgent maternal warning signs, Hear Her Texas was launched as part of a national public outreach campaign from the U.S. Department  of Health and Human Services.

As part of the Safer Childbirth Cities initiative by Merck for Mothers, the Maternal Health Equity Collaborative (MHEC) in Austin received a $1 million grant, the first in Texas. Made of up Black Mamas ATX, Giving Austin Labor Support (GALS), Healing Hands Community Doula Project, Mama Sana Vibrant Woman, Hand to Hold, and Partners in Parenting, MHEC was born out of necessity at the height of the pandemic in 2020 because doulas were being denied access to their clients in the hospitals according to Nakeenya Wilson, currently the only community member on the MMMRC.

“There is a growing and increased awareness around what it looks like to have a birth support team. Midwives are used in most countries outside the United States as the primary way to serve birthing people during pregnancy and childbirth,” MMMRC community advocate, Nakeenya Wilson said. “We’re recognizing that the way we’ve done obstetrics in this country has not been effective for everyone.”

For BMHW 2023, the MHEC organized a community baby shower for pregnant and postpartum families with kids under three years old, giving away diapers, wipes, car seats, strollers and much more.

The Maternal and Child Health Equity Research Lab at the University of Texas at Arlington led by Dr. Kyrah Brown investigates the role of maternal health services (quality of care, safety) on maternal and reproductive health inequities; and collaborates with community stakeholders to identify, implement and evaluate community-based solutions to advance birth equity.

Brown and her team leveraged relationships with community organizers to put on a week-long event line up for BMHW 2023, which included a screening of Birthing Justice.

“We have some events that are on campus and off campus, but a lot of the ideas and the planning has been a collaborative effort with our community partners,” she said.

A 2023 SXSW panel titled “Weathering the Storm of Black Maternal Mortality” focused on Dr. Arline Geronimus’ coinage of the word “weathering” to describe the health deterioration in early adulthood as a physical consequence of cumulative socioeconomic disadvantage of Black women. The panel was made up of a poet, a doula, a doctor and a community advocate.

The Use of Chatbots in Oncological Care: A Narrative Review

Introduction

Chatbots are defined as computer programs that process and simulate human conversation by artificially replicating patterns of human interaction through natural language processing.1 Chatbots widely serve as digital assistants to clients, allowing users to express their interests, wishes, and queries naturally by speaking, typing, and pointing.2 They may be implemented through messaging applications, websites, mobile apps, or telephone. The first-ever use of chatbots or related technology started in the 1960s with ELIZA, which used simple keyword matching techniques to try to convince users that they were real humans, giving the illusion of “intelligence.”3 In the following decades, with rapid growth in text and natural-language-based research and improvement in data mining and machine learning techniques, chatbots became more practical, particularly for commercial applications. Voice-based platforms such as Apple’s Siri and IBM’s Watson have been implemented across a variety of social media and technological platforms.4–6 Additionally, other unique real-world applications can be found in conversational artificial intelligence (AI) with Amazon Echo, which implements the voice service Alexa, found in millions of households around the world and generating 4 billion dollars in device revenue in 2020.7 According to UK-based Juniper Research, chatbots are expected to deliver 4 billion dollars in cost savings in the banking sector by 2022.8 The market size for chatbots is expected to expand at a compound annual growth rate of 25.7% over the next 9 years.9

Chatbots remain underutilized in healthcare and its market size in healthcare is expected to proliferate over the next decade. Healthcare chatbots to date have primarily been mobile apps.10–12 The first report of chatbots in healthcare involved an exploratory study in 2010, where the chatbot answered adolescents’ questions related to sex, drugs, and alcohol.13 Since then, development of AI-driven solutions including chatbots into public care had been relatively slow. It was not until the COVID-19 pandemic where utilization of telehealth and health-oriented chatbots significantly increased.14 As a result, scopes have expanded from patient education for common diseases including malignancies.10 Additionally, chatbots have been deployed to suggest behavior, lessen mental health burden, and offer emotional support.15 This high potential for future development can also be supported through the healthcare chatbot market, expected to increase at a compound annual growth rate of 19.16% from 2022 to 203016 and that chatbots in the healthcare sector are expected to save 3.6 billion dollars globally by 2022.17

Cancer is the second leading cause of death in America.18 With COVID-19 pandemic reducing access to cancer care,19–22 remote and digital cancer care interventions such as chatbots are more relevant than ever before.23 Two scoping reviews in 2019 describe how contemporary chatbots have demonstrated improved accessibility, personalization, and efficiency, with the potential to improve many types of patient care, but only a handful of chatbots are related to cancer care.6,10 There have since been many other studies utilizing chatbots in oncology for preventive screening,24–26 mental health monitoring,27 lifestyle change,28 patient education6,10,29 etc. Therefore, given the increased number and limited assessment of contemporary chatbot studies particularly in the cancer field as well as the high potential of reducing operating costs, we hereby aimed to provide a more thorough, updated review evaluating the strengths and weaknesses of chatbot studies in oncological care to help guide future technological development.

Methods

Search Strategy

This narrative review consists of searches through PubMed containing biomedical literature from the United States National Institute of Health’s National Library of Medicine. The search used five different combinations of the specific terms “chatbot”, “chat bot”, “cancer”, “oncology”, “disease”, and “conversational agent”. The first combination inputted in the query box on PubMed was “(chat bot) OR (conversational agent)) AND (cancer)”, the second was “((cancer) OR (oncology)) AND ((chatbot) OR (conversational agent))”, the third was “(cancer) AND (chatbot)”, the fourth was “(chatbot) AND (disease)”, and the fifth was “(disease) AND (conversational agent)”. Our five combinations were designed to account for variability in terminology and ensure the comprehensiveness of our search to capture all relevant studies.

The literature review for these studies began in June 2021 and was collected through April 24, 2022. These studies included where a chatbot was used in any aspect of oncological care – prevention, patient education, treatment, and surveillance. Published articles, abstracts, and ongoing clinical registered on clinicaltrials.gov discussing use of chatbots for medical care were included and noted as such. Excluded were studies used for purposes not related to cancer or chatbots. We explained these specific details and processes in a PRISM diagram (Figure 1). Data was extracted by one reviewer (AW) and independently verified by another (ZQ).

Figure 1 PRISMA flowchart of literature review process.

Notes: PRISMA figure adapted based on guidelines from Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71. doi:10.1136/bmj.n71. Creative Commons.

Results

The initial search yielded 196 records, 21 of which met inclusion criteria (Figure 1).

Characteristics of Chatbots

Table 1 provides the key details of each of the 21 studies included in this review. These key features included phase of oncological care, study period, data source, study design, effect estimates, and key result summaries.

Table 1 Summary Table of Included Studies

Phase of Care and Type of Cancer

The 21 chatbots included in this review were piloted in all phases of clinical care for patients with breast, ovarian, colorectal, cervical, or prostate cancer. Out of these 21 chatbots, 15 of them focused on specific types of cancers with the remaining six chatbots included mixed populations of cancer patients. Eight wchatbots focused on breast cancer,32,33,36,38,43,44,46,48 three of which also included patients with ovarian cancer.36,38,46 Three more chatbots studied cervical cancer,24,30,31 two on colorectal,32,45 one on prostate,25 one on lung,41 and one on head and neck.42

Chatbot Medium

Included chatbots were implemented through different media forms. Nine studies used text and smartphone-based chatbots.33,37–39,41,43,44,47,48 Ten were web-based,24,25,34,35,38,40,42,43,45,46 Three chatbots were voice or speech-based.30–32

Chatbot Objectives

Eleven chatbots were centered on cancer screening, prevention, and risk stratification.24,25,30,31,35,36,38,39,45–47 These chatbots queried patients’ demographic, clinical, and family histories to inform the decision-making process in cancer screening and prevention.24 To narrow the disparity in cervical cancer care among Hispanic women, Wu et al designed a chatbot acting as a virtual educator to close the knowledge gap regarding cervical cancer screening between Hispanic women from rural US and the general US population.24 Owens et al focused on improving a patient’s cancer knowledge, technology use, and cancer screening decision-making through the screening process.25 Sato et al used a chatbot to screen for family history of breast and ovarian cancer and determine if patients met the National Comprehensive Cancer Network BRCA1/2 testing criteria.36 Additionally, five studies focused on genetic or vaccine counseling to help with cancer prevention.30,31,39,46,47 Two of these studies asked patient for their opinions and beliefs on HPV vaccine to improve vaccine uptake for cervical cancer prevention.30,31 Chavez-Yenter et al used a chatbot to educate patients on cancer risk genetic testing and Kaphingst et al used a chatbot for education on testing for inherited cancer syndromes.39,47 Siglen et al performed digital conversations with breast or ovarian cancer patients about genetic BRCA testing.46

Seven chatbots included in this review focused on cancer treatment, monitoring, and management.33,37,41–44,48 These chatbots answered common questions asked by breast and lung cancer patients about their treatments.41,43,44,48 Chatbots from these studies also addressed the concerns of breast cancer patients via designed texts,41 measured medication adherence rates,37,41 and gave out weekly questionnaires.37,42

In addition to treatment and management, two chatbots were designed to educate patients on technology use and oncologists on communication-skills.34,40 Bickmore et al provided a conversational search experience to help individuals with low health and computer literacy find and learn about cancer-related clinical trials.34 Instead of educating patients, Stuij et al used a chatbot to help oncologists learn communication-skills by providing individualized feedbacks.40 Finally, Mlakar et al focused on cancer survivorship. Their chatbot focused on lifestyle modifications, self-efficacy, and patient reported quality of life among cancer survivors.32

Evaluation of Chatbots

Acceptability

Sixteen of 21 articles studied the acceptability of their respective chatbots.25,30,33–46,48 Five studies are still awaiting published results to be posted or currently do not have results published online.24,31,32,43,47 Acceptability was high in most studies, with only one demonstrating low satisfaction ratings.41 For example, acceptability of chatbots was evidenced by positive user comments on how convenient the chatbot was to use, high usability scores and compliance rates.37 Chetlen et al even found that 33% of women strongly agreed and 54% of women agreed that a chatbot made it easier for them to understand their upcoming breast biopsy procedure.44 Siglen et al measured the fallback or error rates of the chatbot to determine its efficacy and satisfaction among patients.46 Through the first testing trial, the chatbot showed an expected high fallback rate of 43%, leaving a substantial fraction of wrong answers, but eventually ended with a fallback rate of less than 15% for its fourth and final iteration.46 Bibault et al suggested that chatbots led to higher patient satisfaction score in cancer counseling compared to a control physician.48 Patients in Stuij et al expressed a willingness to continue using a chatbot for cancer education.40 However, if some of the chatbots did not have satisfaction or usability assessments, acceptability was determined by the number of patients that completed the chatbot conversation or the length of time taken to complete chat. Three chatbots had completion rates of at least 67%,37,38,45 and two had low completion rates below 32%,35,39 with one averaging 10–14 min to complete the conversation with the chatbot.35

Performance

In addition to assessing user acceptability and satisfaction among chatbots, 12 studies assessed the effectiveness and usefulness of chatbots.30,34,37–42,44 Five articles discussed howchatbots significantly improved patient monitoring, symptom management, and medication adherence with frequent reminders.33,37,42,44,48 The majority of these studies found chatbots to be helpful with management of chemotherapy, radiation therapy, and other treatment-related symptoms. For instance, Bibault et al designed a chatbot to answer common questions asked by patients with breast cancer about their therapy management. These questions were related to breast cancer stages and causes, whether the cancer is under control, types, benefits, and side effects of treatments, and questions related to care outside of the hospital. 85% of patients found answers helpful compared to 82% with a physician.48 Chaix et al used a chatbot to address questions about breast cancer while also reinforcing medication adherence by providing prescription reminders throughout the conversations. This resulted in 88% of patients reporting that the chatbot provided them with support and helped them follow their treatment effectively.33 Piau et al described a chatbot that collects key patient data such as chemotherapy-related symptoms and adherence to medicine to optimize monitoring of older patients with cancer.37 The primary goal of the chatbot was to free up nurses’ time so that on phone calls, they could focus more on education and support rather than recording symptoms.37 Ma et al utilized a chatbot to aid self-management of symptoms such as pain, nausea, salivary duct inflammation, and xerostomia from radiation therapy in head and neck cancer patients, and 61% of patients reported that the chatbot helped with symptom self-management, reducing the need to call the care team.42 Chetlen et al used a chatbot to provide evidence-based answers to frequently asked questions about breast biopsy. They found that around 25% of women in the study strongly agreed, and 49% of women agreed that the chatbot improved their quality of life and care.44

Other studies defined effectiveness by how much the patient learned through genetic testing39 or improved search ability for clinical trials compared to a control conventional interface (non-AI).34 Stuij et al’s study found that users in a communication skills training program claimed texts between the chatbot were “easier to read than a book” and users liked the generation of reminders.40 However, users preferred a conventional e-learning platform that allowed them to learn skills more comfortably than the somewhat fragmented approach of a chatbot.40 In addition, two studies aimed to improve shared decision-making, one resulting in a statistically significant improvement in knowledge of prostate cancer and technology use,25 and the other influencing patient beliefs in the use of HPV vaccine for cervical cancer prevention.32 While most of these studies demonstrated efficacy as variably defined by the authors, Kataoka et al reported that many times, patients “did not get a proper answer” from its chatbot.41 Thus, the chatbot only had an average satisfaction rating of 54%, adherence was low, and no improvement was seen in knowledge of lung cancer symptom management.41

Discussion

With advances in artificial intelligence and machine learning technology, increasing efforts have been made to use chatbots to automate specific aspects of oncological care. This review provides a more contemporary, extensive evaluation of chatbots in oncological care. We found that chatbots have great acceptability and efficacy in automating and improving aspects of oncological care, mostly due to their ability to engage in personalized conversations and patient-centered communication. Chatbots have high future potential to increase the outcomes of all types of oncological care including cancer screening, prevention and risk stratification, treatment and symptom management, patient education, and survivorship. These improved outcomes include expansion of cancer-related information, treatment to caregivers and doctors, and better oncological care accessibility for minority groups. Given chatbots’ ability to save operating costs and replace many forms of communication throughout all phases of care, they have high marketability and potential for widespread implementation.

Overall, most chatbots included in this study were well-received by cancer patients. The high acceptability and satisfaction ratings shared by many included chatbot studies could be related to ever-improving AI technology, making responses by chatbots perceived as personal and caring.30,31,48 Some patients even perceived speaking with a chatbot an easier and more personal experience compared to healthcare providers. For example, patients from Chaix et al interacted with a chatbot named Vik, which used personalized text messages with combinations of questions and actions of contextual information to allow users access to information they would not have thought of and allowing conversations to be more flexible and natural.33 As further support for the success of personalized chatbots, 87% of breast biopsy patients from Stuij et al agreed or strongly agreed that the chatbot made it easier to understand their upcoming procedure, regardless of their perceived technology proficiency.44

Chatbots may also help effectively overcome communication challenges rooted in demographic disparities such as language barriers and low health literacy, increasing access to care for minority groups.30 Bickmore et al showed that 36% of low literacy participants were able to find a correct clinical trial using the chatbot compared to 0% using a conventional search interface34 Wu et al specifically targeted Hispanic women from rural agricultural communities and employed a chatbot to increase their knowledge related to cervical cancer and close the knowledge gap between Latina women and the general population.24 With cancer screening and genetic counseling, chatbots have a high potential to improve the efficiency of these processes by being able to access regions outside of a local hospital or town. Heald et al determined that the chatbot from their study allowed more patients to receive genetic counseling and screening services than would have been possible through individual, in-person appointments.45 The chatbot from this study was also able to provide accessible and timely care to patients from broader geographical regions. Therefore, with more people having access to screening appointments, diagnoses can be made earlier and can possibly decrease the risk of death.

Additionally, chatbots are able to improve care outcomes by allowing education related to cancer to be extended to and available to caregivers, families, and even oncologists. For instance, Kataoka et al aimed to educate lung cancer patients and their caregivers on symptom management, but chatbot satisfaction was low.40,41 The use of a standardized chatbot system can save time and effort of in-person oncologists when educating these additional family members. Stuij et al also used a chatbot to train healthcare professionals to more effectively communicate and educate patients; the chatbot did not interface with the patients.40 Oncologists found the chatbot conversations more convenient to read and engaging than a textbook and users liked generation of reminders and personalized support, helping with their communication skills training.40 Because chatbots designed for caretakers and healthcare professionals are limited, more research should be done to explore how chatbots may empower these groups to better care for patients with cancer.

From a system-level perspective, with cancer-attributed costs in the United States projected to increase by 30% from 2015 to 2030,49 rising expenditures caused by an aging and growing US population50 and increasing treatment costs only create more interest in the cost-saving capabilities of chatbots.24,39,44,48 This creates a significant market for chatbots in oncological care: with cancer being among the top 10 leading causes of death in the world51 and an extensive marathon process, patient communication is crucial in every phase of care given the limited amount of time doctors often have. Similar to how UberEats has evolved their customer service by changing to a live chat system, which starts with a chatbot response that filters out customer problems and redirects the customer to a human representative, the same counterparts can be used with cancer chatbots;52 by taking care of more basic tasks in educating patients about symptoms, screening for cancer, care coordination, and payments, specialized doctors can be directed to patients for more complex care. One specific way chatbots can be implemented to save operating costs is by automating tedious tasks such as collecting data about medication adherence and symptom management so nurses can devote more time to personalized training and support of patients.37 Piau et al found that one of the most valuable benefits patients received from using a conventional phone monitoring approach was moral support (44%), showing the importance of personalized treatment from nurses.37 By freeing up nurses’ time, chatbots, which are generally free or low cost and can be used at any time opposed to nurses, have the potential to save labor costs, which in 1999 accounted for 31.0% of healthcare expenditures in the United States.53 However, since the COVID-19 pandemic, median labor expenses in hospitals across the US have rose over 37%.54 With chatbots having the potential to save billions of dollars in the healthcare industry,9 they provide a promising avenue for commercialization.

Limitations of Chatbots

One factor that limits the utility of chatbots is that they may sometimes have difficulty understanding patients and may not be able to provide adequate responses to specific categories of questions at the beginning stages of use or during development. For example, in a study conducted in Japan, the mean satisfaction score was about 30% or more lower41 than other studies33,37,42,44,48 mostly because this was the first chatbot educating lung cancer patients compared to previous chatbots mainly dealing with breast cancer.33,37,42,44,48 Additionally, Siglen et al initially had difficulty with chatbot-patient communication and had a high error rate, but this percentage eventually decreased in half after the final iteration of the study.32 However, these inaccuracies were not too significant, because more popular chatbots for breast cancer had very little satisfaction or engagement issues.33,37,42,44,48 Although chatbots are currently improving with more advanced algorithms and expanded databases, their accuracies do not need to be perfect to accomplish basic communication tasks that complement current oncological care. Based on most of the chatbots in this review, they are not expected to replace doctors, but primarily to assist them and improve the overall efficiency of the care process, which should also be the expectation for the near future given the current state of chatbot technology.

Another limitation that chatbots pose is possibly being inequitable and further excluding marginalized populations. Because AI chatbots only learn based on the inputs given to them such as data and algorithms, hidden bias can creep into the chatbots’ performance, decreasing its accuracy and possibly being harmful to patients. For instance, if training data ignore certain target groups such as ones with different types of accents or slang, it will skew the ability for chatbots to understand user responses and may possibly recommend wrong treatments, which can be detrimental. In addition, Microsoft chatbot Tay was quickly taken down by tweeting racist comments in 2016 since it was trained on public Twitter conversations with human biases.55 However, while eliminating this unconscious bias is not straightforward, it can be mitigated is by having a representational set of users and data as well as developers being more aware of humans’ cognitive biases. Aside from AI, despite chatbots being used to expand treatment to minority groups, other underprivileged groups or patients with low tech literacy that may barely be able to manage emails can be left behind, possibly creating challenges for implementation across all types of patients.

This review also demonstrates that the majority of chatbots are text-based or web-based, with only three studies primarily using voice or speech-based platforms. While text- or web-based chatbots may be technologically easier to implement, patients may find typing on a small keyboard or smartphone challenging and time-consuming compared to voice- or speech-based platforms. More research using voice-based chatbots will reveal whether they yield increased usability and satisfaction rates. Furthermore, only three studies included chatbots, which had avatars or visual diagrams to assist the main chatbot interface.24,25,34 Including more realistic visual components to chatbots such as advanced, real-time animations or simulations of virtual clinical environments with relevant equipment can help patients fulfill their needs more efficiently. Additional possible limitations of the included text-based chatbots were high dropout rates and low utilization due to the need for application downloads and regular updates.56 Only one study from France assessed retention rates of users actively using the chatbot, which decreased by about 70% after 8 months.33 However, popular messaging apps such as Facebook Messenger, iMessage, Telegram, WeChat, or WhatsApp do not experience these types of dropout rates since they are commonly used in the general population.10 Thus, future research using chatbots embedded into these types of regularly used platforms can assess whether or not they increase retention rates.

Finally, regulatory and security issues will need to be addressed to fully realize the potential of chatbots in oncological care. While some patients report increased comfort in discussing sensitive matters with chatbots, others report concern about private and sensitive data being shared; Stuij et al found some patients felt vulnerable being recorded and hesitated to share sensitive information until they had additional conversations with the chatbot.40 Businesses and companies of these chatbots will need to find verifiable solutions and transparency to consumers to counteract fear and distrust. In terms of regulation, while the Food and Drug Administration does have a process to regulate AI-enabled products used in health care, only 0.1% of healthcare apps on the market in 2014 were FDA approved.57 This can be problematic for AI chatbot technologies because without human regulation to capture possible biases in training data, the patient can be led with false or missing information, which was the case at the Royal Society of Medicine, where a doctor regular tweeted complaints of Babylon’s health AI chatbot missing potentially significant red flag symptoms.58 In the future, more human intervention will be needed to manage and override suggestions from chatbots and more high-quality assurance regulations will need to be implemented, examining detailed processes on how chatbots make their decisions.

Strengths and Limitations of Review

This review implemented a comprehensive search through the PubMed search engine using a wide range of keywords, yielding a greater number of studies involving chatbots related to oncological care than other reviews to date.6,10,12 While PubMed is a well-established and widely used database for biomedical research, it primarily contains studies conducted in the United States and other high-income countries, which may not include all relevant studies published in non-English languages and other countries that were not indexed. This review is also limited by the quality of available studies, many of which included chatbots that were still in the pilot or feasibility stage, often at single-institutions, with small sample sizes, heterogeneity in acceptability and efficacy data, and no long-term followup.36,41,44,47 Given such limited study of chatbots used in oncological care, the field has enormous potential for improvement as chatbot technologies advance and are increasingly implemented and studied.

Conclusion

Studies evaluating chatbots are still rare in healthcare and especially oncology. However, recent years have shown a sharp rise in the number of these studies, with benefits for patients, caregivers, and oncologists. This review summarizes the extant literature to date, demonstrating that chatbots are highly acceptable to patients as well as effective in automating tasks related to cancer screening, prevention, and risk stratification, treatment and symptom management, and survivorship. By facilitating patient-centered communication, increasing access to care, reducing operating costs, and saving time for nurses and doctors, chatbots have great potential for future implementation and commercialization. However, because of technological complexity of AI technology, a great deal of user testing and iterative improvements are needed to optimize user satisfaction and acceptability before widespread implementation is possible. Therefore, over time, chatbots will need to have access to richer data sets to increase their knowledge of medical terms, symptoms, and treatments for potential widespread and more independent use.

Disclosure

QDT reports personal fees from Astellas, Bayer, and Janssen, outside the scope of the submitted work. QDT reports research funding from the American Cancer Society, the Defense Health Agency, and Pfizer Global Medical Grants. APC reports research funding from the American Cancer Society and Pfizer Global Medical Grants. LB reports personal fees from Delfina Inc outside the scope of the submitted work and research funding from the Office of Scholarly Engagement at Harvard Medical School. LOR reports research funding from J. William Fulbright Foreign Scholarship and Brazilian National Council for Scientific and Technological Development – CNPq, Research Productivity: 304747/2018-1 and 310135/2022-2. The authors report no other conflicts of interest in this work.

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52. All topics | restaurants – uber help [Internet]; 2022. Available from: https://help.uber.com/ubereats/restaurants. Accessed April 19, 2023.

53. Woolhandler S, Campbell T, Himmelstein DU. Costs of health care administration in the United States and Canada. N Engl J Med. 2003;349(8):768–775. PMID: 12930930. doi:10.1056/NEJMSA022033

54. Hospitals’ per patient labor spend increased 37% from 2019 to Q1 2022 [Internet]. Fierce Healthcare; 2022. Available from: https://www.fiercehealthcare.com/providers/hospitals-patient-labor-spend-increased-37-2019-q1-2022. Accessed April 19, 2023.

55. Zemčík T. Failure of chatbot tay was evil, ugliness and uselessness in its nature or do we judge it through cognitive shortcuts and biases? AI Soc. 2020;36(1):361–367. doi:10.1007/s00146-020-01053-4

56. Lee K, Kwon H, Lee B, et al. Effect of self-monitoring on long-term patient engagement with mobile health applications. PLoS One. 2018;13(7):e0201166. doi:10.1371/journal.pone.0201166

57. Cortez N, Cohen IG, Kesselheim AS. FDA regulation of mobile health technologies [Internet]. Social Science Research Network; 2014. Available from: https://papers.ssrn.com/sol3/papers.cfm?abstract_id=2512458. Accessed April 19, 2023.

58. Iacobucci G. Row over Babylon’s chatbot shows lack of regulation. BMJ. 2020;368:m815. PMID: 32156741. doi:10.1136/bmj.m815

OVER THE PAST 10 YEARS, GIBSON HAS BEEN RECOGNIZED FOR HIS LEADERSHIP, ENTREPRENEURSHIP AND COMMUNITY INVOLVEMENT.



He also gave free gel to people in need including health care workers and those diagnosed with COVID-19, all within the process of being evicted from his home with his family.

Gibson appeared on the 13th season of “Shark Tank,” striking the $600,000 deal for The Transformation Factory with comedian and actor Kevin Hart and businessman Mark Cuban.

In addition, he is a motivational speaker and has received many awards including the Martin Luther King, Jr. Leadership Award, Apple Innovation Award, Buick Engineering Award, Global Citizen Award, and the Trailblazer of the Year Award from Legacy South Florida.

Along the way he has lost more than 300 pounds and epitomizes a successful African American owner who has grown his company into a multimillion-dollar business.

For more information on PBSC’s graduation, visit palmbeachstate.edu/graduation.

Sunburn — The morning read of what’s hot in Florida politics — 5.5.23

Good Friday morning.

There are clear winners and losers in every Session, while others prove more elusive to pin down.

Once again, Florida Politics is assembling an (arguably) comprehensive look at who walked away from Sine Die 2023 victorious, who tanked and who landed somewhere between. Of course, lawmakers must pass one bill: Florida’s upcoming state budget.

Who are the winners (and losers) of the 2023 Session? We want to know!

Like last year, the 2023-2024 budget is stuffed with billions of dollars and weighs in at more than $115 billion. It will undoubtedly create a lot of winners, but with that much funny money at lawmakers’ disposal, a snub is nothing short of a loss.

That said, we are asking you — our loyal Sunburn readers — for your input.

From lawmakers, newsmakers, state workers and budget writers to lobbyists, advocates and staff (and maybe a reporter or two), which person, group, or issue earned a coveted spot on the list of “Winners and Losers for the 2023 Legislative Session?”

We’ll have the obvious ones covered, so don’t worry about grading the Governor, House Speaker, Senate President or other top officials. A few off-the-beaten-path choices are certainly welcome.

Send your suggestions to [email protected] for consideration

— SITUATIONAL AWARENESS —

Tweet, tweet:

@GovRonDeSantis: On this National Day of Prayer, we thank God for our freedoms and for the many blessings He’s bestowed on America and on the state of Florida.

@ChristinaPushaw: As @GovRonDeSantis said — if you’re demanding that I pretend a man is a woman, you are making me complicit in a lie. We don’t have to accept that. If taking pornography out of kids’ schools is fighting a “culture war,” then that is a war that needs to be fought.

@AGAshleyMoody: Grateful for @DannyBurgessFL and @TaylorYarkosky’s tireless efforts to defend victims of crime, especially the most vulnerable — our children. A bill that would protect these survivors in judicial proceedings from unnecessary depositions is heading to @GovRonDeSantis’desk!

@JaredEMoskowtiz: The FL bill to lower the age to 18 to buy a gun in Florida is dead! As I said from the beginning of Session. The Marjory Stoneman Douglas School safety bill that I helped pass 5 years ago remains intact.

@MaryEllenKlas: Senate votes to approve @FDOT_Secretary Jared Perdue 32-6 after @senpizzo chastises him for “being drawn into political theater” and repeatedly refusing to answer questions about @GovRonDeSantis migrant flights with “millions of dollars on private flights to Martha’s Vineyard.”

Tweet, tweet:

@AP_Sports: Seven-time Formula One champion Lewis Hamilton lashed out at anti-LGBTQ measures in Florida. “I’ll have the rainbow on my helmet,” Hamilton said ahead of F1’s race in Miami this weekend. “It’s no different to when we were in Saudi.”

— DAYS UNTIL —

Florida Chamber 2023 Leadership Conference on Safety, Health & Sustainability — 4; Special Election in House District 24 — 11; Florida TaxWatch’s Spring Meeting — 13; ‘Fast X’ premieres — 13; Martin Scorsese’s ‘Killers of the Flower Moon’ premieres at Cannes — 15; Florida Chamber 2023 Florida Prosperity & Economic Opportunity Solution Summit — 22; NBA Finals begin — 27; ‘Spider-Man: Across the Spider-Verse’ premieres — 27; ‘The Flash’ premieres — 42; DeSantis to headline Nevada PAC’s annual basque fry — 43; ‘Secret Invasion’ premieres on Disney+ — 47; Florida Chamber 2023 Florida Learners to Earners Workforce Solution Summit — 53; ‘Indiana Jones and the Dial of Destiny’ premieres — 56; ‘Mission Impossible: Dead Reckoning — Part One’ premieres — 70; Florida Chamber 37th Annual Environmental Permitting Summer School — 76; Christopher Nolan’s ‘Oppenheimer’ premieres — 81; ’Captain Marvel 2′ premieres — 88; Beyoncé’s ‘Renaissance’ tour in Tampa — 102; 2023 Florida Chamber Annual Meeting & Future of Florida Forum — 171; ‘Dune: Part Two’ premieres — 185; Ridley Scott’s ‘Napoleon’ premieres — 200; South Carolina Democratic Primary — 266; New Hampshire and Nevada Democratic Primaries — 280; Georgia Democratic Primary — 285; Michigan Democratic Primary — 297; ‘A Quiet Place: Day One’ premieres — 308; 2024 Oscars — 310; ‘Spider-Man: Across the Spider-Verse’ Part 2 premieres — 330; ‘Kingdom of the Planet of the Apes’ premieres — 385; Opening Ceremony of the 2024 Olympic Games — 448; ‘Thunderbolts’ premieres — 448; Georgia Tech to face Florida State in 2024 opener in Dublin — 481; ‘Blade’ reboot premieres — 494; ‘Deadpool 3’ premieres — 555; ‘Fantastic Four’ reboot premieres — 701; ‘Avengers: The Kang Dynasty’ premieres — 728; ‘Avengers: Secret Wars’ premieres — 917.

— TOP STORY —

Andrew Gillum not guilty of lying to FBI as jury deadlocks on other charges” via Jeff Burlew of the Tallahassee Democrat — After five days of behind-the-scenes drama and deliberations, jurors found former Tallahassee Mayor Gillum not guilty of lying to the FBI about a “Hamilton” ticket and other gifts he was accused of taking from undercover FBI agents in New York.

In a stunning defeat for the government, the jury deadlocked on the most serious charges against Gillum, Florida’s Democratic nominee for Governor in 2018 and his co-defendant, Sharon Lettman-Hicks, involving the misuse of campaign funds. The 12-person jury was unable to reach a consensus on one count of conspiracy and 17 counts of wire fraud against both defendants.

Andrew Gillum deals a blow to the government with a not-guilty verdict. Image via AP.

U.S. District Judge Allen Winsor declared a mistrial on the counts that ended with no verdict reached.

Assistant U.S. Attorney Gary Milligan II said the government will retry Gillum and Lettman-Hicks on the conspiracy and wire fraud charges. Outside the courthouse, defense attorneys urged the government to reconsider.

“I think about what it has felt like to, in my opinion, be hunted for seven years, to have people who you’ve known forever to doubt you, to read things about you that not only don’t resemble the truth but don’t resemble who you are,” Gillum said.

— DESANTISY LAND —

Donors to Ron DeSantis know he’s struggling. They still want him to be President in 2024” via Erin Mansfield and Zac Anderson of USA Today — As he made public appearances in the past month and a half to increase his national profile before officially declaring a presidential run, Gov. DeSantis came under fire for everything from calling the Ukraine war a territorial dispute to his battle with tourism magnate Disney. But even as he slips in the polls against former President Donald Trump, who has given him monikers like “DeSanctimonious,” the most recent numbers show DeSantis is sitting on more campaign cash for a potential presidential campaign than Trump, a signal that he can’t be counted out just yet.

Ron DeSantis is struggling, but donors still hold hope. Image via AP.

‘The season is what it is’: DeSantis still coy about 2024 plans” via A.G. Gancarski of Florida Politics — The Legislative Session is all but over, and decision time looms for DeSantis regarding 2024. In Panama City, reporters seemed to ask about “DeFuture.” And the response was DeFamiliar: “At the end of the day, these things will happen in relatively due course. I mean, you know, the season is what it is. I mean, there’s only so much time, but I think that so many people just didn’t understand that, you know, you win an election, and you need to do something with what you’ve done. And that should have been my focus and that’s what has been our focus. So, you’re just going to have to stay tuned to all this, OK? You’ll get there one way or another very soon.”

—“DeSantis to headline conservative Nevada PAC’s annual basque fry amid 2024 speculation” via Julia Johnson of Washington Examiner

DeSantis hasn’t fostered deep political relationships. Will it matter?” via Kirby Wilson of the Tampa Bay Times

Bob Iger rebuilt Disney. Fighting DeSantis could define his legacy.” via Taylor Telford of The Washington Post — After boomeranging back to Disney, Iger finds himself in a high-profile political battle with a leading Republican. It’s shaping up to be one of the defining challenges of Iger’s career, with consumers and corporate America closely watching to see whether one of the country’s most powerful companies will face down a threat to its power and free speech. In addition to overseeing Disney’s transformation into a modern media titan, Iger may end up being known “for putting DeSantis in his place,” says Michael Eisner, a former Disney CEO who worked with Iger for years. Although Disney has avoided wading into political issues in the past, Eisner said: “There are certain times you just have to stand up.”

Could Disney move out of Florida? No way, experts say.” via Hannah Sampson of The Washington Post — If Disney were to flee, Florida would lose a visitor magnet and major moneymaker: In 2019, the four theme parks drew nearly 60 million guests combined, according to an industry estimate. And the company said the resort contributed more than $780 million in state and local taxes for fiscal 2021. The vast complex sits on 47 square miles in Orange and Osceola counties, encompassing four theme parks, two water parks, 31 hotels with about 29,000 rooms, a 220-acre sports complex and an outdoor mall. Disney World employs about 75,000 workers. “Too big to move,” said Richard Foglesong, Professor Emeritus of political science at Rollins College in nearby Winter Park and author of “Married to the Mouse: Walt Disney World and Orlando.”

— LEGISLATIVE —

Christmas in July: Lawmakers stuff budget with gifts for DeSantis” via Peter Schorsch of Florida Politics — For DeSantis, the Florida Legislature is the gift that keeps on giving. Florida Politics previously reported on numerous statutory changes lawmakers have OK’d that would benefit DeSantis’ as-yet-unannounced presidential campaign, including a resign-to-run “clarification” and a Sunshine Law edit to exempt law enforcement records on travel and security from public disclosure. As another famous Ron would say, “But wait, there’s more.” The new budget more than doubles spending for “executive administration,” going from about $4 million in the current budget to $8.5 million in the fiscal year that begins July 1.

Florida bills that will alter the lives of transgender people await DeSantis’ signature” via Steve Contorno of CNN — Florida lawmakers have sent to the desk of DeSantis a slate of bills that will alter the lives of transgender people in Florida, including their access to health care and everyday amenities. DeSantis is expected to sign them. Lawmakers gave final passage to a bill that prohibits transgender children from receiving gender-affirming treatments, including prescriptions that block puberty hormones or sex-reassignment surgeries. Under the legislation, a court can intervene to temporarily remove a child from their home if they receive gender-affirming treatments or procedures. The bill treats such health care options, which are supported by the American Medical Association, the same as it would a case of child abuse.

Members of the LGBTQ community are bracing for some major changes. Image via AP.

Ban on sex reassignment surgeries, medications for minors heads to DeSantis” via Lydia Nusbaum of Florida’s Voice — The Florida Legislature passed a bill to ban sex reassignment surgeries and medications for minors. The House voted 83-28 and the Senate voted 26-13 Thursday, sending the bill to DeSantis for his signature. “This is not science. This is a cult that is focused on the abuse of children,” Bill sponsor Rep. Randy Fine said on the House floor. “Trans people are not evil. We get accused of that. They’re not evil. But you know what they are? They’re the victims of those who are, who prey on them and who prey [on] a mental condition to make money,” Fine said.

Lawmakers pass plan to shift funding from public school coffers to charter schools” via Anne Geggis of Florida Politics — A bill that would mean charter schools get a share of school districts’ tax money for capital costs won Senate approval and will next head to the Governor’s desk. The bill (HB 1259) that Sen. Travis Hutson carried forward after swapping out his bill (SB 1328) was approved 29-12, along party lines. “I believe the money should follow the student,” Hutson said as he closed on the bill. Democrats, however, maintain that it makes no sense to distribute capital funding on a per-pupil basis. They say the bill ignores how taxpayer-owned schools are used as hurricane shelters and are often older than the buildings charter schools often lease.

Push to lower Florida’s gun-buying age dead in Session’s final days” via Jacob Ogles of Florida Politics — Florida’s minimum gun-buying age will remain at 21 years old. A proposal to return the minimum age to 18 is officially dead this year. The House in April passed a bill (HB 1543) on a 69-36 vote that would have reduced the purchase age for rifles and long guns. But no such legislation was ever filed in the Senate, and the clock has run out on the bill finding another vehicle to reach the Senate floor. Gun safety advocates cheered the proposal’s demise. “The Florida bill to lower the age to 18 to buy a gun in Florida is dead! As I said from the beginning of Session,” tweeted U.S. Rep. Jared Moskowitz. “The Marjory Stoneman Douglas School safety bill that I helped pass five years ago remains intact.”

Legislature passes bill to retroactively cancel Disney agreement kneecapping new Board” via Gabrielle Russon of Florida Politics — The Legislature has passed a bill seeking to retroactively invalidate Disney’s agreement with its outgoing Board, a contract that is now at the center of an ongoing lawsuit. Senators approved SB 1604 with a 27-13 vote Thursday evening. The bill is seeking to roll back an agreement Disney made with its old Reedy Creek Improvement Board in the weeks before the state fired those members and DeSantis appointed his own Board members in their place. Sen. Joe Gruters, who previously voted against the bill requiring Disney World’s monorail to be subjected to state inspections, broke ranks again and voted against SB 1604.

Ready for upload: Legislature approves data privacy bill” via Jacob Ogles of Florida Politics — After three years of system crashes, the Legislature has passed a data privacy bill. The House approved a bill (SB 262) hours after the Senate approved amendments negotiated over the final days of Session. Rep. Fiona McFarland, a Sarasota Republican, cheered the legislative achievement she had worked on over three Sessions. “Florida took a huge step today toward restoring the balance between our rights to digital privacy and tech companies’ ability to target ads,” she said. She explained on the House floor that the final language would drop many data tracking restrictions that had tied negotiations in the past. “It retains the protection of children in online spaces,” McFarland said. Ultimately, the bill cleared the House on a 110-2 vote.

Fiona McFarland cheers a legislative achievement that took over three Sessions.

Sleep in: Legislature OK’s later school start times” via Jesse Scheckner of Florida Politics — A bill that would give middle and high school students a little more shut-eye during the school week cleared its final hurdle in the Legislature, but the change is still years away for most schools. Senators voted 38-2 for the measure (HB 733) which would require school districts to begin middle school hours no earlier than 8 a.m. and high school classes at 8:30 a.m. or later. The change won’t kick in until the 2026-27 school year.

Revamp of high school sports clears the Legislature” via Anne Geggis of Florida Politics — A measure that revamps high school sports has crossed the legislative finish line. By a 20-12 vote, with Democrats largely against it, the Senate approved legislation (HB 225) that will change up the Florida High School Athletic Association (FHSAA) Board and expand where students can choose to play sports. “This is a school sports choice bill,” said bill sponsor Sen. Jay Collins of Tampa, in a previous debate. “This is about the kids. Everyone’s focused on making sure they have the opportunity to play sports and take part in competition.”

Lawmakers pass bill to strengthen reporting requirements on African American history lessons” via Jesse Scheckner of Florida Politics — A bill that will require school districts across Florida to prove they are teaching African American history to state standards has now cleared both chambers of the Legislature with unanimous support. The measure (HB 551) by Miami Gardens Democratic Rep. Christopher Benjamin and Palm Bay Republican Fine would mandate districts to report yearly to the Florida Department of Education (FDOE) with proof the lessons are being taught, how, and in what ways the curriculum can be improved.


— MORE LEGISLATIVE —

This is big —Florida KidCare expansion clears Legislature with unanimous support” via Christine Jordan Sexton of Florida Politics — In an area of bipartisan accord during a bitterly divided Session, lawmakers agreed to expand eligibility for the state’s children’s health insurance program commonly called Florida KidCare. The passage of the bill comes after House Speaker Paul Renner put his clout behind the Medicaid expansion, saying in his opening-day remarks that families should not lose access to a subsidized children’s health insurance policy just because their incomes have risen. The Senate voted unanimously Thursday to pass the expansion contained in HB 121, sponsored by Rep. Robin Bartleman. The House had voted unanimously to pass the expansion earlier this Session.

Robin Bartleman brings a win for KidCare expansion.

Consumer-centric $1.3B tax cut package deal prepped for final vote in Senate” via Gray Rohrer of Florida Politics — House and Senate negotiators have agreed to a variety of tax cuts valued at an estimated $1.3 billion next year, with a heavy emphasis on eliminating sales taxes for select items but also a cut in the business rent tax, something favored by small businesses throughout the state. The Senate approved an amendment that reflects the deal between the chambers Thursday and will vote it out Friday, the scheduled final day of the Regular Session. The original Senate version of the bill didn’t include a reduction in the commercial rent tax paid by businesses, but the House preferred it, and is part of the final package.

Ophthalmologists win latest battle in long-running ‘Eyeball Wars’” via Christie Jordan Sexton of Florida Politics — The 2023 version of the “Eyeball Wars” is officially over, with ophthalmologists coming out on top. The House on Thursday voted 78-34 to pass SB 230, a top priority for Senate President Kathleen Passidomo. The bill essentially bans anyone but medical doctors and osteopathic physicians from using the word “physician” in their advertisements and daily interactions with patients. Dentists, podiatrists and chiropractors, whose underlying governing statute describes them as physicians, will continue to be allowed to call themselves physicians.

Legislature agrees to license Black cannabis farmers, extend telehealth prescription renewals” via Jacob Ogles of Florida Politics — The Legislature has agreed to extend renewal of marijuana certificates over telehealth. Legislation passed by the House and Senate also authorizes more licenses for almost a dozen Black farmers to enter the cannabis industry. “This has been a long time coming,” said Sen. Darryl Rouson. “The Black farmers were already victimized, and this Legislature in 2017 started to make that situation right.” Passage early this morning seemed shaky, with some House Representatives upset the inclusion of Black farmers wasn’t vetted through House Committees. But no one spoke against the bill on the House floor. Rather, the House passed the bill (HB 387) in a 105-8 vote.

Legislature approves ban on under-21 sales of kratom” via Jesse Scheckner of Florida Politics — After bouncing back and forth between the Senate and House this week, a years-in-the-making measure that would ban the sale of products made from a consumable plant called kratom to people under 21 has finally passed. Sen. Joe Gruters, the only local government in Florida with a kratom ban, accepted a weaker version of legislation he and Rep. Alex Andrade carried this Session. Both bills are named the “Kratom Consumer Protection Act.” Gruters’ bill (SB 136) was far truer to that title and included detailed processing, reporting and labeling requirements.

Legislature gives surgeons relief from pending Brazilian butt lift rules” via Christine Jordan Sexton of Florida Politics — After getting spanked in court, Florida surgeons who perform Brazilian butt lifts got relief from the Florida Legislature. Passed Thursday, HB 1471 puts in statute the standards of care that surgeons must follow when performing the popular procedure, in which a surgeon augments the size and shape of the buttocks by injecting excess fat that has been removed from the patient via liposuction. The bill should negate the need for the Board of Medicine and Board of Osteopathic Medicine to move ahead with proposed rules that would limit to five the number of Brazilian butt lifts a surgeon may perform in a calendar day. Unlike the proposed rules, the bill does not limit the number of procedures performed daily.

In economic development switch, jobs agency could get name change” via Gray Rohrer of Florida Politics — After a 30-year hiatus, the Department of Commerce could be back. Lawmakers passed HB 5, which overhauls Florida’s economic development programs and renames the Department of Economic Opportunity (DEO) as the Department of Commerce. The change is being made for clarity. “If somebody came in off the street and asked you what DEO is — it’s confusing. Department of Commerce — that’s sort of self-explanatory,” said Sen. Ed Hooper, a Clearwater Republican who chairs the Senate Tourism, Transportation and Economic Development Appropriations Committee, during budget negotiations last week. His House counterpart, Rep. Alex Andrade agreed.

Ed Hooper seeks to get some clarity in economic development.

Lovers of historic Florida buildings can relax. Bill that threatened them is dead” via Mary Ellen Klas of the Miami Herald — After warnings that a bill to end local control of historic preservation could lead to the bulldozing of buildings in iconic communities like Miami Beach, the House sponsor of the measure has abandoned the legislation but vowed to bring it back next year. Rep. Spencer Roach said he filed HB 1317 “to defend private property rights, which are under constant attack by local governments.” The measure quietly moved through Committees, receiving bipartisan support but after preservationists sounded the alarm across the state last week, Roach admitted it is dead for the Session, which ends Friday.


— EVEN MORE LEGISLATIVE —

Central Florida secures millions for roadway expansion, public safety” via Jacob Ogles of Florida Politics — Orlando area lawmakers from both sides of the aisle celebrated budget wins. From cultural grants to public safety facilities, Central Florida scored millions. “The budget reflects the priorities of the legislators,” said Sen. Geraldine Thompson, Chair of the Orange County Legislative Delegation. “I am pleased to see that the needs of my district were prioritized.” The budget includes nearly $18.4 million for the widening of Old Kings Road and West Orange Trail. There is another $2 million allotted for the Orlo Vista Integrated Water Resources Project.

Geraldine Thompson celebrates legislative wins for Orange County.

State budget includes $1M for Clearwater ferry service” via Peter Schorsch of Florida Politics — The Legislature has included $1 million for ferry service connecting downtown Clearwater and Dunedin to Clearwater Beach, meaning it is now up to DeSantis whether to leave the funding intact. Lawmakers signed off on the $117 billion budget Tuesday. It includes a funding request from Sen. Nick DiCeglie, whose district includes Clearwater Beach, seeking $1 million to replace outdated vessels, help fund dock renovations and provide an annual subsidy to the existing ferry provider. Clearwater, in partnership with the city of Dunedin, has been operating a pilot program since 2015, using water ferries to transport residents and visitors from mainland Clearwater and Dunedin to Clearwater Beach.


— MORE FROM CAPITOL —

Institute for the Building Envelope praises Senate passage of bill to protect Florida homes against natural disasters” via the Institute for the Building Envelope — The Institute for the Building Envelope (IBE) released the following statement today after the Florida State Senate passed HB 799. The bill requires insurance companies to provide premium reductions for homes with wind uplift prevention solutions. The House passed the bill Thursday. “It is National Hurricane Preparedness Week, making it a great time for the Florida Legislature to incentivize homeowners to improve their homes’ resiliency,” said IBE Board member Doug Brady. “High winds during hurricanes and other natural disasters can have devastating damage. Wind uplift prevention is a key way to prevent losing the roof of your house during high winds. I urge the House to quickly pass the updated bill to help protect Florida homes against natural disasters.”

U.S. education secretary highlights Miami mentor program, slams Florida education bills” via Sommer Brugal of the Miami Herald — Education Secretary Miguel Cardona said Thursday that the slew of education bills coming from this year’s Legislative Session in Florida is the “opposite of what we need for our children.” “There are several states where the state legislation is really attacking public schools, limiting access to students, limiting access to curriculum materials, and even making students feel unwelcome,” Cardona told reporters in Miami after questions were raised about the push from Florida’s GOP lawmakers to curtail what can or can’t be said or taught in public schools.

Miguel Cardona blasts education bills coming out of Session. Image via AP.

AFP-FL cheers downfall of Enterprise Florida — Americans for Prosperity-Florida is jumping for joy after lawmakers approved a bill (HB 5) that would kill Enterprise Florida, a public-private economic development agency that has long been in AFP’s crosshairs. “We commend the Florida legislature for eliminating Enterprise Florida, an ineffective program that did more for existing corporations than for small businesses and job creation,” said AFP-FL State Director Skylar Zander. “We thank the Legislature for this legislation, and we particularly appreciate House Speaker Renner for his leadership and Rep. Tiffany Esposito for shepherding this important bill to passage. We look forward to Gov. DeSantis swiftly signing this important legislation into law.”

Jerry Carter joins crowded field to succeed Sam Killebrew in HD 48” via Peter Schorsch of Florida Politics — Carter, a small-business owner and self-proclaimed family man, is running for the House District 48 seat to replace outgoing Rep. Sam Killebrew. Killebrew is not seeking re-election due to term limits. The seat is up for election next year. Carter said he is running to bring conservative leadership to the eastern Polk County district. “I grew up in Winter Haven, built my business here, and raised my family in East Polk County,” Carter said. “There’s a lot that’s going right in the Sunshine State, and I’m running to build on that conservative legacy.”

New and renewed lobbying registrations:

Brian Ballard, Bradley Burleson, Jordan Elsbury, Adrian Lukis, Ballard Partners: Jacksonville Transportation Authority

Allison Liby-Schoonover, Metz Husband & Daughton: National Association of Social Workers Florida Chapter

—LEG. SKED —

— The Senate holds a floor Session: 10 a.m., Senate Chambers.

— The House holds a floor Session: 10 a.m., House Chambers.

— The Legislature adjourns Sine Die: TBD.

Advertisement— STATEWIDE —

Hollywood Studios say they offered writers a $97 million raise” via Thomas Buckley of Bloomberg — The Alliance of Motion Picture & Television Producers, which represents Hollywood studios in contract talks with striking writers, said it offered wage increases of close to $97 million. That’s more than double the $41 million the writers claim they are being offered, the studios said in a statement Thursday. The Writers Guild of America, which represents some 11,500 screenwriters nationally, went on strike Tuesday, knocking late-night talk shows off the air and threatening the production of hundreds of TV programs and films, including ones for the upcoming fall season. Their talks broke down on Monday after six weeks of negotiations.

The writer’s strike makes headway. Image via AP.

— 2024 —

Donald Trump’s dig at DeSantis over Disney wasn’t a random attack” via “DeSanctus is being absolutely destroyed by Disney. His original PR plan fizzled, so now he’s going back with a new one in order to save face,” Trump wrote. But the Truth Social post wasn’t one of Trump’s reflexive, stream-of-consciousness remarks — in fact, the campaign had been prepping its Disney attack for weeks before Trump’s post, according to two sources close to the former President. Nor was it a one-off moment: As the DeSantis-Disney war continues to ramp up and move to court, it’s expected to be a recurring focus as part of a broader plan to undermine DeSantis’ strengths before an expected run.

DeSantis has a big problem with women voters, new poll shows” via Nick Mordowanec of Newsweek — DeSantis is underwater among national female voters on a variety of issues championed by conservatives as part of the so-called culture wars. DeSantis has been rumored to join the Republican presidential fray this month following months of skepticism of whether he would challenge Trump, who has ratcheted up his attacks against the popular Governor in recent weeks. Trump actually did better among female voters in 2020 than he did in 2016, by a five-point margin, but he still trailed Joe Biden by 11 percentage points. A majority of women have preferred Democratic candidates in presidential candidates dating back to 1996.

Ron DeSantis is struggling with women voters. Image via AP.

Joe Biden’s plan to win back Latino voters is built off his 2020 mistakes” via Christian Paz — One of the biggest challenges that Biden and his campaign will face as they embark on his fourth presidential campaign has been obvious for years: rebuilding support from Latino voters. Republican gains in Latino communities have been a major political story, growing insecurity for Democratic politicians and donors, and a big liability for the Biden administration. In 2020, Trump did 8 percentage points better with Latino voters than he did in 2016, winning nearly 40% of Latino voters nationally. Republicans retained most of this Latino support in the 2022 Midterms, holding about 40 percent of their national popular vote.

‘It’s a hard sell’: Gen-Z activists warn Biden over frustration among young voters” via Gregory Krieg and Eva McKend of CNN — Young voters played a critical role in delivering Biden to the White House in 2020. But as his re-election campaign kicks off, leading activists are uneasy about vouching for the President and concerned the administration could squander years of momentum The relationship between the White House and young organizers is at a crossroads. The President and congressional Democrats have delivered on many notable promises but fallen short on others — a frustrating reality that has contributed to Biden’s plunging approval ratings with 18- to 29-year-olds.

Georgia’s 2024 Presidential Primary date set for March 12” via Greg Bluestein and Mark Niesse of The Atlanta Journal-Constitution — Georgia’s top election official scheduled the state’s Presidential Primary for a date in mid-March, dashing the hopes of state and national Democrats who wanted Georgia to be one of the first states to vote on the 2024 nominating calendar. Republican Secretary of State Brad Raffensperger announced his decision Thursday to hold the Presidential Primary on March 12, a date he said will put Georgia “at the center of the national focus.” “Georgia is the bellwether state. If you can win Georgia, you will win nationally,” Raffensperger said during a news conference at the state Capitol.

— D. C. MATTERS —

Scrambling to avoid default, White House weighs debt-limit fallback options” via Andrew Duehren and Annie Linskey of The Wall Street Journal — The Biden administration and Capitol Hill leaders are scrambling to avoid a first-ever government default that could arrive as soon as June 1, taking potential alternative strategies more seriously after months of deadlock over raising the country’s borrowing limit. Publicly, both Republicans and Democrats are still sticking to their demands as the clock ticks. GOP lawmakers are seeking to force cuts to federal spending in exchange for supporting raising the debt limit, while Democrats continue to call for a debt-limit increase without any other policy conditions.

Joe Biden and Congress struggle to avoid the first-ever government default. Image via AP.

Recession fears abound, but the Fed Chair bets this time is different” via Jeanna Smialek of The New York Times — The Federal Reserve’s push to slow the economy and bring inflation under control is often compared to an airplane descent, one that could end in a soft landing, a bumpy one or an outright crash. Jerome Powell, the Fed Chair, is betting on something more akin to the Miracle on the Hudson: a touchdown that is gentle, all things considered, and unlike anything the nation has seen before. The Fed has raised rates sharply over the past year, pushing them just above 40% on Wednesday, in a bid to cool the economy to bring inflation under control.

Justice Clarence Thomas’ friend defends failure to disclose tuition payments by Harlan Crow” via Charlie Savage of The New York Times — A Republican donor from Texas paid for two years of private-school tuition for Justice Thomas’ great-nephew, a gift that the justice did not disclose, a friend of the justice acknowledged in a statement on Thursday. The acknowledgment added detail to a report on Thursday by ProPublica, which last month documented how Justice Thomas had received gifts of luxury travel from the billionaire donor, Crow. The revelations, which also include the sale of the home of Justice Thomas’s mother to Crow, have raised questions over the justice’s ethical practices.

Top U.S. spy warns that China would seek to exploit a debt default” via Peter Martin of Bloomberg — Director of National Intelligence Avril Haines warned that China and Russia would probably seek to exploit a U.S. government default on its debt. It is “almost a certainty” that both countries would use such an event for propaganda purposes through “information operations,” using it as evidence that the U.S. political system is dysfunctional, Haines told the Senate Armed Services Committee on Thursday. Haines said the intelligence community didn’t have information to provide an independent assessment, but she said that a default would create “global uncertainty” about the value of the dollar, U.S. leadership and American institutions.

GOP Senator harms national security by stalling military promotions, ex-Defense secretaries say” via Azi Paybarah of The Washington Post — A bipartisan group of former defense secretaries, including two who served in Trump’s administration, say that military readiness and U.S. national security are being harmed by one Senator’s delay of the quick approval of nearly 200 military promotions because of his objection to the department’s abortion policy. That delay, which Sen. Tommy Tuberville began in March, “risks turning military officers into political pawns, holding them responsible for a policy decision made by their civilian leader,” the former defense secretaries wrote in a letter to Senate leaders Thursday.

Marco Rubio accuses NIH of pushing Biden’s ‘woke rhetoric’ on taxpayer-funded scientific research” via Emma Colton of Fox News — Rubio is calling out the NIH for “prioritizing” woke initiatives, such as promoting diversity, equity and inclusion initiatives and gender surgeries, demanding answers on how funds at the U.S.’s primary health research agency are allocated. “Instead of allocating critical funding toward important research efforts like Cancer Moonshot or the BRAIN Initiative, the NIH is using its $47.5 billion budget to fund initiatives and put forward messaging that caters to President Biden’s progressive base. These actions call into question the institutional integrity of the agency,” Rubio wrote in a letter to NIH acting Director Lawrence Tabak on Thursday.

Top SBA official oversaw PPP, then did work for one of its worst offenders” via Ben Wieder of the Miami Herald — As the chief of staff at the U.S. Small Business Administration, William Manger oversaw the agency’s implementation of the $800 billion Paycheck Protection Program. The signature small business federal relief program introduced early in the COVID-19 pandemic offered loans up to $10 million that was forgivable if used for approved expenses such as payroll. The money for the program came from the federal government, but the SBA relied on lenders, including thousands that had never previously worked with the agency, to vet applicants and help get money as quickly as possible into the bank accounts of struggling small businesses. Lenders were paid a commission for their work, on a sliding scale based on the size of the loan.

Four Proud Boys convicted of sedition in Key Jan. 6 case” via Alan Feuer and Zach Montague of The New York Times — Four members of the Proud Boys, including their former leader Enrique Tarrio, was convicted on Thursday of seditious conspiracy for plotting to keep Trump in power after his election defeat by leading a violent mob in attacking the Capitol on Jan. 6, 2021. The fifth defendant in the case, Dominic Pezzola, was found not guilty on the sedition charges, although he was convicted of other serious felonies. The verdicts, coming after seven days of deliberations in the U.S. District Court in Washington, were a major blow against one of the country’s most notorious far-right groups and another milestone in the Justice Department’s vast investigation of the Capitol attack.

— LOCAL: S. FL —

Does firebrand Randy Fine want to lead FAU? He won’t say. Others worry he’s not a good fit.” via Stephany Matat of The Palm Beach Post — In a move that could result in conservative leadership at another state public university, a partisan Republican state lawmaker may join those vying to be the next president of Florida Atlantic University. Fine has been approached by DeSantis’ office about the vacancy. Fine, who previously had announced plans to run for the Florida Senate next year, said he would not comment on the FAU post. In a statement, an FAU representative said the university has an established process for choosing its next president, and that will include Fine if the lawmaker chooses to become a candidate. But the word that his name has entered the conversation alone has made some in the university’s community queasy.

‘Family, community and equality’: Joe Magazine launches bid for Miami City Commission” via Jesse Scheckner of Florida Politics — Miami Beach resident and Planning Board member Magazine is running for the City Commission. A third-generation resident with a nearly 20-year career in finance, Magazine is running for the Group 6 seat on the Miami Beach Commission. The current Commissioner in Group 6, David Richardson, filed Monday to run for Miami-Dade County Tax Collector. Magazine said he wants to boost transparency and resident participation in government. “I am running with integrity, service and love for my community because I want my daughter and all residents to enjoy the safety, prosperity and freedoms we all deserve,” he said in a statement.

Joe Magazine is seeking a seat on the Miami City Commission. Image via Instagram.

Florida GOP politics turn top Broward school job into one with flashing ‘caution’ sign” via With DeSantis’ heavy-handed power grabs on local School Boards and the punitive political climate in Florida, especially in education, anyone with the slightest common sense might think twice about raising a hand for the Broward County School superintendent’s job. Just ask the hapless consultants trying to find top-notch candidates for the post. Broward is the sixth-largest school district in the country. This should be a plum position, with people falling all over themselves to apply. But the consultants said that’s not the case.

Flood insurance costs soar in South Florida. New rates to double, even triple for many” via Nicolas Rivero of the Miami Herald — Brace for a few years of flood insurance rate hikes, South Florida. And they’re going to be steep — doubling, even tripling for thousands of homeowners. FEMA has changed the way it calculates flood insurance prices. Instead of relying on old flood zone maps covering broad areas, it’s now basing premium prices on a wider range of factors, like an individual property’s distance from the ocean, rainfall levels and the cost to rebuild a home. Last month, for the first time, FEMA shared estimates for what that will mean for the average flood insurance premium by ZIP code. For the worst-hit ZIP code in South Florida — 33469, a stretch of coastal Palm Beach County that covers parts of Jupiter and Tequesta — that will mean a 342% premium increase, on average.

Will future of the Deauville site go back to voters? A Florida bill may not allow it” via Aaron Liebowitz — After Miami Beach voters rejected a proposal in November by billionaire developer and Miami Dolphins owner Stephen Ross to exceed building-size regulations for a condo and hotel project at the former Deauville Beach Resort site, Ross began wondering if the city could hold another referendum on the matter this year. He raised the idea last month at a meeting with Miami Beach Mayor Dan Gelber, who directed city staff to ask Miami-Dade County’s elections department if and when they could hold a Special Election. The department said it could accommodate a mail-only election in July. “He and his team wanted to know what the possibilities might be,” Gelber said of Ross. “I’m hoping they’re thinking about it, because Lord knows an empty lot is a drain on that community economically.”

Miami should redraw Commission districts over racial redistricting plan, magistrate says” via Douglas Hanks and Joey Flechas of the Miami Herald — The city of Miami’s political battle lines could be redrawn after a federal judge sided with advocates who accused the city of drawing racial gerrymandered district boundaries. In a 100-page report, U.S. Magistrate Judge Lauren Louis recommended that the federal court block the city from using a map approved by City Commissioners in 2022 and force Miami to quickly draw new district boundaries for the November elections, a process that could drastically change the city’s political landscape. At the time, the Board included three Hispanic members, one Black member and one non-Hispanic White member.

‘They are all lying.’ Days as witness show why Joe Carollo is Miami’s most mercurial politico” via Charles Rabin of the Miami Herald — After three days of testimony this week in federal court, Miami Commissioner Carollo has branded almost a dozen witnesses against him as liars, including the attorney asking him questions. He accused one businessman suing him of election fraud. He said he’s convinced wealthy Venezuelans want to buy up Little Havana. And he began to tell a story of meeting a Cuban Jew who told him of Iranians infiltrating a mosque in Cuba with nefarious aims somewhere in Latin America before the judge cut him off. His marathon turn as a star witness has simply been Joe being Joe: outspoken, brusque, combative, meandering, conspiracy-driven and sometimes paranoid — one of the longest-running characters in the soap opera of Miami politics.

Witnesses show why Joe Carollo is Miami’s most mercurial politico. Image via Facebook.

Fort Lauderdale Mayor wants to hand out millions to flood victims. Commission says no way.” via Susannah Bryan of the South Florida Sun-Sentinel — Flood victims with badly damaged homes would have gotten up to $5,000 each, compliments of Fort Lauderdale, under a plan pitched by Mayor Dean Trantalis. “There are limits to what FEMA will cover,” Trantalis said during a news conference last week. “So, the city of Fort Lauderdale needs to pony up.” But for now, it looks like FEMA is your best bet. City Commissioners nixed the Mayor’s idea during a public meeting Tuesday, citing bureaucratic roadblocks and the high cost of paying out millions to flood victims.

DOH in Martin County issues toxic algae health alert for Lake Okeechobee, St. Lucie Canal” via Ed Killer of Treasure Coast Newspapers — The public should avoid contact with toxic algae near the east shore of Lake Okeechobee at the recreation area at Port Mayaca, according to a state health alert. The cyanobacteria, more commonly called “blue-green algae,” contained the toxin microcystin measuring 2.8 parts per billion in water samples taken May 1 on the lake side of the S-308 dam floodgate. When open, the gate allows lake water to enter the C-44, also called the St. Lucie Canal, in Martin County, 10 miles west of Indiantown. At 8 parts per billion, the toxin makes the water too hazardous to touch, ingest or inhale for people, pets and wildlife, according to the Environmental Protection Agency.

Will future of the Deauville site go back to voters? A Florida bill may not allow it” via Aaron Leibowitz of the Miami Herald — After Miami Beach voters rejected a proposal in November by billionaire developer and Miami Dolphins owner Stephen Ross to exceed building-size regulations for a condo and hotel project at the former Deauville Beach Resort site, Ross began wondering if the city could hold another referendum on the matter this year. He raised the idea last month at a meeting with Gelber, who directed city staff to ask Miami-Dade County’s elections department if and when they could hold a Special Election. The department said it could accommodate a mail-only election in July. “He and his team wanted to know what the possibilities might be,” Gelber said of Ross.

U.S. Education Secretary highlights Miami mentor program, slams Florida education bills” via Sommer Brugal of the Miami Herald — Education Secretary Miguel Cardona said the slew of education bills coming from this year’s Legislative Session in Florida is the “opposite of what we need for our children.” “There are several states where the state legislation is really attacking public schools, limiting access to students, limiting access to curriculum materials and even making students feel unwelcome,” Cardona told reporters in Miami after questions were raised about the push from Florida’s GOP lawmakers to curtail what can or can’t be said or taught in public schools. “You want to talk about fixing the teacher shortage? Let’s make sure our educators, parents and students feel welcomed,” he said.

He accused a government attorney of lying. Then a cop hand-delivered a lawsuit threat” via Tess Riski of the Miami Herald — The top government attorney of a South Miami-Dade suburb threatened this week to sue a political activist for accusing him on Twitter of lying — using official Palmetto Bay letterhead and a police officer to deliver the message. Palmetto Bay resident Mark Merwitzer, 23, arrived at Village Hall prepared to comment on the village’s controversial decision to kill a group of Muscovy ducks in a local park. Merwitzer took a seat before the meeting began, he said, and shortly thereafter a police officer tapped him on the shoulder, escorted him out of the chambers and asked to see his ID before handing him a letter. It was written by Village Attorney John Dellagloria on Palmetto Bay letterhead.

Mike Grieco announces $400K raised, 1,000 petition signatures for Miami Beach Mayor” via Jesse Scheckner of Florida Politics — Former Rep. Grieco added $50,000 more in April toward his bid for Miami Beach Mayor, according to his campaign, which says he also collected 1,000 petition signatures supporting his candidacy. Greico’s reported fundraising haul would bring his war chest total to more than $400,000 between his campaign account and political committee in just three months. Official figures are due Wednesday. “Miami Beach voters deserve a Mayor with experience who will get things done for our residents,” he said in a statement.

— LOCAL: C. FL —

Melbourne Mayor hired private eye to follow Brevard political consultant, state report shows” via Eric Rogers of Florida Today — Melbourne Mayor Paul Alfrey hired a private investigator to snoop on a Brevard County political consultant in late 2021, documents related to a state ethics investigation into Fine reveal. The incident also roped in Brevard School Board member Jennifer Jenkins, who filed the complaint against Fine that prompted the Florida Commission on Ethics investigation. Alfrey told state investigators he had hired a Melbourne private investigator to follow and surveil Brevard political consultant Robert Burns at his Viera home in September 2021, according to an investigation report. The private eye took a photo of Jenkins leaving Burns’ home the afternoon of Sep. 17 that later became fodder for attacks from Fine and an anonymous website targeting Jenkins and Burns.

An investigation into Randy Fine reveals some troubling news about Paul Alfrey. Image via Facebook.

Businessman Randy Dye joins two others in a run for Volusia County Council Chair” via Mark Harper of The Daytona Beach News-Journal — There’s still more than a year before qualifying in the 2024 Primary Election, but a third candidate for Volusia County Chair, the top elected post in county government, has emerged. A prominent businessman and community leader, Dye says he’s running for the job. He’s hoping to knock off incumbent Jeff Brower, who said earlier this week he intends to seek re-election. The third candidate who just recently announced is two-term Port Orange Mayor Don Burnette. This is Dye’s first run for political office. “I don’t know that I consider this politics,” Dye said. “I would tell you this is more of an extension of my community service.”

Republican State Committee member files to run for Brevard County Commission” via Tyler Vazquez of Florida Today — Republican State Committee member Kim Adkinson has filed to run for County Commission, hoping to represent Brevard County District 3 on the dais next fall. She and West Melbourne Council member John Dittmore are currently the only two names in the race, setting the stage for a Republican Primary that would determine the ultimate winner of the election. Adkinson is a Melbourne Beach Republican who has previously held various roles in Brevard County’s civic life, including as Republican Chair of District 3, member of the Melbourne Beach Code Enforcement Board, and member of the Melbourne Regional Chamber of Commerce. District 3 is currently represented by Commissioner John Tobia, who is unable to run again next year due to term limits.

Facing termination, Apopka City Attorney resigns: ‘I’ll save you the time’” via Stephen Hudak of the Orlando Sentinel — Apopka City Attorney Michael Rodriguez, squabbling with the City Council over whether they had the authority to fire him, tendered his resignation, telling Commissioners, “I can save you some money.” His surprise announcement was greeted with a smattering of applause from the audience. “At this point, I have serious concerns about the directions the Council is taking and the means by which certain things have just been communicated,” Rodriguez said near the end of the Board’s meeting. “I ultimately fear that I can no longer ethically represent this Council. I fear that this Council could be on the verge of conducting ‘ultra vires’ actions, and I cannot ethically remain as its City Attorney.”

Daytona Beach’s Deputy City Attorney is heir apparent to retiring City Attorney” via Eileen Zaffiro-Kean of The Daytona Beach News-Journal — Barring an unexpected turn of events, it appears Deputy City Attorney Ben Gross will become Daytona Beach’s next City Attorney in a little over a month. Gross signed an employment agreement with the city on April 26, and City Commissioners are expected to approve the contract at their May 17 meeting. They had been slated to vote on the five-page agreement at their meeting Wednesday night, but City Manager Deric Feacher said he wanted to delay that decision because the City Commissioner who helped develop the contract was unable to attend this week’s meeting.

Orange Zoning Board rejects proposed ‘puppy mega-mill’” via Stephen Hudak of the Orlando Sentinel — Animal welfare advocates, most wearing red, erupted in applause Wednesday when an Orange County Advisory Board voted to deny a zoning exception for a dog breeder to build what critics derided as a “puppy mega-mill.” Juan David Valencia Santa, who sought permission to build a 4,800-square-foot commercial kennel on four acres in rural east Orange, said afterward that he was uncertain whether he would appeal the Zoning Board’s decision. “If everyone’s against it, we can’t break the wall,” he said.

Former Orange Commissioner, state legislator Fred Brummer dies” via Stephen Hudak of the Orlando Sentinel — Former Orange County Commissioner and eight-term state legislator Brummer, a political figure who cared little about what people thought of him, died after a brief illness. He was 77. His death was reported on Facebook by Orange County Commissioner Christine Moore, who previously served as Brummer’s Campaign Manager and who now holds the District 2 seat Brummer filled from 2006 to 2014. Moore said Brummer “was like a dad to me,” crediting him with encouraging her to run for office. “He always told me that I could be a Commissioner and appointed me to Boards to build up my skills and resume,” Moore said of her fellow Republican. “I am truly grateful for his large impact in my life.”

RIP: Fred Brummer was a political figure who cared little about what people thought of him. Image via Facebook.

SpaceX launches more Starlink internet satellites from Cape Canaveral” via Emre Kelly of Florida Today — A SpaceX Falcon 9 rocket tore through the early morning sky Thursday, taking more Starlink internet satellites to orbit from Cape Canaveral Space Force Station. At 3:31 a.m. EDT, the rocket’s nine Merlin main engines roared to life with some 1.7 million pounds of thrust, boosting 56 Starlink internet satellites along a southerly trajectory that eventually included a drone ship landing in the Atlantic Ocean. The satellites deployed from the rocket’s upper stage just over an hour after liftoff.

— LOCAL: TB —

Pinellas banned a controversial loan program. Now it’s here anyway.” via Jack Evans of the Tampa Bay Times — For years, Florida counties have sought to curb a controversial loan program that has become infamous for burying unsuspecting homeowners under insurmountable property tax bills. Pinellas County barred the residential arm of the Property Assessed Clean Energy program, better known as PACE, in 2017. Within a few years, Hillsborough and Hernando counties had stopped the program from operating locally, and Pasco had imposed its own regulations. But local government’s ability to ban or regulate the program may have evaporated. In late 2022, a judge in Leon County ruled that the Florida PACE Funding Agency, one of the special districts created to administer the program under state law, can give out loans wherever it wants, regardless of a local ordinance.

Property Assessed Clean Energy programs are controversial but aren’t going away anytime soon.

These Tampa Bay retirees worry about future under Florida LGBTQ+ laws” via Hannah Critchfield of the Tampa Bay Times — Like most older adults, Brian Kelly wants to stay in his home as long as he can. The Seminole resident’s concerns go beyond losing his independence or the rising cost of long-term care. “I wonder, ‘Is the facility welcoming to LGBTQ?’” asked Kelly, who is gay. Fear of having to “re-closet” upon entering a nursing home has long haunted aging LGBTQ+ people. To Kelly, who is 68, the threat feels more palpable these days. As Florida reddens and a wave of anti-LGBTQ+ bills sail through the Legislature, some LGBTQ+ seniors fear for their retirement future in Tampa Bay.

USF lands $8M in grants to train mental health counselors, study student behavior” via Eric Glasser of WTSP — The University of South Florida just received millions of dollars in grant money to help train dozens of graduate students to become mental health professionals in our local schools. The grants, amounting to a little over $8 million, will help train as many as 40 mental health professionals who will be working with counselors and students in local school districts. The CDC reports a surge in mental health issues among young people since the pandemic. The USF program also aims to help schools adopt a framework for mental health assessments, including techniques to increase efficiency — such as spotting issues earlier on when they’re often easier to treat.

Tampa developer wants to buy St. Pete site previously targeted for Moffitt facility” via Breanne Williams of the Tampa Bay Business Journal — Tampa-based Third Lake Partners has offered St. Petersburg $6 million for a city-owned parking lot that was once part of a proposal for a Moffitt Cancer Center facility. The parking lot is at the corner of the 800 block of Second Avenue South and was once targeted for the development of a cancer facility, residential tower and parking garage. Moffitt and its partner, Atlanta-based TPA Group, offered the city $5 million for the property. St. Petersburg Mayor Ken Welch killed Moffitt’s proposal in August 2022, saying it didn’t include enough affordable housing.

— LOCAL: N. FL —

Milton Florida fire 75% contained, no further flares ups expected” via the Pensacola News Journal — The Florida Forest Service reported that a more than 200-acre wildfire in Santa Rosa County is largely under control, with “no future fire activity anticipated.” Dubbed the San Rafael fire, the blaze was reported Wednesday in an area south of Interstate 10 and west of Avalon Boulevard. The wildfire was around 75 acres when the Forest Service issued its first update Wednesday evening. As of about 8 a.m. Thursday, the wildfire was approximately 215 acres and 60% contained. In a final update around 4 p.m. Thursday, the Forest Service reported the fire was mapped at 226 acres and was 75% contained with fire containment lines improving throughout the day.

The Milton Florida fire is mostly contained. Image via WEAR.

Senate sends GRU takeover bill to DeSantis’ desk for signature” via Andrew Kaplan of The Gainesville Sun — Control over the future of Gainesville Regional Utilities now rests in the hands of DeSantis. The Senate gave approval to House Bill 1645 Thursday with little debate and no amendments. The legislation, sponsored by Rep. Chuck Clemons and dubbed the “GRU Takeover bill,” now heads to the Governor’s desk for a final signature. The bill creates a five-member Authority Board appointed by DeSantis to make all GRU-related decisions, stripping away the Gainesville City Commission’s century-long control of the municipal utility.

Cheers! Drinking and dining zones expand in Duval County” via A.G. Gancarski of Florida Politics — The Senate passed legislation already approved by the House that will expand zones in Duval County where liquor can be served legally. The “Downtown Incentive Zone,” the North Florida Keys Corridor, and the Dennis Street Commercial Corridor Area in Mixon Town are all poised to be able to expand alcohol service after Thursday’s Senate vote on HB 1561. The bill, carried by Sen. Tracie Davis in the Senate and Rep. Wyman Duggan in the House, was passed en masse with a swath of other local bills.

Panama City Beach to host 2023 IRONMAN 70.3 Gulf Coast, traffic delays expected” via Nathan Cobb of The Panama City News-Herald — Some traffic detours are around the corner as the Beach is slated to host the 2023 IRONMAN 70.3 Gulf Coast on May 13. According to Ben Rausa, race director, about 2,000 people are registered to compete in the event, which boasts a 2.1-mile swim, a 56-mile bike and a 13.1-mile run. The race is known to attract athletes not only from across the U.S., but the world. “It’s got a long history, with the Gulf Coast Triathlon that owned it before us,” Rausa said of the event. “IRONMAN purchased it in 2016, and we’ve since continued to grow it and maintain it. The first year IRONMAN took it over, we saw a 1,000-athlete increase.”

North Florida lawyer argues judge’s ‘inflexible’ stance is unfair to undocumented defendant” via James Call of the Tallahassee Democrat — A public defender in the Second Judicial Circuit wants a Liberty County judge removed from the trial of a Hispanic defendant because he said the judge has an inflexible sentencing policy for people without government-issued documents. “Balderdash,” is how Judge Kenneth Hosford responded to public defender John Knowles’ assertion. The dispute comes to light after a leaked memo showed the state attorney’s office in Jefferson County was not to accept plea deals offering pretrial diversion programs that withheld adjudication of guilt — which avoids a criminal record and complications to resolve immigration status — for traffic violations with a Hispanic defendant.

— LOCAL: SW. FL —

Legislation could undo land use changes made in Naples since Hurricane Ian” via Laura Layden of the Naples Daily News — A state bill stands to undo more restrictive land use and development rules Naples City Council has adopted since Hurricane Ian. The Senate unanimously approved a bill on May 1 that includes a retroactive prohibition on adopting any harsher regulations. It would essentially render them “null and void.” City Manager Jay Boodheshwar briefed the City Council on the implications of the legislation, with city attorneys weighing in on the potential effects. “The Governor has not signed this yet, but it has been approved and I think if the Governor fails to sign it, it still goes into effect,” Boodheshwar said.

Jay Boodheshwar warns of unintended consequences of land use regulations.

Text messages show New College alum acted as liaison between DeSantis’ Office and Board” via Zac Anderson of the Sarasota Herald-Tribune — Text messages released by New College of Florida through a public records request show that alum Bob Allen functioned as a liaison between DeSantis’ Office and Board members in the early days of the Governor’s conservative takeover of the school. DeSantis appointed six new trustees to the college’s 13-member Board on Jan. 6 to transform the small Sarasota college into something resembling Hillsdale College, a conservative Christian school. On Jan. 9, Allen texted holdover Board member Sarah Mackie and asked her to “please call me,” according to the messages obtained by the Florida Center for Government Accountability through a public records request coordinated with the Herald-Tribune.

Fears of politicization dog another Florida public university’s presidential search” via Francie Diep of The Chronicle of Higher Education — In the wake of several contentious presidential searches across the state, Florida Gulf Coast University is set to choose its next leader. But some students and staff and faculty members worry that there’s an invisible political thumb on the scale for one candidate. That candidate is Henry Mack III, a senior chancellor at the Florida Department of Education and one of four people vying for the post. The others are Neil MacKinnon, provost of Augusta University, in Georgia; Joseph Morgan, president of Morehead State University, in Kentucky; and Aysegul Timur, vice president for strategy at Florida Gulf Coast.

Aysegul Timur selected as FGCU’s next president. What we know.” via Nikki Ross of the Fort Myers News-Press — Timur was selected to become the next president of Florida Gulf Coast University (FGCU) in a 7-6 vote. She is the first woman to hold the top position in the history of the university. “I don’t have enough words to say how honored I am to lead this great institution,” Timur said after the vote. “This is — after my own family, my kids, my husband — this is really a life achievement for me to be considered president-elect of FGCU.” The selection was made after the four finalists were interviewed Thursday morning by the Board of Trustees. Twelve public comments were made and there was a Board discussion.

Board votes, 3-2: Leslie Ricciardelli is new Superintendent of Collier Schools. What we know” via Nikki Ross of the Fort Myers News-Press — The School Board voted, 3-2, in favor of Ricciardelli, choosing her over finalist Charles Van Zant Jr. “Throughout this process, I have heard from hundreds of people: old classmates, former co-workers and current employees, former and current students and parents, and I could not be more grateful for their support of Collier County Public Schools and of me,” Ricciardelli said in an emailed statement. “To our School Board members, thank you for seeing beyond the politics, for putting students and staff at the center of your decision, and for giving me and our amazing team of educators this opportunity to move forward inspiring students to achieve academic excellence. I am humbled, honored, and excited to continue our work.”

Redevelopment of Sarasota mall could result in addition of 1,200 multifamily units” via Derek Gilliam of the Sarasota Herald-Tribune — Sarasota Square Mall could soon have a face-lift, transforming the outdated, enclosed mall built in the 1970s into a mixed-use property with up to 1,200 multifamily units, according to a plan filed with Sarasota County. Most of the enclosed mall would be demolished under the plan and the property reconfigured with three apartment or condo buildings behind the commercial space on the northern end of the 93.5-acre property. The plan appears to show space for a 40,000-square-foot grocery, as well as out-parcel space ranging from a 3,500-square-foot drive-thru to a 32,000-square-foot retail space. The plan does not include any projected tenants besides the three there.

— TOP OPINION —

The limits of press-bashing” via Jim Geraghty of the National Review — Sure, there’s a lot of lousy coverage of presidential candidates out there, and you can find a lot of hagiographic coverage of Democratic figures and unfairly critical coverage of Republican figures.

But press-bashing has now become a reflex among certain Republican officeholders, and it’s starting to become a crutch, an easy way to swat away legitimate questions. The widespread contempt for reporters and the process of covering campaigns raises some questions about just what Republicans think is fair coverage, and whether they would prefer to sit back and watch a Primary that consisted entirely of speeches and scripted applause lines, with no questions or off-the-cuff answers.

Last week, DeSantis completed an overseas trade tour of Japan, South Korea, Israel, and the United Kingdom that was totally focused on increasing Florida’s exports to those countries, and purely coincidentally provided him some B-roll footage for future presidential-campaign commercials touting his relevant foreign-policy experience.

We get it, Republican presidential candidates. You hate most or all of the mainstream media and think they ask stupid questions. And DeSantis has had plenty of feisty interactions with both the state and national press.

Can you run an effective campaign by only talking to a handful of preferred outlets? The presidency is not an easy job, and a candidate doesn’t get prepared for the challenges of running the executive branch and being commander in chief by doing softball interviews.

— OPINIONS —

Vivek Ramaswamy’s vision is America first — even more than Trump” via Miranda Devine of the New York Post — While Trump and DeSantis are busy tearing chunks out of each other, there is an unlikely sleeper candidate in the Republican race who is quietly winning hearts and awakening hope across the country with his sunny version of America First. Ramaswamy, 37, the woke-busting entrepreneur, son of Indian immigrants from Ohio and the GOP’s first millennial presidential candidate, is rising steadily in opinion polls, just 10 weeks after announcing his candidacy on Tucker Carlson’s Fox News show. He’s pitching himself as a more energetic but less divisive version of Trump, as “the outsider that doesn’t just talk about draining the swamp,” he said in New Hampshire this week.

Florida’s anti-immigrant fervor will do great harm” via the South Florida Sun-Sentinel editorial board — Over and over during the House floor debate on two anti-immigrant bills, opposition lawmakers talked about fear. It’s fear of making people afraid to seek access to health care. Making people afraid to drive. Making people afraid to carry out religious missions. The fear is real, and it’s not just among the groups these two bills claim to target. In reality, this legislation will cast a spotlight on anyone who talks with an accent. Or wears clothes that reflect a different heritage. Or speaks a language other than English. Or whose skin tone, accent or behavior suggests they were born someplace else, whether they are American citizens, legal permanent residents of the U.S., legal asylum-seekers or undocumented immigrants.

DeSantis’ anti-ESG vendetta strips away choice” via Ken LaRoe in the Orlando Sentinel — While imperfect, America’s free enterprise system has powered a strong, innovative, formerly best-in-the-world economy. Consumers have a greater voice — determining which companies fail or succeed based on their purchase decisions. Unfortunately, this American recipe for economic resilience and growth is being targeted in Florida by DeSantis and his Republican cohorts — jeopardizing free market blessings for obvious political theater. This Session has seen attacks on ESG principles. This anti-capitalist legislation is part of an initiative to “protect” Floridians from “ESG financial fraud.” But DeSantis and lawmakers aren’t protecting Floridians from anything, except from responsible companies that protect the environment and make positive contributions to the communities they serve. Instead, our leaders are eliminating the freedom of free market choice.

DeSantis vendetta targets Monique Worrell, sends shrapnel flying” via the Orlando Sentinel editorial board — Removing or suspending a duly elected public official is supposed to be a last-ditch option, one to be undertaken only in the direst of circumstances. Usually, in Florida, it comes on the heels of criminal charges or proven grave misconduct. Lately, however, DeSantis has been acting more like he’s planning a surprise birthday party, with Ninth Circuit State Attorney Worrell cast in the role of piñata. He’s smirked and teased about his intentions to put her on ice multiple times, showing blatant disrespect toward Orange and Osceola voters who elected Worrell to occupy this critical office in 2020, and a callous lack of concern for the havoc he’s creating with his attempts to weaponize local law enforcement against her.

Water quality in Florida to take a hit as lawmakers show their disdain for voters” via the Miami Herald editorial board — Florida lawmakers pulled a fast one over the weekend, sliding a new measure into the state budget plan that could damage the state’s water quality and make red tide and blue-green algae worse. Without allowing public comment or discussion, legislators added language to the so-called budget implementing bill that would stop some 117 local governments including Miami-Dade County from imposing strict fertilizer control measures next year, as the Miami Herald reported. The result of this egregious preemption of local government — yes, another state attack on local control — is likely to be dirtier water for all of us. And who stands to benefit from this shortsighted idea? The state’s fertilizer industry, critics say.

Sean Shaw: Floridians deserve full, fair regulations on insurance companies” via Florida Politics — Without life insurance, seniors might not be able to live independently at home, and parents might not be able to put food on the table. MetLife, Prudential and other big insurance companies are using their influence within the National Association of Insurance Commissioners (NAIC), which develops policies and regulations that are adopted at the state level, to steamroll competitors and consumers at the same time. In April, the big corporations that control more than half the life insurance market asked the NAIC to adopt a new policy that would not apply to them but would amount to a 50% penalty on smaller insurers that create competition, provide options to consumers and drive down prices. When the big insurers say jump, the NAIC said, “How high?” The penalty was adopted by an NAIC Committee in a matter of days.

Miami’s bad-boy cop Javier Ortiz gets away with a slap on the wrist and taxpayers be damned” via the Miami Herald editorial board — You often hear that police brutality and misconduct are caused by a few “bad apples.” Solving these problems should be as easy as tossing out cops who are spoiling the reputation of the men and women who honorably serve the public. When you look at the saga of Miami’s bad-boy cop Ortiz, there’s no justice at the end of the day — at least for taxpayers — and no day of reckoning for someone who has served less than honorably. Ortiz — known for racist social media posts and accusations of excessive force — was fired last year but will be reinstated after the city reached a settlement with the South Florida Police Benevolent Association, the police union representing him.

—WEEKEND TV —

ABC Action News Full Circle with Paul LaGrone on Channel 10 WFTS: Political analyst Dr. Susan MacManus; Washington correspondent Joe St. George; Tallahassee reporter Forrest Saunders; and Dr. William Forstchen, author of “One Second After” and an EMP expert.

Facing South Florida with Jim DeFede on CBS 4 in Miami: The Sunday show provides viewers with an in-depth look at politics in South Florida and other issues affecting the region.

In Focus with Allison Walker on Bay News 9/CF 13: A discussion of Asian American Pacific Islander Heritage Month and the influence Asian Americans have in the political arenas, and the continuing struggle in the AAPI community with racism. Joining Walker are Ricky Ly, co-founder of Asian American Pacific Islanders Coming Together (ACT); Mimi Chan, martial arts instructor and director of Make Us Visible Florida; and Hiep Nguyen, Smart City Officer for the City of Winter Haven.

Political Connections on Bay News 9 in Tampa/St. Pete: Sit down interviews with Senate President Passidomo and House Minority Leader Fentrice Driskell to discuss the 2023 Florida Legislative Session.

Political Connections on CF 13 in Orlando: A look at the bills that have passed in the 2023 Florida Legislative Session, including debate and comments from lawmakers on the bills.

The Usual Suspects on WCTV-Tallahassee/Thomasville (CBS) and WJHG-Panama City (NBC): Guest host Sean Pittman speaks with Monique Ellsworth, CEO of Second Harvest and Jonathan Conrad of ISF, Inc., talking all things related to hurricane preparedness.

This Week in Jacksonville with Kent Justice on Channel 4 WJXT: Duval County School Board Chair Dr. Kelly Coker, Florida Times-Union columnist Nate Monroe and Jacksonville City Council District 5 member LeAnna Cumber.

— INSTAGRAM OF THE DAY —

— ALOE —

Disney fan sites cover cupcakes, characters — and now, political wars” via Hannah Sampson of The Washington Post — Sites like the Disney Food Blog, Blog Mickey, WDWMagic and AllEars are better known as a place for fans to get updates and weigh in on menus, merchandise and character greetings. Recently, they’ve been wading into choppier waters as the battle between DeSantis and the company has intensified and writers and commenters have turned into armchair legal correspondents. The online Disney bubble, that pixie-dust-sprinkled atmosphere surrounding the world’s most popular theme parks, hasn’t quite burst. But amid culture wars, occasional fan squabbles and escalating legal maneuvers, it has been pierced. Site editors and owners say they are dedicated to coverage of the topic because it interests readers — and could directly affect their vacations.

Disney blogs are going beyond cupcake reviews. Image via Disney Food Blog.

New Michelin Guide Bib Gourmand Awards announced for Orlando” via Amy Drew Thompson of the Orlando Sentinel — Ahead of the official ceremony on May 11 in Miami, the Michelin Guide has announced eight new Florida debuts to the Bib Gourmand selection, including four in Orlando. These include Isan Zaap, Norigami, Otto’s High Dive and Taste of Chengdu. “It’s a dream come true,” said David Tsan, Norigami’s chef de cuisine, who was surprised by today’s announcement. “Starting out in the restaurant business I always wanted to be a part of the Michelin Guide and now it’s happening. It’s crazy.” Bib Gourmand restaurants offer a meal of good quality at a good value. In February, Norigami was the Critic’s Pick for Best Cheap Eats in the 2023 Orlando Sentinel Foodie Awards.

— HAPPY BIRTHDAY —

Happy birthday to the best political consultant in Southwest Florida and still our favorite Goodman, Max, as well as our friends, Laura Jolly and Jim Magill, as well as Paul Flemming.

___

Sunburn is authored and assembled by Peter Schorsch, Phil Ammann, Daniel Dean, Ryan Nicol, Jacob Ogles, and Drew Wilson.

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Sonoma health official warns of rising syphilis rate in women

SONOMA – Sonoma County is seeing “alarming” increases in congenital syphilis and is urging pregnant residents to access prenatal care as soon as possible and asking care providers to increase testing for the sexually transmitted disease. 

According to a letter to “colleagues” penned by Dr. Kismet Baldwin-Santana, the interim public health officer for the county, California has experienced a steep increase in syphilis among females and in congenital syphilis, or CS, which is when syphilis is passed from a mother to her baby. 

If untreated in babies, syphilis can cause organ damage, neurological disorders and even death.

Baldwin-Santana also said that there are “significant” racial disparities among cases of syphilis in Sonoma County, with significantly higher rates of disease among Black/African American and American Indian/Alaskan Native infants than the statewide rate.

In 2020, the U.S. Centers for Disease Control and Prevention put out a study that said that higher rates of syphilis among certain groups is not due to “differences in sexual behavior” but rather a lack of access to sexual health care.

Prenatal screening is essential, Baldwin-Santana said, because CS can be prevented with timely testing and treatment. But that doesn’t just mean seeing an OB-GYN doctor.

“Syphilis testing and treatment must expand beyond prenatal care clinics to other settings serving women at elevated risk for HIV and syphilis,” she wrote. 

Baldwin-Santana has asked providers in the county to do several things to tackle the problem. First, screen for the syphilis status of all pregnant women that receive care or services in emergency rooms, urgent care clinics, jails, mental health and drug treatment outlets and syringe-service programs. Outreach should also be had with unsheltered people and street medicine organizations.

The syphilis test for women who are expecting should be taken at least three times during pregnancy, with the first test taken as early as possible, such as the first trimester. The second test should be during the third trimester and the third test at delivery.

Pregnant women with syphilis can be treated with a penicillin regimen, Baldwin-Santana said.

According to data from the California Department of Public Health, in 2018 the state saw a 900 percent rise in babies born with CS compared to 2012. From 2011 to 2020, female early syphilis cases increased over 1,181 percent, DPH officials said.  

City of Hope Honored Among ‘Top Hospitals and Health Systems’ for Diversity, Equity and Inclusion

Organization ranked No. 2 this year by DiversityInc as a leader in inclusivity efforts and recognized for the third year running

LOS ANGELES, May 3, 2023 /PRNewswire/ — City of Hope, one of the largest cancer research and treatment organizations in the United States, has been recognized by DiversityInc as one of the nation’s “Top Hospitals and Health Systems” for diversity, equity and inclusion. City of Hope ranked second in the health care group of the 2023 list, distinguishing the organization as one of two National Cancer Institute-designated comprehensive cancer centers and the highest ranked institution in California on the list. This marks the third year in a row City of Hope has been included in the top 10 of the prestigious list, jumping four spots from No. 6 to No. 2 in one year’s time.

Launched in 2001, DiversityInc’s survey is the most comprehensive, data-driven analysis of some of the largest U.S. employers. The assessment collects data across six key areas: Human Capital Diversity Metrics, Leadership Accountability, Talent Programs, Workforce Practices, Supplier Diversity and Philanthropy. DiversityInc receives more than 1,800 submissions from employers for the ranking.

“City of Hope is honored to be recognized by DiversityInc for our ongoing efforts to infuse diversity, equity and inclusion into every facet of our organization,” said Angela L. Talton, City of Hope senior vice president and system chief diversity, equity and inclusion officer. “Our DEI strategy is holistic with a focus on reflecting and respecting the diversity of our staff, patients, their families and caregivers, and the community at large. This complements our approach to understanding a patient’s genetic profile and providing personalized treatment specific to the individual care needs of the whole patient.”

This strategy includes leading the Cancer Care Is Different Coalition, a diverse set of advocates, oncology leaders and organizations with a goal of increasing access to specialized cancer care for all patients who need it. The coalition helped draft the California Cancer Care Equity Act, legislation which ensures that MediCal beneficiaries who receive a complex cancer diagnosis have the choice to seek treatment at a National Cancer Institute-designated cancer center, where they can enroll in clinical trials and receive leading-edge treatment. This law was passed unanimously and became effective as of Jan. 1, 2023.

Internally, City of Hope has instituted interactive, scenario-based training that teaches people managers how to mitigate bias and consciously change behaviors while encouraging accountability. In 2022, City of Hope increased diversity in senior leadership: women, Hispanic/Latinx and Black/African American representation grew 25%, 150% and 25%, respectively. To infuse diversity into its business practices, City of Hope runs a Supplier Diversity Program, which encourages the engagement of minority-owned, women-owned, veteran-owned, LGBTQ-owned, service-disabled, and historically underutilized businesses as suppliers.

City of Hope’s national system of provider and research entities now serves approximately 134,000 patients each year, with more than 11,000 team members, 600 physicians and more than 1,000 scientists and researchers across a network of locations in California, Arizona, Illinois and Georgia.

About City of Hope
City of Hope’s mission is to deliver the cures of tomorrow to the people who need them today. Founded in 1913, City of Hope has grown into one of the largest cancer research and treatment organizations in the U.S. and one of the leading research centers for diabetes and other life-threatening illnesses. City of Hope research has been the basis for numerous breakthrough cancer medicines, as well as human synthetic insulin and monoclonal antibodies. With an independent, National Cancer Institute-designated comprehensive cancer center at its core, City of Hope brings a uniquely integrated model to patients spanning cancer care, research and development, academics and training, and innovation initiatives. City of Hope’s growing national system includes its Los Angeles campus, a network of clinical care locations across Southern California, a new cancer center in Orange County, California, and treatment facilities in Atlanta, Chicago and Phoenix. City of Hope’s affiliated group of organizations includes Translational Genomics Research Institute and AccessHope™. For more information about City of Hope, follow us on Facebook, Twitter, YouTube, Instagram and LinkedIn.

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SOURCE City Of Hope