Board adopts hospital non-ad valorem assessments; county, hospitals cite Medicaid funding role and federal caps

The Clay County Board of County Commissioners on June 24 adopted a resolution to impose and collect non-ad valorem assessments on participating hospitals in the county, a mechanism hospitals use to generate state and federal funding matched to local assessments.

David Elliott, vice president of finance with a hospital association representing private hospitals in the region, thanked commissioners for their help in advancing the timeline this year. Representatives from Ascension and HCA attended in support.

Elliott and commissioners discussed a state-level legislative proposal that would cap provider taxes at a federal-match-tested limit. Elliott said federal rules effectively cap provider taxes at 6% of net patient revenue statewide; he and hospital representatives warned that lower caps or changes could reduce future Medicaid matching dollars and consequently funding that supports hospital services to Medicaid patients.

Elliott noted that the county's current assessment level is not near the federal cap and that Florida's statewide assessment rate is roughly in the mid-3% range. He and hospital representatives said the assessments are an important funding source for hospitals that provide a safety net for Medicaid patients and keep services available locally.

A public hearing was opened and closed with no public speakers; the board then voted to approve the assessment resolution 5-0.

Commissioners and staff noted the need to monitor state legislation and any federal changes that could affect the ability of hospitals and counties to use assessments to fund programs that receive federal matching dollars.