Florida Surgeon General John Armstrong’s confirmation looks uncertain

Surgeon General John Armstrong is in a precarious position as senators question cuts to county health departments, deregulation of children’s heart surgery and the removal of patients from a healthcare plan for the state’s sickest kids.

The Senate Health Policy Committee postponed Armstrong’s confirmation hearing Tuesday after committee chairman Sen. Aaron Bean, R-Fernandina Beach, said there was not enough time for senators to ask all their questions. He said that could take an hour or more.

“The outcome would have been uncertain for Dr. Armstrong, depending upon how he interacted with the committee,” said Sen. Don Gaetz, R-Niceville.

A pivotal vote on the nine-member Senate Health Policy Committee belongs to Republican Sen. Anitere Flores of Miami, who said she’s undecided.

“There were some new questions that came out after the reports this weekend as it relates specifically to HIV and some of the decisions the department has made there,” Flores said. “I need some more information and understanding ... of what are the priorities.”

The disease’s spread has been particularly dramatic in Miami-Dade and Broward counties, which in 2014 led the nation for new infections per 100,000 residents.

Armstrong’s $141,000-a-year job is on the line if the Senate does not confirm him this legislative session. The session is scheduled to end March 11.

Sen. Rene Garcia, R-Hialeah, said he’s supportive “for now” but would like Armstrong to address those same concerns.

In response to a series of written questions from Gaetz, Armstrong provided a long letter in which he called HIV and AIDS “a statewide, national and global public health issue,” and noted that the number of infants born with the virus in Florida is at an all-time low.

“The department is committed to fulfilling its mission and would not advocate for any staffing changes that would impair the ability to carry out that mission,” Armstrong wrote.

He provided data showing that over the past several years, as county health departments have lost jobs, the number of people visiting those units has declined substantially in most counties, from 3.8 million in 2011 to 3 million in the last fiscal year.

Miami-Dade bucked the trend. Patient visits there decreased only by 0.3 percent since 2010. But they declined in Broward by 22 percent, in Pinellas by 10 percent and in Hillsborough by 33 percent — one of the biggest drops of any county in the state.

Bean said he remains supportive of Armstrong and thinks he’ll ultimately win confirmation.

“I think we have the votes to pass,” he said, but “my committee members want time to be able to talk to him and have a dialogue.”

In addition to questions about HIV rates, Armstrong has been under the gun for his department’s handling of Children’s Medical Services, a health coverage program for the state’s sickest kids.

Last year, the Department of Health started using a new screening tool for CMS that resulted in more than 9,000 children being removed from coverage.

And DOH moved to gut regulations for pediatric heart surgery, which Senate Democrats have criticized. Minority Leader Arthenia Joyner, D-Tampa, who sits on the Health Policy committee wrote a letter to Armstrong Jan. 15 demanding changes.

This story was originally published January 26, 2016 at 5:43 PM with the headline "Florida Surgeon General John Armstrong’s confirmation looks uncertain."