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Health Care Safety Net Faces Severe Cuts in Senate Budget Plan

Posted on: Monday, 16 April 2007, 18:00 CDT

TALLAHASSEE, Fla., April 16 /PRNewswire-USNewswire/ -- Florida's health care safety net for the state's neediest citizens and the uninsured is facing $209 million in cuts this year under the Florida Senate's proposed budget. Furthermore, the Senate plan will forfeit $85 million in critical federal funding earmarked for Florida's health care safety net.

While Speaker Marco Rubio and the Florida House's budget provides a sufficient state match to preserve this crucial Medicaid funding, the Senate's proposed budget jeopardizes critical health programs that assist Florida's poor and uninsured.

As a result, Florida's safety net hospitals are urgently advising Senate President Ken Pruitt and Senate budget negotiators to adopt the House's position and preserve this health care safety net funding as the House and Senate begin budget negotiations this week.

If the Senate fails to support the state match, the $209 million in uncompensated health care will be shifted to the local taxpayer and the state's safety net providers -- both of which are already substantially subsidizing the state-federal Medicaid program. The cuts will erode access to health care for uninsured citizens, restrict some health services, and increase private health insurance premiums, since payers would have to pick up some of these costs.

In fact, communities and hospitals have faced growing pressures in recent years to increase their financial support for Medicaid. This year, local communities will contribute $664 million in property and other local taxes to Medicaid, while hospitals will pay about $345 million in "sick taxes" as their share of the partnership for assuring the financial viability of the Medicaid program.

Under the Senate's proposed cuts, the local tax burden for supporting the program would rise to a record $724 million statewide -- nearly a 10 percent increase -- while Medicaid payments to hospitals would be cut anywhere from 9 to 33 percent below audited costs.

"This is a very real, very serious situation for Florida's local communities and for the state's health care safety net," said Tony Carvalho, President of the Safety Net Hospital Alliance of Florida. "We greatly appreciate that Speaker Rubio and the House recognize how crucial the state's support of the safety net is, and that it will enable Florida to access critical federal matching money. The Senate must grasp that their failure to act will harm our state's neediest citizens and those who care for them."

The Safety Net Hospital Alliance of Florida is a group of 14 health care systems that include the state's public, teaching and children's hospitals. While the Alliance hospitals comprise just 10 percent of all hospitals statewide, these hospitals provide more than 50 percent of all the charity care delivered in the state.

The Senate's proposed cuts involve one part of the complex Medicaid program -- the state's Low Income Pool, a capped, $1 billion-a-year fund created just a year ago for the purpose of protecting hospital safety net programs under the Medicaid waiver. The Low Income Pool is used to help cover the costs of charity care and the uninsured who don't qualify for Medicaid.

Medicaid is a state-federal health care program for the poor and disabled. Under Florida's Medicaid program, the state's funding share responsibility is typically around 40 percent, and the federal government's is around 60 percent.

Hospitals lose money on every Medicaid patient they treat, because the Medicaid payments they receive are less than the actual costs of providing care. Today, only 14 percent of Medicaid hospital inpatient costs are paid from state general revenue dollars -- the lowest state share of any Medicaid service. Local communities, hospital taxes and the federal government pay the rest of the tab.

This current funding crisis evolved, in large part, because in recent years, state policymakers have systematically diverted money from the Low Income Pool -- and associated local taxes -- to cover basic Medicaid costs for hospital care. Because of that increasing reliance on local taxes, all available local funds have been used, leaving it necessary for the state to provide the additional $65 million in Medicaid matching funds to prevent major disruptions in this critical safety net program.

Speaker Rubio and House budget writers fulfill the local-state partnership with communities and safety net hospitals by providing the crucial state match in their proposed House budget. But the Senate rejected requests for the same support. If the Senate does not change its stance, Florida's safety net hospitals face the combined loss of the $65 million in state matching money, $86 million in federal matching funds and $59 million that hospitals are voluntarily diverting from hospital payments to help pay for the overall deficit -- a $209 million reduction in the current funding level.

"Safety net hospitals are committed to treating all patients, regardless of their ability to pay," said Marvin O'Quinn, President and CEO of Jackson Health System in Miami -- Florida's largest public hospital -- and board chairman of the Safety Net Hospital Alliance. "But even safety net hospitals cannot continue to offer the same level of services in the face of multi- million dollar shortfalls. These cuts hurt real people in need and the ability to provide safety net programs."

The Senate's cuts will be felt across Florida, but will hit 10 counties with large populations especially hard. They include: Dade ($66 million in cuts), Broward ($28.6 million), Duval ($20 million), Hillsborough ($17 million), Orange ($11 million), Alachua ($9.3 million), Pinellas ($7.7 million), Manatee ($6.2 million), Palm Beach ($5.2 million), and Lee ($4.6 million).

"Speaker Rubio's and the House's budget is both smart and fair," Carvalho added. "That's because the House budget eliminates the need to shift more Medicaid costs down to local communities. The House budget also maximizes the federal funding available to help Florida's neediest citizens, while maintaining Medicaid rates for safety net hospitals at close to their costs."

*See the attached data chart on county-by-county impacts of the Senate's budget cuts.

Proposed Hospital Medicaid Reductions in Senate Proposed Budget for SFY 2007-08 Total Reductions in LIP Medicaid Payments & Number Provider County Exemptions -------- ---------------------- ------------------ ---------- 1 108626 NORTH FLORIDA REGIONAL ALACHUA (323,649) MEDICAL CENTER 2 100030 SHANDS TEACHING ALACHUA (9,063,284) HOSPITAL & CLINIC -------- ---------------------- ------------------ ---------- ALACHUA Total (9,386,933) 3 100048 ED FRASER MEMORIAL BAKER (359,801) HOSPITAL -------- ---------------------- ------------------ ---------- BAKER Total (359,801) 4 100064 BAY MEDICAL CENTER BAY (2,413,585) 5 117617 GULF COAST HOSPITAL BAY (954,962) -------- ---------------------- ------------------ ---------- BAY Total (3,368,547) 6 100072 SHANDS AT STARKE BRADFORD (142,716) -------- ---------------------- ------------------ ---------- BRADFORD Total (142,716) 7 100099 CAPE CANAVERAL BREVARD (154,060) HOSPITAL 8 100081 HOLMES REGIONAL BREVARD (1,619,606) MEDICAL CENTER 9 100102 PARRISH MEDICAL CENTER BREVARD (202,802) 10 100111 WUESTHOFF HOSPITAL BREVARD (402,907) 11 103209 WUESTHOFF MEDICAL BREVARD (139,665) CENTR - MELBOURNE -------- ---------------------- ------------------ ---------- BREVARD Total (2,519,039) 12 100129 BROWARD GENERAL BROWARD (10,846,447) MEDICAL CENTER 13 120405 CORAL SPRINGS MEDICAL BROWARD (827,858) CENTER 14 102148 FLORIDA MEDICAL CENTER BROWARD (439,688) 15 111791 HOLLYWOOD MEDICAL BROWARD - CENTER 16 100188 HOLY CROSS HOSPITAL BROWARD (320,372) 17 108219 IMPERIAL POINT BROWARD (1,534,751) HOSPITAL 18 102229 MEMORIAL HOSPITAL BROWARD (892,532) PEMBROKE 19 102521 MEMORIAL HOSPITAL WEST BROWARD (189,038) 20 100200 MEMORIAL REGIONAL BROWARD (8,687,048) HOSPITAL 21 100218 NORTH BROWARD MEDICAL BROWARD (2,738,817) CENTER 22 104591 NORTHWEST REGIONAL BROWARD (268,654) HOSPITAL 23 120006 PLANTATION GENERAL BROWARD (1,689,244) HOSPITAL 24 112801 UNIVERSITY HOSPITAL & BROWARD (243,431) MEDICAL C -------- ---------------------- ------------------ ---------- BROWARD Total (28,677,882) 25 100269 CALHOUN LIBERTY CALHOUN (50,756) HOSPITAL -------- ---------------------- ------------------ ---------- CALHOUN Total (50,756) 26 100285 SAINT JOSEPH HOSPITAL CHARLOTTE - OF PORT CHARLOTTE -------- ---------------------- ------------------ ---------- CHARLOTTE Total - 27 102199 CITRUS MEMORIAL CITRUS 110,774 HOSPITAL 28 119989 SEVEN RIVERS COMMUNITY CITRUS (122,226) HOSPITAL -------- ---------------------- ------------------ ---------- CITRUS Total (11,452) 29 111741 ORANGE PARK MEDICAL CLAY (369,390) CENTER -------- ---------------------- ------------------ ---------- CLAY Total (369,390) 30 100315 NAPLES COMMUNITY COLLIER (932,235) HOSPITAL 31 103144 PHYSICIAN'S REGIONAL COLLIER (69,049) MEDICAL CENTER -------- ---------------------- ------------------ ---------- COLLIER Total (1,001,284) 32 119768 LAKE CITY MEDICAL COLUMBIA (66,138) CENTER 33 100331 SHANDS AT LAKE SHORE COLUMBIA (211,503) -------- ---------------------- ------------------ ---------- COLUMBIA Total (277,641) 34 116483 ANN BATES LEACH EYE DADE (300,635) HOSPITAL 35 120375 AVENTURA HOSPITAL & DADE (363,356) MEDICAL CENTER 36 100358 BAPTIST HOSPITAL - DADE (1,273,745) MIAMI 37 100366 CEDARS MEDICAL CENTER DADE (1,790,586) 38 109606 CORAL GABLES HOSPITAL DADE (2,158,415) 39 102776 DOUGLAS GARDENS DADE - HOSPITAL 40 120057 HEALTHSOUTH LARKIN DADE (195,416) HOSPITAL-MIAMI 41 100412 HIALEAH HOSPITAL DADE (1,698,427) 42 102261 HOMESTEAD HOSPITAL DADE (640,431) 43 100421 JACKSON MEMORIAL DADE (32,301,473) HOSPITAL 44 120138 KENDALL REGIONAL DADE (4,909,680) MEDICAL CENTER 45 100439 MERCY HOSPITAL DADE (415,007) 46 100609 MIAMI CHILDRENS DADE (5,496,938) HOSPITAL 47 100463 MT. SINAI MEDICAL DADE (3,899,137) CENTER 48 100498 NORTH SHORE MEDICAL DADE (2,025,290) CENTER 49 100536 PALM SPRINGS GENERAL DADE (229,457) HOSPITAL 50 104604 PALMETTO GENERAL DADE (2,098,698) HOSPITAL 51 100544 PAN AMERICAN HOSPITAL DADE (222,732) 52 102385 PARKWAY REGIONAL DADE (4,417,521) MEDICAL CENTER 53 103284 SISTER EMMANUEL DADE (29,727) HOSPITAL 54 100587 SOUTH MIAMI HOSPITAL DADE (442,543) 55 100471 UNIVERSITY OF MIAMI DADE (304,635) HOSPITAL & CLINICS 56 100625 WESTCHESTER GENERAL DADE (930,500) HOSPITAL 57 100595 South Shore DADE -------- ---------------------- ------------------ ---------- DADE Total (66,144,350) 58 101923 DESOTO MEMORIAL DESOTO (220,669) HOSPITAL -------- ---------------------- ------------------ ---------- DESOTO Total (220,669) 59 102326 BAPTIST HOSPITAL - DUVAL (147,483) BEACHES 60 100641 BAPTIST MEDICAL CENTER DUVAL (2,856,934) 61 101931 MEMORIAL MEDICAL DUVAL (553,558) CENTER - JACKSONVILLE 62 100722 SAINT LUKE'S HOSPITAL DUVAL (270,524) 63 100731 SAINT VINCENT'S HEALTH DUVAL (1,182,215) 64 100676 SHANDS AT JACKSONVILLE DUVAL (15,156,651) -------- ---------------------- ------------------ ---------- DUVAL Total (20,167,366) 65 100749 BAPTIST HOSPITAL OF ESCAMBIA (1,272,285) PENSACOLA 66 100765 SACRED HEART HOSPITAL ESCAMBIA (2,011,563) 67 113212 WEST FLORIDA REGIONAL ESCAMBIA (802,100) MEDICAL CENTER -------- ---------------------- ------------------ ---------- ESCAMBIA Total (4,085,948) 68 101893 FLORIDA HOSPITAL FLAGLER (169,488) FLAGLER -------- ---------------------- ------------------ ---------- FLAGLER Total (169,488) 69 100803 GEORGE E. WEEMS FRANKLIN (61,308) MEMORIAL HOSPITAL -------- ---------------------- ------------------ ---------- FRANKLIN Total (61,308) 70 100811 GADSDEN COMMUNITY GADSDEN (39,545) HOSPITAL -------- ---------------------- ------------------ ---------- GADSDEN Total (39,545) 71 100838 TRINITY COMMUNITY HAMILTON (42,002) HOSPITAL -------- ---------------------- ------------------ ---------- HAMILTON Total (42,002) 72 100862 HENDRY REGIONAL HENDRY (74,912) MEDICAL CENTER -------- ---------------------- ------------------ ---------- HENDRY Total (74,912) 73 100871 BROOKSVILLE REGIONAL HERNANDO (381,574) HOSPITAL -------- ---------------------- ------------------ ---------- HERNANDO Total (381,574) 74 100901 FLORIDA HOSPITAL - HIGHLANDS (244,846) WALKER 75 102601 FLORIDA HOSPITAL - HIGHLANDS (78,409) WAUCHULA 76 100897 HIGHLANDS REGIONAL HIGHLANDS (143,891) MEDICAL CENTER -------- ---------------------- ------------------ ---------- HIGHLANDS Total (467,146) 77 118079 BRANDON REGIONAL HILLSBOROUGH (721,484) HOSPITAL 78 120324 H. LEE MOFFIT CANCER HILLSBOROUGH (688,705) CENTER 79 100986 SOUTH FLORIDA BAPTIST HILLSBOROUGH (1,773,140) HOSPITAL 80 100978 ST. JOSEPH'S HOSPITAL HILLSBOROUGH (2,608,370) 81 100994 TAMPA GENERAL HOSPITAL HILLSBOROUGH (10,674,235) 82 119849 TOWN & COUNTRY HILLSBOROUGH (117,516) HOSPITAL 83 100943 UNIVERSITY COMMUNITY HILLSBOROUGH (120,386) HOSP. - CARROLLWOOD 84 101028 UNIVERSITY COMMUNITY HILLSBOROUGH (599,643) HOSPITAL - TAMPA 85 119846 South Bay HILLSBOROUGH -------- ---------------------- ------------------ ---------- HILLSBOROUGH Total (17,303,479) 86 101036 DOCTORS MEMORIAL HOLMES (116,250) HOSPITAL - BONIFAY -------- ---------------------- ------------------ ---------- HOLMES Total (116,250) 87 101044 INDIAN RIVER MEMORIAL INDIAN RIVER 121,048 HOSPITAL 88 120014 SEBASTIAN HOSPITAL INDIAN RIVER (71,983) -------- ---------------------- ------------------ ---------- INDIAN RIVER Total 49,066 89 101940 CAMPBELLTON-GRACEVILLE JACKSON (51,514) HOSPITAL 90 101061 JACKSON HOSPITAL JACKSON (182,938) -------- ---------------------- ------------------ ---------- JACKSON Total (234,451) 91 101095 FLORIDA HOSPITAL LAKE 230,423 WATERMAN 92 101079 LEESBURG REGIONAL LAKE 233,987 MEDICAL CENTER 93 101087 SOUTH LAKE MEMORIAL LAKE (123,910) HOSPITAL -------- ---------------------- ------------------ ---------- LAKE Total 340,500 94 119717 CAPE CORAL HOSPITAL LEE (180,055) 95 102253 GULF COAST HOSPITAL - LEE (1,197,671) FT. MYERS 96 101109 LEE MEMORIAL HOSPITAL LEE (2,925,792) 97 101117 LEHIGH REGIONAL LEE (143,737) MEDICAL CENTER 98 111341 SOUTHWEST FLORIDA LEE (156,370) REGIONAL MEDICAL CENTER -------- ---------------------- ------------------ ---------- LEE Total (4,603,625) 99 119806 TALLAHASSEE COMMUNITY LEON (199,349) HOSPITAL 100 101133 TALLAHASSEE MEMORIAL LEON (2,344,164) HEALTHCARE -------- ---------------------- ------------------ ---------- LEON Total (2,543,514) 101 101141 NATURE COAST REGIONAL LEVY (115,549) HOSPITAL -------- ---------------------- ------------------ ---------- LEVY Total (115,549) 102 101150 MADISON COUNTY MADISON (47,049) MEMORIAL HOSPITAL -------- ---------------------- ------------------ ---------- MADISON Total (47,049) 103 103420 LAKEWOOD RANCH MEDICAL MANATEE (39,402) CENTER 104 101168 MANATEE MEMORIAL MANATEE (6,210,510) HOSPITAL -------- ---------------------- ------------------ ---------- MANATEE Total (6,249,913) 105 101176 MUNROE REGIONAL MARION (137,652) MEDICAL CENTER 106 109886 OCALA REGIONAL MEDICAL MARION (103,983) CENTER -------- ---------------------- ------------------ ---------- MARION Total (241,635) 107 101184 MARTIN MEMORIAL MARTIN (402,979) HOSPITAL -------- ---------------------- ------------------ ---------- MARTIN Total (402,979) 108 101206 FISHERMEN'S HOSPITAL MONROE (77,636) 109 101192 LOWER KEYS HOSPITAL MONROE (476,514) 110 101214 MARINERS HOSPITAL MONROE (108,917) -------- ---------------------- ------------------ ---------- MONROE Total (663,067) 111 101231 BAPTIST MEDICAL CENTER NASSAU (149,016) - NASSAU -------- ---------------------- ------------------ ---------- NASSAU Total (149,016) 112 111325 FORT WALTON BEACH OKALOOSA (317,631) MEDICAL CENTER 113 101265 NORTH OKALOOSA MEDICAL OKALOOSA (143,720) CENTER 114 101257 TWIN CITIES HOSPITAL OKALOOSA (35,074) -------- ---------------------- ------------------ ---------- OKALOOSA Total (496,424) 115 119750 H.H. RAULERSON OKEECHOBEE (100,433) -------- ---------------------- ------------------ ---------- OKEECHOBEE Total (100,433) 116 101290 FLORIDA HOSPITAL ORANGE (5,106,500) 117 101354 HEALTH CENTRAL ORANGE (359,822) 118 101338 ORLANDO REGIONAL ORANGE (5,853,486) MEDICAL CENTER 119 101311 PRINCETON HOSPITAL ORANGE (53,624) -------- ---------------------- ------------------ ---------- ORANGE Total (11,373,432) 120 101389 OSCEOLA REGIONAL OSCEOLA (442,194) MEDICAL CENTER -------- ---------------------- ------------------ ---------- OSCEOLA Total (442,194) 121 101401 BETHESDA MEMORIAL PALM BEACH (2,085,788) 122 120308 COLUMBIA HOSPITAL PALM BEACH (273,127) 123 120090 DELRAY MEDICAL CENTER PALM BEACH (272,765) 124 101443 GLADES GENERAL PALM BEACH (197,505) HOSPITAL 125 101524 GOOD SAMARITAN MEDICAL PALM BEACH (105,135) CENTER 126 101460 JFK MEDICAL CENTER PALM BEACH (53,718) 127 120294 JUPITER MEDICAL CENTER PALM BEACH (21,021) 128 102105 PALM BEACH GARDENS PALM BEACH (7,511) MEDICAL CENTER 129 120260 PALMS WEST HOSPITAL PALM BEACH (398,213) 130 120251 PINECREST PALM BEACH (1,277) REHABILITATION HOSPITAL 131 101486 ST. MARY'S HOSPITAL PALM BEACH (1,418,101) 132 102130 WELLINGTON REGIONAL PALM BEACH (317,424) MEDICAL CENTER 133 120243 WEST BOCA MEDICAL PALM BEACH (15,675) CENTER 134 102610 A.G. Holley PALM BEACH (105,924) -------- ---------------------- ------------------ ---------- PALM BEACH Total (5,273,184) 135 105520 COMMUNITY HOSPITAL OF PASCO (375,287) NEW PORT RICHEY 136 109592 DADE CITY HOSPITAL PASCO (106,823) 137 101494 FLORIDA HOSPITAL PASCO (223,365) ZEPHYRHILLS 138 101508 NORTH BAY MEDICAL PASCO (147,192) CENTER -------- ---------------------- ------------------ ---------- PASCO Total (852,667) 139 101516 ALL CHILDREN'S PINELLAS (5,383,352) HOSPITAL 140 101567 BAYFRONT MEDICAL PINELLAS (435,566) CENTER 141 102598 EDWARD WHITE HOSPITAL PINELLAS (3,464) 142 101613 HELEN ELLIS MEMORIAL PINELLAS (27,532) HOSPITAL 143 119741 LARGO MEDICAL CENTER PINELLAS (22,630) 144 101541 MEASE HOSPITAL - PINELLAS (30,900) DUNEDIN 145 101583 MORTON F. PLANT PINELLAS (1,310,995) HOSPITAL 146 115193 NORTHSIDE MEDICAL PINELLAS (299,172) CENTER 147 120111 PALMS OF PASADENA PINELLAS (149) HOSPITAL 148 120227 SAINT ANTHONY'S PINELLAS (138,246) HOSPITAL 149 120103 SAINT PETERSBURG PINELLAS (8,329) GENERAL HOSPITAL 150 101591 SUN COAST HOSPITAL PINELLAS (122,529) -------- ---------------------- ------------------ ---------- PINELLAS Total (7,782,864) 151 120413 BARTOW MEMORIAL POLK (54,448) HOSPITAL 152 102288 HEART OF FLORIDA POLK (337,252) REGIONAL MEDICAL CENTER 153 101664 LAKE WALES HOSPITAL POLK (96,814) ASSOCIATION 154 101648 LAKELAND REGIONAL POLK (2,865,656) MEDICAL CENTER 155 101699 WINTER HAVEN HOSPITAL POLK (478,222) -------- ---------------------- ------------------ ---------- POLK Total (3,832,392) 156 113514 PUTNAM COMMUNITY PUTNAM (902,987) MEDICAL CENTER -------- ---------------------- ------------------ ---------- PUTNAM Total (902,987) 157 101737 JAY HOSPITAL SANTA ROSA (110,262) 158 101745 SANTA ROSA MEDICAL SANTA ROSA (174,075) CENTER -------- ---------------------- ------------------ ---------- SANTA ROSA Total (284,337) 159 101761 MEMORIAL HOSPITAL - SARASOTA (868,228) SARASOTA -------- ---------------------- ------------------ ---------- SARASOTA Total (868,228) 160 101788 CENTRAL FLORIDA SEMINOLE (239,949) REGIONAL HOSPITAL -------- ---------------------- ------------------ ---------- SEMINOLE Total (239,949) 161 101711 FLAGLER HOSPITAL ST JOHNS (183,586) -------- ---------------------- ------------------ ---------- ST JOHNS Total (183,586) 162 119695 LAWNWOOD REGIONAL ST. LUCIE (1,381,213) MEDICAL CENTER 163 119971 MEDICAL CENTER-PORT ST. LUCIE (202,014) ST. LUCIE -------- ---------------------- ------------------ ---------- ST. LUCIE Total (1,583,226) 164 101796 SHANDS AT LIVE OAK SUWANNEE (176,905) -------- ---------------------- ------------------ ---------- SUWANNEE Total (176,905) 165 DOCTORS MEMORIAL TAYLOR (153,016) HOSPITAL - PERRY -------- ---------------------- ------------------ ---------- TAYLOR Total (153,016) 166 108227 LAKE BUTLER HOSPITAL UNION (280,801) -------- ---------------------- ------------------ ---------- UNION Total (280,801) 167 101834 BERT FISH MEDICAL VOLUSIA - CENTER 168 101842 HALIFAX MEDICAL CENTER VOLUSIA (3,247,443) 169 101851 MEDICAL CENTER- VOLUSIA (240,675) PENINSULA 170 101877 MEMORIAL HOSPITAL - VOLUSIA (216,093) WEST VOLUSIA 171 101826 VOLUSIA MEDICAL CENTER VOLUSIA (153,953) -------- ---------------------- ------------------ ---------- VOLUSIA Total (3,858,164) 172 101885 HEALTHMARK REGIONAL WALTON (79,420) MEDICAL CENTER 173 103233 SACRED HEART OF THE WALTON (53,935) EMERALD COAST -------- ---------------------- ------------------ ---------- WALTON Total (133,356) 174 101907 NORTHWEST FLORIDA WASHINGTON (83,109) COMMUNITY HOSPITAL -------- ---------------------- ------------------ ---------- WASHINGTON Total (83,109) ======== ====================== ================== ============= Grand Total (209,201,964)

Safety Net Hospital Alliance of Florida

CONTACT: Tony Carvalho, President of Safety Net Hospital Alliance ofFlorida, +1-850-201-2096

Source: PRNewswire-USNewswire

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