Organization and Financing of Indigent Hospital Care in South Florida

By Catherine A. Jackson; Amanda Beatty | Go to book overview

3
STRUCTURES FOR GOVERNMENTAL FINANCING OF INDIGENT CARE

How are the governmental bodies that levy the taxes used for hospital and medical care services determining the amount of revenue needed?

Do the differences in governmental structures used to assess, spend, and monitor such public health care resources result in different decisions being made about what services to fund and which people are eligible for local government subsidized care?

Does the ownership or tax status of a provider institution/organization influence its relationship with local government funders or with its patient population?

In this section we highlight how these three South Florida counties support and provide care for the medically indigent, and how funds devoted to this purpose are collected, governed, and distributed. These counties all operate under the same Florida legislative regime, yet given the degree of county autonomy granted by the state, they have implemented varied approaches to raising and utilizing tax dollars for the uninsured.

The fundamental difference among the three counties is the manner in which public funds are used to provide care to the uninsured. Broward County has two hospital districts that operate networks of hospitals and clinics that are geographically dispersed throughout the county. Only these district facilities receive public funds for the care of the indigent. Palm Beach County health care district operates no facilities, but rather uses public funds to reimburse hospitals for the care of indigent persons qualifying for the county program. Broward and Palm Beach Counties have hospital/health districts that levy taxes to support health services for county residents including the uninsured.15 Miami-Dade County has a public agency, the Public Health Trust (PHT), that operates two hospitals and numerous clinics in the county. Public funds for the care of the indigent are only available to PHT facilities. Until 2001, the PHT operated only one hospital in the urban center of the county. The second hospital added to the PHT is in the northern part of what is known as “Deep South Dade.” Thus, the Miami-Dade system is more centralized than that found in Broward. The Trust is funded through

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15
Florida State legislation, Title XIV, Taxation and Finance, Chapter 212, Sales, Use and Other Transactions.

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