In approving new contracts with various health care providers for partial reimbursements for treating indigent patients, Manatee County commissioners applied a two-year tourniquet to a years-long condition that has defied a permanent solution. But there are positive signs that the county and citizenry will finally find that elusive answer for paying some of the medical costs for the working poor who are either uninsured or underinsured.
The stopgap contracts awarded Tuesday cut funding for the Manatee Healthcare System, which operates Manatee Memorial Hospital, by $1.2 million from the old agreement. The new one-year contract allocates $3.525 million for the year ending in September 2016. Blake Medical Center will receive $500,000, down from $670,000. Physicians, specialists, clinics, urgent care centers and other health care providers will split $1.25 million, an increase from the past year's $1 million.
The money will come from county reserves that exceed the minimum amount required by board policy. The contracts hold a provision for a one-year extension, subject to commission approval next year.
By then, the county must come up with a dedicated and sustainable funding stream that will eliminate the frequent community debate and angst over health care for the uninsured and underinsured.
This has not been an issue in other counties, which use sales or property taxes, or a combination of both. But Manatee County once tapped a unique funding source, a trust fund set up decades ago after the then county-owned Manatee Memorial Hospital was sold to private interests. That trust has been exhausted, which the county and community anticipated years ago but struggled over possible solutions. After a half-cent sales tax increase failed at the polls in June 2013, no other viable option materialized, and the predicament continues today.
Moving forward, county Administrator Ed Hunzeker initiated an effort to diversify county revenue streams since the budget relies on property taxes far more heavily than other counties.
This week commissioners approved appointments to the new Citizens Financial Structure Advisory Board, tasked with making recommendations to the commission "on the best combination of available revenue sources to fund county services, programs and capital projects," a county document states.
The 13-member advisory board will first meet later this month. While the panel's overarching mission is finding long-term methods of funding government, indigent health care is a major component. With the county confronting a possible deficit in 2018 when the general part of the budget stabilization reserve fund is expected to be spent, a sense of urgency exists. The advisory board must work quickly since it sunsets in five months.
On a twin track, the county is wisely pursuing another strategy on indigent health care: the development of a comprehensive program that reduces costs and improves outcomes while providing the community with more transparency and accountability. A consultant will examine how other communities handle a range of health-care services so the county gains a broad perspective. The expert's work is intended to be finished by October 2016.
On the revenue end, Hunzeker is following a similar strategy by inviting three Florida county administrators here to outline their various options for funding government. That will provide ideas for the advisory board.
Although his facility took a big reduction in indigent care compensation, Manatee Memorial Hospital CEO Kevin DiLallo sounded very positive about the future after Tuesday's commission vote on the contracts. "I'm glad the commission came up with a reasonable contract and we can partner with them to solve the indigent care issue we have in the county," he told the Herald.
Manatee County can no longer kick this can down the road, and potential solutions on a health care program and funding source must win community support. Today, there is a clearer path forward.