provide millions of dollars to uncompensated care to patients who qualify for Medicaid.
Medicaid only covers 60 percent of those costs”; this is saying it helps them to use the money
to match and get more money from the Federal government; what people are hearing is the
Federal government is cutting those Federal monies, and she asked what the real gain is, as it
does not add up; there are a couple other things; she looked back to a 2021 Agenda and the
documents; some of the players have changed, they signed legal agreements that they wanted
to do this, but then she looked at the tax role and that Ordinance was never executed in terms
of they were never taxed; here the Board is just days before the big beautiful bill and suddenly
it is jumping through hoops; and she asked why. She went on to say the documentation from
2021 there are a few things; prior to the imposition of an assessment, the County shall have a
fully-executed agreement with the State of Florida, but she does not see that in the documents
attached; it says if there is no objection to the property owners of the assessment and some of
those owners have changed; previously, the County had executed agreements from the
hospital and if the Board is doing this now it should have that in place; she showed the Board a
piece of paper and she stated this is Rockledge and that does not have any tax for this, so it
has not been put into place; therefore, the Board cannot just say it did this Ordinance in 2021
so it can do this now. She commented this was a declaration by James Richard Whitney who
says he is Chief Legal Officer of Adelanto Healthcare Ventures and that in his official capacity
he is testifying that the affidavit represents the following hospitals and that they did an official
ballot for voting and all of this; again, that was 2021, four years ago; she asked if the Board has
to go through this process again; she mentioned it seems as though this whole process is
rushed in terms of who benefits, and Health First is 83 percent of these entities; the whole thing
does not smell right and she thinks the public deserves a little more explanation to that just
prior to the big beautiful bill and huge cut backs at the Federal level and this being on the
premise that it will help get reimbursements for Medicaid that is not paid, the 40 percent that is
not collected; none of this seems to make sense; and she thinks the Board owes a little bit
more explanation of what the real agenda is because there is not a lot of trust.
Chairman Feltner noted he would like to say something about the timeliness of this; this was on
the July 8 Agenda, just so people understand; the County was happy to take it up at that time;
because the legislation moved a little quicker than anticipated, this was planned in June to take
it up on July 8, but now that things have progressed quicker than that, the Board has to have
this meeting; there are cards from providers; he asked if someone wanted to come up and
explain; and he noted he feels that ultimately the Board is doing what it can to help protect the
healthcare providers.
Rachel Rexford, Adelanto Healthcare Ventures representing the hospitals, stated she can
provide a little clarity on why this has to be done now; it is because the provider tax freeze
provision that is in the big beautiful bill; basically, once the big beautiful bill goes into effect, the
rate right now that the County can assess the hospitals at will be frozen indefinitely; right now in
Florida statewide, they are at about 3.5 percent in terms of the assessment; under Federal law
they can go as high as six percent; therefore, Florida and the counties across Florida are
missing out on that if the big beautiful bill passes and those freezes go into effect immediately
and that is why it has to be done now; and she asked if there is anything else she can clarify.
Commissioner Altman stated having been in Tallahassee for over 20 years, this Medicaid
program, Florida has been a leader in the country, and it is quite complex; this is nothing new, it
has been debated publicly for many years and reported; it is a program that allows work with
the hospitals through an assessment program to generate revenue to bring down Federal
matching funds; without it, the hospitals would be in serious problems; there is a meeting on
Emergency Medical Services (EMS) today; one hospital has closed; it would be a huge problem
for the State of Florida if the Board does not adapt, so it does not get caught in this freeze; and
he was not aware that the big beautiful bill was freezing these rates. He commented this will
save the Brevard County taxpayers millions of dollars and it will bring down hard-earned
