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Three seats are up for election on the West Volusia Hospital Authority board, and six West Volusia residents will be on the November ballot vying for them.

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.

The stakes in this election are high; some of the non-incumbent candidates have advocated for disbanding the Hospital Authority, or at least studying the possibility of doing so.

Originally set up by the Florida Legislature in 1957 to provide a hospital for West Volusia, the Hospital Authority built and operated for many years 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.

In 2000, the Hospital Authority sold Florida Hospital DeLand to Adventist Health System, a nonprofit health system that currently runs 26 hospitals under the Florida Hospital brand.

Group A, Seat 1 is open due to Commissioner Barb Girtman’s decision to run for Volusia County Council, rather than seek re-election to the West Volusia Hospital Authority. The race is between current school board member Dr. John Hill and Voloria Manning, a retired educator.

Former Hospital Authority Commissioner Raymond Long was eliminated from this race in the Aug. 28 primary.

In the race for Group B, Seat 2, incumbent Commissioner Kathie Shepard faced Michael Ray and former Deltona city commissioner Brian Soukup in the primary, and Soukup was eliminated.

Only two candidates — incumbent Commissioner Dolores Guzman and former Deltona city commissioner Webster Barnaby — signed up to run for Group B, Seat 1, so that race didn’t appear on the August ballot.

The election comes about a year after the Hospital Authority voted to raise its tax rate from $1.59 per $1,000 of taxable property value to $2.37 per $1,100, an increase of nearly 50 percent.

Some property owners questioned the drastic increase, which board members said was necessary due to rising administrative costs, a projected rise in enrollment in the Authority’s health-card program for low-income individuals, and an increase the costs of treating uninsured patients at local hospitals.

Questions have also been raised about the Hospital Authority’s funding of various nonprofit groups, which include Rising Against All Odds, Hispanic Health Initiatives, The Neighborhood Center and others.

Some argue the various groups provide services that, directly or indirectly, improve the health of poorer West Volusians, while others argue the Hospital Authority doesn’t keep close enough tabs on the effectiveness of the work its funding.

The Hospital Authority didn’t increase taxes for the 2018-19 fiscal year, which started Oct. 1., opting to set its millage rate at the rolled-back rate, $2.18 per $1,000.

The rolled-back rate is the millage rate that provides the same amount of revenue it collected this year, not counting revenue on new construction.

The Beacon talked to the six candidates running for the three seats.

We’re publishing interviews with the candidates for Group B, Seat 1, and Group B, Seat 2 in this edition; interviews for the Group A, Seat 1 candidates will run in the Oct. 18-21 Weekend edition.

Read about each of the two races on the following pages.


GROUP B, SEAT 1

WEBSTER BARNABY

<img class="wp-image-5272 size-large" src="https://www.beacononlinenews.com/wp-content/uploads/2020/07/75844d9431f4194cc48df85ccca3f2d7-scaled.jpg" alt="Webster Barnaby — Hospital Authority candidate Webster Barnaby, left, talks with Dan Eriksen at the DeLand Area Chamber of Commerce candidate hob nob in DeLand. Elections Office reports show Barnaby has raised $19,600 for his campaign.” width=”696″ height=”522″ />

Webster Barnaby — Hospital Authority candidate Webster Barnaby, left, talks with Dan Eriksen at the DeLand Area Chamber of Commerce candidate hob nob in DeLand. Elections Office reports show Barnaby has raised $19,600 for his campaign.

What made you want to run for West Volusia Hospital Authority?

“I’m a property owner, and as a property owner I was very sad to hear that the five commissioners had voted 4-1 to raise my property taxes for indigent care in my community, and I felt that that with the budget that the West Volusia Hospital board has, they had sufficient budget monies to take care of the indigent people in our community.

“In my opinion they could have looked at the budget more closely, and spent that $20 million budget more wisely.”

“I intend to be a fighter for the poor and less fortunate in our community.”

What role do you think the Hospital Authority should play, and is it doing so?

“The only role that an agency should play is the role that’s tied to its charter and its mission. I think it’s important for the agency and all agencies, particularly the West Volusia Hospital board, to be singularly focused on its original charter with great passion — that is, the care of the indigents in our community.

“Every other ancillary thing after that needs to come only when we are 100 percent. certain that we are caring for our indigents.

“I’m running because they need to be doing a far better job.”

What can be done to make the Hospital Authority and its services run more efficiently, especially in light of the tax increase in 2017?

“First of all, you need to have the right people on the board, people like myself, with the prerequisite experience of working in local government and having professional qualifications for doing the job. It’s critical.

“This is why I’m supporting not only my candidacy, but the candidacy of Dr. John Hill and Michael Ray.”

What do you think about the Hospital Authority’s relationship with Florida Hospital? Should the hospitals be asked to shoulder a larger portion of costs?

“If you were to go back and look at Florida Hospital’s original charter, they agreed that they would originally care for the indigent. But this was put on the taxpayer by the Florida Legislature.”

“I simply wish to make sure that Florida Hospital understands that they need to step up to to the plate.”

Do you support disbanding the Hospital Authority?

“I would have to look at that, if we came to that. That would have to be looked at very comprehensively. That’s a bridge that we would have to look at at a very comprehensive way, if I were to be fortunate enough to be serving on the commission.”


DOLORES GUZMAN (incumbent)

<img class="wp-image-5273 size-large" src="https://www.beacononlinenews.com/wp-content/uploads/2020/07/21eddbf0737bb3eb1f3d3ee0de0caa56.jpg" alt="DOLORES GUZMAN — Incumbent West Volusia Hospital Authority Commissioner Dolores Guzman sets out on one of the county’s trails. Elections Office reports show Guzman has raised $2,927 for her re-election effort, including $50 she lent her campaign.” width=”696″ height=”464″ />

DOLORES GUZMAN — Incumbent West Volusia Hospital Authority Commissioner Dolores Guzman sets out on one of the county’s trails. Elections Office reports show Guzman has raised $2,927 for her re-election effort, including $50 she lent her campaign.

What made you want to run for West Volusia Hospital Authority?

“In 2013, when I became a navigator for the Affordable Care Act, I saw that many people couldn’t get on the [health-care exchange], because they were under the federal poverty level. So I started researching with the other navigators, because we were devastated, We said ‘Oh my God, this is supposed to be covering everyone, but it’s not.’ So what do these people do? We didn’t expand Medicaid, and the whole thing is a mess.

“I have lived in this community for 24 years, and I did not know about the West Volusia Hospital Authority. If I didn’t know about the [authority], how do the people who live in this community know about these services?”

“I said ‘Well, this is where these people can go, and at least have services for six months until they get better, or they get a job and get on the Affordable Care Act.’

“I thought it was important that someone who is helping the community concentrate on health insurance and health care needed to be part of the board.”

What role do you think the Hospital Authority should play, and is it doing so?

“There are some things that can change and be better. We have a contractual agreement with the two hospitals, that we have a specific amount that they have to get [for providing indigent care], and that amount increased every year by the [consumer price index]. We can’t control that.

“We have an agreement that, 20 years ago, whoever was on the board made that agreement, because they needed to get the hospital out of the [Hospital Authority]. They couldn’t afford to continue that battle.”

What can be done to make the Hospital Authority and its services run more efficiently, especially in light of the tax increase in 2017?

“I want to be part of that new agreement that comes out in 2020. Those rates can be negotiated to, probably, decrease the amount of taxes that we have to charge the property owners in West Volusia

“I can tell you these services save lives no doubt, every day. There’s almost 35,000 people just in West Volusia who have no health care. I know that the [Hospital Authority] cannot take care of all of them.

“It’s like a bridge. It bridges them to going to something else.

“I can tell you, people that are sick cannot think straight. They cannot mentally function in a way that they can see to the future. Out of all the commissioners, I’m the one that’s kind of out there all the time, because I used to be a navigator. People would come to me constantly to get help with the Affordable Care Act. And that’s how I would bridge them with the [Hospital Authority health] card, if they didn’t qualify for the ACA. They would just sit there and cry because they were so sick, they didn’t know what the next step was. They didn’t know what to do to get better.

“Maybe when we negotiate the contract with the hospital, we can maybe put in some free services that our cardholders can get … They don’t pay for mammograms. Maybe that’s one of the services I’d like to get from one of the hospital. Same with the colonoscopies.”

What do you think about the Hospital Authority’s relationship with Florida Hospital? Should the hospitals be asked to shoulder a larger portion of costs?

“I know they do give back to the community constantly … but there’s other ways that are more efficient for the people’s health that it can happen.

“If your child needs something, and they don’t come to ask for what they need, would you know that they need that? We have to be proactive and we have to ask for what we need. Engaging them for the needs of the vulnerable community, we need to go out as commissioners and ask, ‘Can this be possible?’

“They understand that the community has grown in the past five years. It has grown enormously. They know there is a need out there.

“Some people say the budget needs to be cut. But how are you planning to take care of the people in need, if you cut the budget? I agree that we shouldn’t be raising the taxes so much, but at the same time, how are we going to take care of the people who need these services?”

Do you support disbanding the Hospital Authority?

“If the Hospital Authority gets disbanded, Volusia County residents are going to pay higher taxes, because there are three things on our budget that the county passed onto the Hospital Authority. The county said, ‘OK, we don’t want to continue raising taxes … can you take care of it?.’”

“We pay for the Medicaid reimbursement to the state, and that’s $2.25 million. We pay for the mental-health part the county that was supposed to cover, which is $325,000, and we pay for [Health Care Responsibility Act] — that is, the residents that go out of the county and into another hospital, that hospital has the right to charge our county for people who are uninsured, and that’s $819,000.

“So if we were disbanded, guess what? The county has to pick up all that.”

“There is a contractual agreement with the hospitals. You can’t disband it, because you will be in violation of the contract.”


GROUP B, SEAT 2

KATHIE SHEPARD (incumbent)

A01 #20. Kathie Shepard.jpg
A01 #20. Kathie Shepard.jpg

What made you want to run for West Volusia Hospital Authority?

“I was very actively involved with the Hospital Authority about the time they were selling the hospital to the Adventists. First they leased it to Memorial Health Services, then Memorial said ‘This is too big of a mess; We don’t want it.’ Then they sold it to the Adventists.

“About the same time, the Healthy Kids program was being piloted in Volusia County, and I had just had to retire from my teacher job because of my health and my children lost their insurance, because my husband was self-employed.

“I was horrified that the authority at that point hated Halifax [Health, the program’s preferred provider] so bad that they were not going to put in their share for that side of the county, the matching funds. If they didn’t, no child would be covered … I did everything I could do to shame them to cover kids.

“At one of the meetings I was at, a board member came out and asked me to be on Citizens Advisory Committee. I served on that for two or three years, as the chair, and then my health —  the bottom fell out, and I kind of backed out from being involved.

“About eight years ago, a member of my church approached me and said you need to get on the CAC again, which led me to running to office two times unopposed.”

“Then I decided that there needed to be continuity in the negotiations of a contract with the Florida Hospital DeLand, and Florida Hospital Fish [Memorial]. We don’t have to renew our contract, but in the process, I want to provide continuity and institutional memory for those negotiations.”

What role do you think the Hospital Authority should play, and is it doing so?

“I think that health care, and access to health care, the definition of those terms have changed. I don’t think that we need to be contractually required to give over $5 million to the hospitals anymore, [as] in the contract, as it was written 20 years ago.”

“I feel perhaps we may have interpreted it a little too broadly, for some of the things that we’re now funding, but I may be a minority and I may change my mind.

“Everything is fee for service. Nobody just gets money. We don’t have any employees. Everyone is contract, like our accountant — they’re paid an hourly wage. Nobody just gets money thrown at them.”

What can be done to make the Hospital Authority and its services run more efficiently, especially in light of the tax increase in 2017?

“Everyone but the hospital gets paid at or below the Medicaid rate.

“Because we have a contractual relationship, and all of the people get reimbursed at the Medicaid rate or below, we are able to hold costs back. Even the Good Samaritan clinic — they can’t treat anyone there that has insurance. but we do reimburse them for dental care.

“Some people think that we shouldn’t be doing dental care … but that’s debatable.

“I’ve gone on record to say that I don’t think we should be funding dental care, although your mouth is a very important part of the body.”

What do you think about the Hospital Authority’s relationship with Florida Hospital? Should the hospitals be asked to shoulder a larger portion of costs?

“I feel we have a good working relationship with the people who come to our meetings.  Recently I’ve had a couple of constituents call with questions and concerns regarding something that happened at Fish. I spoke to the CFO about it, he gave me his personal cell.

“It’s hard to negotiate with institutions, any institution. I think it’s amicable. It’s a two-way street, it’s open. There’s certain things that they’re bound to contractually.

“They’re changing their name to AdventHealth, and they had to get our permission to do that for Fish and DeLand.

“I asked, ‘What about our expense for having things reprinted?,’ because we have all of this literature for where people can go to get health care. They will reimburse us for the cost of reprinting material. They readily agreed to it, right that moment.”

Do you support disbanding the Hospital Authority?

“I don’t support that, and the thing I don’t think those candidates realize is there are three or four Volusia County Council obligations that they have pushed off to the taxing districts. If we get dissolved, the County Council is going to have to raise taxes to cover this.

“Part of our budget is the Medicaid match, which is required from the federal government for us to bring down Medicaid funds. Halifax pays that, too.”

“Another thing is the Baker Act, which is a legislative mandate, and the County Council is supposed to pay that, and they’ve pushed that off to the taxing districts.

“If a Volusia County resident is hospitalized in an ER or inpatient facility in any of the counties in the state, they can bill the county that the recipient resides in.”

“That is not even taking into account the lost productivity, the human suffering, and perhaps even the increase in crime if the West Volusia Hospital Authority went away. We currently fund a half a million dollars worth of drug and alcohol treatment at the Stewart-Marchman center.”


MICHAEL RAY

<img class="wp-image-5275 size-large" src="https://www.beacononlinenews.com/wp-content/uploads/2020/07/461dac95c76dfe42bedcdd2fdf4d9379-scaled.jpg" alt="MICHAEL RAY — West Volusia Hospital Authority candidate Michael Ray speaks to voters in a forum sponsored by the West Volusia Regional Chamber of Commerce. Elections Office reports show Ray has raised $1,050 for his campaign, including a $500 loan from himself.” width=”696″ height=”812″ />

MICHAEL RAY — West Volusia Hospital Authority candidate Michael Ray speaks to voters in a forum sponsored by the West Volusia Regional Chamber of Commerce. Elections Office reports show Ray has raised $1,050 for his campaign, including a $500 loan from himself.

What made you want to run for West Volusia Hospital Authority?

“I’ve been going to the meetings for, probably, about the last four years, and it was just kind of serendipity that occurred. It was really observing the current commissioners, and some of the decisions they made, most specifically with the 2017-18 tax increase.

“I just felt like they went about it the wrong way. It was how they justified it that kind of infuriated it me, and so that’s what motivated me to run.”

What role do you think the Hospital Authority should play, and is it doing so?

“When the authority was chartered by the Florida Legislature, it was chartered to run a hospital. They haven’t done that for nearly 20 years now. I still think there’s an opportunity to fulfill a mission and save the taxpayer money overall.

“We can take a look at primary care and mental health care. There’s just not a good funding source especially for mental health care. An ounce of prevention is worth a pound of care.”

What can be done to make the Hospital Authority and its services run more efficiently, especially in light of the tax increase in 2017?

“Stop funding duplicative services. Make sure that we’re getting measurable, evidence-based outcomes for the tax dollars that we do spend. We also have to look at some agencies that are pretty well-funded as it is. I’m not sure that additional subsidies need to continue in the form of West Volusia tax money.”

What do you think about the Hospital Authority’s relationship with Florida Hospital? Should the hospitals be asked to shoulder a larger portion of costs?

“I absolutely do. That’s a question that, of course, with the contract renewal coming up with Florida Hospital, everybody will be asking.

“My position is no, they don’t need to continue to receive $5 million in the form of taxpayer subsidies when, quite frankly, I think the number of subsidies they receive from the taxpayers in West Volusia are quite significant.

“You look at [how the hospitals’ properties are taxed]. They receive quite a few breaks as a not-for-profit hospital.”

Do you support disbanding the Hospital Authority?

“I know that that’s something that has been brought up. My opinion is if the authority is going to be in existence, I think there is still a great opportunity to help the citizens of West Volusia. I would not be opposed to a disbanding, but I would not be in favor of a ‘big-bang, shut-it-down.’ And, really, I think for the agencies that are funded that do a great job, I just don’t think that’s fair.”

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