“I think it’s just a little too much,” he said.
Commissioner Xavier Suarez also voiced concerns about low voter turnout in special elections, but sided with the majority in approving the referendum. Suarez also said he had reservations about some of the projects proposed by Jackson administrators, which includes everything from $70 million for a new rehabilitation hospital to $14 million for new elevators to $156.6 million for new computers and software to integrate electronic medical records.
The proposed improvements would take place across Jackson’s main campus in Miami’s Civic Center, and its satellite hospitals in North Miami Beach and South Miami-Dade.
“I don’t like the mix,” Suarez said. “If I was voting on this in the private sector… I would tell you that I would never want to see 20 percent, or $166 million, spent on IT [information technology].”
Carlos Migoya, Jackson’s chief executive, told commissioners he believes Miami-Dade voters will see the bond as an investment in a vital public service, and he predicted they will approve the referendum.
“We believe that last year voters took a great position on education,” he said, referring to November’s passage of a $1.2 billion bond referendum for Miami-Dade County Public Schools. “We believe they will take a great position on healthcare.”
Like Gimenez, Zapata also said he was concerned about the uncertainty of changes that will come with federal healthcare reform, which will move hospitals and physicians away from fee-for-service payments to quality- and outcome-based measures.
“It’s hard to have clarity,” Zapata said. “My gut tells me we’re going to be making a significant investment dealing with a lot of unknowns, and that makes me hesitant.”
Migoya said he expects federal healthcare reform to cost Jackson about $100 million a year, due to declines in Medicaid reimbursements as the state moves Medicaid beneficiaries into a managed care program that will allow private insurers to compete for their business. The competition will force hospitals to accept lower reimbursements for services, Migoya has said.
Commissioner Chairwoman Rebeca Sosa said she will call for public workshops on the proposed projects and bond referendum prior to November’s election so voters and the public can learn more and comment about the plans.
“So no one can say the commission moved this very fast and didn’t allow public hearings,” she said.
Commissioner Audrey Edmonson, who sponsored the resolution calling for the special election, said if voters approve the referendum she will push to increase the county’s administrative oversight of the bond money and how it will be spent.
Edmonson said she wants to require the Public Health Trust to work on the overhaul collaboratively with county staff andthe mayor’s office prior to receiving financing for the projects. Edmonson said she will also ask for quarterly and annual status reports on the projects, which are scheduled to be completed by 2024, according to a preliminary list provided by Jackson administrators.
“We need to ensure to taxpayers that the funds are used as they’re intended to be used,” Edmonson said.
Miami Herald staff writer Patricia Mazzei contributed to this report.