Transcript Halifax Health Town Hall Meeting

Bert Fish Medical Center/
Southeast Volusia Hospital
Special Taxing District
Topics of Discussion






2008 Property Tax
Fact
Ad Valorem Tax Revenue
Financial Review
Board of Directors Fiduciary
Responsibility
Citizens Referendum
2008 Property Tax
2008 Property Tax %
New Smyrna Beach
2.5
12.2
27.7
19.2
County
School
Municipal
38.5
Hospital
Other
Fact
Fact
– Bert Fish Medical Center is a
Community owned health care
center, owned by the residents of
the Southeast Volusia Hospital
District.
– The Southeast Volusia Hospital
District is governed by a seven (7)
member Board of Commissioners
Source of data: Florida House Bill HB 0273
Fact
– Board of Commissioners shall be a
resident of the “Taxing District”
– Board of Commissioners are political
patronage appointees, appointed by
the Governor & are accountable to
“NO” one.
Source of data: Florida House Bill HB 0273
Fact
– According to The Florida Hospital
Association there are 226 acute care
hospitals in Florida
Source of Data: Florida Hospital Association—fla.org
Fact
– Of the 226 acute care Florida hospitals:

34 are Special Districts Hospitals.
– 16 Ad Valorem Tax Authority
 12 Appointed Board of Directors
 4 Elected Board of Directors
– 18 Revenue Sources Varied.
– 85% of all Florida Acute Care Hospitals are
not " Special District Hospitals" they are
Privately held.
Source of data: MyFlorida.com & floridaspecialtaxingdistricts.org
Fact
– Of the 16 acute care hospitals with Ad
Valorem Source of Revenue in Florida, 3
are located in Volusia County.



Halifax Hospital Medical Center
SE Volusia / Bert Fish Medical Center
West Volusia Hospital Authority
Source of data: floridaspecialtaxingdistricts.org
Fact
Florida Memorial located in Daytona
Beach, is owned by Adventist Health
Care, is a Not For Profit, Acute Care
Hospital & receives no Ad Valorem tax
revenues.
Source of Data: Hospitalcompares.hhs.gov
Facts
In 2008 BFMC records show the
Emergency Department Outpatient
Activity exceeded 31,952. National
statistics show 87% of the patients in
the Emergency room did not require
Emergency room services.
Source of Data: The Feasibility of a Managed Indigent Health Care Plan for Volusia County, Fl.; Prepared by:
Health Management Decisions. Inc. and Wittner Companies; October 1993 & BFMC Data
Ad Valorem Tax Revenue
Ad Valorem Tax Revenue
– On September 17, 2008 the
Southeast Volusia Hospital District
approved a 2.85 Millage rate for
2008-9. This will generate a Ad
Valorem Tax revenues of $20.8
million.
– SEVHD reports these revenues are
used to provide Indigent Care.
Source of data: Florida House Bill HB 0273
Ad Valorem Tax Revenue
Southeast Volusia Hospital District Ad
Valorem Tax Revenues can also be
used for:
Debt Service Payment on Notes & Bonds
 Expenses of Operation
 Maintenance
 Construction & Repairs

Source of data: Florida House Bill HB 0273
(Continued)
Payment of indebtedness
 District expenses
 Downtown redevelopment District fees
 Tax collector fees.

Source of data: Florida House Bill HB 0273
Ad Valorem Tax Revenue
Southeast Volusia Hospital Taxing
District Ad Valorem revenue is not
the only source of revenue to pay for
Indigent /Emergency Care.
Ad Valorem Tax Revenue
In 1986 Congress enacted the
Emergency Medical Treatment &
Labor Act (EMTALA) and in 2007
Florida Legislature passed Statute
395.1041 which ensures public
access to emergency services & care
regardless of ability to pay.
Southeast Volusia Hospital
Valorem Tax Revenue







2003
2004
2005
2006
2007
2008
2009
$8.5 Mil.
$10.0 Mil.
$11.5 Mil.
$14.4 Mil.
$17.8 Mil.
$17.7 Mil.
$20.8 Mil.
Source of data: Southeast Volusia Hospital
25
20
15
10
5
0
2003
2005
2007
2009
Ad Valorem Tax Revenue
From 2003 to 2009:
– SEVHD Ad Valorem Tax Revenue
increased 245%
– CPI increased 14.4% (2003 to 2007)
Source of data: BFMC provided data
2003-09 Ad Valorem Tax Revenue/
CPI/ Home Value % inc. / (dec.)
Systemic Flawed Model
2006 Per Capita Property
Tax for Indigent Care





Volusia $131.00
Lee
6.00
Pasco
11.00
Flagler
10.00
Brevard 10.00
State of Florida
2008--09 Special Hospital Taxing District
Gross Ad Valorem Tax per capita

Appointed Boards:
–
–
–
–
–
–
–
–
–
–
–
–
Baker County
Graceville Hospital
Citrus County
Halifax Hospital
Lake County
Lower Florida Keys
Madison County
North Broward
North Sumpter
South Broward
South Lake
Southeast Volusia

$31.90
$52.25
$91.31
$184.80
$72.79
0
0
$153.67
$98.18
$79.45
$274.35
Elected Board:
–
–
–
–
Hendry Country
$151.34
Indian River County $103.78
North Lake County
$84.23
West Volusia
$79.29
Ad Valorem Tax Revenue



2006 Indigent Care cost per
resident in Volusia County was
13 times higher than counties
with approximately the same
population.
2008-09 SEVHD Ad Valorem
Tax Revenue $20.8 Million.
In 2008-9 SEVHD Ad Valorem
Tax is $ 274.35 per (special
taxing district) capita.
Source of data: December2, 2007 News Journal; BFMC 2008-09 Budget
Bert Fish Medical Center
FINANCIAL REVIEW
BFMC 2008 Uses of Tax Dollars.

2008 Gross Ad Valorem Property Tax

Less:





$17,702,388
Discounts & Uncollectible Tax
Tax Collection & Appraiser Comm.
Volusia County Medicare Assessment
Redevelopment Taxes paid to Cities:
TOTAL DEDUCTIONS:
2008 Net Ad Valorem Property Tax to Halifax:
($885,119)
($686,853)
($313,162)
($683,793)
($2,568,927)
$15,133,461
Sources of Data: BFMC
BFMC 2007 Profit
Reconciliation


BFMC 2006-7 Profit / (Loss) (*)
Less:
($1,012,064)
2007 Pre Tax Profit W/O Ad Valorem Tax
($16,408,028)
–

2006-7 Net Ad Valorem Property Tax
($15,395,964)
Source of data: BFMC Data
(*) Excess (Deficiency) of Revenue and Gains Over Expenses and Losses Including Net Ad
Valorem Property Tax,
2003 to 2007 BFMC Gains (Loss) W/O Ad
Valorem Property Tax-($)Millions
Sources of data: BFMC
BFMC 2003-07 Profit
Reconciliation



BFMC Cumulative Excess (Deficiency)
of Revenue and Gains Over Expenses
and Losses including Ad Valorem
Property Tax $13,270,631.
BFMC Cumulative Net Ad Valorem
Revenue (tax) $54,085,764.
BFMC (Losses)W/O Ad Valorem Tax
Revenue ($40,815,133)
Sources of data:BFMC
Cumulative 2003-08
Gross Ad Valorem Tax
Paid
$79,931,590
BFMC Board of Directors
Fiduciary Responsibility
Fiduciary Responsibility


The Southeast Volusia Hospital District
Board of Directors has a fiduciary
responsibility to the citizens they were
appointed to represent.
“A fiduciary is someone who has
undertaken to act for and on behalf of
another in a particular matter in
circumstances which give rise to a
relationship of trust and confidence.”
Defination; Webster,s New Collegiate Dictionary
Fiduciary Responsibility ?
Has the SEVHD Board of Directors
operated in a manner as to
establish trust and confidence
when they:
Fiduciary Responsibility ?
 Consistently
Approve
Administrative costs in excess of
15% of gross revenue: 13%
points higher than U.S. Medicare.
 Approve Increasing Ad Valorem
tax revenues by 245% over five
years while CPI increased 14.4%
Fiduciary Responsibility ?
Approve Indigent care costs of $131 per
capita: 13 times comparable counties.
 Failed to Implement 1993 Volusia
County Indigent Care Study.

Faduciary Responsibility




For 2008-09 approved a 2.85 mil. Ad
Valorem tax on all taxable property
within the taxing district.
$20.8 Million: $275.00 per capita
Highest per capita Millage rate in
Florida
$89.55 Per Capita Greater that Halifax
Medical Center which is #2

WHY the Per Capita differences within
the three Volusia County Taxing
Districts ????
– Southeast Volusia
– Halifax Health
– West Volusia
$274.35
$184.80
$79.29
The SEVHD Appointed Board
of Commissioners have failed
the citizens they were
appointed by the Governor to
serve …
CITIZENS REFERENDUM
Citizens Referendum
Reduce HB 0273 millage
from 4 to .5 mills.
Referendum Verbiage
Shall the maximum ad valorem
property tax rate that can be levied
by the Southeast Volusia Hospital
District be reduced from 4 mills to .5
Mills?
Yes….
No…..
Reference: Laws of Florida Ch. 2004-421: House Bill No. 837 Page 14,
Section 8.