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A Singular Voice in an Evolving City



State’s Zika testing process may require 15 steps, pg. 13 NEW COMMISSION LEADER: County commissioners are to select their new chair and vice chair Dec. 6. Chairman Jean Monestime and Vice Chair Esteban Bovo Jr. have held these roles for two years. There has been no public discussion as to who the new leaders might be, but many of the commissioners currently sitting on the dais have already served as chairman, including newly-elected Joe Martinez, who was on the commission from 2000 to 2012 before giving up his seat representing the Kendall area to challenge Mayor Carlos Giménez. Mr. Martinez is filling the seat left vacated when former Commissioner Juan Zapata chose not to run again.

UM to offer public health pros business skill, pg. 14

The Achiever

By Catherine Lackner

MORE ROOMS, LOWER RATES: Miami-Dade hotels in the first 10 months of this year sold 2% more rooms than last year at the same time but had average daily rates 2% below last year’s, the Greater Miami Convention & Visitors Bureau reported, citing figures from Smith Travel Research. As the supply of rooms in the market rose 4.2% to 53,769, average daily occupancy fell 2.1% to 76.5% and revenue per available room fell 4.1% to $144.07 from $150.22 in the same period last year, though it was sixth highest in the nation this year for the period. The total of rooms sold during the period was 12,333,908 and the average daily room rate was $188.52, fifth highest in the nation. UNIVERSITY’S 70TH BIRTHDAY: St. Thomas University alumni and guests will celebrate the university’s 70th anniversary starting with a noon mass and then a lunch reception on campus Dec. 10. The university was founded in 1946 in Havana by American Augustinian priests from Philadelphia. Fidel Castro ordered the university closed in 1961 but it reopened as Biscayne College in Miami-Dade and in 1984 became St. Thomas University. Details: (305) 628-6601. HIALEAH BONDS OUTLOOK NEGATIVE: More than $83 million in outstanding bonds to be repaid by the City of Hialeah received negative rating outlooks and ‘A’ ratings from Fitch Ratings last week. Fitch cited the city’s “weak financial operations including relying on one-time sources and deferring obligations to fill budget gaps.” Fitch also noted as a negative the city’s “use of deficit financing to support operations.” Fitch noted “per capita personal income estimated at about half of the national level” and a poverty rate of 25.8%, “well above local, state and national levels.” A total of $46.145 million of the bonds that Fitch rated are to be repaid from franchise fee revenues from Florida Power & Light Co. for granting the electric franchise to the corporation. Hialeah pays Fitch to rate the securities for bond buyers.

Diego Lowenstein

Photo by Cristina Sullivan

Pushing a global growth plan for Virgin Hotels team The profile is on Page 4

Land needed to build in dense areas may climb By Susan Danseyar

A resolution before the Miami City Commission next week would significantly increase building lot sizes in the city’s densest urban areas. Over a year ago, the Miami Planning, Zoning and Appeals Board recommended the commission revise the zoning code to increase lot areas permissible for development from 5,000 square feet in some cases to a minimum of 10,000. By many accounts, this change would have only destructive effects. City Commissioner Francis Suarez has voiced opposition several times to altering minimum lot area and width for development in the neighborhoods that would be most affected (T4, T5 and T6), which are primarily in Little Havana, Overtown, Allapattah and Brickell. The proposed amendment passed a preliminary commission vote in October 2015. When presented again last month for a final vote, commissioners deferred it upon Mr. Suarez’s motion to Dec. 8. Should the amendment ultimately pass, development couldn’t take place on properties subdivided in the future that then don’t meet the new standards. The new proposed minimum


Consortion on tax track for new rail

for T4 and T5 is 10,000 square feet; the new minimum for T6 would range from 20,00030,000 square feet. Previously, development was allowed in these zones on lots as small as 1,200-1,400 square feet. The proposal also would change minimum lot width for development from 50 feet to 100. Opponents say the dramatically increased requirement would prevent owners of small lots from developing them and would devalue them. A provision in the zoning ordinance allows a nonconforming lot, shown on the latest recorded plat or prescribed by deed, to be kept and be developed by right at no cost and without the need for a special permit, Planning Director Francisco Garcia told Miami Today this week. Yet, say opponents, the change would create confusion, delay and costs for small business and property owners, thereby reducing lot values and hindering revitalization. Andrew Frey, principal of real estate developer Tecela, wrote Mr. Suarez to say he’s observed that the best urban neighborhoods globally are made up of lots much smaller than what the proposed amendment would allow. In fact, Mr. Frey said,

those world-class neighborhoods – including in Miami – are comprised of lot areas smaller than what Miami zoning already allows. “Why would anyone want to make it illegal to grow such neighborhoods?” Mr. Frey asked. The reason is to have regulations producing predictable development and revenue, Mr. Garcia said. Additionally, he said, the proposed changes are intended to protect city land values long term. “It behooves us as a city to say where there’s a critical mass, we will allow land to be developed in a way that serves people at the best and highest use for the next 50 years or more,” Mr. Garcia said. “What we are proposing to do to our form-based zoning code is properly calibrate land configuration with reasonable, predictable building.” This proposed change has been deferred for 12 months, Mr. Frey said in his letter to Mr. Suarez. “It should be denied, not deferred again, so that thousands of small lot owners can stop living in fear.” Details: See the legislation, http://

A government-business consortium agreed Tuesday that to get Tri-Rail’s Coastal Link rolling a special assessment or tax increment district should cover the area that would benefit most. The only split was over how fast it can go. Miami Commissioner Francis Suarez, who called the meeting, described a tax district as “a winnable corridor that is within our reach,” the half mile on either side of Florida East Coast Railway tracks from downtown to the Broward line, an area poised to develop or redevelop 30 million square feet of land. That development, some already underway, is valued at $18 billion, said Charles Scurr, Citizens Independent Transportation Trust executive director. “We went through the corridor parcel by parcel” to determine its potential for incremental funds, he said. Even assuming slow growth, Mr. Scurr said, the corridor will generate more than $44 million in incremental bond issuance capacity over 10 years. A fast-growth scenario would yield about $188 million in bonding capacity over 10 years, he reported. North Miami Beach andAventura have been very receptive, he said, and have asked private developers about building stations. The transit increment funding would be “very similar to a CRA as far as the mechanics are concerned,” said county Commissioner Esteban “Steve” Bovo Jr. That would freeze property taxes the county collects at today’s level, and any taxes from increasing value would go to the transit district. “The TIF is easy to embrace in this case,” Mr. Suarez said. “This is one of our densest corridors. If we lay it down fast, we’re going to catch $1 billion in construction. Last year, we grew by 26%, and that [potential revenue] is gone.” Though a slowdown is forecast, growth will still be at least 7%-9% next year, he predicted. “The Northeast corridor is ripe,” Mr. Bovo agreed. “We need to activate this,” Mr. Suarez said. “If this can be done by county fiat, I’ll support it all the way.”




















The Insider FLY THE SKIES TO SANTO DOMINGO: Pan American World Airways (PAWA) Dominicana has entered the Miami market. The airline began two daily roundtrips Nov. 16 from Miami International Airport to Santo Domingo on MD-83 aircraft. PAWA Dominicana brought MIA’s total carriers to 107, the most of any US airport. Four new international passenger airlines launched service in September alone, followed by KLM Royal Dutch Airlines on Nov. 1 New cargo-only carriers KF Cargo, 21 Air and NAC Cargo also began serving MIA in April, October and November, respectively, for a total addition of nine airlines in 2016. NEW LEGION DIGS: The American Legion is one step closer to a new home in the Upper East Side after a recent vote of the city’s Urban Development Review Board. On a 3-to-1 vote, the board recommended conditional approval of a plan from ACRE GCDM Bay Investments LLC to construct a five-story building with 237 residences at 6445 NE Seventh Ave. A site plan shows the developer is to incorporate a new 15,000-square-foot facility for the American Legion into the project’s northeast corner. The property is just south of Legion Park, a city-owned site with a public boat launch on Biscayne Bay. The board learned the developer intends to seek a Special Area Plan designation in order to build an adjacent mixed-use project with residential and commercial uses and use a portion of the park to make the 9-acre minimum in the zoning ordinance. The city is expected to be a co-applicant. Neighboring property owners are objecting to the larger development and say they don’t want the public park involved in any way. MORE EFFICIENT BUILDINGS: Miami-Dade County is now a member of the City Energy Project, a united effort of 20 US communities to address their largest source of energy use and carbon pollution: buildings. The project is expected to save the county’s businesses and residents $200 million a year on their energy bills by 2030. Commissioner Daniella Levine Cava sponsored a resolution, passed last month, authorizing Miami-Dade to participate in the initiative. Through the City Energy Project, Miami-Dade will develop a locally tailored plan comprising multiple integrated strategies to significantly reduce building D. Levine Cava energy use, recognizing that a suite of initiatives can make more progress in each city than one program or policy could alone. In addition to providing efficiency expertise and guidance on initiative planning, design and implementation, the project offers a platform for peer-to-peer sharing of lessons learned and best practices. The City Energy Project is a joint venture of the Natural Resources Defense Council and the Institute for Market Transformation. EVERGLADES AT THE ZOO: Zoo Miami will have festivities Dec. 10 and 11 to open a new 4.5-acre, $33 million addition titled Florida: Mission Everglades, which will display about 60 wildlife species from the area, including the North American black bear and the Florida panther, the state’s largest land animals. The project was funded primarily by the 2002 Building Better Communities general obligation bond program, which taxpayers will repay. A number of private donors also helped fund the addition to the zoo, at 12400 SW 152nd St., which is open daily from 10 a.m.-5 p.m. “The goal of Florida: Carol Kruse Mission Everglades is to give our visitors a deeper understanding of the importance of the Everglades and to engage them in helping us save it,” said zoo Director Carol Kruse. “We want visitors to be inspired to actually visit the Everglades.” LIFETIME HONORS: In its 27th year, Art Miami this week will give its first Lifetime Visionary Award to real estate developer Jorge Pérez, founder of the Related Group and developer of more than 90,000 residential units. “We created the Art Miami Lifetime Visionary Award to recognize and celebrate an individual whose philanthropy, personal passions and professional efforts have been inclusive of all and have empowered our community,” said Nick Korniloff, director and executive vice president of Art Miami LLC. Art Miami attracts more than 82,000 Jorge Pérez persons a year.. FROM 13TH FLOOR TO EDENS: Edens, which has a national portfolio of more than 120 retail centers, including Met Miami Whole Foods and Fifth & Alton, has hired Nicole Shiman as vice president-investments, responsible for leading the Florida portfolio and office. She had been vice president of Miami-based real estate private equity group 13th Floor Investments and earlier worked in the Miami, New York and Toronto offices of The Boston Consulting Group. She is a graduate of the University of Western Ontario with an MBA Nicole Shiman from Harvard Business School. REPLAT IN LITTLE HAVANA: The Miami City Commission has accepted the final plat of 3 BROAMIGO from 3 Broamigo Development LLC and 3 Broamigo Development One LLC, executed by Keith Diamond. The specific intent of this plat is to close the right-of-way of Southwest Seventh Terrace within the proposed plat and to create two tracts for commercial development. The platted area consists of 51,280 square feet or 1.177-acres. The Plat and Street Committee determined the plat conforms to the subdivision regulations and Miami 21 zoning rules. The legislation notes a January 2015 city commission decision closing and vacating part of a street at the portion of Southwest Seventh Terrace west of Southwest Eighth Avenue within the plat. GAS PRICE DIPS: Miami gas prices fell a half cent a gallon in the past week to $2.22 a gallon, 10 cents a gallon higher than the national average and 2.7 cents a gallon higher than the same day a year ago, according to GasBuddy tracking service. Still, Miami prices are 10.4 cents a gallon below last month’s level. CORRECTION: In a story about the board of directors of Miami’s Downtown Development Authority in last week’s issue, the picture of John Guitar, an authority board member, is not correct.


DOWNTOWN LAND USES PERMITTED Land Uses Offices (includes Government) (gross sq. ft.) Government office (gross sq. ft.) Retail/Service (gross sq. ft.) Hotel (rooms) Residential (dwelling units) Convention (gross sq. ft.) Wholesale/Industrial (gross sq. ft.) Institutional (gross sq. ft.) Attractions/ Recreations (gross sq. ft.) Marine Facilities

Increment I Increment II Buildout Buildout May 28, 2003 Sept. 28, 2019

Increment III Buildout Sept. 1, 2025








Government offices are included in General Office Category































50 wet slips*



Downtown’s development targets 2,700 units of affordable housing By John Charles Robbins

Miami’s lack of affordable housing is addressed in an updated regional development plan proposed and approved by the Downtown Development Authority. City commissioners gave preliminary approval Nov. 17 to an amendment of the city’s Downtown Development of Regional Impact, or DRI, designation by authorizing an Increment III Development Order. The DRI is designed to allow controlled growth and must be approved by the city’s Downtown DevelopmentAuthority (DDA) and the city commission and then filed with the state. In 1972, the Florida Legislature adopted the Developments of Regional Impact Program, which provides a process to identify regional impacts stemming from large developments and appropriate provisions to mitigate those impacts. As part of the process, the city provides annual development reports to a regional organization and state-level review panel. The application for the third increment has been two years in the making and has been approved by all applicable state agencies, said Joseph Goldstein, an attorney with the Holland & Knight firm, hired by the DDA to prepare the proposal. A Planning and Zoning Department analysis of Increment III reads in part, “A downtown Miami, activated by a thriving commercial sector, bustling nightlife, and charming, walkable, multi-family neighborhoods is a vision realized. There is still room to grow, and Increment III is proposed for adoption to facilitate this growth.” Increment III would allow an added 2.5 million square feet of offices, 758,000 square feet of retail, 2,000 hotel rooms, 18,000 residential units, 250,000 square feet of industrial space, 150,000 square feet of institutional space and 2,000 attraction seats. The city’s Planning and Zoning Department and the Planning, Zoning and Appeals Board recommended approval of the plan. The DDA’s directors approved it in late October. A second and final vote on the amended plan could occur at the commission’s December meeting.

The call for affordable housing appears under the heading of economic development in the third increment. Mr. Goldstein drew attention to the housing goals while describing highlights of Increment III to city commissioners. The city’s serious shortage of affordable housing, including workforce housing, is a problem “in the newspapers every day,” he said. Mr. Goldstein said the new proposal calls for construction of no fewer than 2,700 affordable housing units within the DRI area, representing 15% of all the new residential units proposed as part of Increment III. The range of affordable housing types extends from extremely low income to workforce. Workforce housing policies focus on providing attractive and affordable residential units for middle-income service workers such as police officers, teachers and nurses near their jobs. It is primarily a concern in regions like South Florida with high housing costs, according to a recent study by University of Miami School of Business Administration. Federal, state and municipal government programs rely on a formula usingArea Median Income, orAMI, in determining affordable housing needs and goals. The area median income for Miami-Dade County is $48,100. Increment III reads, in part: “The City shall establish ordinances, programs or other mechanisms that require that housing available for purchase or rental by extremely low (up to 30% AMI), very-low (up to 50% of AMI), low (up to 80% of AMI), moderate (up to 120% of AMI), workforce (up to 140% of AMI) populations ... be constructed or caused to be constructed in an amount equal to no less than 2,700 dwelling units or 15% of the residential units proposed within the DDRI Increment III within an area of a 10 mile or a 20 minute commute shed from and within the boundaries of this DDRI, whichever is less … but in all events, within the jurisdiction of the City of Miami.” The proposal goes on to say that all housing units for extremely low, very-low, low, moderate and workforce populations constructed and conveyed pursuant to this condition “shall limit resale to a price in

accordance with the affordable or workforce price for a control period of 20 years, or more, by providing an appropriately enforceable assurance that said unit shall not be offered for a price greater than the maximum workforce housing unit sales price as … established by the Miami-Dade County Department of Regulatory and Economic Resources at the time of said sale.” And Increment III would require all rental housing for extremely low, very-low, low, moderate and workforce populations provided in satisfaction of this condition “shall be maintained by the owner as affordable for low, moderate, and/or workforce incomes for a period of 20 years. If the units are sold during the initial 20 year period, a new 20 year period will apply.” The proposal notes that the DDA is to work with South Florida Regional Council staff to explore creative affordable and workforce housing solutions, including microunits, co-living, reduced parking requirements, mixed-income housing and “rent to buy” programs, and the rehabilitation of existing housing units. The DDA is also to work with the council to ensure a balanced distribution of housing, based on income levels.

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Texas-based firm plans Edgewater apartments By John Charles Robbins

Mill Creek Residential, a Texasbased company growing its presence in South Florida with several residential developments, is ready to venture into Edgewater. The company plans to build Modera Edgewater 25 on an assemblage of lots at 455 NE 24th St., about halfway between Biscayne Boulevard and Biscayne Bay. The multi-family housing project would bring 297 apartments to the growing neighborhood. The project was recently recommended for approval by the city’s Urban Development Review Board. Ryan Bailine, an attorney representing Mill Creek Residential Trust LLC, called the Modera Edgewater 25 plan “a spectacular urban infill project.” He introduced the project architect: Alberto Cordoves of Corwil Architects Inc., Coral Gables. The project site contains 14 parcels of land east of Biscayne Boulevard, between Northeast 24th and 25th streets, Mr. Bailine wrote in a letter to the city. It is nearly 2 acres. The project is surrounded on all sides by large residential projects, he noted. The project is designed at eight stories with a garage for 417 vehicles. There would be an additional 19 on-street parking spaces. The site plan shows 21,828 square feet of open space.

“The project has an abundance of windows and glass creating a sense of lightness throughout the structure, as well as fluid changes in materials and colors creating an aesthetically pleasing design. In addition, the project contains a beautifully landscaped pedestrian and vehicular cross block passage located on the west side of the property,” wrote Mr. Bailine. Plans show a courtyard in the western end of the project, with a landscaped and meandering pathway. To the east the structure will offer a rooftop pool and amenity deck. “One of the project’s essential programmatic features is the center courtyard containing an open area for residents and their guests to enjoy. In addition to the courtyard facilities, there is an additional amenity space on the eighth floor containing the pool, gym and leisure areas,” Mr. Bailine wrote. The building is accented by a series of elevated stoops with stairs and railings taking persons to and from the structure. This includes ground floor step down apartments. The review board members spoke highly of the stoops. “This is real nice,” said board member Fidel Perez. “I like the ground level step down units … it’s a good way to address the streets and create movement.” “Very well designed,” he said. Mr. Bailine said the developer’s

Modera Edgewater 25 will join more than a half-dozen developments by the company in South Florida.

team worked with the city’s planning staff in a real “collaborative effort” on design elements. Board member Gerald Marston said he liked the project and the stoops. “It’s a sweet project,” said acting board Chairman Neil Hall. “I commend you. I would like to see others use the stoop,” he added. According to the plans filed with the city, the 297 residential units

break down like this: 18 studios, 114 one-bedroom, 16 one-bedroom/ den, 106 two-bedroom and 43 three-bedroom. The developer is requesting several waivers, including up to 30% reduction in required parking spaces; permission to allow above ground parking to extend into the second layer above the first story; permission to reduce the required drive aisle width from 23 feet to 22


feet; and allowing vehicular entries on the principal frontage. Mill Creek Residential has more than a half-dozen apartment developments in South Florida. It most recently opened Modera Station at 3750 Bird Road with 262 apartments, and next door work is progressing rapidly on phase II of that project, to bring another 181 apartments to the area near Bird and Douglas Road in Miami.

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Dear Miami Dade County and the Aviation Department: In 2007, Miami-Dade County via the Aviation Department executed a lease with AVE, LLC in hopes of revitalizing the stagnant Opa Locka Executive Airport. The lease was executed to allow for AVE to develop a 2.5 million square foot Mixed Use Aviation and Commerce Park. The laws changed with respect to financing the transaction via Dodd Frank. In 2013, the State of New York passed a ban of Private Transfer Fees (PTF). Below find an excerpt from the Real Estate Journal. Unlike traditional deed covenants, PTFs run with and burden the land without benefiting it. Although the fees may benefit a homeowners’ association, conservation land bank, non-profit organization, etc., they have been found to NOT be proportional or related to the purposes for which the fees were to be collected. Furthermore, PTFs are also used by builders and developers to provide themselves with an income stream long after a development is complete. The American Law Institute has described such PTFs as “unconscionable;” the U.S. Department of Housing and Urban Development has publicly opposed the use of PTFs, stating that “PTFs violate HUD’S regulations at 2 C.F.R. 203.41, (which includes LEASES) which prohibit ‘legal restrictions on conveyance,’ defined to include limits on the amount of sales proceeds retainable by the seller.” In addition, the Federal Housing Finance Agency, determining that “such covenants are adverse to the liquidity and stability of the finance market and to financial safety and soundness,” has issued a proposed rule, published at 76 F.R. 6702 (Feb. 8, 2011), that would restrict the regulated entities – the Federal National Mortgage Association (“Fannie Mae”), the Federal Home Loan Mortgage Corporation (“Freddie Mac”), and the Federal Home Loan Banks – from investing in most mortgages on properties encumbered by PTFs. A few years ago, Florida Statutes 689 banned Private Transfer Fees via sale or an assignment. The Dodd-Frank Wall Street Reform and Consumer Protection Act, Pub. L. 111-203 (July 10, 2010) (Dodd-Frank Act) granted rule-making authority under RESPA to the Consumer Financial Protection Bureau (CFPB) and, with respect to entities under its jurisdiction, generally granted authority to the CFPB to supervise for and enforce compliance with RESPA. Here is where Dodd Frank expands the CFR to include Commercial Permanent Financing from any FDIC Insured Institution. If one cannot finance, how can one expect to continue to develop and pay rent. It is commercially unreasonable and unsustainable. If the PTFs are not universally applied to all the tenants under Federal Guidelines, and they are ultimately unfair and defeat the purpose, then why have them at all? If we are to build facilities and jobs for the next generation, we need fair and responsible language to foster growth, investment and jobs. Regards, Ernie Cambó AVE, LLC





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Marine stadium’s fate must rest on a business plan, not faith Now that Miami commissioners have voted to borrow $45 million to restore M i a mi M a rine Stadium, where does faith in the stadium’s ability to fund its own future end and guaranteed cash start? Faith is in- Michael Lewis deed an asset, but money in the bank is golden. Assessing the fate of the decayed stadium on Virginia Key nearly seven years ago we wrote, “The one mantra to avoid is ‘Rebuild it and they will come.’ A great asset may never find a great use without solid plans.” So it was déjà vu in reverse when county Commissioner Xavier Suarez told the city commission Nov. 17, “Please, don’t worry about operations there. If you build it, they will come.” Mr. Suarez is certainly a man of faith. He could be right. Profitable stadium uses just might tumble out of the sky. But despite his admonition, we do worry. A solid game plan for that stadium is vital before, not after, the city issues $45 million in bonds that could leave taxpayers on the hook for $80 million or more, depending on how bonds are structured. That plan should start with the stadium’s purpose. If it’s to be just a landmark, the city will have to fund maintenance and operations. If it’s to host boat races as it once did, structural work will have to differ

from use for concerts or for meetings and conventions. Right now the city is open to anything, meaning no plan. Restoration costs will depend on chosen uses. Seven years ago the aim was $11 million. Now the city is putting in $45 million and the county $3 million but still no firm budget. A budget rests on the stadium’s purpose. Business plans also must look beyond purpose at who the users themselves will be. The most frequent use cited is boat races, but who would run them under what terms? Remember, although Hurricane Andrew finally closed the stadium in 1992, in the five years before that not one boat race was run there and the city had to spend millions of taxpayer funds to keep the site up. To hold races, promoters have to find them profitable, and they didn’t. What has changed to make them profitable now? The same concern applies to concerts and performances. There’s no shortage of venues here, all trying to book events profitably. When the marine stadium was last open the Arsht Center’s two buildings didn’t exist, the New World Center on Miami Beach didn’t exist, Marlins Park didn’t exist, the gambling venues with their performance halls didn’t exist, AmericanAirlines Arena didn’t exist, BB&T Center didn’t exist and a soccer stadium with performances wasn’t even dreamed of. We have a whole lot of glitz we never had. How will a stadium’s water view overcome all of that? One thing is certain: the city doesn’t have the expertise to battle with those venues. That’s a job for professionals, either an outside firm that would control

L etters What happened to racing at the Marine Stadium?

No mention of the return of boat racing, the main reason Miami Marine Stadium was built. Would love to see Commissioner Francis Suarez actually say that instead of weaving a new vision for it that includes an “open air chapel.” What? Also, there is no way improved marinas will help pay off that $45 million debt unless you build a mega marina and dry storage facility. I fear the stadium’s original use will be relegated to the dustbin of history. In short, keep any marina improvements out of the stadium’s racing basin. As for that Frankenstein monster known as a “flex park,” do the people a favor and trash the artificial turf and the boat show and make a real park with grass and trees. Move the boat show to the southwest corner of PortMiami and leave the Marine Stadium alone. Build an exhibition center there aimed at the marine industry with offices and a hotel on top of a ground floor dedicated to a boat display every day of the year. DC Copeland

Why does marina require so many acres on Key?

Why does the RFP for the Virginia Key Marina include 26 acres of bay bottom in the North Basin for a 300-slip marina that requires only one or two acres? They will charge our boats that wish to view the concerts and place a moor-

the city’s facility for its own profit or new city employees with proper experience. Marketing has also changed. The digital world requires new skills in everything from social media to ticketing. None of that will be free, either. Whatever paths the city takes, it must overcome a long pattern of letting valued facilities crumble when operating and maintenance funds run dry. If the stadium ran at a loss, who would pay how much to keep it from crumbling again? Remember, before the hurricane the city spent millions a year on upkeep there. Think of the Mildred and Claude Pepper Fountain in Bayfront Park, an expensive centerpiece that the city couldn’t afford to operate once it was built. Think of the historic Miami Circle, purchased for almost $27 million by the state but never funded to actually be seen. It’s now buried for protection. Think of the Olympia Theater at the Gusman, which the city for years tried to close because it couldn’t fund operating losses. It was finally handed to a foundation to control. Think of the old Orange Bowl, which was patched and patched because the city could never afford real restoration. Finally, the city just tore it down – and it was every bit as historic as the marine stadium. If there’s no guaranteed operating funding for the marine stadium and it can’t profit in a competitive environment, it could again be abandoned to decay, with taxpayers still on the hook for the restoration bonds. We go along with Mayor Tomás Regalado, who years ago recommended setting up a foundation to keep up the marine stadium as a city asset. A guaranteed

to the

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ing field in these 24 acres of what is now public waterway. I had asked the city manager this question a few months ago. His response was that the boats need this area to maneuver. There is no truth to this and it is not seen at any other marinas. It is an example of our employees working for the interests of the developers. This is only setting up a vast area for further development. Bob Deresz

We need transit additions to increase the ridership

revenue stream from the city could fuel the foundation along with outside sources. Again, however, that recommendation needs to become reality before, not after, taxpayers are on the hook to repay bonds. A marine stadium doesn’t have to turn a profit to merit restoration. But it does have to have a funding source in perpetuity or restoration will be wasted. Now, during a property tax boom, is probably the time to restore the stadium if it’s a top priority – and the mayor made it his top priority when he was first elected. In his last year in office he can keep that pledge. But rather than a “build it and they will come” faith, commissioners should heed long-time stadium restoration leader Don Worth, who told them “We need a business plan – it will not rent itself.” Nor, he might have added, will it market itself, operate itself, maintain itself or – perhaps – fund itself. The city needs to clarify its plans – in public. For example, the bonding resolution notes that a “welcome center” and a “museum complex” are to rise on the stadium site. Are those code names for year-around convention and events facilities with the stadium as a mere appurtenance, much as animal attractions at the city-owned Jungle Island became the backdrop for a banquet and meeting center? If so, that’s the financial key to the business plan that Mr. Worth calls for – as well as a major city commission debate topic in the open, not in code. We have faith in city hall, but taxpayers still deserve to see how that golden backup money will end up in the bank and not on their future tax bills.

E ditor

vehicles standing by to take commuters to their destinations. Better yet, have smaller buses that can take folks to their final destinations by commuters planning their rides ahead of time on their smart phones and having the transport buses ready take commuters to their destinations. You can eliminate cars on the road. Transit and the Turnpike need to partner to make driving and commuting smart and efficient and provide relief by reducing cars on the road and having the same goal and not competing for tolls. A bus system that only goes on the path needs to have feeder buses to take commuters to their final destinations. This is why motorists do not utilize public transit. We also need an RFP on private transit to offer competition in ridership opportunities for commuters or combine the private sector opportunities to make transit more efficient by partnering with Greyhound, Red Coach, etc. What we are doing presently is not working effectively as we want it to. We need to get serious with our traffic issues and come up with these types of solutions and bring private investment opportunities to augment our funding for transit. Diego Rivadeneira

In order to have ridership, public transit has to have a main core of service, which it does not have. Just to give you an example, the Florida Turnpike is a parking lot with motorists wanting to go north from Homestead. There is not one single bus carrying commuters northbound. That should tell you something – why not? Let us start by having a fleet of, say, 15 FIU’s expansion has the overwhelming buses along the Florida Turnpike and have support of Miami-Dade County voters, strategic stops every five miles to park 65% of whom voted yes in 2014 on a and ride facilities and have Uber and Lyft question about the Fair moving and FIU

expanding. Yes, The Fair has a contract. FIU has worked for six years with the county and the Fair to find a site that meets the Fair’s acreage and access requirements. The ideal site has been located in South Dade, and now the Fair refuses to move. How much longer should FIU wait? How much longer should we put off the building of a new engineering facility where jobs will be created, discoveries will be made and new companies will be started? The Fair, while valuable and important to our community, cannot and should not be equated with our public university. It is time for the Fair to move so FIU can expand. Alian Collazo FOUNDED JUNE 2, 1983 VOLUME XXXIV No. 27 ENTIRE CONTENTS © 2016

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Large murals central to new Edgewater project By John Charles Robbins

A Manhattan-born artist now living and working in Miami has been hired to create large colorful murals as a key to a rising mixed-use project in the heart of Edgewater. 2500 Biscayne Property LLC is constructing a new 19-story tower attached to a ground level retail building with historic status at 25002512 Biscayne Blvd., bordered by Northeast 26th and 25th streets. The project was approved in 2015 and steady construction has topped off the new building, which stands 218 feet, 2 inches tall. When the city’s Urban Development Review Board recommended approval in March 2015, one condition required the developer to return to the board for review and recommendation about the art wall for the north and south sides of the new podium, which is the 271-space parking garage. At its November meeting, the board recommended approval by the planning director of the artwork, with conditions. The project incorporates a historic retail building facing Biscayne Boulevard into the new residential tower. The site is home to the one-story retail building that was tied to a threestory residential building called Wolpert Apartments. They were built at different times in the 1920s. The retail building received historic designation while the apartment building did not, after an appeal process. The apartment building was demolished to make room for the new construction. The project is to have 166 residences, additional ground floor retail and the garage. Review board Chair Robert Behar’s company, Behar Font & Partners, is designing the project. He recused himself from the vote last year and didn’t attend last month’s meeting. Examples of the planned paintings were presented at the meeting by attorney Iris Escarra, who introduced the artist, Magnus Sodamin. The design has an art wall on the north and south, and a planned living green wall on the east elevation that faces Biscayne Boulevard. In a presentation to the board, the developer says Mr. Sodamin uses an expanded painting practice “that is at once hallucinatory and precise, employing a variety of techniques to blur the frontier between abstraction and landscape painting.” Mr. Sodamin told the board he uses many processes to create his art. He said he gets his inspiration from nature and fauna, and through his art he hopes to bring beauty into people’s lives. Mr. Sodamin said for the 2500 Biscayne project he will work on-site on the art walls, which will basically

be paint over stucco and would not be lighted. A board member asked about the long-term maintenance of the art wall: would it survive the elements for years? Mr. Sodamin said the artwork will be coated with a sealant to protect it from the elements. Ms. Escarra said the residential mixed-use project will be a rental, managed by one entity, and they expect to have a longevity plan for the art walls. Site plans show the relationship with planned landscaping around the project, and board member Gerald Marston asked about the trees required. Ms. Escarra said the developer must plant trees every 30 feet. There was some concern about the trees blocking views of the artwork. “I have a problem with the art,” A review board recommended that developers add a third mural to the project along Biscayne Boulevard. said acting board chairman Neil Hall, citing two reasons: the location of the trees and the lack of lights. CITY OF MIAMI, FLORIDA “I’d want it to be seen. It is an art NOTICE OF PUBLIC HEARING piece,” Mr. Hall said, suggesting the developer and artist reconsider lights ANY PERSON WHO RECEIVES COMPENSATION, REMUNERATION OR EXPENSES FOR for the art walls. Mr. Sodamin said he agreed on CONDUCTING LOBBYING ACTIVITIES IS REQUIRED TO REGISTER AS A LOBBYIST WITH lighting for the art, and said they THE CITY CLERK PRIOR TO ENGAGING IN LOBBYING ACTIVITIES BEFORE CITY STAFF, have been discussing that option. BOARDS AND COMMITTEES OR THE CITY COMMISSION. A COPY OF THE APPLICABLE Mr. Hall said he also had a problem ORDINANCE IS AVAILABLE IN THE OFFICE OF THE CITY CLERK (MIAMI CITY HALL), LOCATwith the proposed green wall on the ED AT 3500 PAN AMERICAN DRIVE, MIAMI, FLORIDA, 33133. Biscayne Boulevard side. “I would have loved art there,” AT THE SCHEDULED MEETING OF THE COMMISSION OF THE CITY OF MIAMI, FLORIDA, TO he said, suggesting the developer BE HELD ON DECEMBER 8, 2016, AT 9:00 A.M., IN ITS CHAMBERS AT CITY HALL, 3500 PAN consider replacing the green wall AMERICAN DRIVE, THE MIAMI CITY COMMISSION WILL CONSIDER THE FOLLOWING ITEM with an art wall. RELATED TO THE REGULAR AGENDA: Mr. Sodamin also agreed on this point. “I do think Biscayne needs A RESOLUTION OF THE MIAMI CITY COMMISSION, WITH ATTACHMENTS, ACCEPTING THE more of this,” he said. While the PLAT ENTITLED “MIAMI DOUGLAS STATION AMENDED”, A REPLAT IN THE CITY OF MIAMI, Wynwood Arts District is “overSUBJECT TO ALL OF THE CONDITIONS OF THE PLAT AND STREET COMMITTEE AND THE saturated,” the growing Edgewater PROVISIONS CONTAINED IN CITY CODE SECTION 55-8, AND ACCEPTING THE DEDICAneighborhood could use more color TIONS SHOWN ON SAID PLAT, LOCATED BETWEEN SW 37 AVENUE AND SW 38 AVENUE, and art to strengthen the look of the AND BETWEEN BIRD AVENUE AND PEACOCK AVENUE, AUTHORIZING AND DIRECTING area, he said. Mr. Marston said he was considerTHE CITY MANAGER AND CITY CLERK TO EXECUTE SAID PLAT; AND PROVIDING FOR THE ing making a motion to recommend RECORDATION OF SAID PLAT IN THE PUBLIC RECORDS OF MIAMI-DADE COUNTY, FLORapproval of the art walls, with a IDA. condition the developer consider an art treatment on the Biscayne side. Copies of the proposed Resolution are available for review at the Public Works Department, SurMs. Escarra said there would be a vey and Land Records Section of the Construction Division, located at 444 SW 2nd Avenue, 4th problem with that because the city’s Floor, during regular working hours. Phone 305-416-1232. Historic and Environmental Preservation Board required a covenant The Miami City Commission requests all interested parties be present or represented at the from the developer calling for the meeting and may be heard with respect to any proposition before the City Commission in which green wall on the east. the City Commission may take action. Should any person desire to appeal any decision of the City Mr. Marston recommended the Commission with respect to any matter to be considered at this meeting, that person shall ensure developer “try again” with the that a verbatim record of the proceedings is made including all testimony and evidence upon which historic board to allow an art wall any appeal may be based (F.S. 286.0105). instead of the plain green wall for Biscayne Boulevard. In accordance with the Americans with Disabilities Act of 1990, persons needing special accommoThe review board recommended approval of the art walls with condations to participate in this proceeding may contact the Office of the City Clerk at (305) 250-5361 ditions directing the developer to (Voice) no later than five (5) business days prior to the proceeding. TTY users may call via 711 try to add art on the east side, plant (Florida Relay Service) no later than five (5) business days prior to the proceeding. trees in a type and spacing to afford maximum visibility of the art, and consider adding up-lighting and down-turned lighting to the art walls for variety of visuals. Todd B. Hannon For this project, Mr. Marston City Clerk suggested the developer plant palms instead of shade trees if the city will # 25330 allow it.

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Health Update State testing process for Zika may take 15 rigorous steps By Camila Cepero

The Florida Department of Health’s process for identifying, testing, investigating and informing the public about cases of locally acquired Zika virus is extensive and in some cases may require up to 15 rigorous steps. This is the current process, but as the department learns more about the Zika virus, it may change and updates will be made available, the organization said. According to the Centers for Disease Control and Prevention (CDC), Zika can be transmitted through the bite of an infected mosquito, sexual contact, blood transfusion and from pregnant mothers to their baby. The first step of the process is to identify whether the virus has been transmitted. If the person is a pregnant woman, she may receive a free Zika assessment at Florida Department of Health in Miami-Dade County, the local branch of the statewide Florida Department of Health. “Zika testing is available for free in Miami-Dade County and statewide to pregnant women and anyone who meets CDC testing criteria at local county health departments or at their local health care provider,” said Florida Health Department spokeswoman Sarah Revell. “If a person is not pregnant and does not meet CDC testing criteria, he or she can inquire about a Zika test and its cost through their local health care provider or with a private lab,” Ms. Revell said. The Florida Department of Health in Miami-Dade County currently has a staff of 750,

Three Florida public health labs conduct tests for Zika virus. More than 10,500 people have been tested.

of whom 1% are physicians and 22% provide professional health care. “Florida has three public health labs that conduct Zika testing and we have contracted with a private lab as well,” Ms. Revell said. The department has tested more than 10,580 people through its public health labs, but numbers for the private lab are unavailable. After screening potentially infected people, if the physician determines the person meets criteria for Zika testing, the test is ordered and urine and blood samples are sent to a laboratory for testing and analysis The person is then reported by the health care provider to the county health department

as a person under investigation who might have Zika virus even though many people tested have negative test results. Afterward, the county health department contacts mosquito control within 24 hours of notification of a potential case to conduct a mosquito assessment and begin mosquito elimination around the person's residence. This strategy is proactive and occurs even before the delivery of any laboratory test results. Per the Florida Department of Agriculture and Consumer Services, mosquito control includes looking for standing water and mosquito breeding grounds, spraying within 150 yards of the person’s home and other areas of interest, and education and outreach to residents

in the area on drain and cover precautions. The laboratory that conducts the test shares the results with the medical provider who submitted the specimens for testing along with Department of Health. If there is a positive test result, Department of Health epidemiologists investigate to determine where exposure might have occurred. A person is confirmed as a case if circumstances meet the CDC definition, and the most likely mode of transmission is identified – travel-related, mosquito-borne, sexual or congenital. For confirmed and probable cases, the Department of Health contacts mosquito control to conduct a secondary assessment

and more aggressive mosquito elimination techniques. The department then adds the confirmed case to the daily Zika update which is distributed to media and partners. The investigation is continued to determine if and where active ongoing local transmission is occurring. If additional cases are found, a map is developed to identify the possible area of local transmission. Florida Gov. Rick Scott recently announced that the Florida Health Department has not detected any additional local transmissions of Zika in the north portion of Miami Beach, part of a previously active Zika zone, in more than 45 days, leading officials to lift the ban on that portion of the zone. The newly lifted area is about three miles, from 28th to 63rd streets. The remaining area of active Zika transmission in Miami-Dade includes south Miami Beach with about 1.5 square miles between Eighth and 28th streets and the Little River area with about one square mile. The last few steps in the Department of Health’s protocol involve disseminating the information to the public and announcing the area of local transmission. The Department of Health then continues to work with the Department of Agriculture and Consumer Services, local mosquito control districts and private providers to increase spraying and trapping activities in areas of local transmission in accordance with CDC guidelines until it can be determined that local transmission is no longer occurring.

Tourism industry remains strong as Zika zones contract By Camila Cepero

Miami’s $24 billion tourism industry has been kept on its toes for the latter part of the year as the mosquito-transmitted Zika virus has hurt business in some parts of the county while leaving others unscathed. Florida Gov. Rick Scott recently announced that the Florida Health Department has not detected any added local transmissions of Zika in the north portion of Miami Beach in more than 45 days, leading officials to lift the ban on that portion of the zone. The newly lifted area is about three miles, from 28th to 63rd streets. The remaining area of active Zika transmission in south Miami Beach is about 1.5 square miles between Eighth and 28th streets. The remaining area of active Zika transmission in Little River is about one square mile. Even though multiple Zika zones have been lifted since the first transmission, Zika remains at the forefront of many travelers’ minds, said Rolando Aedo, ‎executive vice president and chief marketing officer for the Greater Miami

Convention & Visitors Bureau. “It’s not to say Zika doesn’t continue to be concern,” Mr. Aedo said, but it’s become a part of life, “just like other mosquito-borne illnesses.” “The US is being affected by Zika like it’s been affected by other mosquitoborne illnesses,” he said. The local hotel industry has stayed afloat. Exactly like this time last year – before Zika madness hit the area with the first transmission in July – hotels are still preparing for their busiest time of the year. Hotel rates are expected to exceed last year’s early-December average room rate of $355.77, while occupancy levels remain high. “In our conversations with our hotels... we expect the same number of people, but there will be fewer travelers – we’re assuming – of the demographic at risk,” Mr. Aedo said. The disease, caused by a virus that is primarily spread to people through the bite of an infected mosquito, has been a major concern for pregnant women as it can cause serious birth defects in babies born to women who were infected with

Zika virus during pregnancy. As of last Wednesday, the Centers for Disease Control and Prevention (CDC) was still urging pregnant women to consider postponing travel to all parts of the county. Additionally, pregnant women as well as women who are planning to get pregnant in the near future and their male partners are urged not to travel to Zika active transmission areas, also called red zones, where local, state and CDC officials have determined that “the intensity of Zika virus transmission presents a significant risk to pregnant women.” The south Miami Beach and Little River areas fall into the red zone. As of the Florida Department of Health’s latest Zika update, published Monday, the total of Zika cases reported in Florida is 1,206. There have been 953 travel-related infections of Zika, 238 locally acquire infections of Zika and 170 pregnant women with lab evidence of Zika. While most of the county managed to power through Zika outbreaks, Wynwood struggled all summer after several Zika cases not related to travel were found in

the area between Northwest 20th and 36th streets, Miami Today reported last month. Wynwood Business Improvement District members complained that their neighborhood was unfairly targeted, as cases were found in many areas of Miami-Dade and Broward counties. During a travel warning imposed by the Florida Department of Health and the CDC, businesses lost money but not one closed permanently. That ban was lifted Sept. 19. According to the Greater Miami Convention & Visitors Bureau, Zika is not the sole factor affecting the tourism industry. “No one factor drives attention to Miami,” Mr. Aedo said. “There have been a lot of headwinds this past year – what happened in Brazil with the economy and the strength of the US dollar does make it a little bit more expensive for international visitors. We had Hurricane Matthew in October... Even the election had uncertainty around it.” Nonetheless, this week alone more than 60,000 people are expected to travel into the county as Art Basel kicks off in the Miami Beach Convention Center.





UM to train public health professionals in business skills

Photo by Marlene Quaroni

Roderick King, assistant dean of public health education, will play a key role in the new certificate program for public health professionals.

NOTICE OF PUBLIC HEARING The Miami City Commission will hold a Public Hearing on Thursday, December 8, 2016 at 9:00 A.M., to consider the award of a contract to the non-profit organization listed below through Anti-Poverty grant funds from the Mayor’s share of the City of Miami’s Anti-Poverty Initiative Program. Miami Music Project, Inc., uses music to empower children, develop community values, creativity, discipline, perseverance and self-esteem, all while improving school performance; and to consider the City Manager’s recommendations and finding that competitive negotiation methods are not practicable or advantageous regarding these issues: • Miami Music Project, Inc. – To continue music education programs. Inquiries regarding this notice may be addressed to Malissa Treviño, Project Manager for the Office of Community Investment, Office of the City Manager, at (305) 416-1005. This action is being considered pursuant to Section 18-85 (A) of the Code of the City of Miami, Florida as amended (the “Code”). The recommendations and findings to be considered in this matter are set forth in the proposed resolution and in Code Section 18-85 (A), which are deemed to be incorporated by reference herein and are available as with the regularly scheduled City Commission meeting of Thursday, December 8, 2016 at Miami City Hall, 3500 Pan American Drive, Miami, Florida. The Miami City Commission requests all interested parties be present or represented at the meeting and may be heard with respect to any proposition before the City Commission in which the City Commission may take action. Should any person desire to appeal any decision of the City Commission with respect to any matter to be considered at this meeting, that person shall ensure that a verbatim record of the proceedings is made including all testimony and evidence upon which any appeal may be based (F.S. 286.0105). In accordance with the Americans with Disabilities Act of 1990, persons needing special accommodations to participate in this proceeding may contact the Office of the City Clerk at (305) 250-5361 (Voice) no later than five (5) business days prior to the proceeding. TTY users may call via 711 (Florida Relay Service) no later than five (5) business days prior to the proceeding.

versally held concept of the “triple aim,” which focuses on patient experience, population health and cost-efficiency, he said. Through the center’s experts bureau, which includes faculty from the School of Business, authorities in health sector management and policy are available to speak and provide expertise to local, state and national legislative bodies, government agencies, the news media, trade associations, conference planners and other organizations. The center also hosts the school’s Business of Health Care impact conference, which draws more than 700 professionals from across industries each year. Looking ahead, Dr. Ullmann said plans are falling into place for the 2017 conference March 3. The impact of the 2016 US presidential election is a main topic, and what can be expected from President-elect Donald Trump. The future of Obamacare under a Trump presidency is bound to dominant the conference. Dr. Ullmann said the center has lined up several former US secretaries of health and human services to participate. A panel that will focus on the effects of the election on all aspects of health care will be manned by heads of the American Medical Association, American Hospital Association, American Health Insurance Plans, Health Care Financial Management Association, and the Medical Group Management Association. Another panel will deal with healthcare’s impact on business in general, offering insight from highlevel people at Bank of America Merrill Lynch, EY and The Carlyle Group. The 2017 conference will be hosted by University of Miami President Julio Frenk, MD, a health care policy expert. “The conference sells out every year,” said Dr. Ullmann. “It serves as a major networking opportunity for the health and business community affected by health care issues,” he said. President Frenk will speak at conference as well.


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by the School of Business, School of Medicine and the de Beaumont Foundation in collaboration with a national advisory committee of federal, state and local health officials as well as public health advocacy organizations. Practitioners in public health will pilot the courses in July 2017, and enrollment for the program will begin in October 2017. The public health physicianresearchers and principal investigators for the program are Dr. Ullmann, as well as Roderick King, assistant dean of public health education, and Alberto CabanMartinez, assistant professor of public health sciences and director of the musculoskeletal disorders and Occupational Health Lab at the School of Medicine. Dr. Ullmann said he believes the center’s work is balanced between the needs of patients and the health care industry. “We really are balanced… we do consultations trying to create better access and efficiency for the patients. We’re about ready to take on a large consultation project for a large organization, focusing on the patient experience. We also consult global health care companies, medical device companies, to provide insight on health care marketing , which in turn is associated with patient populations and access,” he said. This is consistent with the uni-

yp ul e ta Se s ss e io n ns E Av sp ai añ la bl ol e

public health workforce reported proficiency in budget skills. “Because of the dramatic transformations in our overall health system, and in public health agencies, the need for public health professionals to have strong business acumen has never been greater,” Dr. Ullmann said. The Building Expertise in Administration and Management (BEAM) Certificate Program for Public Health Professionals will require 20 contact hours, to be delivered through an interactive, asynchronous platform. The curriculum is to be developed over the next year


The Center for Health Sector Management and Policy at the University of Miami School of Business Administration has grown its faculty in the past year and continues to study issues relating to health care policy and patient safety. “We have expanded our faculty staff and the result has been directing research into a number new areas,” said Steven G. Ullmann, Ph.D., professor and Steven G. Ullmann center director. “We’ve done a lot of work on health care policies at the state and national level. We’re looking at issues associated with price transparency and the impact on healthcare facility decision-making associated with that,” he said. The center, established in 2010, serves as a resource to businesses and policy-making bodies, conducts and disseminates research, offers consulting to the health care and business community and trains and educates those in the health sector. The center became a department at the university in 2015, allowing the school to hire and integrate academic health care programs,

with research being the focus of the center. The center’s think tank has examined issues with Medicaid managed care, and aspects of patient safety looking into new technology in hospital bed systems and nurse call systems. Dr. Ullmann said the think tank is now examining health care processes to assure greater efficiency and greater quality and thereby lead to greater patient care. The center’s education and training programs include open enrollment and customized executive education programs targeting the health sector. Dr. Ullmann said the university is seeing growing interest in health care among graduate and undergraduate students. To meet that interest, the school plans to launch a new masters in health administration program beginning in the 2017-18 academic year, he said. In addition, the School of Business Administration is teaming up with the University’s Miller School of Medicine and the de Beaumont Foundation to establish a unique certificate program aimed at training public health professionals in business fundamentals and skills. An article in the “Journal of Public Health Management and Practice” showed that just under half the 10,246 members of the


By John Charles Robbins



1. No single treatment is appropriate for everyone, it should be customized to the patient 2. Individual or group counseling and other behavioral therapies are the most common treatments 3. Family therapy is generally advisable to restore healthy family dynamics and support for full recovery

Marino E. Carbonell Ed.D LMHC, CAP, FAPA, ICADC

Todd B. Hannon City Clerk

# 25336

7344 SW 48 Street, Suite 104 • Miami, FL 33155 305-447-2882


Dr. Marino E. Carbonell is a private practitioner, licensed and certified psychotherapist who has earned a reputation of excellence in his field with more than 24 years of experience as an addiction specialist. For more information about talk therapy, addiction & recovery, please visit





Baptist team standardizes practices across care network By Camila Cepero

Baptist Health South Florida has found a way to put medical evidence to work for its patients, creating a committee to oversee the standardization of medical practices across the clinical care network. Evidence-based clinical care is a systematic approach developed to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances. The model emphasizes the use of evidence derived from research and stresses that decisions and policies should be based on empirical support, not just the beliefs of practitioners or administrators. In Baptist’s case, the healthcare provider was interested in establishing practices that would be consistent across all Baptist facilities – eliminating all variations and ensuring that a patient would receive the same clinical approaches whether visiting West Kendall Baptist Hospital or Brickell Urgent Care or any other part of the system. “What we do is look at it with a laser focus on quality. Without the quality we won’t ever survive. We won’t be doing what we want to do,” said Jack

Ziffer, executive vice president and chief medical officer for Baptist Health South Florida. “At some point you have to figure out how these things roll out and what is important to do,” he said. “Ultimately, implementing and sustaining it is important and has been one of the challenges of several key institutions.” Baptist has modeled its evidence-based clinical care approach after two leaders in the field – Phoenix-based Banner Health and Utah-based Intermountain Healthcare. “They have been striving to do this since the mid-1980s... not just in one hospital but system-wide,” Dr. Ziffer said. “It has been profoundly important in them achieving very highquality patient care and patient satisfaction and substantially improve in removing unnecessary costs.” The entire evidence-based approach is overseen by the 40-member Evidence-Based Clinical Care Committee comprised of Baptist’s senior-most leadership, including administrators and executives. Committee members include Wayne Brackin, executive vice president and chief operating officer; Michael Zinner, founding CEO of the Miami Cancer

Photo by Marlene Quaroni

Dr. Jack Ziffer, right, talks with Dr. Louis Gidel at Tuesday’s meeting.

Institute; Sergio GonzalezArias, medical director of the Neuroscience Center and chief of the Neuroscience Department and Neurosurgery subsection; and John Uribe, orthopedic surgeon at the Miami Orthopedics & Sports Medicine Institute. “All of this is for performance improvement – to perform at the top of our game medically,” Dr. Ziffer said. Ultimately, half the committee members are physicians and the other half administrators,

CITY OF MIAMI, FLORIDA NOTICE OF PUBLIC HEARING The Miami City Commission will hold a Public Hearing on Thursday, December 8, 2016 at 9:00 A.M., to consider the award of a contract to the non-profit organization listed below through Anti-Poverty grant funds from the Mayor’s share of the City of Miami’s Anti-Poverty Initiative Program. Common Threads, Inc. is a non-profit organization that provides families with nutrition and cooking education programs; and to consider the City Manager’s recommendations and finding that competitive negotiation methods are not practicable or advantageous regarding these issues: • Common Threads, Inc. – will partner with Lotus House and two local elementary schools to implement 13 sessions of cooking and nutrition education programs. Inquiries regarding this notice may be addressed to Malissa Treviño, Project Manager for the Office of Community Investment, Office of the City Manager, at (305) 416-1005. This action is being considered pursuant to Section 18-85 (A) of the Code of the City of Miami, Florida as amended (the “Code”). The recommendations and findings to be considered in this matter are set forth in the proposed resolution and in Code Section 18-85 (A), which are deemed to be incorporated by reference herein and are available as with the regularly scheduled City Commission meeting of Thursday, December 8, 2016 at Miami City Hall, 3500 Pan American Drive, Miami, Florida. The Miami City Commission requests all interested parties be present or represented at the meeting and may be heard with respect to any proposition before the City Commission in which the City Commission may take action. Should any person desire to appeal any decision of the City Commission with respect to any matter to be considered at this meeting, that person shall ensure that a verbatim record of the proceedings is made including all testimony and evidence upon which any appeal may be based (F.S. 286.0105). In accordance with the Americans with Disabilities Act of 1990, persons needing special accommodations to participate in this proceeding may contact the Office of the City Clerk at (305) 250-5361 (Voice) no later than five (5) business days prior to the proceeding. TTY users may call via 711 (Florida Relay Service) no later than five (5) business days prior to the proceeding.

Todd B. Hannon City Clerk

# 25331

he said. “It is the body that defines the standards. We meet between every two weeks and once a month, depending on the rate that the information is coming to us.” An article partly titled “Health Care Mythbusters” released by the Scientific American magazine challenges the belief that the vast majority of what physicians do is backed by solid science. “But we must question them because these beliefs are based more on faith than on facts... Only a fraction of what physicians do is based on solid evidence from Grade-A randomized, controlled trials; the rest is based instead on weak or no evidence and on subjective judgment,” the article stated. “When scientific consensus exists on which clinical practices work effectively, physicians only sporadically follow that evidence correctly.” Dr. Ziffer believes that to be true. “What we think is well known really isn’t,” he said. “We can’t rely on physicians to know what the evidence is. There is so much information from so many places.” Both the physician and administrative leaders of the Miami Cardiac and Vascular Institute are on the committee and were tasked with identifying the available evidence about certain diseases. “Then, they bring it to the committee and say ‘We want to have a standard of care consistent for the treatment of patients for heart failure,’” Dr. Ziffer said. “We need to look at what variations are in our system for heart failure. With that, we defined what standard of care should be provided and the resources to potentially avoid readmissions.” “It’s not just saying ‘Our standard is patients shouldn’t be readmitted.’ That’s just a statement. It’s surveying our entire system and [identifying] what problems we’re facing in heart failure treatment.” The process from an idea for an improvement to a systematic system-wide standard of care is rigorous. First, the committee vets the proposed standard of care. Af-

terwards, it’s sent to the medical education collaborative for comment. It’s then returned to the committee, which makes any necessary tweaks. It’s then passed over to the system’s quality and safety committee, which – hopefully – voices its support. Finally, it lands in the hands of the Board of Trustees, which endorses the final approach. The first standard of care “played out” about two weeks ago, Dr. Ziffer said. It’s the “crises standard of care” and details how Baptist hospitals system-wide are to respond in times of crisis, whether it be a strong hurricane – like 1992’s Hurricane Andrew – or a “medical catastrophe” – such as the 2009 H1N1 influenza virus pandemic. “We would potentially face a tremendous overloading of units,” Dr. Ziffer said. “We need to be able to get more ventilators and more space to support critically incubated patients, so now we have processes in what our standards are in a crisis... but we had a huge head start on existing standards that just needed some revision and systemization.” A more specific example of the emerging standards of care is the operating room tray during hip replacement surgeries, he said. There was a tremendous variation of tray setups among surgeons, but one of the key pieces for a good outcome was ensuring that the appropriate tools were on every tray. Thus, the healthcare group standardized the hip replacement surgeons’ tray. However, the healthcare group is careful to not eliminate leeway for physicians and nurses to customize care for specific patients. “Evidence is developed on broad-based patient trials,” Dr. Ziffer said. “There’s evidence that kids with earaches may not need antibiotics... but that data is for a population of patients and there may not be data on specific patients. So what the physician needs to do is... ask themselves, not necessarily what the evidence is, but always as ‘Is my patient fitting that body of evidence?’ A doctor could say ‘This kid deserves antibiotics.’” The expectation is that the general standard of care is adhered to 75%-80% of the time. The group is rolling out a single enterprise-wide electronic server to hold all patient medical records that will give healthcare providers a predominant single source of patient data. Currently, the EvidenceBased Clinical Care Committee is working on developing systematic standards of care for heart failure and chest pain; sepsis, a potentially lifethreatening complication of an infection; breast surgery, and back and spine surgery. “Evidence-based clinical care is something that’s profoundly important for medicine,” Dr. Ziffer said. “It’s great and everyone has become enthusiastic about it.”

Miami Today: Week of Thursday, December 1, 2016  

Special section on Health Update. Just a preview of some of our top stories this week. Includes editorial page. To subscribe, visit www.miam...