Heat. Heat. Hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey. got feel. Hey N hey.
Hey. Hey. Hey, hey, hey. Hey, hey, hey. Heat. Heat. N. If you wish to speak to any item on the agenda or during the public comment portion of the meeting, please fill out a speaker card. Each person addressing the board shall have three minutes to
complete his or her comments on each agenda item for which he or she has filled out a card. The chair has the discretion to determine or alter the time limits on any agenda item. The board of county commissioners requests that speakers appearing under the public comment section of the agenda limit
their comments or presentations to matters relating to county business that are within the board's control, authority, and jurisdiction. Good morning. Welcome to the July 3rd special meeting for the board of county commissioners. We'll start with the
pledge of allegiance. Commissioner Goodson to the flag of the United States of America and to the republic for it stands. One nation under God, indivisible, with liberty and justice for all.
We have a quorum. I'll call the meeting to order. We have one item on the agenda today. Uh commissioners, we we haven't been here for a little while. So, let's just remember we're going to we're going to intro the item,
then we'll do questions, cards, and uh then we'll have discussion and we'll vote. Just as a housekeeping issue, uh without objection from the board, we're going to have an executive session after this meeting upstairs in the county manager's office. Uh we have uh some
updates from the fire union. I don't anticipate that taking too long. So, without objection, we're going to do that. Okay. Very good. Jill, I think you're ready. Okay. Good morning, commissioners. This agenda item is at the request of the affected hospitals and requests approval of a rate
resolution to impose non-advalum special assessments against private for-profit and nonprofit local hospitals for the state's Medicaid managed care program. Uh the providers listed on the assessment role which is attached to the agenda are the only ones paying this
assessment. This is not an assessment or a tax on any residential or business property in the county. Again, it's only those hospitals listed. Uh, and this federally approved program allows the state to access federal Medicaid funds for managed care expenditures, and that
offsets the hospital's Medicaid shortfalls. And there are representatives here to answer any questions the board may have. Okay. Is there are there questions for Jill? No questions for Jill. Uh just uh I I'll
add something to that just so we we understand why we're having a special meeting today. Um there's language in the big beautiful bill as it's being called and the president's going to uh apparently sign that tomorrow. So we need to do this today. So that's that's
why we're here today just as a point of clarification. Commissioner Delaney for for Jill, do you have a question? Thank you. Yeah. Um I have received a lot of feedback from the public when this meeting came uh public and so people are
concerned about um one are their taxes going to go up and I'm I'm hearing you say that you know and I understand that it's not going to affect us locally in that way but people are concerned about federal taxes. Um, this isn't, just to put it on the record, this isn't an
expansion of um, federal taxes. This is just giving our hospitals more access to money that's already there. That's my understanding of this program. Okay. Thank you.
Any other questions for staff? No. Okay. Uh, we do have some cards. I think the most of the cards are just uh for questions. Sander Sullivan. So I I would like to see additional transparency on why this has to be done
before the big beautiful bill. like what does that garner this process? Um because they're they're talking about a lot of cutbacks um to Medicaid uh you know 14 million illegals allegedly on
Medicaid and not providing services to illegals and you know having people work that should be working in order to receive Medicaid. So there's going to be huge shortfalls in Medicaid. So what what does this do? I mean, this is counterintuitive. This doesn't make
sense to put this in place. Uh, the language says um to local hospitals in Bvard County annually provide millions of dollars to uncompensated care to patients who qualify for Medicaid. Uh Medicaid covers
only 60% of those costs. And so this helps them, this is saying, this helps them to use this money to match and get more money from the federal government. But what we're hearing is the federal government's cutting those federal money. So what's the real gain here?
Like it doesn't it doesn't add up. Um and then there's a couple other things. So I look back on the 2021 uh agenda and the documents and you know some of our players have changed. They signed they
signed legal agreements that they wanted to do this, but then I looked at the tax role and that ordinance was never executed in in terms of it was they were never taxed. And so here we are days before the big beautiful bill and suddenly we're jumping through hoops.
Why? What's the real what's the real story here? um and and the the documentation from 2021. A few things prior to the imposition of an assessment, the county shall have a fully executed agreement with the state
of Florida. I do not see that um in the documents attached. Um it says that um um adoption uh if there's no objection to the the the property owners of the assessments.
And again, some of those owners have changed. Um, so and previously you had executed agreements from the hospital and again, you know, it seems like if you're doing this now, you should have that in place.
Um, here's one of this is Rocklledge that doesn't have any tax for this. So, it's not been put into place. So, you can't just say, well, we did this uh this ordinance in 2021, so we can do this now. Um, this was a a declaration
uh by by James Richard Whitney who says he's chief legal officer of Adelanto Healthc Care Ventures and um in my official capacity I am testifying the affidavit that these these this
represents the following hospitals um and that they did an official ballot for voting um and all of this. But again, that was 21, that was 4 years ago. Don't you have to go through this process again? It just seems like this whole process is is rushed. And then
I'll say, you know, in terms of, you know, who benefits, you know, health first is 83% of of these entities. And so, you know, it the whole thing doesn't smell right. And I think the public deserves a little bit more explanation
that just prior to the big beautiful bill and a huge cutbacks at the federal level. And this is being on the on the premise that this will help get you know reimbursements for you for Medicaid
that's not paid the 40% that's that they don't collect. None of this seems to make sense. Okay. And I just think we we owe a little bit more explanation of what the the the real agenda here. There isn't a lot of trust.
Let me say something about the timeliness of this. We had this on the July 8th agenda just so that you understand. So we were happy I think the county was happy to take it up on July 8th. Uh but because the legislation moved a little bit faster than we
anticipated. I mean in June we were planned to take this up in in July 8th uh meeting and now that things have progressed quicker than that um where we have to have this meeting. So um
could you help us out on maybe just clarifying from um do have some cards here. one of the providers. I mean, ultimately, I think we're doing what we can to help protect our health care providers. Yeah. Rachel Rexford, at
Alanto Healthcare Ventures, we represent the hospitals. I can provide just a little clarity on why it has to be done now. It's because of the provider tax freeze provision that's in the big beautiful bill. Um so basically once the big beautiful bill goes into effect um
the rates right now that the county can assess the hospital at hospitals at will be frozen indefinitely. Um and right now in Florida um statewide we're at about 3.5%
um in terms of uh the assessment. Um under federal law we can go as high as 6%. So really Florida and the counties across Florida are missing out on that if the big beautiful bill um passes and those those um freezes go into effect um
immediately. So that's a little more about why it has to be done now. If that's helpful, if there's anything else I can clarify, just let me know. Commissioner Alman. Yes. Maybe more of a comment. um having been up in
Tallahassee for over 20 years, uh this this Medicaid um program is Florida has been a leader in the country and it's quite a uh quite a complex set of it's nothing new. It's
been debated publicly for many many years. It's been a reported it's a program that allows us to work with our hospitals through an assessment program to generate revenue to bring down federal matching funds. And
without it, our hospitals would be in serious problems. And we already talked about we're having a meeting on EMS today. We have one hospital that's closed. It it would be a huge huge problem for the state of Florida had if
if we don't if we don't adapt so we don't get caught in this freeze. I I was not aware that the big beautiful bill that's freezing the these rates. So obviously it doesn't cost this will save our our Boulevard County taxpayers
millions of dollars and it will um it will um bring down our hardearned federal funds to provide the most basic of service health care for our constituents. So I can think of nothing more important saving taxpayers dollars
providing health care for our citizens just don't get more critical than that. This is really important. I have a question for you though. Um I assume that every county in the state of Florida will have to do what we're doing now. Um about 25 26 jurisdictions. Yeah.
Only the counties that have a local provider participation fund. Um some of the counties can't do it because they only have like one hospital. So under federal law I see um they don't qualify to have an LPPF. Um but yes, all the jurisdictions and so far we just have
Bvard today and Leyon left and so we've done all of them and all the votes have been successful and unanimous and you know I would say that if any member of the public and Sandra included obviously we include you u if they want to if they want to get more information about this
program I would offer myself and my office as a resource we can provide you a lot of history and a lot of data. It's it's a a pretty complex. Like I said, Florida's probably led the nation. Thanks to good good people like yourself, so this is really important.
Okay. Any other questions? Okay. Um, thank you, Rachel. We we appreciate that. I do have three other cards. Um, I think they're going to wave in support if we don't have other questions. Um, Cortez Wetley,
right? Sir, you wave in support. Okay, thank you very much. Terry Ford, sir, Health First, wave in support. Okay. And then we have uh Steven Lord for circles of care today.
Also waving in support. Okay, very good. All right, commissioners, I think we're done with the questions. Any other and cards? Any other discussion on the item before we vote? Is there a motion on the item? So moved. Second. Okay. We have a motion by Commissioner Goodson. We have
a second by Commissioner Alman. Clerk will call the role. Commissioner Delaney? Yes. Vice Chair Goodson? Yes. Commissioner Atinson? Yes. Commissioner Alman? Yes. Chairman Felner? Yes. We'll show that passes 5-0. Thank you very much, Commissioners. We do have one public comment card before we head
upstairs. Sandra Svin. Good morning, Sandra Sullivan, S. Patrick Shores. So, um, previously I came here and expressed concern because in 2021 we had a 20 uh 33% assessment
for fire and um it didn't really pan out because the cost of growth was so high. um there wasn't enough money to really address what the intent of that was, which was close the gap on the wages for the for fire. Um
so here we are, you know, with even more growth and we're doing a 37% increase and it's the magistrate's report indicated um county's words that were competing growth money with paying wages. So, a couple statements in there
that suggest the county doesn't have enough money to address both. Um, so I just want to um mention that the idea brought forth by um gentleman firefighter DO um is absolutely
brilliant and that is a um half cent or 1 cent sales tax. Um, and if you think about it, we have 24 new hotels coming online. We are a tourist county. We do, you know, they do they go to the
hospitals, they go to the port, they go to they they go to the the beaches, um, they do all these calls that are tourism related. And so the sales tax makes a lot of sense. And so you're going to be this fiscal crisis what what even the
what you're talking about um as a contract right now not going to fix the problem. It's a band-aid but you're still bleeding. Okay. So the the solution I'm going to make a suggestion to you because you got two crisises hitting the county. You got you got the
federal government just came down. Bard still has the highest number of deaths of manatees every year. lagoon is, you know, problematic. So now you can't put in any more septic systems and you need to expand your sewer systems and you just got cut by funding by Dannis on
some of those projects. My suggestion to you is not to wait to 2026 to pay the cost cost to doing business to do two referendums. one for an infrastructure sir tax with a half cent for transportation and a half cent to
address the sewage plants over in in near capacity and the pipes that need to go to them and the old pipes and as well as storm water. So that's one scent and you do a second one either a halfcent or full scent for the fire for uh for fire
and EMS. Um, we're spaced. We need a good hazmat. Uh, we we we could deal with with having a FEMA team because FEMA is being cut. You know, there's a lot of things we can do here to do this, right? And it's a it's not a lot of
expense. I talked to Tim Bulanic and I think this would be I think you need to do this and you can't afford to wait another year and this is the right way to do it. Okay. Thank you. That's the last of the
cards. So, it is 9:17. Let's just say we're going to start at 9:30. Can we do that? Make that nice and and round number. Anything else before we go up there? All right. Thank you everyone. The opinions expressed by any member of
the public during any period of public comment do not necessarily reflect the views or opinions of the board of county commissioners of Bvard County, Florida, Space Coast Government Television, or the program sponsor and are solely those of the presenter. The board of county commissioners of Bvard County, Florida, Space Coast Government Television, and
the program sponsor hereby expressly disclaim any and all responsibility or liability for any defamatory or slanderous statements expressed by any member of the public during any such period. Heat. I don't