By Zachary Fagenson
(Reuters) - Miami-Dade County legislators on Tuesday passed a November referendum that will ask voters to approve $830 million of bonds to revamp crumbling facilities at the Jackson Health System, the operator of the third-largest U.S. public hospital.
If approved, the general obligation debt would fund $129 million of new software, a $65 million overhaul of operating rooms and other upgrades. Local leaders say the improvements are vital to drawing privately insured and cash-paying patients, who defray the costs of caring for poor people and the uninsured.
"We've allowed it to deteriorate," said Commissioner Audrey Edmonson, who sponsored the bill authorizing the bond referendum. "The hospital has to come up to the 21st century; that's the only way we're going to be able to compete."
The 9-to-1 vote came as the publicly owned network of six hospitals and thousands of employees begins to recover from years of losses. The system, which includes the 1,550-bed, 95-year-old Jackson Memorial Hospital that treats many of south Florida's poor and uninsured, lost $428 million from 2006 to 2011.
To cut losses, the Jackson Health System laid off nearly 1,000 full-time employees, transferring a lot of work to part-time staff, and posted its first surplus in five years for the fiscal year ended September 30, 2012. At the end of April this year, Jackson Health System reported a $5.9 million surplus.
"Having done all that, the question was, 'How do we get the hospital to be an attractive place for patients with managed care companies to choose Jackson over other hospitals?'," said Carlos Migoya, the system's chief executive since May 2011.
In 2014, Medicaid "reimbursement rates will likely be reduced, so we need to make sure we make this happen," Migoya said in an interview with Reuters.
Jackson's $1.6 billion annual budget is funded by a combination of insurance payments, property taxes and a half-cent sales tax.
The referendum is the latest in a number of big-ticket projects in Miami-Dade, the most populous county in Florida, that voters have considered over the last year.
In November, voters approved a $1.2 billion general obligation bond to fund the overhaul of Miami-Dade County's public schools, the eighth-largest system in the nation, by a 2-to-1 margin.
In late May, local lawmakers approved a $1.6 billion overhaul of the county's crumbling water and sewer system in response to an Environmental Protection Agency lawsuit.
But a bid by the Miami Dolphins, owned by billionaire real estate tycoon Stephen Ross, to increase tourist taxes to fund an overhaul of the team's privately owned arena died in Tallahassee.
(Additional reporting and writing by Michael Connor in Miami; Editing by Jan Paschal)