Little Consensus on Problem of Caring for Uninsured in Florida’s Duval County

There is "no consensus" on how to solve the issue of paying for indigent care in Florida's Duval County, the Florida Times-Union reports. During a recent Communities in Charge meeting -- an initiative funded by the Robert Wood Johnson Foundation -- the area's health care experts conceded that solving the problem would "require multiple programs and approaches." Rhonda Poirier, the initiative's executive director, said, "There are no easy answers. The community is going to need a broad solution and many people to get involved" (Filaroski/Skidmore, Florida Times-Union, 2/25). Between 120,000 and 150,000 Duval County residents, or about one in six people, lack health insurance. The Times-Union reports that Duval County is "particularly vulnerable" to the problem of the uninsured because a majority of the county's 382,000 private-sector employees work for small businesses, and only about half of those businesses offer health benefits. Providing health services to the uninsured cost Duval County hospitals approximately $90 million in 2000, according to a Florida Hospital Association analysis. Shands Jacksonville Hospital provides the most indigent care among the county's hospitals; in 2000, the hospital spent about $46 million on indigent care, according the FHA. State Senate Majority Leader Jim King (R) recently warned state lawmakers that Shands has the potential for bankruptcy, noting that the $55 million the hospital spent on indigent care in 2001 constitutes about 13% of the hospital's $417 million annual operating budget (Filaroski, Florida Times-Union, 2/25). Jacksonville pays Shands $23.5 million annually for "indigent care" and an additional $1.5 million for "debts."

Looking for Solutions
Jacksonville Mayor John Delaney said his administration "might be able to do more" to help the uninsured, but would need assistance from state and federal governments. The Times-Union reports that Duval County could follow the example of Florida's Hillsborough County, which runs an indigent health care plan that covers about 27,000 previously uninsured residents at a cost of $88.5 million per year (Filaroski/Skidmore, Florida Times-Union, 2/25). The Hillsborough plan, funded through a half-cent sales tax, covers county residents who do not qualify for other public health programs and have incomes up to 100% of the poverty level, or $8,590 for a single person and $17,650 for a family of four (Kaiser Daily Health Policy Report, 1/30). But some Duval County officials say such a plan would be a "hard sell" in Jacksonville, where voters recently approved a half-cent sales tax for an alternate, nonhealth-related program (Filaroski/Skidmore, Florida Times-Union, 2/25).