The faces of Florida’s Medicaid system

MEDICAID

MiamiHerald.com/healthcare

The tea party governor now says he wants to expand Medicaid. The Republican Legislature isn’t so sure.

Hanging in the balance?

Access to healthcare for 1 million or more poor Floridians.

Billions of dollars in federal money.

The state budget, which already pumps $21 billion a year into care.

Florida’s Medicaid system today serves more than 3 million people, about one in every six Floridians. The decision whether to expand the system by a full third will be made by men and women in suits in Tallahassee’s mural-filled chambers this spring.

But the impact is elsewhere, in children’s hospitals in Tampa and Miami, in doctors’ offices in New Port Richey and in the home of a woman who recently lost her full-time teaching job.

The Suddenly uninsured

This was not how she envisioned her 60s.

Jean Vincent dreamed of turning her five-bedroom home into a bed and breakfast. She painted murals on walls, created mosaics on floors and let her imagination guide the interior decorating. There is a “garden” room, a “bamboo” room and a “canopy” room.

In 2010, Vincent lost her full-time job teaching in Citra north of Ocala. Her mother became sick with cancer and needed around-the-clock care before dying in August. Then, doctors began prescribing Vincent costly medications to treat osteoporosis and early-onset diabetes.

“I started getting a little behind with my mortgage,” said Vincent, 61. “All of a sudden, I found out I had to have an emergency retina eye surgery.”

Today, Vincent is searching for roommates to move into her home and help pay the bills. She begs Gainesville’s Sante Fe Community College and City College to schedule her for as many classes as she can handle as an adjunct geography professor; this semester’s four is the most she’s ever had.

But her biggest worry? Not having comprehensive healthcare.

Vincent — who is too young for Medicare — is enrolled in CHOICES, a health services program the Alachua County government created for the uninsured. It covers preventative care like her flu shots and helps with her drug therapy. But if Vincent ever got so sick she needed to go to the hospital, she’d be on her own.

Under current Florida law, adults with no dependents are not eligible to participate in Medicaid no matter how little they make. Vincent’s four children are all grown, which means even as her income has dwindled she can’t become eligible for the health insurance program run jointly by the federal and state governments.

If Florida decides to expand the Medicaid system, people in Vincent’s position for the first time could be covered.

The expansion would allow any single adult making about $16,000 a year eligible for Medicaid.

On the matter, Vincent has become an activist. She joined with patient rights group Florida CHAIN and traveled to Tallahassee to lobby lawmakers.

“When I gave my testimony, that’s all I wanted them to do was see there were people out there that weren’t just trying to take advantage of the system,” she said.

This summer, she expects to only be assigned one class at Sante Fe. That will provide about $2,000 for her to live on for three months. Meanwhile, her retirement dreams are put on hold.

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Miami police union challenges officer’s firing for fatal shooting

The Fraternal Order of Police filed a lawsuit against the city of Miami on Friday, asserting that an officer who fatally shot an unarmed motorist in 2011 was improperly fired from the police department.

Officer Reynaldo Goyos shot and killed Travis McNeil as he sat in a car at a Little Haiti intersection. It was one of a string of seven deadly shootings of black men in the inner city by Miami police officers in 2010 and 2011.

Goyos was cleared of criminal wrongdoing by prosecutors in 2012. But he was terminated last month after the department’s Firearms Review Board concluded that the shooting was unjustified.

The police union lawsuit claims that the board violated state open-government laws by failing to open its meetings to the public.

Goyos “was improperly terminated by the city of Miami Police Department by a review board that violates the law,” union President Javier Ortiz wrote in a statement.

The lawsuit contends that Goyos should be reinstated.

City Attorney Julie O. Bru declined to discuss the specifics of the case. “We reviewed the allegations, and the city maintains that the board has operated consistent with the requirements of law,” she said.

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Diogo Morgado as Jesus in 'The Bible'

Producer Mark Burnett and his wife Roma Downey are bringing The Bible to television with an epic, 10-hour, five-part miniseries, and ET's Nancy O'Dell is with the man who portrays Jesus, Diogo Morgado, and the actor who embodies St. Peter, Darwin Shaw.

Pics: Adorable Tots: Celebs and Their Cute Kids!

"Jesus is definitely the most complete and complex figure of mankind; he's just someone who belongs to millions and billions of families all around the world," says Portuguese star Morgado, a religious man himself. "Just [given] the chance [to play him], I'm like, 'Okay, I'm going to try to just give an example of my Jesus.'"

Premiering Sunday, March 3 at 8 p.m. on History, The Bible brings to life some of the more well-known tales from the ancient tome from Genesis through Revelation, including David and Goliath, Noah's Ark, the Exodus, Daniel in the Lion's Den and the crucifixion/resurrection of Jesus. Shot in Morocco, the series is narrated by Emmy winner Keith David with a musical score by Oscar winner Hans Zimmer, also stars Downey as Mother Mary and includes Paul Brightwell, Greg Hicks, Sebastian Knapp, Amber Rose Revah, Greg Hicks and Simon Kunz.

Related: First Look at Russell Crowe as 'Noah' 

Watch the video for the actors' take on tackling such iconic figures – and see the amusing moment after Nancy sneezes in front of Morgado!

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Barney fans dunno dinos

A new study blames toys like Barney for misconceptions about Tyrannosaurus rex. When researchers asked children to draw the dinosaur, most gave it a posture that was far too upright. Why? They’d apparently soaked up the wrong idea from Barney. “It doesn’t matter what they see in science books,” says Warren Allmon, a paleontology professor at Cornell University and an author of the study.

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South Florida hospitals could lose $368 million from sequestration

A detailed survey shows that South Florida hospitals could lose $368 million over 10 years in federal budget cuts starting next Friday, if the sequestration program kicks in as scheduled.

The Florida Hospital Association, using data from the American Hospital Association, estimates that over the next decade, sequestration would cause Miami-Dade hospitals to lose $223.9 million and Broward facilities $144.4 million under the Congress-mandated budget cuts that hit virtually all federal programs unless Republicans and Democrats can work out a compromise.

The New York Times and other national news organizations are reporting that sequestration, unlike the New Year’s fiscal cliff, seems virtually certain to take place.

The law requires across-the-board spending cuts in domestic and defense programs, with certain exceptions. Because healthcare represents more than one in five dollars of the federal budget, it will be a huge target for cuts.

For hospitals and doctors, the major impact will be felt in Medicare cuts, which according to the budget law are limited to 2 percent of Medicare payments. Medicaid, food stamps and Social Security are exempted from cuts, according to the Bipartisan Policy Center.

The FHA study calculates that over 10 years, Jackson Memorial Hospital stands to lose $30.6 million, Mount Sinai Medical Center on Miami Beach $27.3 million, Holy Cross in Fort Lauderdale $23.8 million and Memorial Regional Hospital in Hollywood $21.4 million.

“The problem with sequestration is that it just makes broad cuts across the board,” said Linda Quick, president of the South Florida Hospital and Healthcare Association. “The Affordable Care Act is looking at all sorts of intelligent ways to reduce costs,” including coordinated care that will stop duplicated tests and reduce hospital readmissions. “But sequestration takes an ax, and that doesn’t make any sense.”

FierceHealthcare, which produces trade publications, says sequestration cuts over the next decade will include $591 million from prescription drug benefits for seniors, $318 million from the Food and Drug Administration, $2.5 billion from the National Institutes of Health, $490 million from the Centers for Disease Control and $365 million from Indian Health Services.

The National Association of Community Health Centers estimates that 900,000 of its patients nationwide could lose care because of the cuts. The group said the cuts were “penny wise and pound foolish” because they would mean less preventive care while more and sicker patients would end up in emergency rooms.

Like the fiscal cliff, Republicans and Democrats agreed on a sequestration strategy, with the idea that the drastic measure would force the two sides to reach agreement on more deliberative budget adjustments. That hasn’t happened.

The White House reports that the law will mean that nondefense programs will be cut by 5 percent, defense programs by 8 percent. But since the first year’s cuts must be done over seven months, that means in 2013, nondefense programs need to be cut by 9 percent, defense programs by 13 percent.

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Oscar Pistorius bail hearing nearing decision

AP

Oscar Pistorius stands in the dock during his bail hearing at the magistrates court in Pretoria, South Africa, Friday.

PRETORIA, South Africa — The defense and prosecution both completed their arguments Friday in Oscar Pistorius' bail hearing, with the magistrate soon to rule if the double-amputee athlete can be freed before trial or if he must stay behind bars pending trial in the shooting death of his girlfriend.

The prosecution vehemently opposed bail to Chief Magistrate Desmond Nair in a case that has transfixed South Africans and brought international media attention on the nation's justice system and police capabilities.

Pistorius is charged with one count of premeditated murder inr the Feb. 14 killing of Reeva Steenkamp. He says he accidentally shot her, thinking she was a dangerous intruder inside his home, lurking in a toilet stall off his bedroom.

Pistorius' hands trembled as he said "good morning, your worship" as the session began in Magistrate's Court in Pretoria, South Africa's capital. For the first time in the hearing, two representatives of the Steenkamp family were present in court, sitting behind and to the left of Pistorius in the public gallery.

Prosecutor Gerrie Nel called Pistorius' version that he shot Steenkamp accidentally improbable and argued that Pistorius did not have to have planned the killing for days in advance for it to be premediated.

"He planned it that night when she (Steenkamp) locked herself in (the toilet)," Nel said in response to a question from the magistrate on why Pistorius hadn't staged a break-in at his home to make his story look more believable. "The fact that we have only one survivor of that tragic night is difficult for the state."

Pistorius' defense lawyer, Barry Roux, brought up culpable homicide as a possible charge for the first time in the case when answering questions from the magistrate.

"He did not want to kill Reeva. He had no intent to kill Reeva," Roux said as Pistorius began weeping again — like he has done for much of his bail hearing.

Roux said it was impossible for Pistorius, as famous as he is and with his prostheses, to escape South Africa before trial and bail should be granted.

"Let me tell you how difficult it is for this man to disappear from this world," Roux said.

Prosecutor Nel earlier countered that everyone, whether disabled or famous or otherwise different from the majority, should be treated equally under the law. Nel noted that WikiLeaks founder Julian Assange is famous but is now holed up in the Ecuadorean Embassy in London to avoid extradition to Sweden to face sex-related charges.

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National Hotel nears end of long renovation

A panel of frosted glass puts everything in perspective for Delphine Dray as she oversees a years-long, multi-million dollar renovation project at the National Hotel on Miami Beach.

“Chez Claude and Simone,” says the piece of glass stationed between the lobby and restaurant, a reference to Dray’s parents, who bought the hotel in 2007.

“Every time I am exhausted and I pass that glass, I remember why,” said Delphine Dray, who joined her father — a billionaire hotel developer and well-known art collector in France — to restore the hotel after the purchase.

After working with him for years, she is finishing the project alone. Claude Dray, 76, was killed in his Paris home in October of 2011, a shooting that remains under investigation.

In a recent interview and tour of the hotel’s renovations, which are nearly finished, Dray did not discuss her father’s death, which drew extensive media coverage in Europe. But she spoke about the evolution of the father-daughter working relationship, the family’s Art Deco obsession and the inspiration for the hotel’s new old-fashioned touches.

The National is hosting a cocktail party Friday night to give attendees a peek at the progress.

Dray grew up in a home surrounded by Art Deco detail; her parents constantly brought home finds from the flea market. By 2006, they had amassed a fortune in art and furniture, which they sold for $75 million at a Paris auction in 2006.

That sale funded the purchase of the National Hotel at 1677 Collins Ave., which the Drays discovered during a visit to Miami Beach.

After having lunch at the Delano next door, Dray said, “My dad came inside the hotel and fell in love.” The owner was not interested in selling, but Claude Dray persisted, closing the deal in early 2007. Her family also owns the Hôtel de Paris in Saint-Tropez, which reopened Thursday after a complete overhaul overseen by Dray’s mother and older sister.

Delphine Dray said she thought it would be exciting to work on the 1939 hotel with her father, so she moved with her family to South Florida. She quickly discovered challenges, including stringent historic preservation rules and frequent disagreements with her father.

“We did not have at all the same vision,” she said.

For example, she said: “I was preparing mojitos for the Winter Music Conference.” Her father, on the other hand, famously once unplugged a speaker during a party at the hotel because the loud music was disturbing his work.

“We were fighting because that is the way it is supposed to be,” she said. “Now, I understand that he was totally right.”

She described a vision, now her own, of a classic, cozy property that brings guests back to the 1940s.

Joined by her 10-year-old twin girls, Pearl and Swan, and 13-year-old son Chad, Dray pointed out a new telephone meant to look antique mounted on the wall near the elevators on a guest floor. She showed off the entertainment units she designed to resemble furniture that her parents collected. And she highlighted Art Deco flourishes around doorknobs and handles.

“It’s very important for us to have the details,” she said.

With those priorities in mind, she is overseeing the final phase of the renovation, an investment that general manager Jacques Roy said will top $10 million. In addition to the small details, the renovation includes heavier, less obvious work: new drywall in guest rooms, for example, and new windows to replace leaky ones.

Painting of the building’s exterior should be finished in the next two to three weeks, Roy said. Dray compared its earlier unfinished state to resembling “a horror movie — the family Addams.”

And the final couple of guest room floors, as well as the restoration of the original Martini Room, should be done by the end of April.

“At the end, I will be very proud,” Dray said.

The National’s renovation wraps up as nearby properties such as the SLS Hotel South Beach and Gale South Beach & Regent Hotel have been given new life. Jeff Lehman, general manager of The Betsy Hotel and chair of the Miami Beach Visitor and Convention Authority, said the National has always been true to its roots. He managed the hotel for 10 years, including for a few months after Dray bought the property.

“I think historic preservation and the restoration of the hotels as they were built 70, 80 years ago is such a huge piece of our DNA,” he said. “It’s a lot of what sets us apart from any other destination on the planet.”

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Sleek pizza cafe brightens tech park

Thea Goldman, no stranger to culinary pioneering, has put down roots in a neighborhood on the edge of Overtown dubbed the Health District thanks to an ambitious building project around the University of Miami’s Life Science & Technology Park.

Thea’s Pizzeria and Café is modeled on Joey’s Café, the business she and now ex-husband Joey Goldman opened in Wynwood in 2008. Their bold move spurred a cascade of interest and investment in an area that five years later is a hipster haven.

Here, the willowy, British-accented dynamo has taken a similar approach to an area with few eating options. That is part of the plan, says Goldman who opened in the fall for breakfast and lunch and is testing the dinner waters with Friday night openings.

Though only 15 minutes from South Beach, this tiny and stunning eatery, situated almost under I-95, is worlds away. It’s surrounded by office buildings, warehouses, car repair shops, a technical school and, most importantly, plans for a large hotel and retail space.

Dressed causally in black jeans and T-shirts and hailing from as far away as Naples, Italy, and as close as the surrounding Allapattah neighborhood, wait staff takes its cue from the upbeat boss with sunny smiles and quick service.

A dramatic, 30-foot-wide mural of peonies, roses, daffodils and daisies shimmers with 210,000 pieces of Italian glass pieced together by designer Carlo dal Bianco of Bisazza Mosaico. It’s set against a black backdrop with simple wooden tables set with vases of white hydrangea. Buffed, eggshell-colored concrete floors and soaring ceilings lend an industrial edge, while golden globes of light cast an elegant sheen.

The food is equal parts rustic and refined. Simple starters include pristine salads of baby arugula, mint, escarole and nicely roasted beets and a tiny greenhouse arrangement, all farmed locally.

A nice array of pizzas is cooked in a gas-fueled stone oven. The crust could be a bit saltier and chewier, but it makes a fine vehicle for generous and deftly handle toppings such as sausage-ricotta and anchovy-caper. My favorite is artichoke hearts with arugula, or maybe Gorgonzola with toasty walnuts and truffle oil.

A slightly stiff and too-thin focaccia loaded with shredded pecorino cheese and black pepper could use more loft.

Daily fish specials such as a silken cod fillet over mashed potatoes and a puree of briny black olives are always a good bet, as is the perfectly grilled salmon with lemony caper sauce over white bean and red onion salad. Chicken paillard, pounded thin and served with roasted potatoes and green beans, is simple and satisfying.

Like the menu, the wine list is modest but well done. Most of the two dozen or so labels are available by the glass, including a robust sangiovese from Emiglia Romana coincidentally named Thea.

With the exception of imported ravioli, pastas are of the boxed variety but well handled. We sampled the indulgent rigatoni with nicely browned coins of sausage and Italian ricotta.

Desserts are as simple and elegant as the place itself. Icy frozen espresso, granita topped with whipped cream and salted caramel ice cream are fine choices, as is a light but deeply flavored chocolate cake with a simple dusting of powdered sugar and a handful of plump raspberries.

Thea’s is a bustling hive of activity at breakfast and lunch, and dinner is growing more popular. Like a bright patch in a weed-strewn lot, this burgeoning eatery is full of promise.

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Nike suspends contract with Pistorius

EPA

Oscar Pistorius, seen in court Thursday, has lost the support of sponsor Nike.

Nike suspended its contract with disgraced Olympian Oscar Pistorius.

The athletic apparel company released a statement on its website Wednesday announcing a split with Pistorius, the South African Paralympic runner accused of shooting his model girlfriend to death.

"We believe Oscar Pistorius should be afforded due process and we will continue to monitor the situation closely," Nike said in the statement.

Pistorius had previously appeared in a series of Nike ads. One commercial, titled "Always On," features him discussing his goals and dreams, overlaid with shots of him running using his prosthetic legs.

Another commercial shows a montage of obstacles that "Blade Runner" overcame during childhood.

Two other Nike-sponsored athletes have faced controversy in recent years. Nike terminated its contract with cyclist Lance Armstrong after he admitted to using performance-enhancing drugs. However, the company continues working with golfer Tiger Woods, even after news of his infidelities emerged.

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Caribbean cell phone company asks South Florida relatives to buy minutes for family back home

An Irish billionaire’s telecommunications company, which has revolutionized cell phone usage in some of the world’s poorest countries, is bringing it’s latest marketing pitch to South Florida.

Digicel is tapping into South Florida’s close ties to Haiti and Jamaica in a campaign that asks families stateside to send minutes home.

Irish billionaire Denis O’Brien has staked a claim in the telecommunication industry by building his cell phone company in developing countries in the Caribbean and South America The South Florida Digicel campaign includes bus bench ads, billboards and television spots. The message is simple: “Send minutes home.”

Customers stateside can pay to send airtime minutes to family and friends’ pre-paid cell phones in the Caribbean. The concept is not new, but Digicel is seeking to broaden it’s reach.

It is a nod to South Florida’s ties to the Caribbean and the financial influence of the region’s diaspora. Families in Haiti and Jamaica rely heavily on remittances from abroad.

Haiti received $2.1 billion in remittances in 2011, which represents more than one quarter of the national income, according to the Inter-American Development Bank . In 2011, Jamaica received nearly $2 billion in remittances.

“We understand the value of the diaspora,” said Valerie Estimé, CEO of Digicel’s diaspora division. “They are our lifeline.”

Typically the company relies on ethnic media outlets like radio programs and niche publications for advertising, but there was a gap in reaching second- and third- generation Caribbean Americans, who are more plugged in to mainstream media, said Andreina Gonzalez, head of marketing in Digicel’s diaspora division.

“There was an opportunity to step up and go a little further,” Gonzalez said.

The campaign comes at a time when the company is facing some public relations backlash in Haiti and Jamaica. Customers from both islands have taken to social media to decry shoddy connections and poor customer service.

In Haiti, the problems were so acute that Digicel released an apology letter to its customers in December. When the company tried to integrate Voilà, a competitor Digicel acquired, into its network, the integration caused system failures.

“Quite simply, we did not deliver what we promised and we did not communicate effectively with customers through the problem times,” Damian Blackburn, Digicel’s Haiti CEO wrote in the apology.. “We apologize for letting our customers down and want to thank them for their patience and understanding.”

In South Florida, the marketing pitch is family-centered and draws on the diaspora’s need to stay connected. Digicel representatives say airtime minutes are as valuable as the cash remittances families send to the Caribbean.

The advertising features members of a culturally ambiguous animated family smiling and talking on cell phones.

The ads that appear in Little Haiti, North Miami and North Miami Beach are largely targeting the Haitian community. In South Broward, the focus shifts to the Jamaican population.

A similar campaign has also been launched in New York.

Prices range for $7 to $60 to add minutes to a relative’s Digicel account. Transactions can be made online or at participating stores in South Florida.

“You’re able to make a very big difference with a very small amount of your disposable income,” said Estimé. “We know how important it is to be able to get in touch with a mother, a sister or a brother.”

The company recognizes that some of its older customer base prefer the retail model, while younger and more savvy consumers would rather send pay for minutes directly from their computers or cell phones.

“It was really impressive to see Digicel online,” said Geralda Pierre, a Miami Gardens resident who sends minute to Haiti. “It’s so convenient to add minutes for my dad in Haiti who is sick. It makes it easier for me to get in touch with him.”

For now, Digicel says it will continue to mix the old and new. The Creole-language advertisements on Haitian radio and Island TV, a Creole language cable network, are here to stay.

“We are bringing first world convenience in some cases to third world countries,” Estimé said. “Digicel has in a way improved the lives of our loved ones back home.”

Follow @nadegegreen on Twitter

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