MINUTES OF MEETING OF NORTH



MINUTES OF MEETING OF NORTH LAKE COUNTY

HOSPITAL DISTRICT OF SEPTEMBER 10, 2009

The meeting of the North Lake County Hospital District (the “District”) was held on September 10, 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.

APPROVAL OF MINUTES AND MEMORANDUM OF UNDERSTANDING

Ms. Bainter asked to make a correction to the Minutes, changing the first paragraph of the second page stating “Mrs. Bainter stated that the financial reports show $12.7 million was distributed last year between the hospitals,” to “Mrs. Bainter stated that the 2007 Property Appraiser’s report shows $12.7 million was levied to be distributed between the hospitals.”

On a motion by Mr. Bowersox, seconded by Mr. Carpenter and carried unanimously by a vote of 6-0, the Board approved the Minutes of the Annual Meeting of January 20, 2009, as amended.

On a motion by Mr. Bowersox, seconded by Mr. Carpenter and carried unanimously by a vote of 6-0, the Board approved the Memorandum of Understanding between the Clerk’s Office and the North Lake County Hospital District Board and to authorize the Chairperson and the secretary to sign the Memorandum.

Mr. Gaylord, Chairman, announced that he was advised a few minutes before the meeting that they were able to videotape this session, but it would require a unanimous vote of the Board to do that. A motion was made by Ms. Bainter to videotape the meeting, but the motion failed due to no second being made.

WORKSHOPS

Mr. Lee Huntley, President and CEO of Central Florida Health Alliance, the parent company of Leesburg Regional Medical Center (LRMC), stated that their leadership team was there for the long term to make sense of health care in one of the toughest environments that he has worked in during his 30-year career. He related that LRMC was a private not-for-profit organization, and every dollar that was left over from expenses was put back into the health care infrastructure to take care of their community. He opined that those tax district dollars go further than their community to offset the shortfalls of patients who were not able to pay for themselves. He reported that their profit during the last business year was $2.4 million, which was less than 1 percent, and included $38 million of shortfall from Medicare, Medicaid, and charity. He specified that ten percent of their patients were able to pay very little for their care, and another ten percent of their patients were not able to pay at all. He commented that without tax support, their organization would have been operating in the loss the last two years. He assured the Board that they have been good stewards and have not included loss of jobs among their cost-cutting measures, resulting in very little negative effect on the economic impact to the community.

Mr. Phil Braun, General Counsel for LRMC, commented that having this hospital is important to the economic growth and stability of their community and has been a good steward and partner for 47 years. He pointed out that in addition to providing the medical needs of the community, it also creates jobs and attracts businesses and physician services. He opined that as a not-for-profit tax-exempt organization under heavily regulated scrutiny and as a recipient of governmental funds, they understand and open their doors to transparency by providing every document that was requested and their financials every year as required under the law. He assured the Board that these tax dollars were greatly needed by the hospitals, and he noted that they were not requesting any more money than what they had received last year. He opined that eliminating or not providing the full mill to LRMC would have unintended consequences regarding the access, type, and quality of health care services to this community.

Ms. Phyllis Baum, CEO of LRMC, stated that the vision of those that founded LRMC was that the community could continue to have health care locally for many years to come. She noted that they have put millions of dollars into investing in and expanding services and that residents were able to receive high-quality, safe care for a variety of medical conditions close to home. She commented that they did not receive the funding that covers the costs it takes for them to provide the services that they provided. She mentioned that they focus a great deal on safety and put in a lot of expensive systems that benefit all patients. She stated that more and more people because of the economy have to rely on their emergency department for services, because they have no other option for primary care. She noted that in addition to their emergency department, they have locally at Leesburg a clinic that they fund, the Leesburg Community Medical Care Center, which receives 5,000 patient visits a year, gives over $1 billion in value for health care for the community, and reduces emergency room visits. She mentioned that this year they were expanding the partnership with the clinic because of unmet needs to provide more services to increase the number of patients that were given health care. She commented that they appreciate Lake County residents’ support and commitment to their facilities, and the lack of those funds would have an impact on those services.

Mr. Huntley added that they have never shirked from their responsibilities to take care of the community in the 47 years of LRMC’s operation, and asked not to let a few good people who were well intended but may not fully understand the intricacies of health care and health care financing cause this tax district situation to change. He also mentioned that there was nowhere else for the patients Ms. Baum mentioned to go and that they did a lot of surgery and follow-up care beyond the emergency care. He predicted that Medicare reimbursement would go down, which would make it harder for them. He illustrated on a handout that the support they received from the Tax District Board last year in the amount of $5.2 million did not begin to offset $38 million and growing of shortfalls that they were experiencing in taking care of the community, and pointed out that it was a 7 to 1 return on investment in the community. He related that about a third of the patients that came to their ER did not pay them. He strenuously requested that the tax district continue to help Leesburg Regional and Waterman with their shortfalls, and assured the Board that when the tax support was no longer necessary, they would gladly defer that money back to the County. He also assured the Board that they were steadfastly committed to working with the Tax District Board and the delegation to revisit the methodology and the accountability for the tax dollars that they received.

Mr. Ken Mattison, President and CEO of Florida Hospital Waterman, specified that there were 32 active health taxing districts in Florida, and millage caps went as high as 5 mills. He pointed out that Lake County’s rate of 1 mill, which was the sixth lowest in the state, has contributed to both Waterman and LRMC, and that amount equates to about $100 per homeowner, which safeguards their family by enabling them to have a hospital a few miles from their home. He explained that the proceeds their hospital receives help to cover the enormous cost of those that need charity in their community. He reported that in 2008, Florida Hospital Waterman provided $8.4 million in charity care, and they wrote off a total of $7.7 million in Medicaid shortfalls. He related that Waterman received $6.3 million in tax funds, which covered approximately 39 percent of the cost of charity and the shortfall in Medicaid. He opined that everyone must share the financial burden of caring for those that were too poor to afford health care. He assured the Board that their hospital will be transparent and was eager to provide anything the Board asked of them to show that they were accountable and were good stewards. He commented that without the tax proceeds, they would have to reduce their work force to balance their budget, which would result in the jobs lost putting a strain on their already overburdened County infrastructure and contribute to the already high unemployment rate, and some vital services that were currently available might not be available if that happened. He opined that LRMC and Waterman hospitals were essential pillars of Lake County’s economy, employing 3,700 people, representing $170 million in payroll expenses. He emphasized that the hospitals were a community benefit and were required to provide services to residents that could not pay for them, unlike private businesses. He explained that non-for-profit or tax exempt hospital organizations would go out of business if they were not profitable, because replacing equipment or starting new services requires reinvestment capital that comes from retained earnings. Also, cash reserves are needed to qualify for low-cost financing and to provide a hedge should there be a disruption in reimbursement. He commented that they were focused on the long-term needs of the community. He concluded that in this unstable economy and uncertain health care climate, they need to keep the County’s hospitals on a firm foundation.

Ms. Bainter stated that she had a problem with one of the financial statements from LRMC, but she had no problem with any documents submitted by Florida Hospital Waterman. She stated that the numbers on the 990 did not agree with the Agency for Healthcare Administration documentation.

Mr. Braun responded that Leesburg Regional Medical Center, Inc., not LRMC, Inc., holds the hospital license, and they would be happy to sit down with Ms. Bainter with the 990’s and answer all her questions. He stated that they could go back and show how the numbers on the 990 coincide with each other. He agreed that it was a confusing business, and promised that there was nothing that they were hiding. He also pointed out that their audited financials were provided to them, and the Board’s own separate auditor has never raised a question about their books.

Ms. Pat Sykes-Amos, Accountant, explained that they were comparing two different things and many times the 990’s (not for profit tax returns) will not track to the financial statements or a combined audit, because things such as donated services show up on the audited revenue, but do not show up on the 990.

Ms. Bainter stated that in the folder that was handed out was a copy of the Special Hospital Districts in Florida, and noted that there were 16 of them, two of them which did not tax. She specified that the highest taxing districts were Halifax at 2.25 mills and Southeast Volusia at 2.85294 mills, but that no district was taxing at 5 mills.

Mr. Mattison stated that if she had a question about the taxing districts, he would be happy to bring the data that they have for them to sit down and reconcile that, and he did not want to try to prove his point with her data. He then suggested that they come back together next time with the data that would support what he had shared with her.

Mr. Braun commented that Florida Hospital in Marion County was struggling and looking at closing because they could not levy the tax.

NEW BUSINESS

a. Recitation for the record of the name of the taxing authority, the rolled-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, which represents a decrease in the property tax levy of 8.43 percent, and the millage rate to be levied is 1.0 mills.

Chairman Gaylord asked if there was a motion to waive the formal reading of the entire resolutions and read them by title only.

Ms. Bainter asked if they could read the entire resolution for the benefit of the public that had never been through it.

Chairman Gaylord directed that they would proceed with the reading of the entire resolution, and Ms. Kirste read Resolution No. One-A in its entirety.

Public Hearing on Resolution No. One – A – setting millage

The Chairman opened the public hearing and asked those that were in opposition to speak at this time.

Mr. Steve Barber, a resident of Howey-in-the-Hills, commented that the new Waterman hospital was like a palace, and he was against that it was partially tax supported. He related that a hospital stay for two nights and one day cost him $11,500. He opined that there was a lot of inefficiency at hospitals and that he did not see a lot of employees working during his hospital stay. He stated that as a citizen his opinion was that they should stop the one percent tax, and perhaps they should use something like a sales tax on everyone, since he did not think property owners should pay for uninsured people who did not have property.

Ms. Evelyn Logas, a resident of Mount Dora, pointed out that she already paid taxes monthly for bills such as phone, electricity, and other utilities, as well as sales, gas, and property taxes, and she felt that she was taxed to death. She noted that the hospitals were not-for-profit, which meant that they saved a lot of money since they did not pay anything in taxes. She related that at one time the hospitals made a profit of $28 million, of which $11 million was from local Lake County taxpayers. She commented that the County now had two fine hospitals that performed many life-saving tasks, and she was proud of the fact that the hospitals helped indigents and that she has never known one person who has needed hospital medical care that had ever been refused. She opined that the money was needed at one time, but since the hospitals were now solvent, she believed that the tax for the North Lake Hospital District was superfluous.

Mr. Vance Jochim, a resident of Tavares who writes a blog called on local fiscal government issues, explained that he had over 20 years of experience as a corporate auditor. He commented that Ms. Bainter was asking questions to find out exactly where the money goes, and the legislation had a very vague purpose. He opined that there were a lot of areas that needed to be questioned and challenged and that in the past the 1 mill for the hospitals was approved during a quick meeting where no one asked anything. He stated that he was against this, and thought there should be an amendment to modify it for more oversight from a forensic investigator as well as a variable millage rate of from 0 to 1 mill. He opined that if they did not do that, there would be a referendum from the taxpayers regarding this issue.

Ms. Patricia Sullivan, a resident of Eustis, was encouraged to hear that the hospital administrators stated that they were willing to sit down with the Board and have transparency, and she hoped that they would also go through a process to look at where the money was going and make sure there was accountability. She pointed out that the Board represented her as a taxpayer and would be making a decision about what to do with that money. She asked Mr. Gaylord and Mr. Bowersox how it was not a conflict of interest for them to be representing the taxpayer at the same time they were sitting on a hospital foundation board, representing the interest of the hospital as well.

Mr. Gaylord responded that he sat on a community foundation, not a hospital foundation created by a group of people to be the recipient of the hospital gift as well as many other gifts.

Mr. Bowersox responded that he has served on the foundation board for 12 to 14 years and stated that they were trying to support the hospital, and he referred that question to Mr. Braun. He also commented that he had never heard anything that could possibly be a conflict of interest.

Chairman Gaylord noted that this was an ethics question which would not be addressed in this forum.

Ms. Glennis Barber stated that she was raised in a social medical system in England, and she believed in socialized medicine and that indigents should be allowed to have medical health care. However, she believed that although she objected to paying taxes on her real estate, sales tax should be used for that since it would make everyone pay for their medical care.

Mr. David Van Gunten, a resident of Eustis, opined that scare tactics were being used to indicate that if the tax was not passed, then indigents could not be helped and unintended consequences would result. He stated that he saw evidence of excesses, such as advertising, and he was concerned that the tax dollars given to the hospitals were taken out of the local economy.

Mr. Chris White stated that over the years everyone has always thought that this money was going to indigent health care. He pointed out that they should look at the profit the hospitals were making, despite the fact that they were a not-for-profit corporation, and that there was not a limit to the dividends that they could pay to their shareholders. He noted that the economy had many people scrambling financially, and the only person that lost their job at LRMC was the preacher.

Mr. Ralph Baker, a resident of Tavares, related that his wife was at Florida Hospital Waterman for an operation to straighten out part of her colon, and it was noted during an MRI that a mass in her stomach should be checked out. However, it was not mentioned to them by the hospital, and six months later she was rushed to the emergency room to remove a large tumor. He related that she died in July after they took another piece of the tumor out. He suggested that they use a half cent sales tax for the hospitals, and he opined that a property owner should not have to pay for all the people that receive the care who do not pay for it.

Mr. Tom Mainville, a resident of Tavares, related that he lost his wife three months ago, and he had to take his wife to a Marion County hospital, because Lake County does not take HMO medical insurance. He commented that he did not think he should pay hospital tax for the North Lake Hospital District, when the doctors here did not think his insurance was good enough, which paid about half a million dollars for his wife’s medical treatment. He believed that sales tax would be preferable to property owners in Lake County.

Mr. Douglas Duerr, a resident of Tavares, stated that he saw paying taxes as a social responsibility, but he thought that this was one of those taxes that was really no longer beneficial to the citizenry and that it outlived its usefulness. He stated that the hospitals testified that the benefit that they were receiving from this tax was meaningless and would generate a small percentage of their total losses. He commented that health care providers have to eliminate waste, and the country would be holding them accountable. He suggested that the hospitals should be forced to manage themselves better before coming back to the Board and lay out a case that makes good sense.

Ms. Mary Flanagan, a resident of Tavares, commented that she found it amazing that the room was full of supporters for a 1 mill tax for hospitals that did make a profit, while the school taxes were being turned down which was a reapportionment of what had been dropped by the Florida legislature. She believed that hospitals were important, but she urged the Board to take the time to look at the issue much more closely than they have been with no more rubber stamping.

Ms. Catherine Earhart, a resident of Eustis, mentioned that she had a doctorate degree and a background doing research, and she has been studying this issue with Ms. Bainter. She pointed out that Ms. Bainter spent her own money to run for the unpaid North Lake Hospital Board position to try to help the citizens of this community understand the truth. She stated that despite the fact that they were struggling, the hospitals had been able to run multi-faceted businesses with parent corporations. She pointed out that the hospitals were getting free benefits from not paying any taxes as a trade-off for providing for indigent care, but they had been making huge profits for years. She mentioned that she disputed with the Waterman hospital administrators the number of hospital taxing districts there were, but the data from the government contradicted the hospital’s claim that there were over 30 of them. She disputed the hospital’s claim that 75 percent of their population relies on Medicare and Medicaid to fund their health care, which fall short of meeting the cost of the care provided, and noted that a DRG (Diagnosis Related Group) figures out what a procedure is going to cost. She also noted that there was an incredible amount of marketing that was done by Florida Hospital Waterman, including to Medicare patients. She commented that what the hospitals report to the government shows that there was an intricate scheme that funded parent companies and high-paid executives.

The Chairman closed the public hearing for those in opposition to the resolution and announced at 7:30 p.m. that there would be a ten-minute recess.

The Chairman opened the public hearing for those who were in favor of the resolution.

Mr. Howard Wiener, the Administrator Vice President at Lifestream, mentioned that they got 5 percent of the portion from both hospitals to help treat all the psychiatric patients, since they were the only psychiatric hospital in Lake and Sumter Counties. He reported that this past year they had an increased utilization of their hospital beds by uninsured individuals without any additional money to pay for that service. He stated that Lifestream was the County’s Baker Act receiving facility. He also related that when times get bad, they have more demand on their service, but unfortunately many whom they serve have lost their insurance. He commented that this tax provides approximately 10 percent of their hospital’s revenue.

Mr. Paul Harsh, a resident of Lady Lake, commented that a hospital was an incredibly efficient revenue producing entity that attracts a lot of people to the area. He mentioned that he had been on the contending end against the hospitals with those who had problems with hospitals, usually with paying bills, but he was generally happy with the hospital system they have. He felt that there was an openness and accountability with the hospitals. He also related that by law all the hospitals’ profit has to be given back to the community, but they would go out of business if they were unprofitable. He stated that those who wanted to use another kind of tax to fund the hospitals should not throw the current system away until another one was in place.

Dr. Charles Mojock, President of Lake Sumter Community College, commented that this is not money given to the hospitals, but who these hospitals serve, and the value that they get in return for this investment for their tax dollars far exceeds what they were putting in. He opined that the fact that the hospitals were able to be good managers, give patients new services, and provide beautiful facilities should be applauded and not seen as somehow a shell game. He mentioned that he heard tonight that the hospitals were willing to provide whatever information is needed to be sure that that they were good stewards of the money they have been given. He believed they had a public responsibility to provide health care for those who needed it but could not afford it, and that this system seemed to be a good system for doing that. He also pointed out that this tax is not a new tax or an increase, and less in taxes were actually going to the hospitals this year. He stated that his college had a vested interest in the hospitals, because many of their students were depending on them as one of the largest employers in this community and to gain the experience of taking care of patients when they graduated. He stated that the hospitals were good for economic development. He concluded that they needed a reliable and sustainable source to provide quality health care for all residents, and he encouraged the Board to continue the 1 millage in support of the people that benefit from the hospital services.

Ms. Melissa Simmes, Manager of Waterman’s Community Highway Health Clinic, which was a free clinic that offered free primary medical services to uninsured and low-income patients from Lake County, commented that they have seen a need for their services double in the last two years and that this year they would see about 3,000 patient visits while operating with the same employee base as they have for the last two years of two full-time employees, three part-time employees, and over 60 volunteers. She stated that if tax dollars disappeared and their services were lost or decreased, it would force patients to use the emergency room, which was less cost effective, or not receive any care at all.

Dr. Sharon White-Findley, Medical Director of the Waterman Community Highway Health Clinic, commented that the free clinic was very fortunate because the primary care physicians were able to give one quality standard of care to everyone regardless of their ability to pay, which was made possible by the hospital’s backing by providing laboratory services such as MRI’s, CT scans, and ultrasounds when needed. She opined that she felt strongly that this was a very wise use of the money after watching the stewardship for the past 10 years and that all hospital staff worked very hard.

Ms. Theresa Cirelli, a resident of Volusia County and a nurse manager at Waterman Hospital, cautioned the Board to be careful about what they did at this meeting. She stated that when Halifax Hospital’s millage rate was rolled back from 2.6 to 2.25, there were 400 people laid off, with an additional layoff of over 300 employees to come. The rollback also resulted in the closing of their outreach clinics, higher ratios of nurses, loss of housekeeping staff, and loss of staff to operate CT scans, and these losses have cost lives.

Mr. Mike Hilliard, a Lake County resident, commented that the people who spoke represented very clearly that they needed assistance, and he did not consider it a burden to maintain the one millage. He opined that he thought of that as philanthropy, and the people that can help give their time and money to their community do so for a variety of different causes. He mentioned that there were great financial challenges in this country, and he believed in this process.

Dr. Stacy Berckes, a local physician, stated that for the last 21 years he has worked closely with the administrative team at Florida Hospital Waterman as a member of the medical staff. He commented that he had a low tolerance for inefficiency and a lack of accountability and that he has asked the hard questions. He opined that he has become incredibly amazed at the way that the hospital continues to survive and thrive, and the accountability was there. He explained that this was a difficult business with complicated numbers, and the hospitals would be in a much more difficult position to provide high-quality care if the funding from the tax disappears. He commented that as a society they could not afford to ignore the responsibility that they had, and before they dropped funding it this way, they should have another system in tact.

Mr. Ron Bullocks, Facilities Manager at Waterman Hospital, mentioned that there were only five people at the top executive level at Waterman, who were the President/ CEO, Chief Operating Officer, Vice President of Nursing, Vice President/Chief Medical Officer, and Chief Financial Officer, and those people worked along with all the hospital staff. He commented that he was proud to be a part of the hospital. He stated that he was concerned about the health of the African American and Hispanic citizens of Lake County, especially regarding prostrate cancer and heart disease, and he tells groups at churches about Waterman and encourages them to go there for their health care as well as the educational programs the hospital provides. He opined that they needed that tax in order to provide health for their citizens.

Ms. Lorna Allen opined that there was far more at stake than they could imagine and commented that health care was now provided for those who could not pay. She urged the Board to be careful when making this decision, and commented that the atmosphere would change for everyone if funding was reduced.

Ms. Ann Howard, a resident of Mount Dora, disputed statements from those that indicated that perhaps the hospital was not as transparent as they should be as far as where the money went. She related that she had a degree in clinical laboratory science, but learned about the aspects of accountability such as disproportionate shares, DRG’s, profit margins, and expense management at Florida Hospital Waterman. She emphasized that they were always looking for ways to be good stewards of the funds that had been entrusted to them, and she assured everyone that they were all held accountable to making sure that their expenses were managed so that they could continue to provide the level of care.

Ms. Nancy Ackley related that her husband had stomach cancer, and they had to live close to a hospital. She thought it was important for the residents of Lake County to keep the hospital open, and commented that the equipment and keeping the hospital current was expensive.

Ms. Cheryl Crocker, a nurse and resident of Leesburg, stated that people are realizing that they needed to become involved again and to know what is going on with their tax money. She pointed out that this was not about architecture of a building, but about saving lives. She commented that they had to have health care for those that did not have it, and opined that people did not know how close they were to being indigent themselves. She commented that the hospital employees were making huge sacrifices to keep the hospitals open, and the Board had a huge responsibility. She opined that until they had a better plan, they needed to stay with what they had and not cut it a penny.

There being no one else who wished to address the Board, the Chairman closed the public hearing.

Public Hearing on Resolution No. Two-A and retention resolution

Ms. Kirste read Resolution No. Two-A in its entirety. The Chairman opened the public hearing. There being no one who wished to address the Board, the Chairman closed the public hearing.

Ms. Kirste read the Resolution providing for the recommendation of the retention of the North Lake County Hospital District in its entirety. The Chairman opened the public hearing. There being no one who wished to address the Board, the Chairman closed the public hearing.

Ms. Bainter commented that Resolution No. One-A was giving people’s money away who were struggling to keep their homes, closing their small businesses, and having a hard time feeding their families during these hard times. She added that health care was important, but those issues were important as well. She pointed out that the legislation stated that the one mill was to support continued hospital services, not indigent care. She stated that 57 out of 67 of the counties in Florida did not have a special tax for hospitals, and they have managed to keep their hospitals open. She reported that in addition to the hospital tax, Lake County government expended $5.9 million in 2007/08 for indigent health care. She noted that out-of-district board members receive millions of dollars in compensation from the hospitals, and each hospital reports various investments annually. She also pointed out that not-for-profit hospitals are exempt from federal income tax, state corporate tax, local property tax, intangible tax, and sales tax in exchange for taking care of the charity patients. She stated that there were 19 other counties in Florida with similar or higher percentages of Medicare patients, with only 3 of them in a hospital taxing district. She also opined that the North Lake Hospital District had a very vague purpose, being for continued hospital services, with little or no oversight of the funds.

Mr. Talley stated that he wanted the Minutes to show that there was an exception being made on his part as to what the correct figures were as to profit made by the hospitals, since Ms. Bainter and Mr. Dale Hocking, CFO of Central Florida Health Alliance, were not in agreement as to those figures. He asked Ms. Bainter to make herself available to get that data from them.

Mr. Hocking related that there was a trend towards less full-pay patients that has gone up dramatically and quickly, since people were losing their jobs and insurance.

Mr. Carpenter commented that he looked at the financial statements, and there were some expenditures that the hospitals have that are not deductible and classified as expenditures on the tax and income statement, specifically to equipment. He also mentioned that in addition to that, there were debt payments of $3 or $4 million that were not deductible. He noted that the hospitals were reinvesting in their facilities and infrastructure.

Mr. Gaylord stated that he has been on Waterman’s board in the past, but he currently did not serve on that board. He commented that that experience taught him how to read a financial statement and has served him well to serve on this board to figure out exactly what the hospitals’ bottom lines were.

On a motion by Mr. Bowersox, seconded by Mr. Carpenter and carried by a roll call vote of 4-1, with Ms. Bainter voting “no,” the Board approved the first reading of 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.

On a motion by Mr. Bowersox, seconded by Mr. Talley and carried by a roll call vote of 4-1, with Ms. Bainter voting “no,” the Board approved the first reading of 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.

Ms. Bainter moved to add an amendment to the Resolution for retention of the North Lake County Hospital District to add after the 2nd paragraph “Whereas the North Lake Hospital District values the opinion and the generosity of the citizens in the northeast district and the citizens in the northwest district, a referendum will be placed on the ballot during the primary election in 2010 asking for eligible voters’ and taxpayers’ continued support to tax themselves in support of Florida Hospital Waterman and Leesburg Regional Medical Center. Now, therefore, be it resolved the Board of Trustees by a majority vote hereby recommends this action on September 10, 2010.” The amendment failed due to no second.

On a motion by Mr. Beyers, seconded by Mr. Carpenter, and carried by a roll call vote of 4-1, with Ms. Bainter voting “no,” the Board approved the first reading of Resolution of the North Lake County Hospital District providing for the recommendation of the retention of the North Lake County Hospital District.

OTHER NEW BUSINESS

Ms. Patricia Sykes-Amos, Accountant, explained that she could currently only invest the Board’s money in federally-backed money market accounts, which were now paying very low interest. She asked approval from the Board to open a money market account at First National Bank of Mount Dora. She assured the Board that because of the Public Security Deposit Act, that money would be 100 percent covered, since it was governmental money. She noted that doing this would quadruple the amount of interest from what is currently earned to about 1.5 percent. She also asked for the Board to designate three officers to sign on the account.

On a motion by Mr. Beyers, seconded by Mr. Carpenter and carried unanimously by a vote of 6-0, the Board approved the request by Ms. Sykes-Amos to open a money market account at First National Bank of Mount Dora.

Chairman Gaylord announced that there would be an agenda item on next week’s agenda for the selection of an auditor, and RFP’s have been provided to the Board members.

ADJOURNMENT

There being no further business to be brought before the attention of the Board, the meeting was adjourned at 9:20 p.m.

Frank Gaylord

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Frank Gaylord, Chairman

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