Jackson Health System bond question heads to Miami-Dade voters



The brief campaign to win public financing for Jackson Health System’s long-term needs wraps up this week as Miami-Dade voters cast ballots Tuesday and decide whether to raise their property taxes to fund $830 million in upgrades and new equipment and facilities for the county’s public hospital network.

“We’re now in the home stretch,” Carlos Migoya, Jackson’s chief executive, said this week during a meeting of the Public Health Trust, which governs the hospital system. “It’s all about the turnout of people who believe in the future of Jackson.”

Having spent the past three months speaking to civic groups and homeowners associations, giving interviews on television and radio, and participating in media events at the hospital, Migoya has been the campaign’s most public face.

Separately, campaigns run by Jackson’s employee unions and a political action committee have staged voter drives with doctors and nurses casting early-voting ballots in scrubs and lab coats, and they have unleashed a wave of glossy advertisements and radio and TV ads — as well as airplane banners at football games — urging residents to “Vote Yes.”

The campaign’s message is focused tightly on Jackson’s “miracles,” the stories of individual Miami-Dade residents and others who have received life-saving organ transplants, trauma care and other services through the hospital system.

That message has resounded well with donors.

Citizens for a Healthy Miami-Dade, the political action committee pushing for voter approval, raised $1.8 million during the 3 ½ months ending Oct. 11, attracting donations from well-known South Florida philanthropists such as billionaire car dealer Norman Braman, who gave $25,000.

Other high-profile donors included Leon Medical Centers and Florida Power & Light, each of which gave $100,000 to the campaign. Mike Fernandez, an insurance executive, gave a total of $100,000 as well.

The campaign has spent more than $1 million in the same three months on advertising, polling, website development and other expenditures, according to treasurer’s reports.

But it’s hard to tell how well voters are responding, because the campaign has declined to share the results of telephone polls, and some watchers wonder whether Miami-Dade voters are experiencing tax fatigue — having last year approved a $1.2 billion bond for Miami-Dade Public Schools, and facing higher water and sewer rates to fund infrastructure improvements and higher road tolls planned by the Miami-Dade Expressway Authority.

Another concern is trust.

Though County Commissioner Audrey Edmonson has vowed that an independent panel will be appointed to oversee how the Jackson funds are spent, there is no mention of such a committee in the ballot language, nor does the ballot include a specific list of projects and related costs.

However, the language voters will see does name three specific project areas: emergency rooms, a children’s ambulatory pavilion and urgent-care centers.

Plans distributed by hospital officials call for $477 million in construction projects, including a new rehabilitation hospital at Jackson’s main campus and about a dozen urgent-care centers throughout Miami-Dade.

A significant portion — about $350 million — is for new equipment, everything from hospital beds and patient room furniture to CT scanners, cardiology X-ray systems and oncology radiation devices.

About $130 million is earmarked for computers and software to integrate electronic medical records, clinical information and physician decision-making tools across Jackson’s network of six hospitals, 12 specialty-care centers, and health clinics.

If voters approve the referendum question, bonds will be issued in staggered amounts each year through 2023, with the total cost to repay the $830 million in bonds projected at about $1.4 billion, according to the county Finance Department.

Over the life of the bonds — about 30 to 40 years — the debt tax-rate hike would fluctuate depending on the annual level of borrowing.

According to county projections, that could amount to a peak rate of an additional $48.80 in year 10 (2024) for a homeowner with a taxable property value of $200,000 in an unincorporated neighborhood such as Kendall. In the first year, the hike would be closer to $9.80.

Miami-Dade taxpayers already contribute about $350 million a year, through a half-penny sales tax and property taxes, to help fund Jackson’s operations, which are budgeted at $1.5 billion for the year ending Sept. 30, 2014.

Jackson administrators have yet to release a year-end report for 2013 — and will not do so until after the election — but Migoya said he expects a budget surplus to exceed $40 million.

For next year, Migoya projects a modest surplus of about $11.6 million, due in part to reductions in reimbursement rates from Medicaid and changes brought about by the Affordable Care Act — adding urgency to the hospital’s needs for project funds.

But no matter the outcome, Migoya has vowed, Jackson administrators will continue to focus on fulfilling their mission to provide a high standard of medical care for all residents of Miami-Dade, regardless of their ability to pay.

“Win or lose next Tuesday,” he said, “we stay true to our guiding principles.”

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