A presumably slimmed-down version of a controversial taxing district in support of Fishermen’s Community Hospital in Marathon will continue for one final year, according to a 3-2 vote by the Marathon City Council.
Confirmed in a special call meeting on March 31, Marathon Mayor Lynn Landry, Vice Mayor Jeff Smith and councilwoman Robyn Still voted to continue the tax, while councilman Kenny Matlock and councilwoman Lynny Del Gaizo voted against it.
The final year of the Middle Keys Health Care Municipal Services Taxing Unit (MSTU), instituted by the Monroe County Commission in 2018 with the support of Marathon and Key Colony Beach, will run for fiscal year 2026 and will fulfill the remaining balance on a maximum 10-year, $15 million pledge.
The tax was initially billed as funding to support brick-and-mortar construction for Fishermen’s Hospital, destroyed in Hurricane Irma. In a move that has remained a subject of criticism throughout the 7 years of the tax, the district was later changed to support reimbursement for the care of underinsured and indigent patients when municipal leaders realized that funds raised from a taxing district could not be lawfully used to back construction costs without a binding referendum vote.
Since its inception, the MSTU has netted roughly $2 million per year from Middle Keys taxpayers from Marathon to Conch Key. Properties in the taxing district have been assessed at an annual rate of 0.5 mills, or $50 per $100,000 in taxable value.
Last week, Monroe County Tax Collector Sam Steele told the Weekly that his office has collected $14,438,498 from constituents in the taxing district. On Monday night, Baptist officials told the council the hospital has $774,339 remaining in reimbursements to reach the $15 million. Tax revenues are collected by the county, and eventually paid to Baptist to reimburse documented expenses stemming from the care of indigent or underinsured patients.
As Monroe County is the governing body that adopted the tax in 2018, with Marathon and Key Colony Beach “opting in,” Marathon is unable to independently alter the MSTU millage rate. However, the resolution passed Monday night states that Marathon will continue to participate in the MSTU for the final year only if the county commission reduces the applied millage to meet, but not exceed, the balance of the original $15 million commitment.
In the fiscal year ending in September 2024, Fishermen’s turned a profit of $17.5 million, according to an annual financial report. However, hospital CFO Patti Boylan told the council that when combined with the hospital’s purchase price, the subsequent and unexpected expenses of both a field hospital and modular hospital in the aftermath of Hurricane Irma, capital investments and losses from Baptist’s local physician practices, the company stands at a net loss of $31.2 million since acquiring Fishermen’s in 2017.
“Baptist stepped up and made the investment into the community, with the generosity of the community, to open up a brand-new hospital, and then finish off the entire campus last year with the brand-new Walsh Family Medical Arts Building,” said Fishermen’s CEO Drew Grossman. “Probably the biggest (service) is having cancer care right here in the Keys with our chemo infusion services, and we’re not done there. We’re going to keep expanding these services.”
Monday’s special call session drew a much larger crowd than the week prior, when a last-minute addition to discuss the MSTU caused a stir for local residents.
Speaking before the council, proponents of the tax said they viewed the original $15 million figure as a promise to be kept by the city, praising Baptist’s willingness to invest in the Middle Keys community as rural hospitals across the United States are forced to close. Detractors cited myriad billing, insurance, accessibility and staffing issues, saying they felt the exclusion of services like pediatric care and frequent patient transfers to other facilities constituted a broken promise to the Marathon community.
“I was in favor of supporting Baptist initially,” said Marathon resident Dion Watson. “But we don’t have a community hospital – we have a mash unit. It runs us in and runs us out, and the second you walk in the door, it’s ‘How are you going to pay for it?’”
Dr. Alex Palma, who himself spent seven years working in Baptist’s system in Miami and the Keys but has since become an outspoken opponent of the taxing district, called the levy “the right decision then, but the wrong one today.”
“When I worked with Baptist in Miami, it was one of the best experiences I’ve had in a hospital,” he told the Weekly by phone after the meeting. “But my problem is continuing to support a profitable hospital that’s doing so well on its own. If they were in the red, this would be a different conversation.”
“What the hospital has done for us, I don’t know how you can repay that,” said Baptist Health Foundation director Jane Packard. “But all we’re talking about tonight is commitment. We only have $780,000 left out of $15 million. We’re talking less than a year. … If we don’t commit now, who are we?”
“As I read through the old minutes of meetings, (Fishermen’s CEO’s) direct quote was that the services offered will be full services except OB,” said Matlock. “They’re not meeting their end of the deal in my book. … It’s hard for me to grasp forcing a tax on the public to make a very well-off organization more well-off.”
“We teach our kids to honor their work and follow through,” said Still. “(Baptist) struggles with staffing, the same as everybody else who owns a business here in our community and nationwide. That is not their fault. … I’m not negating the points that have been made tonight, but at the end of the day, we made a commitment.”
“I think this community has stepped up to the plate towards getting a hospital here as a community,” said Del Gaizo. “I know it’s not a dollar amount (that people are against), but I think it’s the principle, and I think the community has spoken.”
“I recognize all the turnover we’re having (at Fishermen’s), but having the care available, you can’t really put a price on that, compared to many communities who don’t have a community hospital,” said Smith, adding that he “hope(d) (Baptist) was listening to the community and to us about the services we feel we need.
“They were one of two (hospitals) that have been built in rural areas in the last decade in the United States, and they’re closing every day.”
“I have a mother-in-law who’s been battling a disease for close to 20 years, and Baptist probably saved her life twice in the last few years,” said Landry. “We understand that we need this hospital. It’s not perfect – maybe it doesn’t offer all the services we think they should, but they do offer services and they’re trying to bring more.”
Exact millage for the 2025-26 tax, if reduced, will be determined throughout the county’s annual budget process based on property values provided by the Monroe County Property Appraiser Office in July.
County Mayor Pro Tem Michelle Lincoln told the Weekly by phone on April 2 that while she could not speak to, or for, other commissioners regarding the tax before a formal vote this summer, she would support a lowered millage rate to reach, but not exceed, the $15 million threshold, and that she had discussed the reduced rate with county staff.
