County offers TGH $3.5-million

The struggling hospital would have to create a three-year business plan and allow two commissioners on its private board.

By WAYNE WASHINGTON

© St. Petersburg Times, published April 8, 2000

TAMPA -- Cattle-prodded by exasperated state legislators, the Hillsborough County Commission on Friday offered troubled Tampa General Hospital $3.5-million from the reserve fund of the county's indigent health care program.

But the money, just over half what local legislators want the county to give the struggling hospital, comes with a set of strings that would pull TGH as close to public status as it's been since it went private three years ago.

To get the money, TGH would have to put together a three-year business plan by Wednesday. The plan would have to be submitted to the county, and a committee of two commissioners, two Hillsborough County Hospital Authority board members and two members of TGH's private board would oversee its implementation.

Most significantly, the hospital would have to accept two county commissioners on its private board. That would effectively open the board meetings to the public, though a judge already has ruled that the meetings should be open. The hospital is appealing that decision.

Hospital officials sat stoicly during the commission debate Friday and refused to comment afterward. TGH has lost $30-million since it went private, partly because of expensive services only it provides.

Isaac Mallah, president and chief executive officer of St. Joseph's Baptist Health Care, reiterated his concern that the county is playing favorites. County assistance to TGH creates an uneven playing field, Mallah said, and forces St. Joseph's to question whether to discontinue some of its own expensive services.

"We have to seriously consider that," Mallah said. "I plan to discuss it with my board chair. The financial losses are significant for us as well."

County officials said all Hillsborough hospitals receive some funding through reimbursements for services they provide under the indigent health care plan. Those reimbursement rates are tied to the top level of service a hospital can offer, with TGH offering the highest level.

Commissioners and Hillsborough legislators agree that TGH provides services too important for county residents to lose, but they disagree strongly on how much aid the hospital should receive.

The commission's actions on Friday came after Hillsborough legislators introduced amendments in Tallahassee requiring the county to spend $6-million of the reserve fund on TGH. They also are pushing for as much as $20-million more in funding for the hospital because it is a teaching facility for University of South Florida medical students. Less than a month remains before the legislative session ends.

Consultants could be called in to examine TGH as early as October if the hospital's finances don't improve and it fails to meet its bond obligations.

So far, the county's efforts to keep that from happening have been lax, legislators said. Friday's decision didn't change that perception.

"I don't even think that's a good faith offer," said Sen. John Grant, R-Carrollwood. "Six-million is the figure. They need to get realistic."

Commissioners said they are reluctant to dig deeper into the $106-million reserve fund because they might want to expand its services.

"That's just an excuse for not doing what they should be doing," Grant said.

Added Sen. Tom Lee, R-Brandon: "Ultimately, we're going to want to see them do more."

Part of the proposal approved by the commission on Friday calls for only $1.75-million to be pulled from the reserve fund if the Legislature amends a lien ordinance it passed two years ago. That ordinance would restore to TGH power to demand a portion of any insurance settlement former patients get after receiving care for which they could not pay.

TGH had that authority as Hillsborough's only public hospital. Hospital officials have said that power is worth up to $6-million a year. Commissioners have refused to implement the lien ordinance because they believe it's simply a boon to trial lawyers and gives hospitals too much clout over poor patients.

Commissioner Chris Hart said the county has repeatedly tried and failed to get the Legislature to change the ordinance to make it more acceptable to the commission. Several commissioners seemed unaware that, because the ordinance requires a 30-day notice before it can be changed, it can't be altered this legislative session.

"All we're down to is one legislator who doesn't want this lien law changed," Hart said during the commission meeting. "He did a good job representing the trial lawyers. He did not do a good job representing the very people who were injured. Now, I won't mention John Grant's name."

Grant and Hart spoke on Friday afternoon and seemed to be making an effort not to personally criticize each other further. But their central disagreement remains: Grant thinks the county has been slow and stingy; Hart thinks the state should fund a hospital that offers state and regional benefits.

The commission voted to send one of its members to Tallahassee to meet with legislators on Tuesday. An emergency meeting planned for today was scrapped after several legislators refused to participate.

Tuesday's meeting seems to have a better chance of actually taking place. But Grant is less than certain he'll be there.

"I don't know whether we will meet with them or not," Grant said. "It's not on my calendar."

- Wayne Washington can be reached at (813) 226-3387 or washington@sptimes.com.

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