Public Health Trust adopts balanced FY2026 operating budget and $258.7M capital plan, cites $39M sales‑tax drop

The Public Health Trust Board of Trustees adopted a balanced operating budget for fiscal year 2026 and approved a $258.7 million capital program at its public budget hearing Aug. 27.

Jackson Health staff presented projections and major capital priorities for FY2026, citing revenue growth, service‑line expansions and planned capital investments. The capital plan includes $92.1 million for an emergency department expansion, $35.6 million for infrastructure upgrades, $31.6 million for medical equipment, and $32.8 million for information technology investments that include a $26 million allocation for the EPIC electronic health record implementation.

On the operating side, staff projected modest volume growth and targeted breakeven performance. Key operational projections presented were 80,511 missions (a 1.6% increase from FY2025), 30,211 surgeries (a 2.4% increase), about 4,500 additional emergency department visits, and an average length of stay of 6.18 days. Deliveries were projected to decline by nearly 6%, a change staff attributed to the closure of the labor and delivery unit at Jackson South.

Jackson Health staff warned of a $39 million projected decline in sales tax revenue compared with FY2025. Presenters said $26 million of that decline results from a state legislative change eliminating sales tax on commercial leases; the remaining $13 million came from the county’s sales‑tax revenue estimates. Staff combined that sales‑tax decline with an expected 7% increase in ad valorem property taxes and projected a net reduction of roughly $15 million in county funding lines referenced in the presentation.

The FY2026 operating budget assumes 6% revenue growth over FY2025 driven in part by higher case mix from specialized services and improved managed‑care rates. Expense assumptions include a 1% cost‑of‑living increase for eligible employees, a 5% rise in retirement costs, 3.85% pharmaceutical inflation and 2.3% inflation for implants and other supplies. Recurring obligations presented in the record include about $80 million for inmate medical services, $34 million for county medical Medicaid liability, $2.6 million for the county attorney’s office, $4.9 million for Community Health of South Florida, and $1 million to the Department of Health.

Budget presenters also discussed risk tied to potential federal changes affecting ACA coverage. Staff said Jackson currently receives roughly $100 million in revenue from patients with ACA coverage and that, if federal subsidies or provisions were eliminated, the system could face revenue reductions ranging from an estimated 19% to 30% of that $100 million (presenters cited potential impacts in the $19 million to $30 million range), though they described those estimates as speculative and dependent on federal action.

After the presentation and brief trustee questions about sales tax and retirement cost assumptions, a resolution approving the operating and capital budgets for fiscal year 2026 was moved, seconded and approved by voice vote.

The transcript records the board meeting adjourned after approval. Specific implementation timelines, capital project schedules and vendor contracting steps (such as EPIC procurement or infrastructure contracting) were not detailed in the public record provided.