Miramar and Pembroke Pines HomeCare Agency, A Family Member HomeCare, Notes Florida Current Report: Bill aimed at Lake hospital district offers glimpse of Taxpayer-Funded Hospital District Commission recommendations

The Florida Current; by Travis Pillow, November 7, 2011--A proposed bill that would dissolve the North Lake County Hospital District and propose a revamped district in its place, subject to a referendum, offers a preview of some of the policy recommendations likely to emerge from a statewide commission studying hospital taxing districts.

Dominic Calabro, the chairman of the Commission on Review of Taxpayer Funded Hospital Districts, said draft legislation by Rep. Larry Metz, R-Eustis, offers a framework that "could be applicable statewide, to give the voters a chance to have a say, and also restructure how they want the districts governed, if they want them at all."

In place of the current North Lake Hospital taxing district, which levies 1 mill to support the "continuation of hospital services," Metz's bill would propose a new district dedicated to providing "a means to pay for health care services for medically indigent persons who are qualified residents" — meaning some of the money could flow to other providers located in the district.

The replacement district would have to be approved by a local referendum next year, and its board would have more power over how the money is spent, including authority over which providers can receive tax dollars for the indigent care they provide. Under current law, the money is automatically allocated to Leesburg Regional Medical Center, Florida Hospital Waterman and LifeStream Behavioral Center.

Metz said that under his proposal, money would "follow the patients," borrowing a phrase from Gov. Rick Scott's executive order that created the review commission. It includes other provisions Calabro views favorably, such as a ten-year sunset clause.

Waterman president Kenneth Mattison said in a letter that if the current district is dissolved, the loss of revenue would "significantly disrupt" the financial support for the indigent care provided by the hospitals.

"If we lose this funding in the face of decreasing Medicaid and Medicare reimbursements, it will limit everyone's local healthcare options at a time when your community needs local healthcare access more than ever," he wrote.

Metz said he intends to introduce the bill after the public weighs in during a 41/2-hour meeting of the Lake County Legislative Delegation on Wednesday.

"I have to look at the bigger picture of what the taxpayers deserve," he said. "They don't deserve an entitlement system that has no accountability or transparency in it."

Although the bill may foreshadow some of the hospital review commission's recommendations, lawmakers have been skeptical of addressing all of the districts in a single legislative package. Metz's proposal stems from local concerns about the current North Lake district (the foment includes a court challenge of its taxing authority, as reported by the Orlando Sentinel), and a campaign promise he made to address them.

The report is due to the Legislature and governor Jan. 1, 2012. The commission decided it would not be able to conclude whether the quality of care at government-operated hospitals is better or worse than non-government operated facilities, one of the tasks called for in Scott's executive order.

Commission staff director Jeff Gregg told commission members that it's not a "bad thing" if the commission were to note in its report that it was unable to directly connect the cost and quality of health care, adding that the current outcome measurements are not sophisticated enough yet to allow the commission to compare hospital to hospital.

Calabro said that the commission can still advocate that consumers "empower" themselves with available information, such as comparisons of hospitals' performance on specific procedures.

The group, which has spent the summer discussing hospital taxing districts, has agreed that the costs of care at 21 government-operated hospitals is between 11 and 12 percent more expensive than their commercial sector counterparts. The number is based on a presentation made by Florida State University associate professor Keon-Hyung Lee with input from University of Florida professor and commission member Paul Duncan.

Although the figures were disputed by the Safety Net Hospital Alliance of Florida, which questioned whether the analysis controlled for all the differences between public and private hospitals, commission chairman Calabro noted, "You can't let perfection get in the way of goodness."

Reporter Christine Sexton contributed to this report.

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