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Hospital backs out of stopgap funding deal with district

STORY BY MEG LAUGHLIN (Week of March 26, 2015)

Whatever shred of hope there might have been for agreement between the Hospital District and Indian River Medical Center management on indigent care reimbursement fell apart last week when IRMC CEO Jeff Susi backed out of an apparent one-year stopgap funding deal.

The next step in the long-running dispute is unclear at this point.

In a surprise email to his own hospital board and to Hospital District trustees Thursday afternoon, Susi denied that the hospital and the District had ever agreed on how the District would reimburse the hospital for indigent health care and, also, on how much the District would give the hospital in fiscal year 2015 for Partners, the hospital’s childbirth program. 

The email arrived just before a televised Hospital District meeting where District trustees had planned to announce the formula for reimbursement and the Partners funding agreement, which are a small part of a larger agreement that the hospital and District have been unsuccessfully trying to negotiate for over a year.

Wanting to make the most of what little agreement there was, District trustees had planned to memorialize the formula and Partners funding amount in two resolutions at their Thursday monthly meeting in county commission chambers.

But the unexpected email from Susi left them wondering whether to pass the resolutions at all. As a result, the meeting, which is televised every month beginning at exactly 4:30 p.m., began several minutes late.

District trustee and negotiator Gene Feinour called Susi’s email “another hand grenade” from the hospital. “The taxpayers need to be aware that we have been in arduous negotiations. But we get to a point and suddenly things dissipate,” said Feinour. “These hand grenades at the last minute are not how I choose to operate.”

District Chairman Tom Spackman agreed, saying that there were “too many 11th-hour surprises” from the hospital.

Susi’s email began: “It is important for the Trustees to know that the negotiating team members from the Medical Center do not agree with the assertion that the Medical Center representatives have agreed upon the reimbursement formula ... nor have they agreed to accept $1 million as full funding for the Partners program in FY 2015.”

The $6 million cap that the District budgeted for the hospital for indigent care for fiscal year 2015 is incorrect, wrote Susi. It should be “a soft cap of approximately $6.7 million.”

Further, he said, the hospital had not agreed to the $1 million cap for Partners for FY2015.

Instead, the hospital had agreed that a group from both sides would decide the amount “with the expectation that the District funds the financial shortfall,” said Susi.

The District Trustees say that under Florida law, it is up to the District trustees alone, as elected representatives of the taxpayers, to decide how much the hospital gets for indigent care, while the hospital management says the District should pay whatever the hospital needs and asks for.

Despite the Susi email, District trustees voted unanimously to cap the amount from taxpayers at $6 million for FY 2015, with the understanding that if indigent care expenses went over that, the hospital could ask for more tax dollars and the District would “consider said request.”

Also, the District voted unanimously to stick with the $1 million Partners amount for this year and to collaborate with the hospital over future funding recommendations.

But the decision on the amount for Partners would be up to District trustees alone.