Hillsborough County Health Care Plan Workshop - January 14, 2026
Hillsborough County Board of County Commissioners Health Care Plan Workshop - January 14, 2026
This workshop was held on January 14, 2026, to provide the Board of County Commissioners with a comprehensive overview of the Hillsborough County Health Care Plan (HCHCP), its history, financial status, and future considerations. No formal action was taken, but commissioners provided guidance and direction for potential changes. The fund balance has grown to an estimated $531 million, prompting discussion on how to best utilize or reduce it.
Presentations & Provider Testimony
- Kevin Wagner (Health Care Services Director) presented an overview of the plan's origins (1991), mission, eligibility (18-64, 0-175% FPL), enrollment (23,527 in FY25), and budget ($129M medical, $38M admin). He highlighted the plan's award-winning integrated care model and the need to address the large fund balance. He presented two scenarios: (1) expanding expenditures (trauma payments, capital outlay, step-down facility) and (2) reducing the sales tax (from 0.5% to 0.45% or 0.4%).
- Sarah Dodds (BayCare Health System) described BayCare's role as a level II trauma center, treating 6,500 HCHCP patients over 26,000 encounters in three years. She emphasized the plan's impact on medication access and avoiding ER visits.
- Joe Liney (IBIS Health Care) shared that behavioral health patients have shorter life expectancies and that HCHCP helps transition homeless and underserved populations into primary care, saving lives and reducing ER visits.
- Sherry Hoback (Tampa Family Health Centers) noted that 54% of HCHCP members are served by Tampa Family, with 41,000 encounters per year. She highlighted cost efficiency ($463 per member per month vs. national average $1,214) and quality outcomes exceeding national benchmarks.
- Steve Harris (Tampa General Hospital) stated TGH is the largest provider of hospital services for HCHCP, handling 800 inpatient discharges in FY25. He noted the Health Park specialty clinic operates at a $15M annual loss and is at capacity, and requested additional trauma funding.
- Brad Herrmanns (Suncoast Community Health Centers) commended HCHCP for coordinating community health responses, integrating behavioral and primary care, and leading opioid and behavioral health initiatives.
Discussion Items
- Chair asked about the enrollment increase since 2023, which Kevin Wagner attributed to improved communication and technology, not solely economic factors.
- Commissioner Wistel questioned whether local taxes could be used for charity care for undocumented individuals. Wagner confirmed no such expenditures occur (99.991% documentation compliance). Wistel also argued that membership has been flat (~15,500) yet expenses doubled recently, and questioned the motivation for increasing expenditures. He cited a 1991 board resolution that the tax should be reviewed if federal programs like ACA provided coverage. He criticized a provider executive's high salary while asking for taxpayer funds.
- Commissioner Cohen noted uncertainty (ACA subsidies, legislative property tax changes) and urged proceeding gingerly. He highlighted the fund balance growth is expected to stabilize, and suggested waiting for more information before making changes.
- Commissioner Miller requested data on what percentage of provider programs are funded by HCHCP and emphasized the need for ample time to consider options.
- Commissioner Bowles supported measured reduction of the tax and expanding services to those most in need. He questioned the categorization of food security under enhanced trauma programs and suggested hybrid options. He noted potential ACA subsidy expiration could affect 229,000 residents.
- Commissioner Myers strongly defended the program, stating it is vital for her district's low-income residents. She called for better marketing of the plan and opposed criticism of provider salaries, focusing instead on the program's impact.
- Chair concluded by thanking participants, agreeing to proceed gingerly, and suggesting exploring any additional opportunities to relieve the general revenue fund burden.
Key Outcomes
- No formal votes were taken; the workshop was informational.
- Commissioners expressed interest in further analysis before any decisions.
- Direction was given to explore potential hybrid models combining expenditure increases with a modest sales tax reduction.
- Staff will provide additional data on provider dependency on HCHCP funding and the timeline for potential ACA subsidy changes.
- Further board discussions will occur, with no immediate action planned.
Meeting Transcript
You to and from the vehicle and making sure you're secured every step of the way. Scheduling is simple. Just call 813-272-7272 to see if you qualify and start your application process today. Sunshine Line is here to keep you moving safely, affordably, and with a smile. Visit HCFL.gov slash Sunshine Line to learn more and get started today. Sunshine Line. Hillsborough's ride on the bright side. Good afternoon, and welcome to the Hillsborough County Board of County Commissioners Health Care Plan workshop. And this time I'm going to pass things over to the County Administrator for opening remarks. Thank you. And good afternoon, everybody. Happy New Year. And we have our county attorney here today. Welcome, Julia. Thank you. So our workshop today is on the Hillsborough County Health Care Plan. This workshop is in person, obviously, but it is really due to the board's interest in having our various partners participate today. We've had two or three discussions about this plan before, but this current board was not all serving at the time. So some of this information is going to be repetitive for some new for some others. But regardless, the information will be comprehensive and informative for all of you, we hope. At this workshop, no formal action will be taken because it is a workshop. That said, however, your guidance, your input, your suggestions and feedback are welcomed and appreciated because that will help us guide whether any information should come back to the board for further consideration. And I'd like to thank you for your time today, extend our appreciation to our partners who are going to be participating in the discussion today. I'll turn it over to Kevin Wagner, who is the department director. He'll provide an overview of the plan, and following his presentation, we'll briefly briefly hear from our community partners and answer any questions. So thank you all. Good afternoon, Kevin. Good afternoon, Commissioners. Kevin Wagner, Healthcare Services Department. So I'd like to first say thank you for having this workshop. We always think it's a great opportunity to promote and talk about the Hillsborough County Healthcare Plan to you, the board, and to the public. So again, thank you for doing this, setting your time, and we value your leadership. On our presentation, this is quite robust by design because there's a lot about the health care plan, but I promise to move quickly through some slides and through detail on some other ones. So to manage everyone's time. So we appreciate it, and so we'll get started. After I speak, as Bonnie indicated, our community partners will briefly discuss their role as well. The question is why do we exist? What is the purpose of the Hillsborough County Healthcare Plan? Back in the late 80s and early 90s, the board itself recognized the high cost of health care as a public and private sector concern problem. The plan was really a response to the strain, financial strain that the county public hospital TGH was having. From an oral history standpoint, since I've taken this job, there were explanations to me that there was a concern the safety net system would have collapsed and been significantly impacted due to the strain on TGH. So the plan was really to address that. The board appointed a health health care advisory committee to look into the problem of finance and engine health care. Now, this committee was one of the values of what Hillsborough County does by having community representation. It involved health care industry, USF, public, private, and the chambers of commerce, the business were supportive of this role and it participated. As a result, the Hillsborough County health care plan started in 1991 to address the rising costs of providing care for the uninsured low-income residents. And today we have clients throughout the county. We have 23,000 plus residents throughout the county through all the districts. So it is countywide program. Our mission statement really is quite simple.
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