First Lady Casey DeSantis, House Healthcare Budget
Committee Chairman Rep. Alex Andrade, and State Surgeon General Joseph Ladapo (Images via Gov. Ron DeSantis’s Office, the Florida House of Representatives, and the Florida Department of Health.)
The DeSantis administration’s move to eliminate a dedicated funding source for four National Cancer Institute (NCI) facilities and open it up to other providers will face an uphill battle during the Legislature’s 2025 session.
House Health Care Budget Subcommittee Chairman Alex Andrade told the Florida Phoenix he supports keeping the money flowing to Moffitt Cancer Center; University of Florida Health Cancer Center; Sylvester Comprehensive Cancer Center; University of Miami Miller School of Medicine; and Mayo Clinic Comprehensive Cancer Center.
The Senate has not addressed the DeSantis proposal and it’s not yet clear how that chamber feels about redirecting the money away from the NCI facilities and to other providers.
Andrade, meanwhile, said he supports the targeted funding for the four NCI facilities, telling the Florida Phoenix: “Intelligent minds can differ, but I tend to believe Gov. Scott, who was very intelligent man who understood the health care system.”
His comment harkens to the state’s decision in 2014 to invest in the NCI facilities and the leading research and care being provided there, an initiative championed by then-Gov. Rick Scott. The legislation mandated that the facilities share best practices and work together through the Florida Academic Cancer Center Alliance.
The funding stream has later branded “Casey DeSantis Research Funds” in honor of the First Lady, who was diagnosed with breast cancer in October 2021 and declared cancer-free the next March.
Department of Health Secretary Joseph Ladapo submitted a long-range plan to the Legislature in December that argues the “exclusivity limits funding accessibility for other cancer facilities and research institutions across Florida, including those in rural or underserved areas.”
Ladapo’s plan notes that the NCI facilities treat just 10% of the cancer patients in the state. Additionally, just 2.6% of the state’s cancer funding is directed toward pediatric research, despite the large number of children who live here.
“Transforming Florida’s approach to cancer prevention, treatment, and research will provide funding for a broader range of cancer facilities, improve cancer care, and further drive innovative research,” the long range plan states.
Keeping their counsel
While the proposal would make money available to more hospitals and providers, none of the systems that would potentially benefit are speaking publicly about the proposal, some on the advice of their lobbyists. The House budget committee took no public testimony and there were no appearance cards from lobbyists. The Florida Cancer Specialist & Research Institute, a medical and oncology and hematology practice with locations across the state, did not respond to the Florida Phoenix’s request for comment.
Ladapo, meanwhile, appeared before Andrade’s committee in a panel discussion that included researchers from the four NCI-designated facilities, all of whom reported that the funding commitment, $847.1 million to date, has enabled them to lure top researchers away from renowned cancer research facilities.
“Cancer is a major challenge. Many people, just about everyone, have some personal connection to it, either personally or through a family member, and in Florida unfortunately we have about 47,000 of our fellow Floridians who die every year because of cancer,” Ladapo said.
Best and brigthtest
John Cleveland, Moffitt’s executive vice president, director, and scientific officer, said the funding has helped the NCI facilities recruit 980 premier investigators since its inception. Cleveland estimates the money has produced a $3.1 billion multiplier effect on the state’s economy annually. In the next 10-15 years, he said, that could reach $10 billion.
“Florida used to be a state where you flew to New York City or Boston to get your care,” he said. Before he joined Moffitt in the same year the program began, Cleveland lived in Jupiter.
“Everybody was flying up North to get their clinical care,” he recalled. “No longer. So now they actually want to stay in the state. And I think that’s super important — we have to support our citizens. Having them get on a plane to get their care up in other states is just ridiculous.”
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Cleveland stressed that the state funds have allowed the NCI-designated facilities to recruit and retain the best researchers in the nation.
That was a theme other NCI representatives participating in the committee hearing touched on.
Oncologist Thomas George of the University of Florida Health Cancer Center is a second-generation Floridian and has raised his family here.
“The only reason we are still in Florida is in part because of this program. Otherwise, I’d be in a Northeast school or perhaps a Midwest school practicing in those locations,” he said.
“So, what Dr. Cleveland mentions about the recruitment to this state of the brain trust and the retention in the state of the brain trust is absolutely, absolutely true. We’ve been very successful in being able to keep a large number of our trainees here in the state, either at our centers or in communities.”
Javier Milian is charged with recruiting talent to the University of Miami Sylvester Center and oversees satellite operations and recruitment at Sylvester Comprehensive Cancer Center. In that capacity, he competes against Ivy League universities for the talent.
Milian says the researchers aren’t too focused on the salaries they earn.
“What these physicians really want to know is, what is the commitment from the cancer center and what is the commitment from the state. Because it’s not about money for them. It’s about legacy and it is about impact. And so, if they can’t get the funding and if they can’t get the support they need, they are nervous they aren’t going to be able to make the impact they could somewhere else.”
Mayo Clinic Comprehensive Care Center Director Dr. Roxana Dronca said the cancer center in Jacksonville has made it a priority to offer care outside the clinic’s walls, in the communities where patients live and even in their homes. It’s called the Cancer Care Beyond Walls program.
They have performed 250 at-home infusions with no adverse events since launching the program. The next step, she said, is to bring the program to rural counties in the Florida Panhandle.
“With Cancer Care Beyond Walls, we are flipping the paradigm a little bit and we are reserving hospitals and clinics for the high-intensity part of the cancer journey while administering lower-acuity treatment … maintenance, chemotherapy, biologics, and hormonal therapies in the patients’ homes,” Dronca said.
“The infrastructure that we have set up with the states’ support is actually an infrastructure where patients can have a benefit from advanced digital technologies. The have the ability to do remote patient monitoring when needed and we have a command center that oversees the care in the home in real time.”
Comprehensive status is the goal
The National Cancer Institute is the federal government’s principal agency for cancer research and training. NCI leads, conducts, and supports cancer research across the nation in 72 facilities, including Florida’s four.
NCI has three levels of cancer designation: basic laboratory, clinical, and comprehensive. Moffitt and Mayo are NCI-designated comprehensive cancer centers, according to the NCI website, while Sylvester Comprehensive Cancer Center and the University of Florida Health Cancer Center are clinical cancer centers.
Cleveland said the goal of the program should be for the four NCI centers to all earn “comprehensive” status.
“You are creating an ecosystem that is really feeding upon itself. That is really quite remarkable. Florida should be commended about the investment it makes,” he said.
Additional cancer funding
In addition to the Casey DeSantis Research Funds, the state has cancer-related grant programs including Live Like Bella Childhood Cancer Foundation; the William G. “Bill” Bankhead Jr. and David Coley Cancer Research Program, named after two former lawmakers who died from cancer; the James and Esther King Biomedical Research Program, named after a former Senate president’s parents. Those programs received $20.8 million in grant funds to distribute to applicants.
The Legislature also appropriated $60 million to a Cancer Innovation Fund and charged the Cancer Connect Collaborative with allocating the funds. The collaborative was announced by the First Lady in 2022 during a press conference following her treatment. She assembled a team and charged the members with rethinking the state’s approach to combatting cancer.
The Legislature agreed to codify the collaborative into law last year and charged it with distributing $60 million in Cancer Innovation Funds.
The governor’s proposed budget for state fiscal year 2025-26 proposes earmarking an additional $5 million to the funding stream for the NCI-facilities, bringing total annual funds to $132.5 million.
DeSantis recommended an additional $30 million for what the budget describes as the Cancer Connect Collaborative Incubator, which would provide funding grants for pediatric cancer research.
When asked about spending an additional $30 million to establish the incubator, Andrade said: “I don’t know if we’ll have the money to do anything that dramatic. If there’s the funds, I’d be happy to do it.”
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