No action has been taken on the controversial struggle over Sarasota County's indigent care fund, but Doctors Hospital leaders are undeterred.

 

"We continue to ask our county officials for fair and open dialog about this issue," said Lynda Cassan, spokesperson for Doctors Hospital. "In the meantime, the problem of indigent care does not stop at the front door of public hospitals. An increasing number of patients who cannot pay their hospital bills come to us for care. All community hospitals need support from government sources. We are committed to providing quality care for all patients and we want to be able to sustain our level of care. "

 

The controversy over the Sarasota County pot of indigent care funds began last year around Thanksgiving, when an administrator at Doctors Hospital spotted a previously unnoticed clause in a 1959 amendment to the 1947 state law the Florida legislature passed establishing the Sarasota Public Hospital District. It mandated the commission to reimburse other hospitals in the county for indigent care in the same manner it reimburses non-profit Sarasota Memorial.

 

Just before Christmas, Doctors Hospital presented the county with the first of several monthly bills. Englewood Community Hospital and Venice Regional Medical Center followed suit. Collectively, the three taxpaying hospitals have requested reimbursement from Sarasota County for more than $31 million, the amount they say the county owes them for caring for a surging sea of uninsured and underinsured patients. Doctors Hospital and Englewood Community are managed by HCA; Venice Regional is an HMA hospital.

 

When asked if Doctors Hospital might sue the county, Cassan said, "We believe the law supports our position. Still, what we continue to hope for is open dialog with our political leaders. This issue is a matter of fairness."

 

Peter Taylor, spokesperson for Sarasota Memorial, said the HCA hospitals in Sarasota have submitted "indigent care" bills to Sarasota County for reimbursement over the past year with the claim that the county is obligated to use its tax dollars to reimburse for-profit hospitals for whatever indigent care they provide.

 

"They're basing their argument on an archaic, unused provision in our Hospital Board's enabling legislation that dates back to the 1950s," Taylor said. "But current Florida statutes and the state constitution have made it clear that counties are no longer responsible for funding hospitals' indigent care. This position has been affirmed by the Florida Supreme Court, and Sarasota County's lawyers also agree."

 

HCA also has suggested that Sarasota County reimburses Sarasota Memorial Hospital for indigent care, said Taylor.

 

"This is simply untrue," he said. "Sarasota Memorial has not sought and has not received reimbursement from Sarasota County for decades. Our hospital is governed by the publicly elected members of the Sarasota County Public Hospital Board, an independent entity that has its own taxing authority—completely separate from the county. We use our tax dollars to help offset the cost of the safety-net care we provide to our community."

 

Taylor said Sarasota Memorial provides 70.5 percent of the self-pay/uninsured care delivered in Sarasota County, and 92.8 percent of the Medicaid/Medicaid HMO hospital care in the county.

 

"We continue to deliver high-cost, high-risk essential services that local HCA hospitals have dropped or never provided," he said. "For instance, we're now the only hospital in Sarasota County providing obstetrics, neonatal intensive care, pediatrics and psychiatric care, and the only one providing the full range of 24/7 emergency specialty services, such as plastic surgery and oral/maxillofacial care. We also are the only hospital to make a significant investment in the underserved North Port community with our new freestanding emergency room. We don't cherry-pick profitable services and patients."  
Taylor said that while HCA's position on the issue is both unfounded and unfair, it is also unsurprising.

 

"For-profit hospitals have long tried to compare themselves to public hospitals and claim that we somehow have an unfair 'advantage,'" he said. "But they fail to mention the critical healthcare needs filled by public hospitals that private hospitals choose to ignore for the sake of the bottom line and a return to their shareholders. They also fail to mention that unlike for-profit providers, public hospitals re-invest all of our public funds to benefit our one shareholder: the Sarasota community."
Taylor said the county has made it clear that it has no plans to reimburse the for-profits.
"We support this position," he said. "As we've done in the past when for-profit hospitals have launched high-profile efforts to dip into public funds to subsidize profit margins, SMH will work to counter misleading information, and focus on the critical role the public hospital plays as the safety net for the county."