Voter Guide - Teresa Carafelli

AGE: 61
FAMILY: Husband, Fred; golden retriever, “Dixie”
EDUCATION: Henry Ford Hospital School of Nursing
PROFESSIONAL CAREER HIGHLIGHTS: Elected to the Sarasota Hospital Board in 2008; current first-vice chairman; chairman of the Quality Committee last three years; registered nurse since 1972; endorsed by the Suncoast Firefighters & Paramedics; supported by the Sarasota County Medical Society
FUN FACT: Came for a vacation in 1977 and never left!



What qualifies you more than your opponent to be a member of the Hospital Board?
Registered nurse employed at Sarasota Memorial Healthcare System for 30 years — all levels of responsibility from staff nurse to management, including patient care, scheduling coordinator, materials management, capital purchases and budgetary process.

I have been a hospital board member for four years, promoting a safe, healthy environment for patients, staff and physicians;

I am passionate about our hospital, determined and fearless in my approach to issues concerning SMH and our community’s health and well being.

I adhere to the ANA Code of Ethics: “The nurse’s primary commitment is to the patient, whether an individual, family, group or community.”

Name three top challenges that you expect the Hospital Board to confront over the next two to three years, and how, specifically, should the board address them?
1) Continue providing top-quality and cost-effective care;
2) Health-care reform; and
3) State changes and challenges in Medicaid funding and programs.

SMHCS has been living with health-care reform for sometime now, but as the law continues to go into effect, we will face more challenges with our delivery of health care and the treatment of a growing number of patients. We are deeply concerned about the uncertainty of Florida’s participation in the Medicaid expansion program; we treat more than 90% of the county’s Medicaid cases and have already seen a 30% cut in funding in the last few years. And even before these cuts, Medicaid only paid 50% of the cost to care for our patients. The board has made numerous trips to visit our state and federal representatives regarding these cuts and the financial and personal impact to our community. But no matter the outcome in November, SMHCS will continue to do what we do best: focusing on improving quality, increasing efficiency, reducing costs and working with health-care providers to improve people’s access to essential services.

Sarasota Memorial wrote off $68 million in uncollectible debt in fiscal 2010-2011 and through nine months had written off another $50 million — which accounts for care to indigent and poor who are unable to pay. What is your position on the way the board and management has handled uncompensated care? What, if anything, would you advocate to be changed if elected?
Despite all of our accomplishments, we have not lost sight of our mission as a public hospital and our dedication to providing care for the uninsured and underinsured who rely on us. We are the only ones in the region providing maternal care, including pre- and post-partum and labor and delivery, a level 3 NICU, a behavioral-health program, and emergency rooms in North Port and Sarasota that have 24-hour coverage of all specialties. We are working, in conjunction, and with the help of a grant from the Patterson Foundation, with the Sarasota Health Department and the Senior Friendship Centers to ensure we provide care to the uninsured and the underinsured in the most cost-effective location and cost-effective way possible.

Sarasota Memorial operates a health care center in Heritage Harbour in Manatee County. Given that Sarasota Memorial collects 1 mill in property taxes from Sarasota County property owners, what is your view on where Sarasota Memorial should operate facilities? Should it limit itself only to Sarasota County? Why or why not?
The historical data (75,000 cases) indicate that Manatee residents often choose SMH as a primary-care facility — having an outpatient facility makes their continuum of care convenient and timely. None of our tax dollars leaves our county.

Sarasota Memorial regularly receives high ratings for its quality of care and operations. No one is perfect; for what changes and improvements would you advocate as a member of the board?
As chairman of the board’s Quality Committee for the last three years, I can assure you that the board and administration are relentless in their pursuit of constantly improving our quality — it’s what we stand for. This past year, I recommended board observational experiences in clinical areas throughout the year. The board gets a first-hand look at our operations and views our staff delivering the excellent care for which it is known.

Taxpayers contributed $48 million and $43 million in cash in 2010 and 2011 to the hospital board, respectively, via property taxes. Without those contributions, the hospital board still would have shown $14 million and $15 million annual surpluses. What will be your position on the board on whether to raise or lower the hospital’s tax rate?
We have decreased our reliance on taxes each year since 2008; it is only 6% of our revenue. We have seen a 27% reduction in the last few years, and we are not recommending an increase for 2013. Our tax dollars stay in our community, not to shareholders, and we continually re-invest in our people, our technology, and our infrastructure.

Advocates of other hospitals in Sarasota County contend that the hospital’s property tax collections should be shared among all county hospitals for the reimbursement of indigent care. What is your opinion of that?
These privately owned hospitals do not provide the same 24/7 comprehensive services that SMH, your public county hospital, does. So it’s not a level playing field for care — why should it be for taxes? Our tax dollars stay in our community and are reinvested in our services.

Why do you want to be elected?
Faced with a changing health-care picture over the next several years, due to reforms and federal budget reductions, we will need a strong, informed board that will enable SMH to continue to provide safe, efficient, quality health care to our community. Decisions by the board affect the health and well being of EVERY citizen in Sarasota County. It’s not about politics; it’s about having the best health-care system, and I am committed to this goal.








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