MINUTES OF MEETING OF NORTH LAKE COUNTY



MINUTES OF MEETING OF NORTH LAKE COUNTY

HOSPITAL DISTRICT OF SEPTEMBER 17, 2009

The meeting of the North Lake County Hospital District (the “District”) was held on September 17, 2009 at 5:15 p.m. in County Commission Chambers, Administration Building, 315 W. Main Street, Tavares, Florida.

Attorney M. Meredith Kirste called the roll to ascertain the trustees present for the meeting. The following members were in attendance: Frank Gaylord, Chairman; William Bowersox; William Talley, Jr.; Roger Beyers; Ken Carpenter; and Marilyn Bainter. Also in attendance were Patricia A. Sykes-Amos, accountant, and M. Meredith Kirste, attorney for North Lake County Hospital District. After having a quorum of Trustees present in accordance with Florida Law, the meeting was called to order.

WORKSHOP

Mr. Lee Huntley, President/CEO Central Florida Health Alliance, mentioned that their CFO, Dale Hocking, met with Ms. Bainter and a small group as requested and that the CFO’s from both groups have prepared a summary of the operating profit analysis and provided that to the Board.

Mr. Ken Mattison, CEO of Florida Hospital Waterman, stated that he appreciated the opportunity to bring forth information that the Board requested, and they wanted to be transparent. He mentioned that they were trying to consolidate those reports to report that information in similar fashion to Leesburg Regional Medical Center (LRMC) in the future.

Mr. Dale Hocking, CFO of Central Florida Health Alliance and Leesburg Regional Medical Center, explained that the first column in the Operating Profit Analysis for the Hospital Tax District chart shows the operating income or loss and what their profit or loss would be without the tax and the matching funds from the State for 2002 forward. He pointed out that it took a turn in 2007 when they had a loss of $147,000, in 2008 with a loss of $3.7 million, and in 2009 with a loss of $6.4 million, without including any investment income, tax, or State support. He noted that all hospitals in the State of Florida pay a tax into a public medical assistance trust fund, which was 1.5 percent of their net patient service revenues for in-patient and 1 percent for out-patient revenues. He illustrated that from 2002 to 2007, they paid over $2 million a year into that fund and over $3 million in 2008. He related that the last column illustrated capital that they have invested in LRMC, which ranged from $12 million to $41 million in the prior years until this year, when they had to reduce that to only $6.3 million. He commented that the tax support was critical for them, and they would be in a severe loss without it, which could result in an inability to update their technology and improve their facilities or equipment. He also mentioned that he spoke with Ms. Bainter and two other people regarding issues such as structure, finance, income statement vs. balance sheets, health care finance, and accounting in general and reconciled the 990’s.

Ms. Frances Crunk, CFO of Florida Hospital Waterman, thanked the Board for the opportunity to share with them the importance of having a healthy operating margin to sustain the organization for the future. She referred to the second page of the attachment referenced by Mr. Hocking showing the operating income in the first column which excluded their investment income and the tax. She noted that they have shown a profit. She related that having a positive operating margin was critical for a hospital, and a hospital would continue to spiral downward without it, resulting in an inability to meet their debt obligations, purchase new technology, update or replace equipment or buildings, meet the community’s growth demands, or bring new services to the community. She also pointed out that access to financing would be difficult at best without a healthy margin or adequate cash reserves, and it would be at a higher interest rate as a result. She reported that their operating margin for the last seven years shown in the chart, including the tax dollars, averages 5.5 percent, and was 2.9 percent without the tax dollars. She referenced data showing that on average in the southern United States, the operating margin for the top performing hospitals was 11.19 percent. She opined that if tax dollars were not available, Florida Hospital Waterman would be committed to maintaining a reasonable operating margin, but with a reduction of capital spending, services, and workforce and an eventual increase in rates. She stated that this could result in the long run in physicians admitting patients to other facilities, patients leaving the community to seek services elsewhere, inadequate workforce, an overcrowded emergency room, and the decline of a community hospital. She commented that they had been able to use the funds from the tax to offset a portion of the cost associated with the uninsured, to expand their services, and to provide equipment that was important to their patients. She pointed out that the hospital has spent approximately $151 million in capital improvements in the last seven years. She predicted that in 2010 they were likely to see a 4 percent reduction in their Medicaid payments and the potential elimination of one of the Medicaid programs, and commented that with the increasing uninsured and unemployment rates, the need for their support was greater than ever. She noted that there was an error in Column 11 for 2004 and that it should be $1,078,161.

Ms. Bainter stated that when she went through the financial statements, she saw that in 2007, LRMC had 57 percent and Waterman had 49 percent Medicare patients. The chart she handed out from AHCA (Agency for Health Care Administration) showed that Waterman was at 3.09 percent of their gross revenues for Medicaid and Leesburg was at 2.44 percent. She opined that the cost to the property owners of about $150 for a total of $11.2 million could be left in the economy in Lake County. She pointed out that the hospitals were not paying any federal, sales, state, corporate, or ad valorem taxes. She also stated that the County was paying for the health insurance of its employees, who were part of the insured population that were making up for those that were not insured and the indigent. She commented that if the tax proceeds were used for charity care, then they had to make a change in the law to reflect that it would be used for that rather than continued hospital services. She opined that she has had to make an effort to ask for any information or data regarding indigent care. She stated that she went back through the minutes of previous years’ meetings and did not see that this Board discussed much during their tax hearing times about whether they should go through with the tax, discontinue it, or ask the legislature if they could change the wording to vary the tax rate. She opined that the hospitals had high paid directors and employees and special interest groups that were sharing in some of the profit margins, and she asked for differentiations between Leesburg Regional Medical Center, Inc., LRMC, the Skilled Nursing Center, and the Villages Tri-County Medical Center.

Mr. Hocking stated that Leesburg Regional Medical Center is a hospital, and the Skilled Nursing Center was a department of the hospital when it existed and was included in LRMC’s financial statements, but it had been sold. He also clarified that LRMC, Inc. is the corporate structure that included the hospital and that The Villages Tri-County Medical Center, Inc. had nothing to do with this tax district. He also explained that there are structures in place because of bond issues and the Medicare regulations.

Phil Braun further explained that Leesburg Regional Medical Center, Inc. is a Florida not-for-profit corporation which holds the license for the hospital. He emphasized that the point Ms. Bainter was trying to make about the separate corporations had nothing to do with this tax district. He commented that hospital care and skilled nursing care were related entities, and the information that they were provided was all related to the operation of that hospital.

Ms. Bainter pointed out the net asset transfer of $11,705,000 to the affiliate hospital, Villages Tri-County Medical Center, and she stated that according to VHA (Voluntary Hospitals America) and the Catholic Health Care Associated United States of 2005, charity care does not include bad debt.

NEW BUSINESS

a. Recitation for the record of the name of the taxing authority, the roll back rate, the percentage of decrease over the rolled back rate, and the millage rate to be levied.

Ms. M. Meredith Kirste, attorney for the North Lake County Hospital District, announced that the rollback rate was 1.092 mills, the decrease of percentage over the roll back rate was 8.43 percent, and the millage rate to be levied was 1.0 mills.

On a motion by Ms. Bainter, seconded by Mr. Tally, and carried unanimously by a vote of 6-0, the Board moved to waive the formal reading of Resolution No. One-A in its entirety, and Ms. Kirste read the resolution by title only.

Ms. Bainter moved to make an amendment to the resolution changing the first paragraph to “Whereas, the North Lake County Hospital District may levy a millage to raise operating revenue” and under “Now Therefore, Be It Resolved As Follows,” she wanted to change to “1. The North Lake County Hospital Board of Trustees hereby approves a levy of 0.0 mills; and 2. The levy of 0.0 mills represents a decrease in the property tax levy of 0.00 percent under the rolled-back rate of 1.092 mills.”

Mr. Gaylord, Chairman, stated that at this point, for the purpose of clarification and since they had public hearings to be made, the amendment should be made at the time of the formal motion for the adoption.

Public Hearing on Resolution No. One-A setting millage

The Chairman opened the public hearing on the resolution and asked those that were proponents of the resolution to speak at this time.

Mr. Art Ayris, a resident of Fruitland Park as well as the executive pastor at First Baptist Leesburg and Executive Director of the Community Medical Care Center, stated that the value of the millage rate was far greater than the actual dollars. He related that the hospital has probably put over $3 million into the Community Medical Care Center in Leesburg, which were highly leveraged dollars, and there were 50 volunteer doctors that work with them and thousands of hours donated by volunteer nurses, other practitioners, and dentists, as well as over $1 million of donations given by pharmaceutical companies. He noted that they also partnered with the Sexual Assault Nurse Examination Program so that the victims did not have to go to an emergency room. He opined that if the millage went away, the hospital would have some hard choices, and it would leave a huge gap in services in Leesburg.

Dr. Celia Nelson, a general surgeon in Lake County since 1992 who was on the medical staff at LRMC, stated that it would be tragic and unnecessary for the tax dollars to go away. She related that there were patients showing up at their hospital who could not pay for the services that they have to provide there for them, but they get the same treatment and excellent care as those that were insured. She noted that they had to keep paying the bills in order to keep providing the supplies and services, and the hospital was not going to or wanted to turn the uninsured away. She commented that the hospitals had to be functioning, viable entities to be able to provide medical services for the community, and those tax dollars were well spent and well invested in a healthier community.

Ms. Patricia Stover-Jones, a resident of Fruitland Park, stated that when she first came to this area 36 years ago, LRMC was considered a small rural hospital that was adequate for bumps, bruises, and limited medical services. She described the negative effect on the community when LRMC closed its obstetrics department until they finally returned this service to their community by acquiring a for-profit hospital. She mentioned the heart problems that her father had suffered and that they had to travel to a hospital in Orlando for heart surgery and treatment at a time when those services were not provided locally. She also related that her mother’s onset of cancer three years later necessitated them driving to Orlando for a 17-month course of chemotherapy, which caused great hardship to her family. She related that later LRMC had both a cancer and a heart treatment center that made it easier for her parents to get the medical care they needed right there in Lake County. She commented that this illustrated that the progress of LRMC has been able to bring substantial increases in safety and state-of-the-art health care to the citizens of Lake County, and without the tax district funds, there would not have been much needed funds to reinvest in facilities, equipment, and services. She pointed out that the profits were invested in this community’s future health and not given to shareholders. She opined that having to travel out of the area for health treatments would add more of a burden on their citizens than the average cost of $100 a year for the tax. She stated that she understood that health care finance was complex and why the questions have been asked regarding the issues being discussed for the last few months. She also admired the efforts Ms. Bainter had made to understand those complex issues and ask many mind-provoking questions. She stated that LRMC holds in the highest regard the value of stewardship, integrity, and quality. She asked the Board to please not take those resources away.

Ms. Rosie Short, who worked at Florida Hospital Waterman, related that she has recently taken in her unemployed 24-year old niece who had symptoms and was exposed to someone with meningitis. She stated that the hospital treated her niece, even though she had no insurance or money, without harassing her or asking her for money. She opined that it would be appalling to take away this money, which was only a small part of what the hospitals contribute to the community.

Mr. Marc Westerman, Vice President of Support Services at LRMC, commented that in all of his years of experience he had never worked with a team that took the fiduciary responsibility and stewardship of the dollars the way that the team at LRMC does. He reassured the Board that they focus and have pride in ensuring that they properly spend every dollar as economically as possible with the balance of quality of the service and products.

Ms. Kathy Lieffort, a resident of Howey-in-the-Hills and an employee of LRMC, stated that she would not have moved to this area if the hospitals and health care system was not here. She was given support from the administration to start a program called Compassionate Companions using volunteers so that patients would not have to die alone. She commented that she was very proud to be working for that organization and knew that the tax dollars were important for their hospitals. She also stated that she was proud to pay those taxes for those fantastic hospitals.

Ms. Linda Ball, a nurse at LRMC, commented that their emergency room sees a phenomenal number of patients, and they provide that care without asking about their ability to pay. She stated that the employees at the hospital were part of the community and received the benefits of the care that was provided there. She opined that there was an attitude and an environment at Leesburg Regional that she had not seen in any other hospital in which she had worked, and it fostered a genuine desire to care for those that were entrusted to them. She has seen the hospital grow and include new services such as the heart institute and open heart surgery and advancements in the technology that was available. She opined that they could not do that without the support of the tax money. She expressed pride that she spent almost 25 of her 38 years as a nurse working for LRMC and had no intention of going to work anyplace else, because it is a special place providing special care.

Dr. Charles Mojock, President of Lake-Sumter Community College and a LifeStream board member, recapped that he spoke in favor of the one mill for the hospital district last week and commented that he believed the hospitals have delivered on their promise of transparency. He believed it was clear that the hospitals needed the one mill to support them and the work that they were doing, and he encouraged the Board to adopt the one mill rate.

Ms. Kathy Hilliard, a resident of Leesburg and an employee of LRMC, stated that LRMC was a lot more technologically current than it was when she first came to this County 17 years ago. She commented that the hospital has given her a home, a job, and a community to raise her children in a wonderful environment. She related that the hospital has given many opportunities back to the community, and she asked the Board not to shortchange the hospitals.

Mr. Paul Harsh, a resident of Lady Lake, reaffirmed his support of the tax that he expressed at the September 10 meeting and commented that it was the only tax that he felt good about, since it gave him a chance to act on his belief that they had a responsibility to help others. He opined that the arguments against the tax really have not addressed the real issue, have been emotional, and a lot of it seemed moved by a vendetta. He noted that nothing was free, and someone had to pay for health care. He believes that this tax actually would produce more than it takes, and he mentioned the many hours that his wife worked both in and out of the office as one of the hospital administrators.

Ms. Donna Brooker, a resident of Fruitland Park and an employee of LRMC, stated that she has worked with over 300 compassionate, hard-working physicians and that they have been able to draw them into their community because of the state of the hospital facilities. She expressed desire that the County would continue to be an area where well-trained physicians would want to practice and would not have to leave because funding was not available. She mentioned that her father did not have to go out of the county for any of his extensive heart surgeries and that she was thankful that four of her grandchildren were able to be born at local hospitals. She stated that the one mill will help provide good health care to all their citizens, and she asked the Board to vote in favor of keeping the one mill tax.

Dr. Howard Vesser, who worked at the free clinic in Leesburg, opined that this was an investment, since they were able to see a patient for about $50 versus $2,000 in the emergency room. He mentioned that the State Volunteer Health Care Act protects the licensed professionals from lawsuits. He noted that patients with chronic health conditions cost less to treat if they came in earlier than if that person put off treatment until the condition was a much more serious and expensive problem. He related that they fill out forms to send to the pharmaceutical companies for patient assistance and receive over $1 million worth of pharmaceuticals a year in the clinic. He stated that they had about 50 professional volunteers that gave some type of service during the year.

Mr. Howard Wiener, LifeStream Behavioral Center, thanked the Board for helping their center provide services to the mentally handicapped in the community. He reported that they served approximately 26,000 individuals in the county last year in both the hospital and their out-patient services and that their clients got between $350,000 and $400,000 worth of free medications a month.

Mr. Greg Beliveau, a resident of Okahumpka, commented that 5.5 percent profit was not considered good in the private sector, and he was surprised about the revenue streams that come into a hospital and the fact that they had almost no control over those. He further explained that the hospitals could not count on the revenue streams to be constant over an annual period, but one of the constants they did have was this tax, and it would be a shame for this one reliable source to be taken away. He believed that the services being provided by both the hospitals were phenomenal and were well beyond what those funds actually provided. He stated that those funds were important, provided roll-over funds, seed money for other funds, and the power within the community to make it work, and he strongly urged the Board to keep the one mill.

Ms. Maggie Evans, a resident of Umatilla, stated that the property owners had the greatest stake in the community and got the greatest amount of benefit from the excellent hospitals and medical care. She specified that a property owner with property worth $250,000 pays 68 cents a day toward this mill, and she thought that it was ridiculous to suggest that it was a large burden on the property owner. She also thought that the idea that the hospitals’ tax advantages took away funds from our community was not true, because they put those tax dollars that are saved back into the community. She strongly urged the Board to approve the one mill.

Ms. Tamra Halsey, Director of Community Medical Care Center in Leesburg, which was a partnership between LRMC and First Baptist Church of Leesburg, stated that they provided free primary care for people from their tax district area that had no insurance coverage and low incomes, and they have seen over 80,000 patients over the years for ailments including colds, diabetes, hypertension, asthma, and depression. They also provide over $1 million a year in medications for these patients. She pointed out that they save the hospital money on emergency room care, but the hospital will provide any care or surgeries for free that were needed if the patients qualify to get it.

Mr. Bob White, who was on the Board at Florida Hospital Waterman, pointed out that this tax stays in the County to take care of its own residents. He opined that if they had the rest of their taxes applied as effectively as this one with such a tangible benefit, they would be happy to pay more taxes than this. He urged the Board to approve this for the benefit of their people right now.

There being no one else who wished to speak in favor of approval of the resolution, the Chairman closed that portion of the public hearing and announced a recess until 7:25 p.m.

The Chairman opened the public hearing for those in opposition to the resolution.

Ms. Constance Albright, a resident of Eustis, started out by assuring the hospital workers that no one questioned their integrity or that they did a great job, but commented that their efforts would never be as appreciated and compensated as they deserved. She found Ms. Sykes-Amos’ plan for putting the tax aside in a CD or money market a good one, but that she did not shop around for the best rate was troubling. She also suggested that they videotape the meeting and show it on public access television. She opined that if a CEO of a major hospital did not understand or believe in health reform, it was needed more than ever.

Ms. Evelyn Logas, a resident of Mount Dora, stated that she was a registered nurse who had spent all of her career in the field of medicine working with directors, administrators, financial counselors, nurses, and doctors. She evaluated indigent cases to determine whether the case would be paid for by Orange County or absorbed by the hospital. She commented that they were very fortunate to have two fine hospitals in this County now which they did not have before, as well as the clinics, but she did not think the tax was needed the way it was before. She opined that the $5 million that the hospitals would get from this tax would not make or break them, and she believed everyone should discuss in a civilized manner whether this tax was needed anymore.

Ms. Catherine Earhart, a resident of Eustis, stated that she looked at the hospital’s 990 tax forms that were submitted to the IRS as well as the audited financial forms, and she opined that the staff was misinformed by the CEO’s. She noted that she had no complaints about either hospital, and she thought the staff was doing a good job running the hospitals. She questioned whether the hospitals needed the extra support that most hospitals did not have, and she stated that 57 of the 67 counties in Florida currently did not have a special tax for hospitals, which was verified by Ms. Bainter’s calls to every county. She pointed out that residents were paying for the hospitals through other taxes as well including Lake County, state, and federal taxes. She reported that Florida Hospital Waterman pays its executives and out-of-district board members millions of dollars in compensation and that the hospitals reported annual investments of $36.1 million for Florida Hospital Waterman and $71.5 million for LRMC in 2007. She related that Waterman’s 2006 section on community benefits reported spending of $2,516,979 for cash and other in-kind donations and $498,262 for clinic/primary care services, and she believed that more of the money should have been spent for the clinic instead. She commented that the hospitals that serve a disproportionate share of low-income patients get increased payments. She referred to a report from the Agency for Health Care Administration (AHCA) regarding charity care information which showed that in 2008 the percentage to gross revenue for Florida Hospital Waterman was 3.9 percent and for LRMC was 2.44 percent for charity care, but data from hospitals in Orange, Volusia, Lake, Marion, Seminole, and Sumter Counties illustrated that the percentage for other hospitals ranged from 4 percent to 21 percent. She opined that even though the hospitals claim that they have the most patients that did not pay full insurance, there were at least 16 other counties that had about the same or more percentage of Medicare patients as Lake County did but did not have a hospital tax. She felt it was important to point out that the reason why the hospitals report a shortfall with respect to Medicare was because Medicare or insurance does not reimburse for excessive executive salaries, benefits or other perks; lobbying budgets; grandiose facilities; exquisite landscaping; over-the-top marketing activities or costly advertising; valet parking; lavish parties; management fees to a parent corporation; and funds to affiliated entities. She noted that both hospitals made millions of dollars in profits and that the tax collections from 2002 to 2007 doubled, and these profits were in excess of budgeted annual needs. She pointed out that Ms. Bainter had to actively search and ask for information such as the 990 forms. She explained that the hospitals had both an operational and a nonoperational budget, but chose to report only the operational budget, which funded the staff, utilities, repairs, and depreciation and amortization, and she stated that the money for the nonoperational budget was money that was taken from the operational budget.

Mr. Vance Jochim, a resident of Tavares who writes a blog called , stated that he opposed the millage increase, and he felt that if they did not have income, they should reduce their budget. He related that he had been a corporate auditor, and he pointed out that there was currently no middle ground of choice between zero and one mill. He did not think there was any kind of public discourse on this issue in the past, and he was in favor of transparency. He commented that both hospitals have been very willing to share their information, and he did not see any problems with their financial statements. He noted that there had not been discussion of the conditions attached to the funding that would be provided or the reasoning behind why the Board should vote for the one mill, and he did not feel there was transparency from the Board. He thought that approval of the mill should be contingent on conditions that it was spent in a specific way. He informed the Board that as a consequence, when he goes to the legislative delegation meeting, he will ask for a referendum for the public to decide if they want to continue taxing only the property owners, and he believed there should be public discourse on this issue. He suggested that they post on the website information such as the 990’s and other things that have been discussed for the public to review.

There being no one else who wished to address the Board, the Chairman closed the public hearing regarding Resolution One-A and opened the public hearing regarding Resolution Two-A.

Public Hearing on Resolution No. Two-A

Ms. Kirste read Resolution No. Two-A by title only. There being no one who wished to address the Board, the Chairman closed the public hearing.

Ms. Bainter reiterated her motion for an amendment to Resolution No. One-A that she had previously made changing the first paragraph to “Whereas, the North Lake County Hospital District may levy a millage to raise operating revenue” and under “Now Therefore, Be It Resolved As Follows,” requesting a change to “1. The North Lake County Hospital Board of Trustees hereby approves a levy of 0.0 mills; and 2. The levy of 0.0 mills represents a decrease in the property tax levy of 0.00 percent under the rolled-back rate of 1.092 mills.” The motion failed due to a lack of a second.

Mr. Gaylord commented that the first striking matter relating to this tax is that he did not see one businessman there in opposition to the one mill on commercial real estate, because they recognized the value of having the hospitals nearby that could service their employees as well as encourage new business to come in. He stated that he believes that the value of a community is determined by how they treat the poorest residents, and he was proud to say that the less fortunate residents of Lake County could get medical help and that he stood behind this tax if this was the way to do that.

Ms. Bainter commented that the hospitals made a deal with the government to do charity care in exchange for not being charged for federal income tax, state corporate tax, and local ad valorem tax on property or equipment. She noted that the poorest residents were taken care of by Medicaid.

Mr. Tally stated that when the hospital district was formed, he had their attorney look carefully at it to determine if there was a mission statement or a job description that stated whether they needed to monitor that on a regular basis or whether they would take the information and financial statements that were presented to them at face value. He was not aware that they should be making job performance evaluations of the hospital staff, and the hospital district that was created was in response to taking the one mill and conveying that to the deserving hospitals. He pointed out that the hospitals were private corporations.

Ms. Bainter responded that they were not trying to run the hospitals, but they wanted to know that their money was being spent in the right way. She added that as long as the hospitals were profitable, there was really not much need for the tax, but when they reach the point that they were not profitable, then they could consider it again.

Mr. Gaylord pointed out that the statements show projected losses, even though that was regarding the operating as opposed to a consolidated statement.

Mr. Carpenter stated that he had some background as a CPA with some experience in putting together those kinds of audited financial statements, and he was more trusting of the hospitals’ intentions. He thought that some of the items that were shown on the overhead were very misguided. He mentioned that he has spent time speaking with both staffs and outside sources and has tried to find out if in fact there was an industry standard for determining what indigent or charity care costs were, and found that the information presented by the hospitals was accurate. He asked each one of them to contact their auditors to find out if it would be possible and what the cost would be for putting together some kind of an independent third-party supplemental schedule to indicate that those numbers were in compliance with industry standards. He was pleased to hear the information that cash to debt ratios for the top 100 hospitals in the country, and he pointed out that the money stayed in the community. He assured everyone that he did not take this issue lightly, and he applauded Ms. Bainter and her group for bringing this to everyone’s attention.

Mr. Beyers stated that he was new to this board, was a business owner in the taxing district, and that he paid between $2500 and $3000 annually for the hospital tax. He commented that he did not hesitate to pay it, and as a business owner he knew that not having a good quality hospital would become a detriment to their economy. He stated that he thought everyone agreed that transparency was a good thing. He related that some of his family members have used the services of the local hospitals, and he was proud of the fact that there were decent hospitals in the area.

Mr. Bowersox reported that LRMC had to pay a mandated state indigent tax of over $3 million.

On a motion by Mr. Carpenter, seconded by Mr. Beyers and carried by a roll call vote of 4-1, with Ms. Bainter voting “no,” the Board approved Resolution No. One-A of the North Lake County Hospital District providing for the adoption of the proposed millage rate of 1.0 mills for the 2009-2010 fiscal year, which represents a decrease in the property tax levy of 8.43 percent under the roll back rate of 1.092 mills.

Adoption of Resolution No. Two-A

Ms. Bainter moved to amend Resolution No. Two-A to state in the first paragraph “Whereas the North Lake County Hospital District may adopt a budget for the 2009-2010 fiscal year,” and to change under “Now Therefore, Be It Resolved As Follows: 1. The North Lake County Board of Trustees hereby adopts total budget expenditures of $24,850 for 2009-2010. 2. The adopted budget represents a decrease in expenditures of 109.28 percent under last year’s budget.” The motion failed due to lack of a second.

On a motion by Mr. Carpenter, seconded by Mr. Beyers and carried by a roll call vote of 4-1 with Ms. Bainter voting “no,” the Board approved Resolution No. Two-A of the North Lake County Hospital District providing for the adoption of the proposed budget for the 2009-2010 fiscal year with total expenditures and carry forward of $10,664,487, representing a decrease in expenditures of 9.28 percent under last year’s operating budget, to take effect on October 1, 2009.

OTHER NEW BUSINESS

Proposals for Annual Independent Audit

Chairman Gaylord related that they had sent out proposals for their audit and have received two submittals, and he believed they were provided to the Board members last week.

Mr. Carpenter stated that he has looked at the two proposals, and there was a very significant difference in cost. He specified that the current auditor has offered to do the work this year for $4,000, and the other response to the proposal came in at almost $9,000. He added that the current auditor was local, and he did not think there was any problem with the work he has performed.

Ms. Bainter asked if they could get that audit before the meeting next year.

Mr. Gaylord responded that under their agreement with him, they could ask him to get that to the Board three weeks ahead of time.

Ms. Sykes-Amos stated that they could probably get it to them two weeks ahead of time.

On a motion by Mr. Carpenter, seconded by Mr. Tally and carried unanimously by a vote of 6-0, the Board moved to continue to use Mr. Ross’ firm for the audit and to ask to get that audit two weeks before the next meeting in January 2010.

Discussion Regarding Website and Retention of Public Records

Chairman Gaylord mentioned that the Clerk had been very helpful in working their way through the process for the transition from the Water Authority to the Board of County Commissioners’ meeting room. He stated that they needed to have an ongoing discussion about how a website can be furnished and a procedure to deal with the retention of public records at the January meeting.

Ms. Kirste explained that they would like to come back with a proposal regarding retention of public records for a policy to work with the Board members and to set aside the funds in order to hire the Clerk for the retention of the records.

Mr. Gaylord stated that they would probably need to do a budget amendment in January to take care of those items.

On a motion by Mr. Bowersox, seconded by Mr. Tally and carried unanimously by a vote of 6-0, the Board moved to adjourn at 9:00 p.m.

________________________

Frank Gaylord, Chairman

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