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What Next for the Health Department?

I have serious concerns that Florida’s Public Health will continue to be marginalized and politicized.  I see no evidence that current leadership in the Florida’s health department pursues a strong community public health effort.  Responsibilities should include environmental regulatory authority and core public health programs including a strong emphasis on communicable disease, maternal and child health, health education, and Women’s Infants and Children services. 

Recently, Miami Herald reporters published a report noting a Department of Justice Lawsuit against the State of Florida naming the Department of Health, Agency for Health Care Administration, and Department of Children and families.  DOJ claimed that “Florida health care agencies have acted with deliberate indifference to the suffering of frail and disabled children by offering parents no meaningful choice but to warehouse their children along with elders.”

One should remember that this is the same health department that prematurely closed the State’s only TB hospital during the worst Florida TB outbreak in recent memory and at the time identified as the worst TB outbreak in the country.  Compounding this inane decision was the placement of many of the hospital’s TB patients in motels exposing staff and other motel residents to risk of serious disease.  The result of the attention given the health department as a result of this embarrassment was to fast track contracts to Hospitals to then house the patients.  It would be interesting to see exactly what the state saved in this venture.  Certainly, it showed a complete lack of expertise and public health concern.  I am convinced these patients would be roaming free in our streets had not the media showed interest in the TB hospital closure.

The current state of health department ineptness points to the purging of talent and politicizing of this agency which prior to the current administration was rated one of the finest health departments in the country.    

Responding to the DOJ suit, a spokesman for the Agency for Health Care administration claimed, “The federal government is meddling in our business.” I am reminded of the Health Department response downplaying the Federal health agency’s assessment of Florida’s TB homeless outbreak.

I am concerned that Florida’s Health Department will disappear into a myriad of political agencies divested of responsibility for regulation and essential core public health programs.  The current Department of Justice suit exemplifies what can be expected when our elected officials show a lack of sensitivity or commitment to health and human services.  

--Marc Yacht, MD, MPH, is retired director of the Pasco County Health Department (2007).