Ethics and Elections

>> Chair: THIS IS THE FLORIDA SENATE COMMITTEE ON ETHICS AND ELECTIONS. THE COMMITTEE WILL COME TO ORDER. CALL THE ROLL. >> Chair Gaetz: HERE. >> Senator Bernard: HERE. >> >> Chair: SENATOR AVILA EXCUSED. >> Senator Bradley: HERE. >> Senator Garcia: HERE. >> Senator Grall: HERE. >> Senator Polsky: HERE. >> Senator Rouson: HERE. >> A QUORUM IS PRESENT. >> Chair: A QUORUM BEING PRESENT COMMITTEE COME TO ORDER AND WE ASK YOU TO SILENCE ALL ELECTRONIC DEVICES STARTING WITH MINE. 500 DOLLAR FINE IF YOU ARE OFF. SERGEANT AT ARMS IN THE BACK WILL COLLECT THE FINE. WE HAVE A PLACE IN THE BASEMENT OF THE CAPITAL. ANYONE WISHING TO SPEAK BEFORE THE COMMITTEE TODAY SHOULD COMPLETE AN APPEARANCE FORM AND HAND IT TO A MEMBER OF THE SERGEANTS OFFICE. IF YOU WANT TO HAVE THE COMMITTEE UNDERSTAND YOUR POINT OF VIEW BUT YOU DON'T WANT TO SPEAK YOU CAN WAIT FOR OR AGAINST ANY OF THE ITEMS THAT ARE BEFORE US TODAY. WE HAVE 62 APPOINTEES ON THE AGENDA TODAY AND TO WILL APPEAR BEFORE THE COMMITTEE. VOTES ON THOSE APPOINTEES WILL BE TAKEN UP INDIVIDUALLY WE HAVE HAD A REQUEST FROM A SENATOR TO TAKE A SEPARATE VOTE ON THE APPOINTEE IN TAB 24. IRA SCHAPIRO AND THE APPOINTEE IN TAB 27th THOMAS SMITH. WE WILL TAKE UP THOSE INDIVIDUALLY. WE WILL BEGIN TODAY OUT OF ORDER AND START WITH TAB NUMBER TWO DOCTOR JOHN LAPEL AN APPOINTEE OF GOVERNOR DESANTIS TO THE BOARD OF MEDICINE. PLEASE COME FORWARD. THANK YOU FOR BEING HERE. RAISE YOUR RIGHT HAND. DO YOU SWEAR OR AFFIRM THE EVIDENCE YOU ARE ABOUT TO GIVE WILL BE THE TRUTH, THE WHOLE TRUTH, AND NOTHING BUT THE TRUTH? THE WITNESS IS SWORN. YOU ARE RECOGNIZED TO PROVIDE INTRODUCTORY REMARKS TO THE COMMITTEE. >> [INAUDIBLE]. MONDAY BUT THANK YOU FOR GIVING ME THE HONOR OF APPEARING BEFORE YOU. THEY ASKED ME TO COME UP HERE AND I LOOK FORWARD TO QUESTIONS. I'M AN OLD FAMILY DOCTOR WHO HAS BEEN DOING THIS FOR 40 YEARS I'M BLESSED TO HAVE SERVED THE U.S. ARMY. MY WIFE I MET AS AN ARMY PEDIATRIC NURSE. WE MET SOME TIME AGO AND I WAS FORTUNATE TO SERVE IN DESERT STORM AND JOINT TASK FORCE GUANTANAMO BAY AND AS DIRECTOR OF SOLDIER CARE AND RECEIVED THE MERITORIOUS SERVICE MEDAL FOR MY WORK AND TOTAL QUALITY MANAGEMENT PARTLY DUE TO MY WORK IN GUANTANAMO BAY WITH THE HAITIAN REFUGEES AND I SERVED WITH THE NATIONAL SERVICE CORPS IN RURAL MONTANA AND EVENTUALLY GOT RECRUITED TO KISSIMMEE AND 98. I NEVER WANTED TO COME TO FLORIDA AND NEITHER DID MY WIFE BUT WE HAVE NEVER LOOKED BACK. WE'VE BEEN HERE SINCE 1998 AND IT HAS BEEN A BLESSING TO BE A DOCTOR HERE IN CHIEF OF STAFF AT HOSPITALS IN THE DEPARTMENT OF FAMILY MEDICINE AND CHAIRED FIVE DIFFERENT MEDICAL SCHOOLS. I HAVE THREE MEDICAL STUDENTS WITH ME AS WE SPEAK ROTATING AND MOST IMPORTANTLY I DO WHAT I LOVE TO DO WHICH IS TO BE A FAMILY DOCTOR. THANK YOU FOR LETTING ME COME UP HERE AND LETTING ME GO FIRST SO I CAN GET BACK TO WORK. >> Chair: LET'S BEGIN BY ASKING MEMBERS OF THE COMMITTEE IF THEY HAVE QUESTIONS FOR THE DOCTOR. ANY QUESTIONS? SENATOR POLSKY YOU ARE RECOGNIZED. >> Senator Polsky: THANK YOU FOR COMING DOCTOR. I KNOW IT IS A LONG DRIVE FOR ALL OF US AND I KNOW YOU HAVE PATIENCE AND THANK YOU FOR YOUR SERVICE TO THIS COUNTRY. CAN YOU TELL ME YOU HAVE BEEN SERVING ON THE BOARD SINCE NOVEMBER IF THAT'S CORRECT CAN YOU TELL ME WHAT YOUR ROLE IS AS A MEMBER OF THE BOARD OF MEDICINE PLEASE? >> ESSENTIALLY THE BOARD SERVES THE QUAZI JUDICIAL ENTITY WHICH IS GEARED TOWARD REVIEWING THE PERFORMANCE PHYSICIANS AND PA’S THROUGHOUT THE STATE OF FLORIDA AND IF NECESSARY TAKE DISCIPLINARY ACTIONS. IN A SENSE WE SERVE AS JUDGES FOR OUR FELLOW PHYSICIANS AND PAS BY APPLYING THE STATUTES THAT YOU ALL LEGISLATE AND PUT OUT THERE AND WE APPLY THEM TO INDIVIDUAL CASES. WE HAD ONE MEETING IN JACKSONVILLE ABOUT ONE MONTH AGO AND IT WAS EMOTIONALLY AND PHYSICALLY DRAINING TO BE IN THAT CAPACITY TO HAVE TO ADDRESS THESE SOMETIMES YOU HAVE A DOCTOR WHO HAS BEEN AN EXCEPTIONALLY GOOD DOCTOR THEIR WHOLE CAREER AND HAS MADE ONE LAPSE OF JUDGMENT AND THEN WE AS A BODY MUST TAKE DISCIPLINARY ACTIONS TO DETERMINE WHETHER THE DOCTOR SHOULD BE ALLOWED TO CONTINUE TO PRACTICE MEDICINE. SEE YOU CAN IMAGINE THE KIND OF STUFF WE HAVE TO DEAL WITH. IT'S AN HONOR TO BE THERE. THANK YOU FOR GIVING ME THE OPPORTUNITY. >> Senator Polsky: WHEN YOU MAKE A JUDGMENT ABOUT THE FELLOW DOCTOR DO YOU FOLLOW FEDERAL GUIDANCE FDC CDC ROLE OF CARE? >> THIS IS NOT RELEVANT TO MY ROLE ON THE BOARD OF MEDICINE. WE LOOK AT THE STATUTES THAT YOU GUYS HAVE IMPLEMENTED OR GROSS NEGLIGENCE I'LL GIVE YOU SOME EXAMPLES. MEDICARE FRAUD WOULD BE A BIG ONE FOR ME. PEOPLE SELLING CONTROLLED SUBSTANCES ILLEGALLY IN SOME CASES TO MINORS WE HAVE SEEN THAT. PEOPLE HAVE COPIOUS SEXUAL RELATIONSHIPS AND THEIR PRACTICES AND THEN OF COURSE MALFEASANCE AND MALPRACTICE CASES WHICH DISPLAY A LACK OF JUDGMENT. THAT IS ABOUT IT THAT I'M AWARE OF IN TERMS OF CURRENTLY REPORTED TO THE BOARD OF MEDICINE. AND FOR EXAMPLE THE PRO LIFE WORLD. IF WE FIND A DOCTOR WHO IS PERFORMING SURGICAL ABORTIONS IN THE STATE OF FLORIDA AFTER SIX WEEKS CLEARLY THAT'S A VIOLATION AND WE MUST TAKE ACTION BASED ON THE STATUTE THAT YOU GUYS HAVE PUT INTO PLACE WHEN I SAY YOU I MEAN THIS BODY HERE IN TALLAHASSEE TELLS US OTHERWISE WE JUST GO BY THE STATUTE THAT IS APPROVED BY THE STATE OF FLORIDA LEGISLATURE AND SIGNED INTO LAW BY GOVERNOR DESANTIS. >> Chair: PLEASE CONTINUE SENATOR POLSKY. >> Senator Polsky: SINCE YOU MENTIONED ABORTIONS AFTER SIX WEEKS I DON'T KNOW IF YOU'VE COME ACROSS BECAUSE IT'S BEEN A SHORT TIME SINCE YOU'VE BEEN THERE BUT IS A POSSIBLE A CASE WOULD COME BEFORE YOU OF A DOCTOR WHO PERFORMED ONE AFTER SIX WEEKS BECAUSE THE DOCTOR BELIEVED IT WAS, YOU KNOW, NECESSARY FOR SAVING THE LIFE OF THE MOTHER IS A POSSIBLE THAT YOU WOULD HAVE TO MAKE A JUDGMENT CALL ON ONE OF THOSE SITUATIONS? >> IF IT IS REPORTED TO THE BOARD OF MEDICINE THEY HAVE A PROBABLE CAUSE PANEL THAT MEETS EVEN BEFORE OUR FULL BOARD MEETS. AND THEY LOOK AT THE CIRCUMSTANCES TO DETERMINE THIS ON THE BOARD, AND WE HAVE LAWYERS FROM THE ATTORNEY GENERAL APPOINTED BY THE ATTORNEY GENERAL FOR THE STATE OF FLORIDA THAT WORK WITH THE DOCTORS. LET'S FACE IT, WE ARE DOCTORS FIRST AND FOREMOST SO WE DO NOT INTERPRET THE LAW. WE ARE JUST THERE TO ESSENTIALLY DETERMINE IF THE PHYSICIANS BEFORE US HAVE VIOLATED THE LAWS WITH THE GUIDANCE OF THE LAWYERS ON THE BOARD THAT ARE POINTED TO THE BOARD AND I GUESS THE CASE MAY COME UP SOME DAY BUT IT HAS NOT TO MY KNOWLEDGE YET. >> Chair: GO AHEAD SENATOR POLSKY. >> Senator Polsky: YOU VOCAL IN YOUR ANTIABORTION STANCE. DO YOU THINK THAT THIS WOULD AFFECT YOUR JUDGMENT ON WHETHER OR NOT AN ABORTION WAS DONE CORRECTLY UNDER OUR LAW AFTER SIX WEEKS? >> NO, ALL HUMAN LIFE IS SACRED AND I HAVE UPHELD THAT FROM AS LONG AS I CAN REMEMBER. I WAS AT CORNELL IN DEFENSE OF HUMAN LIFE BACK IN THE 70s. IT'S A CLEAR PRINCIPLE FOR ME. I HAVE ALWAYS SAID YOU WOULD NOT WANT A PHYSICIAN THAT IS NOT PRO LIFE AND I STAND BY THAT. I JUST REALLY LOVE HUMAN LIFE AS I BELIEVE GOD DOES. AS FAR AS MY ROLE ON THE BOARD WE DON'T SEEM TO HAVE THOSE CASES COME UP BUT AGAIN I'VE ONLY BEEN ON FOR A FEW SHORT MONTHS. I GUESS YOU WOULD HAVE TO CIRCLE BACK ON THAT ONE AND LET YOU KNOW WHAT COMES DOWN THE PIKE. I CAN ONLY TELL YOU THE KIND OF PERSON I AM AND I BELIEVE MY VALUES ARE PART OF THE REASON I WAS ASKED TO BE ON THE BOARD THAT REMAINS TO BE SEEN. I DID NOT ASK. >> Chair: SENATOR POLSKY. >> Senator Polsky: LAST QUESTION ON THIS PARTICULAR SUBJECT. IT SOUNDS AS IF YOU HAVE NOT HAD THIS OPPORTUNITY TO MAKE A JUDGMENT ON A CASE LIKE THIS. BUT IT SOUNDS AS IF YOU HAVE A STRONG LEANING AND SO SOMETIMES IN AN EMERGENCY SITUATION A DOCTOR DOES HAVE TO PERFORM AN ABORTION TO HOPEFULLY SAVE THE LIFE OF THE MOTHER AT THE EXPENSE OF THE FETUS. WOULD YOU BE ABLE TO VIEW THAT IN AN OBJECTIVE WAY? >> I'M ONE OF 13 MEMBERS ON THE BOARD OF MEDICINE RIGHT NOW AND I CAN TELL YOU HONESTLY I'M SURE WE DO NOT AGREE AND A LOT OF THESE ISSUES. I'M JUST ONE VOICE AT OF 13 AND IF THAT CASE COMES TO OUR ATTENTION THAT YOU CAN BE SURE THERE WILL BE SOME DEBATE AND IT WILL HAVE TO BE A VOTE AS YOU GUYS HAVE HERE 776 OR MORE IN FAVOR OF THE OUTCOME. YOU NOW IT IS A LOT OF DISCUSSION THAT TAKES PLACE AND I WOULD BE CONFIDENT I MYSELF AS ONE DOCTOR ON THE BOARD OF MEDICINE CANNOT MAKE ANYTHING HAPPEN, FRANKLY. >> Chair: SENATOR POLSKY. >> Senator Polsky: I UNDERSTAND IT BUT I WANT TO NOW WOULD YOU AUTOMATICALLY VOTE AGAINST THE DOCTOR WHO PERFORMED AN ABORTION IN THAT SITUATION BECAUSE OF YOUR STRONG STANCE. >> I WOULD LOVE TO DEBATE WITH YOU ABOUT THE PRO LIFE ISSUE SEPARATELY AND I THINK WE SHOULD SPEAK TO THE CHAIRPERSON ON THIS BECAUSE THAT'S A WHOLE SEPARATE THING. I WOULD LOVE TO DISCUSS THE LIFE ISSUES. IT IS NOT SOMETHING I BELIEVE IS GOING TO HAPPEN DURING MY ROLE AS A MEMBER OF THE BOARD OF MEDICINE. >> Chair: SENATOR POLSKY IF YOU WOULD ALLOW SENATOR GARCIA AND I PROMISE WE COME BACK TO YOU. >> Senator Garcia: THANK YOU. DOCTOR, GIVE ME CLARITY ON WHAT A SITUATION LIKE THIS THAT THE SENATOR MENTIONED DOES THE MOTHER DETERMINE WHO MAKES THAT CALL ON HER LIFE OR THE CHILD'S LIFE? WHAT IS IT THAT HAPPENS WITH THE EXPERIENCE THAT YOU HAVE HAD GIVEN A SITUATION LIKE THAT? >> I WANT ANSWER THAT QUESTION BECAUSE I DELIVERED BABIES FOR 25 YEARS AND WAS ON THE ETHICS COMMITTEE OF HOSPITALS. AND THOSE SORTS OF SITUATIONS ARE INCREDIBLY FRAUGHT WITH A LOT OF EMOTION AND A LOT OF BIAS. I CAN JUST TELL YOU I WILL THROW IT OUT THERE I WAS TOLD NOT TO MENTION THESE DETAILS BUT THE LAST BABY THAT WAS KILLED -- AND I WILL USE THAT TERM -- IN THE HOSPITAL THAT I WORK AT OR HAD THE PRIVILEGE TO BE AT -- THEY WON'T SAY WHICH ONE BECAUSE THERE ARE SEVERAL. THERE WAS A DOWN SYNDROME BABY THAT AN OBSTETRICIAN WHO HAD BEEN WORKING WITH PLANNED PARENTHOOD WAS ABLE TO DO DURING COVID WE ONLY HAD ZOOM MEETINGS AND I WAS ABLE TO CONVINCE THE ETHICS COMMITTEE THAT THIS CHILD HAD A TERMINAL CONDITION. I ARGUED ON THE OTHER END OF THE COMPUTER THAT THIS WAS NOT THE CASE AND THEY INDUCED ABORTION AT 22 WEEKS FOR THIS BABY. SO, YES, THESE THINGS HAPPEN. HE WAS CONVINCED IT WAS FOR THE LIFE OF THE MOTHER AND I CAN GUARANTEE YOU IT WAS NOT. BUT IT COULD HAVE COME BEFORE THE BOARD I SUPPOSE IF SOMEONE HAD REPORTED IT. THAT'S TIP OF THE ICEBERG STUFF SOMETIMES WITH THE BOARD LOTS OF THINGS HAPPEN A MEDICINE THAT REQUIRE SO MUCH REPORT. >> Senator Garcia: ONE MORE QUESTION. >> Chair: OF COURSE. >> Senator Garcia: I KNOW THAT THERE IS A LOT OF THINGS THAT ARE UNFORTUNATE WHEN WE BRING POLITICS INTO MEDICINE AND HAVE YOU EVER SEEN A WHERE A DOCTOR MAY HAVE BEEN ACCUSED OF ABORTING A CHILD WHEN IN REALITY THE MOTHER HAD A MISCARRIAGE OR VICE VERSA. AND THEN THERE IS THE TOP OF WHAT IF THE MOTHER HAS AN ECTOPIC PREGNANCY AND IT NEEDS TO BE TAKEN CARE OF AND THEY WON'T PERFORM IT BECAUSE THEY CONSIDER IT CAN YOU GIVE US CLARITY ON THAT? I WANT US TO START TALKING ABOUT WHAT TRULY HAPPENS AND NOT WHAT IS CONFLATED DURING POLITICAL CAMPAIGNS. >> THANK YOU SO MUCH. AGAIN, I TAKE CARE OF WOMEN. GO TO MY WEBSITE, I HAVE AN ARTICLE ON PREVENTING MISCARRIAGE USING NATURAL PROGESTERONE. MY WIFE AND I HAD SIX MISCARRIAGES AND WE HAVE TWO BABIES THROUGH THE MIRACLE OF PROGESTERONE AND I HAVE WOMEN COME TO ME FROM ALL OVER OF THE STATE OF FLORIDA TRYING NOT TO HAVE MISCARRIAGES. AT A WOMAN JUST LAST WEEK YOU HAD AN ECTOPIC PREGNANCY. FASCINATING ACTUALLY SHE ONLY HAS THE OVARIES ON THE LEFT SIDE. THE RIGHT SIDE HAD NOT BEEN THAT WAS REMOVED AND NO ONE FIGURED OUT HOW THE BABY ENDED UP IN THAT TOO WITHOUT THE OVARY BUT THE REALITY IS WHEN YOU ARE MANAGING AN ECTOPIC PREGNANCY SURGICALLY OR CHEMICALLY WHICH ARE THE TWO OPTIONS OR A MISCARRIAGE THERE IS NO DOCTOR THAT SHOULD EVER BE ACCUSED OF KILLING THAT BABY. OR HAVING PERFORMED AN ABORTION AND THERE WAS BAD PUBLICITY THAT WENT AROUND WHEN A YOUNG LADY WHO IS HEMORRHAGING WENT TO THE ER I BELIEVE IT WAS IN SOUTH CAROLINA AND THEY SAID THEY WOULD NOT DO WHAT NEEDED TO BE DONE IN THE EMERGENCY ROOM BECAUSE IT WAS AN EMERGENCY ROOM AND THE GIRL WENT HOME AND BLED TO DEATH AND THEY BLAMED WHATEVER POLICIES BUT SOME DOCTORS MISSED WHEN WOMEN BLEED. THAT'S A COMMON DIAGNOSIS TO MISS IT. I WOULD SAY MOST ECTOPIC PREGNANCY IT'S ONE OF THE MOST COMMON THINGS TO MISS IS A DIAGNOSIS AND A WOMAN CAN HEMORRHAGE TO DEATH AND MISCARRIAGE AND IT'S FASCINATING THE CONVERSATION BECAUSE WE DO IT EVERY DAY NOW WITH CHEMICAL ABORTIONS. EVERY DAY IN THE STATE AT LEAST 20 BABIES ARE BEING KILLED BECAUSE WOMEN ARE TAKING DO IT YOURSELF MISCARRIAGE KITS AND GOING HOME AND HEMORRHAGING. IT'S INTERESTING THAT SOMEONE WOULD DEBATE THAT A DOCTOR WE SHOULD GET RID OF YOU KNOW PRESERVE A WOMAN'S RIGHT TO ABORTION WHEN IN FACT THE MAJORITY OF WOMEN I HAVE SPOKEN TO HAVE BEEN SO TRAUMATIZED BY THESE AT HOME MISCARRIAGES YOU KNOW I CAN GET TO THE DETAILS I'M SURE SOME OF YOU HAVE HEARD ABOUT WHAT HAPPENED WITH CHEMICAL ABORTIONS THESE WOMEN ARE 12, 13, 14 WEEKS WHO ARE GETTING MAIL FROM NEW YORK AND CALIFORNIA AND THE R 46 AND THEN THEY REACH OUT TO ME AND IT'S TOO LATE. THERE ALREADY HEMORRHAGING AND THE BABY IS GONE. I WOULD LOVE TO BE OF ASSISTANCE BUT IT'S OFF SIDE OF MY PURVIEW. >> Chair: THANK YOU. SENATOR POLSKY DO YOU WISH TO CONTINUE. >> Senator Polsky: THANK YOU. DURING THE COVID 19 PANDEMIC THE FDA AND CDC ADVISED AGAINST USING IVERMECTIN TO TREAT COVID. DO YOU ACKNOWLEDGE THAT GUIDANCE TODAY? >> I THINK IVERMECTIN SAVED A LOT OF LIVES DURING COVID A LOT. AND IT IS AMAZING. I REALIZE THIS IS NOT PART OF MY BOARD OF MEDICINE AND I WAS TOLD NOT TO ADDRESS THESE ISSUES BUT I'M DOING THIS FOR EDUCATIONAL PURPOSES IF NOTHING ELSE BUT IT WAS DEVELOPED AS A MACRO ANTIBIOTIC AND IT IS IN THE SAME CATEGORY AND PATHWAY AS IS Z PACK. IT WAS LABELED AS IVERMECTIN BECAUSE IT'S FIRST UTILITY WAS CALLED SOMETHING ELSE NO ONE WOULD HAVE HAD AN ISSUE. IT'S ANTI INFLAMMATORY, ANTIVIRAL, ANTIPARASITIC, AND HAS ANTIBACTERIAL PROPERTY. HAVING THROWN ALL THAT OUT THERE I WILL SAY THIS, I HAVE NOT HAD TO PRESCRIBE IVERMECTIN TO KEEP SOMEONE OUT OF THE HOSPITAL SINCE 2022. BUT I DON'T BELIEVE THAT'S AN ISSUE THAT WILL COME BEFORE THE BOARD OF MEDICINE. >> Senator Polsky: I DISAGREE THESE STANDARDS OF CARE WOULD NOT COME BEFORE YOU ON THE BOARD OF MEDICINE BECAUSE YOU ARE JUDGING A DOCTOR'S PERFORMANCE AND, SO, I AM CONCERNED ABOUT THAT. CAN YOU COMMIT TO APPLYING CDC FDA STANDARDS WHEN EVALUATING COMPLAINTS EVEN IF YOU PERSONALLY DISAGREE WITH THE STANDARD OF CARE FROM THE FEDERAL GOVERNMENT? >> IF SOMETHING COMES TO THE BOARD BY THE WAY OF A COMPLAINT ABOUT THE BEHAVIOR OF A PHYSICIAN AND BY THE WAY SENATOR POLSKY AND MR. CHAIRMAN WE ARE LIKELY TO GET COMPLAINTS FROM OVERUSE OF IVERMECTIN THEN I WILL HAPPILY REVIEW THEM AS A BOARD. I AM ONE WHO BELIEVES IN TRADITIONAL MEDICINE AND THE MEDICINE I LEARNED AT GEORGE WASHINGTON UNIVERSITY AND SINCE THEN I'M A BIG CRITIC OF A LOT OF MEDICINE BUT I'M ALSO A CRITIC OF A LOT OF WHAT PEOPLE ARE DOING OUTSIDE OF TRADITIONAL MEDICINE. AND I GUESS IF YOU WANT TO KNOW ONE THING SENATOR POLSKY I AM VERY MUCH OPPOSED TO THE CONCEPT OF PROFITEERING ON MEDICINE. YOU KNOW I HAVE A TEXTBOOK IN EXPORT OF CAPITALISTIC SOCIETY AND THAT SUMS IT UP. WHEN WE SEE PATIENTS AND DOCTORS COMMITTING MEDICARE FRAUD OR DEFRAUDING PATIENTS THOSE COME TO OUR ATTENTION I AM SURE. >> Chair: SENATOR POLSKY I'D LIKE HIM TO CLARIFY YOUR ANSWER. I DON'T MEAN TO PUT WORDS IN SENATOR POLSKY'S MOUTH BUT I THINK WHAT SHE MAY BE AFTER IS ON THE ONE HAND YOU HAVE THE FLORIDA STATUTE WHICH YOU ARE OBLIGED TO USE IN MAKING DECISIONS ON THE BOARD OF MEDICINE. THAT IS THE TEMPLATE. ON THE OTHER HAND YOU HAVE CDC RECOMMENDATIONS AND RECOMMENDATIONS FROM OTHER FEDERAL AGENCIES THAT ARE NOT NECESSARILY IN CONFLICT WITH WHAT FLORIDA LAW SAYS, BUT THEY MAY BE OUTSIDE OF THE SCOPE OF FLORIDA LAW WHEN IT COMES TO A PARTICULAR TOPIC. I THINK THE QUESTION PERHAPS SENATOR POLSKY I DON'T KNOW IF SHE WILL CORRECT ME IF I'M WRONG BUT THE QUESTION THAT ALL OF THIS SEEMS TO MAKE A RISE IN MY MIND IS TO WHAT EXTENT IF YOU HAVE CDC GUIDANCE ON A PARTICULAR TOPIC TO WHAT EXTENT DOES THE CDC GUIDANCE CONTROL OR GUIDE OR DERIVE YOUR DECISION AS A MEMBER OF THE BOARD OF MEDICINE IF THE CDC GUIDANCE CONFLICTS WITH A BELIEF THAT YOU HAVE COME THROUGH THE PRACTICE OF MEDICINE AND YOUR EDUCATION AND EXPERIENCE? I'M SORRY SENATOR POLSKY. >> THANK YOU. I THINK I COULD GO ON AND ON. I WROTE A BOOK WHICH WAS EITHER GOING TO GIVE YOU ALL THE HIDDEN TRUTH WHICH GO THROUGH MANY OF THE CDC AND FDA RECOMMENDED TREATMENTS AND PREVENTATIVE STRATEGIES THAT HAVE BEEN PROVEN FALSE IF NOT DANGEROUS OVER THE YEARS AND ONE EXAMPLE IS SOMETHING CALLED E SURE WHICH IS FDA APPROVED I HAD MANY PATIENTS HAVE THIS ROD PUT INTO THEIR TUBES FOR BIRTH CONTROL AND IT LED TO UNNECESSARY HYSTERECTOMIES AND IN MANY CASES DEATH AS WE SEE WITH TUBAL PREGNANCIES. AND THE ONLY THING THE FDA DID IN RESPONSE TO THOSE AND I'M DATING MYSELF NOW BECAUSE THIS IS PROBABLY 15 YEARS AGO IS THEY TOLD OBSTETRICIANS TO HAVE THE PATIENT SIGN A 20 PAGE DOCUMENT ABOUT ALL THE RISKS THAT COULD HAPPEN WHEN THIS IS PUT IN. AND YOU KNOW ARON BROCKOVICH DID A WHOLE THING ON THIS PEA RIDGE SHE WAS VERY MUCH A WOMAN'S ADVOCATE. AT THE FDA, APPROVAL WAS DONE WITHOUT ANY RESEARCH AT ALL. IT WAS PRESSURED BY BIG PHARMA THAT WANTED TO COME THROUGH AND I CAN SAY THAT ABOUT MANY THINGS WITH THE FDA AND THE CDC DURING COVID WITH MASKS AND FRANKLY SOME OF THE COVID I WON'T GET INTO DETAILS ON PROTOCOLS. BUT YOU'RE ASKING IN THE STATE OF FLORIDA IF PHYSICIANS ARE GOING AGAINST GUIDELINES FOR THE CDC OR PERHAPS EVEN THE FDA FOR WHAT WILL THE BOARD OF MEDICINE DO ABOUT IT? THAT IS A FLUID QUESTION. >> Chair: I APOLOGIZE DOCTOR WHAT I MEANT TO ASK IS IF YOU HAVE CDC OR FDA GUIDELINES WHICH YOU MAY DISAGREE WITH BASED ON YOUR OWN VAST EXPERIENCE AND EDUCATION DO YOU BELIEVE THAT THAT CREATES A PROBLEM FOR YOU IN CARRYING FORWARD YOUR POSITION AS A MEMBER OF THE BOARD OF MEDICINE IF ON THE ONE HAND YOU HAVE CDC GUIDANCE THAT CONFLICTS WITH WHAT YOU BELIEVE DOES IT GET IN YOUR WAY IN MAKING DECISIONS ON THE BOARD OF MEDICINE? >> THERE IS NO INTERFERENCE IN MY JUDGMENT. I FOLLOW THE HISTORY OF THE CDC SINCE HENRY FOSTER AND JOCELYN EDWARDS AND I'VE SEEN POPULATION CONTROL STRATEGIES AND ROLL GEORGE ORE LEADING UP 12 YEAR OLD FOR DEPO PROVERA INJECTIONS. IT'S BEEN A HOUSE OF HORRORS IN MY CAREER DEALING WITH THE CDC I'M GLAD IT IS BEING REVAMPED. IT'S HARD TO FIND DOCTORS WILLING TO DO THAT JOB THAT'S ANOTHER STORY. IT'S HARD TO FIND GOOD DOCTORS WILLING TO WALK AWAY FROM PATIENTS TO EVEN DO YOUR JOB HERE. IT IS HARD THING TO FIND DOCTORS WHO WANT TO BE ADMINISTRATIVE FOLKS WHEN THEY ARE GOOD DOCTORS. >> Chair: SENATOR POLSKY I APOLOGIZE. YOU ARE RECOGNIZED. >> Senator Polsky: WHAT IS THE CURRENT STATUS OF YOUR CERTIFICATION WITH THE AMERICAN BOARD OF FAMILY MEDICINE? >> YES MA'AM, THANK YOU FOR ASKING MR. CHAIRMAN AS WELL AND FULLY BOARD CERTIFIED I'M IN THE RECERTIFICATION WHICH IS EVERY TENURE PROCESS I HAVE TO ANSWER LOTS OF QUESTIONS AND A HUNDRED 50 HOURS OF CME CURRENTLY BOARD AND I PLAN TO KEEP GOING AND BEING BOARD CERTIFIED. I LIKE TO TAKE CARE OF MY HOSPITAL PATIENTS AND TEACH MEDICAL STUDENTS AND THAT CAN BE A PREREQUISITE FOR THAT. >> Chair: SENATOR POLSKY. >> Senator Polsky: DIDN'T THEY TAKE AWAY YOUR CERTIFICATION AT ONE POINT AND HAS BEEN REINSTATED THROUGH LEGAL CHANNELS? >> YES IT WAS A STRANGE TURN OF EVENTS DURING COVID. I WAS ACCUSED OF BEING UNPROFESSIONAL BECAUSE I HAD BEEN CRITICAL OF THE COVID VACCINE AND THEY SENT ME A LETTER SEPTEMBER OF THAT YEAR AND THEY SAID YOU'RE STRIPPED OF YOUR BOARDS' EDUCATION FOR THREE MONTHS MAY, JUNE, AND JULY AND WE RESTORE THEM IN AUGUST. SO SOMEHOW I HAD THREE MONTHS OF BEING NOT BOARD CERTIFIED BUT WAS NEVER NOTIFIED OF IT. THERE WAS LOTS OF PRESSURE BEING PUT ON THE AMERICAN BOARD OF MEDICINE BY CONGRESSWOMEN AND SENATORS BECAUSE YOU KNOW LEST THEY HEARD AN AMERICA WE CAN SPEAK OUT ABOUT THINGS AND NOT BE ACCUSED OF YOU KNOW NOT BE A GOOD DOCTOR. BUT I HAVE BEEN FULLY BOARD CERTIFIED EVER SINCE THEN AND I PLAN TO CONTINUE IT. >> Chair: SENATOR POLSKY ANYTHING FURTHER? >> Senator Polsky: YES. SO OBVIOUSLY AS THE BILL GOES THROUGH THIS BODY RIGHT NOW THERE IS LOTS OF DISCUSSION ABOUT DOCTORS ROLLS IN OFFERING VACCINES AND THE INFORMATION THAT THEY NEED TO PROVIDE AND I CAN CERTAINLY SEE IN THE FUTURE WHERE THERE WOULD BE A COMPLAINT TO THE BOARD OF MEDICINE FROM A PATIENT EITHER A DOCTOR DID NOT PROVIDE VACCINES WHEN THEY WANTED THEM OR DID PROVIDE OR PUSHED VACCINES AND THEY DID NOT WANT THEM SO I FEEL LIKE THIS IS GOING TO COME BEFORE THE BOARD. AND IT SEEMS THAT YOU ARE VERY SKEPTICAL ABOUT VACCINES EVEN BEYOND THE COVID VACCINE I READ A BUNCH OF THINGS EVEN THE WELL ESTABLISHED CHILDHOOD VACCINE. SO HOW WOULD YOUR FEELING ABOUT VACCINES AFFECT THE DECISION ON THE BOARD ABOUT DISCIPLINE OF ANOTHER DOCTOR. >> IT COMES BACK TO THE STATUTES. I THINK THIS MAY COME DOWN TO WHERE A PHYSICIAN WE GET A COMPLAINT ABOUT A PHYSICIAN WHO IS NOT ALLOWING PATIENTS TO MAKE INFORMED DECISIONS ABOUT THEIR CHILDREN AND THAT IS WHERE WE ARE IN FLORIDA NOW THAT WE ALLOW OTHERS TO MAKE INFORMED DECISIONS ABOUT THEIR CHILDREN. I SUPPORT THAT BUT WE MUST WAIT AND SEE WHAT COMES BEFORE THE BOARD. I THINK THIS IS TOO THEORETICAL FOR RIGHT NOW CHAIR FOR SENATOR POLSKY. >> Senator Polsky: I WANT TO CLARIFY IF THE COMPLAINT COMES BEFORE YOU THAT A DOCTOR DROPPED A PATIENT BECAUSE THEY REQUIRED VACCINATIONS IN THEIR PRACTICE. PEDIATRICIANS FOR EXAMPLE. HOW WOULD YOU COME OUT ON THAT DISCIPLINE IF A DOCTOR REQUIRED VACCINATIONS IN HIS OR HER OFFICE. >> I HAD MANY PATIENTS COME TO ME WHO WERE TURNED AWAY. IT COULD BE A CHRONIC ILLNESS. EVEN IF THEY ARE NOT THE PEDIATRICIAN SAID WE WILL NOT SEE YOU ANYMORE. MANY ARE MEDICAID PATIENTS. I TAKE CARE OF A LOT OF MOMS AND BABIES. AND I AM HONORED TO DO SO. I HAD ONE MOTHER WHO LOST A 2 YEAR OLD WHO DIED WITHIN TWO WEEKS OF RECEIVING LIKE THREE TO FOUR DIFFERENT VACCINES AND SHE WAS SKEPTICAL AND DID NOT WANT HER NEW BABY TO GO THROUGH THE SAME BARRAGE THAT WE DO IN THIS COUNTRY WHICH I THINK WE HEARD IS MORE THAN MOST OF THE NATIONS AROUND THE WORLD. MORE THAN JAPAN AND FINLAND. SO HER DOCTOR KICKED HER OUT OF THE PRACTICE. THAT WAS TRAUMATIZING FOR HER. UPSETTING FOR ME TO AS WELL. IF IT COMES BEFORE ME IT'S A CASE BY CASE SCENARIO AND WE HAVE TO SEE WHAT HAPPENS WITH THE FLORIDA STATE STATUTE AND WHETHER THE COMPLAINT COMES BEFORE US ON THE BOARD. >> Chair: SENATOR POLSKY. >> Senator Polsky: UNDER THE CURRENT STATUTES A DOCTOR IS NOT REQUIRED TO KEEP ANY PARTICULAR PATIENTS. HOW WOULD YOU JUDGE A COMPLAINT THAT CAME BEFORE YOU AT THE STATUTE DOES NOT CHANGE WHEN YOU HAVE BEEN KNOWN TO SAY THAT IT IS CHILD ABUSE TO REQUIRE VACCINES? >> THOSE ARE NOT MY EXACT WORDS AS I RECALL. I THINK THE CASE I JUST MENTIONED MAY HAVE BEEN MORE OF WHAT I THOUGHT ABOUT AS BEING I DON'T WANT TO I REALLY CANNOT ANSWER THAT QUESTION I HAVE TO GET BACK TO YOU. I'M PRETTY CLEAR ABOUT THE RIGHT OF PARENTS TO MAKE INFORMED DECISIONS ABOUT THEIR CHILDREN. MEDICINE IS NOT A ONE SIZE FITS ALL KIND OF THING. THE ART OF MEDICINE HAS GONE DOWN THE TUBES. IT'S IN THE TOILET. PHYSICIANS ARE AI DRIVEN. I HEAR ALL THE TIME I WENT TO A MEETING WITH ADVENT HELP AND SAID FAMILY PHYSICIANS ARE NOT EVEN NEED IT ANYMORE WE NEED A PATIENT AND A PHONE AND A AND THAT'S IT. THIS WAS A PLASTIC SURGEON SOUTH FLORIDA WHO SAID THIS. WE ARE BECOMING EXPENDABLE. BECAUSE EVERYONE THINKS THEY HAVE A BETTER IDEA WITH PROTOCOLS AND AI. THE ART OF MEDICINE. I LOVE THE PROFESSION OF MEDICINE. I HAVE SEEN IT EVAPORATE IN THE 40 YEARS I HAVE BEEN IN THIS PROFESSION AND IF I AS A MEMBER OF THE BOARD OF MEDICINE CAN DO ANYTHING TO BRING BACK THE TRUE PROFESSION OF MEDICINE, YOU CAN BE SURE I WILL BE FIGHTING FOR THAT AND THAT'S ALL I NEED TO SAY. HAS FURTHER SENATOR POLSKY. >> Senator Polsky: YES. AS A FAMILY PHYSICIAN YOU ARE ABLE TO PRACTICE FERTILITY MEDICINE AS A FAMILY PHYSICIAN? CAN YOU EXPLAIN THAT? >> I WAS AN ARMY TRAINED FAMILY DOCTOR AND HE GOT TO DELIVER LOTS OF BABIES. I RAN THE OB WARD AT FORT BRAGG DURING DESERT SHIELD AND O MY LORD I LOVE OBSTETRICS. UNFORTUNATELY IN THE STATE OF FLORIDA IS MORE IN COMMON FOR FAMILY DOCTORS TO DELIVER BABIES BUT REMEMBER I WAS ONLY DOCTOR IN THE COUNTY IN MONTANA AND OTHER SITUATIONS WHERE WE DO A LOT OF FERTILITY CARE. NOW KIND OF MY WIFE'S INSISTENCE I DELIVERING BABIES LEAVING AT 3:00 A.M. BUT I STILL DO A LOT OF FERTILITY CARE HELPING WOMEN WHO ARE INFERTILE AND SUFFER THROUGH MISCARRIAGES AND COUPLES ET CETERA. >> Chair: SENATOR POLSKY. >> Senator Polsky: DO YOU PRACTICE SOMETHING CALLED KNOB PRO TECHNOLOGY AND IS THAT APPROVED BY THE FDA? >> TO MY KNOWLEDGE IT HAS NOT YET EXPLORED WHAT DOCTOR TOM HILL AND OMAHA HAS DONE. 3,000 DOCTORS AROUND THE COUNTRY HAVE LEARNED NATURAL PROCREATIVE TECHNOLOGY, WHICH IS REALLY JUST THE WAY OF SAYING TO YOUNG COUPLES YOU DON'T HAVE TO ALWAYS GO TO IVF. WE CAN HELP YOU. THAT IS WHAT MY BOOK IS ABOUT I WAS GONNA BRING IT. IT'S IN MY CAR IF YOU WANT TO CHASE OUT AFTER ME I'LL GIVE IT TO YOU. BUT IT'S ALL ABOUT RESTORING THE NORMAL REPRODUCTIVE CYCLE AND YOUNG WOMEN. I TALKED TO COUPLES PREPARING FOR MARRIAGE OVER 100 PEOPLE IN OUR CHURCH DOWN IN OCALA AND I SAY WHAT IS HAPPENING IN THIS WORLD'S WOMEN AT 15 ARE BEING STRIPPED OF THEIR FERTILITY AND THEN WHEN THEY ARE 35 AND READY TO HAVE BABIES THEY CANNOT HAVE THE BABIES BUT THEY CAN HAVE IVF BABIES. THEY GET THEM COMING AND GOING. DOCTOR TOM HILL IN OMAHA AND MY DAUGHTER HAS GONE TO THE PROGRAM AND THOUSANDS OF DOCTORS AROUND THE COUNTRY. REALLY IT HAS SAVED TENS OF THOUSANDS OF BABIES. >> Chair: SENATOR POLSKY. I WANT TO NOTE THAT WE HAVE 61 OTHER NOMINEES. >> Senator Polsky: YES BUT YOU KNOW I'M NOT ASKING QUESTIONS OF 59 OF THEM. >> Chair: YOU NEVER KNOW. >> Senator Polsky: NO, NO, NO, NO, NO. THIS IS MY LAST TOPIC. YOU HAVE BEEN A CRITIC OF HORMONAL BIRTH CONTROL. IF A 19 YEAR OLD WOMAN WHO YOU TREAT ASKED YOU FOR BIRTH CONTROL WOULD YOU PRESCRIBE IT? >> AGAIN, I'M DOING THIS FOR EDUCATIONAL PURPOSES NOT AS A MEMBER OF THE BOARD OF MEDICINE AND I WILL SAY THIS CLEARLY IF THERE WAS ONLY ONE BIRTH CONTROL PILL THERE WOULD BE NO BIRTH CONTROL PILLS. THE CLOSEST WE HAVE TO THAT WAS WHEN YAZ WAS BEST THAT CAME OUT 20 YEARS AGO AND EVERYONE WAS HOT TO TROT ON THIS AND WOMEN WERE DROPPING LIKE FLIES THEN ALL OF A SUDDEN LAWSUITS WENT AROUND AND THEY SAID LET'S NOT CALL IT THIS LET'S CALL IT YAZMINE AND WE HAVE OVER 215 TYPES OF BIRTH CONTROL PILLS OUT THERE AND THEY IN DETERRENT IS TO NOT HAVE ANY IN EXISTENCE AND THOSE CHEMICALS HAVE DONE MORE DAMAGE TO WOMEN THAN ANY SINGLE DRUG EVER CREATED BY MANKIND. >> SENATOR POLSKY. >> Senator Polsky: THIS IS NOT SO MUCH HOW YOU PRACTICE MEDICINE BUT OBVIOUSLY YOUR EXPERTISE AND BIASES WILL PLAY INTO JUDGING OTHER DOCTORS SO IN THAT CONTEXT IF A MOTHER AND MADE A COMPLAINT THAT A DOCTOR GAVE THEIR DAUGHTER BIRTH CONTROL AND THERE WAS SOME RESULTS THAT THEY WERE NOT HAPPY WITH YOUR STANCE ON BIRTH CONTROL WHICH HAS BEEN OUT FOR VERY LONG TIME WOULD THAT AFFECT YOUR DECISION MAKING ON THE DISCIPLINE OF DOCTOR? >> I CAN SAY IT WAS THERE AND I WAS ONE OF THOSE DOCTORS. I WOULD NOT SIT IN JUDGMENT OF THAT DOCTOR TOO HARSHLY BECAUSE AS I WROTE IN MY BOOK IT TOOK ME MANY YEARS TO COME AROUND TO MY THINKING. IT TOOK MY WIFE AND I HAVING THREE CHILDREN MAKING A DECISION OURSELVES TO COME AROUND IN MY THINKING. I ALWAYS SAY IN REGARD TO ANYTHING THAT WE DO IN THE BOARD OF MEDICINE AS I SAID WE ACT AS A JUDGE OF OUR PEERS AND I FIND MYSELF BEING OVERLY SYMPATHETIC IF ANYTHING BECAUSE I HAVE BEEN THERE. I AM JUST ONE OUT OF 13 SENATOR POLSKY. I LOOK FORWARD TO SERVING A LONG TIME ON THE BOARD OF MEDICINE. >> Senator Polsky: LAST QUESTION. >> Chair: YES MA'AM OF COURSE. >> DOCTOR YOU ARE MENTIONED A FEW TIMES YOU WERE TOLD NOT TO MENTION DETAILS. WHO TOLD YOU THAT? >> PEOPLE WHO KNOW ME WELL. PEOPLE WHO KNOW MY PROPENSITY TO SAY MORE THAN I SHOULD SAY. THAT IS JUST ME. I REELED IT IN. MY WIFE IS BACK THERE. SHE IS GOOD. SHE CAN'T KICK ME UNDER THE TABLE. I'M JUST VERY BLUNT I'M FROM NEW YORK AND I'M PROUD OF IT AND I BELIEVE THAT YOU CANNOT HIDE YOU KNOW ONCE YOU HAVE SEEN THE TRUTH AND SEEN CLEARLY IT IS HARD TO HOLD BACK WHEN YOU SEE SO MUCH HAPPENING AROUND YOU THAT IS NOT RIGHT I THINK I HELD BACK PRETTY WELL TODAY. EVEN THOUGH I SPOKE MORE THAN I SHOULD THANK YOU MR. CHAIR. >> Senator Polsky: LAST FOLLOW UP ON THAT QUESTION. DID ANYONE FROM THE STATE ADMINISTRATION TELL YOU NOT TO MENTION DETAILS IN YOUR TESTIMONY TODAY? >> TO MY KNOWLEDGE NO. WE HAD A FORMAL CONVERSATION ABOUT ME AND HOW I TEND TO ANSWER QUESTIONS AND MOST OF THIS WAS ME REALIZING AND LETTING THEM KNOW THE KIND OF PERSON I AM. PEOPLE DON'T REALLY KNOW ME THAT WELL. I THINK YOU DO KNOW THOUGH. >> Senator Polsky: I SURE DO. THANK YOU. >> Chair: FURTHER QUESTIONS FOR THE DOCTOR? IF NOT, DOCTOR, WE DO APPRECIATE VERY MUCH YOU BEING HERE AND YOU ANSWERING OUR QUESTIONS. WE TAKE THE BOARD OF MEDICINE VERY SERIOUSLY. WE THINK IT IS ONE OF THE MOST IMPORTANT DECISIONS WE HAVE TO MAKE IS WHO TO CONFIRM FOR THE BOARD OF MEDICINE. AND ARE THERE ANY APPEARANCE FORMS REGARDING DOCTOR PATEL? IS THERE DEBATE? DEBATE? YES SENATOR. >> Senator Grall: THANK YOU. I'M GLAD I GOT TO BE HERE TODAY TO HEAR YOUR ANSWERS. AND I DO APPRECIATE THE VOICE THAT YOU ARE IN THE WORLD OF CORPORATE MEDICINE THAT HAS TAKEN OVER AND KILLED THE ART THAT YOU SO BEAUTIFULLY TALKED ABOUT. I THINK THAT I KNOW A LOT OF OLDER DOCTORS WHO ARE NOT ABLE TO ENCOURAGE THEIR CHILDREN TO PURSUE THE SAME PROFESSION BECAUSE OF HOW MUCH IT HAS CHANGED. THAT IS SAD TO ME. THOSE RELATIONSHIPS. YOUR EXPERTISE. IS NOT WHAT IS VALUED ANYMORE AND MANY PEOPLE FEEL THAT. I DON'T THINK THERE IS A SMALL GROUP. I THINK THERE IS A LARGE GROUP OF PEOPLE WHO FEEL LIKE IT IS A PREDETERMINED OUTCOME WHEN THEY WALK INTO THE DOCTOR BASED ON THOSE PROTOCOLS THAT YOU DISCUSSED. I ALSO APPLAUD YOU FOR CHALLENGING THE STATUS QUO IN HOW WE TREAT WOMEN AND FAMILIES AND FERTILITY. BECAUSE YOU ARE UP AGAINST BILLION DOLLAR INDUSTRY INDUSTRIES THAT SEEK COULD ADJUST PROFIT ON VERY EXTREME MEASURES TO BECOME PARENTS. THESE ARE DIFFICULT TIMES WHEN ALL THEY WANT IS TO HAVE A CHILD AND HAVE A FAMILY AND THEY ARE PROMISED SOMETHING THAT COMES WITH A LOT OF CONSEQUENCES. WHEN THERE ARE ALTERNATIVE PATHS THAT ARE VERY SUCCESSFUL. I LOOK FORWARD TO YOUR VOICE BEING ON THE BOARD OF MEDICINE AND GOING ALONG TODAY THANK YOU. >> Chair: ANY MORE DEBATE? YES SENATOR POLSKY. >> Senator Polsky: THANK YOU FOR COMING IN ANSWERING QUESTIONS. I THINK IT WAS IMPORTANT FOR PEOPLE TO SEE. I HAVE A LOT OF CONCERNS. ESPECIALLY WHEN YOU WOULD SAY I'M JUST ONE OF 13 SO IF I HAVE A BIASED VIEWPOINT DOES NOT MATTER BUT THAT IS NOT RIGHT. IT SEEMS CLEAR THAT YOU HAVE YOUR STANCES AND THERE IS NOTHING WRONG WITH YOUR STANCES AS AN INDIVIDUAL PRACTICING PHYSICIAN. BUT THERE IS SOMETHING WRONG WITH IT WHEN IT CAN BE POSED ON DISCIPLINE OF THE TENS OF THOUSANDS OF DOCTORS YOU KNOW WHO MIGHT COME BEFORE THE BOARD OF MEDICINE. WE ARE CREATING THIS LEGISLATURE AN ATMOSPHERE OF ATTACKING DOCTORS. THIS MEDICAL FREEDOM BILL RUNNING THE LEGISLATURE IS ONLY GOING TO MAKE IT WORSE THAT THEY WILL HAVE PEOPLE WHO ARE CREATING MORE COMPLAINTS AND A LOT OF THEM WILL BE ALONG THE LINES OF THINGS THAT WE DISCUSSED TODAY. I AM VERY CONCERNED ABOUT THE POSITIONS ON ABORTION. I DON'T THINK ANYONE WOULD GET THROUGH WITHOUT YOU WANTING TO DISCIPLINE SOMEONE WHO PERFORMED AN ABORTION EVEN TO SAVE A LIFE OF A MOTHER. I'M VERY CONCERNED ABOUT YOU NOT WANTING TO FOLLOW FDA CDC GUIDELINES. THAT COULD COME INTO EFFECT. I'M VERY CONCERNED ABOUT THE ANTI VACCINE PHILOSOPHY WHEN IT COMES TO DISCIPLINING OTHER DOCTORS. LIKE I SAID IT'S ONE THING TO DO IT IN YOUR OWN PRACTICE AND PEOPLE CAN CHOOSE TO SEE YOU OR NOT. LUCKILY, I SAW A DOCTOR WHO WAS ABLE TO HELP ME HAVE TWO CHILDREN THROUGH TRADITIONAL IVF OTHERWISE WEATHER NEVER WOULD HAVE. I SAW DOCTORS WHO SAVED MY LIFE WITH TREATMENT AFTER AN ECTOPIC PREGNANCY. IT IS HARD TO PRACTICE MEDICINE IN THE STATE. YOU WILL FIND THAT THERE ARE FEW OB/GYN'S COMING IN. IT IS BECAUSE OF STANCES LIKE THIS. IT IS BECAUSE OF THE JUDGMENT AND THE DECIDING THAT THE FETAL LIFE IS MORE IMPORTANT THAN THE LIKE OF THE MOTHER. IT SAYS ON A ZOOM CALL THAT THERE IS NO WAY THE LIFE OF THE MOTHER WAS OR THERE IS NO WAY THE FETUS WAS TERMINALLY ILL WHEN IT HAD DOWN SYNDROME AND IT COULD NOT HAVE HAD ANYTHING ELSE AND THEREFORE IT MUST HAVE BEEN A LEGAL ABORTION. AND IT IS THAT AUTOMATIC JUMP TO THE JUDGMENT. THIS IS NOT A DEBATE ABOUT PRO LIFE. THIS IS ONLY HAVING TO DO WITH BEING OBJECTIVE ENOUGH TO JUDGE OTHER DOCTORS WHO HAVE DIFFERENT NOT ONLY POLITICAL VIEWPOINTS, MEDICAL VIEWPOINTS, THE WAY THEY TREAT THEIR PATIENTS DIFFERENTLY, AND IT IS APPLYING AN OBJECTIVE STANDARD. YOU HAVE THE ABILITY TO TAKE AWAY A DOCTOR'S LICENSE. THAT IS A SERIOUS CHARGE. I AM CONCERNED THAT SOMEONE WHO HAS SUCH STRONG VIEWPOINTS. I WILL NOT SAY THEY ARE WRONG AND I WILL NOT SAY THEY ARE OUT THERE BUT THEY ARE SO STRONG IN THEIR VIEWS AND YOU SAID IT HERE TODAY THAT I THINK IT WOULD BE THE BULL FOR YOU TO JUDGE OTHER DOCTORS FAIRLY AND THEREFORE I CANNOT SUPPORT YOU FOR THIS NOMINATION. >> Chair: ANY FURTHER DEBATE? YES? SENATOR GARCIA? >> Senator Garcia: I APPRECIATE YOU AND I SECOND EVERYTHING THAT SENATOR GRALL ALWAYS SAYS SO GRACEFULLY. BUT I CAN SEE WITH THE VAST KNOWLEDGE THAT YOU HAVE HAD THAT YOU HAD TO MAKE DECISIONS WHERE YOU KNOW BETTER BUT YOU STEP BACK AND ALLOWED THE SITUATION TO BE WHAT IT IS. WHATEVER THE PERSON HAD DECIDED AT THAT MOMENT. AND SENATOR POLSKY LIKE YOU I WENT THROUGH A SIMILAR SITUATION. BORN WITH EPILEPSY ALL MY LIFE I WAS TOLD I COULD NOT OR I SHOULD NOT HAVE CHILDREN. THEN I HAD A SITUATION WHEN I WAS 19 YEARS OLD WHERE I LOST MY FALLOPIAN TUBES. ONE OF THEM. AND IT WAS A DOCTOR LIKE YOU WHEN I DID FIND OUT THAT I WAS PREGNANT AT 12 WEEKS THAT WALKED ME THROUGH MY PREGNANCY AND ALLOWED ME TO HAVE THE AMAZING SON THAT I HAVE TODAY. SO THANK YOU FOR YOUR SINCERITY. THANK YOU FOR BEING SO BRAVE BECAUSE IT IS A TOUGH INDUSTRY TO BE IN. AND I WILL DEFINITELY BE SUPPORTING YOU TODAY. THANK YOU. >> Chair: FURTHER DEBATE? ANY FURTHER DEBATE? OKAY. THOSE OF US WHO RUN FOR OFFICE ARE SUPPOSED TO HAVE STRONG VIEWS AND PRINCIPLES. AT THE SAME TIME WE ARE REQUIRED TO MAKE DECISIONS AND DECISIONS WHERE WE HAVE TO TAKE INTO ACCOUNT THE VIEWS OF OTHERS AND OCCASIONALLY WE HAVE TO LEARN FROM THEM I LEARNED FROM MY COLLEAGUES ALL THE TIME. I AM GRATEFUL FOR A PHYSICIAN WHO KNOWS WHO HE IS AND KNOWS WHAT HE DOES. AND I AM GRATEFUL FOR JUDGES WHO KNOW WHO THEY ARE AND WHO HAVE STRONG PRINCIPLES. THE REASON I WILL VOTE FOR YOU IS BECAUSE OF MY RESPECT FOR YOUR EXTRAORDINARY BACKGROUND IN MEDICINE AND THE FACT THAT HERE YOU ARE A FAMILY PRACTICE PHYSICIAN IN FLORIDA AND IN MY VIEW THE JEWEL IN THE LARGE CROWN IS A FAMILY PRACTICE PHYSICIAN. THAT IS WHO KEEPS ME ALIVE. I'M FORTUNATE TO GO TO OTHER DOCTORS WHEN MY FAMILY PRACTICE PHYSICIAN SENDS ME THERE BUT IT IS MY FAMILY PRACTICE DOCTOR WHO KEEPS ME AND MY FAMILY SAFE. SHE HAS STRONG VIEWS AND HER VIEWS ARE NOT MY VIEWS AND SO WE HAVE FRUITFUL DISCUSSIONS BUT AT THE END OF THE DAY SHE IS A DOCTOR AND I'M THE PATIENT AND SHE GIVES A MEDICAL DIAGNOSIS AND OFFERS A PLAN FOR MEDICAL TREATMENT AND I CAN EITHER CONFORM TO THE PLAN OR NOT. AND IF I FIND IT TERRIBLY TROUBLESOME I GUESS I CAN FIND ANOTHER DOCTOR BUT I SURE DON'T WANT TO BECAUSE I LIKE HER. BUT I WILL CERTAINLY VOTE FOR YOU BECAUSE OF MY RESPECT FOR YOUR EXPERIENCE AND YOUR BACKGROUND AND YOUR CREDENTIALS AND FOR THE FACT THAT YOU ARE A PERSON OF HIGH PRINCIPLE. I BELIEVE THAT YOUR JUDGMENT DEVELOPED OVER THIS YEAR JUDGMENT DEVELOPED OVER YEARS AS ARMY PHYSICIAN AND AS A PHYSICIAN SERVING POOR PEOPLE IN RURAL MONTANA AS A PHYSICIAN SERVING MEDICAID MOMS AND BABIES IN FLORIDA I BELIEVE YOUR JUDGMENT IS SUCH THAT YOU HAVE STRONG PRINCIPLES. I BELIEVE THAT YOU HAVE A VIEW THAT WILL ALLOW YOU TO USE YOUR JUDGMENT IN A COMPASSIONATE AND SYMPATHETIC WAY AS YOU INDICATED YOU ARE A SYMPATHETIC DOCTOR. CONSEQUENTLY I WILL VOTE FOR YOU AND PROUDLY SO AND I THINK THE GOVERNOR FOR APPOINTING YOU AND I THANK YOU FOR TAKING TIME AWAY FROM YOUR PATIENTS THAT YOU LOVE TO WORK TO HELP THE PRACTICE OF MEDICINE IN THE STATE OF FLORIDA. IS THEIR MOTION TO RECOMMEND CONFIRMATION? MOVED BY SENATOR GARCIA. SECOND BY SENATOR GRALL TO RECOMMEND CONFIRMATION. PLEASE CALL THE ROLL. >> SENATOR AVILA. SENATOR BRADLEY. SENATOR GARCIA. SENATOR GRALL. SENATOR POLSKY. SENATOR ROUSON. VICE CHAIR BERNARD. CHAIR GAETZ. >> Chair: YES, BY THE ACTION OF THIS COMMITTEE YOU ARE RECOMMENDED TO THE FULL SENATE FOR CONFIRMATION AS A MEMBER OF THE BOARD OF MEDICINE. THANK YOU DOCTOR. GO HOME TO YOUR PATIENTS. >> THANK YOU. GOD BLESS. >> Chair: TAB ONE PLEASE. CONFIRMATION OF THE NOMINEE FOR THE FLORIDA DEPARTMENT SECRETARY OF HEALTH MS. TAYLOR HATCH. PLEASE COME FORWARD. PLEASE RAISE YOUR RIGHT HAND. PLEASE AFFIRM THAT YOU WILL TELL THE TRUTH THE WHOLE TRUTH AND NOTHING BUT THE TRUTH. THE WITNESS BEING SWORN SECRETARY HATCH YOU ARE RECOGNIZED TO ADDRESS THE COMMITTEE AND I'M CONFIDENT THERE WILL BE QUESTIONS AND DEBATE ON THE SUBJECT. YOU RECOGNIZE MAM. >> Taylor Hatch: GOOD MORNING CHAIR, MEMBERS OF THE COMMITTEE, I'M TAYLOR HATCH AND I APPRECIATE THE OPPORTUNITY THIS MORNING TO PROVIDE REMARKS. I'VE HAD THE PRIVILEGE OF WORKING ALONGSIDE MANY OF YOU FOR A NUMBER OF YEARS AND I REMAIN SO THANKFUL FOR YOUR PARTNERSHIP AND FOR YOUR ADVOCACY FOR THE FLORIDIANS THAT EACH OF YOU REPRESENT. WE SERVE YOU WITH EVERYTHING WE HAVE EVERY DAY. I WANT TO SHARE HOW INCREDIBLY GRATEFUL I AM TO THE GOVERNOR AS WELL FOR THIS OPPORTUNITY. WHEN I ACCEPTED THE ROLE OF SECRETARY I DID SO WITH CONVICTION IN MY HEART AND FAITH IN GOD'S GUIDANCE. I DID SO WITH A COMMITMENT TO SERVE OTHERS AND TO LEAD WITH THE VALUES THAT MY PARENTS TAUGHT ME AND THE SAME VALUES THAT MY HUSBAND AND I WORKED TO INSTILL IN THEIR OWN CHILDREN. I DID SO WITH THE THOUGHTFUL UNDERSTANDING OF THE RESPONSIBILITY THAT. THE DUTY TO LEAD WITH INTEGRITY, COMPASSION, COURAGE, AND ACCOUNTABILITY. SENATORS, THESE COMMITMENTS ARE NOT REALLY WORDS THAT I SHARED TODAY BUT THE FOUNDATION UPON WHICH MY LIFE AND MY CAREER HAVE BEEN BUILT UPON. THEY ARE COMMITMENTS THAT MAKE ME WHO I AM AND THEY ARE THE FORCE THAT COMPELS ME. THROUGHOUT MY WORK IN THE PRIVATE AND PUBLIC SECTORS ACROSS POLICY AREAS THAT HAVE INCLUDED GENERAL GOVERNMENT, WORKFORCE DEVELOPMENT, AND HEALTH AND HUMAN SERVICES BY DEMONSTRATED EXPERIENCE HAS SHARPENED MY CONTINUED APPROACH TO LEADERSHIP AND MY COMMITMENT TO STRENGTHEN THE SYSTEMS THAT WE WORK WITHIN SO THEY FUNCTION AS INTENDED EFFECTIVELY AND WITH ACCOUNTABILITY TO THOSE THAT WE SERVE. MORE SPECIFICALLY EXAMPLES INCLUDE DURING MY TIME SERVING AS THE DIRECTOR FOR THE AGENCY FOR PERSONS WITH DISABILITIES TO 2025 WHERE I LED EFFORTS TO MAKE A PD APPLICATION FOR SERVICE IS AVAILABLE ONLINE. FOR THIS UNDERTAKING, OUR APPROACH WAS DIRECT. BEFORE WE LAUNCH THE ONLINE APPLICATION IT WAS IMPORTANT THAT WE ADDRESSED TO THE FUNDAMENTAL OPPORTUNITY AT HAND. ASKING AND ANSWERING CRITICAL QUESTIONS LIKE DOES THE CURRENT APPLICATION FOR SERVICES MAKE SENSE. DO THE WORDS THAT WE USE RESONATE? CAN WE ELIMINATE UNNECESSARY WORK AND BURDEN ON BEHALF OF THE APPLICANT? AS A RESULT OF WORKING ARM IN ARM WITH THOSE SELF ADVOCATES AND WITH FAMILIES MANY DIFFERENT STAKEHOLDERS AS WELL THE FINAL PRODUCT OF THIS EFFORT RESULTED IN CUTTING THE APPLICATION FOR SERVICES AND HALF AND UTILIZING EXISTING INFORMATION THAT WE SHARE AMONGST SISTER AGENCIES TO REDUCE FRICTION AND CREE CAPACITY. FOR INDIVIDUALS SEEKING SERVICES THROUGH APD THE IMPLEMENTATION COUPLED WITH THE DEPLOYMENT OF INTERNAL STREAMLINING EFFORTS RESULTED IN THE ELIMINATION OF UNNECESSARY BUREAUCRACY AND INCREASED CAPACITY. IT DOUBLED THE AMOUNT OF INDIVIDUALS THAT WERE ENROLLED IN CRITICAL WAIVER SERVICES AND HALF THE AMOUNT OF TIME. THIS ENSURE THE AGENCY CAPITALIZED ON TREMENDOUS RECORD LEVEL INVESTMENTS THAT WE RECEIVED FROM THE LEGISLATURE. OTHER EXAMPLES CAN BE FOUND DURING MY TIME PREVIOUSLY SERVING AT THE DEPARTMENT OF CHILDREN AND FAMILIES AS A DEPUTY SECRETARY. I HAD THE OPPORTUNITY TO LEAD THE DEVELOPMENT AND DEPLOYMENT OF A BEHAVIORAL HEALTH MODEL DESIGNED SPECIFICALLY FOR FAMILIES INVOLVED IN THE CHILD WELFARE SYSTEM CONTENDING WITH COOCCURRENCE CHALLENGES LIKE DOMESTIC VIOLENCE WITH YOUNG CHILDREN IN THEIR HOME. THIS MODEL HAS RESULTED IN A REDUCTION OF REMOVALS WITHIN THIS POPULATION AND SUSTAINED SAFETY OUTCOMES WITH NEARLY 90 PERCENT OF CHILDREN AND PARTICIPATING FAMILIES EXPERIENCING NO SUBSEQUENT MALTREATMENT WITHIN 12 MONTHS OF SERVICE ENGAGEMENT. THIS MODEL WAS DEVELOPED BY CONVENING SUBJECT MATTER EXPERTS AND CONDUCTING A THOROUGH REVIEW OF DATA TO ESTABLISH KEY LEAD TO MEASURES INCORPORATING A JOINT RESPONSE THAT ADDRESSED THE NEEDS OF FAMILIES EXPERIENCING COMPLEX DYNAMICS AND THIS APPROACH COMPLEMENTS AND PRESERVES THE EXPERTISE THAT WE HAVE WITH THE CHILD PROTECTIVE INVESTIGATOR AND THE QUALIFIED BEHAVIORAL HEALTH PROFESSIONALS THAT STRENGTHEN SAFETY INVESTMENTS, SAFETY ASSESSMENTS, EXCUSE ME, RAPIDLY ACTIVATES APPARENT RESOURCES AND ENABLES THE TARGET DELIVERY OF INDIVIDUALIZED SUPPORTS DRAWING ON THE SAME LEADERSHIP PRINCIPLES TO FRAME COMPLEX CHALLENGES AND DIAGNOSE FOUNDATIONAL SOLUTIONS LEADING ME TO THE LAST EXAMPLE WHILE SERVING AT THE DEPARTMENT FOR THE ASSISTANT CHAIR OF ECONOMIC SELF SUFFICIENCY IN WHICH THE TEAM PERFORMANCE STANDARDS AND TIMELINESS AND QUALITY LED THE NATION. WHEN FACED WITH IMMENSE CHALLENGES ON THE PUBLIC HEALTH EMERGENCY RESULTED IN A VOLUME INCREASE OF 400 PERCENT AND PUBLIC BENEFIT APPLICATIONS THE TEAM SHOWED TREMENDOUS GRIT THROUGH THE DEVELOPMENT AND ENABLEMENT A OF ACTIONS THAT ADDRESS POLICY, PRACTICE, AND RESOURCE SHIFTS RESULTING IN AN APPLICATION APPROVAL BEING PROCESSED AT NEAR PRE PANDEMIC LEVELS AS WELL AS BELOW NATIONAL TIME STANDARDS. MEMBERS, IT IS WITH CONVICTION, A FOCUSED MINDSET, AND MY DEMONSTRATED EXPERIENCE THAT I SHARE THREE PILLARS THAT ANCHOR MY ROLE AS SECRETARY. NUMBER ONE, WE ARE GROUNDED IN THE DEPARTMENT'S MISSION WHICH IS IN CHAPTER 20 OF FLORIDA STATUTE. THIS IS IMPORTANT BECAUSE IT IS WHO WE ARE CALLED TO BE AS AN ORGANIZATION. WE ARE THE DEPARTMENT DESIGNED TO WORK IN PARTNERSHIP WITH LOCAL COMMUNITIES TO PROTECT THE VULNERABLE FROM STRONG ECONOMICALLY SELF SUFFICIENT FAMILIES, AND OUR MISSION SETS THE TONE FOR THE TYPE OF CULTURE WE MUST OPERATE UNDER. A CULTURE OF SERVICE TO THE PERSON ON THE OTHER END AS IF THEY WERE YOUR OWN LOVED ONE. NUMBER TWO, WE ARE ACUTELY FOCUSED ON EXECUTING WHAT HAS ALREADY BEEN ENTRUSTED TO US SUCH AS THE IMPLEMENTATION OF RECENT LEGISLATION OR FUNDING INVESTMENTS. NUMBER THREE, WE ADVANCE OUR WORK THROUGH TWO DISTINCT LENSES. DATA, AND LIVED EXPERIENCE. DATA ALLOWS US TO UNDERSTAND WHERE WE ARE, WHAT IS WORKING, AND WHERE WE HAVE OPPORTUNITIES FOR IMPROVEMENT. AND LIVED EXPERIENCE, LIFTING UP THE VOICES OF THOSE WE SERVE TO POINT US WHERE WE NEED TO GO TO ENSURE SOLUTIONS DON'T SIMPLY LOOK GOOD ON PAPER BUT DELIVER REAL OUTCOMES IN PEOPLE'S LIVES IN ACTION FROM MY TIME SERVING IN THIS ROLE FOR NEARLY A YEAR CAN BE FOUND IN THE WORK THAT WE HAVE DONE ALONGSIDE MANY OF YOU SUCH AS THE CREATION OF A STATE STATEWIDE ADVISORY BOARD WHICH IS AN IDEA THAT WAS BROUGHT FORWARD FROM YOUTH AND YOUNG ADULTS TO CREATE AN ELEVATED CONSISTENT FORMAL AVENUE FOR YOUTH TO WORK IN PARTNERSHIP WITH THE DEPARTMENT. IT'S PURPOSE IS INTENTIONAL TO ENGAGE YOUTH AS ADVISORS AND ENSURE THEIR PERSPECTIVES, NEEDS, AND LIVED EXPERIENCES AND FOREIGN POLICY, PRACTICE, AND SERVICE DELIVERY. IN DOING SO IT STRENGTHENS HOW WE COMMUNICATE, HOW WE RESPOND TO EMERGING NEEDS AND DESIGN SUPPORT SO THEY ACHIEVE THE INTENDED IMPACT. OTHER EXAMPLES INCLUDE BUILDING ON FOUNDATIONAL TOOLS AND AVENUES PROVIDED BY THE LEGISLATURE IN PREVIOUS SESSIONS TO ENCOURAGE COMPETITION AND BOLSTER ACCOUNTABILITY WITHIN THE SYSTEM OF CARE. THIS INCLUDES THE DEVELOPMENT OF A REFINED FUNDING MODEL AS OUTLINED IN SENATE BILL 2502 DURING THE 2025 LEGISLATIVE SESSION WITH A RECOMMENDATION THAT HAS BEEN PRESENTED BEFORE THE LEGISLATURE FOR YOUR CONSIDERATION NOW. THE MODEL UTILIZES EXPENDITURE DATA FROM COMMUNITY BASED PEER ORGANIZATIONS FROM THE BUREAU OF LABEL STATISTICS TO ACCOUNT FOR GEOGRAPHICAL DISTANCES. THIS IS SIMPLE BUT IMPORTANT GREATER TRANSPARENCY WE CAN MORE CLEARLY SEE FUNDING THAT IS GOING TOWARD ADMINISTRATION INCLUDING CASE MANAGEMENT AND THE FUNDING GOING DIRECTLY TO EACH CORE SERVICE FOR CHILDREN AND FAMILIES. BY CLEARLY ITEMIZING FUNDING WE HELP ENSURE PARTNERS OF THEIR RESOURCES THAT THEY NEED AND WE REDUCE UNNECESSARY MANUAL REPORTING AND WE GIVE BOTH THE DEPARTMENT AND THE LEGISLATURE BETTER FINANCIAL VISIBILITY SO POLICY DECISIONS AND FUNDING DECISIONS ARE ALIGNED. THEY ARE INTENTIONAL AND ACCOUNTABLE. ANOTHER EXAMPLE INCLUDES AN LIMITATION OF AN EXPANDED CO TEAM STRUCTURE THAT INCLUDES THE DEPARTMENT AND INDIVIDUALIZED COMMUNITY BASED CARE ORGANIZATIONS FOR THE PURPOSE OF CREATING A CONTINUOUS CYCLE, COLLABORATION, ASSESSMENT, AND ACTION. MORE SPECIFICALLY THIS STRUCTURE IS BEING UTILIZED TO BRING IN FOCUSED COLLABORATIVE ACTION AND ATTENTION TO KEY PRIORITIES SUCH AS A NEW CONTRACTUAL REQUIREMENT FOR A PLAN TO ENSURE ADEQUATE RECRUITMENT AND RETENTION OF PROVIDERS FOR QUALITY PLACEMENT THAT MEETS THE EVOLVING NEEDS OF THE CHILDREN THAT WE WORK TO SERVE THIS INCLUDES A CONFERENCE OF ANALYSIS OF THE NEEDS OF FAMILIES WITHIN EACH LOCAL AREA AS WELL AS AN ASSESSMENT OF PROVIDER CAPACITY TO MEET THOSE NEEDS. THIS PROCESS PROVIDES A TANGIBLE EXAMPLE OF THE DEPARTMENTS WORK TO ENSURE A CONTINUOUS IMPROVEMENT AND ACCOUNTABILITY CYCLE WHERE DATA IS DIGESTED AND EVALUATED WITH THE CREATION OF TARGETED IMPROVEMENT PLANS AND ONGOING MONITORING TO ENSURE QUALITY OUTCOMES. IN THE REALM OF BEHAVIORAL HEALTH OF THE DEPARTMENT ACCELERATED PROVIDER DEVELOPMENT EFFORTS RESULTING IN AN INCREASE OF HUNDRED 40 PERCENT LICENSED BED CAPACITY STATEWIDE AND A NEWLY CREATED BEHAVIORAL QUALIFIED RESIDENTIAL TREATMENT PROGRAM FOR USE WITH INTENSIVE BEHAVIORS ENSURING THAT THEY HAVE BOTH THE PLACEMENT AND THE SUPPORT THAT THEY NEED THIS GROWTH IS NOT A RESULT OF ENGAGING NEW AND EXISTING PROVIDERS TO SOLICIT FEEDBACK AND ANALYZE DATA AND THE PURSUIT OF THE FRAMEWORK IN WHICH BUSINESS DEVELOPMENT AND HIGH STANDARDS OF OVERSIGHT AND ACCOUNTABILITY ARE NOT MUTUALLY EXCLUSIVE ALSO WITH THE BEHAVIORAL HEALTH SPACE IS OUR INTENTIONAL FOCUS TO EXPAND PEER SUPPORT NETWORK STATEWIDE. WHICH HAS INCREASED MORE THAN 40 PERCENT OVER THE LAST YEAR AND THIS INCREASE WAS MADE POSSIBLE BY ACTING ON DIRECT STAKEHOLDER FEEDBACK STRATEGICALLY STRENGTHENING WORKFORCE DEVELOPMENT SUPPORT THROUGH SCHOLARSHIPS FOR PEER SUPPORT SPECIALIST TO PROVIDE MENTOR SHIP, RECOVERY SUPPORT, AND ADVOCACY FOR THOSE NAVIGATING SUBSTANCE USE DISORDERS. LASTLY, AN EXAMPLE OF THE DEPARTMENT'S INTENSIVE FOCUS TO ALIGN WITH FEDERAL CHANGES RELATING TO QUALITY PERFORMANCE STANDARDS FOR THE SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM. COMMONLY KNOWN AS SNAP WHICH IS A PROGRAM THAT DEPARTMENT ADMINISTERS. THE DEPARTMENT HAS WORKED TO EXPEDITE MANY OF THE STRATEGIES THAT WERE ALREADY IN FOCUS TO MEET AND EXCEED PERFORMANCE MEASURES PRIOR TO FINANCIAL CONSEQUENCES AS A RESULT OF RECENT FEDERAL LEGISLATION. THESE STEPS WERE DEVELOPED BY PRIORITIZING FORENSIC DATA ANALYSIS TO PINPOINT ROOT CAUSES AND DEVELOP SOLUTIONS INFORMED BY DISCUSSIONS WITH FEDERAL PARTNERS, COLLEAGUES IN OTHER STATES, AND INNOVATIVE INPUT AS A RESULT OF 40 MEETINGS WITH PRIVATE SECTOR ASSESSMENTS. THE END OF THE STRATEGIES IN KEY AREAS SUCH AS PERFORMANCE MONITORING AND ACCOUNTABILITY TARGET TRAINING POLICY PROCESS ENHANCEMENTS TECHNOLOGY IMPROVEMENTS AND ONGOING COLLABORATION WITH OUR FEDERAL OUR SHOWN MEASURABLE RESULTS IN THE LAST YEAR. MORE SPECIFICALLY A DECREASE IN THE PAYMENT ERROR RATE FROM 15.13 PERCENT FROM FEDERAL FISCAL YEAR 2024 COMPARED TO AN UNOFFICIAL RATE OF 12.81 PERCENT OVERALL IN 2025 AND IN RECENT MONTHS DECLINING EVEN MORE RAPIDLY WITH AUGUST SEPTEMBER AND OCTOBER REPORTING AT THE PRELIMINARY RATE WITHIN 7 PERCENT AND BELOW WHICH MORE CLOSELY ALIGNS THE FEDERAL STANDARD OF BELOW 6 PERCENT FOR FEDERAL FISCAL YEAR 2026. TO FURTHER EXPEDITE AND SUSTAIN THIS PROGRESS THE DEPARTMENT ALSO SUBMITTED A LEGISLATIVE BUDGET REQUEST TO CONTINUE THE MODERNIZATION OF THE ACCESS SYSTEM TO ENHANCE VERIFICATION TOOLS AND STRENGTHEN DECISION MAKING SUPPORTS FOR THE TEAM. THESE INVESTMENTS WILL DIRECTLY SUPPORT CONTINUED QUALITY IMPROVEMENT WHILE BALANCING TIMELINESS AND SERVICE DELIVERY FOR FLORIDA FAMILIES. WHILE THESE ARE JUST A FEW EXAMPLES THEY SERVE AS MILESTONES IN OUR TEAM'S PURSUIT OVER THE LAST YEAR TO ADVANCE THE PRESERVATION OF CHILDHOOD AND SUPPORT CAREGIVERS TO PROMOTE FAMILY WELL BEING AND INDIVIDUAL RESILIENCY. LOOKING AHEAD WE KNOW THE WORK IS FAR FROM FINISHED AND WE WILL CONTINUE TO BUILD UPON OUR INVESTMENTS AND OUR COMMITMENTS TO MAKE EVERY MOMENT COUNT FOR THOSE WE ARE HONORED TO SERVE. MEMBERS, IT IS WITH THAT I APPEAR BEFORE YOU TODAY AND REQUEST YOUR FAVORABLE CONSIDERATION. THANK YOU SIR. >> Chair: THANK YOU. QUESTIONS FOR MISS HATCH? YES SIR VICE CHAIR BERNARD. >> Senator Bernard: THANK YOU MR. CHAIR MADAM SECRETARY THANK YOU FOR BEING HERE. YOU SPOKE ABOUT REDUCING THE ERROR RATE COULD YOU GO OVER THAT I COMPLETELY UNDERSTAND. I THINK YOU'RE SAYING THE FEDERAL ERROR RATE IS 6 PERCENT AND BUT THE STATE IS AROUND 12 RIGHT NOW. >> Chair: MADAM SECRETARY. >> Taylor Hatch: THE FEDERAL GOVERNMENT SETS PERFORMANCE MEASURES AND ONE RELATES TO QUALITY. THE QUALITY RELATING TO PUBLIC BENEFIT DECISIONS FOR THE SNAP IN THE SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM. THE DECISIONS WE HAVE MAKE THE FEDS THE WAY THEY REVIEWED THIS IS THEY TAKE A SAMPLE OF THE CASES THAT WE MAY DECISIONS ON THROUGHOUT THE ENTIRE PROCESS WORKING WITH THE CLIENT AND THEY REACH OUT TO THE CLIENT AND THEY REACH OUT TO THE CLIENTS EMPLOYERS AND THEY LOOK AT DATA SETS AND THEY DO THEIR OWN INVESTIGATION AND THEN THEY MAKE THE ELIGIBILITY DETERMINATION. THEY COMPARE THAT ELIGIBILITY DETERMINATION TO THE ELIGIBILITY DETERMINATION THAT WE MADE THAT THE CLIENT CAME IN TO SEEK APPROVAL FOR IF THERE IS A DIFFERENCE IN THE DOLLAR AMOUNT IT IS SEEN HERE. TRADITIONALLY WE HAVE LED THE NATION IN THIS PERFORMANCE MEASURE. I MENTIONED CURRENTLY I USE TO SERVE AS THE ASSISTANT DIRECTOR AS ECONOMIC SELF SUFFICIENCY AND WE ARE BELOW 6 PERCENT IN 2019 TO GIVE YOUR POINT OF REFERENCE. AS WE HAVE HAD HURRICANES WITH AND OUR STATE WE AS YOU ALL NOW BECAUSE YOU'RE SERVING YOUR CONSTITUENTS ALONGSIDE WITH US AND MANY OF THESE STORMS WE ARE FOCUSED ON MAKING SURE THAT PEOPLE ARE SAFE AND THEY HAVE WHAT THEY. SO WE PUSH THE ELIGIBILITY TIMEFRAME IN WHICH THEY COME IN AND CHECK IN WITH US FOR THAT ELIGIBILITY DETERMINATION, WHICH AGAIN CREATES MORE LINKS BETWEEN THE LAST TIME THAT WE SAW THE CLIENT AND ANY CHANGES THAT THEY MAY HAVE HAD ECONOMICALLY. GETTING A BETTER JOB, EARNING MORE MONEY, WHEN THE FEDS ARE COMING IN AND COMPARING AND DOING A RECALCULATION OF THE BENEFIT AMOUNT COMPARED TO OURS. THERE'S A GREATER PROPENSITY FOR THAT TIMEFRAME TO IMPACT THAT AIR RATE ESPECIALLY WHEN WE HAD SOME HURRICANES THAT WE HAVE SEEN HIM. WHERE WE ARE NOW IS AN INTENSIVE FOCUS ON RETURNING BACK TO WHERE WE WERE AND RETURNING BACK TO NATIONAL PROMISE AND WE HAVE IMPLEMENTED A SERIES OF STRATEGIES OF WHICH I WENT THROUGH EARLIER WHICH POINTS US IN THE DIRECTION TO SAY WE ARE ABSOLUTELY ON THE RIGHT TRACK WITH A 12 PERCENT THAT WE SAW FOR FEDERAL FISCAL YEAR LAST OVER THE LAST QUARTER WE HAVE HIT WITHIN 7 PERCENT MARK AND EVEN BELOW THAT. SO WE KNOW WE ARE HEADED IN THE RIGHT DIRECTION. WE ARE CONTINUING TO DEPLOY STRATEGIES EVERY SINGLE DAY AND TALK TO STATES EVERY DAY. WE HAVE 40 PRIVATE SECTOR MEETINGS UNDERSTANDING IS THERE ANYTHING ELSE OUT THERE THAT WE CAN DEPLOY AS A STRATEGY? ONE OF THE ASKS BEFORE YOU THIS SESSION IS THE LEGISLATIVE BUDGET REQUEST WOULD ALSO HELP PROPEL US TOWARD THE GOAL OF BEING BELOW 6 PERCENT. WITH SOME OF THE TECHNOLOGY WE HAVE ASKED EMBEDDED WITHIN. >> Chair: FOLLOW UP. >> Senator Bernard: THE ELEPHANT IN THE ROOM IN REGARD TO HOPE FLORIDA IS WHAT CURRENTLY IS THE ROLE OF HOPE FLORIDA WITH THE DCF RIGHT NOW? >> Taylor Hatch: THE PROGRAM OF HOPE FLORIDA IS EMBEDDED THROUGHOUT THE DNA OF OUR DEPARTMENT AND IT IS IMPORTANT BECAUSE IT HELPS REPEL US AND ACTS AS A SPRINGBOARD TO MAKE SURE THAT WE ARE MAKING THE MOST OF EVERY SINGLE MOMENT WHEN A CLIENT COMES OUR DEPARTMENT. MAKING SURE THAT WE ARE ALIGNING WITH OUR STATUTES OF HELPING SOMEONE ACHIEVE SELF SUFFICIENCY. FOR EXAMPLE, I JUST MEANT TO THE PUBLIC BENEFIT SIDE OF OUR DEPARTMENT. OUR ECONOMIC SELF SUFFICIENCY TEAM. WHEN AN INDIVIDUAL REACHES OUT TO SEEK ASSISTANCE FOR US NOT PROGRAM LIKE WE HAVE BEEN TALKING ABOUT WE WANT TO MAKE SURE THAT WE ARE MEETING THE NEEDS OF THAT INDIVIDUAL IMMEDIATELY AND MEETING THEIR IMMEDIATE NEED MAKING SURE THEY HAVE FOOD IN THEIR BELLY SO THEY CAN THINK ABOUT TOMORROW AND WE ALSO WANT TO WORK ALONGSIDE THEM TO UNDERSTAND WHAT ARE THEIR GOALS THE END OF WHAT TRADITIONALLY STOOD IN THE WAY OF THOSE GOALS AND WHERE DO YOU SEE YOURSELF IN FIVE YEARS? AND THEN WORK TO NAVIGATE AND ACTIVATE THE PRIVATE SECTOR NON FOR PROFIT DOING AMAZING WORK ALL THE TIME BUT PERHAPS THEY DON'T KNOW ABOUT THE NEED THAT'S RIGHT DOWN THE STREET. SO ELEVATING THAT FOR INDIVIDUALS THAT WANT TO HELP AND PEOPLE WHO CAN HELP SO WE CAN REMOVE BARRIERS AND HELP OUR CLIENTS ACHIEVE THEIR GOALS. WE HAVE SEEN CASCADING BENEFITS WITHIN THE OTHER SYSTEMS OF CARE THAT WE HAVE WITHIN THE DEPARTMENT AND WE KNOW THE CASCADING BENEFIT OF A JOB. AND THE DIGNITY OF WORK AND HOW THAT IMPACTS AREAS SUCH AS SUBSTANCE ABUSE AND MENTAL HEALTH AND AREAS SUCH AS CHILD WELFARE. IT IS PART OF HOW WE RESPOND AND HOW WE WANT TO SERVE AGAIN AS IF THE PERSON ON THE OTHER END WAS YOUR OWN LOVED ONE. >> Chair: YES MR. VICE CHAIR. >> Senator Bernard: YOU MENTION SELF SUFFICIENCY DOES DCF DO MOST OF THE WORK IN REGARD TO MEETING THESE NEEDS? OR IS IT HOPE FLORIDA THAT DOES THIS? >> Chair: MADAM SECRETARY. >> Taylor Hatch: HOPE FLORIDA IS ALL ABOUT PARTNERSHIP. WHEN WE ARE MEETING WITH THE HOPE FLORIDA UNDERSTANDING WHAT THEIR GOALS ARE AND THE BARRIERS ARE IT IS A CUSTOMIZED PROCESS IN WHICH THE CLIENT IS IN THE DRIVER SEAT DEFINING GOALS AND BARRIERS THEN WE ACTIVATE PARTNERS AND SOME PARTNERS MAY BE NON FOR PROFIT OFTEN TIMES IT'S WORKING WITH CAREER SOURCE. CAREER SOURCE FLORIDA'S AMAZING WORK BUT IS REALLY CUSTOMIZED TO THAT INDIVIDUAL ACTIVATING THE RESOURCES THAT ARE AVAILABLE BUT SOMETIMES YOU DON'T KNOW ABOUT IT YOU CAN DO THE BEST THING IN THE WORLD BUT IF NO ONE KNOWS ABOUT IT WHAT GOOD IS IT. SO THE ROLE OF HOPE FLORIDA IS NAVIGATOR. THE PERSON WHO SAYS TAYLOR I HAVE CATHERINE WAITING TO VISIT WITH YOU I SPOKE TO HER ABOUT YOUR STORY AND YOUR SITUATION THIS IS HOW SHE CAN HELP YOU AND YOUR FOLLOWING UP WITH TAYLOR AND YOU SAY HOW DID THE MEETING WITH CATHERINE GO AND IT IS A CONTINUOUS PERSON THAT IS IN YOUR CORNER WALKING ALONGSIDE WITH YOU GIVING YOU THE HOPE THAT YOU NEED TO KEEP GOING AND ACHIEVE YOUR GOALS. >> Senator Bernard: ONE MORE QUESTION. WHO MAKES -- IS IT THE FAMILY MEETING WITH DCF FIRST? OR IS IT HOPE FLORIDA THAT IS HAVING THE INITIAL CONTACT WITH THE INDIVIDUAL FAMILY? >> Chair: MADAM SECRETARY. >> Taylor Hatch: ALL KINDS OF WAYS. WE HAVE A TELEPHONE NUMBER WE SHARE WITH INDIVIDUALS AS A SINGLE POINT OF CONTACT. WEBSITE AS WELL. THERE'S A BUTTON YOU CAN PUSH IF YOU NEED HELP AND A BUTTON YOU CAN PUSH IF YOU WANT TO HELP. BUT LIKE I MENTIONED WHEN WE TALK ABOUT PUBLIC BENEFITS IT IS SOMETHING WE ARE INTRODUCING. ARE YOU INTERESTED IN THIS? WHEN WE HAVE A CHILD PROTECTIVE INVESTIGATOR THAT IS ENGAGING WITH THE FAMILY IF THERE ARE RESOURCES THAT THEY ARE IDENTIFYING THAT NEED TO RAP AROUND THE FAMILY IN SUPPORT THEY COULD TAP INTO THE HOPE FLORIDA TEAM. SAME THING WORKING WITH OUR SISTER AGENCIES AND WORKING WITH THE AGENCIES OR PERSONS WITH DISABILITIES. THEY ARE PROACTIVELY REACHING OUT TO CLIENTS. THERE'S A MYRIAD OF WAYS THAT HOPE FLORIDA TEAM IS ACTIVATED. THIS IS BASED ON THE INDIVIDUAL'S NEEDS AND GOALS. >> Senator Bernard: THANK YOU MR. CHAIR. >> Chair: FOR THE QUESTIONS. SENATOR GRALL. >> Senator Grall: THANK YOU SECRETARY HATCH FOR BEING HERE AND FOR YOUR COMMENTS AND YOUR WILLINGNESS TO TAKE YOUR QUESTIONS. IF YOU COULD SPEAK ABOUT HOW YOU VIEW YOUR ROLE IN RELATION TO WORKING WITH AND RESPONDING TO THE LEGISLATIVE INQUIRIES. >> Taylor Hatch: THANK YOU FOR THAT QUESTION. I THINK WHEN WE ARE THINKING ABOUT ALL THE AVENUES IN WHICH WE ARE SOLICITING FEEDBACK AND CONSUMING FEEDBACK OUR ROLE AND OUR PARTNERSHIP WITH THE LEGISLATURE IS INCREDIBLY IMPORTANT. IT'S ONE OF THE AVENUES IN WHICH WE APPRECIATE BEING ABLE TO HEAR DIRECT FEEDBACK. YOU ARE WORKING TO SERVE CONSTITUENTS EVERY SINGLE DAY. THEY ARE THE SAME THAT WE WORK TO SERVE EVERY SINGLE DAY. OUR POSTURE IS ONE THAT IS PARTNERSHIP TO ENGAGE TO UNDERSTAND WHERE THE ISSUES ARE TO LOOK SYSTEMICALLY ACROSS THE DATA THAT WE ARE SEEING OTHER AVENUES IN WHICH WE HAVE INFORMATION AS WELL AND WORK ALONGSIDE THE LEGISLATURE TO DEVELOP SOLUTIONS. WHEN YOU SERVE PEOPLE AS YOU CAN IMAGINE THE WORLD DEVELOPS AROUND US EVERY SINGLE DAY WHEN YOU ARE AGENCY YOU MUST EVOLVE AS WELL AND ONE AVENUE THAT WE APPRECIATE GREATLY IS THE PARTNERSHIP OF THE LEGISLATURE AS AN AVENUE OF INFORMATION AND PARTNERSHIP TO DEVELOP SOLUTIONS. >> Senator Grall: I KNOW YOU HAVE ONLY BEEN THERE FOR A SHORT TIME FRAME BUT I KNOW THERE HAS BEEN NOT JUST ME BUT OTHER LEGISLATORS WHO REACHED OUT FOR INFORMATION ESPECIALLY ON BILLS AND A FORMAL ANALYSIS OF WHAT IS BEING PROPOSED BECAUSE USUALLY FRANKLY WE PROPOSE LEGISLATION USUALLY IN RESPONSE TO SOMETHING THAT HAS OCCURRED. AND WHETHER OR NOT IT IS SYSTEMIC OR NOT OR ONE OFF OR NOT IS USUALLY THE CONSIDERATION WE ARE GIVING IT AS WE THINK ABOUT IT BECOMING POLICY AND THERE HAS NOT BEEN A CONSISTENT FEEDBACK FROM THE AGENCY ON LEGISLATIVE PROPOSALS IN THE PAST FEW CAN YOU SPEAK TO HOW IF YOU THINK IT NEEDS TO CHANGE AND IF IT DOES NEED TO CHANGE HOW YOU PROPOSE THAT IT HAPPENED. >> Chair: MADAM SECRETARY. >> Taylor Hatch: I ASSURE YOU WE PRIDE OURSELVES AND BEING RESPONSIVE AND WE WANT TO PROVIDE ACCURATE INFORMATION AND TIMELY INFORMATION BECAUSE THESE ARE THE DECISIONS THAT ARE BEFORE YOU AND THE TIME YOU HAVE IN TALLAHASSEE A SHORT AND MY COMMITMENT TO YOU IS TO SHOW UP EVERY SINGLE DAY WITH THAT MINDSET TO BE ABLE TO PULL IN THE EXPERIENCES THAT WE HAVE AND THE DATA WE HAVE TO INFORM THOSE DISCUSSIONS. WE HAVE AN ENTIRE TEAM THAT WAS TASKED DURING LEGISLATIVE SESSION AND OUTSIDE ALSO. WE WORK HARD TO GET OUT OF TALLAHASSEE AND OUT OF LEGISLATIVE SESSION AND VISIT DIRECTLY WITH MEMBERS OF THE LEGISLATURE DIRECTLY WITH THE COMMUNITY AND PROVIDERS THAT WE HAVE SO WE CAN WORK ALL THROUGHOUT THE YEAR AS WELL AS LEGISLATIVE SESSION IN COMMITTEES AS. >> Chair: FOLLOW UP. >> Senator Grall: I GUESS MORE SPECIFICALLY CAN YOU MAKE A COMMITMENT TO PROVIDING AGENCY AND ANALYSIS ON THE BILLS THAT ARE MOVING THROUGH THE PROCESS? MOVING FORWARD? IT IS SOMETHING THAT IS VERY MEANINGFUL TO ALL THE MEMBERS TO UNDERSTAND EXACTLY. WE MAY MAKE A PROPOSAL BUT OPERATIONALLY YOUR FEEDBACK IN A FORMAL DOCUMENT IS EXTREMELY HELPFUL. IT IS NOT TAKEN AS GOSPEL BY ANY MEANS. THERE IS PUSH AND PULL I THINK BETWEEN THE LEGISLATURE AND THE AGENCIES WHEN THOSE ANALYSIS ARE PERFORMED BUT AT LEAST IT PUTS A STAKE IN THE GROUND IN TERMS OF THE AGENCY'S POSITION. IS THIS SOMETHING THAT YOU CAN MAKE A COMMITMENT TO DOING AS WE MOVE FORWARD? >> Chair: MADAM SECRETARY. >> Taylor Hatch: YES. >> Senator Grall: FOLLOW UP. DIFFERENT LINE. WE HAVE DIFFERENT CONSTITUENT ISSUES FROM HOME IN OUR OWN DISTRICTS AND MANY SENATORS HAVE OTHER ISSUES THAT AFFECT THE AGENCY AND SOMETIMES IT IS CHALLEN