Physicians Regional, NCH possible suitors if Marco voters approve 24/7 clinic tax

Marco City Council Chairman Larry Magel.

Photo by LANCE SHEARER

Marco City Council Chairman Larry Magel.

The ballot language doesn't identify the amount of the proposed tax levy. It says the proceeds would be used solely to "supplement the costs of maintaining and operating" a 24/7 clinic. The levy considered is 0.1 mill, which would cost taxpayers with a property assessed at $500,000 about $52 a year, according to a presentation to the council at the June 4 meeting.

— Marco Island voters will be asked on the Aug. 14 ballot if they want to be taxed to pay for a medical clinic to stay open around the clock.

The Marco Island City Council has a non-binding referendum on the ballot that asks if residents would support a tax levy to cover the added costs of extending a walk-in clinic's hours to 24/7. The clinic would be run by one of the two hospital systems in Collier County.

The referendum is "advisory" and similar to a straw ballot to garner voter sentiment, Marco Island City Council Chairman Larry Magel said. He has been instrumental in having the measure drafted, which the council agreed to at a special June 4 meeting.

"If citizens do not want to support it with a tax then we will drop it," Magel said. "If they do favor it, we will continue discussions with the hospitals to see if we can reach an agreement."

The ballot language doesn't identify the amount of the proposed tax levy. It says the proceeds would be used solely to "supplement the costs of maintaining and operating" a 24/7 clinic. The levy considered is 0.1 mill, which would cost taxpayers with a property assessed at $500,000 about $52 a year, according to a presentation to the council at the June 4 meeting.

Magel said he doesn't know why the ballot doesn't include the proposed levy.

"The language I saw had a specific amount on it," he said.

Larry Sacher, a candidate for City Council, opposes the measure because the language is open-ended and there is a misconception about which services would be offered 24/7 at the clinic.

"I think people can very easily misunderstand what that means," Sacher said. "In terms of vetting to the council and the public, there has been none of that."

City officials have met with representatives from Physicians Regional Healthcare System, which intends to open a walk-in center on the island, and with officials from the NCH Healthcare System.

NCH runs the Marco Healthcare Center at 40 Heathwood Drive, which at one time was open 24 hours but there weren't enough after-hour patients to support it. Six years ago, NCH reduced the hours to 8 a.m. to 7:30 p.m., seven days a week.

Physicians Regional, which operates the nearest hospital to Marco with its 100-bed hospital on Collier Boulevard, plans to open a walk-in center in Marco near the end of the year but hasn't disclosed the location. The clinic wouldn't be equipped or staffed for medical emergencies.

The lack of a 24-hour medical center in Marco has been a contentious issue among some residents, coupled with the island having only one ambulance.

In a July 6 proposal to the city, Physicians Regional said the estimated annual subsidy needed to offer 24/7 services at its future walk-in center would be $700,000 to $800,000.

In a July 6 proposal to the city, Physicians Regional said the estimated annual subsidy needed to offer 24/7 services at its future walk-in center would be $700,000 to $800,000.

"We do not intend to make a profit on any potential subsidy from the city, but rather break even while providing an additional 5,000 hours of walk-in clinic operating hours 24/7 to the Marco Island residents," according to the proposal from Scott Campbell, chief executive officer of Physicians Regional at Collier Boulevard.

The biggest expense of extended hours is a projected $1.1 million annually in additional salary and benefits for staff. Supplies and utilities would add another $50,000. The expenses would be offset by projected revenue of $400,000.

"In the event that revenue exceeds our estimate, then the subsidy could be reduced," according to the proposal. "Conversely, if the revenue falls below our estimates, we would request additional subsidy from the city."

Dr. Allen Weiss, president and chief executive officer of NCH, sent an email Thursday to the Marco city manager stating NCH would respond to a request for proposal to expand the clinic hours.

"The additional resources involved would be substantial and we think it would not be appropriate to provide an estimate without first knowing the parameters," he said. "They have not given that to us."

Adding overnight hours would mean three more staff members — a physician, nurse and a multi-functional person at the front desk, he said.

When the walk-in center was open during the overnight hours, the center averaged fewer than two patients a night, he said.

© 2012 marconews.com. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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Comments » 22

RayPray writes:

Why is this referendum nonbinding?

These clinics will make big bucks on the island.

This is like the morons running Lee County screwing their middle class residents to enrich the sports billionaire owners to erect superfluous sky-box stadia up there.

GFonda writes:

Why, after several WEEKS was there no article in the Eagle addressing the "non-binding" referendum being placed on the ballot in AUGUST addressing spending $750,000 for an additional number of hours in the evening at the NCH walk-in clinic on Bald EAGLE? I believe the only way the vast majority of part time residents can be made aware of this issue is by timely reporting and thoughtful commentary about the pluses and minuses of this proposal; and this paper is not providing that. Lets see how long it takes for the EAGLE to publish this letter that was submitted June 9th.

My position is that non-emergency, after hour demand for this service is NOT supported by what was stated as statistics at the Council meeting and that it's an outrage that we would have to contribute any funds for this unneeded service. NCH will benefit financially from the fees they charge treated patients without our adding to their coffers.

ajm3s writes:

Where was the public outcry for subsidization of a 24hr clinic?

It must have been lost with the signed petitions sent by citizens earlier this year expressing their concerns with regard to the Community Center expansion!

More minority malcontents?

Thanks council for great representation! I think NOT! And please, we all know it only advisory! Really?

Is this another public private partnership? P3 or PU [as in stinky]

Will need more beds, to handle all the groups sleeping with each other.

Got to go to the clinic, my tongue-in-cheek is sore and may need medical attention.

MrBreeze writes:

Maybee the clinic can set up shop in the City Hall. This way they can all hang out and do nothing all night but collect a check.

captnjimbo writes:

Years ago we contributed 100.00 to NCH for the 24 Hour E services. Now it becomes a tax for everyone. I do not recal being asked to increase the donation to maintain the service.

I think it just got tough to have a doc sitting around all nightin the summertime with nothing to do. Different story in season.

Tough call, this one.

Northerner writes:

Here's an idea...24/7 in season only.

marco826 writes:

One dollar a week to have emergency care near by sounds reasonable to me....

GFonda writes:

in response to marco826:

One dollar a week to have emergency care near by sounds reasonable to me....

That's the problem - IT'S NOT EMERGENCY CARE as Marco 826 believes. Somehow the word has to go out to the voters that it's only clinical services provided NOT emergency care.

chinkley writes:

Just another tax for Marco Island residents. If you need emergency care, drive a few miles as most of the rest of the country does. Otherwise let the medical providers pay for the right to be on Marco Island

marcofriend writes:

Our new mayor Mr Magel says that it is a non-binding referendum, but the City Council can still vote to fund and tax us even if it is turned down. He's made this statement several times. We tax ourselves to subsidize a hospital and then pay for their redi-med service on top of it. How crazy is this. I hope there is no one on Marco Island foolish enough to see this as being a positive for anyone.
Now that we seem to have a mayor in place, why do we have a city manager. Let's save almost $200,000 in salary and costs.

ajm3s writes:

in response to marcofriend:

Our new mayor Mr Magel says that it is a non-binding referendum, but the City Council can still vote to fund and tax us even if it is turned down. He's made this statement several times. We tax ourselves to subsidize a hospital and then pay for their redi-med service on top of it. How crazy is this. I hope there is no one on Marco Island foolish enough to see this as being a positive for anyone.
Now that we seem to have a mayor in place, why do we have a city manager. Let's save almost $200,000 in salary and costs.

Yes! Now that is what I call paying attention.

ed34145 writes:

This is NOT emergency care. Any one who uses this service for an emergency instead of calling 911 is just delaying needed assistance. We do NOT need a 24 hour doctor's office....especially not one subsidized by tax dollars. Physician's Regional is just trying to make money from the taxpayers. Shame on them.

ajm3s writes:

in response to marco826:

One dollar a week to have emergency care near by sounds reasonable to me....

I would not encourage giving a dollar a week in the form of a tax to subsidize a private company that is currently collecting a fee for a service currently you pay through premiums paid to your insurance provider accompanied with a copay or deductible.

How many ways can the city and private industry "nickle and dime" you? The answer, as many ways citizens and customers are willing to accept the slogan, "its only a dollar a week".

Quite an innocuous slogan.

So I guess to those who like to evaluate cost on a weekly basis:

8hr after hours care......$1/wk
Veterans Park Purchase... $2/wk
Community Center......... $1/wk

and we could go on with this list to include EMT services by the county, the cost of accompanying services by Fire and Rescue, Police etc.

Folks, when the government starts convincing you that subsidizing a private entity is a good thing is the day we relinquish the benefits of sound management and efficient allocation of capital.

Where is Milton Friedman when you need him in this climate with council leaders promoting "public private partnerships" in all its distorted applications.

I get concerned when smart folks fall victim to these slogans. Some elected representatives know how to use these slogans to promote and market whatever project they deem for the "benefit" of the citizens.

NEWS FLASH: We already have the benefit of 24 hr emergency care --- 911 and a trip to an emergency facility. Depending on the nature of the emergency it may be a trip to Physicians Regional by ambulance or Naples or Ft. Myers by helicopter to Lee Memorial depending on seriousness of injury or ailment.

http://www.leememorial.org/trauma/abo...

Or do the folks simply need smelling salts?

ajm3s writes:

Let me be very clear as to why I caution the folks as to the allure of Mr. Magel's $52/year or $1/wk sales pitch. In Mr. Magel's own words, he laments that the cost is not included in the referendum:

"The ballot language doesn't identify the amount of the proposed tax levy. It says the proceeds would be used solely to "supplement the costs of maintaining and operating" a 24/7 clinic....."

Not included is the levy considered: 0.1 mill, which would cost taxpayers with a property assessed at $500,000 about $52 a year, as originally presented by Mr. Magel to the council at the June 4 meeting.

Why is he concerned about this omission? Because Mr. Magel understands the allure of the slogan "its $52/year", that is why he says it repeatedly when speaking publicly and privately. It is a powerful message. In fact, the rationale for including the language is equally powerful. His retort: when voting we should know the associated costs.

My retort: Let us back up and ask the more basic questions:

1. Where is the public outcry for this specific request?
2. Why the urgency?

If history is a guide, I would caution any proposal that must be rushed through because of filing deadlines. The only agendas that deserve to be rushed are emergency legislative measures, to which this does meet the criteria.

My limited dealings with Mr. Magel led me to believe, he is deftly using the allure of low cost and added services to promote what is essentially a progressive view of government.

But if you like progressivism then I believe you will like Magelcare.

ajm3s writes:

I have been advised.

Correction: The only agendas that deserve to be rushed are emergency legislative measures, to which this does NOT meet the criteria.

gladesgator writes:

I'd rather see the city spend that money on fireworks and we could really have a July 4th Celebration.

At last that is something the landowners could enjoy.

I support the community center. Again, something Marco Islanders could enjoy. You gotta wonder who would use the clinic anyway.

Any illegals hiding here on the island?

lauralbi1 writes:

Larry: My sincerest apologies for not having the time or patience to watch the entire Campaign video that the Eagle has posted on their website about your comments regarding the 24 hour clininc to be voted on by Marco Island voters.

Having watched only 5 minutes of the video, I would ask (hypothetically) if this was a paid campaign ad. I will check with the Eagle on that soon.

But without watching the entire video, my only comment, and you may, in fact, have said this in the video, is that ANYTHING or any SUBJECT that is voted upon by the voters on Marco Island is a GOOD THING !!!

Giving the voters a chance to express their opinion by Ballot can never be a bad thing, no matter the tax or subject matter of the vote. I am certain that Fay Biles would most certainly agree, irrespective of the fact that she is President of MITA !!! If not, that would be a very selfish position.

The fact that it is coming before the voters, who are NOT s----- or uninformed (as many bloggers feel is the case) means that your opinion on the subject is your opinion only and has no value to each and every voter.

If this is what you said in your 30+ minute video, then congratulations. Someday, I hope to be able to watch the entire video.

Ed Issler

ajm3s writes:

in response to lauralbi1:

Larry: My sincerest apologies for not having the time or patience to watch the entire Campaign video that the Eagle has posted on their website about your comments regarding the 24 hour clininc to be voted on by Marco Island voters.

Having watched only 5 minutes of the video, I would ask (hypothetically) if this was a paid campaign ad. I will check with the Eagle on that soon.

But without watching the entire video, my only comment, and you may, in fact, have said this in the video, is that ANYTHING or any SUBJECT that is voted upon by the voters on Marco Island is a GOOD THING !!!

Giving the voters a chance to express their opinion by Ballot can never be a bad thing, no matter the tax or subject matter of the vote. I am certain that Fay Biles would most certainly agree, irrespective of the fact that she is President of MITA !!! If not, that would be a very selfish position.

The fact that it is coming before the voters, who are NOT s----- or uninformed (as many bloggers feel is the case) means that your opinion on the subject is your opinion only and has no value to each and every voter.

If this is what you said in your 30+ minute video, then congratulations. Someday, I hope to be able to watch the entire video.

Ed Issler

ED:

Again, I seriously suggest you listen to the entire video because Mr. Sacher clearly indicated why this referendum is ill prepared.

Mr. Sacher offers a non-prioritized list of reasons why this referendum is shoddy in its language and ill prepared. Let alone there has been no public vetting prior to a discussion by the council to vote.

All I can say based on this interview, Mr. Sacher, if elected would raise the level of discourse on the next Council. Perhaps he could offer good debate to our new unofficial Mayor, Mr. Magel under the stewardship of Ms. Litzan et al.

captnjimbo writes:

I came out with AJM and Chinkly on this one. Would like the service...but is a private enterprise issue. The clinic is a feeder to the NCH system...If a competitor comes to have a feeder to their hospital...well that's the American way. I would support either one with a donation but I don't go for the socialistic approach. Voted "no" and it is in the mail. Sorry.

mahiman writes:

Having a home, but only on the island a few weeks a year, I say NO! Investing in another ambulance and two staff would cost less..but I'm not even advising that. If one of the hospitals wants to open 24/7, let them. If the clinic is open til 7:30pm, that's good enough for me.

OutWithTheOldies writes:

Physicians Regional is coming to Marco regardless of the referendum, just not for 24 hour services.

But as NCH figured out a long time ago, overnight 24hr clinic services are not financially sustainable on Marco Island....

If you want to be able to get 24 walk in clinic services on Marco, then you gotta pay for it. Otherwise, just vote NO and move on. Majority wins.

Whats the big deal? I don't understand why every issue becomes an exercise is overstamement by every yahoo with an opinion. Why can't people just have a thoughtful debate about things? The over the moon reaction of some people is just nuts.

If you want 24 hour care from your provider and think $50/year is too much, why don't you see what its like to hire a concierge MD! It might make a difference on which box you mark come November...

ajm3s writes:

in response to OutWithTheOldies:

Physicians Regional is coming to Marco regardless of the referendum, just not for 24 hour services.

But as NCH figured out a long time ago, overnight 24hr clinic services are not financially sustainable on Marco Island....

If you want to be able to get 24 walk in clinic services on Marco, then you gotta pay for it. Otherwise, just vote NO and move on. Majority wins.

Whats the big deal? I don't understand why every issue becomes an exercise is overstamement by every yahoo with an opinion. Why can't people just have a thoughtful debate about things? The over the moon reaction of some people is just nuts.

If you want 24 hour care from your provider and think $50/year is too much, why don't you see what its like to hire a concierge MD! It might make a difference on which box you mark come November...

I guess you again do not appreciate a vetting process, in which the referendum undergoes a vigorous review.

Over the moon reaction? I suspect you are numb to the genesis of this referendum, the marketing of this referendum by the city and Chairman, and its ramification on property owners. But then again you believe this is a concierge service?

If you believe that, then may I suggest you call a concierge service at midnight, and I suspect they will tell you to call 911 for prompt service.

I believe there is a hugh difference between private concierge services offered in Collier County and what the city (sponsored) public/private arrangement.

But your last statement is very interesting! I suspect you see the candidates in terms of providing for a host of city provided services, whereas, I see the candidates relative to their ability to discern and evaluate efficient use of public assets to address public concern. And speaking of assets, are you aware there are approx. 1500 less single family homes on this island since 2000.

Yet I hear the lament from the city that we need expansion of services. Are these expansions, public initiated or city initiated? Why only a referendum on 24hr care, because it requires the creation of a special taxing district? Quite a limited option.

So as to your categorization of some comments as "overstatements" I say, it is the "understatements" of the city and Mr. Magel when viewed against a backdrop of issues that are more vital that are NOT considered for a vote.

But then again, I demand more from my city and council, NOT in terms of services, but rather quality of fair and balanced review of policies and proposals and vetting of issues.

In fact, I believe this referendum is a poor response to the debacle that occurred earlier this year at the existing facility. From that view, it does not come close to addressing the issues raised. In fact, Mr. Murphy, Fire and Rescue Chief, had offered better options when viewed as emergency issue and better falls under the mantle of public policy.

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