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Bill would require voters or courts to approve public hospital sale

A pair of proposals to require the courts –- or, in some cases, voters –- to sign off on the sale or lease of a public hospital advanced in the Florida House and Senate Monday. But lawmakers had a lot of questions on the bills, with only two weeks left in the annual legislative session.

The sponsors of the legislation -- Sen. Rene Garcia, R-Hialeah, and Rep. Ed Hooper, R-Clearwater -- said their bills were prompted by the botched merger of Bert Fish Medical Center, a former public hospital in New Smyrna Beach, with the nonprofit Adventist Health System. A judge found the deal was negotiated in 21 secret meetings that violated the state's Sunshine Law.

But in the House Health & Human Services Committee and the Senate Judiciary Committee on Monday, there was also frequent mention of South Florida hospitals.

The North Broward Hospital District last year supported and later backed off from a plan to privatize its four hospitals; in February, Miami's Jackson Health System received a $1.1 billion bid from a Massachusetts hospital chain.

The Jackson bid went nowhere. But had it moved forward, its governing body, the Public Health Trust -- and ultimately the Miami-Dade County Commission -- would have had to sign off on the deal.

The bills under consideration (HB 619 and SB 1448) would give a judge the power review any deal to make sure any lease or sale is of "fair market value." If it's not, the hospital would have to justify why it chose a lower bid -- for example, to keep services that are not profitable, such as trauma centers or a transplant program, or to provide care for indigent patients.

The company acquiring the hospitals would have to make an "enforceable commitment" to preserve existing services, particularly for the indigent and the uninsured.

In cases where the sale or lease of a hospital is not made by a governing body composed of elected officials, a deal would not go to a judge but to a voter referendum instead.

Eight of Florida's 31 public hospital systems would be exempt from the additional oversight in the bills because they have not received tax dollars from the state in the past five years.

The Florida Hospital Association and the Safety Net Hospital Alliance of Florida, which includes Jackson, oppose the bills, saying the extra review is unnecessary. The Bert Fish hospital case was unfortunate, they said, but it was because a governing body was breaking the law -- not because there weren't laws on the books to make hospital deals transparent.

"There are already layers and layers and layers of protection," said Ron Book, a lobbyist for the North Broward Hospital District.

Not so, argued Barney Bishop of Associated Industries of Florida, a business group. He suggested hospital trustees couldn't be trusted.

"Are you kidding me?" he said. "Are we on drugs?"

In the committees in both chambers, the votes went largely along party lines, with Democrats voting against the bills and Republicans voting for them. There was at least one exception: Rep. Ari Porth, a Coral Springs Democrat, who voted in favor.

Several Republicans said they would like tweaks to the bills. One of them, Rep. Gayle Harrell of Stuart, said she fears courts overstepping their boundaries.

The bill has cleared four of four committees in the House but still has one more stop in the Senate before moving on to the floor.