WEEK OF THURSDAY, JANUARY 12, 2017
A Singular Voice in an Evolving City
New Miami Cancer Institute breaking new ground, pg. 11 CONDO FRAUD ALLIANCE: Four municipal police departments have told Miami-Dade County Police that they want to join in a condominium association fraud network to eliminate and prevent condo association fraud. Those departments are from Miami Beach, Surfside, North Miami Beach and Aventura. County Commissioner Bruno Barreiro broached the concept of a condo fraud network last June. The aims include enhancing condominium law via state or county statute and creating an ordinance to empower county police to get records from condo associations and authorize fines on property managers or management companies if they won’t cooperate. Mayor Carlos Gimenez told commissioners the concept was to be placed on the commission agenda for action.
Medical job market bright with opportunities, pg. 14
By Catherine Lackner
UM SEARCH TO BEGIN: University of Miami President Julio Frenk says he will work closely with the university’s board of trustees and the faculty senate as he appoints a search committee to replace the university’s top academic officer, Provost Tom LeBlanc, who last week was named the next president of the George Washington University in Washington, DC. Dr. LeBlanc had been provost since 2005, overseeing the university’s 11 schools and colleges, research administration and funding, academic and student affairs, admissions and expenditures. He starts his new post Aug. 1. WHAT GOES UP: The City of Miami has chosen Maverick United Elevator LLC for elevator maintenance. Commissioners accepted the company’s bid to provide elevator maintenance on an as-needed basis for three years, with the option to renew for one additional three-year period, allocating funds from various departments. The estimated annual amount is $79,500. A background memo says various departments need elevator maintenance services. The city received five bids and the Procurement Department recommended awarding the contract to Maverick, which was deemed the lowest responsive and responsible bidder. NEW PLAT FOR MIXED PROJECT: Miami city commissioners have approved a final plat of Miami Douglas Station Amended from MCREF Bird Road Development LLC and MCREF Bird Road Development Phase II LLC, executed by Jeff Meran. On Jan. 28, 2016, the city commission approved closing and vacating part of Southwest 37th Court between Bird and Peacock avenues within the plat. The intent was to close the right of way of Southwest 37th Court that is within the plat and create three tracts of land for residential development. The platted area is 3.256 acres. The Plat and Street Committee determined its conformance to the subdivision regulations and Miami 21 zoning rules. Mill Creek Residential is building apartment buildings at the site.
Photo by Cristina Sullivan
Developing multi-family, mixed-use real estate projects The profile is on Page 4
Don’t seek marinas operators, board advises city By John Charles Robbins
Study never asked city marinas chief, pg. 17 contentious meetings and ended with city
On a split vote, the Virginia Key Advisory Board recommended that Miami not request new proposals to improve and manage marinas on the barrier island, affording the board more time for review. City officials say not requesting proposals now could delay the process a year or more. The city owns the land and any new lease of the marinas to a private operator would require city voter approval. City staff says if proposals aren’t requested by Jan. 20, the opportunity to get the marinas lease on the November ballot will likely be lost. The process was set up for a city commission vote today (1/12). The advisory board had deferred the marinas issue twice before meeting again Jan. 4. In the 7-3 vote, Steve Kneapler, Lynn B. Lewis and Esther Alonso Luft opposed another deferral. Spencer Crowley III was absent. When city commissioners act today they will have an advisory board resolution that says in part: “The Board recommends that the Miami City Commission reject the issuance of the Virginia Key Marina RFP as drafted in its current form … The Board further declares its
intent to develop a holistic view and concept, consistent with the 2010 Virginia Key Master Plan as adopted by the Board, for the Miami Marine Stadium Basin within 60 to 90 days...” Board Chairman Greg Bush told Miami Today he’s trying to schedule a sunshine meeting to look broadly at the entire basin area. The marinas are adjacent to idled Marine Stadium, targeted to be restored, and a so-called flex park. Several members said they felt rushed and such an important, long-term decision shouldn’t be hurried. Some said many unanswered questions hover over the latest request for proposals and they ought to take the time to “do it right.” Members expressed concern about the marinas’ potential ecological impact, the likelihood of dredging, the scope of new commercial uses, the size of new boat slips and more. Preservationists and others have for years warned about overdevelopment of Virginia Key. The last attempt to secure a new private operator for both the Rickenbacker Marina and Marine Stadium Marina resulted in long,
Highways litter-filled, state hears
commissioners rejecting all bids and directing staff to start over. That’s what the Department of Real Estate and Asset Management did, preparing a more restrictive request for proposals that doesn’t include marina expansion nor wet slips in the historic larger basin fronting the stadium. City officials argue the existing marinas are out of date, with decades-old infrastructure in poor condition. An introduction to the latest proposals draft reads, “The goal of this RFP is to create a vibrant recreational marina and restaurant destination with an ancillary ship’s store facility for city residents and tourists alike.” Board member Blanca Mesa said, “If we’re not ready to endorse the RFP let’s not – I’m not ready.” Board member Robert Vernon said more time is needed to get everyone on the same page. “I don’t believe we’re even close,” he said. City real estate and asset Director Daniel Rotenberg, a non-voting board member, defended the latest draft: “This is a limited scope RFP … this is not going to be a megayacht marina.”
The rights-of-way alongside major highways are in urgent need of attention, said members of the Miami-Dade’s Metropolitan Planning Organization (MPO). “I need help in keeping the Golden Glades area clean,” Jean Monestime, county commissioner and MPO chair, told Harold A. Desdunes, director of transportation development for the Florida Department of Transportation. “My office has constantly been on phone with the department,” Mr. Monestime said during a December meeting of the MPO’s governing board. “Last month, they probably spent 48 hours on the phone to get some of these rightsof-way clean, because there were going to be some special visitors to District 2. We don’t have to have that in order to get the area clean. “Your contractors have done a wonderful job. But for the last year, honestly – I know it’s been raining a lot – a better job can be done,” Mr. Monestime said. “This is a high-traffic area, and an access point to Miami-Dade County for people who are traveling. We need to do a better job there; your office needs to help us out.” Mr. Desdunes asked for a list of trouble spots and promised to investigate. “The entire Golden Glades area has been a dismal situation,” Mr. Monestime said. If a contractor is not doing its job, the state transportation department should terminate the agreement, he said. Perhaps the portion of the transportation department’s budget that is allocated to maintenance should be scrutinized, said Dennis Moss, who is a county commissioner, MPO member and chair of its Transit Solutions Committee. “We need to talk with FDOT, because we may need to go to our state legislators and say to them that we need to have a higher level of maintenance in our community,” he said. “Again, if we want to be a world-class city – and that’s what we’re embarking on here in MiamiDade County – our front yard’s got to look good. We can build other stuff, but we’ve got to take care of the stuff we have.”
AIRPORT IN TALKS WITH SEAPORT TO LAND TRADE ZONE ...
RESTAURANT RIVERWALK MEANDERING BACK ON TRACK ...
AFFORDABLE-HOUSING PLAN COULD DOUBLE DENSITIES ...
CANADIANS PLAN EDGEWATER LIFESTYLE HOTEL BRAND ...
VIEWPOINT: NARROWING BOULEVARD HELL OF AN IDEA ...
CITY MAY WARN RESIDENTS OF PARKING CHARGE PLANS ...
COUNTY RESUMES QUEST FOR AIRPORT HOTEL OPERATOR ...
SCHOLARSHIP WINNERS MIGHT HAVE TO TUTOR OTHERS ...
The Insider PARK IMPROVEMENTS: The Miami-Dade Economic Prosperity Committee gave initial approval to legislation that removes “Gloria Floyd-Pineshore Pineland Preserve” from the Building Better Communities General Obligation Bond program and adds “Improvements to county-owned parks in District 8.” The legislation, sponsored by Daniella Levine Cava, if approved by the full commission, will transfer the original $250,000 allocated to the preserve to the many other county parks in the district in need of renovation and upgrades. The Gloria Floyd project is an environmentally sensitive and healthy pineland preserve D. Levine Cava where construction would harm the pineland ecology. The commission must delete the project, and declare the funds surplus to create a new bond project for the existing county-owned parks in District 8. NEW PARKINSON’S CEO: The Parkinson’s Foundation, created in August by the merger of the Miami-based National Parkinson Foundation and the New York-based Parkinson’s Disease Foundation, this week announced the selection of a new CEO, John L. Lehr. In an earlier role as CEO of Food Allergy Research & Education, he merged two legacy organizations into one national organization. He most recently was president of Orr Associates, a consulting firm focused on nonprofits with offices in Washington, DC, and New York. JOIN THE TRANSFORMATION: The public can John L. Lehr comment on design proposals by James Corner Field Operations for Brickell Backyard Phase 1 at a 6-8 p.m. meeting Jan. 19 at 45 SW 13th St., in the Southside Elementary School Auditorium. Registration is at 5:30 p.m. The meeting – held in partnership with Friends of the Underline, Miami-Dade Transportation and Public Works and Parks, Recreation and Open Spaces – will highlight the stretch from the Miami River to Southwest 13th Street of the proposed 10-mile greenway with urban biking, pedestrian trails and park amenities beneath Metrorail. To sign up, http://bit.ly/2hkK4Kb UTILITY EASEMENT IN BRICKELL: Miami commissioners have accepted a grant of public access and utility easement from Tigervest N.V. and Pacific National Bank (“grantors”), for non-exclusive public access and utility services through the grantors’ property located between Brickell Avenue and South Miami Avenue, and from Southeast 13th to 14th streets. The plat of Center Brickell Subdivision includes the closure of the alley between Brickell and South Miami avenues from Southeast 13th to Southeast 14th streets. A condition of the alley closure, by the city’s Plat and Street Committee, is the granting of an access and utility easement to the city on the footprint of the former alley, with any development of the plat coordinated to avoid creating a “dead end” access. NURTURING TOWN SQUARE: The Town Square Neighborhood Development Corporation – a nonprofit created to foster development of Miami’s Town Square neighborhood in downtown Miami near the Arsht Center as its core – announced election of executive officers: Armando Codina, founding chair; Manny Diaz, chair; and Jessica Goldman, vice chair. The organiManny Diaz zation also elected new directors Armando Codina Cesar L. Alvarez and Richard L. Kohan. “Heading into the new year, [the development corporation] is looking forward to the design selection for the I-395 signature bridge project and other enhancements to the area,” Mr. Diaz said in a written release. “Working together as an expanded board will allow us to implement our shared goals for the community as we continue to drive exciting changes in this thriving urban core.” TOURIST DEVELOPMENT GRANTS: Miami-Dade County’s Economic Prosperity Committee unanimously gave initial approval to funding 30 grants totaling $308,325 from the fiscal 2016-2017 Tourist Development Council Grant program – first quarter for tourist-oriented and community events. Funding for the grants comes from the 2% tourist development room tax revenue and the 2% hotel/motel food and beverage surtax revenues. Additionally, the Greater Miami Convention & Visitors Bureau provides $25,000 to the Tourist Development Council in accordance with a multi-year agreement. A remaining balance of $50,097 from fiscal 2015-2016 in unspent grant funds was carried over and is being appropriated as part of this year’s program. For 2016-2017, $1.2 million has been allocated for the grants. SMALL BUSINESS GRANTS: Small business owners in Commissioner Sally Heyman’s District 4 can apply for the annual Mom and Pop Small Business Grant Program. Applicants may be eligible to receive up to $5,000 for buying equipment, supplies, inventory, commercial liability insurance, security systems, advertising and marketing and making minor renovations. Applications will be accepted Feb. 6-24 by noon. Applicant businesses must have existed two years, employ no more than seven, not be in default or non-compliance with any county loan or grant program, not be affiliated with a national chain and not own Sally Heyman more than two businesses. Applications can be mailed or delivered to Commissioner Sally A. Heyman, District 4 Office, 1100 NE 163rd St, #303, North Miami Beach 33162. Details: (305) 787-5999. Applications are available at www.miamidade.gov/district04. MOM & POP GRANTS: Small business owners in Commissioner Jose “Pepe” Diaz’s District 12 can apply for up to $2,500 from the Mom and Pop Small Business Grant program. To be eligible, businesses can have no more than 10 employees, must be at least one year old, can’t be part of a national chain and must be in District 12. Prior recipients may apply as long as they have not received funding for the prior two years. Applications are available through Jan. 18 at www.miamidade.gov/district12 or at Mr. Diaz’s district office at 8345 NW 12th St. Completed applications will be accepted by 4 p.m. Jan. 19-26 at the district office. Applicants must attend a workshop explaining requirements and how to complete the application at 6:30 p.m. Jan. 18 at the Firefighters Memorial Building, 8000 NW 21st St.
WEEK OF THURSDAY, JANUARY 12, 2017
Coral Gables aboard for land swap with Codina for new safety building By Catherine Lackner
The Coral Gables commission has approved, at least in concept, a land swap between the city and Codina Partners LLC that will allow an expansion of the new public safety building set to rise on Salzedo Street betweenAlcazar and Minorca avenues. In June 2015, the commission agreed with city staff that the present police, fire and emergency services building at 2801 Salzedo St. is obsolete and would be too expensive to renovate. It was decided that the building should be demolished and a new site found for a more modern facility. City parking lot No. 6, an Lshaped parcel with 104 parking spaces and a vacant lot adjoining it, was chosen as the site. Coral Gables approached Codina Partners with the goal of acquiring the lot but said the project would go forward with or without the additional land. Codina Partners responded that it had made a commitment to a developer the land for an investor, but it would be open to discussions. “This process has been deliberative and detailed,” City Manager Cathy Swanson-Rivenbark told the commission Tuesday. “This will allow us to build a better – not just
‘This will allow us to beuild a bettter – not just bigger – public safety building that will give us an improved response time.’ Cathy Swanson-Rivenbark bigger – public safety building that will give us an improved response time” to the North Ponce area and Little Gables, should it be annexed to Coral Gables. The North Ponce corridor is experiencing an uptick in development, she added. The city would exchange 63,000 square feet of land beneath the current public safety headquarters for Codina Partners’ 35,000-squarefoot parcel. “This will allow us to
square off the lot and add additional parking,” Ms. Swanson-Rivenbark said. “We can’t strip parking away from that neighborhood.” It would also allow for about 16,000 square feet of office and retail space to be added. Details of the swap are still being worked out and must be approved – in the form of an ordinance – by a four-fifths vote of the commission. The value per square foot of the parcels is equal, at $185, said Leonard Roberts, city assistant director of economic development. The swap would offer many benefits to the city, and would allow the prominent local developer to fulfill its commitment to the investor, he said. As part of the deal, Codina Partners has asked for a transfer of development rights and $2 million in impact fee credits, Mr. Roberts added. The new public safety building is expected to cost about $37 million to construct, he said, which will be funded partially in cash, with the balance coming from bond sales. Part of the cash would come from a slight citywide parking fee increase, which would not kick in until the ongoing Miracle Mile and Giralda Avenue streetscape project is done.
Airport in talks with seaport to land foreign trade zone cargo magnet site By Camila Cepero
Miami-Dade’s Aviation Department continues its work to set up a foreign trade zone magnet site on Miami International Airport property. Officials have said that the zone will attract new business opportunities and better utilize vacant cargo and non-terminal areas. Emilio González, Miami-Dade Aviation Department director and CEO, first told Miami Today of the plan in April 2016. Currently, the airport is still in talks with PortMiami, the grantee of the foreign trade zone (FTZ), and the federal application has moved forward. The new magnet site, within the airport property, will allow manufacturers to lease available airport property and have their tariffs deferred, reduced or eliminated. On Nov. 1, the Miami-Dade County Commission approved an application to the US Department of Commerce that would designate the airport as an FTZ magnet site. The application was then submitted to the US Department of Commerce’s Foreign Trade Zone Board in Washington, DC, where it is currently under review. Once a decision has been made about the airport’s application, the Foreign Trade Zone Board will notify PortMiami, the grantee of the FTZ. The airport FTZ has the potential to generate $7.7 million a year in lease revenue and create an estimated 1,500 jobs at the airport. Foreign trade zones lure businesses because the sites allow goods to be unloaded, manufactured, reassembled, tested, sampled, processed, repacked and re-exported
‘Our profit would come from leasing out the airport space.’ Emilio González
without intervention by US Customs authorities. Foreign trade zone users pay no duties on re-exports and customs duties and federal excise taxes are deferred on imports. And duties are eliminated on waste, scrap and rejected or defective parts. By reducing costs, businesses can become more globally competitive. “Our profit would come from leasing out the airport space,” Mr. González previously told Miami Today. Today the airport has 424,046 square feet available for lease – 248,223 square feet of warehousing and 175,823 of offices. Aside from the Commerce Department, foreign trade zones are also approved in part by US Customs and Border Protection, because the areas are in or near ports of entry. Officially, the Foreign Trade Zone Board grants authority for establishing the foreign trade zones under the Foreign Trade Zones Act of 1934. About 250 general-purpose zones and over 500 subzones are approved in all 50 states and Puerto Rico, according to the Foreign Trade Zones Board.
Potential site users in the airport’s FTZ include auto parts, electronics, textiles, footwear, perishables, metals, minerals, pharmaceuticals, avionics and machinery equipment companies.
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WEEK OF THURSDAY, JANUARY 12, 2017
Miami affordable-housing plan could double some densities By John Charles Robbins
In the past three years City of Miami officials have taken several steps to help encourage construction of affordable housing. In an area where the market rate for rentals seems out of reach for many, city officials have over time approved a series of incentives to get more affordable housing built. The latest proposal, authored by city staff, could double allowed density of residential projects under certain conditions, and focuses on where there is the greatest need: workforce housing and extremely low-income housing. The proposal is due for a first reading by the city commission today (1/12). The applicant is listed as City Manager Daniel J. Alfonso. The legislation would update the Miami Comprehensive Neighborhood Plan to reflect changes in local conditions regarding housing affordability, including new goals, objectives and policies. This update would support land development regulations that allow for a density increase for projects that provide a specific mix of housing that is entirely affordable to individuals and families that meet the established criteria for workforce, affordable and extremely low-income housing. The cityâ€™s Planning and Zoning Department recommends approval. The Planning, Zoning and Appeals Board voted unanimously Dec. 7 to recommend the commission approve the changes. The legislation notes that the city commission adopted the Miami Comprehensive Neighborhood Plan in 1989. Itâ€™s a policy document to guide development; evaluate how the city will meet the needs of residents, visitors and development; and provide a master plan
In the Brickell area, Brickell View Tower was the first project to unite market rate and affordable housing.
that the city considers when making development decisions. State law dictates that the plan should be regularly updated to reflect changes in local conditions. Affordable housing is a significant issue affecting the residents of the city, it says. Attached to the legislation is a study by the New York University Furman Center that says that the City of Miami is the least affordable to the median renter of 11 metropolitan areas studied. Embracing the tenets of New Urbanism and Smart Growth, the city has established residential density increase overlays in the urban core where mixed-use development is encouraged and transit exists, it says. The city is among one of the 100 Resilient Cities, a Rockefeller Foundation program dedicated to helping cities become more resilient to the centuryâ€™s physical, social and economic challenges. Equitable distribution of decent, affordable housing has been recognized as a fundamental element of
Book says Beach funds should fight downtown homelessness By Catherine Lackner
When Ron Book, chair of Miami-Dade Countyâ€™s Homeless Trust, spoke to about 50 members of the Downtown Neighbors Alliance last week, the message was simple: more money is needed to address homelessness downtown. And, he said, it should come from three cities on the other side of Biscayne Bay. The neighbors are concerned, said Brian Andrews, who moderated the event, because it has been said that 43% of the countyâ€™s homeless are downtown, â€œand they are untethered, mentally ill folks who donâ€™t want help,â€? he said. â€œThe shelter-resistant chronic population is harder to place,â€? Mr. Book conceded. The trust has placed emphasis on downtown, he said, though only 27% of food and beverage tax proceeds that support it are generated there. â€œWe have done this to the detriment of other parts of the county. But if we donâ€™t get more revenues, your numbers are going to go up,â€? he told the group. Part of the problem, he said, is that Miami Beach, Surfside and Bal Harbour were able to opt out
of paying what other cities pay when the enabling legislation was written. â€œWe had to get it done,â€? he explained. He urged association members to contact their elected officials and to tell management of restaurants they frequent in Miami Beach that establishments in the city should pay their fair share. â€œTell them how important it is.â€? In Miami Beach, change may be in the wind, he said. â€œTheir [homeless] numbers are going north, and the problem is not going to get better. Theyâ€™re not going to get any more resources until we get help.â€? If Miami Beach agrees to pay part of its food and beverage taxes for the homeless trust, â€œSurfside and Bal Harbour are prepared to follow quickly,â€? Mr. Book said. â€œPoliticians let Miami Beach off the hook,â€? said Miami Mayor TomĂĄs Regalado, who attended the discussion, as did Miami Commissioner Francis Suarez and representatives of Miami Commissioner Ken Russell. But the mayor said that the trustâ€™s focus on downtown is appropriate. â€œWe have more homeless people downtown,â€? Mr. Regalado said. â€œWe need more resources.â€?
a â€œResilient City,â€? modeled by the resiliency strategy of Oakland, CA. The legislation mentions a significant change anticipated in the cityâ€™s housing market this year. It says 47% of the Miami Metropolitan Area subsidized housing stock is due to expire by 2017, displacing low-income tenants who are rent-burdened. Another cited report says that mixed-income developments offer an opportunity for people with low incomes to access low-poverty neighborhoods and better performing schools. The city aims to encourage affordable housing in appropriate locations, the legislation says. One new goal to add to the comprehensive neighborhood plan is this: â€œIncentivize sustainable, affordable housing solutions while continually improving the quality of life for all who live in Miami.â€? New objectives listed under this goal include: reserve 5% of the new housing stock to be built over the next five years for mixed-income developments; reserve 40% of the
housing stock built under affordable and attainable mixed-income programs over the next five years for housing low-income elderly households; and reserve 40% for workforce housing. Proposed policy language reads in part, â€œDevelopers building residential projects that are built for extremely low income housing and workforce housing â€Ś are encouraged to build additional units per acre to increase the amount of sustainable housing solutions available for households that are cost-burdened relative to housing expenses.â€? Examples of proposed density bonuses include: n Areas designated as Low Density Multifamily Residential currently allow residential structures to a maximum density of 36 dwelling units per acre. Suggested as an amendment it would read â€œand may allow residential structures to a maximum density of 72 dwelling units per acre if the residential structure is entirely comprised of Workforce, Affordable, and
Extremely Low Income housing units â€Śâ€? nAreas designated as Medium Density Multifamily Residential allow residential structures to a maximum density of 65 dwelling units per acre. The proposal says, â€œand may allow residential structures to a maximum density of 130 dwelling units per acre if the residential structure is entirely comprised of Workforce, Affordable, and Extremely Low Income housing units â€Śâ€? nAreas designated as High Density Multifamily Residential allow residential structures to a maximum density of 150 dwellings per acre. The proposal may allow up to 300 dwellings per acre if the residential structure is entirely comprised of workforce, affordable and extremely low income housing units. The legislation also lists the Central Business District, where residential facilities (except for rescue missions) alone or in combination with other uses are allowable to a maximum density of 1,000 dwelling units per acre. The proposal adds the wording: â€œand may allow residential facilities to a maximum density of 2,000 dwelling units per acre if the residential structure is entirely comprised of Workforce, Affordable, and Extremely Low Income housing units â€Śâ€? These would all be subject to the provisions of the applicable land development regulations and the maintenance of required levels of service for facilities and services included in the cityâ€™s concurrency management requirements. Policies that encourage workforce housing strive to provide affordable homes for middle-income service workers â€“ such as police officers, firefighters, teachers and nurses â€“ near their jobs.
Public Notice NOTICE IS GIVEN that meetings will be held before the following Committees on the dates stipulated below in the Commission Chambers, located on the Second Floor, of the Stephen P. Clark Center, 111 NW First Street, Miami, Florida, wherein, among other matters to be considered, a public hearing will be held relating to the following proposed ordinances/resolutions: Transit & Mobility Services (TMSC) Committee. Meeting â€“ Thursday, January 19, 2017, at 12:00 PM t 3FTPMVUJPOBQQSPWJOHUFSNTBOEmMFUISFF(SBOU"QQMJDBUJPOTXJUIUIF6OJUFE4UBUFT%FQBSUNFOUPG5SBOTQPSUBUJPO 'FEFSBM5SBOTJU"ENJOJTUSBUJPOGPSVQUP PG'JTDBM:FBS4FDUJPO6SCBOJ[FE"SFB'PSNVMB 4FDUJPO4UBUFPG(PPE3FQBJS'PSNVMBBOE4FDUJPO#VTBOE#VT'BDJMJUJFT'PSNVMB1SPHSBN'VOEJOHBOE BVUIPSJ[JOHSFDFJQUBOEFYQFOEJUVSFPGGVOETQVSTVBOUUPTVDIBQQMJDBUJPOTBOEBHSFFNFOUTBOEPGBOZBEEJUJPOBM GVOETBTTQFDJmFEJOUIFBHSFFNFOUTTIPVMETVDIGVOETCFDPNFBWBJMBCMF t 0SEJOBODFSFMBUJOHUP3PBE*NQBDU'FFTSFRVJSJOHUIBU#JDZDMF1BUIT #JDZDMF-BOFTBOE(SFFOXBZTBSFFMJHJCMFGPS DPOTJEFSBUJPOBTPGGTJUFSPBEXBZJNQSPWFNFOUDPOUSJCVUJPOTJOMJFVPGGFFBNFOEJOH4FDUJPO&PGUIF$PEF Economic Prosperity (EPC) Committee. Meeting â€“ Thursday, January, 19, 2017, at 2:00 PM t 0SEJOBODFSFMBUJOHUPUIF*OmMM)PVTJOH*OJUJBUJWF1SPHSBNBNFOEJOHEFmOJUJPOTSFWJTJOHEFmOJUJPOTPGMPXBOE NPEFSBUF JODPNF IPVTFIPMET BOE BEEJOH EFmOJUJPO GPS WFSZ MPX JODPNF IPVTFIPMET EFMFUJOH SFIBCJMJUBUFE EXFMMJOHVOJUTGSPNCFJOHFMJHJCMFVOEFSUIFQSPHSBNFYUFOEJOHGSPNPOFZFBSUPUXPZFBSTUIFUJNFQFSJPEGPS EFWFMPQNFOUPGJOmMMIPVTJOHCZEFWFMPQFSTFTUBCMJTIJOHDPOEJUJPOTGPSDPOTUSVDUJPOMPBOTBOEPUIFSmOBODJOH SFWJTJOHSFRVJSFNFOUTVOEFSXIJDIIPNFTDBOCFSFOUFEBNFOEJOH"SUJDMF7**PG$IBQUFSPGUIF$PEF Unincorporated Municipal Service Area (UMSA) Committee. Meeting â€“ Friday, January 20, 2017 at 9:30 AM t 0SEJOBODFSFMBUJOHUP"OOFYBUJPOQSPDFEVSFTSFRVJSJOHB.VOJDJQBMJUZUPQSPWJEFBDPNQBSJTPOCFUXFFO$PVOUZ BOE.VOJDJQBMMBOEVTFSFHVMBUJPOTQSJPSUP.VOJDJQBM"OOFYBUJPOPG6OJODPSQPSBUFE"SFBTJOUIF$PVOUZBNFOEJOH 4FDUJPOTBOEPGUIF$PEF "MMJOUFSFTUFEQBSUJFTNBZBQQFBSBOECFIFBSEBUUIFUJNFBOEQMBDFTQFDJmFE "QFSTPOXIPEFDJEFTUPBQQFBMBOZEFDJTJPONBEFCZBOZCPBSE BHFODZ PSDPNNJTTJPOXJUISFTQFDUUPBOZNBUUFS DPOTJEFSFEBUJUTNFFUJOHPSIFBSJOH XJMMOFFEBSFDPSEPGQSPDFFEJOHT4VDIQFSTPOTNBZOFFEUPFOTVSFUIBUB WFSCBUJNSFDPSEPGUIFQSPDFFEJOHTJTNBEF JODMVEJOHUIFUFTUJNPOZBOEFWJEFODFVQPOXIJDIUIFBQQFBMJTUPCF based. .JBNJ%BEF$PVOUZQSPWJEFTFRVBMBDDFTTBOEFRVBMPQQPSUVOJUZBOEEPFTOPUEJTDSJNJOBUFPOUIFCBTJTPGEJTBCJMJUZ JOJUTQSPHSBNTPSTFSWJDFT'PSNBUFSJBMJOBMUFSOBUFGPSNBU BTJHOMBOHVBHFJOUFSQSFUFSPSPUIFSBDDPNNPEBUJPO QMFBTFDBMMPSTFOEFNBJMUPagendco@miamidade.gov. )"37&:367*/ $-&3, $)3*4501)&3"(3*11" %&165:$-&3, For legal ads online, go to http://legalads.miamidade.gov
WEEK OF THURSDAY, JANUARY 12, 2017
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Closing half of boulevard’s lanes to cars is a hell of an idea For a 20-day trial, Biscayne Boulevard downtown has become either – you choose – an urban heaven or urban hell. If you’re there to walk your dog or take yoga lessons or play on the streets you’ll prob- Michael Lewis ably say that downtown has become heavenly. But if you’re trying to drive from north to south or south to north on downtown’s only true thoroughfare in those directions, we can sense the fire and brimstone. In fact, if you plan to drive on Biscayne Boulevard through downtown at what used to be rush hour be prepared for a good look at the revamped area where there used to be eight lanes of traffic. For the trial period, four lanes are reserved for buses and bicycles. So you’re sure to get a nice slow-w-w-w look around at the changes as you try to drive past with only four lanes remaining. If you want to stop for sidewalk dining or strolls – or out of frustration at crawling
traffic – don’t bother trying to park in the six blocks of median that for decades have been city-run parking lots. They’ve been turned over to all those outdoor activities in leisure heaven. There was even talk of basketball there. The heavenly or hellish conditions – you decide – are the work of Miami’s Downtown Development Authority, which since 2006 has been envisioning a large expanse of green at Miami’s front door right smack in the middle of Biscayne Boulevard. The idea has finally come to fruition – it started Friday with the temporary transformation as a trial. It will certainly be a trial to motorists. Biscayne Boulevard also happens to be US 1, the first federal highway, stretching 2,377 miles from Maine to Key West as a fast motoring route before there were expressways. Unfortunately, other than I-95 across downtown to the west, it’s the only north-south mainland highway anywhere near Biscayne Bay. In recent years Biscayne Boulevard has become even more: it is downtown Miami’s lifeline, its link with booming Brickell and its Brickell City Centre, and with now also booming Midtown and Edgewater and Wynwood. The boulevard is also home to thousands of new condo units, two performing arts halls, AmericanAirlines Arena, the new PérezArt Museum Miami and very soon the Frost Museum of Science.
And while there are new port tunnels, the boulevard is still one of only two ways into and out of PortMiami, the world’s busiest cruise port and a vital cargo port. All of that is in one 15-block stretch, the center of which just became a temporary green leisure area with half the traffic capacity it had before Friday. If all of this works out, the Downtown Development Authority will try to make the changes permanent later on. The folks from the authority say studies show that you can drive just as fast, or even faster, in the four lanes remaining for cars along the boulevard as you previously could in eight congested lanes that already seemed like hell when a Heat game coincided with a hot performance or two at the Arsht center. Those folks from the authority are authorities, so that idea about equal driving speed in fewer lanes may not be as crazy as it sounds. But some of us are old enough to remember when four out of five New York doctors told us that smoking a certain brand of cigarette was sure to improve our health and rid us of that nasty cigarette cough. Those doctors were authorities too. So skepticism won’t hurt. Speaking of New York experts, backers of the Biscayne Green plan to turn our federal highway over to bicyclists and pedestrians and leisure enthusiast equally with motorists tell us that New York has done something
Obamacare changes likely to raise costs, cut coverage Lori Eng, a 62-year-old office manager in western Nebraska, sent an email telling me she was “terrified” she might loose her Obamacare health insurance. The many horror stories passed along in the media had Trudy Lieberman frightened her, and she wanted me to hear from someone who had benefitted from the law. No wonder Ms. Eng is scared. Ever since the Affordable Care Act passed almost seven years ago, opponents, mostly Republicans, have vowed to repeal the law and replace it with a different plan. The November election results now make that a possibility. Ms. Eng didn’t have health insurance before the Affordable Care Act came along. Her four-day-a-week job did not provide it, and her salary – less than $20,000 a year – was too low for her to swing an insurance premium. She bought her first Obamacare policy from one of the insurance co-ops that operated in Iowa and Nebraska that was supposed to offer cheaper coverage. It did – until it collapsed. With her government subsidy, she was able to buy a plan for only $50. She also qualified for an extra subsidy to help pay her deductible and coinsurance. When the co-op failed, as most eventually did, she got a similar plan the next year from another company. Because her subsidy had increased, she paid only $34 each month. That year Ms. Eng was diagnosed with breast cancer, and her treatment, which included chemotherapy and a double mastectomy, cost around $200,000. She paid just $1,450 out of pocket. In 2016, marketplace realities hit home. Premiums and deductibles were going up a lot. She found a plan with
Trudy Lieberman, a journalist for more than 40 years, is a contributing editor to the Columbia Journalism Review She is also a fellow at the Center for Advancing Health She has had a long career at Consumer Reports specializing in insurance, health care and health care financing. Contact her at firstname.lastname@example.org a relatively small deductible; but still must pay 20% coinsurance on everything until she reaches $2,250, the policy’s out-of-pocket limit. Other plans had much higher out-of-pocket limits, a risk she couldn’t take considering her health. “I’m hanging on by my toenails until I get Medicare if it’s still there when I’m able to get it,” Ms. Eng told me. Because of people like Ms. Eng, it’s unlikely Congress will simply repeal the existing law without creating a new plan to help out people with Obamacare policies. What it will be is anyone’s guess. But if it follows the thinking laid out by Georgia Rep. Tom Price, the incoming Secretary of Health and Human Services, it might well mean people will pay more. Mr. Price proposes scrapping the individual mandate that requires nearly everyone to carry health insurance and eliminating the federal subsidies that make insurance premiums affordable for people like Ms. Eng. Instead, policyholders would be given tax credits to help buy insurance. Whether the credits would be adequate, given how high premiums are now, is an open question. More insurance policies would be offered with health savings accounts; a tax-advantaged arrangement consumers would use to pay most of their bills. It would be combined with highdeductible insurance for catastrophic medical bills.
A new plan would continue to let people with pre-existing health conditions obtain coverage, but there might be strings attached. They might need to have been covered for a certain period, like 18 months, before obtaining new coverage. Insurers want to stop people from signing up when they get sick. The minimum benefits now required for Obamacare policies might become a thing of the past. That means insurers could offer cheaper coverage without maternity or psychiatric care or other services that will make policies cheaper and possibly more attractive to younger people. Older people could end up paying a lot more. Currently the law prohibits insurers from charging older policyholders more than three times what they charge younger ones who are presumably in better health. Under a new version of Obamacare older people could pay five times more. Keep in mind no health system is perfect. Every system has the same stresses and strains resulting from increasing drug prices, high-priced technology and physician demands for more money. How countries address those cost pressures involves trade-offs. All countries, including ours, limit medical services, a point to remember when the spin takes over in the Obamacare war. Other countries may have a fixed number of very expensive imaging machines available in a particular hospital or community, so queues form for some kinds of treatments. In the US, the cost of care limits who receives it. If you can’t afford some high-priced scan or have no insurance, chances are you won’t get the service. I’m not a betting person, but if I had to wager on an Obamacare replacement, I would bet it would almost certainly mean Ms. Eng and millions of others will assume more of the financial burden for their care.
similar and it works there. Well, New York has mass transit everywhere and just added a new subway line. You don’t need a car in Manhattan – in fact, a car is a hindrance. You can get from here to anywhere in fast, reliable transit. Miami has transit, too. We have a Metromover downtown, but it doesn’t run through the night, it’s frequently shut evenings and weekends for maintenance, it’s not all that reliable daytime – and it only goes a few places. To get anywhere else, get in a car. Oh, we do plan six new transit corridors. After we find the money for all six and when they’re all up and running and all link to downtown, the Biscayne Green relaxation heaven will make sense for people trying to get to or from work or to or from events or museums or even just across town. Unfortunately, that heavenly transit scenario is decades away, at best. In the meanwhile, we finally have the vibrant 24-hour downtown that we’d been dreaming about for 40 years. Some of those residents over the next two weeks will be up in the clouds over a dog park and basketball and yoga in the middle of what is still US 1. But when those new downtown residents or the rest of us try to get somewhere else, Biscayne Boulevard’s conversion to Biscayne Green is going to be pure hell.
Beach needs shuttle buses
Beach logistics – street width and flooding – make it impossible for light rail and pedestrian and cars to all fit nicely. Nice idea for another place. Miami Beach needs eco-clean rapid shuttle buses. Jennifer Caccamo
We need bridge quickly
I’m in favor of the Florida Department of Transportation I-395 signature bridge and all the traffic improvements that will come with it, 836/I-95, as soon as possible. The Miami Beach Baylink to Miami is another big project. Miami Beach, the City of Miami and Miami-Dade County need to get together and work on all the issues. Jose Pepe Cancio
Build new bridge rapidly
Great idea. I do not know how the original structure is, but it is old and needs to be updated. How about getting this project done in record time? Like three to four years. Steven Dloogoff
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WEEK OF THURSDAY, JANUARY 12, 2017
County resumes decade-long quest for airport hotel operator By Susan Danseyar
Photo by Maxine Usdan
Guests check in to the Miami International Airport Hotel in 2015. A quest for a new operator continues.
County commissioners have has been in a holding pattern for ment agreement is seven years and may be extended at the county’s questioned why, with such a cap- over a decade and what might be discretion for three one-year terms. tive market, the hunt for an operator missing if none of the bidders has
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Once again, the county is seeking a qualified firm to manage for at least seven years the aging but profitable Miami International Airport Hotel and will begin the selection process after applications come in next month. Located inside the airport at the departure level on Concourse E, the 58-year-old independent hotel, owned by Miami-Dade, has been managed on a month-to-month basis by Hotels International Inc. County commissioners and Aviation Department officials expressed displeasure with the Tampa-based firm many times over the past few years and have long wanted to find a national operator. Yet firms responding to bids have been rejected for various reasons, usually lack of qualifications. Other attempts the county has made in over a decade to find a new operator have also resulted in rejection, most recently Nov. 24, 2014, when three of the four firms responding did not meet bid parameters and the fourth was ultimately unable to reach a labor peace agreement as the county requires. The Aviation Department, representing Miami-Dade, put out the most recent request for qualifications Dec. 9. They are due at 2 p.m. Feb. 10, when all qualification statements will be taken to a room in the Stephen Clark Center, publicly opened and the names of respondents read aloud. The scope of services asks that a qualified firm manage the 252-room, seven-suite hotel and related amenities such as business center, conference center, full catering services, Wi-Fi and room service. Minimum qualifications are that the firms have five consecutive years operating a full-service hotel within the past 10 years in each category of managing, operating and maintaining a minimum of 250 rooms at one single location; have generated at least an aggregate of $50,000 in gross revenues operating a full-service hotel for the five qualifying years; and must be authorized to do business in Florida by the time of the award. The request states that if a respondent is an individual or partnership, the partner responsible for the operation of the hotel should meet all minimum qualifications. If a joint venture, then at least one partner of the joint venture should satisfy all the minimum qualifications. A respondent, joint venture or otherwise, may offer the experience of its corporate parent, sister or affiliate but the selection company will determine what weight – if any – to give to an affiliated company. The request for qualifications describes the Miami International Airport Hotel as remaining a successful, independent hotel “because of its ability to be distinctive in the airport-district market.” It’s in a prime terminal location ideal for travelers who are arriving late or departing early, according to the request, and leads the surrounding marketplace in both average daily rate and occupancy. The term of the hotel manage-
been qualified or a chain such as the Marriott does not show interest. During the most recent public discussion at a county commission meeting last April, Aviation Director and CEO Emilio T. González said the hotel, built over five decades ago was quite an old building with a shelf life. “Anyone who bids now knows there’s a time limit,” Mr. González said. “The bigger chains take a step back because it’s an old hotel and they want to re-brand. There might be interest, but in a luxury hotel.” Aviation officials plan to eventually develop a new four-star hotel on airport property. Speaking the day after the April 5 commission meeting at the Greater Chamber of Commerce’s trustee lunch, Mr. González said that 10 years from now the current hotel must either must come down, be renovated or turned into offices. “At the same time, we’re looking at another project to build on airport property – more than likely a four-star hotel.”
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WEEK OF THURSDAY, JANUARY 12, 2017
80% minorities in first class at Larkin pharmacy college By Catherine Lackner
Larkin Health Sciences Institute College of Pharmacy, MiamiDade’s first pharmacy school and the only college in Florida to offer a three-year program culminating in a doctor of pharmacy degree, reached a fast milestone when it opened in August with 62 students. “We immediately achieved one of our goals, that of serving the under-represented population,” said Gary Levin, the college’s dean and also a professor. Almost 80% of the class is made up of minorities, mostly from South Florida and primarily from Miami-Dade, that tend to be under-represented in higher education, he said via email. “Our goal for next year is an entering class of 80. Our application numbers have more than doubled for our second year,” Dr. Levin added. “At present, we have more than 200 applicants; at this time last year, we had less than100.” The private, not-for-profit pharmacy school plans to accept applications until the end of March. “We anticipate a final applicant
Photo by Marlene Quaroni
One goal of the pharmacy college is to serve the under-represented population, said Dean Gary Levin.
pool of close to 400 for 80 seats,” he said. “Therefore, we anticipate an alternate list.” The college operates in a 44,000-square-foot building (formerly Everest University) at 18301 N. Miami Ave., which has been specially converted for medical training, with large class-
rooms that can hold 120 students. It is part of Larkin Community Hospital’s 10-year strategic plan and is eventually to move to a 48-acre site the hospital bought in Naranja Lakes, near Homestead, which is to house its health sciences campus. The design of the curriculum
allows students to complete the program earlier and to pursue their career goals sooner, Dr. Levin said. The doctor of pharmacy program traditionally takes four years to complete, he said, after three to four years of pre-pharmacy undergraduate work. “We are the only three-year
doctor of pharmacy program in Florida,” he said. “This is a huge advantage to the student and saves them a lot of money in living expenses for a fourth year of pharmacy school. “Additionally, while others in their fourth year are paying tuition and still in school, our graduates will be making, on average, $115,000 salary that same year,” Dr. Levin said. Graduates are offered positions in retail, chain and community pharmacies, as well as in hospitals, ambulatory clinics and health centers, he continued. They are needed in “Veteran’s Administration Medical Centers, academia, industry, specialty pharmacies, and so on,” he said. According to the American Pharmacists Association, there are more than 80 unique types of positions for pharmacists, he added. Many require post-doctoral training in residencies or fellowships that range from one to three years. “Pharmacists still enjoy 100% job placement following graduation,” Dr. Levin said, “and have many job offers.”
Mount Sinai Medical Center expansion’s finish due by 2018
By Catherine Lackner
The $275 million expansion of Mount Sinai Medical Center is on time and on budget, Steven Sonenreich, hospital president and CEO, said last week. With the initial phase – a 750-space employee parking garage – completed, construction on the seven-story surgery tower and expanded emergency department has commenced, with completion expected by fall 2018. Most of the financing comes from a $110 million tax-exempt bond the medical center issued in 2014, he said. A fundraising effort, guided primarily by the hospital’s trustees, brought in another $45 million. “The rest will be supported by the hospital’s balance sheet,” Mr. Sonenreich said. “No expenses will be passed on to the patient population. The impact
Mount Sinai’s expansion began with a 750-space garage and continues with a seven-story surgery tower and larger emergency department.
on the Miami-Dade community is only positive, in terms of the jobs created.” When expansion is finished, Mount Sinai will double the number of surgeries it can perform,
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from the current 13,000 per year: the surgical tower will add 154 private patient rooms, each with a view of Biscayne Bay, and 12 new operating rooms. A new emergency department will triple the size of the existing facility (which was built in 1972) and will see about 100,000 visits per year, he said. The entire project will add 350,000 square feet to the medical center campus. Mr. Sonenreich has described Mount Sinai as “very much a surgical destination,” and has said that more than 70% of
surgery patients come from an area outside Miami Beach. “In a time when convenience is highly valued, we find that people will travel to Miami Beach for surgery,” he said. ‘We have a superb surgery facility and our positioning is about the quality of the facility and our focus on patient satisfaction.” Rooms in the surgery tower have been designed “with the total safety, well-being and comfort of the patient and the family in mind,” he said. “They are state-of-the-art and sized for comfort.”
The new emergency department will house the City of Miami Beach’s Emergency Management Department, which will have a command center there for weather emergencies and other crises. The construction shouldn’t interfere with the hospital’s regular operations, said Joanna Palmer, medical center spokeswoman, when the project launched. The current emergency department is still in service, and wait times there are “amongst the best in the state,” Mr. Sonenreich said last week.
The design of Mount Sinai Medical Center’s expansion encompasses a growth costing $275 million.
WEEK OF THURSDAY, JANUARY 12, 2017
Job market for nurses bright with opportunities, benefits
By Camila Cepero
Due to factors ranging from an oncoming retirement wave to regional shortages, the job market for nurses is full of opportunities and benefits, including competitive salary offerings and a multitude of positions to choose from. According to the Florida Center for Nursing’s 2016 annual report, Florida’s potential registered nurse (RN) workforce gained nearly 21,000 nurses between 2012 and 2015. The majority of these new RN’s are recent graduates of nursing programs. Likewise, the advanced registered nurse practitioner (ARNP) supply increased by about 4,000 over the same period. Most of the ARNP nurse supply is attributed to a greater number of RN’s returning to school to complete advanced degrees. The licensed practical nurse (LPN) workforce has experienced equal gains and losses over the past three years, so the cumulative change in the LPN workforce is very small. “The job market seems to be more of an open one where many of the students have multiple job offers from different facilities and are picking and M. Rutherford choosing what types of nursing positions they want to work in,” said Marcella Rutherford, dean of the College of Nursing at Nova Southeastern University. This is a notable change from as recently as three or four years ago, she said, when students didn’t have as many opportunities right out of school, but is part of a regularly recurring cycle in the nursing world. “In literature it is very well
Photo by Maxine Usdan
The job market for nurses is full of opportunities and benefits, including competitive salary offerings.
publicized that by 2022 there will be a very significant nursing shortage across the US because of two factors: the large population of nurses that fall into the baby boomer category are beginning to retire, and the aging of the population in general means a greater need for nurses,” Dr. Rutherford said. The Florida Center for Nursing reports that currently 41.5% of ARNP’s, 44% of RN’s and 38.1% of LPN’s are over age 50. This group of nurses is expected to retire in the next five to ten years, resulting in the loss of highly skilled mentors with years of organizational and experiential knowledge. “We know that there’s a high market for specialized nurses who can deliver high quality care, including nurse practitioners, nurse anesthetists and midwives,” said John McFadden, dean of the College of Nursing and Health Sciences and an associate professor of anesthesiology at Barry University. Many internal and external
factors contribute to nursing shortages, he said. “ Yo u n g women were traditionally the group that entered the nursing profession. Now, they have John McFadden many more opportunities – from studying cybersecurity to being president of the United States. That is a great thing, but it dilutes the number of people who would consider nursing as a career.” According to Dr. Rutherford, “we’re also seeing a utilization of nurses in many more settings than before.” “The majority still go to the hospital setting... but many conditions that before were treated only inpatient are now being treated and cared for in a variety of settings. What you’re seeing is nurses getting utilized in those environments because patients are transitioning from acute care
to outpatient more quickly than it would have happened 10 or 15 years ago.” Hospitals are the top employment setting for RN’s (63.5%) and ARNP’s (44.3%), while most LPN’s (38.8%) work in long-term care settings. About 39% of ARNP’s work in primary care settings. Clinical specialties vary by the type of nurse – most ARNP’s specialize in anesthesia and adult and family health, RN’s tend to specialize in acute or critical care and medical surgical, and a large proportion of LPN’s work in geriatrics. “There’s still going to be a need for nurses at the bedside but there’s a growing need for nurses in the primary care setting as well, such as accountable care organizations, hospices, home health, health clinics and other resources related to care.” Pre-licensure, nursing graduates in South Florida with a Bachelor of Science in Nursing are finding it easier to get jobs due to their clinical experience,
Dr. Rutherford said. “The salary offerings and the packages are close across South Florida,” Dr. Rutherford said. “There are differences, but you’d have to look at the full benefit package to do an accurate comparison. I do hear about quoted salaries but the differences are not huge.” The hiring market is certainly competitive, Dr. McFadden said. “Many facilities help with tuition assistance, either while the student is in the nursing program or upon graduation. They have been very creative with residency programs that help new nurses transition into their role. They’re looking at both financial and nonfinancial incentives.” As the nursing shortage increases, Dr. Rutherford said, hospitals will look for ways to retain the nurses they have to avoid the costs of retraining. “It costs approximately $60,000 to retrain a new nurse when one leaves – it’s very costly,” she said. “When you have a trained nurse that knows the facility, culture, patients, resources and other team players, it takes time and it takes training to bring in new nurses.” In past shortages, she said, facilities have offered incentives like educational money and funding and more flexible hours. “We certainly have a growing population, a diverse population, with healthcare needs that are unique, and that is absolutely a contributing factor,” Dr. McFadden said. “You can’t blame shortages on any one factor – it’s a combination of factors that results in these cycles of shortages and there are regional differences as well,” he said. “But no matter where you live, nursing care is an integral part of healthcare. Who can imagine a hospital or home care facility without nurses?”
New Nicklaus equipment offers young patients more safety By Camila Cepero
Nicklaus Children’s Hospital’s new leading-edge addition to its Brain Institute is promising to enhance the safety of patients and ensure the complete removal of tumors and preservation of healthy tissue. The hospital is the first pediatric facility in Florida to acquire the equipment, called the IMRIS Surgical Theatre. It is an intraoperative magnetic resonance imagining (iMRI) system attached to a ceiling-mounted track system that brings the MRI directly to the child in the surgical suite, as needed. Already installed, the system is expected to be in use by midFebruary after all necessary staff members have completed training. “Essentially, it allows us to use the MRI to differentiate from healthy and abnormal brain tissue directly in the surgical suite prior to finishing up a surgery,” said pediatric neurosurgeon Toba Niazi, one of the leaders of the Division of Pediatric Neurosurgery, part of Nicklaus Children’s Brain Institute.
With the IMRIS Surgical Theatre are pediatric neurosurgeons John Ragheb, Toba Niazi and Sanjiv Bhatia.
According to the hospital, the high-resolution magnetic resonance images provide surgeons with a view of the affected area in real-time to determine if the targeted area is thoroughly treated or if surgical plans need to be adjusted before a procedure is completed.
After procedures, Dr. Niazi said, doctors typically take a postoperative image of the patient to make sure that the entire tumor or epileptic focus was removed, and children usually have to be sedated. However, she said, the new equipment “really eliminates the
need for more pediatric sedation and anesthesia because it lets us know immediately if our surgical goals are met.” When not in use, the iMRI is housed in a separate imaging suite, where it can be used for MRI procedures for hospital inpatients requiring anesthesia monitoring.
The technology provides surgeons with “GPS-like guidance” within the brain, according to the hospital. John Ragheb, director of the Division of Neurosurgery at Nicklaus Children’s, has been working on acquiring the system for at least a decade, Dr. Niazi said. “Studies demonstrate that use of an intraoperative MRI improves safety and effectiveness of the surgery,” Dr. Ragheb said in a statement, “therefore giving the best possible neurosurgical results in the hands of an experienced surgical team.” The iMRI is housed in a new state-of-the-art surgical suite within the hospital’s Advanced Pediatric Care Pavilion, a new six-story critical care tower on the Nicklaus Children’s campus that opened in October 2016. “The equipment is very heavy,” Dr. Niazi said. “It can’t just fit into a nook or cranny; it has to be built-in with the building.” “It’s a great addition for our patients,” she said. “It puts us on par with other top-tier programs for pediatric neurosurgery. It’s becoming the gold standard.”
WEEK OF THURSDAY, JANUARY 12, 2017
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WEEK OF THURSDAY, JANUARY 12, 2017
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