Treating Florida’s children poorly: Cynicism multiplied by chutzpah

MIAMI – There ought to be a special place in hell for politicians who don’t care about the needs of the most vulnerable among the vulnerable in our society, frail children with medical conditions that require specialized medical care.

I don’t know my Dante, but in my book the Florida legislature instantly qualified for the hottest ring of hell when in 2011 it passed a law that transformed the state’s Children’s Medical Services (CMS) program from one based on need to one based on the total number of dollars the state budget assigns to the program. In a state when human needs come last, it was predictable that the money needed to pay for medical care for by all the eligible children would exceed the budget.

That scenario has now come to pass and the state’s solution is both brutal and devious. It is kicking 9,000 children of the rolls misusing a questionnaire never designed for that purpose as a tool for screening kids out of the program. It amounts to nothing but a sham concocted to provide a pretext for throwing kids under a bus in order stay within an arbitrary number of dollars.

Modesto Abety, former CEO of the Children’s Trust of Miami-Dade, emailed me his comments on the issue, which I copy below in their entirety.

“These cuts to the State’s program for children who are among the most vulnerable and medically needy are unconscionable and cannot be justified. The denial of medically approved services to these very fragile kids will push them to become even more sick and vulnerable, and eventually the State will end up paying more money to treat and educate them. There’s no reason for this. Florida is not a poor state. We just treat our children poorly.

“I hope the good people of Florida, rise up to demand justice for these children and their families….”

The story was reported on the front page of Sunday’s Miami Herald. It is a fine piece of investigative journalism which, in my opinion, should be on the short list for the Pulitzer Prize. I have often flailed the Herald, and for good reasons, but this time I will say just one word: Kudos.

My role as an opinion columnist, however, differs from that of the reporter, Carol Marbin Miller, who researched and wrote this story. Unlike a reporter, who under the canon of American journalism should strive for objectivity, which is unattainable and usually amounts to nothing more than reporting on contradictory claims, I get to say openly what I think and feel about an event like this, morally, philosophically and politically.

What the legislature did in 2011 to deform the CMS program is detestable. The way the Florida Department of Health is implementing the 2011 law is dishonest. In fact, the doctors and professors who developed the instrument said it was never intended as a screening device but only as a survey. One of them said he was horrified at the way Florida was using the questionnaire. Beneath the pretense of a knowingly misused “screening tool,” the Herald uncovered this reality:

“Emails and other records …show the screening process imposed earlier this year was part of a deliberate attempt to reduce spending … by making the number of youngsters in a program called Children’s Medical Service shrink to line up with the money the state wanted to spend.”

The cynicism involved in such a deceitful scheme is brazen and breathtaking. So determined is the state to cleanse the rolls to fit the dollars that it failed to admit that the jig was up when in

September a judge declared the screening tool invalid. Instead, the state is fighting to have it reinstated. This is cynicism multiplied by chutzpah.

It is not as if the state cannot come up with the money to fix this disgraceful situation. This is not Burundi or Sierra Leone, the poorest countries in the world. It’s not even Greece. In fact, unlike the years of the Great Recession, the state of Florida has a surplus to the tune of $635.4 million. What does the anything-but-honorable governor Rick Scott want to do with the money?

Certainly not providing medical care to children with detached retinas, cleft palates or other conditions that make their lives physically and/or emotionally miserable. Instead, Scott wants to cut $1 billion in business taxes. With such priorities the state motto should be “screw the needy, coddle the greedy.”

The state in fact never even considered dipping into the surplus to make up the shortfall between the needs and the budget. Instead, the Herald reports the acceptable “remedies” were:

– Reduce the number of children eligible for services.

– Cut the payroll—170 positions, including nurses, doctors and case workers were eliminated.

– Curtail funding for specialized clinics that treat children with facial deformities, such as cleft palates. At least two of the clinics were forced to shut down.

– Cease payment for expensive food items that can, among other benefits, prevent children with metabolic disorders from suffering permanent brain damage.

These are remedies? Cutting eligible children out by using a trick questionnaire. Firing dozens of health professionals. Shutting down clinics that treat children with facial deformities. And the clincher: quit paying for food that can prevent permanent brain damage.

I feel personally ashamed, outraged, disgusted, embarrassed and dismayed living in a state where this could go on. The solutions considered by the state of Florida for ensuring medical care for fragile children are solutions only in the sense that certain unspeakable regimes used that term.

[Photos from The Children’s Trust on Facebook]