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Hospital panel may require voter approval of taxes

Tallahassee, FL - Tuesday, November 8

Published in the Ocala Star Banner on Tuesday, November 8, 2011

Florida public hospital districts that raise taxes for health care may face extinction unless they are endorsed by voters.

That’s one of the key recommendations being considered by a commission appointed by Gov. Rick Scott to study the role of tax-supported government hospitals. Scott, a former for-profit hospital executive who has questioned the role of tax-supported hospitals, created the commission last spring. He directed it to determine if “it is in the public’s best interest to have government entities operating hospitals.”

Facing a Jan. 1 deadline for its report, the 10-member Florida Commission on Review of Taxpayer Funded Hospital Districts is starting to discuss its recommendations but has not taken any formal positions.

Recommendations will go to the Legislature, which ultimately would decide whether to enact any of the proposals.

On Monday, the commission heard from state Rep. Larry Metz, R-Eustis, who is preparing a bill that would abolish a Lake County hospital district unless voters reapprove it in next year’s election.

Metz’s bill would also make other changes to the district, including specifying that the property taxes raised by the district be restricted to the care of the poor — not for more generic “hospital services.”

It would also put the district — if approved by voters — under a 10-year “sunset” provision, meaning the district would have to be renewed every decade or face an automatic abolition.

Dominic Calabro, the hospital study commission chairman, said some of the concepts in Metz’s bill may be recommended by the panel.

Calabro is president of Florida TaxWatch, a pro-business research group that authored a 2009 study that identified 16 hospital districts in Florida that could raise property taxes. The report suggested the need for a comprehensive review of the districts, saying some have evolved far beyond their original concepts, which for some hospitals date to the 1920s.

Calabro said the commission is focusing on eliminating “conflicts” that arise when tax-supported public hospitals compete with other non-tax supported hospitals. He said the commission’s research has found that the cost of care in the government hospitals is about 11 percent to 12 percent higher than other hospitals.

The panel is moving toward consensus on the idea that if tax dollars are raised for indigent care, it could be used by any facility in the region that treats the patient and not just the government hospitals, Calabro said.

He also said he liked Metz’s idea of restricting the tax money to indigent care, rather than allowing a broader use of the funds.

But Paul Duncan, another commission member and a health care researcher at the University of Florida, cautioned against restricting how districts could use tax money.

“If that hospital isn’t there in the first place, we aren’t going to start that conversation” about indigent care, he said.

Calabro said other potential recommendations could involve requiring more audits and revising the way district board members are appointed or elected.

Many of Florida’s hospital districts were enacted by special laws passed by the Legislature. Sarasota Memorial, for example, is governed by a 1949 act that created the Sarasota County Public Hospital Board.

Brad Dinkins, an Ocala businessman and another commission member, said he supported giving local taxpayers a say in the districts.

“I think there is a consensus that we want to see more accountability. We want to see more transparency. We want to see the citizens of the districts treated more fairly and more responsibly,” Dinkins said. “And then we want to give those people a vote on how and when and where their taxes are spent.”

The committee’s work is being monitored in Ocala because of the debate about whether Munroe Regional Medical Center should pursue tax support to help cover indigent care.

The hospital study commission has three more meetings scheduled before its Jan. 1 deadline, with the next meeting set for Nov. 21.

http://www.ocala.com/article/20111108/ARTICLES/111109727


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