INDIAN RIVER COUNTY — The Hospital District last week approved a fiscal year 2015 budget that gives a series of other healthcare agencies in the county everything they asked for, while continuing to stand firm on the reductions they want to make in what Indian River Medical Center will receive as reimbursement for indigent care.
The dispute between the District and the hospital management over indigent care reimbursement – the two sides are $2 million apart – is still the subject of negotiation. A series of settlement attempts have not yet yielded any agreement with both sides sticking to their respective legal positions.
The District is offering $7 million and the hospital is still seeking at least $9 million – and perhaps as much as $9.4 million – for indigent care. The total of what the District provides to all the other agencies is much less.
Nevertheless, the approval of the smaller amounts to the other agencies was practically a love fest – a sharp contrast to often heated discussions over the past few months with the hospital.
Through the end of the current fiscal year, the District had budgeted $8.1 million for the hospital, but the hospital is running about $700,000 over budget, which the District is obligated to cover.
For next year, the District has capped its offer at $7 million.
With the District’s money, the hospital also runs the Partners childbirth program, which has drawn questions from District trustees.
“With Partners, we’ve been doing some work – looking at what the hospital has told us to pay and whether that’s appropriate since the hospital has expanded beyond the original program,” said District Chairman Tom Spackman.
“The amount the hospital wants for the Partners program is outrageous,” said District Trustee Mike Weiss. “The District should pay only for indigent care because we have an obligation to the taxpayers to do that.”
The agencies that did receive their financial requests included the Indian River County Health Department, which is getting about $300,000 more for a new primary physician service called “We Care” to provide follow-up care for indigent patients when they leave the hospital.
This service is expected to reduce re-admissions and thus save money.
“We’re very appreciative, especially for We Care,” Health Department Director Miranda Hawker told the trustees.
The Mental Health Association is getting $25,000 more than last year. Treasure Coast Community Health clinics are getting $575,000, after being totally excluded from District money last year.
“The shrinking of TCCH last year was a huge loss to our community,” said District Executive Director Ann Marie Suriano.
“TCCH was able to meet our qualifications” this year, said Trustee Gene Feinour.
“Thank you for the great process. It was a great learning experience on both parts,” TCCH Director Vicki Soule told trustees.
Two of the agencies – the UF Center for Psychiatry and New Horizons, both providers of mental health and substance addiction care – asked for less money for 2015 than they are getting this year.
“We thank you for your support,” said Julie Dolan, chief administrative officer for New Horizons.
“There was such clarity surrounding the presentations that I feel very comfortable that the numbers budgeted are appropriate,” said Trustee Feinour, referring to the requests of all the agencies other than the hospital.
Spackman said there was “a significant difference” between the requests of the other agencies and the escalation of financial demands from the hospital.
Former hospital board member Paul Nezi, who attended the meeting as a taxpayer, urged the trustees to continue to question the hospital’s financial demands.
“Why does the hospital need this money – $9 million – from the District? In the interest of taxpayers, someone needs to look into it,” said Nezi.
“That’s what we’re trying to do,” said Trustee Burton Lee, “and I have no doubt we’ll find out.”