MARK SCHUMANN

A June 10 letter from Indian River Medical Center Treasure Jack Weisbaum to Indian River Hospital District Treasurer Trevor Smith suggests their respective boards may be close to reaching a new three-year agreement on how the Hospital District will reimburse the IRMC for care it provides the county’s indigent patients. (See exchange of correspondence below)

Weisbaum indicated the IRMC board is prepared to accept the Hospital District’s proposed cap of just over $7 million for the 2015 fiscal year.  The IRMC had asked for reimbursement of between $9 million and $9.7 million.  In accepting the Hospital District’s final proposal, Weisbaum wrote, “In response to your latest proposal, IRMC does not want to go to arbitration as it is a lengthy and expensive process…Therefore, we hope to reach an agreement within the total $7,047,000 reimbursement you suggest for FY 2015, even though it will put a strain on the hospital’s budget.”

Recently, the Hospital District board and the IRMC board have held what some have described as contentious negotiations over the rate at which local taxpayers will reimburse the IRMC for indigent care.

The Hospital District, which levies a tax on Indian River County property owners to pay for indigent care, also owns the hospital. Indian River Medical Center, a non-profit corporation formed to operate the hospital, leases the publicly-owned facility from the Hospital District.

The IRMC, then, is essentially a creature of the Hospital District, and was formed to enable the hospital’s management to operate outside the state’s open government and open records laws.  Ironically, the Hospital District board has recently been frustrated in its efforts to gain more access to IRMC’s financial information.

Weisbaum, writing on behalf of the IRMC board of directors, did not accept the Hospital District’s proposal for a new formula for calculating reimbursements, but did agree to $7 million for the 2015 fiscal year.

At issue is the question of what operating costs the IRMC should include in its calculations.  Some members of the Hospital District board, and a growing number of the IRMC’s critics in the medical community and in the broader community, believe taxpayers should not share in any operating losses resulting from the IRMC’s expansion into services not directly related to the scope of a community hospital.

Critics of the previous formula for indigent care reimbursement say that if IRMC’s leadership and its patrons what the publicly-owned county hospital to become a renowend regional medical center, then they need to bear the full costs of fulfilling those dreams. They point out that the Sebastian River Medical Center, as an investor owned hospital, receives no reimbursement from the Hospital District for care it is legally required to provide indigent patients.

Yet, on the whole, SRMC’s rates are no higher than IRMC’s, and the care offered in Sebastian, in the minds of many, is at least a good as the care offered at the IRMC.  Some of IRMC’s harshest critics, and others, say a debate may be looming over continued public ownership of the hospital.  One alternative, they say, is to sell the hospital and invest the proceeds to fund indigent care, while shifting the focus to offering more primary and preventative care through health care providers such as community health clinics.