Considering modifying Lee Health’s governing structure.

Lee Health: From Humble Beginnings to a Thriving Health System

Lee Health has a rich history that is deeply intertwined with the growth and development of Southwest Florida. In 1975, I joined the Lee Health team and eventually became its president/CEO, serving in that role for more than three decades. Over the years, Lee Health has transformed from a single downtown hospital to the integrated health system it is today. However, our growth was not driven by a desire to become large and powerful, but rather to ensure that we had the financial resources to care for the less fortunate members of our community.

At the core of Lee Health lies its safety-net mission, which is to treat every individual, regardless of their economic status. What sets Lee Health apart is that it is the largest public hospital district in the United States that does not collect a local tax to support the hundreds of millions of dollars of free or uncompensated care provided annually. This commitment to serving our community, regardless of their financial means, has remained unchanged throughout Lee Health’s 105-year history. However, many people may not be aware that the governance structure of Lee Health has evolved over time in response to the changing needs of our community.

Evolution of the Governance Structure and the Impact on Lee Health

Lee Health was founded in 1916 as a private, not-for-profit hospital. It operated as such until 1968 when it transitioned into a public hospital district known as Lee Memorial. This change was in line with a trend during the 1960s, where several public not-for-profit hospital districts were established across Florida. However, unlike many of these districts which received local tax support or taxing power, Lee Health did not. At one point, there were nearly 60 such districts in the state, but more than half of them have since converted from public to private entities. Examples of successful conversions include Tampa General Hospital and Tallahassee Memorial, both of which remain dedicated to their safety-net missions while operating as private not-for-profit health systems.

Assessing the Governance Structure: An Opportunity for Lee Health

Recently, the Florida Legislature has granted Lee Health the authority to review its governance structure, aiming to better serve the region and ensure financial stability amidst the changing landscape of healthcare delivery. Over the years, reimbursement for services has declined while costs have consistently risen. In light of these challenges, it is crucial for Lee Health leadership to explore options that will allow them to continue providing excellent care to their patients.

Consequently, Lee Health’s Board of Directors can now consider converting from a public not-for-profit system to a private not-for-profit system. Should they choose this path, it is imperative that they develop a comprehensive plan that prioritizes patients and community members while remaining committed to the safety-net mission. The plan must include a perpetual, enforceable commitment to maintain this mission. The process of converting would involve four votes, including one by the Lee County Commission, ensuring that the best interests of taxpayers, residents, and patients are served.

Exploring Available Options: Pros and Cons

As defined by the state, there are several potential options for Lee Health’s future:

• Selling Lee Health to a private for-profit health system is a possibility; however, this option would jeopardize the system’s safety-net mission, which I strongly oppose.
• Maintaining the status quo may give a competitive advantage to for-profit providers, but it could also limit Lee Health’s ability to expand access to essential health services.
• Seeking tax support for indigent care would require a referendum for approval. However, based on historical trends, it is unlikely to gain the support of the taxpayers of Lee County.
• Capitalizing on the authorized conversion from a public not-for-profit to a private not-for-profit system would provide the best value to taxpayers and patients. This model would ensure a strong business foundation while maintaining the safety-net mission.

It is important to note that the best option for Lee Health’s future is still unknown. However, embarking on this review process will allow our health system to explore and identify the most suitable direction. Let us come together and find the path that will strengthen Lee Health and enable it to continue serving our community with unwavering dedication.

Jim Nathan is the former President and CEO of Lee Health.