For first time in 30 years, Manatee County has no contract with a hospital for indigent care

MANATEE -- For the first time in 30 years, Manatee County doesn't have a contract with a hospital to provide care for the county's indigent population.

"It is a large concern of mine to not have a contract in place after we've had one for 30 years and not to know what to tell some of these patients," said Kevin DiLallo, CEO of Manatee Healthcare System, which operates Manatee Memorial Hospital. "We have instability in the health care market in Manatee County at this point. We are not sure how we are going to address the indigent care population in our care that we have addressed for the last 30 years."

The most recent contract expired Sept. 30. Karen Windon, deputy county administrator, said they knew that there would be a gap between contracts due to the budget uncertainty and evolving health care landscape.

"Our community has always stepped up when the needs are there," Windon said. "We anticipate taking contracts to the Board of County Commissioners Nov. 3 and we will continue working with hospitals in the interim. We all see this as an important issue in our community."

Windon said the county was waiting for the Affordable Care Act determination this summer about whether they would get matching funds from the low-income pool. While they received notification at the end of July, Windon said they needed to wait for the commission to adopt the 2015-16 budget on Sept. 22 to know the amount of funds for health care. While there is about $7 million in reserves for health care, that's about $2 million less than available in previous years, Windon said.

With the lump sum set aside from the sale of Manatee Memorial Hospital years ago for treating Manatee's needy nearly depleted, the county has been working toward finding a plan to serve the indigent.

"Without knowing what dollars would be available for those contracts, getting ahead would be pretty difficult," Windon said. "We couldn't develop hospital contracts until we developed what budget allocations would be."

County staff has drafted contracts, which went to the County Attorney's Office on Monday, Windon said. The contracts would be for one year and would be for Manatee Memorial Hospital, MCR Health Services and Blake Medical Center. Last year's contract was also for one year but in previous years, they have been for three years, Windon said.

DiLallo said they've had several physicians and patients contact the hospital.

"They would like to get treatment, surgical and chemotherapy and we continue to work with the medical staff and the county in trying to come up with some short-term solutions," he said.

In Manatee County, there are a lot of people that "go to bed every night worrying about what they are going to do for health care because the system is broken," DiLallo said. "There is a lot instability in how that system works and we need to stabilize that."

But the lack of a contract isn't entirely stopping Manatee Memorial Hospital from providing services to this segment of the population, DiLallo said. As of Monday afternoon, DiLallo said he hasn't seen a proposed contract, which he would like to review.

"We don't want to see patients suffer," he said. "We will do whatever we can to come up with solutions and help patients."

DiLallo said there is some uncertainty because the hospital doesn't know if they will be getting reimbursed. On average, Manatee Memorial Hospital serves 300 to 400 indigents per month, DiLallo said.

"We are taking some huge chances at this point," DiLallo said. "There is uncertainty in the market. I don't know what I can expect as I move forward."

In an email sent Friday, Commissioner Carol Whitmore wrote "we have no hospital at the present time that will take indigent patients."

"As a county commissioner and health care liaison, I am disappointed that it got this far and that we have good citizens in Manatee County that do need health care and some assistance and there is no avenue right now," Whitmore said Monday. "I have every confidence in the world that the county commission will do the right thing."

Linda Cooper, who lives in Central Florida, has been helping a Manatee County resident who needs treatment but is unable to pay.

"I believe that we should be able to take care of our own citizens," said Cooper, who contacted the county before contacting Manatee Memorial Hospital. "I was just appalled by the fact that someone who had worked, paid taxes and had gotten to a point that could not afford to pay for medical treatment, that there was absolutely nothing being done for this man."

Despite the lapse between contracts, Manatee Memorial Hospital will cover the costs of the treatment, which is estimated at $25,000.

But Cooper said the fact that they were making "an exception" to pay for health care "added insult to injury," she said.

"It shouldn't be an exception," she said. "It should be a norm because we should be taking care of our citizens."

Commission Chairwoman Betsy Benac thanked Manatee Memorial Hospital in an email Friday for "stepping up to help in a desperate situation."

"I understand the hospital is not required to provide this service," Benac said in the email. "I also understand that for the first time in 30 years that the county is without a contract to provide hospital based medical services in this community. It makes me very sad, and more than a little ticked off that the community seems to care more about a dog that was injured in a dog fight than what is happening to human beings who are without health care. I hope that these stories will be shared and that we will move forward as quickly as possible to get back to a situation where people are not left in Manatee County with nowhere to turn."

Windon said the hospital will continue to treat "life and limb injuries." Some things that aren't emergent may be delayed, but Windon said due to reduced funding "those impacts will be there."

"People still have that access to care," she said. "They are continuing to do business. They have been good citizens and ensuring the care of this community."

Benac said Monday that she thinks it is important that they continue the great partnerships.

"They've stepped up in many different ways," she said. "We are going to try to continue a partnership. It's something that we have known was coming for a long time. It is a little bit disconcerting to me that we don't have a plan. ... I've been assured that it is on the schedule for Nov. 3."

Claire Aronson, Manatee County reporter, can be reached at 941-745-7024. Follow her on Twitter@Claire_Aronson.

This story was originally published October 12, 2015 at 5:54 PM with the headline "For first time in 30 years, Manatee County has no contract with a hospital for indigent care ."