Update 2: We added a second article from the Orlando Sentinel at the bottom of this document.
The North Lake County Hospital Tax District Board meeting is tonight at the Lake County Commission Building (the old ROUND courthouse) on Main st. in Tavares. Official start time is 5:15 pm (the article below says 5:30 pm, but don't believe it), but the hospital staffs, their investors, management and supporters of taxpayer funded free healthcare may try to fill the seats so get there early to get a seat.
At the bottom of this page is an article published today in the Daily Commercial about the Hospital District. It fairly describes the issues and quotes Marilyn Bainter, a new member on the Hospital Tax District Board who has been the initiator of questioning the purpose of the District and legitimacy for the automatic 1 mill tax.
The issue is that the Board will vote like they have for 40 years and approve an automatic 1 mill property tax on North lake propery owners without any investigations, dialog or power to reduce the millage rate to keep in line with actual economic indicators.
The Board will consider two resolutions - one to continue, and one to drop the Hospital District. We think this is purely a ploy to claim they had a public hearing and vote to continue the District so they can give an "official" recommendation to the local County legislators when they have their own public hearing on continuing or modifying the legislation defining the District.
If you are a North Lake County property owner, here is what you need to know:
- The Board automatically approves a 1 mill property tax on you and splits the approximately $11-12-million between the two local hospitals, Leesburg, and Waterman. The legislation is VERY vague about how the funds are used, and the Board rarely ever asks for information on exactly how it is spent and the return to the community. Instead, they are given "audited" financial statements showing the hospitals have large bad dept, and charity care spending.
- Only 10 Florida counties out of 67 have such taxes. So, ask your Hospital District Board member or legislator why we in Lake County have to pay such taxes when they are not needed in most counties. Is it that the Hospital management are not capable of competing with hospitals in other counties?
- By giving the tax only to the two local hospitals, they get a competitive advantage over any other competitor, including clinics or other hospital chains that might want to open an office here.
- Neither Hospital has a "trauma" center, so why haven't funds been used to create them here?
- A hospital supporter says if LRMC loses their tax revenue, their bond rating would drop. Is that a reason why property owners should be taxed? Why can't the hospital management achieve the desired bond rating without taxing the local property owners?
- The Board needs to evaluate the level of management compensation and huge deferred compensation and determine if the taxpayers should be contributing to that.
- The hospitals are non-profit hospitals, thus taxpayers are already giving them millions in tax breaks vs a for profit organization. Why should local property owners be taxed to provide another subsidy.
- LRMC has a second hospital by the Villages and many patients are from Villages homes in Sumter or Marion counties which do NOT have similar hospital tax assessments. Thus Lake County property owner taxes are subsidizing residents of those counties, including many of the retirees from the Villages whose Medicare or Medicaid plans may not cover full costs of services. As a consequence, we think the hospitals should have a discount only for Lake County residents, and not those from other Counties.
- I have watched the Lake County School Board go through spending plans on a line by line basis, but the Hospital District Board does no such thing. In the past, they have had 15 minute meetings and approved the 1 mill tax without negotiating any conditions from the hospitals (like create a trauma center, or prove they actually have tried to collect on bad debts).
There are many issues, which should be investigated by the Board, but all Board members but Marilyn Bainter were appointed or elected without opposition, and pretty much always vote to automatically give the funds without questions.
Our recommendation is that the Hospital District Board should recommend to the local Legislators group to change the existing law to specify:
- The allowable millage rate should be made flexible, so the Board can select any amount between 0 and 1 mill, rather than the current allowable choices of only 0 (zero) mills OR 1 mill,
- The Board should be mandated to budget at least $20,000 per year to hire a forensic auditor to investigate the actual spending (not what is in the financial statement) to determine the TRUE uses of funds and the value provided to local taxpayers. Are the funds going for excess salaries and free lunches, or are they going to highly needed equipment that benefit local Lake County (not Sumter or Marion) residents.
- The legislation should clearly define the fiduciary responsibilities of the Board to investigate actual funding, and to publicly have hearings and publish results for public comments before decisions at public hearings.
Additionally, The Board and the Local legislators group should recommend and initiate a new tax referendum so the public can vote whether to continue any hospital taxes based upon an open, public dialog. After 40+ years, we think it is time for another public vote on the merits and value of the tax.
See you tonight!
If you attend the meeting tonight, please line up or register at the Board meeting to give
public comment, and the major issues to support are:
-
After 45 years of the Board mostly rubber
stamping a 1 mill tax without investigating details of provided services, it is time to modify the legislation
to allow the possible tax rate approved by the Board to be any value between 0
and 1 mill, instead of the current choice of either 0 or 1 mill. This will encourage better evidence and
investigations on the part of the Board.
-
Modify legislation to mandate that any vacancies
by appointed by objective outside organizations which include taxpayers, and
not be made by insiders on the Board.
-
Modify legislation to require that prospective
Board members provide a disclosure form describing any social, financial or
other relationship with any of the hospitals receiving the tax funds. Prohibit such members from being on the
Board, which should be made up on affected taxpayers who do not have
relationships with the fund recipients.
-
Request the Board budget for, and hire a
forensic accountant to review ACTUAL hospital expenses (not billings) to
indicate true costs and value of community benefits received in return for the
taxes.
-
Demand that the Board (and local Lake County
State legislators) approve a referendum for the public to vote on renewing the
tax.
-
To minimize major financial jolts to taxpayers
or the receiving hospitals, require that changes in millage rates should be
limited to 1 mill per year. Thus if the Legislation
approves elimination of the tax, it would be phased out over 5 years. We think that is fair.
vj
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Article from Daily Commercial today, Sept. 10, 2009
Do North Lake County
---------------------------------------------------------
Hospitals cite growing shortfalls from indigent care and Medicare/Medicaid shortfalls
DAVID DONALD
Staff Writer
When the North Lake County Hospital District was created in 1957 its
founders intended the taxpayers in north
Lake
to help keep the hospitals open.
Now some of the elected trustees of the hospital district are questioning whether the hospitals need that taxpayer support.
The board of trustees meets today at 5:30 p.m. at the
County
Administration
Building
in downtown Tavares to decide whether to adopt the proposed property tax rate for next year.
The hospital district can either choose to tax homeowners living in the hospital district up to a property tax rate of $1 for every $1,000 in taxable value or not at all. That means a homeowner with a $150,000 house exemption would pay $100 a year after homestead exemption.
That's
money
Lake
County
residents and business don't have to spend, said Marilyn Bainter, a hospital district trustee who was elected to the position last year.
"It's coming from real people and small businesses," said Bainter.
"This economy is not getting any better and we need to be thinking about
the people of
Lake
County
."
Since taking the position as a trustee, Bainter has questioned whether a
hospital district is needed in
North
Lake
County
.
Bainter says
Leesburg
Regional
Medical
Center
and Florida Hospital Waterman, which receive about $11 to $12 million annually from the hospital district, make enough profits to not need the tax.
Every year the Florida Hospital Waterman and
Leesburg
Regional
Medical
Center
go before the trustees to present their case for why they need the hospital district.
Hospital officials say the money they've received from the hospital district helps pay for expanding uncompensated health care costs, such as indigent care, charity care, bad debt and Medicaid and Medicare shortfalls.
Total uncompensated care at LRMC rose to nearly $39 million in 2008.
In 2007, LRMC recorded more than $12.2 million in Medicaid and Medicare shortfalls -- the medical bill balance after the federal government reimbursed the hospital. That figure more than doubled in 2008, rising to just over $28 million.
In 2008, Waterman provided $8.5 million in charity care and saw $7.7 million in Medicaid and Medicare shortfalls. The tax moneys Waterman received from the hospital district only covered 40 percent of the cost of indigent care.
Last year LRMC received $5.3 million from the hospital district. In the law that created the taxing district, the tax money must go toward "continued hospital services." It doesn't spell out a specific category, such as indigent or charity care.
The hospital district issue brings the national health care debate into
sharp focus as the country decides how to provide adequate health care to the
growing number of uninsured. There are more than 47 million uninsured in the
U.S.
today, according to the latest estimates.
There were 3.7 million uninsured Floridians in 2007, according to a U.S.
Census Bureau report on Income, Poverty, and Health Insurance Coverage in the
United States
.
Florida
ranks third in the nation behind
Texas
and
California
for number of uninsured.
Hospitals in
Florida
racked up more than $2.5 billion in uncompensated care costs in 2007, according to the Florida Hospital Association.
Those numbers will likely rise as the nation combats a deep recession and people lose their jobs along with their health care benefits.
Without the tax dollars to help stem the rise in uncompensated costs, hospital officials say they may have to cut services -- sending people out of the area for care.
Bainter doesn't buy that argument.
"They have been threatening and bullying this board for years," Bainter said. "I've heard this over and over from them."
Bainter said a good question to ask is how do hospitals in other counties get by without taxpayer support.
There are only nine other counties in Florida that have hospital taxing districts -- Baker, Broward, Citrus, Colombia, Hendry, Hardee, Indian River, Jackson and Volusia.
Some counties have more than two districts. In
Lake
County
, there is also a South Lake Hospital District, which supports the
South
Lake
Hospital
.
While a hospital district in some of
Florida
's most rural counties may be need a taxing district, Bainter said
Lake
isn't one of them.
Bainter said she intends to vote against establishing the property rate for next year.
Bainter said she also plans to speak to the Lake County Delegation -- state
legislators -- on Sept. 30 at
Lake-Sumter
Community College
about dissolving the district.
"I would like to see a referendum," said Bainter. "I think it's up to the people. They're the ones paying the bill."
-----------------------------------------------------------------
Hospital taxing body makes move toward openness
TAVARES
— Board members from the North Lake Hospital District will begin a
discussion today on how property-tax dollars should be used this
upcoming fiscal year to cover medical-care costs for the poor at local
hospitals.
The little-known taxing body, which doles out millions of dollars each year for Florida Hospital Waterman and Leesburg
Regional Medical Center, will discuss the proposed tax rate, which is
tentatively set at $1 for every $1,000 of a homeowner's taxable value.
The meeting, to be at 5:15 p.m., will be the board's first of two
public hearings before the district's budget is approved.
The district, which collects taxes from northern county residents from Mount Dora to Lady Lake,
likely will take in less money this year when the tax rate is approved
because of a decrease in property values within the district.
Currently, state law allows trustees to only set the rate at $1.
But
board member Marilyn Bainter of Eustis, a newcomer, went on a crusade
during the past year for a change in state law that would allow board
members to be more flexible about how they set the tax rate. Bainter
said she hopes to continue the push for the legislation change — which
would allow trustees to lower the rate, but not raise it — at a meeting
of Lake County's legislative delegation Sept. 30.
Meanwhile,
the board has made changes to its meeting structure to provide more
efficiency and openness to the public. At Bainter's urging, the board
agreed to purchase tape recorders to keep audio files of its meetings.
The group also changed its meeting location from a small room at Lake County Water Authority offices in Tavares to the larger Lake County Commission chambers at the round courthouse in Tavares.
Bainter,
who was elected in November, said she hopes the more comfortable space
for attendees will allow for a greater public discussion about the
taxing body's budget.
"I'm really looking forward to the
discussion," she said. "If we have some people turn up, I'm looking
forward to educating them some, too."
Tonight's meeting will be
in the commission chambers. The second and final meeting, during which
the budget will be approved, will be at 5:15 p.m. Sept. 17.
Christine Show can be reached at [email protected], at 352-742-5917 or on Twitter @showc.
Copyright © 2009, Orlando Sentinel
Thursday, September 10, 2009 - Read the full article at http://www.dailycommercial.com/localnews/091009hospital
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