FORWARD Florida Edition #5

THE VOICE of FLORIDA’S SUPER REGION ™ HOW2

• INSURANCE • ACCOUNTING • INTERNATIONAL BUSINESS • LAW

R&D AT UCF Commercializing Innovation

ISSUE 5 • 2013 $5.95

MEDICAL TECHNOLOGY BOLD NEW THINKING ( AND A LOT OF NERVE ]

THE REAL DEAL

Orlando's Simulation and Training Industry Cluster

page 26

OBAMACARE

An Inside Look

page 42

LEGISLATIVE UPDATE

The Shutdown

page 45

HANDS-ON SYNERGY: Surgeons practicing nerve repair at Alachua-based AxoGen's 2013 Surgeon Summit, held at Tampa's CAMLS

forwardflorida.com

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CONTENTS 38

DEPARTMENTS

10 I.C.Y.M.I. IN CASE YOU MISSED IT

10

INNOVATIONS

GROWING IDEAS INTO ENTERPRISES

POLYMERIC DISCOVERY OPENS DOOR An important new finding could prove instrumental in biomedical research.

Plus: pharma development; Blackstone launchpad; elite innovation and batteries included.

16 COUNTY REPORT SUPER REGION AT A GLANCE

20 PERSPECTIVES

LEADING POINTS OF VIEW

50 PARTING SHOT

PEOPLE AND PLACES ACROSS THE SUPER REGION

SECTIONS

22 HOW2

40 HEALTHY ANALYSIS REQUIRED

Turning health care data into meaningful insight involves getting the right information into the right hands, which leads to economic growth.

20

EXPERT TIPS AND ADVICE

UNMASKING OCCUPATIONAL FRAUD To prevent employees from playing tricks, you must recognize where fraud occurs, who commits it and how to thwart it. Then work to establish and enforce the correct internal controls.

23 DISCLOSURE CONTROL

Intellectual property is a valuable commodity. However, the available layers of protection don’t emerge automatically.

24

PREVENTING GLOBAL GAFFES

45

22

LEGISLATIVE UPDATE

Not doing your homework in the world marketplace can have dire consequences for businesses.

POLICY MAKING IN ACTION

VOICES OF THE SHUTDOWN October brought an epic battle over government spending and health care reform.

BALANCING ACT

25

SHOPPING FOR PROTECTION The new health insurance Marketplace: what individuals and small businesses need to know.

4 W EDITION 5 / 2013 • FORWARDFLORIDA.COM

48

WELLNESS YOUR PERSONAL BOTTOM LINE

A tip for the scale: Totally depriving yourself is not the answer to weight loss.

TAMPA HILLSBOROUGH EXPRESSWAY AUTHORITY

Y O U R E X P R E S S WAY A U T H O R I T Y

BUILT

TAMPA’S EXPRESSWAY IN 1974.

CHANGED NAME TO

LEE ROY SELMON

EXPRESSWAY

IN 1999 IN HONOR OF NFL HALL OF FAMER.

GENERATED MORE THAN

10,000 LOCAL JOBS AND

$1.4 BILLION

IN BUSINESS SALES.

INNOVATIONS REVERSIBLE ELEVATED LANES SUCH AS

COMMITTED

AND

ALL-ELECTRONIC TOLLING.

TO BUILDING A TRANSPORTATION SYSTEM

FOR THE FUTURE THROUGH INNOVATIONS SUCH AS

BUS TOLL LANES, AUTONOMOUS VEHICLES AND MORE.

tampa-xway.com

FEATURES COVER PHOTO: COURTESY OF AXOGEN INC.

26

THE REAL DEAL From our military to high-tech companies, Orlando's MS&T industry cluster is a global model of economic might and sustained growth.

ABOUT US

/ who we are

FLORIDA HIGH TECH CORRIDOR AND SUPER REGION As the lines separating traditional industries have blurred, so too have the geographic borders inside the 23-county Florida High Tech Corridor region. Drawn together by partnerships in industry, education, workforce and economic development, the organizations of Florida’s Super Region are collaborating across county lines to drive Florida’s new economy—one based on high tech sectors and innovative jobs of the future.

Stretching across the center of the state from Tampa Bay, through Metro Orlando to the Space Coast and up to Gainesville, the Florida High Tech Corridor makes up the 10th largest economy in the U.S., with a technology workforce of more than 230,000 people. Also driving its growth are three world-renowned research universities: the University of Central Florida, University of South Florida and University of Florida.

Florida’s Super Region is the 40th largest metropolitan economy in the world, with the potential to successfully compete not only nationally, but also across the globe.

FORWARD FLORIDA MEDICAL TECHNOLOGY

30

ADVANCED COLLABORATION In only its second year, CAMLS, a one-ofa-kind center of education and training, is blazing trails in Tampa and soon across the world.

32

ORGANIC GROWTH

34

REGENERATING HOPE

36

By virtue of a continually evolving industry cluster, Lake Nona Medical City is a case study in economic development.

In the emerging field of regenerative medicine, AxoGen is a company with a lot of nerve.

HEALTH REFORM Leadership is needed to allow employees to be great.

FORWARD Florida Magazine is the definitive resource for and about economic development and the emerging growth companies of Florida’s Super Region.

[

[+

The bi-monthly business magazine is published in cooperation with the Central Florida Partnership, Florida High Tech Corridor Council and Tampa Bay Partnership. Including Tampa Bay and Metro Orlando—two FLORIDA regions that alone account for a $269 billion gross regional product—the magazine covers 23 counties, an area promoted 20 13 M ED IA G U ID E as Florida’s Super Region. The magazine is pro-business, pro-entrepreneurship and pro-economic development, with an emphasis on business, technology, education and legislative issues.

PUBLISHING

PARTNE

RS CENTRAL FLO FLORIDA HIG RIDA PARTNERSHIP H TAMPA BAY TECH CORRIDOR COU PARTNERSH NCIL IP

The mission of FORWARD Florida is to promote the existing business and community strengths and assets of the Super Region, and to foster effective growth, strategic alliances and general economic development. The magazine showcases the region’s vibrant business environment while providing its own blueprint for success. As part of that mission to be the “Voice of Florida’s Super Region,” FORWARD Florida regularly devotes coverage to topics that mirror the region’s chief industries while also addressing topics and issues that resonate among key stakeholders.

42

SPECIAL REPORT Obamacare has been both reviled and revered. Here's a closer look.

6 W EDITION 5 / 2013 • FORWARDFLORIDA.COM

Distribution of the magazine includes direct mail to high C-level executives, along with civic and community leaders and policy makers across the 23 counties, Tallahassee and Washington, D.C. Out-of-market distribution also includes prominent site selectors throughout the U.S. Additionally, there is bonus distribution at a number of major business events.

Central Florida’s Full serviCe port.

Our backyard: Tampa Bay-Orlando I-4 Cooridor is home to Florida’s largest concentration of distribution centers.

More than 9 million residents and close to 50 million visitors in Central Florida rely on the retail products, food, fuel, fertilizer and building materials that come through the port of Tampa every day. And that’s the only the import side as hundreds of companies send products abroad. www.TampaporT.com 800-741-2297

We ARE the economic gateway for Central Florida.

Bulk • Break Bulk • Cruise • Container Cargo • automoBies

THE VOICE of FLORIDA’S SUPER REGION ™

FLORIDA PUBLISHING PARTNERS

EXECUTIVE PUBLISHER

TWITTER

LINKEDIN

FACEBOOK

FORWARD FLORIDA MEDIA INC. PRESIDENT JACOB V. STUART

CHAIR AARON J. GOROVITZ

130 S. Orange Ave., Suite 150 Orlando, FL • 32801 407.206.1011

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PRESIDENT RANDY BERRIDGE

CO-CHAIRS JOHN C. HITT JUDY L. GENSHAFT J. BERNARD MACHEN

FLORIDA HIGH TECH CORRIDOR COUNCIL

1055 AAA Drive, Suite 140 Heathrow, FL 32746 floridahightech.com

MANAGING EDITOR SUSAN REVELLO susanr@forwardflorida.com

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SOCIAL MEDIA DIRECTOR LAURA KERN lauraforwardfl@gmail.com

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ADVERTISING ACCOUNT EXECUTIVES ARLENE JACOBS arlenej@forwardflorida.com 813.431.8795

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8 W EDITION 5 / 2013 • FORWARDFLORIDA.COM

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ANY REPRODUCTION IN WHOLE OR IN PART WITHOUT EXPRESS WRITTEN CONSENT IS STRICTLY PROHIBITED. FORWARDFLORIDA WELCOMES ARTICLES, STORY IDEAS AND FEEDBACK. OPINIONS EXPRESSED BY GUEST AUTHORS DO NOT NECESSARILY REFLECT THOSE OF FORWARDFLORIDA, THE CENTRAL FLORIDA PARTNERSHIP, THE FLORIDA HIGH TECH CORRIDOR COUNCIL OR THE TAMPA BAY PARTNERSHIP.

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I

I.C.Y.M.I.

/ in case you missed it

MCO Spells Expansion

Disney plans to build the first AVATAR themed land at Walt Disney World within the Animal Kingdom.

Lights, Camera, AVATAR STEVEN SPIELBERG WAS A BIG HIT. NOW, IT’S JAMES CAMERON’S TURN .

Walt Disney Parks and Resorts Worldwide has joined forces with Cameron’s Lightstorm Entertainment and Fox Filmed Entertainment to bring the world of AVATAR to life at Disney parks. Producing partner Jon Landau will also get in the act to create themed lands that give guests the opportunity to visit Pandora.

Disney plans to build the first AVATAR themed land at Walt Disney World within its Animal Kingdom park. Construction is expected to begin soon.

With two new AVATAR films currently in development, the timing is right for new collaboration, Cameron says: ”I’m chomping at the bit to start work with Disney’s legendary Imagineers to bring our AVATAR universe to life.”

The agreement gives The Walt Disney Co. exclusive global theme park rights to the AVATAR franchise and provides for additional AVATAR themed lands at other Disney parks.

In addition to setting a global box office record, AVATAR has been hailed as one of the most innovative and visually stunning movies ever produced.

Obviously, Disney is hoping for similar accolades.

Aside from setting a global box office record, AVATAR has been hailed as one of the most innovative and visually stunning movies ever produced. Movie director James Cameron will work with Disney.

Seeds and Incentives WITH A NEW SEED CAPITAL PROGRAM AND REVENUE INCENTIVE PATENT COST SHARING , the University of South Florida is going to the... entrepreneurs.

The Seed Capital Accelerator Program for Tampa Bay Technology Incubator-affiliated companies was established to support and provide funds to new and existing startups that were formed from the licensing of USF technologies.

The program provides up to $50,000 of funding, based on meeting specific criteria.

“This innovative program can help earlystage companies grow their business and

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THIS ISN’T ONLY ABOUT THE BIG GETTING BIGGER, IT’S ALSO A CASE OF ENSURING relevance for the future.

Following approval in mid October by the Greater Orlando Aviation Authority Board, the wheels are in motion to nearly double Orlando International Airport’s passenger capacity.

The airport was originally designed to accommodate 24 million travelers annually, but the approved expansion plans will increase the capacity of MCO's current terminal to 45 million passengers per year.

“Over $5 billion has been earmarked for investment into local industries, which creates jobs, and we must anticipate the demand these investments will create,” says Frank Kruppenbacher, chairman of the Greater Orlando Aviation Authority.

Much of the improvements are predictable, encompassing the terminal ticket lobby, baggage claim and ground transportation.

The largest chunk of money ($470 million) is earmarked for the South Airport APM Complex, designed to support future multimodal travel connections, including All Aboard Florida. Another $114 million is slated for airside international improvements. Work is expected to begin in fiscal year 2014 and conclude by fiscal year 2017.

The first phase of OIA's capital improvement program includes an automated people-mover complex and a 2,400-space parking garage.

succeed, while also providing a positive economic impact for Florida,” comments Paul R. Sanberg, USF senior vice president for research and innovation.

The Revenue Incentive program, one of the first of its kind among U.S. universities, is a one-year pilot program to provide researchers with the opportunity to increase their share of income generated from the licensing of their inventions. Inventors who participate will pay a portion of the direct costs incurred by the university for protecting, maintaining, licensing, and preserving the invention’s patent rights.

In exchange, inventors will receive additional revenue from the licensing of their inventions.

I.C.Y.M.I.

/ in case you missed it

Soccer Vote Nets Stadium THERE HASN’T BEEN THIS BUZZ SINCE THE 1994 WORLD CUP MATCHES IN ORLANDO. When the Orange County Board of Commissioners approved funds for a new downtown, multipurpose soccer stadium, fans let out a collective sigh of relief while officials entered final negotiations with Major League Soccer to bring a franchise to Orlando.

The vote approved the use of Tourist Development Tax funds for multiple venues, including a soccer stadium. If a franchise is awarded as expected, the Orlando City Lions would begin MLS play in spring 2015. The team has been playing in the United Soccer Leagues, a level lower than MLS. “Our stated goal has always been 2015, and we’ve always shared that with MLS,” says Orlando City President Phil Rawlins. “They’re very aware of our goals — a vision of bringing the league here in ’15. We’ll stick to that, it’s what we want to do. The timing is right.”

The economic impact: A new MLS franchise in Orlando would generate nearly $1.2 billion in new direct spending over the next 30 years, according to city of Orlando data.

Innovation Square’s 40 acres in Gainesville near the UF campus will eventually be surrounded by more than 5 million square feet of research, retail, residential, laboratory and office space.

Innovation Square Takes Shape THE MASTER PLAN IS TO ESTABLISH AN ANIMATED LIVE-PLAY-WORK COMMUNITY stretching between downtown Gainesville and the University of Florida campus. The idea is to connect research and talent at UF with the private sector to accelerate scientific and technological development and local economic growth.

Things are taking shape.

Construction has begun on new roads in Innovation Square with a goal of creating small, “walkable” blocks—a framework that will “facilitate interactions between individuals in the science and technology community.”

According to officials, by turning the old

Alachua General Hospital “super-block” back into a pedestrian-friendly grid of interaction, adjacent streets and avenues will literally pave the way for companies that wish to relocate and create jobs in Gainesville. Specifically, SW 9th Street and SW 3rd Avenue will intersect in Innovation Square’s 40-acre core and eventually be surrounded by more than 5 million square feet of research, retail, residential, laboratory and office space. Land for the streets has been donated to the city’s Community Redevelopment Agency by the University of Florida Development Corp.

The activity is attracting attention. Savion Park, a $10 million apartment complex scheduled to open in July 2014 and neighboring Innovation Square, has pre-leased about 30 percent of its units.

Trade Talk

If a franchise is awarded as expected, the Orlando City Lions would begin MLS play in spring 2015.

FLORIDA AS AN INTERNATIONAL TRADE HUB? That’s what the Florida Chamber of Commerce is touting as a way to diversify the state’s economy. In October, the Chamber released its Trade and Logistics 2.0 report, an update from 2010.

By the numbers, turning Florida into an international trading hub is a daunting task.

The report notes the goal in 2010 of doubling state exports in five years is unlikely to be met, with the current trend line of $70 billion by 2015 far short of the $110 billion goal.

Similarly, Florida has also lost 4 percent of the market share of goods moving through the state to Latin America, as other states with large ports in the Gulf of Mexico ramp up, creating competition.

The new report targets boosting international trade, improving Florida’s manufacturing sector to increase its exports and increasing the “multiplier” effect from global trade. To achieve that, Florida must invest

The Florida Chamber of Commerce is touting trade and exports, such as at Port of Tampa, as a way to diversify the state's economy.

more dollars in infrastructure, reduce taxes and regulatory burdens on manufacturers and the “logistics” industry—companies involved in making the transfer of goods more efficient—and increase investments in education.

Diversifying Florida’s economy and reducing its reliance on tourism, agriculture and growth has long been a goal of the state’s business sector. Apparently, that hasn’t changed.

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/ news, notes and commentary N E W OR DE R S AT M AC DI L L A I R F OR C E B A S E

Plans call for the 92,000-squarefoot Florida Blue Innovation Center at Lake Nona to be the “embodiment of the future of health care.”

The building is scheduled to open in 2015.

The wait appears over at the previously dormant Gardens at Ravaudage development in WINTER PARK . The project, including restaurants, shops and offices, is now scheduled to open this summer. The development had consisted of one tenant, a Miller's Ale House restaurant, for months, as developers wrestled with the Winter Park City Commission on infrastructure improvements. The site has held much promise, even being included in discussions about a new stadium. Score one for development progress.

building will feature both a wet lab and office space. Tavistock anticipates groundbreaking for the Florida Blue Innovation Center by Q2 2014, with a grand opening in 2015. Plans call for the center to be the “embodiment of the future of health care.” Florida Blue will serve as the building’s anchor tenant with its Collaborative Imagination Center. Other tenants include a 15,000–square-foot life sciences incubator to be managed by the University of Central Florida in partnership with the University of Florida.

EMBRAER S.A . is at it again in Melbourne.

The company intends to open an aircraft assembly plant and related facilities at Melbourne International Airport for its twin-engine Legacy 500 and Legacy 450 executive jets. The new project could create 600 jobs and add 250,000 square feet to Embraer’s operations on the Space Coast, which already include the company’s customer center, the Phenom 100 and Phenom 300 assembly plants, and a paint facility.

The current employee count exceeds 260.

Also, Embraer plans to open its Engineering and Technology Center in Melbourne sometime early next year, employing mostly engineers.

Call it Pinellas County's beach hotel renaissance, led by Clearwater Beach, where about 2,000 rooms are proposed.

There is plenty of available space, too.

BEACH BY DESIGN , a 2001 master plan to encourage and guide redevelopment of then-sagging Clearwater Beach, was amended in 2008 to create a hotel-density reserve of 1,385 units in hopes of attracting mid-price hotels. Density reserve units allow developers to pack more hotel rooms onto a property than would otherwise be allowed and help with financing projects on expensive beach land. And that’s the current plan.

TAVISTOCK GROUP and FLORIDA BLUE are developing the Florida Blue Innovation Center at Lake Nona Medical City, featuring the Florida Blue Collaborative Imagination Center. The 92,000-square-foot, three-story

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SIDERIS PHARMACEUTICALS —a spinoff from a UF research lab—has attracted $32 million in venture capital investment as part of an agreement that could be worth up to $300 million.

As part of the financing, Sideris has an

agreement granting exclusive rights to Novartis Pharmaceuticals to acquire the company and its technology. Novartis is a Switzerland-based health care company with $57 billion in net sales in 2012. Sideris is developing a treatment for iron overload from multiple blood transfusions with technology licensed from UF. Tampa, the epicenter of international special ops coordination? Just maybe. The U.S. Special Operations Command, headquartered at Tampa’s MACDILL AIR FORCE BASE , has established the International Special Operations Forces Coordination Center. The center, known as the ISCC, for the first time provides foreign special operations liaisons space in the Special Operations Command headquarters to coordinate activities around the world. The simple concept: Special operations leaders can gather in the same room and have the ability to communicate on a secure, common system.

In what qualifies as putting your mouth where the money is, SOUTH LAKE HOSPITAL in Clermont is no longer hiring tobacco users. In 2007, South Lake instituted a policy banning employees from smoking while on duty. Now, it won’t hire tobacco users at all. According to data from the Centers for Disease Control, U.S. hospitals collect an estimated $96 billion annually because of tobacco use. In addition, tobacco use is attributable to $97 billion

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/ news, notes and commentary N A NO T H E R A PE U T IC S GR OW S U P

Approximately 2,000 new rooms are being proposed for picturesque Clearwater Beach, as part of a hotel renaissance in Pinellas County.

in lost productivity. The policy affects all parts of South Lake's campus, including the National Training Center and its new Fitness Center, called Live Well.

Mergers and acquistions are alive and well across the state. Roughly $19 billion in deals were recorded in Q3, making it the strongest period for Florida since the same period in 2007, according to a report from the Mergermarket Group. During the previous five years, Florida had posted one deal worth more than $2 billion. Three such deals occurred in the past quarter worth a combined $15.7 billion. Among the biggest was COMMUNITY HEALTH SYSTEMS' $7 billion acquisition of the hospital chain run by Naples-based Health Management Associates. That added four Tampa Bay area hospitals to the portfolio of Tennesseebased Community Health. Pharmaceuticals, medical and biotech continued to be Florida's dominant sector by deal value (17 deals worth a combined $8.9 billion).

Tech companies are finding Pasco County particularly appealing. Most recently, RETAIL PROCESS ENGINEERING LLC , an information technology consulting firm serving retail clients worldwide, purchased an office building in Land O’ Lakes.

The company is expanding and bringing a total of 16 new jobs to the county, with an average wage of $105,000, more than three times the Pasco County average annual wage. It’s the fourth tech company to locate there this year.

Just before the government shutdown, the region’s defense contractors scored big, according to media reports. The military awarded deals worth more than $500 million in the week leading up to the

Embry-Riddle Aeronautical University and SkyWest Airlines are partnering on a new program that gives Embry-Riddle students a substantial boost toward becoming SkyWest first officers.

shutdown, which also was the end of the federal government's fiscal year. LOCKHEED MARTIN CORP.’S Central Florida operations obtained the most contracts. Bethesda, Md.-based Lockheed is the state's largest contractor and its biggest Florida operations are located in Orlando.

EMBRY-RIDDLE AERONAUTICAL UNIVERSITY and SkyWest Airlines are partnering on a new program that gives Embry-Riddle students a substantial boost toward becoming SkyWest first officers.

Under the agreement, Aeronautical Science (professional pilot) students who have achieved a Certified Flight Instructor rating are eligible to apply for the SkyWest Pilot Cadet Program through the Career Services offices at Embry-Riddle’s campuses in Daytona Beach and Prescott, Ariz. EmbryRiddle has similar agreements with other airlines—American Eagle/American, Cape Air/JetBlue and ExpressJet/Delta—in which students start flying for smaller airlines associated with large carriers. In other news: For the fifth year in a row, Military Advanced Education has honored EmbryRiddle as one of the best schools for activeduty military and veterans in its 2014 Guide to Military-Friendly Colleges & Universities.

HEALTHPLAN SERVICES is expanding its headquarters in Tampa, a move that could create more than 1,000 new jobs

by 2018 and bring $34.4 million in capital investment to Hillsborough County. The administrative services provider for the insurance and managed care markets is developing a 95,689-square-foot facility in eastern Hillsborough to accommodate the expansion. Healthplan Services currently employs 652 people in the county, with an additional 119 employees throughout the state. Hillsborough and Tampa were among multiple locations, including Nevada, Pennsylvania and Ohio, that sought the new jobs and investment.

NANOTHERAPEUTICS —which uses tiny, nanometer-scale particle technology to make new drugs and to make existing drugs more effective—has broken ground on a 165,000-square-foot facility in Alachua. After starting in UF’s Sid Martin Biotechnology Incubator 14 years ago, the company plans to move into its $135 million Advanced Development and Manufacturing Center in early 2015. The facility is being built to fulfill the company's contract with the Department of Defense to develop and manufacture drugs to combat bioterrorism and radiological threats. There is talk of 150 new jobs.

SEMINOLE STATE COLLEGE OF FLORIDA and Basic Health Care College of Fredericia-Vejle-Horsens in Denmark have established a five-year partnership, the first

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/ news, notes and commentary BIG G OV E R N M E N T C ON T R AC T F OR B A N YA N BIOM A R K E R S

media methods, tools and platforms. Each school is reviewed on how effectively they engage with their audiences using popular social networks, including Facebook, Twitter and YouTube, as well as incorporating new platforms such as Pinterest and Instagram. Full Sail, which has moved up from No. 19 since the rankings were last published in 2011, was recognized for its innovative approach across various social media platforms in sharing news, elevating engagement and utilizing robust content creation.

Seminole State College hosted a contingent from Basic Health Care College of Fredericia-Vejle-Horsens in Denmark as part of Seminole State's first partnership with an international college or university.

agreement between Seminole State and an international college or university. The two colleges have agreed to develop faculty and staff exchanges, as well as share educational materials. The move is part of Seminole State’s renewed international effort as the college builds its Center for Global Engagement. The center, created in 2012, promotes service learning, study abroad and internationalization efforts.

Also: Seminole State’s academic affairs leadership has identified new degrees or programs in high demand areas, along with possible partners, to help transform its Altamonte Springs Campus into a regional center for education and job opportunities.

The plan identifies academic programs and partnerships in five high-demand areas: health care; modeling and simulation; education; business; and hospitality.

In October, FLORIDA POLYTECHNIC UNIVERSITY—the state’s 12th university— has completed its first month of official recruitment for its inaugural class, and those efforts are already exceeding expectations. The Florida Poly admissions team received more than 2,000 inquiries and more than 400 applications. They expect to receive a total of 2,500 applications before August 2014 when the inaugural class begins. Florida Poly’s curriculum focuses exclusively on applied research in science,

14 W EDITION 5 / 2013 • FORWARDFLORIDA.COM

technology, engineering and math (STEM).

Florida Poly will accept a total of 500 freshmen, transfer and graduate students for its fall 2014 entering class.

According to OPEN SMALL BUSINESS MONITOR , released this fall, among Florida business owners: Nearly all offer incentives to customers for repeat business; they have a more positive outlook for their business prospects over the next six months compared to other business owners in the South and elsewhere; more than half pay themselves a salary—on average $75,500 annually (up from $62,100 last year); more than half report cash flow issues over the next six months; half will make capital investments over the next six months; and 47 percent are planning to hire within the next six months. The American Express OPEN Small Business Monitor, released each spring and fall, is based on a national representative sample of 1,038 small business owners/managers of companies with fewer than 100 employees.

FULL SAIL UNIVERSITY in Winter Park was named by StudentAdvisor.com as one of the 2013 Top 100 Social Media Colleges in the U.S., earning No. 7. The ranking tracks more than 100,000 data points to compare federally recognized colleges in the U.S. in terms of their mastery of public social

FLORIDA HOSPITAL has appointed Dr. Steven R. Smith as chief scientific officer of Florida Hospital Research Services. In this new role, Smith will organize and streamline clinical and translational research across the eight Florida Hospital campuses in Central Florida. The appointment is viewed by the hospital as a commitment to building upon existing research activities and developing a defined research agenda for Florida Hospital. Smith will be responsible for leading the Florida Hospital research enterprise and external scientific and academic relations. He has more than 20 years of experience as a physician/scientist. For the past four years, he has led the development of the Florida Hospital – SanfordBurnham Translational Research Institute for Metabolism and Diabetes as scientific director, a role he will continue. Now working alongside Smith in his new role is Robert Deininger, who was appointed vice president for research operations.

Big news for Alachua-based BANYAN BIOMARKERS : It received a $13 million Department of Defense contract to adapt its blood test that diagnoses traumatic brain injury to work with a lab test device made

by Ortho Clinical Diagnostics, a subsidiary of Johnson & Johnson. Banyan has 42 total employees; 30 in Alachua and 12 in Carlsbad, Calif. Additional hiring depends on pending grants from the National Institutes of Health. Banyan Biomarkers was founded in 2002 by researchers at the UF McKnight Brain Institute, who discovered proteins from the breakdown of dying brain cells in blood.

Backed by record state funding and spending on marketing, Florida is on pace to top 100 million visitors this year. Tourism

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officials cite there is a point of diminishing returns, but “we’re not there yet.” The Legislature approved a $9.5 million increase in Visit Florida funding during the 2013 session, upping the annual allocation to $63.5 million. Gov. Rick Scott had proposed an even larger funding increase before the 2013 session. VISIT FLORIDA estimates the state accommodated 91.4 million visitors in 2012.

The “birthplace of Florida tourism” is back.

With SILVER SPRINGS now a part of the state park system, the Silver Springs Advisory Group is working to determine its future. The early consensus among the 21 government officials, scientists and representatives of various interest groups is that Silver Springs can deliver both environmental and economic gains. Incorporating the springs into the adjacent Silver River State Park has prompted state parks managers to update a plan written for the park in 2010. A determination is anticipated within a year.

With historic Silver Springs now part of the state park system, the 21-member Silver Springs Advisory Group is working to determine its long-term future. A resolution is expected next year.

Look AT My AbiLiTy Smart employers know an inclusive workforce makes good business sense.

Give a job seeker with a disability a chance to deliver significant bottom line value for your business.

In return, you get a chance to: • Contribute to career path decisions by offering mentoring, job shadowing or internship opportunities to people with disabilities • Access an underutilized pool of dependable, productive and capable workers • Recruit, screen and interview interns, volunteers or long-term employees

Renzo burga, Able Trust mentor, Broward College student and recipient of The Able Trust’s 2013 Young Adult Leadership Award 2 0 1 3

F l o r I d a

Find out how at AbleTrust.org d I s a b I l I t y

E m p l o y m E n t

C o a l I t I o n

Vocational Rehabilitation

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COUNTY REPORT

/ super region at a glance

— Rep. C.W. Bill Young (1930 – 2013) —

THE PASSING OF A GIANT

Plus: Amazon Comes to the Super Region, an Osceola Mystery solved and more.

I

PINELLAS n a 1999 interview with the New York Times, longtime Florida Congressman C.W. Bill Young, who passed away last month at 82, said, “In my short life I’ve been shot, I’ve been hit by a truck, survived an airplane crash, I’ve had my chest opened and my heart rebuilt. And it’s sort of hard to get me flustered after all that.”

Young, R-Indian Shores, remained unflappable to the end. A staunch advocate for Florida and his beloved 13th Congressional District, he was at the time of his death the longest-serving GOP House member, having been in office 42 years.

Young was born in 1930 in Harmaville, Pa., a gritty coal town and suburb of Pittsburgh. His family moved to Florida when he was in his teens, and he had to drop out of high school to help support his ailing mother. At 18, he joined the Army National Guard, serving from 1948 to 1957 and achieving the rank of Master Sergeant.

It was there that Young began what was to become a lifelong allegiance to the military.

He was elected to the Florida Senate in 1960 at age 29. In an era when the Democratic Party still ruled Florida, he was the chamber’s only Republican.

After his election to Congress in 1970, Young rose steadily through the ranks, accumulating power and respect along the way. For most of his tenure in Congress, he served as a member of the powerful House Appropriations Committee. From 1999 to 2005, he was the committee’s chairman.

Additionally, he served three different stints as chairman of the Defense Subcommittee (1995-98, 2005-06 and 2011 until his death).

It was from his position on the Appropriations Committee that Young was able to steer significant federal funds to his district and work as a staunch advocate for the military. Young is credited with helping save MacDill Air Force Base in Tampa from being closed in a base-reduction effort. One of the largest Veterans Affairs

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hospitals in the country is located in his district, the VA Medical Center in Bay Pines, which opened in 1933. He was responsible for generating substantial funding for the hospital, including $110 million in 1976 following a visit by him and President Ford. In a posthumous tribute it is being renamed the “C.W. Bill Young Department of Veterans Affairs Medical Center.”

Additionally, he was instrumental in providing $21 million in funding for the U.S. Central Command headquarters in Tampa.

Young was an equally strong advocate for education and biomedical research. He earmarked millions of dollars for research funding at the University of South Florida.

His official biography says that during his tenure as Appropriations chairman, “he

COUNTY REPORT / super region at a glance

As a tribute, the former VA Medical Center in Bay Pines is now “C.W. Bill Young Department of Veterans Affairs Medical Center."

doubled federal medical research funding over five years.” Some of his specific passions were increased immunization for preschoolers, improved public health programs and cures for Parkinson’s and Alzheimer’s. In 1986, in conjunction with the Navy, he spearheaded a national registry for bone marrow donors, the “C.W. Bill Young Marrow Donor Recruitment and Research Program.” One of Young’s proudest achievements, the registry today has a database of 11.5 million possible donors and more than 55,000 people have received transplants.

Though a pioneer in the Florida GOP, he was not afraid to buck his party at times. In 1974, Young joined the other three Florida Republican congressmen in announcing he would vote to impeach President Nixon. In 1976, he endorsed Gerald Ford over Ronald Regan in the Republican Primary and in 1980 endorsed George H.W. Bush over Reagan.

He also spent his career trying to place strict limits on offshore drilling after watching the damaged caused by a 1970 tanker spill that dumped 20,000 gallons of crude oil into Tampa Bay. On Oct. 9, Young announced he would not seek re-election. In a quote to the Tampa Bay Times a week before his passing, he said, “It seems there’s too much politics. It’s a different Congress.”

His services drew several thousand people, including 34 members of the House and current and former members of the military.

He is survived by his wife, Beverly, five children and numerous grandchildren. Young and his wife would visit injured veterans at Walter Reed almost weekly. Appropriately, he was laid to rest in the Bay Pines Cemetery, near the VA and the veterans he devoted his career to helping.

HILLSBOROUGH AND POLK IN LATE OCTOBER, RETAIL GIANT AMAZON

confirmed plans to build two fulfillment centers in Hillsborough County (Ruskin) and Polk County (Lakeland), with each site slated to be more than 1 million square feet.

“We look forward to offering more than 1,000 full-time jobs with comprehensive benefits at our new fulfillment centers in Hillsborough County and Lakeland, Florida,” said Mike Roth, Amazon’s vice president of North America operations. “We appreciate the state, city and county officials who A look inside: Amazon. The have worked with us to bring these fulfillment Central Florida fulfillment centers to Florida.” centers will each feature 1 million Given Amazon’s business model, Polk will square feet. The retail giant handle large items and Hillsborough will deal amassed sales in excess of $61 with smaller items. In talks since June with billion in 2012.

Ruskin, Amazon will open in the South Shore Corporate Park, located west of Interstate 75 and north of State Road 674.

Hillsborough County commissioners approved economic incentives worth more than $6 million over seven years, with the state contributing an additional $900,000.

“Amazon’s decision to invest in Florida is yet another vote of confidence in the state’s business climate,” said Secretary of Commerce and President and CEO of Enterprise Florida Gray Swoope. “The distribution facilities in Hillsborough County and Lakeland are incredibly important for those regions as well as the state. This announcement signifies that Florida has the infrastructure, workforce and business-friendly climate needed to support companies like Amazon.”

The Hillsborough County project will be developed by Seefried Development Management Inc., and Johnson Development Associates Inc. will develop the Lakeland site. USAA Real Estate Co. is the landlord for both projects.

Amazon.com is a Seattle-based Fortune 500 company with net sales topping $61 billion in 2012.

OSCEOLA

THE CAT IS OUT OF THE BAG REGARDING THE MYSTERY COMPANY COMING TO

Osceola. It was reported in August that Osceola County commissioners approved an incentive deal for an unnamed company. Now it's known that Photon-X, a 3-D imaging company, is relocating its headquarters from Alabama to a countyowned building in Osceola Heritage Park on U.S. Highway 192 near Kissimmee.

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COUNTY REPORT

/ super region at a glance

Flagler County brings its bright lights to the big city in a billboard in midtown Manhattan.

FLAGLER

SEEMS FLAGLER COUNTY IS READY FOR

The “Greatest Show on Earth” is beginning its headquarters transition to Ellenton.

core products. Today it serves a variety of areas, including optics, imaging, sensors, photonics, physics and computer science.

The high-tech company will create 110 jobs, paying an average annual salary of $62,000. Due to its high-level compensation, the company qualified for $770,000 in incentives, including tax refunds and reduced rent. Under the terms, the company must create the 110 jobs within three years.

Osceola Commissioner Frank Attkisson, who helped attract Photon-X to the county, calls the move "a game changer."

Media reports quoted Osceola County Commission Chairman Frank Attkisson: “This is a game changer for Osceola County. We’re staking our claim that we’re going high tech.”

Reportedly the company wanted close proximity to the region’s theme parks, the Medical City at Lake Nona and the military-simulation businesses based here.

Founded in 1999, Photon-X is an imaging technology company focused on Spatial Phase imaging (SPI) research and

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MANATEE

IN EARLY OCTOBER, FELD ENTERTAINMENT

completed the first phase of its multiphase move to the 580,000-square-foot former GE and Siemens manufacturing plant on the Manatee River that the company bought in May 2012. The quiet city of Ellenton is now the worldwide headquarters of the “Greatest Show on Earth.”

Feld Entertainment, a live show production company, presents the Ringling Bros. and Barnum & Bailey Circus, in addition to numerous entertainment events, including “Disney on Ice” and monster truck shows.

Keep that popcorn close.

prime time in its economic development marketing efforts. The county, through its tourism development arm and its economic development department, teamed up to purchase 276 minutes on an electronic billboard close to New York City’s Times Square on West 42nd Street.

The 10-second spots, which began on Oct. 1, will run once an hour, 18 times a day, through Jan. 2.

The ad shows a man in a business suit wearing sunglasses walking on a beach with a surfboard, then eventually cutting to him in orange business trunks. The tag line: “Your business forecast in Florida is SUNNY.” According to media reports, Helga van Eckert, director of economic development, said, “It will be running for the full three months, during the parade, Christmas, the ball drop, everything.”

Hopefully, the county will receive a warm reception for its effort.

BREVARD

LOCAL AND STATE OFFICIALS WERE ON

hand for the groundbreaking ceremony in late October in Titusville for the Space Coast Gap section of the East Central Florida Rail Trail that will cover 12 miles and cost $3.6 million. Part of the Coast to Coast Connector, the continuous biking and walking trail will stretch the width of the state–beginning in Titusville and featuring 275 miles all the way to St. Petersburg.

It is expected to generate more revenue for local businesses along the trail and also draw in more tourists.

Come hear

Andrew Davis author of

Brandscaping: Unleashing the Power of Partnerships

as he inspires new vision for the future of our region.

Q PERSPECTIVES LEADING POINTS OF VIEW

HEALTHY OPPORTUNITY

By

Dotty Bollinger

THE TIME IS RIGHT FOR HEALTH CARE PROVIDERS AND MEDICAL INNOVATORS TO BECOME A REGIONAL ECONOMIC FORCE.

O

nce a year, Laser Spine Institute’s surgeons, doctors and health care executives gather at the Center for Advanced Medical Learning and Simulation (CAMLS) in downtown Tampa. Laser Spine Institute hosts this forum to improve care for our patients—to share best practices, and to find innovative new solutions for those suffering from back and neck pain.

We are evolving in our health care knowledge over the course of those three days, sure. But I can’t help but think about what a facility like CAMLS is doing to change the landscape of advanced medicine the rest of the year. On any other day there, students are learning new technologies that will change the way medical care is delivered. Experts are coming to Tampa Bay to learn, share and innovate within these walls.

I truly believe that health care is being reinvented every day in the Tampa region and across the entire Super Region. I see it in the impact of what we are doing at Laser Spine Institute, at a place like CAMLS and at other leading institutions, including Moffitt Cancer Center, where doctors are reinventing the process for how patients recover from one of the nation’s most complex diseases.

If the Tampa region can rally around an industry right now, it’s health care. The right mix of industry leaders, educational systems, government support and the drive for economic development are all in place.

The opportunity the health care industry possesses on regional economic growth has been seized by the Tampa Bay Partnership.

The organization has identified Applied Medicine & Human

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Performance as one of four target sectors in the Tampa Bay Regional Business Plan, with that sector alone accounting for about 70 percent of overall jobs.

The Tampa Hillsborough Economic Development Corp. is embracing this sector, too. The organization hosts its second MediFuture conference in 2014. The initiative will create national attention when it brings thought leaders to the region with the goal of disrupting health care and positioning Tampa Bay as the example. Global management firm Oliver Wyman serves as consultant on this initiative.

With a climate so ripe, what can we, as health care providers and medical innovators, do to support the movement? We need to own it, embrace it and move it forward. At stake is regional economic development.

To better understand the potential impact, Laser Spine Institute conducted the analysis in partnership with the University of South Florida’s College of Business. The results of a study revealed Laser Spine Institute had an impact of nearly $140 million on the local economy in 2012. This amount included operational expenditures, employee spending and spending by out-of-area patients. More than 90 percent of patients who come to Laser Spine Institute are non-local residents, driving nearly $14.9 million in medical tourism to the local Tampa Bay economy.

That’s just one example.

As we align and the region becomes even more defined as the destination for quality, specialized health care services, not only will more patients come, but more jobs will come too. Medical companies will thrive. New companies will take notice of the region for consideration as headquarters. And why not? We have a viable workforce, the state is business friendly, and we have access to an amazing location for our employees to live and thrive. editor’s note: dotty bollinger is president and coo of laser spine institute, with headquarters in tampa bay and other facilities in philadelphia, oklahoma city, houston and scottsdale, ariz. [ laserspineinstitute.com ]

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/ expert tips and advice

ACCOUNTING

UNMASKING OCCUPATIONAL

FRAUD To prevent employees from playing tricks, you must recognize where fraud occurs, who commits it and how to thwart it. Then work to establish and enforce the correct internal controls.

by JENNIFER GAVRICH

Occupational fraud can occur within any organization, but weak internal controls coupled with a vulnerable organizational culture increase the risk of fraudulent activity.

When faced with a perceived pressure, employees identify a perceived pressure, and justify their actions with a perceived rationalization. The presence of these elements, known as Donald R. Cressey’s Fraud Triangle, along with weak internal controls, create the ideal environment for fraud.

The Association of Certified Fraud Examiners (ACFE) linked the lack of internal controls to 35.6 percent of frauds in 2012. To prevent employees from playing tricks on you, you must recognize where fraud occurs, who commits it and how to thwart it, so that you can establish and enforce the correct internal controls in your organization.

While fraud occurs within most types of organizations, these schemes impact the banking and financial services, government and public administration, manufacturing, and health care industries most frequently.

The majority of victim organizations reported corruption as the primary source of fraud. However, in health care, the ACFE identified billing schemes as the most prevalent fraudulent activity. In fact, the study linked billing schemes, such as upcoding, unbundling and double billing, to more than one-third of health care frauds.

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Upcoding, for instance, occurs when a provider submits a claim to either a health insurance company or government program for a procedure coded under a higher reimbursement amount than the service provided to the patient. Successful reimbursements of upcoding result in overpayment.

In the fiscal year ending 2012, the Medicaid Fraud Control Unit recovered more than $161 million in overpayments, according to an Agency for Health Care Administration report (The Stats Efforts to Control Medicaid Fraud and Abuse 2011-2012).

Surprisingly, most perpetrators who commit occupational fraud have not previously engaged in criminal activity. Consider that 87.3 percent of fraudsters have never been charged with a crime, and only 5.6 percent have received prior convictions. The ACFE reported that employees (as opposed to managers, owners or executives) committed 41.6 percent of occupational frauds in 2012. Of those crimes, 65 percent were conducted by males, 19.6 percent were between the ages of 41 and 45, and 36.9 percent held college degrees.

Those statistics help to identify the most common characteristics of a fraudster, but they do not answer the most ominous question: What corner is the criminal hiding in?

The ACFE found that more than half of occupational fraudsters work in the accounting, operations and sales

departments, with 22 percent representing employees in the accounting department.

Another question: Have you reviewed the internal controls in your accounting department lately to see whether anyone is hiding behind a mask in your organization?

According to the ACFE, in 2012, nearly one in four frauds occurred when the perpetrator simply overrode the existing internal controls to execute the scheme.

Clearly, investing in anti-fraud controls will increase the chances of fraud detection.

Yet, small companies, those with less than 100 employees, invest fewer resources in anti-fraud controls—while nearly half of frauds in small companies result from the lack of internal controls. In 2012, only 55.7 percent of small companies that reported fraud engaged an external auditor compared to 91.4 percent of other companies.

Apart from engaging an external auditor, an organization interested in improving internal controls should perform surprise audits, establish internal audits, require mandatory vacations and job rotations, and implement a code of conduct. Other safeguards include a fraud hotline, an anti-fraud policy and a whistleblower reward policy. editor’s note: jennifer gavrich is a senior associate for forensic accounting and litigation support at cross fernandez & riley llp. she provides consulting services in bankruptcy, insolvency, litigation, securities, fraud, economic damages and income replacement matters. [ cfrcpa.com ]

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LAW

DISCLOSURE

CONTROL Intellectual property is a valuable commodity.

However, the available layers of protection don’t emerge automatically.

by RYAN SANTURRI

What are you doing to protect your intellectual property? Have you or your business taken steps to protect your brand, innovative products, original software or other forms of intellectual property?

You probably know there are a variety of options to protect these valuable assets, principally patents, copyrights and trademarks. But if you are not taking advantage of these protections, you are making a costly mistake.

All of these protections, with the exception of state trademark rights, are secured through formal registration with the federal government. These registrations provide you and your business with layers of protection for many types of intellectual property, as well as providing notice of your intellectual property to others in the market and to the public at large. For some companies, intellectual property is one of its most valuable assets, and can be leveraged against competitors both offensively and defensively.

Many people may not realize the disclosure of a novel product, process or design jeopardizes the ability to protect it. Depending on the circumstances, an inventor may be prevented from securing a patent if the invention was disclosed before filing the patent. Similarly, trade secret protection is lost when those secrets become publicly known. While many larger companies have policies addressing the use and disclosure of information outside the company, most individuals and small businesses do not.

Since 2006, a lesser-known Florida statute also limits the available remedies for

anyone whose ideas and creations are used by others. Florida Statute 501.972 bars any claim or cause of action for the use of “an idea, procedure, process, system, method of operation, concept, principle, discovery, thought, or other creation” that is not protected by patents, trademarks, copyrights or trade secrets unless there is a written contract. In other words, if someone uses your idea, concept, creation (or the other forms enumerated in the statute), you cannot prevent that use or obtain damages—unless there is something in writing defining the terms of use.

Florida Statute 501.972 appears to be one of the first of its kind in the U.S., and in its seven years of existence only once has §501.972 been the subject of a published legal opinion. In 2010, BP solicited the public for ideas to stop the leak from the Deepwater Horizon rig that gushed oil into the Gulf of Mexico for 87 days. BP ultimately received more than 100,000 submissions from the public, and at least one person sued BP for compensation based on his submissions.

However, a Federal Court recently ruled that the litigant’s claims based on submissions to BP were barred by Florida Statute 501.972.

What does this mean for you? In short, you should never disclose any idea, concept,

creation or other intellectual property without a written contract defining terms of use and, depending on the circumstances, secrecy. There are a number of examples of instances where such disclosures occur in the business world. For example, business owners or entrepreneurs may disclose projects they have in the works to entice investors, venture capitalists and potential partners. A physician may speak to medical device or pharmaceutical representatives about improvements in technology. Your business may contact an engineering firm or a manufacturing company to build a new prototype or product. Sometimes individuals disclose their product improvement ideas to manufacturers. Indeed, some large companies have websites or other mechanisms for customers to submit these suggestions.

Each one of these examples may present the need to obtain a written agreement or understanding of the terms of use and disclosure.

Protect yourself. editor’s note: ryan santurri is a florida board certified intellectual property law attorney. he advises clients in the areas of intellectual property and related litigation involving patents, trademarks, trade secrets, copyrights and right of publicity. he also provides trademark and copyright acquisition and counseling services. [addmg.com]

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TRAINING

PREVENTING

GLOBAL GAFFES Not doing your homework in the world marketplace can have dire consequences for businesses.

A foot-in-mouth mishap by Nike a few years back illustrates the dangers of navigating the culture of foreign lands without a good map.

The footwear giant meant to honor the Irish by naming its newest sneaker after the black and tan alcoholic beverage made from a combination of stout and lager. As it turns out, the Irish drink isn’t so beloved in Irish bars, for the “Black & Tans” was also the name of a British paramilitary organization despised in Ireland for its brutality on civilians.

Nike hurriedly issued an apology and stated that the sneaker had another, kinder, gentler official name, but the damage was done.

Ignoring cultural differences and the histories of other countries can be costly for businesses. For members of the military, it can be deadly.

“Cultural dexterity can save lives and ensure the military achieves its mission,” says Richard Griffith, executive director of the Institute for Cross Cultural Management of Florida Institute of Technology in Melbourne, and author of “The Age of Internationalization” and “Leading Global Work Teams.” Griffith’s work has been featured in The Wall Street Journal and Time magazine.

The Institute for Cross Cultural Management is currently working with the Department of Defense and international corporations to develop research-based solutions for cultural training. The concentration is on issues that affect the day-to-day conduct of personnel sent overseas, as well

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as on strategies for more effective global leadership and negotiation.

The U.S. military is very serious about this issue, as witnessed by the DOD mandate that every U.S. soldier must be trained in cross-cultural competency.

“Understanding how to interpret actions in the light of the local culture allows our soldiers to respond appropriately under tremendous stress.”

For its corporate clients, the institute is coaching employees on the appropriate nuances to effectively communicate and interact with diverse individuals. In a two-day workshop, management professionals gain new insight on how their own culture shapes their views of proper work behavior and how those behaviors are viewed by those from other countries.

“Something as simple as the way an executive presentation is structured and communicated can differ widely across the globe,” cites Griffith, who provided cultural coaching to Harris Corp.’s international program managers so they can more effectively influence international customers. The institute’s global leadership workshop examines how leaders are viewed in different societies and provides tools for leaders to adapt their strategies.

“What is considered a leadership best practice in Chicago won’t resonate in Sao Paulo and will demotivate employees in

Shanghai,” Griffith adds.

Working with a local technology firm that had been acquired by a Japanese corporation, the institute helped the firm understand how to better communicate with its new Japanese management. “Japanese decision-making is vastly different than the traditional style employed in the U.S. Decisions must go through a lengthy series of peer reviews before they are approved by top management. However, once the decision is made, Japanese leaders move very rapidly to implementation. In the U.S., we make faster decisions and then work out the bugs on the fly,” explains Griffith.

The institute has partnerships with universities and consulting firms in Europe, Asia, Africa and South America.

The institute also leverages the large Florida Tech international student body for firsthand information and resources for their workshops.

Ultimately, sensitivity to foreign customs is all about building trust by respecting the diversity and sharing common ground.

“Smart organizations understand and leverage cultural differences to meet and exceed their business goals,” concludes Griffith. “Ignoring international business practices ultimately increases operational time and costs, and damages business relationships.

“You don’t always get a second chance.”

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INSURANCE

SHOPPING

FOR PROTECTION The new Health Insurance Marketplace: what individuals and small businesses need to know.

by KELLY DAVIS

On Jan. 1, 2014, the Health Insurance Marketplace (or Exchange) will become a new way for individuals and employees of small businesses to obtain health insurance coverage. Enrollment began on Oct. 1, 2013.

The Marketplace is intended as an easy way to shop for health insurance—it will have all options available in one place and a comparison of price, benefits, quality and other factors. In 2014, the U.S. Department of Health and Human Services (HHS) expects that 25 million Americans will have access to quality health insurance. In addition, up to 20 million people, including families, may qualify for assistance to make coverage more affordable. In 2016, the Marketplace will be available to those working for businesses with 100 full-time employees and full-time equivalents, and in 2017 each state has the option to expand the Marketplace to employers with more than 100 workers.

By law, the Marketplace includes provisions to determine eligibility for premium tax credits or cost-sharing subsidies toward individual or family health insurance based on an individual’s prior year tax return.

An individual cannot get Marketplace cost-sharing subsidies if he or she is eligible for employer-sponsored coverage that is deemed affordable and meets minimum value. Although there is no requirement to purchase health insurance through the Marketplace, to receive premium tax credits or cost-sharing subsidies, an individual or small employer must buy coverage through the Marketplace (not the outside market).

ESSENTIAL HEALTH BENEFITS

While insurance plans are offered by private companies, the Marketplace will be run by either the federal government

(federally-based exchange) or by your state (state-based exchange). The insurance plans offered in the Marketplace will cover the same core set of benefits, called the “essential health benefits.”

In addition, a plan may not turn someone away or charge more due to an illness or medical condition, or charge women more than men for the same plan. Florida is operating the Marketplace from HealthCare.gov.

Specific plans and prices are available now.

SMALL BUSINESS MARKETPLACE ENROLLMENT

Starting on Oct. 1, 2013, small businesses are able to enroll in the Marketplace, and purchase employee coverage that will begin on Jan. 1, 2014. The Marketplace for small businesses is referred to as the Small Business Health Options Program, or the “SHOP Exchange.” This is a streamlined way for small employers and small tax-exempt entities to shop for health insurance coverage. Small businesses may enroll directly through the SHOP Exchange or through a broker registered with the SHOP. Small employers using the SHOP Exchange may be eligible to receive the tax credits available under the Affordable Care Act (ACA).

INDIVIDUAL MARKETPLACE ENROLLMENT

Individuals who want to participate in the Marketplace must live in its service area, be a U.S. citizen or national, or be a non-citizen who is lawfully present in the U. S. for the entire period for which enrollment is sought, and is not incarcerated.

The Marketplace lists all of the health plans available in your area, including the monthly premium costs for private insurance plans. It will explain if you qualify for premium tax credits, cost-sharing subsidies, Medicaid, or the Children's Health Insurance Program (CHIP).

NAVIGATORS

The ACA includes a community-based navigator program, where individuals trained on the regulations will provide outreach, education and enrollment resources for individuals. You can apply for Marketplace insurance in person with the help of a navigator or other qualified helper. You can also apply online or by mail. HHS is working with local libraries and community colleges to assist those who do not have computer or web access.

Application help is available 24/7 at 800.318.2596 and online.

HEALTH INSURANCE EXCHANGE EMPLOYEE NOTICE

All employers were required to provide their current employees with the Health Insurance Exchange Notice no later than Oct. 1, 2013, regardless if they do or do not offer coverage. This notice informs employees of the existence of the exchange, the services offered, and contact information. For employees hired after Oct. 1, 2013, the notice must be provided upon hire.

Model notice language is available on the Department of Labor website for employers who offer a health plan as well as employers who do not.

PLANNING FOR OPEN ENROLLMENT

Individuals and businesses can stay informed about open enrollment by: • Signing up at healthcare.gov to receive email or text updates about the Marketplace • Finding out which Marketplace will serve you • Learning about the different types of health coverage available through the Marketplace • Determining if you will have employersponsored coverage in 2014, and if not, how to obtain insurance through the Marketplace or other sources • Starting the Marketplace application process to find out if you are eligible for premium tax credits or cost-sharing subsidies. editor’s note: kelly davis is an employee benefit plans manager for cliftonlarsonallen, one of the nation’s top 10 certified public accounting and consulting firms. [cliftonlarsonallen.com]

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THE

REAL DEAL

BY MICHAEL CANDELARIA

FROM OUR MILITARY TO HIGH-TECH COMPANIES, ORLANDO'S MS&T INDUSTRY CLUSTER IS A GLOBAL MODEL OF ECONOMIC MIGHT AND SUSTAINED GROWTH.

During his 34-year military career, Lt. Gen. (Ret.) Thomas L. Baptiste was a real-life “top gun.”

He started out as an Air Force navigator/ weapons systems officer before getting handpicked to become part of the initial cadre of instructor pilots for the new F-16, the latest and greatest at the time in the early 1980s. He ended his service as the Deputy Chairman of NATO’s Military Committee, the highest military authority in the North Atlantic Treaty Organization. In that role, Baptiste also served as the second most senior military advisor to the NATO Secretary General.

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So in 2007, when he retired, Baptiste easily could have ridden—or rather jetted—into the sunset. Instead, after three years of dabbling as a consultant he landed at the National Center for Simulation in Orlando as president and executive director.

There, he pilots by encouraging collaboration and celebrating others’ victories.

“I’m a cheerleader,” he readily concedes.

“That’s kind of easy to do because this is a great news story, and it’s something that supports the warfighter, which, of course, I’ve got a continual burning in my heart for anybody who serves in the military.”

An Army soldier trains at one of the U.S. Army Medical Simulation Training Centers, with simulation systems delivered by the U.S. Army PEO STRI.

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simulation and training

T

he National Center for Simulation, or NCS, is a not-for-profit trade association with 216 government, academic and industry members operating as an open consortium.

The goal is to be the internationally recognized leader in supporting and expanding the modeling and simulation community by promoting technology expansion, enhanced education and workforce development.

While Baptiste arrived in Orlando upon retirement to spend time with his daughter and grandchildren, largely unaware of the region’s burgeoning military simulations and training , it didn’t take him long to find out. As a young officer, he remembers simulation training as being “pretty crude and not very good.” By contrast, in Orlando he found that simulation was “absolutely critical to the warfighter in America.” Since then, that indispensability has only magnified, he says—not only to the military but for the entire regional economy.

The sheer numbers: The U.S. military organizations in Orlando (Army, Navy, Marines and Air Force) are at the core of a simulation and training industry that contributes roughly $5 billion to Florida’s gross state product. Nearly 30,000 high-tech jobs, with salaries averaging $70,000 per year, directly support the industry. When combined with indirect and induced jobs, the industry employs more than 60,000 people. In all, 100-plus companies in Metro Orlando are active in what’s called the MS&T industry.

The growth hasn’t happened by accident. Aside from the statistics, there is uncommon synergy among multiple components.

Orlando is home to the Naval Air Warfare Center, Training Systems Division (NAWC-TSD); U.S. Army Program Executive Office for Simulation, Training and Instrumentation (PEO STRI); U.S. Army Research Development and Engineering Command Simulation and Training Technology Center; Air Force Agency for Modeling and Simulation; U.S. Marine Corps Program Manager for Training Systems; the Army Research Institute Human Research and Engineering Directorate; and the Coast Guard Liaison Office. For starters.

Each is located adjacent to the other at the 1,027acre Central Florida Research Park, recognized among the world’s top 10 research parks, housing more than 100 high-tech companies. Along with the military, many have joined together to form Team Orlando, a partnership comprising military services, industry and academia that works to leverage resources. Additionally, the University of Central Florida’s Institute for Simulation and Training is located at the park, serving as one of the nation’s leading research centers for simulation, training, modeling, virtual, augmented and mixed reality research for both defense and com-

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The P-8A Poseidon simulator is designed to ensure the Navy's future in long-range maritime patrol capability while transforming how the Navy's maritime patrol and reconnaissance force will man, train, operate and deploy. The P-8A provides more combat capability from a smaller force and less infrastructure.

The Navy’s Mobile Adult Trainer mannequin is the most advanced human patient simulator and enables medical personnel to test their skills.

“

I don’t have any problem at all being the No. 1 head cheerleader for promoting something that’s good for Florida, good for Orlando, good for Orange County, good for Central Florida and good for the High Tech Corridor.

”

LT. GEN. (RET.) THOMAS L. BAPTISTE

mercial applications. Nearby, UCF has the largest program in the U.S. dedicated to MS&T, awarding both master’s and doctoral degrees in that arena.

Drive down campus-like Central Florida Research Park, which was developed in the 1970s, and you see a slew of small companies attracted like magnets to the surrounding forces, literally ranging from A (Acudyn) to T (The Safety Doctor).

Moreover, giants like Lockheed Martin, Northrop Grumman, Boeing, General Dynamics and Rockwell Collins are prominent locally, too. Broader, the Florida High Tech Corridor contains the highest concentration of simulation and training related activities in the nation.

For the industry, the growth curve has lasted about six decades. The region’s initial foray into

simulation and training

“

With budget constraints, there’s no better return on investment than modeling and simulation through repurposing for the commercial industry.

”

WAYMON ARMSTRONG

The Tactical Combat Casualty Care Simulation was developed by ECS to support simulationbased training environments for Army combat medics.

simulation dates back to 1943, when one of the earliest military flight simulators was developed at NAS Banana River, now Patrick Air Force Base in Brevard County. That effectively tied the future Space Coast to Orlando. The cluster in Orlando firmly developed with the relocation of NAWC-TSD and PEO STRI from Long Island in 1965. Fifteen years earlier, paving that way, the Secretaries of the U.S. Army and Navy had agreed to collaborate on training and training devices.

As the needs of U.S. military training became more complex, Metro Orlando kept pace and grew in prominence. By using simulation, the military found training better and less expensive than in the past, while also being environmentally sound. The 1980s brought the invention of laser weapons training, providing soldiers with immediate feedback when firing their weapons during training and more accurate scoring. The 1990s delivered large-scale operations with tanks, planes and large- scale military exercises and the use of personal computers and video games as new ways to train.

In 1985, the state of Florida issued a resolution recognizing and endorsing a Center of Excellence for MS&T in Metro Orlando. In 2007, Congress declared modeling and simulation a “critical technology.”

“We’re not just known nationally; we’re known internationally,” affirms Waymon Armstrong, president of Engineering & Computer Simulations (ECS), an Orlando company that specializes in the military simulation experience.

“When you look at Central Florida, we’re thankful for how we’re known for tourism and the attractions. But to a lot of people, when you look at dealing with life-or-death issues, as far as training for our Armed Forces and our first responders, they think of what we do in modeling and simulation first.”

Yet, Armstrong spends at least some of his time these days huddling with Baptiste and other local officials in another sort of battleground: protecting their turf. In the midst of robust growth and Central Florida’s continuing economic recovery, there is talk of Base Realignment and Closure Commission (BRAC) closures, and Metro Orlando’s MS&T cluster just might be in the crosshairs. The 2012 President’s Budget calls for two rounds of Base Realignment and Closure. Although nothing is imminent, officials aren’t waiting around.

And collaboration, again, is playing a chief role.

Last spring, Orange County Mayor Teresa Jacobs formed the MS&T Blue Ribbon Commission to work in partnership with the Metro Orlando Defense Task Force and others in helping to protect and grow Central Florida’s MS&T cluster. “MS&T represents precisely the type of science-driven discovery and high-tech economic activity that is so vital to our future,” says Jacobs.

“In partnership with our local military commands and numerous defense contractors, the economic strength resulting from our MS&T assets will allow Florida and our region to remain at the forefront of national and global innovation economies.”

On Dec. 2, the Jacobs’ commission and the

Metro Orlando Defense Task Force are slated to meet and discuss next steps at the annual I/ITSEC meeting. The Interservice/Industry Training, Simulation and Education Conference is the largest gathering of its type in the world, annually held in Orlando.

Among the focal points, says Armstrong, who is chair of that committee, are spinoffs encompassing the medical, gaming, education, aviationaerospace, animation/theme park, emergency management and public safety sectors. “That’s where you see the future going, aside from what we’re doing for the DOD,” he says.

“With budget constraints, there’s no better return on investment than modeling and simulation through repurposing for the commercial industry.”

Indeed, the local spinoffs to other industries can be seen in a variety of ways. Digital media, entertainment and serious games connect MS&T to Orlando’s new Creative Village; and medical, and health care training has ties to Lake Nona Medical City. Through an IST digital puppetry program, new teachers can train in a virtual classroom and interact with role players portrayed in the simulation as students with challenges that the new teacher may face—before they enter a real classroom. Surgeons can practice before they make the first cut; emergency managers can practice response scenarios through simulation to ensure they are prepared for the real crisis.

Armstrong’s company is a case in point. With 16 years in military simulation, ECS is seeking to transform crisis response training in the oil and gas industry. The Crisis Response Simulation, or CRS, is a web-based, critical-thinking tool that immerses corporate senior executives in intense, realistic scenarios. The scenarios cover decisions that impact the preservation of life, the support of affected family members, oil rig stability, communication and social media, mitigation of legal risks and other factors.

“This industry brings not only technology, but learning and performance improvement all together in one,” notes Armstrong.

For a military man like Baptiste, such assertions add fuel to his fire. Metro Orlando’s simulation and training activities clearly are noble, he believes: “It’s part of the training of our warfighters and making sure that more of them come home alive.”

Also, for a pilot who accumulated nearly 3,000 flight hours in fighter and trainer aircraft, the cause lifts his spirit.

“I don’t have any problem at all,” Baptiste concludes, “being the No. 1 head cheerleader for promoting something that’s good for Florida, good for Orlando, good for Orange County, good for Central Florida and good for the High Tech Corridor.”

W FORWARDFLORIDA.COM 29

medical technology

ADVANCED COLLABORATION

In only its second year, CAMLS, a one-of-a-kind center of education and training, is blazing trails in Tampa and soon across the world.

USF Health CAMLS' Surgical and Interventional Training Center, the largest surgical training arena in the nation, features two daVinci robots in its high-tech robotics training suite.

By Michael Candelaria

D

r. Stuart Hart, medical director of the Tampa Bay Research and Innovation Center, calls his organization the “model of the future.”

In the room is a collection of top talent across academia, medicine and private industry, all focused on a single objective: shortening the time it takes to develop medical devices.

Welcome to the Center for Advanced Medical Learning and Simulation (CAMLS) in downtown Tampa, where his hub is one of four technologyinfused centers of experimentation, creation and uber sophisticated thinking outside the box.

The three-story, 90,000-square-foot CAMLS, affiliated with the University of South Florida, also includes the Surgical and Interventional Training Center; the Virtual Patient Care Center; and the

30 W EDITION 5 / 2013 • FORWARDFLORIDA.COM

Education Center. CAMLS (pronounced camels) opened in February 2012, with Hart’s Research and Innovation Center the newest addition, having opened last spring.

Hart works with a multidisciplinary team of health care providers and engineers to assist medical device companies during the entire product life cycle—from device conceptualization, development and pre-clinical/validation testing through sales force and health care provider training.

“I really think it’s the model of the future,” he says. “Academicians working in silos and industry working in silos—I don’t think is the best method for medical device development and for future technology development. I think we all have to work together. It’s all about the team approach.

It’s all about collaborations.”

Hart and his associates actively search among industry leaders for partnerships. They also identify

other experts and work with groups like the Food and Drug Administration on regulatory approval.

Plus, they engage university faculty to gather data with the goal of seamless access to realistic health care environments.

The divergent parts combine to create synergy.

“It’s extremely entrepreneurial. ... You can get the work that would take many months done in one week,” he says. “I am sure there’s a business model somewhere out there [like this]. But I really haven’t found it. When industry hears about it, they’re so intrigued that it can work within an academic environment, while still being more of an industry setting.

“Typically, in an academic environment if a company wants to work with the university, the company gives the university a grant, some research may be done and [the company] may get some product at the end. We are very different in

medical technology

Dr. Deborah Sutherland, CEO of CAMLS, points to international interest in CAMLS’ innovation. Dr. Stuart Hart, medical director of the Tampa Bay Research and Innovation Center, calls his organization the “model of the future.”

that we function more like a private entity. We are really a private/public partnership.”

Talk about realistic health care environments.

The Surgical and Interventional Training Center houses a surgical skills lab with more than 30 operating stations; an on-site tissue bank; a robotics suite with two da Vinci robots (S and Si); a synthetic cadaver; and a 64-slice CT scanner. Also, a hybrid catheterization lab/operating room, the first such training facility in the world, is designed to allow health professionals to move from performing an interventional procedure to open surgery in the same setting without patients having to go through the additional risk of a time-consuming move.

Another first-of-its-kind trauma operating room can change settings to suit different training purposes, from providing soothing light and sounds for a complex surgery to mimicking the noise of an urban emergency department and even the desert light and explosive noises of the battlefield environment faced by combat medics.

CAMLS uses innovative simulation technology and robotics to enable students, doctors and residents to practice the latest surgical techniques in a safe environment.

Additionally, there is integration or, using Hart’s description, no silos.

All of this is happening right according to plan, cites Dr. Deborah Sutherland, CEO of CAMLS. Industry partners are engaged. Specialty medical societies are using the facilities. Local hospitals

“

Typically, in an academic environment if a company wants to work with the university, the company gives the university a grant, some research may be done and [the company] may get some product at the end. We are very different in that we function more like a private entity. We are really a private/public partnership..

”

DR. STUART HART

and health care systems are receiving assistance.

Students are learning. A Department of Defense combat defense training grant is in place. Medical insurers and medical malpractice providers are developing pilot projects for high-risk specialties.

And that’s only a sampling.

One result: a big economic win for Tampa Bay. CAMLS’ first fiscal year brought 12,900 room nights to local hotels, and related discretionary spending was tabbed at close to $3 million. A total of 14,000 visitors arrived in year one.

“Everything that we had planned for is now in place. Everyone that we expected to be here is here, and they’re coming back,” she says.

Sutherland is quick to point out there are even people she didn’t expect. The immediate growth that has emerged, particularly from overseas, has been a surprise. After visiting, some want to return home and implement the CAMLS concept.

“I never thought I would be talking about international expansion in the first year of operation,” Sutherland offers.

A feasibility study was conducted for Panama.

Two feasibility studies are pending for Brazil. A group from India was scheduled to visit as well.

There are serious conversations with the American University of Beirut. Each country is interested in a licensing agreement with CAMLS, where facility development and course content would be developed by CAMLS and made available.

“That’s the way we’re heading,” says Sutherland.

Like the activity within its walls, CAMLS is in a continual state of discovery, Sutherland contends: “We are always evaluating and looking at new opportunities for research and training. ... This has been a journey, an evolution.”

W FORWARDFLORIDA.COM 31

medical technology

By virtue of a continually evolving industry cluster, Lake Nona Medical City is a case study in economic development.

Residents of Medical City represent some of the most powerful names on Orlando’s health care scene: Nemours Children’s Hospital, SanfordBurnham Medical Research Institute, the University of Central Florida College of Medicine, the Cancer Research Institute of MD Anderson Cancer CenterOrlando, University of Florida Academic and Research Center and Valencia College.

ORGANIC GROWTH

By Laura Kern

L

ake Nona Medical City, 650 acres of health care-related education, research and clinical care, located in southeast Orlando near the Orlando International Airport, is a test bed for collaboration. Or, call it a test tube.

Medical City residents represent some of the most powerful names on Orlando’s health care scene: Nemours Children’s Hospital, SanfordBurnham Medical Research Institute, the University of Central Florida College of Medicine, the Cancer Research Institute of MD Anderson Cancer Center-Orlando, University of Florida Academic and Research Center and Valencia College. And in 2014, the Department of Veterans Affairs’ Hospital and its sole Medical Simulation Center for Excellence in the country open.

Not surprisingly, an economic impact study performed in 2008 found the UCF College of Medicine, combined with the life sciences cluster in Lake Nona, could create 30,000 jobs with $2.8 billion in annual wages, generating $460 million in annual tax revenue and spurring $7.6 billion in

32 W EDITION 5 / 2013 • FORWARDFLORIDA.COM

annual economic activity for the region by year 10 of operation.

Better yet, there appears the promise of even greater returns—with one single unique development fostering uncommon synergistic relationships among scientists, doctors and researchers.

The sort of organic growth that is difficult to both measure and predict.

The hype has certainly been there since dirt was first turned in 2007. So, is it happening? Are partnerships forming? Is synergy taking hold?

Yes, yes and yes.

Recent highlights:

LAKE NONA IMPACT FORUM Inspired by the Aspen Institute, TED Conferences and the Clinton Global Initiative platforms, the nonprofit Lake Nona Institute launched the Lake Nona Impact Forum. The three-day, invitationonly conference attracts the nation’s preeminent CEOs, scholars and health care leaders to generate and exchange ideas that inspire new ways to address health care, wellness and sustainability practices. In late October, attendees explored the roles technology, innovation, collaboration,

“

With this incredibly diverse group, we are confident we can come up with innovative programs and solutions, which can be tested and expanded to additional markets around the world.

”

THADDEUS SEYMOUR JR.

imagination, wellness and prevention played in the uncertain state of national health care. During the meeting and also informal conversations, the group of industry leaders, including Sen. Tom Daschle (Obamacare architect), Johnson & Johnson CEO Alex Gorsky and Cleveland Clinic Chief Wellness Officer Michael Roize, shared insights and discussed solutions.

“With this incredibly diverse group, we are confident we can come up with innovative programs

medical technology

and solutions, which can be tested and expanded to additional markets around the world,” notes Thaddeus Seymour Jr., president of the Lake Nona Institute and host of the 2013 Lake Nona Impact Forum.

UCF COLLEGE OF MEDICINE Doctoral students at the College of Medicine (UCF COM) are required to have two years of research project experience for graduation, and in addition are encouraged to choose a topic important to them. Some students have chosen to complete their “Fire Research Projects” with physicians at Nemours.

UCF COM is also conducting Research Initiative discussions, much like meet-ups or speed dating, for research partners and resident organizations.

Most recently, the event featured 50 five-minute presentations.

“We are seeing the results of bringing together brilliant minds, each with a different perspective, in one room,” says Wendy Sarubbi, UCF COM spokesperson. “Medical City residents are finding ways to take their ideas much further through these collaborative exercises and partnerships that form from these casual conversations.”

SANFORD-BURNHAM MEDICAL RESEARCH INSTITUTE The Florida Translational Research Program

(FTRP) provides nonprofit Florida scientists with access to Sanford-Burnham’s expertise and chemical screening technology at its Conrad Prebys Center for Chemical Genomics. The Prebys Center screens chemical compounds by the millions to identify those that could be developed into new medications. Results live in a public database, PubChem, made available to all researchers in both the public and private sectors, for use in studying biology and disease.

Essentially, the efforts bridge the "valley of death" between laboratory discovery/development and medicine—the most critical phase in the drug discovery process. Funded by the state of Florida through the Florida Department of Health, FTRP has jointly supported successful projects in the fields of cancer, diabetes and obesity—with UCF, the University of Florida, the University of Miami and Scripps Florida.

"The FTRP exemplifies what is at the heart of Sanford-Burnham’s mission: collaboration,” says Layton Smith, Ph.D., principle investigator for the FTRP and director of drug discovery at SanfordBurnham at Lake Nona. “The FTRP allows us to collaborate with Floridabased scientists to develop a pipeline of potential new therapies to meet today’s most urgent medical needs.”

“

Having access to Sanford-Burnham’s drug discovery platform takes our research to the next level. The ability to bring therapies from the research bench to a patient’s bedside is extremely valuable and rewarding.

”

DR. KENNETH LIECHTY

NEMOURS CHILDREN’S HOSPITAL Dr. Kenneth Liechty, surgeon in chief and chair of the Department of Surgery at Nemours, is focused on cardiovascular disease at his research lab, at nearby Sanford-Burnham and works with his partners at UCF’s Particle BiomateriAn economic impact study performed in 2008 found the als Group.

UCF College of Medicine, combined with the life sciences According to Liechty, Lake Nona’s cluster in Lake Nona, could create 30,000 jobs with $2.8 billion in annual wages, generating $460 million in annual environment helps break down optax revenue and spurring $7.6 billion in annual economic erational silos between organizations. activity for the region by year 10 of operation.

He envisions a new model forming in Medical City for health care delivery, research and other innovations, where risk-taking, with UCF COM to collaborate on an equestrian collaboration and new procedures in health care therapy research program. Led by UCF’s Dr. are encouraged.

Manette Monroe, a lifelong horse enthusiast, the “Having access to Sanford-Burnham’s drug research will seek to scientifically quantify the discovery platform takes our research to the next ways in which horseback riding helps veterans level,” he says. “The ability to bring therapies who are physically disabled or suffer from postfrom the research bench to a patient’s bedside is traumatic stress disorder. extremely valuable and rewarding.”

In 2010, Dr. Deborah German, dean of the UCF College of Medicine, told The New York Times, DEPARTMENT OF VETERAN’S “We are working at warp speed here.”

AFFAIRS HOSPITAL Almost nothing has occurred since then to Although the VA Hospital is still being conchange that statement. At the same time, almost structed, there already are discussions taking place everything has changed.

W FORWARDFLORIDA.COM 33

medical technology

Greg Freitag, Jill Schiaparelli and Karen Zaderej in Times Square last summer when their company, AxoGen, joined the NASDAQ.

ANATOMY OF ADVANCEMENT

By Susan Revello

W

hen it comes to AxoGen’s market potential, the human body offers millions of nerves for this company to showcase its products.

Firmly positioned in the emerging field of regenerative medicine, the company is in the business of peripheral nerve repair—and there are a lot of people who need help.

Traumatic nerve injuries— especially in the extremities and oral/maxillofacial area—are a market worth more than $1.6 billion annually

34 W EDITION 5 / 2013 • FORWARDFLORIDA.COM

in the U.S. alone. Sufferers range from members of the military to healthy babies with birth canal injuries to active adults having accidents. Sadly, the list is long.

“We saw that there was really a tremendous unmet need in these injuries with peripheral nerves,” says Karen Zaderej, president and CEO. “And we really weren’t satisfied with the current solutions. We can provide solutions with our suite of products that gives patients new options for their repair. And we are excited about that.”

NASDAQ was also excited to have the Alachuabased company join the exchange in August. Traded as AXGN, its current market capitalization is about

In the emerging field of regenerative medicine, AxoGen is a company with a lot of nerve. $75 million. Not bad for a company that started with four employees.

Zaderej explained that surgeons don’t change treatments on a whim; they rely on data. “We have a real internal mandate to educate the surgical community in terms of new options and repair techniques,” she cites, adding that AxoGen also wants to educate patients about new treatment choices.

While its current core market focuses on surgeries for extremities, especially hands, in the short term the company is looking to new clinical applications for existing products. In April, AxoGen started working with surgeons on trigeminal

medical technology Edward Bonfiglio, a Navy Corpsman injured in Afghanistan, pictured in 2009 after leg-saving surgery using AxoGen's Avance Nerve Graft. The Purple Heart recipient, with major damage to his sciatic nerve, was the first patient to receive this product at Walter Reed Medical Center in Washington, D.C.

“

Regenerative medicine is really going back to the building blocks of the body. It is individualized treatment.

”

nerve (jaw) injuries as a complication from some dental procedures. In November, the company is scheduled to sponsor an educational forum for oral and maxillofacial surgeons in Chicago.

It’s obvious that first and foremost AxoGen is a health care company in the business of helping people. Zaderej is animated when discussing new clinical applications for her company’s products. On the horizon: breast cancer. After reconstruction, women don’t have normal nerve sensation in the new breast(s). AxoGen would like to change that and is currently working with several surgeons on the technique to hook up the nerves. “We think you need to have sensory function to feel normal again,” comments Zaderej. While this type of procedure is in the early stages, Zaderej thinks in a year or two in it will be available to patients.

Another disease with nerve consequences is prostate cancer. The company just completed enrollment of a preliminary study in this area.

Common side effects for men who have their cancerous prostates removed are erectile dysfunction and incontinence. “We have conducted a pilot study that repairs the nerve when you can’t spare them. Nerves are right on the surface of the prostate, and the surgeon has to decide to either leave cancer behind or take out the nerve,” Zaderej explains. She believes the nerve can be repaired and the patient’s quality of life is maintained while achieving cancer-free status: “We will see those results in about a year.”

AxoGen’s suite of products includes Avance Nerve Graft, processed human nerve allograft; AxoGuard Nerve Protector, a material to wrap and protect the nerve; and AxoGuard Nerve Con-

nector, a nerve coaptation aid. These off-the-shelf products enable surgeons to repair nerves without a second surgical incision to harvest nerves from another part of the body to fix the injured nerve.

There are a lot of advantages to keeping the surgery to one incision site.

AxoGen Corp. was founded in 2002 and, as the result of a reverse merger with LecTec Corp. in 2011, became today’s AxoGen Inc. It was spun out of the Sid Martin Biotechnology Incubator at the University of Florida.

Zaderej is a fan of the Gainesville area. Recruited in 2006, she was amazed at the resources offered to her by the incubator and views them as problem-solvers for companies. Whenever a business need arose, small or large, the staff was on hand with solutions. It enabled AxoGen to focus on its product development.

KAREN ZADEREJ

“I wasn’t really familiar with the resources that were available in the Gainesville area. And I have been amazed and impressed with the support infrastructure here for starting a company,” Zaderej. “I tell people all the time this is an area they should look to.” She also mentions the resources at UF, especially in the area of research.

Being a health care company in the exciting regenerative medicine field, research is essential.

It’s the “process of replacing or regenerating human cells, tissues or organs to restore or establish normal function.” This area of medicine holds the promise of regenerating damaged tissue and/or by stimulating the body’s own repair mechanisms to heal previously irreparable tissues or organs.

In terms of economic impact, some estimates place the regenerative medicine market at $17 billion in the coming years.

“Regenerative medicine is really going back to the building blocks of the body. It is individualized treatment,” concludes Zaderej. “There are many things on the horizon that will happen over the next five years.”

AxoGen's off-the-shelf nerve repair products include AxoGuard Nerve Connector, a nerve coaptation aid and AxoGuard Nerve Protector, a material used to wrap and protect the nerve.

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medical technology

Craig Technologies' family picnic at Cape Canaveral Lighthouse.

HEALTH

REFORM:

By Carol Craig

T

alking about employee benefits doesn’t sound like a very unique topic given all of the recent focus on health care reform that has been highlighted in the news. However, talking about the importance and commitment to employee benefits now, specifically in regards to medical coverage, is probably going to “go against the grain” for what a lot of company executives are doing or thinking. I don’t think a week has gone by recently without mention of Fortune 500 or other large companies announcing their intentions to remove dependents from their insurance plans, reduce hours to eliminate full-time positions or only hire part-time employees, as a strategy against the rising cost of health insurance and health reform.

While I understand the pure economics of the decision, I am not sure I fully agree that the economics outweigh the negative impact on the morale for the employees, their families and by extension, the company. I believe that my company has achieved the success it has because of the hard work and daily contributions of all of our employees.

36 W EDITION 5 / 2013 • FORWARDFLORIDA.COM

LEADERSHIP IS NEEDED TO ALLOW EMPLOYEES TO BE GREAT

“

By abandoning health insurance and sending employees or their dependents to the Insurance Marketplace (i.e., the exchanges), I believe businesses send the wrong message to employees and their family members that they are on their own.

”

Very early on in starting the business, I made a commitment to providing the best benefits I could possibly find for my employees and their families without focusing on the cost to the company or the bottom line alone. Obviously, with family and loyalty being an integral part of our company’s core values, doing anything different would go against the principles for which the company was founded. Going the extra mile for our employees has paid big dividends well beyond

the pure economics. Putting people first inspires loyalty, commitment and motivates everyone to work hard for a common goal.

By abandoning health insurance and sending employees or their dependents to the Insurance Marketplace (i.e. , the exchanges), I believe businesses send the wrong message to employees and their family members that they are on their own. I am not naive enough to believe everything we were told about health reform will make things easier.

Insurance is still insurance, it is complicated enough when it works as it is intended. It’s especially complex—sometimes a veritable nightmare - when it’s not working. I am a firm believer that employers have an obligation to provide a human resources department and a benefits broker/consultant who is accessible, actively engaged, and knowledgeable on insurance to support the needs of employees and their dependents. It’s hard for me to understand how any HR department or broker/consultant would be able to provide proactive support to people who are sent outside of the organization to get health insurance.

I am not able to predict the impacts of this law or estimate how well I think it will fix the medical care or coverage issues of our country.

Like any law, there are parts that are inherently good (i.e., preventative health coverage), but there are parts that could have negative outcomes (i.e., additional taxes). If you haven’t heard about the Patient Centered Outcome Research Institute Fee, Transitional Reinsurance Fee, Medical Devices Tax or the other taxes outlined in this law, then you should probably bring yourself up to speed fast. This law is going to impact everyone and every company regardless of size. While some businesses may fare better under this law, I already know that I will see increased costs to the plans I offer with the fees and taxes associated with the reform, but I am committed to leading my organization through the challenges of the U.S. health care overhaul.

It is difficult to put a monetary value on employees who don’t have to worry about how and where to get coverage, or who they can call when they need help with benefits. But I am going to venture to guess that it far outweighs the savings found by reducing full-time employees or removing dependents from the plan. While there is still a lot to learn about the law’s implications as time goes on, I think the greatest challenge is for business leaders to give proper attention to the needs of employees and their families as a priority over the bottom line cost. In doing so, employees are free to focus on being great for the organization instead of being troubled by managing changes to their health coverage. editor's note: carol craig is founder, ceo and cfo of cape canaveral-based craig technologies, a $40 million engineering and advanced manufacturing firm. [craigtechinc.com ]

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ECONOMIC DEVELOPMENT

POLYMERIC DISCOVERY OPENS DOOR

A

team of researchers from the University of Central Florida, along with collaborators from the Massachusetts Institute of Technology, has reported an important research finding that could prove instrumental in biomedical research.

The study, led by Ayman Abouraddy, an assistant professor from the College of Optics and Photonics, builds on a technique discovered last year to produce uniformly sized polymeric particles.

Polymeric particles (micro or nanoscale) play an important role in medical diagnostics and therapeutics, since they can serve as beacons for detecting pathogens or as vessels to transport drugs. Many approaches have been developed by researchers to produce such particles.

However, each technique is typically limited to specific materials and, therefore, produces particles with particular sizes and structures. Using heat and a “stackand-draw” process, researchers can produce cable-like fibers containing multiple round cores made with the polymer of choice, all encased in a cladding comprised of another polymer.

Controllable access to such a wide range of sizes enables broad applications in cancer treatment, immunology and vaccines. With a tumor, for example, no single nanoparticle size can reach all areas.

Biological application of Abouraddy’s discovery was conducted in Associate Professor Ratna Chakrabarti’s laboratory at the UCF Burnett School of Biomedical Sciences, where the research promises significant applications in biomedical science, specifically cancer treatment and disease recognition.

“A major problem these days is the inability to specifically target cancer cells,” says Chakrabarti. “The advantage of this methodology is that it is polymerindependent and allows for the fabrication

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Professor Ayman Abouraddy (far left) and his graduate students Joshua Kauman, Soroush Shabahang and Guangming Tao identified the method for breaking molten fiber into spherical droplets.

of a hollow or solid core. The significance of this is that the polymeric particles can be conjugated with antibodies or proteins for specific recognition of a certain type of cancer cell in the body. Also, the shell can be made of a biodegradable polymer, and the hollow core can be filled with a particular drug. This way, the particles could target and deliver drugs specifically to the cancer cells without disturbing normal cells.”

The Sept. 9 edition of the prestigious Proceedings of the National Academy of Sciences (PNAS) Journal published the UCF CREOL team research, marking the school’s inaugural entry in the journal.

EXPEDITING PHARMA DEVELOPMENT

A team of researchers from UCF’s NanoScience Technology Center has developed the world’s first lab-monitored process to examine muscle function and its response to various treatments. The breakthrough may prove invaluable in furthering research efforts aimed at developing effective treatments for some progressive

muscular diseases, such as Amyotrophic Lateral Sclerosis and Myasthenia Gravis.

The result, according to James J. Hickman, Ph.D., professor of chemistry, biomolecular science and electrical engineering at UCF, and senior author of the work, could be a shortening of the long, arduous pharmaceutical development process.

“This technology, while exciting, is part of a larger goal aimed to better mimic conditions in the body,” Hickman says. “The pharmaceutical industry is in desperate need of highly predictive preclinical screening systems to streamline drug development and shorten current validation protocols, which can take a decade to implement.”

The work builds upon other breakthroughs by Hickman-led research teams.

Earlier this year, his team developed a method that uses nonembryonic stem cells to explore treatment options for spinal cord injuries and diseases, such as multiple sclerosis. In 2011, his team developed a process that uses stem cells to grow neuromuscular

INNOVATIONS / growing ideas into enterprises junctions (key connectors used by the brain to control muscles) between human muscle cells and human spinal cord cells.

Led by James J.Hickman, Ph.D., professor of chemistry, biomolecular science and electrical engineering, a UCF team of researchers could help shorten the arduous pharmaceutical development process.

BLACKSTONE LAUNCHPAD TAKES OFF

On Sept. 26, the university opened the new Blackstone LaunchPad, a program that provides students with a network of venture coaches and entrepreneurial support to transform ideas into viable companies. Created by a $1.4 million grant by the Blackstone Charitable Foundation, the program is open to all students, regardless of age or field of study.

“As America’s leading partnership university, UCF is proud to participate in an exciting new alliance to launch the next generation of Florida entrepreneurs,” comments UCF President John Hitt. “This effort will greatly benefit our students and enhance the economic prosperity of our community, which is good news for all of Central Florida.”

UCF is the 10th school in the country to launch the program, which encourages entrepreneurship as a viable career path. It was developed by the University of Miami and expanded by Blackstone.

"Entrepreneurship is the single most effective way to spur economic growth and job creation,” says Stephen A. Schwarzman, Blackstone's co-founder, chairman and CEO. “We must all play a role in nurturing talent, and through Blackstone LaunchPad, we can foster new generations of entrepreneurs who will transform local economies by creating new and innovative companies."

ELITE INNOVATION

UCF is one of the nation’s 16 leading universities when it comes to innovation and economic prosperity, according to the Association of Public and Land-Grant Universities.

UCF, which joins the ranks of The Ohio State University and the universities of Michigan, Georgia and Minnesota on the inaugural list, was recognized for offering several programs that stimulate economic growth in Central Florida and aggressively pursuing partnerships that benefit the region. Also, UCF was recognized for recruiting top students and faculty members in fields vital to the region’s economy, promoting a campus culture that can adapt quickly to meet regional needs and for effective leadership.

Collaborating with local partners, UCF has achieved significant milestones in the areas of innovation and economic

development. Among them are UCF’s Business Incubation Program, GrowFL, the Blackstone LaunchPad and the Florida High Tech Corridor Council. The incubation program recently graduated its 100th company, edgefctory, and from October 2011 through December 2012 its network of current/graduate clients created a regional output of more than $400 million—almost $6 in return for every $1 invested in the program.

GrowFL, administered by UCF’s Economic Gardening Institute, has helped more than 400 Florida companies grow at a rate three times faster than their peers, adding more than 4,100 direct and indirect jobs. The Blackstone LaunchPad empowers student entrepreneurs. The Florida High Tech Corridor Council, conceived by Hitt in 1996 as a partnership with the University of South Florida, University of Florida and economic development organizations, has created an estimated 4,000 jobs and served more than 375 companies.

In addition, UCF was hailed for academic programs focused on industries that are deemed vital to Central Florida’s economy, including the College of Medicine, Florida Interactive Entertainment Academy, College of Optics and Photonics, Institute for Simulation and Training, and College of Engineering and Computer Science.

include new markets, such as glass used in building construction, according to Svetlana Shtrom, director of technology commercialization at UCF. Mesdi’s innovative nozzles and proprietary spray coating, Nanostorm ™, enable vacuum coating of almost any nanoparticle on a large scale with precision and little waste.

Mesdi President Brandon Lojewski developed the idea for the tool while working as a research assistant in his professor’s laboratory. Weiwei Deng, assistant professor of mechanical and aerospace engineering, and Lojewski formed the company and won $10,000 in the Department of Energy-sponsored Megawatt Ventures competition to develop the product. Mesdi went on to win $100,000 in the DOE National Clean Energy Business Plan Competition last year and has recently opened a manufacturing center in Brevard County.

BATTERIES INCLUDED

UCF has signed a license agreement with an award-winning student-led spinout company looking to expand the market for its spray-on battery coatings.

Mesdi Systems Inc. specializes in the production and implementation of advanced spray equipment used to manufacture nanomaterials and ultra-thin coatings. The agreement gives Mesdi the tools it needs to scale up manufacturing of its proprietary battery coating to

By virtue of an agreement with UCF, studentled Mesdi Systems Inc. now has the tools it needs to reach new product markets.

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I

INNOVATIONS / growing ideas into enterprises

RESEARCH

HEALTHY ANALYSIS REQUIRED TURNING HEALTH CARE DATA INTO MEANINGFUL INSIGHT INVOLVES GETTING THE RIGHT INFORMATION INTO THE RIGHT HANDS, WHICH LEADS TO ECONOMIC GROWTH.

H

ealth care generates an abundance of data, Big Data.

Yet, according to a study

by HIMSS Analytics, less than half of hospitals are taking full advantage of technology to analyze the information and make it actionable. That, coupled with the exponential growth of Big Data and the fact that health care accounts for roughly 30 percent of the world’s data, reveals there is tremendous value within the sector. In fact, health care data usage alone is valued at $300 billion over the next decade.

“One of the greatest management challenges is the complexity and fluidity of the health care system, requiring advanced clinical and business intelligence systems for decision making, particularly in the world of growing structured and unstructured data sources,” says Joe Woodside, Ph.D., assistant professor of business intelligence and analytics at Stetson University.

“Big Data in health care not only represents the growth of data, but also the potential value available through the use of data.”

For example, in a recent article in the Journal of Healthcare Information Management, Woodside discussed integrated care intelligence—a combination of integrated care management and business intelligence, or social and technical components.

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“It is a well defined and coordinated set of targeted services delivered to individuals by care providers across organizations, and supported by applications and technologies,” cites Woodside. Such systems’ thinking processes are increasingly being applied to areas of health care, such as quality and redesign.

Woodside’s development of a multidimensional view of quality and an analytical framework for managing organizational quality allow hospitals and other health care providers to determine the best course of action to address stakeholder requirements for patients, employees and shareholders. Literature has shown the right information in the right hands leads to improved quality.

However, to get the right information into the right hands, and thereby to garner the greatest value out of Big Data, requires analysis of the data. But skilled analysts, who know how to turn systems data into meaningful insights, are in short supply, according to Woodside An Accenture report on finding analytical talent shows the U.S. is producing only half the demand for analytical experts. To address this shortfall, organizations are partnering with educational institutions to update curriculum, design career paths and increase visibility among university recruiters.

At Stetson University, the talent transformation process is well underway with new courses and curriculum focused on business intelligence and analytics within specific application domains and industries such as health care.

“The health intelligence knowledge and research stream within Stetson’s business intelligence and analytics programs represents an opportunity for health care companies to take advantage of student interest in clinical, business and technical career paths,” Woodside says. “Existing courses in business intelligence and analytics are the core of the curriculum, allowing us to extend key courses to health care management, health care informatics, and integrative health to complete degree or certificate programs and develop health care industry ready talent.”

“Given increases in demand for talent to analyze the data, health care organizations should be seeking university partnerships to develop focused curriculum programs, research projects and placement opportunities,” comments Tom Schwarz, Ph.D., dean of Stetson’s School of Business Administration. “The growth of the health care industry in Central Florida provides a tremendous opportunity to contribute to the regional economic growth of the area and attract leading organizations and professionals to the area.”

Announcing Our 2014-2015

LEADERSHIP ORLANDO Class Chairs

William G. Oakley President/CEO Goodwill Industries of Central Florida, Inc. Chair, Leadership Orlando Class 86

Carol Craig Founder and Chief Executive Officer Craig Technologies Chair, Leadership Orlando Class 88

John M. Lewis Chief Executive Officer LYNX Chair, Leadership Orlando Class 87

Tony Jenkins Market President for Central and Northwest Florida Florida Blue Chair, Leadership Orlando Class 89

With over thirty years of proven success, Leadership Orlando, America’s largest “Community Leadership Program,” continues to recruit, cultivate and encourage emerging and established leaders, to better serve the Central Florida Region.

ENROLL TODAY! Contact Kathy Panter at 407.835.2499 or Kathy.Panter@IdeasToResults.org.

Visit us online: LeadershipOrlando.org for Class Schedules and Enrollment Information.

S

SPECIAL REPORT / timely and topical

Obamacare { A CLOSER LOOK }

W

hy were Republicans willing to shut down the federal government and risk the first default in U.S. history to repeal or scale back the Patient Protection and Affordable Care Act (ACA)—Obamacare? Why were Democrats willing to risk the same to preserve it?

Does the ACA represent a massive, unworkable new federal program that will cripple businesses, reduce real worker wages and destroy the American health care system, as Republicans charge? Or, does it provide essential access to health care for millions of previously uninsured Americans, as Democrats claim?

Peeling back the layers of rhetoric surrounding the ACA and finding some essential truths about this controversial law is a daunting task. There’s no doubting

42 W EDITION 5 / 2013 • FORWARDFLORIDA.COM

the passion on both sides of the debate, but a close examination of the act, its origins and its potential future reveal that those passions may be less about the merits of the law—good or bad—than about the political weapon it has become in our nation’s partisan battles.

We’ll try to examine some myths about the ACA and provide accurate information that will better illuminate what the law is and isn’t. The goal is not to confirm or allay fears about the law, nor is it to buoy or temper support. We seek simply to replace hyperbole with fact as the debate moves forward.

WHAT DOES THE ACA ACTUALLY DO? It does many things, but here are the ones that are likely to affect the most individuals:

1. Beginning Jan.1, 2014, it requires all Americans not covered by employer-paid insurance or other programs to purchase health insurance or pay a penalty (the “individual mandate”).

2. Beginning Jan. 1, 2015, it requires all employers with 50 or more people to offer health insurance to full-time employees or pay a penalty (the “corporate mandate).

3. It establishes minimum standards for insurance policies.

4. It prohibits the denial of insurance because of pre-existing conditions.

5. It prohibits insurers from rescinding a policy once a person becomes ill.

• Who came up with the idea for the individual mandate? The Heritage Foundation. • 6. It creates health insurance “exchanges” as an option to purchase health insurance policies.

7. It provides premium subsidies to Americans making 400 percent of the poverty level.

8. It gives states the option to expand Medicaid to families making 138 percent of the poverty level.

THE HEART OF THE ACA IS THE INDIVIDUAL MANDATE, WHICH THE SUPREME COURT NARROWLY UPHELD IN 2012. WHO CAME UP WITH THE IDEA FOR THE INDIVIDUAL MANDATE? The Heritage Foundation. Yes, that Heritage Foundation. Others may have articulated some form of the idea before, but the conservative think tank’s Stuart M. Butler put it in the political mainstream during a 1989 lecture outlining a conservative alternative to universal, single-payer national health insurance. Point No. 2 in Butler’s program: “Mandate all households to obtain adequate health insurance.”

Butler likened a health insurance mandate to those for seat belts or auto insurance: “Neither the federal government nor any state [currently] requires all households to protect themselves from the potentially catastrophic costs of a serious accident or illness.”

Like the plan that became law, Butler also called for government support

(primarily in the form of tax credits) and changes to state Medicaid programs. There were numerous other features for the elderly not reflected in the ACA. Heritage maintained its support of the individual mandate through 2006, when it was the centerpiece of a Massachusetts health care bill signed into law by thenGov. Mitt Romney (with a Heritage scholar present at the signing ceremony).

As for Butler himself, he had dropped his support of the mandate by early 2012, saying “health research” and “advances in economic analysis” convinced him “an insurance mandate isn’t needed.”

HOW DID PRESIDENT OBAMA COME TO EMBRACE THE MANDATE, GIVEN ITS ORIGINS? Reluctantly. Obama spent the 2008 campaign opposing an individual mandate. During that year’s primaries, Hillary Clinton and John Edwards were proponents of a mandate and candidate Obama blasted them. One Obama television ad warned voters: “Hillary Clinton’s attacking, but what’s she not telling you about her health care plan? It forces everyone to buy health insurance, even if you can’t afford it, and you pay a penalty if you don’t.”

In 2009, the President finally accepted the mandate, coupled with an employer mandate to provide insurance for full-time workers, as the clearest path to health care reform.

WHAT DID OBAMA WANT IN THE WAY OF HEALTH CARE REFORM? At the outset of his campaign, it wasn’t clear. In the speech announcing his candidacy, Obama devoted 62 words to his call for health care reform. He used 87 words to praise ethanol and other alternative fuels. Later, he released a more fully developed plan, but the closest he came to an individual mandate was a proposal that all children have health insurance. Some of the eventual ACA was there, including the employer mandate and insurance exchanges. He even had a limited public, single-payer plan for small businesses and individuals.

WHY DOES THE INDIVIDUAL MANDATE START THIS COMING JAN. 1 BUT THE EMPLOYER MANDATE DOESN’T START UNTIL JAN. 1, 2015?

The administration exercised its discretionary authority to push back the employer mandate by a year, saying that the federal government wanted to give businesses more time to prepare for implementation. ACA opponents have used this delay to say even the administration knows the plan is unworkable.

WHAT ABOUT THE PROBLEMS WITH THE HEALTH INSURANCE EXCHANGES AND WILL IT DELAY THE INDIVIDUAL MANDATE? The exchanges opened for business on Oct. 1, in preparation for the upcoming individual mandate, and the results aren’t

W FORWARDFLORIDA.COM 43

• What is the Medicaid expansion, and why did Florida opt out? •

THE ADMINISTRATION EXERCISED ITS DISCRETIONARY AUTHORITY TO PUSH BACK THE EMPLOYER MANDATE BY A YEAR, SAYING THAT THE FEDERAL GOVERNMENT WANTED TO GIVE BUSINESSES MORE TIME TO PREPARE FOR IMPLEMENTATION. a family of four). Because Medicaid is administered by the states, the Supreme Court ruled that states did not have to participate (so far Florida and 21 other states are not participating). The ACA committed the federal government to cover the cost of the expansion, which for Florida would have meant an average of about $5.1 billion per year in extra federal funding for the next 10 years to insure an extra 1 billion Floridians. Gov. Rick Scott supported the expansion, but the Legislature rejected it, for now. At least one Super Region lawmaker, State Rep. Jim Boyd, R-Bradenton, said the Legislature could give the concept a second look.

CHRISTOPHER HALLORAN / SHUTTERSTOCK.COM

Once a fierce opponent of an individual mandate for health insurance, the president ultimately embraced the mandate as the centerpiece of his signature domestic legislation.

pretty. People can’t log in, individual information is wrong and it is unclear whether they have successfully signed up.

Administration spokespeople are leaving a tiny amount of wiggle room about the individual mandate, but for now the administration is relying on a “tech surge” (hiring more outside consultants) to address the problem. Here, too, opponents are having a field day.

ALL THE POLITICS AND GLITCHES ASIDE, DOES THE ACA PROVIDE UNIVERSAL HEALTH CARE COVERAGE? No. The Congressional Budget Office (CBO) estimates that 53 million non-elderly Americans are uninsured today. In a July 2012 report, CBO estimates that about 30 million of those Americans will remain uninsured by 2022.

44 W EDITION 5 / 2013 • FORWARDFLORIDA.COM

WHY ISN’T EVERY AMERICAN INSURED? Neither proponents nor opponents ever claimed the ACA would provide universal coverage.

The Supreme Court’s upholding the individual mandate guaranteed more Americans than expected will participate in the health insurance exchanges, which opened for business Oct. 1. However, in allowing states to opt out of the ACA’s expanded Medicaid program, the court ruling limits somewhat the number of poor Americans who will be covered.

WHAT EXACTLY IS THE MEDICAID EXPANSION AND WHY DID FLORIDA OPT OUT? As noted, the ACA expands Medicaid coverage to families making 138 percent of the poverty level (about $32,500 for

WHAT ABOUT THE CHARGES THAT THE ACA IS TOO BURDENSOME ON BUSINESS AND THAT IT WILL LOWER REAL INCOME? There is no question the ACA will create new requirements, paperwork and otherwise, for business, and FORWARD Florida covered many of these earlier (see Issue 3, Page 47). As for the impact on real income, it is likely some workers will experience a wage squeeze. More than a few businesses and other organizations may choose to lower workers’ hours below 30 per week, the point at which the mandate to provide insurance applies.

(Actually, employer insurance has been on the decline for some time. According to a 2012 report from the Employee Benefit Research Institute, the number of workers offered health insurance declined slightly between 1997 and 2010, from 70.1 percent to 67.5 percent. The number of workers accepting the insurance coverage dropped from 60.3 percent to 56.5 percent. Keep in mind, though, some of these workers may be covered by their spouse’s insurance.)

L

LEGISLATIVE UPDATE / policy making in action

VOICES OF THE SHUTDOWN OCTOBER BROUGHT AN EPIC BATTLE OVER GOVERNMENT SPENDING AND HEALTH CARE REFORM. WASHINGTON REPORT

We should not pass a short term budget unless it defunds #Obamacare.

SELF EXPRESSION. The government

shutdown that ended in October stirred deep emotions across the political spectrum. That the Patient Protection and Affordable Care Act (ACA)—also known as "Obamacare"—was at the heart of the shutdown only inflamed those passions.

Instead of rehashing the well-documented facts of the shutdown, we will use the words of those involved to capture the essence of what all sides believed the battle was about.

Most of the voices will be from Florida and the Super Region, though a few from outside the area will be called upon to help paint as full a picture as possible. Reflecting the era, many of these quotes come directly from the lawmakers' Twitter accounts.

"We should not pass a short term budget unless it defunds #Obamacare."—Sen. Marco Rubio (R) on July 11, in his first tweet explicitly tying an ACA funding

Marco Rubio SENATOR [R]

july 11

cut-off to the short-term funding and the debt ceiling legislation. Between then and the end of July, Rubio tweeted 30 attacks on the ACA, most of them about defunding.

Several were in concert with Sens. Ted Cruz, R-Texas, and Mike Lee, R-Utah, the other leaders of the defunding movement. "#ObamaCare is bad for both #FL06 families and job creators—please RT if you

agree," Rep. Ron DeSantis, R-Ponte Vedra Beach, also on July 11.

"President #Obama is giving business a break in @Obamacare, but not you. RT if you agree we deserve #FairnessForAll."— Rep. Ted Yoho, R-Gainesville, on July 17, attacking the administration's decision to postpone the mandate that employers provide health insurance to full-time employees without also delaying the mandate that all individuals have insurance.

"Listen, as long as Barack Obama is president, the Affordable Care Act is gonna be law. Defunding the Affordable Care Act through shutting down the federal government is not achievable."—Archconservative Sen. Richard Burr, R-N.C., on July 26, as the defund Obamacare movement gained momentum.

(For most of Congress' August recess, veteran D.C. prognosticators believed the effort to defund the ACA would be a rallying cry for the GOP base but that Congress would find a way to keep the government open. Soon after Labor Day, though, the mood began to change.)

W FORWARDFLORIDA.COM 45

LEGISLATIVE UPDATE

Ted Yoho

REP. GAINESVILLE [R]

President #Obama is giving business a break in @Obamacare, but not you. RT if you agree we deserve #FairnessForAll july 17

"Good news for hard working Americans. House will vote on short-term budget that avoids shutdown but will also #defundobamacare."—Rubio's tweet of Sept. 18, two days before the pivotal House vote on government funding.

"Starting now—House GOP holds rally following vote to protect all Americans from #Obamacare. #SenateMustAct."— House Speaker John Boehner, R-Ohio, on his official Twitter account Sept. 20, the day the House voted to pass a continuing appropriations resolution (CR) that stripped ACA funding.

/ policy making in action

"Proud to vote today with my House GOP colleagues to keep the government open while ending funding for this harmful law!—DeSantis' tweet the same day.

(Though the House would vote on additional, largely symbolic variations of the CR in the ensuing days, it was the Sept. 20 vote that signaled a government shutdown was inevitable. The measure passed the House along almost straight-party lines, 230-189, with every Super Region Republican voting for it and every Super Region Democrat voting against it.)

"During the government shutdown, I have asked to have my pay withheld."—Rep. Tom Rooney, R-Okeechobee, in an Oct. 1 tweet, the day the shutdown began.

"On this day #POTUS help (sic) move the country FORWARD with open enrollment for #ACA and #GOP moved country BACKWARDS by creating the #GOPShutdown."—Rep. Corrine Brown, D-Jacksonville, also on the first day of the shutdown.

(After the shutdown began, the House passed bills refunding parts of the government in an effort to force the president and the Senate to the negotiating table.

Facing an Oct. 17 deadline to increase the federal debt limit or face even more draconian funding restrictions, some GOP House members began to press for negotiations while also trying to downplay the significance of the debt ceiling.)

"Open dialogue critical to any negotiation. Partisan blame-game will not turn on a single light or put a single American back to work #shutdown."—Rep. Vern Buchanan, R-Sarasota, in a tweet on the second day of the shutdown.

"It is a fact that hitting the debt ceiling does not automatically trigger a default. Our nation would default only by not being able to service our debt. Contrary to the naysayers, the U.S. Treasury takes in enough money to service our debt. After that, it is all about prioritization of spending—something that should have been done long ago."—Yoho in an Oct. 10 USA Today guest editorial.

"Thanks to all who took my survey on the govt shutdown last week. I agree—both sides need to negotiate."—Rooney's tweet of Oct. 15, the day before the crisis ended.

(Ultimately, the majority in Congress was not as sanguine as Yoho about what would

IN TALLAHASSEE FLOOD INSURANCE FIX? Against the

backdrop of the government shutdown, state leaders in early October began a full-court press for the federal government to postpone significant rateinsurance hikes.

Gov. Rick Scott fired the first shot in an Oct. 1 news conference in Clearwater, where he said: "We are calling on President Obama to take immediate action to prevent these flood insurance hikes on Florida's families. This is unfair and could devastate the Tampa Bay area's real estate market."

Scott was joined by St. Petersburg Mayor Bill Foster, state Sens. Jeff Brandes, R-St. Petersburg, and Jack Latvala, R-Clearwater, as well as other state lawmakers and local officials. At the news conference, Latvala said, "It's a problem that needs to be addressed by the federal government now—and not later."

The shutdown undoubtedly delayed action, but it appears Scott and his colleagues' pleas may be answered. On Oct. 26, Rep. Maxine Waters, R-Calif.,

46 W EDITION 5 / 2013 • FORWARDFLORIDA.COM

announced a bipartisan deal to delay the rate hikes called for in legislation the congresswoman had passed earlier.

Calling the ill-effects of that bill "unintended consequences," Waters indicated the bipartisan compromise would include a four-year delay in most rate increases.

The crisis was triggered by the passage of Waters' 2012 bill reforming the National Flood Insurance Program (NFIP), the sole provider of flood insurance. Seen as critical last year because the NFIP was $18 billion in

debt, with about $15 billion of that debt coming from the damage caused by 2005 Hurricanes Katrina and Rita. To address the problem, last year's bill cut off federal NFIP subsidies to some 430,000 policyholders immediately, and another 715,000 policyholders' subsidies were set to be phased out.

Waters indicated new legislation would be circulated in the House and Senate the last week of October in hopes that the legislation could be passed quickly by both chambers.

LEGISLATIVE UPDATE

Corrine Brown

REP. JACKSONVILLE [D]

On this day #POTUS help (sic) move the country FORWARD with open enrollment for #ACA and #GOP moved country BACKWARDS by creating the #GOPShutdown.

october 1

happen on Oct. 17. Senate leaders from both sides of the aisle brokered a deal to end the shutdown.)

"The government will open tonight but the real crisis remains. Congress did nothing to address our real problems."— Rubio's tweet on Oct. 16 after he voted against the compromise to reopen the government. The CR passed the Senate anyway, 81-18.

"Our children and their children deserve to inherit a country whose reputation is untarnished for meeting its obligations."— Buchanan, also on Oct. 16, explaining via Twitter why he was one of three Super Region Republicans to vote for the CR. The House passed the Senate version of the CR, 285-144.

"Looking forward to Congress tackling immigration post-shutdown as the economy will need a boost!"—Rep. Kathy Castor, D-Tampa, in one of the few forwardlooking tweets on the night shutdown ended.

"Voted last night to reopen government, maintain historic spending cuts and remove threat of default."—Rep. Daniel Webster, R-Winter Garden, in one of the other upbeat tweets Oct. 16.

"We fought the good fight, but we lost."— Boehner, in a Cincinnati radio interview that same afternoon, signaling he would urge his GOP colleagues to vote for the Senate compromise that would reopen the government.

"There's no education in the second kick of the mule."—Senate Minority Leader Mitch McConnell, R-Ky., when asked if the Republicans would try to shut down the government again.

"No."—President Obama, when asked if

/ policy making in action

he anticipated a second shutdown.

(For the record, the CR funds the government through Jan. 15, 2014, and suspends the debt ceiling until Feb. 7. Stay tuned.)

REFLECTIONS ON BILL YOUNG. An excellent appreciation of the life and accomplishments of the late Rep. C.W. Bill Young, R-Indian Shores, can be found in COUNTY REPORT (see Page 16). Here, we offer a telling story about the extent of the power Young possessed and the way he wielded it at the height of his congressional career.

One day in early 2000, a Democratic congressman who served on the House Appropriations Committee was meeting with a trade association that represented a sizable employer in his district. His chief of staff was in the meeting and, after about 15 minutes, she looked at her watch and said in a voice approaching reverence, "We're going to need to leave in 10 minutes. We have a meeting with Mr. Young."

There wasn't any question in the lobbyists' minds about who "Mr. Young" was, nor was there any surprise at the reverence he was accorded by a member of the opposing party. As chairman of the Appropriations Committee, he was an oldschool legislator who believed in earmarks, was unapologetic about the occasional need for deficit spending or for using the appropriators' power to further political as well as policy goals and—as he hinted in the retirement announcement made a week before his death—a believer in according respect to everyone elected to the U.S. House, regardless of party.

Ironically, he also became chairman of

The late Rep. C.W. Bill Young was an old-school legislator who believed in earmarks and was unapologetic about the occasional need for deficit spending or for using the appropriators' power to further political as well as policy goals.

the Appropriations Committee at more or less the exact moment the federal budget begin showing surpluses for the first time in three decades. It was a signature achievement of the "Republican Revolution" of 1994 and a rare triumph of bipartisan relations with the Clinton White House.

The goal of budget surpluses would evaporate less than two years later, but at that moment the Democratic congressman in question knew the pressure "Mr. Young" was under from his party's leadership. The congressman knew he would get a fair, even sympathetic hearing from the chairman, but he also knew his case had to be airtight and have a minimal impact on the overall budget surplus. Honoring Young and his way of doing business came first, and everything else, including the large employer in the congressman's district, was going to come second.

That's how you define power and respect on Capitol Hill.

WRRDA. Not everything in Congress is contentious these days. In late October, the House passed H.R. 3080, the Water Resources Reform and Development Act (WRRDA) of 2013 by an overwhelming margin, 417-3.

House leaders touted the legislation as a sign that bipartisanship still lives on Capitol Hill, and Super Region legislators praised the move.

"Crucial investment in FL's future economy and environment passed the House just now," Webster wrote in a tweet moments after the Oct. 23 vote. Earlier in the evening, Webster alerted his followers to watch his comments during House debate. Webster is a member of the House Transportation and Infrastructure Committee that initially passed the bill.

WRRDA authorizes 23 water projects for the U.S. Army Corps of Engineers and also deauthorizes $12 billion worth of old projects. The legislation also reaffirms that Congress should pass a new WRRDA every two years.

Every Super Region lawmaker voted for the bill except Castor, who did not cast a vote.

A separate water resource bill passed the Senate in May, 83-14. Sen. Bill Nelson (D) supported the measure while Rubio opposed it. It was unclear when the magazine went to print whether the Senate would consider the House version of the bill or ask for a conference to resolve differences between its measure and H.R. 3080.

W FORWARDFLORIDA.COM 47

W

WELLNESS / your personal bottom line

BAL ANCING

ACT A tip for the scale: Totally depriving yourself is not the answer to weight loss.

I

f you are one of those people who feel certain foods call out to you, you are not alone. Many of us experience that cacophony all the time.

It usually emanates from foods that are not necessarily the healthiest, but they sure taste good!

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WELLNESS / your personal bottom line The old adage that we should eat to live versus live to eat is a wise one. But like everything in life, there must be a balance. Studies have shown that most successful weight-loss stories involve people eating what they love occasionally and not totally depriving themselves.

In the U.S. alone, about 70 percent of people are overweight. So weight management is a huge health concern, and the holidays do beckon with foods that would tempt even the most disciplined.

And when we think of holiday parties, there are usually beverages available.

While alcohol is fat free and low in carbs, there are calories to consider. Even if you are careful about your alcohol consumption, all drinks are not created equal on the dieting scale and some choices are better than others. If you’re going to imbibe, wine is the most calorie-friendly selection with a typical 20 calories per ounce. Some bottles of beer contain nearly 200 calories. Light beer would be the best choice if you are a beer drinker.

A sampling of 1.5 ounces of hard liquor will generally fall in the 100 calorie range. But keep in mind that is just the alcohol, not the calories from whatever mix you may choose for your drink.

6. FIND A BUDDY. Team up with a household member or join a support group for better results.

7. TOSS THE JUNK. Discard any

food or drinks that would interfere with your weight-loss plan.

8. SLEEP WELL. Women who

sleep under five hours a night are 32 percent more likely to have major weight gain than those who sleep more than seven hours.

9. CHECK YOUR MEDS. Many

medications can lead to weight gain—ask your health care provider if you’re concerned.

10. SIMMER DOWN. Stress can

increase your risk of weight gain.

Fortunately, exercise helps both manage stress and promote weight loss.

Where to begin? Here are some excellent weightmanagement tips:

1. WRITE DOWN EVERYTHING YOU EAT. Doing so increases your

chances for weight loss. Studies show people underestimate how much they eat.

2. TURN OFF THE TV. Television

and other screens encourage us to be sedentary. Study participants who cut their TV time in half burned an extra 120 calories a day.

3. EAT MORE FIBER. Americans

only eat about half the recommended daily amount they need. Get more fiber from whole grains, legumes, fruits and vegetables.

4. DRINK MORE WATER. Two

cups of water before each meal fills you up and may lessen your appetite, which may help you shed more pounds.

5. STEP ON THE SCALE.

Individuals who weigh themselves more frequently (at least weekly) are more successful at weight management.

While working on a weight-management routine, be mindful that science shows a strong connection between excess abdominal fat and some of our most serious diseases. People with wide girths often have large amounts of “hidden” visceral fat around their internal organs, which raises the risk of type 2 diabetes, heart disease, stroke and some cancers.

Belly fat alarms health experts because it can produce inflammatory substances that promote these diseases. Though overweight people have too much belly fat, even normal-weight adults are at risk if they carry excess pounds around the middle. So what is “excess” fat? It’s a waist measurement of more than: 40 inches for men 35 inches for women To measure weight circumference: Run a tape measure around your torso just above your navel.

The good news is that belly fat appears to be the first to go when you lose weight. Santa Claus best be careful.

PERILS OF PROCESSED FOOD

For centuries, people have “processed” foods, from pickling cucumbers in vinegar to sweetening fruit jam with sugar.

Thousands of food additives are used to maintain or improve the freshness, taste, texture, appearance or nutritional value of products. Some are familiar, such as vanilla or yeast, while others have hard-to-pronounce names.

Federal agencies determine whether an additive is “generally recognized as safe” (GRAS). But safe isn’t the same as desirable: Many processed foods contain added fat, sugar and salt, which can contribute to health problems.

In addition, certain sensitive individuals may experience negative reactions. For example, someone who is allergic to soy may have a reaction to soy-derived lecithin or hydrolyzed vegetable protein.

ON THE RADAR: 1. Sulfites can trigger asthma attacks.

2. People with phenylketonuria (PKU) should avoid foods and beverages with aspartame.

3. Monosodium glutamate (MSG) and nitrates can cause headaches and chest pain.

4. Artificial fats can cause an upset stomach.

5. Although controversial, some parents insist that artificial colors and flavors cause hyperactivity in their kids.

BEST APPROACH? Read labels carefully and call the product manufacturer if you have concerns. If you have unpleasant symptoms after consuming certain foods or beverages, keep a log to determine common additives. If you have a health condition, ask your doctor or health care provider if you might react to particular additives (for example, tyramine in cheese for migraine sufferers).

W FORWARDFLORIDA.COM 49

P

PARTING SHOT / people and places across the super region

LAKERIDGE WINERY & VINEYARDS CLERMONT

In 1988, Gary Cox and some investors envisioned opening a winery in Central Florida.

Today that vision is known as Lakeridge Winery & Vineyards, a producer of more than 80,000 cases of wine (960,000 bottles), making it the largest winery in the state. Set on 127 aces of rolling hills, it supplies the majority of fruit for both the Lakeridge and San Sebastian labels, which together have won more than 1,000 awards for excellence in winemaking. Its 2013 harvest, completed in late September, collected 1,813 tons of grapes, yielding nearly 314,000 gallons of fermenting juice. Another impressive tally: Each year, more than 110,000 people visit the winery, where they enjoy the tours and festivals. Think red and white, and the green of economic impact.

50 W EDITION 5 / 2013 • FORWARDFLORIDA.COM

The best defense may be a good offense …

But it begins with well-trained forces.

Since the 1940s, when some of the earliest military flight simulators were developed in Central Florida, Metro Orlando has been center stage in the creation of simulation and training tools. Today the region hosts the largest concentration of industry and military simulation activity in the country: ■ 1,000+ companies ■ More than 27,000 direct jobs ■ Average salary of nearly $70,000 ■ Employment impact exceeds 60,000 jobs ■ Navy, Marine & Army Simulation Commands ■ World-renowned Institute for Simulation & Training at UCF ■ Annually home to I/ITSEC … the world’s leading simulation trade show

Metro Orlando … the World’s Epicenter of Modeling & Simulation

www.OrlandoSimulation.com Use of military photos does not imply or constitute endorsement by the U.S. Department of Defense.

WE CAN DO IT! DECLARE WAR ON BREAST CANCER.

Dede

Breast Cancer Survivor

JoinThePinkArmy.com. Get screened. Donate.

Enlist today at JoinThePinkArmy.com.

MKTGPR-12-10903

We’re at war. Let’s arm ourselves to win. By enlisting passionate soldiers, getting your annual mammogram for the best intelligence on what the enemy is doing and spreading the word, we can accomplish our mission!