By Lynn Hatter
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Tallahassee, FL – Florida lawmakers continue to grapple with the high costs of healthcare. One area the state thinks it can make a difference is in the area of hospital funding. In addition to state and federal support, some hospitals are also getting local taxpayers to chip in to cover costs. But as Lynn Hatter reports, a panel appointed by Governor Rick Scott is looking at scaling back what the taxpayer portion of that funding actually pays for.
Down a winding, canopied lane littered with fallen leaves sits a facility that provides follow-up care for people recently discharged from Tallahassee Memorial who may not have access to healthcare or insurance.
Judy Griffen is a nurse practitioner at Tallahassee Memorial Hospitals Transition Center. The hospital invested in this program as a way to give people follow-up care once they're discharged from the hospital, in the hope that they won't come back. And Griffen says,it's working.
"What we're finding is that when we get a patient who didn't have good follow-up care and we get them stabilized medically and we provide them out-patient services, they tend to not utilize the hospitals or community services as much, because they get what they need."
A panel created by Governor Rick Scott to examine special taxpayer-funded hospital districts, is taking a look at Tallahassee's model as a solution to the problem of how to pay for the people who can't afford to pay for themselves, WITHOUT having to charge property owners.
One area where those special hospital taxes have created controversy is in Lake County. Republican State Representative Larry Metz, is sponsoring a bill to scrap the current district and let voters decide whether they want to create a new one where the money raised would ONLY go to pay for indigent care and not other areas of hospital budgets.
"The taxpayers are paying all their taxes and out of those general taxes we're paying come all these programs, general programs. Then on top of that the taxpayers of North Lake County are paying 1 mill to pay for these Medicare and Medicaid (mostly Medicaid) shortfalls. I just don't think the system is properly structured."
There are about 20 hospital taxing districts in the state which generate about five billion dollars annually. However, Not everyone is on board with the idea of scrapping those districts. Florida Hospital Association President Bruce Rueben says there could be a big problem down the road if the state's tinkers with that revenue source. That's because the money those districts generate go to help the state draw down matching funds for an even larger program that almost all the state's hospitals are dependent on: MEDICAID.
"We in Florida have come to rely on this source of funds to provide the state match for Medicaid. If we're going to dismantle that or put it at risk, then we simply have to know where that match is coming from."
Reuben says the governor's Hospital Review Commission is tinkering with a very delicate instrument, and, if it's not careful with its proposals, it could create a problem that it may not be able to fix.
"I don't know what they're really trying to accomplish or focus on, but I hope, before this thing is over, that they will address this issue of what really could be a gigantic unintended consequence."
Meanwhile, the Commission is set to make recommendations to the governor and legislature in January on how to treat those special hospital taxing districts. Ideas on restructuring districts, eliminating them and, in the case of Lake County, allowing money only to go to indigent care, have been proposed. Governor Rick Scott says lawmakers may not act on the recommendations until 2013. However proposals, like the one to send the Lake County Hospital District to a voter referendum, could well come up in the upcoming session.
*This story is part of a reporting partnership that includes WFSU-FM, NPR and Kaiser Health News.*