The Hospital District deferred a decision last week on subsidizing maternity care at Cleveland Clinic Indian River Hospital, but it seems likely to soon offer some taxpayer assistance to help cut the hospital’s losses on its Labor and Delivery Unit.

After hospital Vice President and Chief Medical Officer Dr. Richard Rothman reported that labor and delivery services continue to lose millions annually while overall hospital operations move toward the break-even point, three town hall meetings were held and a phone survey was conducted of 600 people to gauge community interest in keeping maternity services in Vero.

“We’ve had a great outpouring of support for maternity and labor and delivery,” Hospital District Chairman Bill Cooney said last week. He said the phone survey and town halls were “very similar in their outcomes, demonstrating a clear message. Save maternity. Save labor and delivery within our county.”

Many participants and 80 percent of those surveyed were open to using taxpayer dollars to “save” local maternity care.

Cleveland Clinic, in its 2018 agreement to take over the Indian River hospital, only committed to keep Labor and Delivery open for the first 10 years of its lease, through 2029.

A loophole in the 75-year agreement could let Cleveland Clinic close the unit sooner, however, because HCA Lawnwood Hospital delivers babies only 17 miles away in Fort Pierce.

As reported in the June 16 issue of this newspaper, the Cleveland Clinic unit is designed to service the 1,200 babies born per year to Indian River County parents. But Vero’s hospital has drawn less than 75 percent of the maternity market since Cleveland Clinic took over.

Expectant moms travel outside the county for a variety of reasons, many of which could be overcome by enhancing local newborn care and marketing the under-construction $7 million revamped facilities. Over time, Indian River County must also attract more young families to have babies here as the population ages. 

While a strategy is being developed to keep more expectant moms in Vero, the Hospital District seems inclined to help stem Cleveland Clinic’s losses in the short-term.

Still, a motion last week to earmark $2 million for labor and delivery failed for lack of a second.

Trustee Allen Jones had proposed “that we work together with Cleveland Clinic to try to solve this labor and delivery issue on a sustainable basis, and that for the next year, we fund an additional $2 million, which is roughly half their loss. So that's like a partnership.”

Cleveland Clinic is already receiving large sums from taxpayers through the hospital district to subsidize outpatient prenatal care provided through Partners in Women’s Health. In calendar year 2024, it received $3.13 million and Partners is expected to be awarded $4.2 million in the coming year for this prenatal and gynecological care for uninsured, indigent and Medicaid patients.

One big sticking point with district trustees is that Rothman has not directly asked the Hospital District for more money, or filled out a funding application for the labor and delivery program. He has only told the district that maternity operates at a significant loss and that Cleveland Clinic is determined to support labor and delivery as long as it can financially sustain it.

When Hospital District trustees meet for a public hearing of their proposed $23 million 2025-26 budget on Sept. 4, they will determine how to balance the community’s tax burden and district reserve funds with the opportunity to make labor and delivery better and more sustainable, long-term.

As it stands right now, the district set a maximum property tax rate for the next fiscal year of .765 mills, or 76.5 cents per $1,000 of taxable value – the same as the current year’s rate, which will bring in nearly $1.9 million more taxes due to rising property values.

“There's different spending levels, different views on the millage rate, but I think the board is working all together, and holding reserves as they are and moving forward. We have to remember that we are a taxing authority through our special act and that provides for opportunities to help the citizens of our county through taxing,” Cooney said.

Unfortunately, hospital district budgets have soared in recent years, putting pressure on the seven elected trustees to cut taxes – not to find new things to spend money on.