Hillsborough commissioners waive notice rules to speed hospital directed payment ordinance

The Hillsborough County Board of County Commissioners on June 18 voted 7-0 to waive several board rules and to adopt an emergency schedule that shortens the public-notice timeline for a hospital directed payment program assessment public hearing.

The action, moved by Commissioner Ken Hagan and seconded by Commissioner Gwen Myers, allows the county to reduce the required mailing notice period from at least 20 days to at least five calendar days and to notify only local hospitals that pay the assessment. County Attorney Christine Beck told commissioners the move is authorized under Florida law in chapter 125.66 and requires a four-fifths vote.

The change was presented as a time-sensitive measure to preserve hospitals’ access to state-authorized federal matching dollars for Medicaid-related supplemental payments. Joanna Weiss, chief financial officer at Moffitt Cancer Center, told the board the alignment of federal, state and county actions is “time sensitive” and requested favorable support for the motion to approve an emergency ordinance. John Corus, president and CEO of Tampa General Hospital, told the board Tampa General provided “238,000,000 in unreimbursed indigent care costs” last year and said failure to act could end the county’s ability to access matching dollars.

Hospital executives and system representatives from BayCare, AdventHealth and HCA said the directed payment program (DPP) helps bridge Medicaid shortfalls and supports services that operate at a loss, including behavioral health and pediatric care. Colleen Ernst, representing hospitals in the county, said the proposed rate resolution would impose a special assessment only on providers and “is not passed along to patients.” Carrie Eisenbeis, chief of staff at BayCare Health System, said BayCare provided “over $272,000,000 in care” last year for Medicaid patients where reimbursement fell short and described DPP dollars as “critical.”

Commissioner Hagan framed the emergency timing as a response to pending federal proposals and to actions other Florida jurisdictions were taking: “Over 20 counties and municipalities across Florida are scheduled to take similar action between now and July 4,” he told the board, saying the county risked losing the opportunity to access federal funds. County staff and hospital representatives said the assessment dollars would be funded by providers and would not require additional county taxpayer funding.

The board also voted to withdraw a related consent item (A27) and directed staff to schedule the assessment public hearing for July 1, 2025, at 9 a.m. The motion to waive board rules and enact the emergency ordinance passed by recorded vote, 7 to 0.

Board members and staff emphasized that the emergency process shortens notice but does not eliminate the public hearing or the eventual vote on the assessment rules. County Administrator Bonnie Wise and County Attorney Christine Beck were thanked by Hagan for preparing the ordinance language and legal review.

Bonnie Wise told the board staff would proceed with the scheduling required by the motion; Beck confirmed the statutory basis and that record evidence from hospitals had been provided to justify emergency action.

The board’s steps set the timetable for a separate public hearing and final vote on the hospital directed payment assessment resolution, while leaving the specifics of any assessment rate and final contract terms to the subsequent hearing and resolution process.