TITLE
RESOLUTION EXPRESSING CONCERNS REGARDING SB 556, HB 285 AND SIMILAR LEGISLATION THAT WOULD ABOLISH THE LOW INCOME POOL COUNCIL; URGING THE FLORIDA LEGISLATURE NOT TO PASS LEGISLATION THAT WOULD THREATEN FUNDING TO SUPPORT CHARITY CARE PROVIDED BY JACKSON HEALTH SYSTEM AND OTHER SAFETY NET HOSPITALS IN FLORIDA

BODY
WHEREAS, the Low Income Pool (LIP) was created by the Florida Legislature in 2005 as part of the Medicaid reform waiver, and the LIP is a pool of funds made up of contributions from local communities to maximize Medicaid revenues that are drawn down from the federal government; and
WHEREAS, the LIP Council makes recommendations to the Legislature on how to distribute federal, state and local Medicaid-related funds to those hospitals and clinics that provide the vast majority of care for the poor and uninsured; and
WHEREAS, just ten percent (10%) of the state�s hospitals, represented by the teaching, public and children�s safety net hospitals, provide more than half of the state�s charity care; and
WHEREAS, in contrast, two-thirds of Florida hospitals, mostly private, for-profit hospitals, provide only twelve percent (12%) of Florida�s charity care; and
WHEREAS, each year, the LIP Council makes recommendations to the Legislature the almost $2 billion in LIP should be distributed to those hospitals and other agencies that provide most of the care to charity patients, the uninsured and underinsured; and

WHEREAS, LIP Council members are appointed by the Secretary of the AHCA, and by law, the LIP Council consists of 17 members:
a. Three representatives of statutory teaching hospitals;
b. Three representatives of public hospitals;
c. Three representatives of nonprofit hospitals;
d. Three representatives of for-profit hospitals;
e. Two representatives of rural hospitals;
f. Two representatives of units of local government which contribute funding; and
g. One representative of family practice teaching hospitals; and
WHEREAS, currently, 20 counties voluntarily contribute over $800 million in local tax revenue to the state to finance the non-federal share of the LIP and its related Medicaid components, and these local taxes allow the state to draw down an additional amount in federal Medicaid matching funds that is more than $900 million; and
WHEREAS, while 20 counties provide local tax funds to help fund the program, the heaviest burden falls on the taxpayers of 10 counties, who contribute 94 percent of the local taxes to finance these programs, with Miami-Dade County taxpayers contributing the largest amount; and
WHEREAS, 37 counties in Florida do not currently contribute any tax dollars to the LIP, but still receive LIP funds; and
WHEREAS, the current LIP Council process works because the LIP program distinguishes between those hospitals that are providing the vast majority of charity care and those that provide a limited amount of this care; and
WHEREAS, the LIP Council is able to ensure that the hospitals that provide a disproportionately high volume of charity care receive the highest proportion of Medicaid-related federal, state and local funding; and
WHEREAS, the LIP Council makes recommendations in a public process that allows all interested parties to participate, make funding recommendations and review all materials and information considered by the LIP Council; and
WHEREAS, bills have been filed for consideration during the 2009 state legislative session that would abolish the LIP Council, SB 556 by Senator Don Gaetz and HB 285 by Representative Jimmy Patronis; and
WHEREAS, SB 556 and HB 285 would turn over to AHCA the responsibility for making recommendations to the Legislature on how to distribute LIP funds; and
WHEREAS, the attempt to abolish the LIP Council is an effort by for-profit hospital corporations to get a larger share of LIP funds by shifting funding away from safety net hospitals to for-profit hospitals; and
WHEREAS, abolishing the LIP Council would bypass an important step in the public process that allows the local communities that contribute more than $800 million in local taxes to the LIP to have a significant role in deciding how their taxpayers� money is spent; and
WHEREAS, abolishing the LIP Council would put these important decisions in the hands of a state agency; and
WHEREAS, abolishing the LIP Council would have a significant fiscal impact on Jackson Health System at a time when Jackson is already facing substantial fiscal challenges,

NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS OF MIAMI-DADE COUNTY, FLORIDA, that this Board:
Section 1. Expresses strong concerns regarding legislation that would abolish the Low Income Pool Council.
Section 2. Urges the Florida Legislature not to pass SB 556, HB 285 or similar legislation that would threaten funding to support charity care provided by Jackson Health System and other safety net hospitals in Florida.
Section 3. Directs the Clerk of the Board to transmit a certified copy of this resolution to the Governor, Senate President, House Speaker, the Chair and Members of the Miami Dade County State Legislative Delegation, Senator Don Gaetz, Representative Jimmy Patronis and the Secretary of the Agency for Health Care Administration.
Section 4. Directs the County's state lobbyists to oppose the legislation set forth in Section 1 above, and authorizes and directs that the 2009 State Legislative Package be amended to include this item as a Critical Priority.