Dr. John Armstrong, the state surgeon general appointed by Gov. Rick Scott, narrowly cleared his first confirmation hearing Tuesday in the Florida Senate.
Armstrong, the state’s top doctor and secretary of the Department of Health, faced tough questions from the Senate Health Policy Committee’s nine members before ultimately being confirmed on a 5-4 vote.
With his $141,000 job on the line, Armstrong must be confirmed by the full Senate during this session, which is scheduled to end March 11. Before being appointed surgeon general in 2012, Armstrong, an Army veteran, was a top medical officer at the University of South Florida in Tampa.
For the past year, he’s been under fire for the removal of kids from the Children’s Medical Services program, the repeal of standards for pediatric heart surgery, the slow rollout of medical marijuana and rising HIV infections amid cutbacks to county health departments, highlighted by Herald/Times reporting last month.
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Lawmakers brought up all of those issues in Tuesday’s hearing.
For his part, Armstrong defended his record, saying that the department has changed its focus in recent years, moving away from direct care to patients and toward preventing infectious disease outbreaks like the Zika virus and energizing communities to fight local health problems.
Some senators weren’t convinced, including Sen. Oscar Braynon, D-Miami Gardens, who said he hasn’t seen the health department do much to fight the “epidemic” of HIV. Florida leads the country for new HIV infections, and no area in the United States has a higher infection rate per 100,000 residents than South Florida.
“He still falls short on that,” Braynon said.
Armstrong needed support from five of the health panel’s nine members. Five Republicans — including Sens. Don Gaetz, R-Niceville, and Rene Garcia, R-Hialeah, who have been critical of Armstrong — voted in favor of the surgeon general’s confirmation.
One Republican, Sen. Anitere Flores of Miami, joined with the panel’s three Democrats to oppose Armstrong.
“I didn’t quite get the answers I needed today to vote in favor,” Flores said.
She has asked to see data showing that patients who had access to primary care in the county health departments are now being served by other charitable clinics in local communities, which Armstrong said has been part of a change in the department’s goals.
Part of that change has been a decrease in the number of positions authorized by the Legislature in the department’s budget. The 67 county health departments have declined to 10,519 positions, compared with 12,759 in 2011. In defending those cutbacks — amounting to 17.5 per cent — officials in DOH and the governor’s office often point to them being vacant positions.
This year, the governor is asking for more than 700 additional cuts across the department, many of them in county health departments.
But Armstrong said Tuesday that he anticipates the widespread cuts will not prevent some county health departments from filling vacant positions.
In addition, Flores said she has questions about “what role Dr. Armstrong might play in advising and advocating” for Gov. Rick Scott’s veto of $9.5 million for free clinics in last year’s budget.
Armstrong said he and Scott did not discuss those vetoes.
Still, Braynon said it’s the Senate’s job to hold high-level gubernatorial appointees accountable.
“Unfortunately, if you’re the person telling the governor what he should do in health care ... and that’s what the governor decides to do, I kind of hold you responsible for it,” Braynon said.
Not every senator has been critical, however.
Sen. Denise Grimsley, R-Sebring, said Armstrong has done a “good job.” So did Sen. Garrett Richter, R-Naples, who chairs the Ethics and Elections Committee, which is Armstrong’s next hurdle.
“I don’t have any concerns,” he said.
Richter said he plans to give Armstrong a hearing. But it could be tough for him to secure support from 6 of the ethics committee’s 10 members.
Four of the senators on the panel are Democrats, and Flores sits on the committee as well. Those five votes against Armstrong could handicap his confirmation.
Flores said she isn’t yet ready to support Armstrong, but she might come around.
“It’s not an easy or fun decision to be voting for or against someone’s livelihood,” she said. “I guess that I’m not there yet. Let’s see what kind of information I get in the next week.”
Contact Michael Auslen at email@example.com. Follow @MichaelAuslen.