Florida’s counties are active participants in the provision of health care services. Outside of providing health insurance to their employees, local governments are also contributing to state and federal programs. Counties pay a portion of the state’s share for certain Medicaid services, contribute funding to their local County Health Departments and Federally Qualified Health Centers and, in some instances, manage county indigent health care programs. Local governments also contribute the matching dollars required to draw down federal funding for the Low Income Pool program, which helps to offset the cost of uncompensated care incurred by hospitals around the state.
County Health Departments
Florida is unique in that our County Health Departments work in partnership with both state and county government. Florida’s public health system is recognized as one of the best in the nation. Much of this success is due to a centralized administrative system but decentralized priority setting process that primarily takes place at the county and community level.
Medicaid is the national health program for eligible individuals and families with low incomes and resources. It is a means-tested program jointly funded by the states and federal government. Among the groups of people served by Medicaid are eligible low-income parents, children, seniors, and people with disabilities. In Florida, counties pay a portion of the state’s share for certain Medicaid services.
Florida's 1115 Medicaid Reform Waiver is a comprehensive demonstration project designed to improve the value of the Medicaid delivery system by coupling the increased use of managed care principles with innovative approaches like customized benefit packages, opt-out provisions, and health-related incentives or enhanced benefits for beneficiaries. The demonstration was implemented in Broward and Duval Counties on July 1, 2006 and expanded to Baker, Clay and Nassau Counties on July 1, 2007. For information on Florida Senior Care, the Long-term Care portion of Medicaid Reform, please refer to the Aging section of our website.
Indigent Health Care
In 1977, the Florida Legislature declared that it was inequitable for hospitals and taxpayers of one county to be expected to subsidize the care of out-of-county indigent persons. In order to assure that adequate and affordable health care is available to all Floridians, the Health Care Responsibility Act (HCRA) was enacted. The Act places the ultimate financial obligation for an indigent patient’s out-of-county emergency care on the county in which the indigent patient resides. Additionally, there are several counties around the state that have health care programs for indigent residents who do not qualify for other coverage.
The Medically Needy program in Florida covers those who make too much money for Medicaid, but do not make enough money to cover their medical bills and general living expenses.
Low Income Pool (Disproportionate Share Program)
The Low Income Pool (LIP) was established through Florida's 1115 Medicaid Reform Waiver to ensure continued government support for the provision of health care services to Medicaid, underinsured and uninsured populations. The LIP consists of a capped annual allotment of $1 billion for each year of the 5 year waiver demonstration period. Local governments contribute the matching dollars required to draw down federal funding for this program. Visit the LIP website for additional information.
Given the fact that Florida’s counties are active participants in the provision of health care services, FAC closely monitors developments in the area of health insurance, including programs for the poor and children.