Expressing continuing concern about hospital care for poor people in West Volusia, the West Volusia Hospital Authority adopted a budget for the coming year that cuts expenditures by about $1 million.
The Hospital Authority collects property taxes from across West Volusia to assure that health care, including hospital care, is available to those who cannot pay.
The final budget for the 2020-21 fiscal year totals $18.6 million.
The Hospital Authority’s elected commissioners approved a millage rate that’s 14.4 percent lower than the rate that would have brought in the same amount of money as last year.
The new rate is 1.5035 mills. Someone who pays taxes on $50,000 worth of property will pay about $12 less in Hospital Authority taxes under the new rate.
Much of the savings comes from the elimination of AdventHealth from the budget, which freed up nearly $3 million. Instead of a contract with a West Volusia hospital, the Hospital Authority set aside $1.5 million for “other health care costs,” which could include reimbursing hospitals.
A new initiative the Hospital Authority will spend money on in the coming year is opening clinics where West Volusians who are members of the WVHA health-card program can get a variety of services.
The plan to lower the millage and pull money from reserve funds concerned one longtime observer of the Hospital Authority, Tanner Andrews.
Andrews submitted a letter to the WVHA for its Sept. 24 budget meeting, concerned that one-time costs for the new clinics and uncertainty due to the COVID-19 pandemic could spell trouble.
“I sincerely hope that our membership projections are realistic; the COVID-19 situation makes it somewhat uncertain,” he wrote.
Even with the budget finalized, there are still concerns over hospitals in the area. While an agreement is expected soon between the WVHA and Halifax Health, according to the Hospital Authority, there is no formal contract yet between the WVHA and any area hospitals.
This means members of the health-card program have no designated hospital for inpatient care.
The planned agreement between WVHA and Halifax Health would allow health-card holders to access care at Halifax Health | UF Health – Medical Center of Deltona, as well as the new miCare clinics.
The first miCare clinic, at 844 W. Plymouth Ave. in DeLand, just opened. The second clinic, most likely located in Deltona, will open in the coming months, and a third is planned to open in Pierson by summer 2021.
The Hospital Authority tried for months to negotiate an agreement with AdventHealth, with no success, causing several commissioners concern about whether AdventHealth’s hospitals in DeLand and Orange City would take care of indigent patients.
Spokespeople for AdventHealth have explained that the hospital cannot turn away any patient in need of emergency care, no matter their financial standing. But commissioners feared that patients will be kicked out of the hospital once they are stabilized, or faced with a huge bill if they stay in the hospital.
Commissioner Judy Craig said there have been instances when indigent people have been charged for medical expenses they couldn’t afford, and had to declare bankruptcy in order to avoid legal action.
The Beacon reached out to AdventHealth in regard to Craig’s concerns and received this statement in response.
“As of Oct. 1, 2020, all AdventHealth hospitals and services will be considered out-of-network for patients covered by the West Volusia Hospital Authority (WVHA). It is important to note that if a WVHA card holder comes to an AdventHealth emergency department, they will still receive high-quality care for their emergency conditions. However, without new agreement, the WVHA member card does not carry a benefit. If the WVHA chooses not to pay for services provided to a WVHA member at AdventHealth, the patient may receive a bill for services.”
With the COVID-19 pandemic still a threat, Craig stressed the importance of leaving money aside in the budget in the event that Advent hospitals need to be reimbursed for inpatient care. The commissioners also tasked the WVHA attorney, Ted Small, with looking into what services AdventHealth hospitals must offer indigent patients to maintain their status as nonprofit hospitals.
“Right now, with COVID-19, I am sorry, I am not heartless,” Craig said. “I have known patients that went to the ER, they didn’t have insurance, they were sent home, and they died at home. Please, let’s remember, that we are taking care of human beings. The dollars are minuscule compared to the lives of our patients.”
ROLLBACK: The ad valorem property-tax rate that would produce for an agency the same amount of income it had the year before.
AD VALOREM: A Latin phrase meaning “by the value.”
MILLAGE RATE: The amount owed per $1,000 of taxable property value.