Florida's Community Health Centers are raising concerns about their own financial health due to what they've said are inadequate Medicaid reimbursement rates.

The centers are urging lawmakers to adjust the rates to cover what they've found to be a gap of $106, or just over 42%, for every Medicaid patient visit.

Bradley Herremans, CEO of Suncoast Community Health Centers in Hillsborough County, said filling the funding gap could enable them to expand services and even open new clinics, while failure to do so would force them to curtail or close some services, disproportionately affecting low-income populations.

"The population is just growing exponentially around here, and that just drives the additional need for additional services," Herremans explained. "You can kind of see where you start to get that 'crunch,' between revenue and what's expected of a Community Health Center."

Sen. Kathleen Passidomo, R-Naples, president of the Senate, achieved unanimous passage of her "Live Healthy" proposal, Senate Bill 7016, touted as a plan to increase the state's health-care workforce. Health centers are optimistic lawmakers will address funding gaps in budget negotiations between the House and Senate.

Jonathan Chapman, president and CEO of the Florida Association of Community Health Centers, said they comprise 54 centers spanning over 800 locations. He does not expect any one entity to make them whole.

"We're looking at a $40 million 'ask' of state recurring funds," Chapman pointed out. "This would also be leveraged with federal dollars, so with the state's $40 million investment, we would actually leverage that and it would be close to a $100 million investment, which really equates to about $22 per FQHC patient."

FQHCs are Federally Qualified Health Centers. Annually, Chapman said the centers provide care to 1.8 million patients, with 51% covered by Medicare or Medicaid, and 28% uninsured. He added more than 87% of patients served by Community Health Centers live below the Federal Poverty Level.

Counterfeit medicine sales are on the rise, in Connecticut and nationwide.

The state faced trouble with growing sales of counterfeit Xanax pills laced with fentanyl in 2021. Raids on two Westbury mini-markets that year uncovered sweeping "pill press" operations. Now, criminals are counterfeiting the weight-loss drug Ozempic. Some variations are insulin pens with an Ozempic label.

Shabbir Imber Safdar, executive director of the Partnership for Safe Medicine, said telehealth pushes people to take medications they would not normally qualify for.

"To do something significant, like to go on an injectable drug for a long period of time that is going to have serious consequences for your health and nutrition and your weight, you really need to see a real doctor, not a computer doctor, not a doctor in a chat room," Safdar contended. "I think some telehealth companies have normalized the fact that that's not important."

Some pharmacies and clinics face lawsuits for selling knockoff drugs through telemedicine. In its efforts to keep people safe, the Food and Drug Administration seized thousands of units of fake Ozempic in late 2023. But research shows numerous lifestyle drugs are being counterfeited daily.

Safdar pointed out a major red flag is when an online ad promises expedited access to a certain drug without a prescription. Social media has only expanded a person's ability to get counterfeit drugs. A Long Island TikTok influencer has been indicted for selling fake medication to her followers.

Though federal agencies and lawmakers issued warnings, Safdar argued the biggest challenge to maintaining public safety is the public.

"When you skip that pharmacist in that white coat and you go online and try to pick a pharmacy yourself, or you pick a telemedicine doctor yourself, you've skipped all of the safety checks," Safdar emphasized.

There are reports some counterfeit Ozempic has led to hypoglycemia or dangerously low blood sugar. Safdar noted some counterfeits are injectables mixed with impurities. The Food and Drug Administration said other side effects like nausea, vomiting, abdominal pain and constipation are consistent with the real drug.

By Haley Miller for Chalkbeat Indiana.
Broadcast version by Joe Ulery for Indiana News Service reporting for the Chalkbeat Indiana-Free Press Indiana-Public News Service Collaboration.

When Alma Figueroa visited the homes of Indianapolis Public Schools students who were pregnant or parenting earlier this year, she noticed hazards that put babies at risk of suffocation or strangulation — from bed-sharing to stuffed animals in the crib.

But Figueroa has a response ready for the upcoming school year.

As the case manager for the IPS Stronger Tomorrows program for pregnant and parenting students, she plans to give them the items to guard against babies sleeping at angles in car seats or swings, sharing beds with adults or pets, and sleeping with loose objects. Figueroa wants the additional resources she’ll hand out, like sleep sacks and portable cribs, not only to lower the infant mortality rate in Marion County, but also help the parents feel secure enough to stay in school and on track to graduate.

“If their babies are not OK or if something is not going well at home, then we know that’s really going to affect their success at school,” Figueroa said. “Making sure that their babies are well is essential for them to be successful in the classroom.”

The resources Figueroa will distribute are supported through a $10,000 donation from the Shepherd Community Center.

In the 2023-24 school year, IPS had around 60 students who were pregnant or parenting, according to Figueroa; in the past school year, 14 IPS students who were pregnant or parenting graduated.

She said many of the students didn’t know about safe-sleep practices, or they didn’t have the money or space to provide a secure sleeping environment.

Figueroa also hopes the increased access to safe-sleep items will help reduce Marion County’s high infant mortality rate. In 2022, the county had an estimated 8.1 deaths for every 1,000 live births, compared to the statewide rate of 7.2 and the national rate of 5.6 in the same year.

“Do you have a place for the baby to sleep is a big thing,” Figueroa said. “A lot of our students were not prepared.”

A report released last year by the Indiana Department of Health found that 528 babies died suddenly and unexpectedly from 2015 to 2019, and 99% of the deaths had at least one unsafe sleep risk factor present.

In Figueroa’s experience, providing resources like safe-sleep items for pregnant students before they give birth is key to help them feel prepared when the baby comes and stay on track to graduate.

Figueroa noted that the district created the Stronger Tomorrows program to ensure pregnant and parenting students know their rights under Title IX — a civil rights law that prohibits sex-based discrimination by schools that receive federal funding — and remove barriers to their education.

The program helps students receive accommodations from their school, like excused absences, and connects them to organizations in the community where they can access support for young parents.

The Shepherd Community Center received grant funding specifically to promote safe-sleep initiatives on the eastside of Indianapolis, said Jay Height, the group’s executive director.

“We believe IPS is doing a great job, and it’s important for our neighborhood to have strong schools,” Height said. “This is one of many ways that we support them and our students.”


Haley Miller wrote this article for Chalkbeat Indiana.


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In Pennsylvania, a unique mobile van brings reproductive resources to communities across Western Pennsylvania. A new podcast, called "(In)Accessible," explores the challenges people have in finding reproductive healthcare, including abortion, in the state.

Podcast host Rebecca Susman, communications and development director for the Keystone Progress Education Fund, said it features guests doing innovative work to address these barriers, with topics like fertility treatments and menopause care. Susman describes one of the conversations.

"I spoke with Alecia Ott from The Auto(nomous) Body Shop or the 'auto body shop,' which is an amazing mutual aid van, where she brings it all over the place, to universities, to events. And she gives out information about birth control and emergency contraception - as well as harm reduction, such as Narcan," she said.

In Pennsylvania, abortion remains legal until 24 weeks of pregnancy, and it's one of the closest locations to receive care for people living in many nearby states with abortion bans.

In the podcast, Alecia Ott explains that when she parks the van, she puts out a chalkboard inviting people to stop by for free information and contraception. The eye-catching orange van often sparks curiosity.

"You'd be surprised at how quickly somebody is telling me a story about how they accessed care, or they had to help somebody else find a place to have an abortion or emergency contraception or, you know, fertility help. People are sharing really intimate stories very quickly," Ott said.

Ott points to a few resources, like the Steel City Access Network in Pittsburgh, that provide transportation for abortion seekers, while the Western PA Fund for Choice offers financial assistance. She also envisions a collaborative network of mobile units to strengthen her advocacy.

Susman said the podcast also has covered the impact of the Dobbs decision, and the confusion people may have about their options, with ever-changing legal challenges in nearby states. She sees Pennsylvania's current abortion access as the result of strong political leadership, but acknowledges it could be under threat.

"Every single seat in the House, the Pennsylvania House, is up for grabs this fall. And we have another state Supreme Court election as well. This could all change. And these decisions happen because of who we elect into office and who they appoint, so it's very, very important that we all show up this November," Susman explained.