Florida turns down millions that would help children, the elderly, the sick and the disabled

From the New York Times

by Kevin Sack

TALLAHASSEE, Fla. — When it comes to pursuing federal largess, most of the states that oppose the 2010 health care law have refused to let either principle or politics block their paths to the trough. If Washington is doling out dollars, Republican governors and legislators typically figure they might as well get their share.

Then there is Florida. Despite having the country’s fourth-highest unemployment rate, its second-highest rate of people without insurance and a $3.7 billion budget gap this year, the state has turned away scores of millions of dollars in grants made available under the Affordable Care Act. And it is not pursuing grants worth many millions more.

In recent months, either Gov. Rick Scott’s administration or the state’s Republican-controlled Legislature has rejected grants aimed at moving long-term care patients into their homes, curbing child abuse through in-home counseling and strengthening state regulation of health premiums. They have shunned money to help sign up eligible recipients for Medicare, educate teenagers on preventing pregnancy and plan for the health insurance exchanges that the law requires by 2014.

While 36 states shared $27 million to counsel health insurance consumers, Florida did not apply for the grants. And in drafting this year’s budget, the Legislature failed to authorize an $8.3 million federal grant won by a county health department to expand community health centers.

In interviews, Mr. Scott, a Republican, and state legislative leaders were clear about their rationale. They said they detested everything about the federal health law, which was declared unconstitutional by a federal judge in a case filed by the state. Unless ordered to do otherwise by an appellate court, they said, they had no intention of putting it in place, even if that meant leaving money on the table.

“There are a lot of programs that the federal government would like to give you that don’t fit your state, don’t fit your needs and ultimately create obligations that our taxpayers can’t afford,” said Mr. Scott, a former hospital company executive who rose to political prominence by financing an advertising campaign against the health care legislation.

State Representative Matt Hudson, the chairman of the Health Care Appropriations Subcommittee, said his chamber’s leadership felt the same way.

“I do not believe that act is the right thing for the country or the right thing for Florida,” Mr. Hudson said, “and I am not going to start implementing things that I don’t believe in.” Asked whether states had the authority to stymie federal law, Mr. Hudson answered, “We’re not required to accept a grant.”

Florida is by no means the only state hostile to the health care law. A majority of those states have gone to federal court to challenge the law’s central requirement that most Americans obtain health insurance. Alaska, Oklahoma and Wisconsin, among others, have turned away grants, some of them substantial.

But many of the states challenging the law have taken a posture more like that of Idaho, where Gov. C. L. Otter, a Republican, made a show this spring of ordering his agencies not to pursue Affordable Care Act grants and then quickly issued 10 exceptions to that rule.

Florida has had few peers in subverting the law’s provisions since Mr. Scott took office in January. After a federal district judge in Pensacola invalidated the entire act later that month, Mr. Scott quickly put the brakes on planning for the insurance exchanges and started rejecting grants pursued by his predecessor, Charlie Crist, a more moderate Republican. The state maintained its stance even though the judge, Roger Vinson, suspended his ruling pending appellate review.

“I don’t want to waste either federal money or state money on something that’s unconstitutional,” Mr. Scott said in a 30-minute interview in his office on Friday.

The governor, sporting black cowboy boots embossed with the state seal, said his subordinates had made case-by-case decisions about whether particular grants advanced the state’s efforts to remake its Medicaid program. This year, Mr. Scott and the Legislature enacted Florida’s own law directing most recipients into managed care plans.

But Mr. Scott deflected requests to explain where the line was drawn, other than to say that competition, personal choice and quality incentives should drive the health care market.

I’d have to go through each program to look at it,” Mr. Scott said. “We have a Medicaid plan, so if it fits with that plan, then we’re interested, and if it doesn’t, we’re not.”

In distancing itself from the law, Florida declined to participate in a Medicaid pilot program that would have authorized up to $2 million in reimbursement to providers using a new hospice model for severely ill children. The state insurance commissioner applied to the Obama administration for a waiver from this year’s requirement that health insurers spend at least 80 percent of premium revenue on medical care. Only at the last minute did the State Health Department agree to provide required letters of support for community groups applying for federal wellness and prevention grants.

Critics say the state’s Republican leadership has carried its opposition to the health care law too far. The grants being shunned by the state, they point out, have little connection to the provisions that Florida is challenging in court, namely the insurance mandate and the expansion of Medicaid eligibility.

“It’s simply unconscionable that they’re turning back federal tax dollars that our citizens and businesses pay and sending those tax dollars to other states,” said Representative Kathy Castor, a Democrat who represents the Tampa Bay area. “Florida’s economy has been hit very hard, and we need every dollar and every job in our state.”

Health care advocates scoff at the assertion by Mr. Scott and the Legislature that some of the rejected grants would duplicate existing state programs (a few of the grants require a state contribution).

“Residents will suffer if the grants are turned away,” said Elizabeth M. Rugg, the director of the Suncoast Health Council in St. Petersburg. “There’s a lot of need in Florida, as everywhere else.”

Although Florida is the fourth most populous state, it ranks 12th in the amount of money received from health care act grants, according to the government’s grant-tracking Web site. The law has directed $46.4 million to the state out of $1.98 billion awarded nationally. Much of the money has gone directly to local governments, community groups and medical providers.

Three of four grants to expand community health clinics in Florida went to medical centers that are beyond the reach of the governor and the Legislature. The fourth was to the Osceola County Health Department, which under Florida law is effectively a unit of state government. The Legislature used its power to not authorize a grant won by the county to expand two health centers and build a third.

“The speaker had a policy that we weren’t going to be implementing any part of health care reform, so those grants were not included in our budget,” said Katherine Betta, a spokeswoman for Dean Cannon, a Republican and speaker of the State House.

Some of the forsaken grants were for small amounts, but others, over time, would have infused state programs with substantial sums. As long as the state makes no moves toward setting up an insurance exchange, it will not compete for grants worth tens of millions of dollars to help establish them and invest in needed technology. If Florida does not demonstrate adequate progress by early 2013, the federal government can take over the state’s exchange.

Although many conservative governors consider that the worst scenario, Mr. Scott said his antipathy toward the exchanges was so strong that he would oppose running it. “I’d rather nobody run it,” Mr. Scott said. “I don’t think there’s any way the state can do it where it’s good for health care policy.”

Just where is the Florida Lottery money going?

From Sunshine News

by Gray Rohrer

Florida lottery sales totaled $4 billion in the 2010-2011 fiscal year which ended June 30, an increase of 2.8 percent. The numbers reverse a two-year trend in declining sales due to the downturn in the economy.

The sliding sales figures had led to a decrease in the amount of money given to Florida’s Education Enhancement Trust Fund, to which the lottery was designed to contribute. Last year, lottery transfers to the fund totaled $1.122 billion, but are expected to increase for the 2011-2012 fiscal year along with increasing sales.

“Lottery sales continue to move because people want the opportunity of the fun and the entertainment. It’s really just that simple. They want the entertainment value the lottery offers regardless of the economic times. But people have to make choices with their discretionary dollars. It is a discretionary entertainment dollar,” Department of Lottery Secretary Cynthia O’Connell said Friday at a meeting of the Economic Club of Florida in Tallahassee.

She was appointed to head the Department of Lottery in February by Gov. Rick Scott.

“I can only take credit for half the year, but I’ll take credit for it,” O’Connell said.

O’Connell’s goals for the current fiscal year are to improve on the uptick in sales. She expects to hit $4.22 billion in sales and give $1.25 billion to the Education Enhancement fund.

Yet many taxpayers remain concerned about the amount of money flowing into education from the lottery. It was set up in the 1980s to do just that, but lawmakers have consistently siphoned funds from the education trust fund for general revenue, leading the lottery money to sustain rather than “education” funding.

In the late 1980s, voters approved a lottery for Florida primarily because those who sponsored the ballot initiative promised the proceeds would go to bolster education, not replace money the state held back.

It didn’t happen. In fact, that broken promise was a bone that stuck in the craw of voters for 10 years — until 1997 when Ken Pruitt, then in the House, and Don Sullivan in the Senate, crafted and sponsored the Bright Futures scholarship program.

Bright Futures was funded with 25 percent of the state’s lottery proceeds, with an understanding that the scholarship program could grow to 50 percent without touching the lottery’s payouts or administrative costs.

Over the years the lottery trust fund has been raided, legislators talk about Bright Futures as “too costly too sustain in its original form” and there is little public discussion of how much “enhancement” money now goes straight into education general revenue.

“We’re in the business of providing revenue to the Department of Education,” O’Connell said when asked about the lack of increase in education enhancement dollars.

The lottery gives money to the DOE, and can’t help what it does with the funds and how legislators appropriate for education, she explained. “We let them appropriate where it goes.”

Lawmakers have been nearly unanimous in their support of the state lottery, but some have sought to curtail unsanctioned forms of gambling throughout the state. Most recently, this has come in the effort to shut down Internet cafes, where customers pay money for a card to play games of chance on a laptop.

The new businesses have popped up in strip malls throughout the state. O’Connell admitted they present a rival to the traditional lottery, but highlighted the differences between the two games.

“Well, certainly it’s competition for the Florida lottery. We publish odds for our players, we’re a legal entity and we’re moving forward to show our players great benefits in terms of their play going to fund education,” O’Connell said, adding that a legislative study to determine the impact of Internet cafes on the lottery has been commissioned.

Reach Gray Rohrer at grohrer@sunshinestatenews.com or at (850) 727-0859.


Veteran teachers flee Florida’s struggling schools

From the Daily Journal


TALLAHASSEE, Fla. — Math teacher Antoine Joseph already had been thinking of leaving Miami Norland Senior High School, so when its annual grade from the state dropped from a D to an F nine years ago that just solidified his decision.

Joseph said it wasn’t just a matter of being stigmatized as a failure — he was just tired of the circumstances behind the failing grade.

“There is a propensity to go to another school where the parents are more involved, the students are more eager to learn and they are more thirsty for knowledge,” he said.

Joseph apparently was not alone. A recent study by a trio of economists showed a disproportionate number of Florida teachers left schools that got lower grades in 2002 after the state changed the way it evaluated them.

The researchers call it “accountability shock.” That’s their term for unexpected results from shake-ups in the way students, teachers, administrators or schools are evaluated, graded, rewarded or punished. The study is timely advice because accountability changes are in the works across the nation due to President Barack Obama’s “Race to the Top” school initiative. The program is providing $4.35 billion in federal stimulus money to Florida, 10 other states and the District of Columbia for innovative changes aimed at improving student achievement.

Not a single Florida school had failed in 2001 before the grading change, but Norland was among 63 that received an F after the new procedure was adopted. It bases A-through-F grades on gains students make on standardized tests from year to year rather than simply on that year’s scores.

“The increased pressure probably produced some benefits but also led some teachers to move away from low-achieving schools,” said Florida State University economist Tim Sass. “The general lesson there is you have to be careful about potentially unintended consequences.”

A key provision in Florida’s Race to the Top plan, as well as part of a new accountability law, is teacher merit pay that will be closely tied to how much students improve on the standardized tests. Joseph thinks the changes will again cause more teacher transfers.

Joseph transferred in 2002 to William H. Turner Technical Arts High School, which received a C that year, and he’s still teaching there. Besides the school grading change, Joseph said a conflict with Norland’s principal and personal issues, contributed to his decision to leave.

Saul Berenson said the new grading system also was a factor, but not the only one, in his departure from Miami Jackson Senior High School. He said he decided to retire after 40 years in part because of the focus on testing and computerization that was taking up more of teachers’ time.

“Anybody who stays in teaching needs their heads examined,” Berenson said. “You are no longer a teacher. You are a glorified baby sitter or you’re teaching to the test.”

The Associated Press contacted seven other Miami-Dade County teachers who left failing schools in 2002, but all said they did so for other reasons. Robert Black left Norland for Lake Ariel, Pa., so he could be closer to his aging parents, but said he found the researchers’ theory interesting.

“They may not be off by much,” Black said. “I know that teachers get very frustrated.”

Sass collaborated with Li Feng of Texas State University-San Marcos and David Figlio of Northwestern University. Their study was published by the National Bureau of Economic Research, a private, nonprofit, nonpartisan research organization based in Cambridge, Mass. All three also have done other research on school accountability and performance measures.

They found teachers at failing schools were 1.4 times more likely to leave than those at schools with higher grades.

“The evidence is pretty clear that teachers tend to move toward schools that have higher achievement, fewer kids in poverty, fewer discipline problems,” Sass said.

Besides the stigma, Florida’s F schools miss out on financial rewards given to those that get an A or show significant improvement. Failing schools, though, do get other help such as additional reading coaches and they may undergo staffing changes. They also could face closure or conversion into charter schools. This year, 31 Florida schools received an F — 1 percent of the total.

While some poorly performing teachers left in 2002, the study indicated that wasn’t entirely the case. The researchers found teachers who left for other schools as well as the ones who remained showed improvement. The extra help given to failing schools may have been a factor in the improvement shown by those who stayed, Sass said.

Figlio agreed with the unintended consequences lesson that can be drawn from the study, but said the results also showed “it’s really challenging to design a system that takes everything into account.”

“The big takeaway message for Race to the Top will be that the schools that serve low-income kids are going to be particularly vulnerable,” he said. “Any system that’s going to provide incentives for good teachers needs to be particularly focused on these most vulnerable schools.”

Florida school officials realized they had a problem with teacher mobility in failing schools soon after the 2002 grading system change.

Wayne Blanton, executive director of the Florida School Boards Association, said some districts gave extra pay to teachers who stayed.

Florida House Education Committee Chairman Bill Proctor, a St. Augustine Republican who is a career educator and chancellor of Flagler College, said he wasn’t surprised by the findings.

“We need to take cognizance of it,” Proctor said. “We probably need to be sensitive to it, but the question with each school may be a different.”

Former Florida K-12 Chancellor Frances Haithcock said the findings are correct but that she’s confident the state will avoid another accountability shock from its $700 million Race to the Top plan

The merit pay provision in that plan could keep teachers from leaving shocked schools, Sass acknowledged, but he said there are plenty of pitfalls in designing evaluation systems. One is test scores. He called it a “noisy” measure due to outside influences such as illness or even a fire alarm going off.

“You give the same test to the same kid a couple days apart and the score won’t be the same,” Sass said. “They get lucky guessing on a few questions or misinterpret a question.”

Haithcock said that’s why Florida isn’t relying on a single test but will use scores from a three-year period.

“That lessens the noise to the point that it’s fair,” Haithcock said.

Sass said the research also shows student testing can do a good job of identifying teachers at the very top and bottom of the performance scale, but not for those that are “a little better than average or a little worse than average.”

The researchers expect Race to the Top will give them more opportunity to study accountability shock and related issues.

“Researchers love when there are policy changes,” Figlio said. “Every policy change is going to introduce some type of good and bad luck. I mean, that’s just the nature of the beast.”