Senate President Andy Gardiner on Wednesday cast what could be the deciding vote in the clash over the confirmation of Florida Surgeon General John Armstrong.
Meeting with reporters, Gardiner acknowledged that --- despite his support for the embattled surgeon general --- he would not use a procedural move to pull Armstrong's stalled nomination out of a committee and hold a confirmation hearing on the Senate floor.
"I've really struggled with it," Gardiner said. "I wouldn't say, 'Never say never.' By two-thirds (vote of the Senate), he (Armstrong's nomination) could come up. But at least from my standpoint, we would not be removing him from committee."
If not confirmed by the Senate before the legislative session ends Friday, Armstrong would be forced out of the position he's held since 2012.
Armstrong, who is also secretary of the Florida Department of Health, was narrowly approved by the Senate Health Policy Committee last month in a 5-4 vote. But since then, the Senate Ethics and Elections Committee twice tabled a scheduled vote on the agency head.
Gov. Rick Scott strongly supports the surgeon general and has trotted out a series of press statements to indicate as much. Recently, the governor met with Armstrong and the Cancer Action Network, the AIDS Healthcare Foundation, the Florida Medical Association, the Florida Public Health Association, Nemours Children's Health System and the Council of Medical School Deans --- all of which have backed the surgeon general's confirmation.
But given that Sen. Anitere Flores, R-Miami, joined Democrats on the Ethics and Elections Committee in opposing the confirmation, Armstrong did not have the votes he needed to get approval from the panel.
As a result, Gardiner, R-Orlando, said last week he'd begun considering bringing Armstrong's nomination to the Senate floor, a potentially dramatic move aimed at breaking the logjam over the surgeon general's fate.
The Senate president said last week he had some "soul-searching" to do over the procedural move. He also noted Wednesday that another senator could waive the rules and force the confirmation hearing with a two-thirds vote of the chamber.
"I think the president's a pretty good vote-counter," said Sen. DonÂ Gaetz, a Niceville Republican and another Armstrong supporter. "If the surgeon general couldn't get out of the Ethics and Elections Committee, I don't know if he can get two-thirds of the votes on the Senate floor."
Critics have taken issue with the Department of Health's performance on Armstrong's watch.
For instance, Armstrong faced senators' questions about issues such as a steep drop in the number of people receiving services from county health departments and Florida's highest-in-the-nation rate for new HIV infections.
During the Health Policy Committee discussion on Feb. 16, Gaetz noted that county health departments now see 200,000 fewer patients and provide 800,000 fewer individual services than they did when Armstrong became surgeon general.
Senators also asked about Children's Medical Services, a program for youngsters with "chronic and serious" conditions that last year dropped more than 13,000 kids from its rolls.
Opposition to Armstrong's nomination was led by Sen. Oscar Braynon, a Miami Gardens Democrat who is slated to become Senate minority leader this fall. Braynon said he'd heard Tuesday that members of the Senate Democratic Caucus were being approached by Republicans in search of votes.
At a Democratic Caucus meeting Wednesday morning, Braynon said his opposition was partly due to policy issues, but also to procedural ones.
"I didn't think it was appropriate for us to be pulling him out of a committee if he didn't pass it --- procedurally and collegially, as the Senate, we shouldn't do it," Braynon said. "My caucus agreed with me."
And after the meeting, Braynon went to discuss the matter with Gardiner.
"(I said), 'I want to talk to you about Armstrong. Have you made a decision yet? He said, 'I have no intention of bringing him back up,' " Braynon said.
After Gardiner announced his decision, Senate Rules Chairman David Simmons, R-Altamonte Springs, and Ethics and Elections Chairman Garrett Richter, R-Naples, said they would talk with Gardiner about the issue. Both backed Armstrong's nomination and are members of Gardiner's leadership team.
"I think that what we'll do is talk to the president and see exactly where he is based upon getting the temperature of the senators --- and that's all of the senators," Simmons said.
Richter added, "We want to sit down and speak with the president and find out what's in his mind and on his heart."
But children's health advocate Karen Woodall was already looking ahead to a new surgeon general.
"It opens up a lot of new possibilities," she said. "I hope that the concerns that were raised about the surgeon general and things that have happened at the Department of Health --- or, more importantly, not happened --- under his leadership will send a message about what's important to folks in this state to legislators and to people who are concerned about the populations the Department of Health is responsible for."