Miami-Dade County

Miami-Dade voters approve $830 million for Jackson Health System

Four months of campaign messages about the long-deferred needs of Jackson Health System and the urgency for the aging public hospital system to more effectively compete against South Florida’s private and not-for-profit hospitals paid off Tuesday.

Miami-Dade voters approved a referendum to raise their property taxes and fund $830 million in upgrades and new equipment and facilities for Jackson.

The victory at the polls helps secure Jackson’s long-term future in the face of declining reimbursements from state and federal government programs and the uncertainties of the Affordable Care Act, said Carlos Migoya, chief executive.

It also allows Jackson to complete the financial turnaround that brought the hospital system back from the brink of bankruptcy in 2011, and begin the renovations, equipment upgrades and new construction that Jackson’s leaders believe are needed to attract more insured patients to help pay for the large numbers of uninsured and indigent patients whom the hospital serves.

“Plenty of people who voted for this bond today did it without thinking they would ever need Jackson themselves,’’ Migoya said, acknowledging the broad support the referendum received. “Over the next decade, we will look back at this as the turning point.’’

The Jackson bond referendum cost the county about $2 million, according to the elections office, though the total election — including city council races in Hialeah, Homestead, Miami and Miami Beach — cost an estimated $4.3 million.

Jackson administrators, employees and patients gathered in a ballroom at the Hilton Miami Downtown on Biscayne Boulevard shortly after polls closed, with loud music, appetizers and a cash bar giving the room a celebratory atmosphere even before the votes were tallied.

When nearly half of the precincts were counted — the “yes” votes led by a comfortable margin throughout the night — Migoya, who had been waiting in a separate room, entered the ballroom and took the stage along with Miami-Dade County Commissioners Audrey Edmonson, Barbara Jordan, Sally Heyman and Javier Souto. University of Miami President Donna Shalala and Darryl Sharpton, chairman of the Public Health Trust that governs Jackson, also joined Migoya on the stage.

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

He lauded employees, thanked elected officials and vowed to complete bond projects on time and within budget.

“Proud as I am of the way we ran this campaign,” Migoya said, “everyone here knows we will truly be judged by the way we manage this project.’’

The campaign’s core message emphasizing Jackson’s mission to provide quality healthcare to all Miami-Dade residents, regardless of their ability to pay, resonated with voters and donors.

Citizens for a Healthy Miami-Dade, the political action committee pushing for voter approval, raised $2.1 million during the four months ending Oct. 31, attracting the support of a broad section of South Florida civic and business leaders, including billionaire philanthropist and car dealer Norman Braman, who gave $25,000 to the Jackson effort but famously opposed Miami-Dade’s financing of the Miami Marlins baseball stadium in 2008 and most recently opposed a proposal to renovate Sun Life Stadium for the Miami Dolphins using public funds.

The campaign also drew strong support from Jackson’s longtime academic partner, the University of Miami, whose physicians make up about 90 percent of the doctors who work at the hospital system’s Miami campus.

Campaign supporters included UM’s Shalala, who gave $2,500 in October, and a number of university physicians and academic leaders, including Stephen D. Nimer, a researcher and clinician who also is director of UM’s Sylvester Comprehensive Cancer Center, and Barth Green, a neurosurgeon and chairman of the Department of Neurological Surgery at UM’s Miller School of Medicine.

However, several high-profile elected officials, including Miami-Dade Mayor Carlos Gimenez, never fully endorsed the campaign — even if they publicly voiced support for using public funds to fill Jackson’s capital and long-term needs.

Gimenez said Tuesday that he voted yes on the bond referendum, but he expressed reservations in a written statement this week explaining why he has not publicly endorsed the campaign.

“While I am personally in favor of funding the modernization and improvements of facilities to the Jackson Health System, I still have questions on the long-term use of those funds in light of the Affordable Care Act,’’ Gimenez said in the statement. “That said, if the voters approve the funding, I will ensure that we exercise the necessary due diligence so that the people’s money is well spent.’’

Commissioner Edmonson vowed again on Tuesday night that an independent panel will be appointed to oversee how the bond funds are spent and to ensure they are used for Jackson, although there was no mention of such a committee in the ballot language, nor did the ballot include a specific list of projects and related costs.

The ballot language did include three specific project areas: emergency rooms, a children’s ambulatory pavilion and urgent-care centers.

“I promised this community that we will have a citizen’s oversight board,’’ Edmonson said. “That’s the next step.’’

Plans distributed by hospital officials call for $477 million in construction projects, including the 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.

The 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.

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