Miami-Dade Legislative Item
File Number: 122407
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File Number: 122407 File Type: Resolution Status: Failed
Version: 0 Reference: Control: Board of County Commissioners
File Name: FINANCIAL RECOVERY BOARD TERM EXTENSION PUBLIC HEALTH TRUST Introduced: 12/5/2012
Requester: NONE Cost: Final Action: 12/18/2012
Agenda Date: 12/18/2012 Agenda Item Number: 11A18
Notes: Title: RESOLUTION EXTENDING AN ASSISTIVE MEASURE, PURSUANT TO SECTION 25A-9(C)(5) OF THE CODE OF MIAMI-DADE COUNTY, IN THE FORM OF EXTENDING THE TERM OF THE FINANCIAL RECOVERY BOARD TO HELP RESOLVE THE FINANCIAL SUSTAINABILITY CONDITIONS THREATENING THE PUBLIC HEALTH TRUST OF MIAMI-DADE COUNTY
Indexes: PUBLIC HEALTH TRUST
Sponsors: Sally A. Heyman, Prime Sponsor
Sunset Provision: No Effective Date: Expiration Date:
Registered Lobbyist: None Listed


Legislative History

Acting Body Date Agenda Item Action Sent To Due Date Returned Pass/Fail

Board of County Commissioners 12/18/2012 11A18 Adopted F
REPORT: County Attorney Robert Cuevas read into the record the title of the foregoing proposed resolution. It was moved by Commissioner Heyman that the foregoing proposed resolution be adopted, as presented. This motion was seconded by Vice Chairwoman Edmonson, followed by discussion. Commissioner Heyman noted a few years ago, she agreed to have her position on the PHT eliminated by voting for the Financial Recovery Board (FRB), because she knew how important it was for Jackson Memorial to be solvent. She said she was concerned that the hospital’s financial situation had not yet been stabilized, and it was unclear what the hospital’s obligations would be under recent legislation. She noted several of the commissioners agreed on the FRB’s mandate, which was to make Jackson sustainable, and enable it to fulfill its mission. Commissioner Heyman pointed out that the FRB had not yet outlived its purpose, and she believed it would be premature to replace it with the PHT. She said that this item simply changed the sunset date for the FRB. Commissioner Moss asked what the PHT would be unable to achieve should this extension not be granted. Assistant County Attorney Valda Clark-Christian indicated that there was no particular activity that the PHT would be unable to do; however, more frequent reporting to the Commission was required by the FRB as opposed to the Board of Trustees of the PHT. In addition, other special charges focused on financial management were specifically delineated for the PHT’s Board of Trustees, noted the Assistant County Attorney. Commissioner Moss asked Mr. Lapciuc whether the PHT’s Board of Trustees would be able to function effectively without the assistance of the FRB. Mr. Lapciuc said that having resolved the number of the Board of Trustees’ members, he would urge the Commission members to consider issues of succession, nomination and the length of time of this Board’s existence. He said it would be advisable to formalize it, and noted the importance of maintaining the quality of Board members. Commissioner Moss said that he was inclined to let the PHT do the work that was necessary, while ensuring frequent reporting. He noted unless he could be persuaded that it was important to keep the FRB title in place, he was prepared to establish the new PHT with seven members. Mr. Lapciuc said he concurred with Commissioner Heyman that it was important to maintain a sense of urgency regarding the financial situation of Jackson Memorial Hospital. However, he noted, a name is just a name, and stressed the necessity to formalize the PHT. Commissioner Bovo indicated that he disagreed with the timing of this proposal. He noted he understood that the current FRB sunsets in May 2013. He said he would be more comfortable to support this proposal if a downward trend was evident at that time. He suggested that the Commission allow the current sunset provision to run its course, and the Commission members could revisit this proposal in April when they had a more accurate view of Jackson’s financial situation. Commissioner Suarez said he was inclined to agree with Commissioner Bovo, and asked Mr. Lapciuc why it was necessary to formalize the PHT in light of what the Commission did today. Mr. Lapciuc noted the PHT needed some formality. He strongly urged the Commission members to give the Jackson governing board stability. He pointed out that given the political process, if the Commission were to wait a few months to formalize the PHT, it would create an aura of instability. Commissioner Suarez asked whether the Commission members would provide Jackson with more autonomy by formalizing the PHT. Mr. Lapciuc explained that the FRB was under heightened reporting, and ethics requirements, but he noted, the monitoring requirements under the PHT did not have to lessen. Commissioner Diaz pointed out that the Commission members had just adopted Agenda Item 7C, which seemed to conflict with the present item. County Attorney Cuevas explained that Agenda Item 7C stipulated how the PHT would operate when the FRB’s term ended. He clarified that the present item provided that the FRB’s term would be extended for two tears. Commissioner Diaz asked whether the present item would help make the PHT permanent. Mr. Lapciuc noted if the succession was guaranteed with seven members, and if members could choose to serve for one, two or three-year terms, then Agenda Item 7C would provide the necessary formality. Commissioner Diaz stressed that it was most important to provide permanence to the body that was in place, whether it was the FRB or the PHT; therefore, he was not in favor of the present item. Commissioner Monestime asked whether the adoption of Agenda Item 7C effectively eliminated the FRB. Assistant County Attorney Clark-Christian explained that the current governing board, the seven-member FRB, would stay in place until May 2013; the present item would extend the May 2013 date into the future. Commissioner Monestime asked which of the two items would make the governing board permanent. Assistant County Attorney Clark-Christian explained that Agenda Item 7C provided that the current membership of the FRB, whenever the FRB expires, would roll over to the governing board of the PHT. She noted the FRB was established with a 24-month term, and the adoption of Agenda Item 7C meant that the FRB’s membership would roll over to the PHT at the end of that term. Commissioner Monestime said that he did not appreciate the name FRB, because it had a connotation of failure; for this reason, he favored the name PHT. He noted it was crucial for this body to be self-sustaining, and proficient. Commissioner Heyman said she was most concerned with Jackson’s governing board enjoying stability, and continuity for transition; this was the reason she wanted to extend the sunset date. Commissioner Heyman noted it was premature to return to the PHT. Hearing no further questions or comments, the Board members proceeded to vote on the foregoing proposed resolution, as presented.

County Attorney 12/5/2012 Assigned Valda Clark Christian

Legislative Text



TITLE
RESOLUTION EXTENDING AN ASSISTIVE MEASURE, PURSUANT TO SECTION 25A-9(C)(5) OF THE CODE OF MIAMI-DADE COUNTY, IN THE FORM OF EXTENDING THE TERM OF THE FINANCIAL RECOVERY BOARD TO HELP RESOLVE THE FINANCIAL SUSTAINABILITY CONDITIONS THREATENING THE PUBLIC HEALTH TRUST OF MIAMI-DADE COUNTY

BODY
WHEREAS, pursuant to Chapter 25A of the Code of Miami-Dade County, Florida (“Chapter 25A”), the Public Health Trust of Miami-Dade County (the “PHT”) was created as an agency and instrumentality of Miami-Dade County responsible for the governance, operation and maintenance of Jackson Memorial Hospital and other Designated Facilities (as such term is defined in Chapter 25A); and
WHEREAS, the PHT provides health care services to all segments of the Miami-Dade County community; and
WHEREAS, in the Spring of 2011, the Commission found that the PHT was facing one of the most serious financial crises in its history and had projected a deficit of approximately $90 million that fiscal year, following a deficit exceeding $200 million in the immediate prior fiscal year; and
WHEREAS, the PHT has not shown a true surplus since 2006 and has lost $430 million since 2007; and
WHEREAS, at the May 3, 2011, meeting of the Board of County Commissioners, the Commission adopted, as amended, a resolution establishing a Financial Recovery Board (“Recovery Board”) to help resolve the financial sustainability conditions threatening the PHT; and
WHEREAS, the resolution establishing the Recovery Board set a twenty-four (24) consecutive month term extending from date of establishment of the Recovery Board, unless earlier dismantled by subsequent Commission resolution; and
WHEREAS, during the 2012 fiscal year, while under the governance of the Recovery Board, the PHT earned a surplus of nearly $1.5 million; and
WHEREAS, the PHT achieved this surplus, for the first time in six years, while facing declining patient volumes as well as reductions to Medicaid rates and Low-Income Pool funds which negatively impacted the PHT’s revenue stream in an amount exceeding $100 million; and
WHEREAS, despite its recent success achieving a surplus while confronting challenging financial trends, the PHT continues to face financial obstacles including far-reaching health care reform at the state and federal levels; and
WHEREAS, the current financial condition of the PHT evidences ongoing risk of financial failure and the need for intervention to ensure that the PHT continues to meet the County’s health care delivery goals and requirements; and
WHEREAS, the Commission has determined that the PHT needs continued Recovery Board assistance to address and resolve the financial challenges facing it and threatening operations; and
WHEREAS, Section 25A-9 of the Code of Miami-Dade County (“County Code”) allows the Commission to implement assistive measures to preserve a fully functioning and sustainable PHT; and
WHEREAS, pursuant to Section 25A-9(c)(5)(ii)(D) of the County Code, the Financial Recovery Board shall serve for twenty-four (24) months or a longer period of time as determined by resolution of the Commission; and
WHEREAS, the Commission now finds that extending the term of the Financial Recovery Board until May 1, 2015, will provide needed assistance to the PHT in order to resolve the PHT’s continuing financial challenges and thereby will promote, protect, maintain and improve the health and safety of all Miami-Dade County residents and visitors served by the PHT.
NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS OF MIAMI-DADE COUNTY, FLORIDA, that this Board:
Section 1. In accordance with Section 25A-9(c)(5) of the County Code, effective immediately extends implementation of an assistive measure to address the Public Health Trust’s financial sustainability concerns, specifically by extending the term of the incumbent Financial Recovery Board until May 1, 2015.
Section 2. Requires the Mayor or Mayor’s designee to continue to report periodically to the Commission on the Public Health Trust’s progress resolving the current financial crisis.



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