An indigent-care levy may be on the November ballot in Hamilton County, but a recommending committee is struggling to decide the amount.

        Hamilton County's Tax Levy Review Committee was split Monday and will decide July 23 whether to recom mend that county commissioners place a five-year, $263.8 million health and hospitalization levy on the November ballot.

        The greatest part of the proposed health and hospitalization levy — $217 million — is the indigent-care levy. The overall levy would represent an increase over the current levy, which raised about $240 million over five years.

        The review committee on Monday heard a report on the levy from Bruce Miller, director of internal audit services of Jefferson Wells International, who recommended the current levy funding be increased.

        The seven tax levy review committee members and two nonvoting members were divided on whether to support the increase. Four members appeared to be in favor of no increase in the levy, three were in favor of the proposed increase, one favored an increase under certain conditions, and one member, the chairman, George Vincent, did not say how he was leaning.

        Some of the division stems from a report submitted by a local doctor who spent months studying Hamilton County's indigent-care tax levy, which is included in the $263.8 million health and hospitalization levy. Dr. Kevin D. Martin, a former member of the tax levy review committee, says University and Children's hospitals make a profit providing “uncompensated” care to the poor and uninsured.

        Dr. Martin said University Hospital turned a $68.9 million profit providing indigent care over the past five years, while Children's Hospital made $2.4 million.

        That resulted in part, he said, from a federal program

        called the Hospital Care Assurance Program, or HCAP, which since 1996 has sent more than $147 million to the hospitals on top of the money generated by local taxpayers. University Hospital receives 80 percent of the local levy funds with Children's garnering the rest.

        The hospitals contend they lost a combined $12 million last year in providing health care to poor people.

        Dr. Martin's report called into question the necessity of raising the indigent-care portion of the health and hospital levy.

        Jefferson Wells, the outside auditor hired by the tax levy review committee, reviewed financial information from Children's, University and other local hospitals. The information was taken at face value and the numbers were not audited, Mr. Miller said.

        “Our goal was to look at the approach,” he said. “We did not have an opportunity to audit every number that came to us.”

        Some information could not be provided by the hospitals in the time requested, he said.

        Following his report, Mr. Miller said it appears the hospitals are not turning a profit on the indigent-care programs.

        “The levy is needed and should be renewed as proposed (with the increase),” he said.

        Dr. Martin, who attended Mon day's meeting, said the auditor's report did not address the HCAP funding.

        Mr. Vincent said the members owe Dr. Martin a debt of gratitude for causing them to take a hard look at the indigent-care program.

        They'll continue the debate next Monday and will vote for a recommendation to forward to the county commissioners.

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