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Halifax Health Special Taxing District Impact Study

Halifax Health Special Taxing District Impact Study. Topics of Discussion. 2008 Property Tax Fact Ad Valorem Tax Revenue Halifax Health Waste Access to & Cost of Health Care Financial Review Board of Directors Fiduciary Responsibility Citizens Referendum. 2008 Property Tax.

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Halifax Health Special Taxing District Impact Study

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  1. Halifax Health Special Taxing District Impact Study

  2. Topics of Discussion 2008 Property Tax Fact Ad Valorem Tax Revenue Halifax Health Waste Access to & Cost of Health Care Financial Review Board of Directors Fiduciary Responsibility Citizens Referendum

  3. 2008 Property Tax

  4. 2008 Property Tax %Daytona Beach District 4

  5. Fact

  6. Fact Halifax Hospital Medical Center is a Community owned health care center, owned by the residents of the Halifax Special Taxing District. The Halifax Special Taxing District is governed by a seven (7) member Board of Commissioners Source of data: Florida House Bill HB 1457

  7. Fact Board of Commissioners shall be a resident of the “Taxing District” Board of Commissioners are political patronage appointees, appointed by the Governor & are accountable to “NO” one. Source of data: Florida House Bill HB 1457

  8. Fact According to The Florida Hospital Association there are 226 acute care hospitals in Florida Source of Data: Florida Hospital Association—fla.org

  9. Fact Of the 226 acute care Florida hospitals: 34 are Special Districts Hospitals. 16 Ad Valorem Tax Authority 12 Appointed Board of Directors 4 Elected Board of Directors 18 Revenue Sources Varied. 85% of all Florida Acute Care Hospitals are not " Special District Hospitals" they are Privately held. Source of data: MyFlorida.com

  10. Fact Of the 16 acute care hospitals with Ad Valorem Source of Revenue in Florida, 3 are located in Volusia County. Halifax Hospital Medical Center SE Volusia / Bert Fish Medical Center West Volusia Hospital Authority Source of data: floridaspecialtaxingdistricts.org

  11. Fact Florida Memorial located in Daytona Beach, is owned by Adventist Health Care, is a Not For Profit, Acute Care Hospital & receives no Ad Valorem tax revenues. Source of Data: Hospitalcompares.hhs.gov

  12. Facts In 2007 Halifax records show the Emergency Department Outpatient Activity exceeded 120,000. National statistics show 87% of the patients in the Emergency room did not require Emergency room services. Source of Data: The Feasibility of a Managed Indigent Health Care Plan for Volusia County, Fl.; Prepared by: Health Management Decisions. Inc. and Wittner Companies; October 1993 & Halifax 8/05/08 Financials

  13. Ad Valorem Tax Revenue

  14. Ad Valorem Tax Revenue Halifax Medical Center approved Ad Valorem Taxing District revenues for 2008-9 is $41.6 million. Halifax reports these revenues are used to provide Indigent Care. Source of data: Florida House Bill HB 1457

  15. Ad Valorem Tax Revenue District Ad Valorem Tax Revenues can be used for: Debt Service Payment on Notes & Bonds Expenses of Operation Maintenance Construction & Repairs Source of data: Florida House Bill HB 1457

  16. (Continued) Payment of indebtedness District expenses Downtown redevelopment District fees Tax collector fees. Source of data: Florida House Bill HB 1457

  17. Ad Valorem Tax Revenue Halifax Medical Center Taxing District Ad Valorem revenue is not the only source of revenue to pay for Indigent /Emergency Care.

  18. Ad Valorem Tax Revenue In 1986 Congress enacted the Emergency Medical Treatment & Labor Act (EMTALA) and in 2007 Florida Legislature passed Statute 395.1041 which ensures public access to emergency services & care regardless of ability to pay.

  19. Halifax Health Ad Valorem Tax Revenue 2003 $23.6 Mil. 2004 $25.5 Mil. 2005 $37.6 Mil. 2006 $45.6 Mil. 2007 $52.7 Mil. 2008 $52.8 Mil. 2009 $41.6 Mil. Source of data: Halifax Health

  20. Ad Valorem Tax Revenue From 2003 to 2008: Halifax Health Ad Valorem Tax Revenue increased 224% CPI increased 14.4% (2003 to 2007) Source of data: Halifax 2006 Bonding Data & Halifax Health

  21. 2003-08 Ad Valorem Tax Revenue Systemic Flawed Model

  22. Counties of Comparable Size- 2006 Per Capita Property Tax for Indigent Care • Volusia $131.00 • Lee 6.00 • Pasco 11.00 • Flagler 10.00 • Brevard 10.00

  23. 2008--09 Special Hospital Taxing District Gross AdValorem Taxper capita Appointed Boards: Baker County $31.90 Graceville Hospital $52.25 Citrus County $91.31 Halifax Hospital $184.80 Lake County $72.79 Lower Florida Keys 0 Madison County 0 North Broward $153.67 North Sumpter South Broward $98.18 South Lake $79.45 Southeast Volusia $274.35 Elected Board: Hendry Country $151.34 Indian River County $103.78 North Lake County $84.23 West Volusia $79.29

  24. Ad Valorem Tax Revenue 2008-09 Halifax Health Ad Valorem Tax Revenue $41.6 Million. For 2008-9 Halifax millage is 2.25 mills; $ 184.80 per (special taxing district) capita. Source of data: December2, 2007 News Journal; Halifax 2008-09 Budget

  25. Halifax Waste

  26. Halifax Waste Halifax Marketing expense are about twice what hospitals nationwide spend on average. Approx. 1.1% of Gross Revenue. Halifax Spent about $1 million for TV advertisements $275,000 in salary for a chief marketing officer, twice what similar hospitals spend $40,000 signing bonus $127, 000 moving expense $101,666 severance $60,000 Country Club Membership $45,000 Butterfly Logo Source of data: The news Journal December 2, 2007.

  27. Halifax Waste $15 plus million for 220 acres of land on LPGA Blvd. (TNJ 1/04/08) Federal Medicare administrative costs are less than 2.0% of gross revenue. ( Source of data: TNJ July 1, 2008) In 2007 Halifax administrative cost exceeds 15% of Gross Revenue. (2007 Deloitte Independent Audit Report)

  28. Halifax Waste $350,051.00 Tower Ground Breaking Ceremony. ( Halifax internal Memorandum dated: July 12, 2007) Halifax Appears to be in violation of Florida Code of Ethics. Will File a Form 50 with Commission on Ethics. Due to Halifax Medicare errors &“over-billing”; discovered as part of U.S. “RAC” Audit Program, Halifax was required to refund Medicade$3,867,455.10. (Halifax letter dated May 12 & June 13, 2008)

  29. Access to & Cost of Health Care

  30. Access to Health Care For Humana Choice PPO & HMO and Blue Cross Blue Shield Advantage Medicare Plans participants (approximately 35, 000 plan members in the Halifax Taxing District) Halifax is considered a “Out of Network” provider because Halifax & Humana & BC/BS can not agree to fee for services. Source of data: Humana, BC/BS & Halifax Health

  31. Cost of Health Care Florida Ormond Memorial is the “In Network Provider” for these Medicare Plan Participants. With Insurance A “Out of Network” stay at Halifax will cost the patient $750.00 per day compared to Ormond Memorial “In Network” cost of $500.00 regardless of length of stay.

  32. Cost of Health Care Medicare (HUMANA & BC/BS) Plan Participants living in the Halifax Special Taxing District & Paying Ad Valorem Property Taxes, to support the Hospital they own, can not utilize Halifax Hospital with out paying “Out of Network” charges.

  33. Cost of Health Care Additionally cost of Hospital services ONLY (Patient W/O insurance) depend on family size, patient net worth & income level and vary significantly between Halifax & Ormond Memorial. Source of data: Halifax & Ormond Memorial Procedures.

  34. HALIFAX HEALTH FINANCIAL REVIEW

  35. Halifax Health 2008 Uses of Tax Dollars. 2008 Gross Ad Valorem Property Tax $52,720,269 Less: Discounts & Uncollectible Tax ($1,845,216) Tax Collection & Appraiser Comm. ($1,484,530) Volusia County Medicare Assessment ($2,079,000) Redevelopment Taxes paid to Cities: ($3,333,356) TOTAL DEDUCTIONS: ($8,742,102) 2008 Net Ad Valorem Property Tax to Halifax: $43,978,166 Sources of Data: Halifax Health

  36. Halifax 2007 Waste Interest on LPGA /Williamson property: $1,000,000 US Government RAC Audit: 3,867,455 TV Advertising Costs 2,000,000 Chief Marketing Officer 563,000 Butterfly Logo 45,000 Tower Project Groundbreaking 350,000 Excess Physicians Salaries (MGMA-95%) 2,061,796 Senior Executive Excess Benefit Plan 773,000 Annual Car allowance for 19 Employees 151,200 TOTAL $10,811,451 Source of Data: Halifax Health , MGMA< TNJ

  37. Halifax 2007 Profit Reconciliation Halifax Health 2006-7 Pre Tax Profit $59,228,000 Less: 2006-7 Net Ad Valorem Property Tax ($43,978,166) 2007 Pre Tax Profit W/O Ad Valorem Tax $15,249,834 Source of data: Halifax Health Fiscal 2008-09 Preliminary Operating Budget

  38. 2004 to 2007 Halifax Gains W/O Ad Valorem Property Tax-($)Millions Sources of data: 2008-9 Halifax preliminary budget

  39. Halifax 2004-07 Profit Reconciliation Halifax Cumulative Excess (Deficiency) of Revenue and Gains Over Expenses and Losses including Ad Valorem Property Tax $192,180,000 Halifax Cumulative Net Ad Valorem Revenue (tax) $132,841,000 Halifax Gains W/O Ad Valorem Tax Revenue $59,339,000 Sources of data: Halifax 2008-09 Budget Preliminary Operating Budget

  40. With Out Ad Valorem Taxes--Cumulative 4 Year Tax District Savings $161,540,000

  41. Use of Funds !!! • Reduced Property Taxes • City Infrastructure • After School / Summer Programs • Homeless Programs • Additional Police • Attracting New Businesses • Drug rehabilitation • ECT

  42. Halifax Board of Directors Fiduciary Responsibility

  43. Fiduciary Responsibility The Halifax Board of Directors has a fiduciary responsibility to the citizens of the taxing district they were appointed to represent. “A fiduciary is someone who has undertaken to act for and on behalf of another in a particular matter in circumstances which give rise to a relationship of trust and confidence.” Defination; Webster,s New Collegiate Dictionary

  44. The Governor Appointed Halifax Health Board of Commissioners has failed the citizens they were appointed to serve , when they…

  45. Fiduciary Responsibility ? Consistently Approve Administrative costs in excess of 15% of gross revenue: 13% points higher than U.S. Medicare. Approve Increasing Ad Valorem tax revenues by 224% over five years while CPI increased 14.4%

  46. Fiduciary Responsibility ? Approved $15 million purchase of land on LPGA—Approx. $1 mill. annual Interest Approved Excessive Employment Agreement for Physicians & Executives while reducing Nurses Compensation. 2007 Approved $773,383 for 3 Senior Executive Retirement Benefit Plans for 12 Senior Executives.

  47. Fiduciary Responsibility ? Approve Indigent care costs of $131 per capita: 13 times comparable counties. Failed to Implement 1993 Volusia County Indigent Care Study.

  48. Fiduciary Responsibility ? Approved construction of $200 million “Tower Project” –creating the largest ER in Florida without addressing 87% of the ER patients that could have been treated in a less costly manner

  49. Fiduciary Responsibility ? Deny 35,000 Volusia County Residents Medicare patients “in network” fees because Halifax can not agree on “fee for Service” costs with Humana & Blue Cross/Blue Shield.

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