Two weeks ago, Citrus County Commissioner Jeff Kinnard called a special assessment plan for the two county private hospitals a “scheme” and vowed to defeat it.
On Tuesday, he led its passage, acknowledging an about-face after conducting more research.
“I did take a strong position against it,” he said. “The more I dove into this, I’ve gotten to a position of being very comfortable with it.”
The board’s 3-2 vote places a 3.2% annual assessment on net profits against Citrus Memorial Hospital in Inverness and Bayfront Health Seven Rivers in Crystal River to be used as a match for federal dollars to cover Medicaid shortfalls.
The assessment is only against the hospitals. No one else is affected.
Both hospitals requested the assessment under a program created by the Legislature and approved by the federal government. It allows private hospitals to request a special assessment by the local government, and the money sent to the federal government for a partial match on Medicaid reimbursements.
Colleen Ernst, a former deputy general counsel for Gov. Ron DeSantis, said she represented hospitals with similar requests with local County Commissions. She said hospitals receive 60% Medicaid reimbursement, and the assessment will bring more federal dollars back to hospitals.
The county’s outside attorney, Greg Stewart, said there was a significant sticking point: Neither hospital, he said, will indemnify the county.
Should the federal government, which approved the Statewide Medicaid Managed Care program in April, eventually decide otherwise and withhold matching payments to hospitals, he said nothing prevents the hospitals from seeking assessment reimbursement from the counties.
Ernst pledged the hospitals will not take that route regardless of the final outcome.
“They will put it in writing,” she said. “They will not come after the county. They will not sue.”
Ernst said the process protects the county. The county collects the fee, then sends it to the state, which sends it to the federal government, which provides the matching amount back to the hospital.
“The county never touches federal dollars,” she said. “The county is not involved.”
Kinnard noted the agreement provides up to $150,000 to the county a year for administrative costs. Should there be a legal barrier to cross, he said, the county could use those funds.
Tuesday’s meeting was to set the assessment amount. At the board’s Sept. 14 meeting, Commissioners voted unanimously to approve the special assessment ordinance, though Kinnard and Commissioner Ron Kitchen Jr. were dead set against levying any actual tax.
“What this is, is a scheme,” Kinnard said Sept. 14. “If our county attorney is not 100 percent comfortable with the indemnification, I will guarantee you I will be a no vote when we hear it again.”
On Tuesday, however, he said he spoke with several attorneys, including in Hernando County, where the County Commission approved something similar for its private hospitals. He said he believes the county is protected.
Kitchen was incredulous.
“You called it a scheme,” Kitchen said, directing his comments at Kinnard. “There’s been a lot of heavy arm twisting come down from Tallahassee.”’
Kinnard said it wasn’t like that.
“This has nothing to do with arm twisting,” he said.
Commissioners Ruthie Davis Schlabach and Holly Davis said they supported the assessment for the two hospitals. Board Chairman Scott Carnahan joined Kitchen in opposition.