News of the Nature Coast of Florida

Citrus County's Legislative Delegation rolled into town today, bringing state Sens. Mike Fasano, Charlie Dean and Rep. Ron Schultz to the new Inverness Courthouse.

The delegation heard from a number of area residents, local governments and organizations as things got underway at 9 a.m., and at 11 a.m. they were presented with what is arguably one of the most important issues - a request for a bill to deal with the current dispute at Citrus Memorial Hospital between the hospital board (trustees) and its foundation.

That bill would seek a legislative remedy to the power struggle between the CMH's hospital board (trustees) and its foundation, which has drawn much public scrutiny and articles by the local newspaper. The two entities have tried recently to end the impasse between them, but have failed to reach a solution that would satisfy either party.

The foundation is a creation of the hospital board. It was set up as a private, not-for-profit corporation in 1990. The foundation entered into a 40-year lease and an agreement for hospital care, which set the parameters for the foundation to operate Citrus Memorial Hospital. Over the years, the foundation contends, it gave more and more control to the hospital board, even going so far at one point as to make the hospital board its sole "member."

As it now sits, the hospital board has challenged the constitutionality of the board-foundation arrangement, but the foundation says the arrangement is indeed constitutional. Cited is a Florida appellate court's ruling in Indian River County Hospital District vs. Indian River Memorial Hospital, Inc., 766 So. 2d 233 (Fla. 4th DCA 2000). The court upheld the constitutionality of an arrangement where there was less government control over a not-for-profit hospital than there is in Citrus County. In so doing, the court noted: "Contrary to the District's concerns, leases of this nature are not only allowed under current law, but they are being aggressively encouraged by the Florida Legislature. The District contends its lease violates public policy, but it is actually in furtherance of public policy."

While the foundation's guiding light has been that appellate ruling, one of the the hospital board's major problems is what is known as "sovereign immunity," which just means that, in accordance with state law, lawsuits against the hospital are capped at $200,000. The hospital board contends that this immunity depends on the board having oversight over business operations.

It is a long, complex legal issue - and is now a political one. A recent stab at mediation ended in a stalemate. The board wanted oversight of major decisions being made so it could meet its responsibility to taxpayers, and wanted the number on the foundation's board of directors to be reduced from 13 to nine - with five of those positions to be populated by hospital board members.

At today's meeting, two of the three lawmakers - Dean and Fasano- decided to accept what is the only local bill, and to move forward with it. It would allow the hospital board to have ascendancy over the foundation in hospital matters, and could lead to a shakeup in the foundation's makeup.

In summarizing the decision to accept the bill, Schultz said, “We will have a divorce, but we will not settle it today." Added by the legislators were provisions covering travel expenses, transparency and contract acquisition, all of which the board has contended were problematic when dealing with the foundation.