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    County finds funds for indigent care

    Hillsborough's model program to provide health care for the poor survives as County Commission provides a bailout.

    By DONG-PHUONG NGUYEN, Times Staff Writer
    © St. Petersburg Times
    published January 31, 2002


    TAMPA -- After months of debate, the Hillsborough County Commission gave its struggling indigent health care program new life Wednesday by voting to shift funds, dip into reserves and slash services.

    The program for the poor, hailed as a national model and replicated across the country, faced a $6.6-million deficit and an uncertain future without the bailout.

    But all was not saved. After four hours of discussion, a majority of commissioners agreed that key cuts and changes had to be made to salvage the taxpayer-funded health plan, which serves about 19,000 of the county's poorest citizens.

    The vote was met with mixed reviews by those happy to see the $90-million-a-year program kept afloat, but unhappy with the cost of the life jacket.

    "They have picked this thing like vultures on a carcass," said Dr. Dennis Penzell, the medical director of Suncoast Community Health Centers, which operates clinics in Ruskin, Dover and Plant City. "It would have been wonderful had they kept the level of service. I would have liked to see money pulled from other places."

    Penzell was particularly critical of the decision to limit enrollment qualifications for patients suffering from catastrophic illnesses. The revised plan raises the income level to qualify for treatment for such serious ailments as chronic lung disease and diabetes. Officials did not know how many people might be turned down because of the new guidelines.

    Several times commissioners bandied about the idea of raising money with a one-cent gas tax, but ultimately voted that idea down 4-3.

    Among the changes commissioners enacted:

    Transfer $3.1-million from the county's reserves.

    Use property tax money earmarked for road construction along Bruce B. Downs Boulevard to pull in $2.5-million per year over the next five years. (Community investment tax funds will pay for the roadwork instead, keeping that project on schedule.)

    Transfer some money now being used to help pay for medical treatment for inmates.

    Shorten the enrollment period.

    All of the moves, with the exception to dipping into reserves, came at the suggestion of county staff. It was Commissioner Jim Norman who suggested scooping from the county's reserves, estimated at $20-million.

    "It could not come at a worse time to touch our reserves," said Commissioner Jan Platt. "I'm sure that right now, with the climate that exists in our world, you never know."

    But Norman asked that the money be taken with the understanding that it would be restored, somehow, in the 2004 budget.

    The commission voted 5-2 to transfer the funds, with Platt and Commissioner Thomas Scott dissenting.

    Scott, who expressed reservations over raising the qualifying income limit for catastrophic illness treatment, otherwise praised the staff's recommended changes.

    "It's a good one to an award-winning national program," he said, adding that he would have been willing to pay more in property taxes to save the program.

    The votes came after more than a dozen residents spoke in support of the program, which serves about 5 percent of the 12 percent of the population who qualify.

    For months, they urged commissioners to save the 10-year-old program, which uses 12 primary care clinics, five hospitals and 600 physicians.

    "We agonized over this," Kathy Harris, assistant county administrator, told commissioners. "No one is coming out of this completely unscathed."

    -- Dong-Phuong Nguyen can be reached at 813-226-3403 or nguyen@sptimes.com

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