It has taken over 2 months to get one of the local newspapers to cover the problems with the North Lake County Hospital District, and the Orlando Sentinel's Christine Show did call new Board member Marilyn Bainter, plus myself, and also TRIED to get responses from the other Board members. As noted in the article below, NONE of the other elected District Board members or the attorney returned calls to the reporter, or if they did, they had "no comment".
You can read our earlier list of issues HERE, and HERE.
This lack of respect for the taxpayer or the reporter smacks of cronyism, when the other Board members won't even return calls to the press. This, to me, means that problems are deeper than we thought and this might be a smoking gun where the District Tax collections of over $12-million might be going for improper expenditures.
For instance:
- A main issue is that the two major hospitals ( Leesburg and Waterman) receiving taxpayer funds totaling $12.7-million but had total profits per Marilyn Bainter of over $28.4-million, thus our taxes are subsidizing their profits. (They each also give 5% of their total tax distribution to Lifestream which also runs a local hospital). They are supposed to be non-profit organizations and should be absorbing some community costs. Instead, the reporter took info from the hospitals, and only compared the received $12.7-million total to the claimed totals spent for "underprivileged" services which were much more. The problem is that the District Board doesn't demand or ensure the hospitals take any clear action to collect unpaid bills before claiming a loss. Thus, it could be possible that anyone that stiffs the hospital is not pursued by collection actions to get payment. (Hospitals are required by Federal law (I think it is Federal) to take anyone into emergency services without verifying ability to pay - that is why so many illegal immigrants, etc. know they can can get services in the emergency ward, then never pay for it.)
- Since Leesburg Hospital gets lots of business from Sumter County and the Villages, Lake County residents may be subsidizing Sumter residents who do not have such a Hospital District Tax because they go to the Leesburg hospital, and do not provide subsidies to the Hospital like Lake County residents.
- State legislators, including Marlene O'Toole (Villages), Carey Baker, and Alan Hays put off having a meeting earlier this year to change the District tax laws so the Board "could" vote to assess a lower tax millage rate than the current, automatic 1-mill annual tax rate on all North Lake County property owners. Carey Baker told me that he postponed the meeting, originally scheduled in Tallahassee, until the next annual Lake County legislators meeting in November or December, which means the Tax Board would be able to approve another 1-mill tax in their annual September meeting without discussion. However, at the last annual legislator's meeting, Marilyn Bainter and other supporters tried to speak at the legislator's meeting, and Baker postponed their public input until the very end of the meeting when very few people were left to hear the issue.
This all smacks of insider issues, and O'Toole, Hays and Baker may be receiving funds from the Villages or other people, who want Lake County taxpayers to keep subsidizing hospital services to Sumter County Villages residents. I don't have formal evidence of this, but judging by the attorneys that showed up at the last District Board meeting, it seems the Villages and the Hospitals have a big interest in deferring any activities to investigate or allow reduced tax rates.
Naturally, I don't expect to be asked to any cocktail parties by the legislators. They may be doing a good job in other areas, but I am focusing here on this fiscal fiasco.
- The funds only go to three local hospitals, and no funds go to the County Health Department, or other hospitals and clinics in lake County, thus tax funds are creating a non-competitive environment in Lake County. Why should only three hospitals (includes Lifestream, Leesburg and Waterman) get funds and not other health service departments or competing organizations.
- There seems to be a conflict of interest. One or more Hospital District Board members are also on the Boards of the local Hospitals. More details later.
- I just received from Hospital Board member Marilyn Bainter a Form 990 schedule of the fees paid to Board members of Waterman Hospital. Not all Board members are in Lake County, and several only work an average of 1 hour per week on Lake County's Florida Hospital - Waterman related matters. Although they did not receive any compensation for Waterman Board duties, they receive compensation and "other benefits" from the parent company ranging from $280,000 up to $2.5-million. Out of the nine listed Waterman Board members, only 3 list a Lake County address, thus most of the hospital governance is by people from outside Lake County. This gives you an idea of the incentives to maximize income from the Hospital District tax collections.
- The GAO finished an audit in Sept., 2008 at the request of Senator Charles E. Grassley, Ranking Member of the Committee on Finance in the United States Senate. The purpose was to examine the non-profit status of "non-profit hospitals" that received tax exempt status if they provided "community benefits". The GAO found inconsistent definitions of "community benefits" and the report is 75 pages long. We will review the report and cover it in a future blog posting. However, the issue here is that if the hospitals are claiming "community benefits" in order to qualify for tax exemption, why is Lake County subsidizing those "community benefits"? i.e. if I have a business lunch and submit a receipt to claim a tax deduction, is it proper if another person actually paid for the lunch? So, we have another issue to explore in this Hospital tax quagmire. It seems like every rock we turn over has a scorpion underneath it.
Conclusion:
It seems the only way to get the Board's attention is to shift emphasis from getting the law changed to allow variable tax rates to instead initiate outright campaigning that the North Lake Hospital District Board vote at their meeting in September to NOT give any tax to the hospitals unless public hearings are held to substantiate the value of the contributions and evaluate how well and where the funds are really spent (details are currently not available).
- I will add more details in future blog entries as a I get them.
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orlandosentinel.com/news/local/lake/orl-lklnorthlake05040509apr05,0,4424376.story
OrlandoSentinel.com
Marilyn Bainter seeks openness for hospital taxing board
Christine Show
Sentinel Staff Writer
April 5, 2009
Marilyn Bainter of Eustis is shining a light on an obscure Lake County taxing
body that quietly dispenses millions of property-tax dollars annually to help
cover the cost of medical care for the poor at Florida Hospital Waterman and
Leesburg Regional Medical Center.
Bainter, elected in November to the
six-member North Lake Hospital District board of trustees, is on a crusade to
make the taxing district more accountable to taxpayers. She criticized the
agency for failing to tape-record meetings and not having a system to make it
easy to access public records.
She also is pushing for a change in state
law that would allow trustees to be more flexible in how they set the tax rate
every fiscal year.
"I think there needs to be a whole lot more
transparency," said Bainter, wife of former longtime state Rep. Stan Bainter,
R-Eustis. "Doesn't everyone want to know where their tax dollars are
going?"
The taxing body collects taxes from residents in the county's
northern region, from Mount Dora to Lady Lake. The tax proceeds help Florida
Hospital Waterman and LRMC cover costs for care of a range of people who are
unable to afford hospital services. LifeStream Behavioral Center shares a
portion of the sums already given to the two hospitals needed for indigent
health care.
More flexibility
One aspect of the district that Bainter is most passionate about is the fact that it has a fixed tax rate of $1 for every $1,000 of a home's taxable value. So, for example, a house on the tax roll for $150,000 with a $50,000 homestead exemption would pay $100 in hospital-district taxes.Bainter, 73, wants to make it so trustees have the option of setting the tax rate at up to $1, which would leave room for the taxing body to set the rate lower if they decide to do so. This would compel board members to think about how much tax dollars should be spent each year, she said.
"I'm just asking for the board to have a choice," she said.
Calls to trustees Frank Gaylord, Kenneth Carpenter and Roger Beyers were not returned. Board member William Bowersox said he had no comment on the issue. Board member William Talley would not comment, referring questions to the board's lawyer, M. Meredith Kirste. Kirste also did not return a call for comment.
Hospital officials stressed that the tax proceeds help provide the hospital with support to take of those who are unable to pay for services.
"What these tax proceeds do is they go to help offset what it costs the hospital to provide that care," said Ken Mattison, president and chief executive officer of Florida Hospital Waterman. "I would love to have those who believe somehow a hospital does not need those dollars to walk in the shoes of a nurse or physician."
Uncertainty
The total cost for care of the underprivileged for Florida Hospital Waterman in 2008 was $16.5 million. The hospital received almost $6.6 million in property taxes last year.Lee Huntley, LRMC president and CEO, said if the tax rate was not set at a fixed rate each year, it would add uncertainty to hospital finances and threaten the continuation of current services.
LRMC counts on proceeds from the fixed tax rate to help determine how indigent care is paid for each year. The total cost of "charity care, bad debt and government shortfalls" was just under $39 million in 2008. The tax proceeds amounted to about $5.2 million.
But advocates of Bainter's proposal want to see more openness for the taxing body.
"There seems to be all these underlining issues, and the only way to resolve it is to get it out in the open," said Vance Jochim, 64, a Tavares resident who runs a blog called the Lake County Fiscal Rangers.
Little scrutiny
Aside from the tax rate, other concerns about the taxing district on Bainter's list:•The location for the district's three meetings each year is in a small room inside the Lake County Water Authority at Main Street and Lake Avenue in Tavares.
•The district does not have a Web site.
•Minutes of meetings, financial records and all other materials are not easily accessible to the public. Such documents are stored in a file cabinet located at the office of the board's accountant, Patricia A. Sykes-Amos, in Mount Dora.
Bainter, who ran an unsuccessful bid in 1990 for county commissioner, spent about $2,900 on her North Lake Hospital District race, during which she emphasized her idea that the tax rate should be more flexible, in an unusual contested election for the low-profile board.
Lake residents may be unfamiliar with the district, whose trustees routinely do not face opposition and therefore are elected automatically and without their names being placed on the ballot. Trustees are unpaid and serve four-year terms with a maximum of two terms.
The North Lake district also rarely receives media attention. The board is only scheduled to meet three times a year — once at the beginning of each calendar year and during two mandatory public budget hearings.
Speaking out
This is not the first time Bainter has been outspoken about special taxing districts. In 2006, she called for the Lake County Water Authority to be dissolved. Although her husband was a member of the board at the time, Bainter said the water authority was outdated and eliminating it would have cut down on bureaucracy.In her hospital-district campaign, she and supporters made about 4,000 calls to voters. It paid off. In a race in which the top two vote-getters won seats, Bainter topped the field with 42 percent of the vote.
At Bainter's first meeting as a trustee in January, she asked for the meetings to be taped and requested a second meeting be called to address the tax rate. The board agreed to tape-record meetings but rejected her request for a second meeting.
Bainter has sought the help of Lake County's state legislative delegation to address the legislation's language on the tax rate to provide more flexibility.
Although she expects difficulty ahead, Bainter said she will continue to fight for accountability by district trustees.
"I knew this is what I had to do when I ran," she said. "You don't make any progress if you don't try."
Christine Show can be reached at [email protected] or 352-742-5917.
Copyright © 2009, Orlando Sentinel
