BRADENTON, Fla. – After emerging from a financial crisis in recent years, Jackson Health in south Florida is telling Miami-Dade County residents their public hospital system needs a large infusion of capital funding.

The Miami-Dade County Commission recently set a Nov. 5 referendum to ask voters for approval to issue $830 million of general obligation bonds to upgrade and expand hospital facilities over the next decade.

In early 2010, the public health system, whose flagship is Miami’s Jackson Memorial Hospital, faced a deficit as high as $230 million.

That led the County Commission, which oversees the board of directors known as the Public Health Trust, to appoint a financial oversight panel.

The panel was dissolved in April. The health system, now under new leadership, is on target to have a surplus this fiscal year.

“Jackson has undergone a dramatic transformation and witnessed the sunset of the financial recovery board,” Jackson President Carlos Migoya told commissioners in an annual report last week. “We need to find ways to reach new patients … to grow.”

Migoya said revenues are not keeping up with expenses, and during the financial crisis the health system did not have resources to invest much in capital needs or expansion efforts.

Florida’s largest health system currently consists of the flagship and five other facilities, including a children’s hospital.

The GO bonds would fund numerous facility upgrades, and additions to attract new patients and bring medical services to neighborhoods, said hospital spokesman Ed O’Dell.

Some of the big-ticket items being planned with bond proceeds are new neighborhood urgent care centers, a children’s ambulatory center to complement the larger hospital, emergency and operating room upgrades, inpatient unit renovations, upgrading electronic medical records, and infrastructure improvements.

“Jackson needs facility upgrades to continue to grow the business,” O’Dell said. “These are long overdue and this is the time that we think we need to do it before we fall further behind.”

It’s not a major election year but with the economy still recovering from the downturn a political action committee has been formed to raise money for marketing efforts to explain the referendum to voters.

Meanwhile, a Securities and Exchange Commission inquiry into an $83.3 million bond deal that Miami-Dade County sold in 2009 on behalf of the health system is still under way, according to the Public Health Trust’s 2012 audit.

In April 2010, the SEC demanded the PHT turn over documents and communications, including those pertaining to the 2009 bond issue, as well as financial statements, projected operating deficits, information about patient accounts, internal revenue projections, and audits.

Miami-Dade issues bonds for the health system, which is a county department.

In the fall of 2010, a Miami-Dade County grand jury released a report on Jackson Health System describing its financial problems as “a colossal mess.”

The report said those who had the responsibility of running the institution “as well as those who had the duty of oversight, have been irresponsible, complacent and reckless.”

Officials “blindly relied on financial misstatements,” the report concluded without recommending formal charges.

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