JACKSONVILLE — Gov. Rick Scott's plan to spend tax dollars to boost the national prominence of Florida's top cancer centers came as a pleasant surprise to the Mayo Clinic.
One of the country's most prestigious names in research, the Mayo Clinic Cancer Center is in three states — the mother ship in Minnesota, plus Florida and Arizona. Mayo Jacksonville officials figured they — and the 14,000 cancer patients seen at the Florida site — would benefit from Scott's plan.
After all, the glass doors of its research building bear the federal seal of approval Scott wants more Florida centers to have: "A comprehensive cancer center designated by the National Cancer Institute."
But Mayo, nestled in a forest of pine trees in suburban Jacksonville, has learned that being "Florida's best kept secret," as its leaders like to say, has political consequences. As this year's legislative session wore on, it became clear that Mayo would be snubbed in favor of centers that enjoy more support in Tallahassee.
"It was eye-opening to us," said Layne Smith, Mayo's director of state government relations.
Consumers who wait eagerly for the latest news on the war against cancer might imagine that medical research is a purely scientific pursuit. But especially now, as federal research dollars grow scarcer and competition for whatever other funds can be found intensifies, it's a political challenge as well.
Just ask Mayo Jacksonville.
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The center, which opened in 1986, has participated in Florida's competitive grant program and has won cancer research awards over the years.
But this year's budget, with a $60 million appropriation that will be repeated four more years, represented a huge leap in state spending on cancer research.
Budget language restricted the funds to Moffitt Cancer Center in Tampa — which also has the NCI designation — and the cancer centers at the University of Florida and the University of Miami, which hope to gain the distinction.
This isn't just an issue of status. NCI designation, which comes after a rigorous application process, is the key to getting federal cancer research dollars. Florida ranks second in the nation in cancer incidence and mortality, but 15th in NCI grant funding, according to the American Cancer Society, fueling the current interest in attracting more research money.
But if UF and UM gain the designation — and access to NCI funds — that also will mean even more competition for scarce resources. Little wonder Mayo is so eager to make friends in Tallahassee.
"What we need to do is a better job educating legislators about who we are, what we do and why we deserve state support,'' said Panos Anastasiadis, chairman of Mayo Florida's department of cancer biology.
But Mayo will also have to counteract critics who insist the fact that it is part of a three-state network means it will siphon dollars away from Florida centers that don't have out-of-state affiliates.
Not so long ago, Mayo didn't have to worry so much about its clout in Tallahassee. But now state dollars matter more than ever.
The federal government awarded $3.5 billion in National Institutes of Health research grants in 2013, roughly the same amount as five years prior. But the competition is stiffer now. In 2008, nearly 22 percent of research applications were funded. Last year, it was less than 17 percent.
National Cancer Institute funding — only centers with the NCI designation can apply — is even more competitive. The success rate for NCI grants dropped nearly 7 percentage points between 2008 and 2013 to 13.7 percent.
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Moffitt was created by the Legislature — it bears the name of former House Speaker H. Lee Moffitt, a cancer survivor. Many powerful lawmakers also hail from the Tampa Bay area, including House Speaker Will Weatherford and Senate health care budget chief Denise Grimsley.
As the governor was shaping his cancer center funding proposal, his office called Moffitt officials.
"They did ask for our thoughts, and, based on their intention, we were happy to contribute our advice and feedback to them," said Thomas Sellers, Moffitt's director and executive vice president.
Scott later scheduled appearances at the UF Proton Therapy Institute in Jacksonville and the Sylvester Comprehensive Cancer Center at the University of Miami to drum up support. Meanwhile, Mayo leaders were learning about the plan in the media.
Jacksonville area legislators said they got into the game too late to help.
"The leadership from our community wasn't a part of that decisionmaking process," said Rep. Mia Jones of Jacksonville, the ranking Democrat on the House's health care committee. "Everything is about the leadership, and if your leadership is not included or listened to, then that's where you end up."
The delegation did get Mayo a $2 million consolation prize, and Mayo agreed to drop the issue until next year.
"I just think the votes weren't there for us this year. It's a new thing," said Sen. Aaron Bean, R-Fernandina Beach.
Mayo clearly has a job ahead to win over the state's leaders.
Florida Surgeon General John Armstrong said on Friday that the state's NCI funding program is for "home-grown cancer centers" and Mayo doesn't fit that description.
"The model that is in Mayo Jacksonville uses a central relationship with an institution that is in Minnesota," he said.
Mayo Jacksonville officials insist they are equal partners with Mayo centers in Minnesota and Arizona, and bristle at the notion that they are not Florida-based. They point out that they serve and employ thousands of Floridians.
They also note that NCI teams make separate inspection visits to each Mayo facility — though NCI research dollars are funneled through Mayo in Rochester, Minn.
Competitors aren't convinced.
"The proposal from Gov. Scott was to create Florida-based centers to take care of our own citizenry and to attract folks from other states and countries to receive outstanding cancer care in our state," UF lobbyist Mark Delegal said.
Politically, the stakes are clear: If Mayo becomes eligible for the state money, the $60 million pot would have to be spread across four centers, not just three.
Interestingly, Mayo often works with other Florida centers on cancer research projects and clinical trials. They've shared grant funding, facilities and expertise.
But in the budget process, at least for now, Mayo is looking for allies.
Contact Tia Mitchell at firstname.lastname@example.org or (850) 224-7263.