BRADENTON – Manatee Healthcare System's CEO is lobbying for another go at an indigent health care sales tax referendum. Kevin DiLallo met with Manatee County Commissioners last week to try to convince them to revive the plan that would allow local hospitals to continue receiving large, blanket payment for treating indigents, even after the county's dwindling funding source expires by adding a half-cent to the local sales tax. .

Last June, Manatee County voters overwhelmingly rejected the idea, despite an expensive and largely-misleading campaign funded mostly by Manatee Memorial's parent company, King of Prussia, PA-based Universal Health Services, that tried to erroneously link the half-cent sales tax to property tax cuts.

In accordance with state law, Manatee County established a corpus fund of over $40 million from the proceeds of the 1984 sale of its community hospital to pay for indigent care services. That agreement specifically stipulated that doing so would in no way obligate the county to pay for such services if and when that corpus expired.

Originally, only the interest earned on the fund was spent, which protected the funding source indefinitely. But the county decided to increase spending – and continues to do so through periods of lower interest and diminished returns – ensuring that the considerable principal in the fund would eventually be spent down to zero, as it says will be the case by FY 2015.

Another misrepresentation of the issue supposed that the county was responsible for the payments to the hospitals for indigent care, when in fact, such is not the case. Emergency rooms only have to admit and treat all patients regardless of their ability to pay if they participate as Medicare providers and doing so does not bring the burden of payment to the community.

Critics have argued that the county should explore more efficient ways to direct such care (and resources) to much less expensive clinics, suggesting that by giving the hospitals guaranteed payments of millions each year, it instead incentivizes a much less cost-efficient status quo.

"I hope I could provide you with information that was understandable and informative for you to support a referendum to be placed on the ballot this November," DiLallo wrote in an email to the commissioners last week. "A vote this November would be a pro-active decision to address a problem that will surface in future years."

Commissioner Robin DiSabatino was skeptical of the suggestion.

"I am upset, but I am going to see how it is played out," said DiSabatino, who confirmed she had met with DiLallo last week. "The people already rejected it by a 61 percent vote, at a cost of almost $400,000."

related:

TBT Editorial: County Failed to Make Case on Half-Penny Sales Tax