Commissioners are elected to the West Volusia Hospital Authority to plan and oversee the spending of funds collected from taxpayers to assure that poor people have access to medical care.
West Volusia voters will be electing three commissioners this fall.
The Hospital Authority’s mission has changed in many ways since the Florida Legislature first established the taxing authority in 1957. The mission started with the need to build a public hospital for DeLand.
The Hospital Authority did that, spending its money to build and operate what is now Florida Hospital DeLand, which opened in 1962 with 60 beds.
Eventually, however, running a hospital became more and more complicated, and the Hospital Authority leased the DeLand hospital, then eventually sold it.
Without a hospital to run, the Hospital Authority now focuses on partnering with private entities like Florida Hospital and other nonprofits, like Good Samaritan Clinic, The Neighborhood Center of West Volusia, and Northeast Florida Health Services, to provide health care to West Volusia’s poorest residents.
Races for seats on the Hospital Authority board have often been low-key, low-budget political campaigns, and Hospital Authority commissioners have not infrequently been elected or re-elected without opposition.
Not this year.
Of the five seats on the Hospital Authority, three are up for election, and all the races are contested. Two of the races have three candidates each, and these two races will be on the ballot in the Tuesday, Aug. 28, primary.
The surge of interest in the Hospital Authority may have something to do with the commissioners’ vote in September 2017 to raise its tax rate nearly 60 percent, from 1.59 mills for 2017 to 2.366 mills for the current year.
The owner of property with a taxable value of $100,000 is paying about $237 a year to fund the Hospital Authority.
Several of the candidates say that’s too much money. Some of them think the Hospital Authority is no longer needed. Others, including, generally, the incumbents, say the Hospital Authority’s funds are making a big difference in the lives of those who don’t have health insurance, or otherwise struggle to pay for medical care that saves lives — and saves taxpayers money in the long run.
Another key factor is the pending expiration of the Hospital Authority’s contractual obligation to support West Volusia’s two Adventist-owned hospitals. That contract, which currently costs taxpayers $5.6 million a year, ends at the end of 2019, unless the Hospital Authority renews it.
Voters in these races will be helping to shape the future of health care for poor people in West Volusia for years to come.
— Beacon staff
Read profiles of the candidates on the following pages.
Group A, Seat 1
West Volusia Hospital Authority commissioners in Group A serve two-year terms. In this contest, there is no incumbent, since Barb Girtman is giving up the seat to run for the County Council District 1 seat.
Former Hospital Authority Commissioner Voloria Manning, who operates a child care center, along with Dr. John Hill, a family physician who recently served one term on the Volusia County School Board, and Raymond Long, a retired fitness-center owner who previously served on the Hospital Authority, are running for the seat.
Hospital Authority commissioners are not paid. The races are nonpartisan, so all registered voters who live in the hospital district — which includes all of West Volusia — may cast ballots in the race.
Dr. John M. Hill
The West Volusia Hospital Authority hasn’t “had any real representation from a medical perspective,” according to Dr. John Hill.
He said his experience as a West Volusia physician who also has worked in the area’s hospitals would bring a fresh viewpoint to the table.
From Hill’s viewpoint, the Hospital Authority probably should be dissolved.
Hill said the Hospital Authority is costing taxpayers more than it should.
“I dove into the budget and found a litany of vendors providing services at a huge cost to the taxpayer,” Hill told The Beacon.
Hill wants all those service-providers to resubmit their proposals for funding, once the election is over, so the commissioners can examine what services are being provided, at what cost, and whether those services are duplicating services already available to the poor.
Early on, when the Hospital Authority owned the DeLand hospital, it was responsible for covering hospital employees’ retirement benefits, Hill said, but that responsibility ended when the hospital was turned over to private enterprise.
Hill was 18 years old and working at the hospital when privatization occurred, he said.
Now, as a physician, Hill remains on staff at Florida Hospital DeLand.
A key program offered by the Hospital Authority is its health-card program, which allows cardholders — who don’t have private insurance and aren’t eligible for Medicaid — to access health care services paid for by the Hospital Authority.
Hill is concerned that billing snafus have caused the Hospital Authority to pay twice for services provided under the health-card program.
The Hospital Authority administration said that didn’t happen, although there was some concern about bills that were submitted late, which caused confusion about whether those bills had already been paid.
Hill also takes issue with the fact that some card carriers are not legal United States citizens.
Another of Hill’s concerns is marketing costs. When enrollment in the health-card program dropped to 800, Hill said, the Hospital Authority voted to spend $100,000 on a marketing campaign “to try to get people to sign up.”
Legal fees are another problem, he said.
The Hospital Authority’s legal fees, Hill said, “are excessive and arguably not necessary.”
The Hospital Authority’s preliminary budget for the coming year sets aside $70,000 for legal services provided by DeLand attorney Ted Small.
Hill also pointed to revenue going to Volusia County government.
“The property appraiser turned into the beneficiary of almost half a million dollars,” he said.
According to the West Volusia Hospital Authority’s current-year budget, in addition to tax dollars allocated for indigent care, more than $625,000 is earmarked for “tax collector and property appraiser fees.”
A Hospital Authority official said those fees are a percentage, required by law to be paid by any agency that collects property taxes.
“It’s time for this contract to dissolve,” Hill said. “If property owners want to pay extra taxes, use that money to supplement EVAC, instead.”
Ray Long remembers.
The 72-year-old retired business owner, whose family goes back several generations here, remembers when West Volusia citizens voted to tax themselves to establish a community hospital.
There’s a lot the former West Volusia Hospital Authority commissioner remembers from his eight years as a commissioner.
Long remembers when the Hospital Authority leased the DeLand hospital to Memorial Health Systems, and he remembers when Memorial exercised its back-out clause, and Adventist Health System bought the DeLand and Orange City hospitals.
Once the hospitals were sold, Long said, the tax rate decreased for five years in a row.
Long said he used to emphasize that, in the Halifax hospital district, which owned a community hospital, taxes kept going up.
“Ours came down because we had no community hospital,” Long said.
On the Hospital Authority, Long said, he voted to reduce the tax rate cap from 5 mills to 4 mills.
“I tried to get it to 3,” he said. “I wanted 2, but I knew that was unrealistic.”
Now, he said, taxes to support East Volusia’s Halifax are decreasing and those in West Volusia are rising.
“How come Halifax still has a community hospital and millage keeps coming down? We don’t have a [hospital owned by the Hospital Authority] and ours keeps going up?” Long said.
Long is keeping a close eye on the lawsuit filed to prevent the Halifax hospital district from building a hospital in Deltona. He said the West Volusia Hospital Authority could end up paying for indigent care at that hospital.
“And by law they should,” he said.
Long said he’s very confident in his knowledge of what went right with the Hospital Authority, what went wrong, and the importance of looking ahead.
The founder of Personal Best Fitness in DeLand, Long said 40 years in business for himself taught him a key element to fiscal success: “always looking down the road.”
The West Volusia Hospital Authority is like a derailed train, Long said, in which taxpayers have lost confidence.
“We need to get this under control, with expenses,” he said. “We need to get the train on track and quit raising people’s taxes.”
“I warned them last year that if they voted for a tax hike, people would uprise,” he said. “And now look; every seat is being challenged.”
Years ago, the Hospital Authority had $12 million in a reserve account, Long remembers.
“They got sidetracked and started funding things that didn’t fit the defined purpose,” he said. “They literally spent $100,000 with an advertising agency, saying ‘Come get some.’”
Long is referring to a marketing program for the Hospital Authority’s health-card program.
When hospital administrators complained that their costs were rising due to so many underinsured and indigent people visiting the emergency rooms — where federal law mandates they must be treated — the Hospital Authority funded clinics in Pierson and DeLand.
“That’s what we should have stuck to doing,” Long said.
If elected, he’s determined to closely examine where the tax dollars are spent.
“It’s time to turn this train around,” he said. “Just like before, I’m going to give it 100 percent.”
Long said he has been enjoying retirement from the fitness business, but is ready to go back to work.
“We have to go back and show fiscal responsibility, so we can regain taxpayers’ trust,” he said. “If you’re on an ego trip, don’t run for political office. Honesty and integrity are not only good, they’re good business.”
Voloria L. Manning
Voloria L. Manning is a retired Volusia County educator and founder of Temple Learning Center, which provides voluntary prekindergarten and summer camps for children in DeLand’s Spring Hill area. She previously served on the Hospital Authority, and has most recently been serving on the Hospital Authority’s Citizens Advisory Committee.
Her concerns naturally extend to children.
If elected to serve on the West Volusia Hospital Authority, one change Manning said she wants to effect is the addition of child-friendly areas in local hospitals.
Too often, Manning said, children are subjected to negative and frightening experiences while waiting for an adult in their family — mother, father, grandparent — to be treated.
“I don’t want kids to go to the hospital and think it’s a bad place,” Manning said. “And people pass away there, so the last experience a child had was a person, grandmother, for example, passed away there.”
Creating safe, pleasant child-friendly areas within hospitals would alleviate stress both for the patients — who often have no alternative to taking a child with them as they seek medical treatment — and the children, Manning said.
A former member of the National Guard, Manning also served as an assistant to Joyce Cusack when Cusack was serving in the Florida Legislature. Manning is currently chairwoman of the West Volusia Hospital Authority Citizens Advisory Committee.
As such, Manning said, she is well-aware of what is working and what is lacking for uninsured, underinsured and indigent West Volusia residents.
On the other end of the age spectrum, Manning’s sense of duty also extends to the elderly, and to any adult who feels isolated.
“I want to visit the sick and shut-ins,” she said.
If their needs are unknown, those needs risk being unmet, according to Manning.
Manning is a strong believer that “an ounce of prevention is worth a pound of cure,” and she has been a strong proponent of the Hospital Authority funding preventive health care.
She said prevention should not be a luxury only for those who can afford it.
Making preventive health services easily available eliminates suffering for the underserved and saves taxpayers in the long run, Manning has preached repeatedly.
“I am my brother’s keeper,” she said.
Group B, Seat 2
West Volusia Hospital Authority commissioners in Group B serve four-year terms. In this race, Commissioner Kathie Shepard is running for re-election. She’s being challenged by Brian Soukup, a former Deltona city commissioner, and Michael Ray, an accountant and health care administrator.
Hospital Authority commissioners are not paid. The races are nonpartisan, so all registered voters who live in the hospital district — which includes all of West Volusia — may cast ballots in the race.
Michael Lee Ray
Michael Ray’s extensive educational background, financial-employment experience, and his volunteerism and his in-depth study of the West Volusia Hospital Authority all contribute to his being the ideal Group B, Seat 2 candidate, he told The Beacon.
For four years, Ray has attended meetings of the West Volusia Hospital Authority.
He also serves on the Citizens Advisory Committee, which includes 10 members appointed by Hospital Authority commissioners.
Ray works as a certified public accountant. He has lived in DeLand for 14 years.
He has worked as chief financial officer and as chief operating officer for various health-care-related organizations. He holds a bachelor’s degree in business administration and two master’s degrees — in taxation and not-for-profit management — as well as a doctoral degree in health science, specializing in service and delivery of health care, Ray told The Beacon.
He also served in the U.S. Navy, is designated as a certified management accountant, is certified in financial management and is licensed by the State of Florida as a nursing home administrator.
Among Ray’s observations of the taxpayer-supported Hospital Authority: frequent member turnover and too many appointed, versus elected, commissioners.
“I think that has had a lot of impact on the Authority,” he said.
He proposes a new vision and direction for the Hospital Authority, in the shape of lower taxation and paying nonprofit contractors only for the level of services they are actually delivering.
During budget meetings, members of the Hospital Authority expressed concern that many of the organizations that were funded had not spent their allocation, but were asking for more.
If elected, Ray said, he will be focused on the budget: “making sure we’re spending money where there’s a return on the dollar,” he said.
“I think we just kind of spread the dollars around like pixie dust and hope for the best,” Ray said. “I think we can do better than that.”
He said the Hospital Authority also can, and should, decrease its expenditures.
From 2013-14 through the present, the Hospital Authority has collected $74 million from West Volusia taxpayers, according to support staff at Dreggors, Rigsby and Teal, P.A., which provides administrative services to the Hospital Authority.
“The West Volusia Hospital Authority does not own or operate a hospital,” Ray reminded voters in a post on social media.
Last year’s nearly 60-percent tax increase to fund the Hospital Authority shocked Ray, along with many fellow taxpayers.
“I look at the property records, and taxes went up more than $100 for a lot of people who can’t afford the additional expense,” he told The Beacon.
If elected, Ray said, he will “cut unnecessary or duplicative spending and be a faithful steward of West Volusia taxpayers’ money.”
Kathie Shepard currently is serving a second term on the West Volusia Hospital Authority.
She wants voters to know that she voted against a costly line item in the fiscal year 2016-17 budget — marketing to boost enrollment in the Hospital Authority’s health-card program.
“I was the only one who voted against the $100,000 for advertising,” Shepard told The Beacon.
The marketing must have been effective, though.
Shepard said enrollment in the program rose 38 percent that year, using up all of the financial reserves, and increasing the budget.
“So, we raised taxes 2017-18 to cover the increase in enrollment,” she said.
For decades, Shepard has studied and worked with the taxing district to provide health care resources to those who otherwise would not have access.
Twenty years ago, she said, she lobbied the Hospital Authority to fund the Healthy Kids program in West Volusia, “so that all kids in the entire county could be covered.”
From there, she was appointed to its Citizens Advisory Committee, and went on to be elected to the seat she now occupies.
One of Shepard’s primary goals is education.
“I feel like many people don’t understand what the West Volusia Hospital Authority does, other than taxes,” Shepard said.
Shepard is satisfied with the Hospital Authority’s efforts to assure that those who receive help really need it.
“Applicants who qualify have to be at or below 150 percent of the poverty level, and have less than $5,000 in assets,” Shepard said. “You have to show that you have no access to insurance, that you applied for the Affordable Care Act.”
She added, “If you’re eligible for the ACA, you cannot get a health care card from the West Volusia Hospital Authority.”
When the Hospital Authority sold West Volusia’s two hospitals to Adventist Health System, the Hospital Authority became contractually obligated, for 20 years, to pay Florida Hospital DeLand and Florida Hospital Fish Memorial in amounts that increased each year, according to the cost-of-living index.
“Since I’ve been involved, it’s been over $5 million, and the two hospitals split it,” Shepard said.
This year, the amount to cover indigent care at the hospitals is more than $5.6 million, she added.
“The hospital has to present an invoice showing where the cardholder has received services before it can be reimbursed,” she said. “These people have no Medicare, Medicaid, Affordable Care Act, nothing.”
Shepard acknowledged the hospitals get reimbursed at a higher rate than other agencies, and she wants voters to know that for as long as she serves, she will remain open to change where needed.
“That contract is going to expire at the end of next year,” she said. “Neither party has to renew the contract at all.”
She added she is open to renewing the contract.
Shepard said she wants those who don’t otherwise have access to receive needed care.
“People still need health care, even those who make more than 150 percent of the poverty level,” she said.
Shepard said her focus on the disenfranchised population, and her thorough knowledge of how the Hospital Authority’s assistance works for them, is what sets her apart from her opponents.
In 2001, then-Florida Sen. Evelyn Lynn appointed Shepard to serve as a consumer member of the Agency for Health Care Administration District 4 Managed Care Ombudsman Committee.
The committee was established to assist the Agency for Health Care Administration in monitoring quality issues, to advocate for consumers enrolled in managed-care programs and to encourage public input in developing managed-care policies.
“For the last 25 years, I have been advocating for health care for all children and those adults who have none,” Shepard wrote in an email. “My appointment as consumer advocate by Senator Lynn was a great honor, as I feel she was recognizing the work I had done and my passion for getting and keeping people healthy so they can become productive members of our community.”
Former Deltona City Commissioner Brian Soukup said his candidacy for a seat on the West Volusia Hospital Authority is compelled by a desire to protect citizens like himself.
“I work in the private sector,” Soukup said. “My health insurance went up after Obamacare. Health insurance is going up; taxes are going up; wages are not going up.”
Soukup moved to DeLand six months ago, after resigning his seat on the Deltona City Commission after clashing with Deltona city administration.
Soukup’s word on the West Volusia Hospital Authority: “If you’re going to take taxpayer money, you’d better be spending it for the original purpose.”
At this point, Soukup said, the Hospital Authority is “taxation on top of taxation.”
As more community hospitals have sold to corporate health systems, taxing districts such as the West Volusia Hospital Authority have been dissolved, Soukup said.
“There are less than 30 hospital taxing districts across the state of Florida,” Soukup said. “Volusia County has three of them.”
Soukup said he is not against nonprofit organizations getting money for providing services to citizens.
“But I want accountability, and it needs to be within reason,” he said. “We’ve done public-records requests through the Hospital Authority’s website, and have not gotten a response.”
Soukup said residents and businesses are paying county, state and federal taxes, while not-for-profit institutions such as Florida Hospital, under Adventist Health System, are tax-exempt, yet getting taxpayer funds from the Hospital Authority.
Soukup called that double dipping.
“The nonprofit hospital system in West Volusia is essentially not paying any property tax,” Soukup said. “Central Florida Regional in Sanford pays $446,000 a year in property tax.”
He added, “Florida Hospital DeLand pays $11,000.”
West Volusia’s two Adventist hospitals pay a total of just under $21,000 in Volusia County property taxes, according to Jan Cornelius, deputy Volusia County property appraiser.
“They pay some because some of their office space is leased to doctors who are not employed by the hospital,” Cornelius said.
“If you are a nonprofit hospital system, under Florida law, you’re supposed to be giving back to the community,” Soukup said.
He also said funding nonprofit organizations that serve a specific race of people is not fair to all citizens.
He’s referring to Hispanic Health Initiatives, which received $75,000 from the Hospital Authority in the fiscal year 2017-18 budget.
“The people in my family should be able to get money from the same organizations as everyone else is,” he said. “There are illegal aliens out of Pierson receiving these services.”
He added, “For those of us who have to pay for health insurance, it’s kind of a slap in the face.”