DeSantis’ pick for Florida surgeon general confirmed by Senate

TALLAHASSEE — As Florida grapples with its response to the novel coronavirus, the Senate Thursday voted to confirm Scott Rivkees as the state surgeon general.

Rivkees is a pediatrician who was appointed to lead the state health department by Gov. Ron DeSantis in April 2019.

The vote was 31-9. Only Democrats voted “no.”

Rivkees has been by DeSantis’ side in recent weeks, traveling the state in response to the coronavirus, which has recently been classified by the World Health Organization as a global pandemic. Forty-six people in the state have tested positive for the flu-like illness.

The surgeon general’s reaction to the virus, his leadership of the state health department and his lack of experience in public health have been largely criticized by senators as Rivkees has gone through the confirmation process. On the floor, some Democrats questioned whether he was fit to serve, let alone lead the response to coronavirus.

Sen. José Javier Rodríguez said leading up to the session, he was “going to give him a shot” but Rivkees’ recent inaction made him second guess.

“It is important to have someone in public health in the driver’s seat when we deal with public health emergencies,” said Rodríguez, D-Miami. “We don’t have that. We need proactive and not reactive actions from our executive.”

Lawmakers also brought up the empty positions throughout the department, which gives them pause.

The deputy secretary position that is tasked with organizing the 67 county health departments is still vacant. The director of that office, Beth Paterniti, worked as a policy analyst under governors Rick Scott and Charlie Crist but doesn’t have a background in community health.

Rodríguez added that while other “democracies in the world” have worked to get ahead of the virus’ spread, Florida seems to falling behind.

“When we look at our own state of Florida, my assessment is we have been reactive and not proactive,” he said, criticizing the lack of testing kits and information that caused some problems when the first positive cases in Florida were announced March 1. “A lot of the steps should have been taken weeks or months ago.”

Sen. Lori Berman, who was critical of Rivkees during his committee stops, said she was upset to see Rivkees not “going above and beyond” the guidelines from the U.S. Centers for Disease Control and Prevention.

“We need someone who steps up to the plate,” the Latana Democrat said. “Yesterday my doctor said he was on the phone all day trying to get answers from the Department of Health. We shouldn’t have to be begging them for information. They are not taking the forward view of this. I don’t feel like we, in the state, are doing the right thing.”

Rodríguez said he sent a letter to Rivkees asking if Florida Medicaid will cover the cost of testing and treatment for Medicaid beneficiaries who meet the COVID-19 diagnostic criteria and raised similar questions about health insurance coverage for state employees.

Rivkees answered him the next day that all testing and treatment would be covered and for those with no insurance, “county health department’s would test for no charge and treatment — basically the safety net system.”

But when Rodriguez asked about what was being done to provide for employees ordered into quarantine who do not get sick leave “his answer was bizarre,’‘ he said.

“He said those who have been isolated and are facing special hardships if they need assistance, will be given help on a case by case basis. He literally told me they are providing food vouchers and rent and we have not been able to follow up and confirm that anybody’s gotten some sort of food voucher or rent through any kind of state agency,’‘ he said. Rodriguez said there may be local agencies that the state is using for this work but they haven’t found them.

“My assessment is we are being reactive and not proactive,’‘ Rodriguez said.

“At this point in the crisis, none of us see the governor, and the surgeon general as being proactive,’‘ he said. “Everything is reactive. We criticized them for not managing the public information, they immediately responded by starting to have more public dialogue. We criticized them for not doing testing, they announced that they’re buying 2500 testing kits. All of these things, however, they should have done weeks ago.”

While ordering new testing kits and protecting seniors are good steps, he said, it should have been done weeks ago not on Thursday. [end print trim]

Sen. Janet Cruz, a Tampa Democrat, said Rivkees called her before the confirmation vote and told her that testing was available at all Quest Diagnostic labs, “and that isn’t true,’‘ she said.

She has little confidence in his leadership, she said, and she believes the state is “wholly unprepared for what’s happening.

She echoed Rodriguez’s concerns that state leadership is following a failing national model.

“I’m very concerned that we are putting politics over people and that’s what I’m seeing happen here,’‘ she said.

She worries that Florida could go the direction of Italy, doing too little too late and for the “older and the weaker, they’re just leaving to die.”

Those who voted to confirm Rivkees said “now is not the time to change teams” and that having someone stable in the position is more important than finding someone more qualified.

"It sends a terrible message that at the peak of our anxiety, this Legislature doesn’t have faith in a surgeon general,” said Sen. Jason Pizzo, D-Miami Beach. “I don’t think we have a replacement for tomorrow afternoon.”

Sen. Gayle Harrell, who has known Rivkees for years, said he is “really an authority” when it comes to patient care and that Florida needs his “calm, cool leadership.”

The Stuart Republican chairs the Senate Health Policy committee, which approved Rivkees for a floor vote.

Rivkees made it through three Senate confirmation hearings, but not without his share of controversy.

In questioning before lawmakers and the public, he was questioned about his qualifications for leading the state’s Department of Health despite a career spent in pediatrics, academia and research rather than epidemiology or public health.

The only mention of “public health” on his curriculum vitae is where he lists his position as chair of the CASE Public Health Board. CASE is the Connecticut Academy of Science and Engineering. Rivkees has said he has “longstanding interests” in public health, which go back to his time as an undergraduate student at Rutgers University, where he worked in a lab testing blood samples for lead poisoning. He added that when he was a fellow at Massachusetts General Hospital in Boston, he was involved in newborn screening research that he eventually helped develop into a program in Indiana.

The physician’s start date was delayed by the negotiation of a two-year agreement with the state to keep him employed by UF, where he is still a tenured professor. The state pays UF a total of $140,000 annually to cover Rivkees’ “assignment” to serve as surgeon general, and according to a state website Rivkees also makes $243,000 from various contracts and grants at the university.

Though committee chair Sen. Aaron Bean, R-Fernandina Beach, had previously asked questions of Rivkees’ commitment to the job, Rivkees assured lawmakers that “Florida has a full-time surgeon general.”

Several people who worked with him at the University of Florida have also said Rivkees was a harsh manager fueled by vindictiveness. The News Service of Florida reported he faced sexual harassment allegations at UF.