We at Shands and the University of Florida are pleased that the Florida Legislature has voted to override Governor Crist’s veto of $9.7 million in funding for Shands at UF, a provision that has been in the state budget for 30 years. These funds plus federal matching dollars, which combined total approximately $15 million, have been used by Shands to partially cover the costs of our Graduate Medical Education Programs and our safety-net mission.
Providing medical care to those who with limited or no health insurance has always been an integral part of our commitment at Shands at UF and continues today. Calculated in terms of our true costs, in the fiscal year ending June 30, 2010, we provided $80.1 million of unreimbursed patient care at cost to such safety-net patients.
We are also committed to providing top-notch training for residents and fellows in 62 different Accreditation Council for Graduate Medical Education (ACGME) programs. There is a national cap on Medicare funding for GME. In response to the educational goals of our clinical departments, Shands has paid salaries, benefits and educational costs for 135 residents above the cap at a total cost of more than $15 million. These commitments have continued since Governor Crist’s veto, but under significant financial duress.
Shands at UF is different from the other safety-net hospitals in Florida, in that there is no local hospital taxing authority in Gainesville to pay for the care of those with limited or no health insurance. Safety-net hospitals in Broward, Dade and Duval counties, for example, all receive local tax support to help pay for the care of such patients. Such funding can be quite significant, in the hundreds of millions. In the absence of such community-based funding for Shands, the only source of reimbursement to offset part of the costs of safety-net care has been the line-item state funding. It is gratifying that the Florida Legislature has seen the wisdom of restoring this funding.
We will continue to care for patients with limited or no health insurance in our primary-care region of 13 counties, just as we always have. Furthermore, in recognition that we have specialized services at Shands at UF that may not be available elsewhere in Florida, we will continue to care for patients from all over Florida who need services that are not available in their local communities, just as we always have. Given that many patients who live outside our primary service area need services that are available at a safety-net hospital funded by their local community, we will work with referring physicians and hospitals, as we always have, to ensure that such patients receive the care they need at nearby facilities.
We are proud of the clinical services we provide at Shands at UF, which include a substantial safety-net mission for those who have limited resources. We are also proud of our educational programs that prepare the next generation of clinicians in virtually all medical and surgical specialties. In close collaboration with University of Florida faculty, we have created UF&Shands — the UF academic health center — that is rapidly gaining momentum in advancing the highest quality patient care, education and research. Continued funding by the Florida Legislature, which permits matching federal funds, will ensure the robust continuation of our safety-net and educational missions.