by Vance Jochim
Updated April 2 to include Orlando Sentinel editorial link. Updated March 31 & Apr. 1 to add link to Lauren Ritchie's March 30 & Apr. 1 columns...
Tavares, FL - March 28, 2011 - Just in the last week, the Board Members of the North Lake County Hospital District (NLCHD) must be questioning the logic in being on the Board or the legitimacy of the District. Here are several news articles and posting about NLCHD in the last two weeks.
A major issue is that some news sources, including the Orlando Sentinel, didn't understand a recent Executive Order from Governor Scott regarding "Hospital Districts" when it only partly may apply to Lake County Hospital Districts. (Read below).
Be sure to read the comments to the online articles, which give a good flavor of the issues.
- You can read our March 3rd blog posting on the NLCHD if you want an overview of the issues, with links to older articles. READ it HERE.
- We published an article on March 23rd on how the Lake County government has ignored a regulation that would let them invoice the local North Lake County Hospital District for reimbursement for Medicaid payments made by the County. Current estimates are that
- Activist Marilyn Bainter's lawsuit against the NLCHD is still pending after the first hearing in January. She and her experienced attorney claim the NLCHD is unconstitutional because many procedures required for special tax districts required by the State Constitution were ignored. According to one source, the next hearing will be April 7th at 1:30pm in Judge Singletary's courtroom.
- Governor Rick Scott issued a new initiative to create the "Commission on Review of Taxpayer Funded Hospital Districts" and review the current methods of funding "government-operated" hospitals in the State, and maybe Hospital Districts that fund them. THIS article says there are 33 government owned hospitals in Florida. However, in Lake County, none of the hospitals are government-operated hospitals - they are private non-profit hospitals, so I am not currently clear on the impact of this Commission on Lake County. 5 of 7 objectives focus only on government-operated hospitals, and it is unclear to me if the other two apply to Lake County. READ that article HERE from the Miami CBS TV station website, which includes a link to Scott's actual order for the Investigation. HERE is his official press release. Note: If you do a google search on "Rick Scott Hospital District" you will find later articles on how Scott is already appointing new Board members to some Hospital Districts (where we assume he has the authority - not the case in Lake County unless someone resigns, and maybe not even then.) - we assume they are favorable to shutting down the Districts.
- HERE is a link to Governor Rick Scott's actual Executive Order Number 11-63 that setup the "Commission on Review of Taxpayer Funded Hospital Districts". As mentioned above, the title is misleading, because it mostly focuses on government-operated hospitals funded by Hospital Tax Districts, and there are none in Lake County. I called the office of Florida Taxwatch, which is run by Dominic Calabro, the new Chair of the above Commission. He was not in, but Dan Krassner told me that they were still defining what would be done and revisions to the executive order to clarify direction were possible.
- The Orlando Sentinel on March 24, 2011 published a table of "What hospital districts cost taxpayers" HERE. NLCHD taxes every property 1 mill, or $100 per $100,000 in valuation. Keep in mind that 57 of 67 Florida Counties do NOT have a hospital tax district, so Lake County is only ONE of TEN Counties to have the tax. The Sentinel also published on the same day an article "A look at Central Florida's hospital taxing districts" which lists Board members and other facts about the two local Lake County Hospital Districts, and how two of the Board members are professionally connected to the health industry (which benefits from the District taxes). You can READ it HERE.
- The Orlando Sentinel published a follow up on the issue of Governor Rick Scott's Commission to review Hospital Districts in this area, describing efforts to reduce or eliminate the few special tax districts for hospitals in the Orlando area, including Lake county. Read that article HERE. HOWEVER, as mentioned earlier, most of the Commission objectives are focused on reviewing government OWNED hospitals funded by local tax districts (See Miami TV article above) , which is NOT THE same as Lake County's Hospital Districts, which provide partial funding to local, private non-profit hospitals. Scott's focus seems to be mostly on government owned hospitals like in Broward and some other counties.
- The Lake section of the Orlando section published on March 27, 2011 another follow up just on the North Lake Hospital District featuring a picture of local activist Marilyn Bainter, who has been working to reform or eliminate the District. Read that article HERE.
- Lake Sentinel columnist Lauren Ritchie posted a column on Sunday (March 26) about the NLCHD and lack of support for it. READ it HERE. And, HERE is the second article in the series published on Wednesday, March 30, and a third was published on April 1 and the link is HERE. The third column focused on the reasons why the local hospitals receiving funds from the North Lake Hospital District had "strayed from their non-profit mission" and cited reasons for the Lake County Board to invoice the District for the approximately $2.7-million in Medicaid costs previously paid by the County.
- April 2, 2011: The Orlando Sentinel, following the three columns mentioned above, published an editorial supporting a review of Hospital District funding HERE, describing payments to hospitals in excess of expenses by local and nearby Hospital Districts, and said " Publicly run or subsidized hospitals are no different than any other taxpayer-backed entity. They have a responsibility to be efficient and accountable. "
- The Daily Commercial, as always, was asleep on the issue. They published an editorial on January 27, 2010 (over a year ago) HERE that was supporting the North Lake Hospital District even though there is no oversight on how funds are to be spent. Here is their Jan. 27, 201 article on Bainter's lawsuit. They rarely write any investigative stories or editorials criticizing any big Government spending program, or criticize lack of government accountability, which is a main issue with the NLCHD. They have NOT written any articles on the Hospital District since before the November 4, 2010 elections. I could not find an article about Scott's new investigation Commission. (This comment based upon using their search engine, which does not work well, and apparently does not sort by date...).
- Lake County Commissioner Jimmy Conners posted a follow up on the issue on his blog based upon Ritchie's column. READ it HERE.
The issue of viability of Hospital Tax Districts in Florida is rising in public and media awareness. Scott's initiative, and Bainter's lawsuit, and the possibility of reimbursing Lake County government for $2.7-million in Medicaid expenses will continue to keep the issue in the public eye.
NOTE: Most of this article applies to the NORTH Lake County Hospital District. There is another one in South Lake County, but they have not been the focus of our reviews.
As always, our primary recommendations are:
- To rewrite the State regulations that created the NLCHD so they actual specify allowable and non-allowable expenses like normal grants do. Currently, there are no spending restrictions or rules other than "for continued Hospital services...". Why should Walt Disney's foundation have tougher rules for how their grant funds for kids programs can be spent compared to NO RULES for NLCHD?
- Define a requirement for a strict audit trail or accounting process so the usage of every dime given to local Lake County Hospitals from NLCHD (about $10-million) can be traced and verified.
- Modify the NLCHD formation regulations to allow the Board to determine any rate between 0 and 1 mill, rather than the current automatic 1 mill tax rate.
- Initiate a new referendum to allow voters to vote on the above revisions and continuation of the NLHCD taxes.
Here is text from some of the above articles for archive purposes:
Aiming to end tax, Bainter fights hospital district from inside
By Christine Show and Ludmilla Lelis, ORLANDO SENTINEL
March 27, 2011
Editor's note: This is a follow up to a story that ran on Page A1 of Friday's Orlando Sentinel about efforts to rein in hospital districts that levy taxes on property owners. Last week, Gov. Rick Scott ordered a review of special taxing districts that provide public funds to hospitals. If you missed it, Friday's story can be found at LakeSentinel.com.
Marilyn Bainter is like the skeptical patient who pores over the hospital bill looking for exorbitant charges.
Only she's looking at her tax bill.
The 75-year-old grandmother is challenging the legality of an obscure hospital district that collects millions of dollars from Lake County taxpayers and hands it over to hospitals. She is crusading to overturn the district, joining activists in Volusia County who also question whether it is appropriate for property owners to subsidize hospitals.
"They're robbing the public," the Eustis resident said.
However, officials with Florida Hospital Waterman in Tavares and Leesburg Regional Medical Center, which receive tax support from the North Lake County Hospital District, argue that the money is desperately needed to help cover the cost of indigent care. The district brought in $10.9 million in 2009.
"Clearly, any business person will understand that if we were running an additional $2.5 [million] to $3.5 million of shortfalls, we would have to make difficult decisions," said Phyllis Baum, chief executive officer of Leesburg Regional of what would happen if the hospital lost the tax money. "I don't really want to guess what those might be."
Volusia's three hospital taxing districts have also faced several adversaries. No one has been able to dismantle them.
The late John Ostalkiewicz made headway as state senator in the 1990s. The Orange County Republican, who died last year, led a successful offensive against an Orange district, which ended the hospital tax in 2000 for Health Central hospital in Ocoee. But he couldn't end the Volusia districts.
''I think the time has come for us to give the taxpayers a break,' Ostalkiewicz said at a 1997 Volusia legislative delegation meeting.
Few hospital-tax opponents have had the political support to get far.
Volusia Tax Reform, a political-action committee formed in 2006, is currently the most outspoken foe in the county. Last year, the districts collected more than $60 million, creating an unjust burden for residents, said Ed Connor, Tax Reform board member.
Connor questions whether the tax is the best way to cover indigent care, but the group hasn't been able to get support for legislation to do away with the districts.
"We've created a monster that is a multimillion-dollar gorilla with lobbying power," he said. "The economics of why we don't need the district is clear. Attacking it is a political problem."
But a freshman legislator, state Rep. Larry Metz, R-Yahala, has jumped on the issue. Metz has pledged to scrutinize the North Lake district.