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Hospital lease is a work in progress

Choice Health Alliance submits a routine lease and Tarpon Springs' city attorney responds with one of his own _ one that favors the city.

As anyone who has bought or sold a house knows, the negotiations and paperwork have just begun when the buyers say, "We love it; we'll take it."

Similarly, the City Commission agreed in November that non-profit Choice Health Alliance should take over financially struggling Helen Ellis Memorial Hospital. Choice Health is a partnership between Adventist Health System of Winter Park and University Community Hospital of Tampa.

However, three months after choosing Choice Health, the city's negotiating team and the lawyers for the health care company are still working on drawing up a contract that everybody is willing to sign.

Choice Health Alliance began the process by sending over a fairly standard lease. On Friday, City Attorney John Hubbard responded with a much longer and more complicated document: the ideal lease from the city's perspective.

It includes provisions like rent payments that go up with the consumer price index, no decrease in charity care and a guarantee that the same number of employees will receive the same or higher wages for at least two more years.

It would obligate Adventist and University Community to guarantee that Choice Health, their new joint venture, will live up to its end of the deal. Those companies are older and financially stronger than their new offspring, so that would give the city more security.

"Some of this will probably not be very attractive to some of those parties," Hubbard conceded in a memo to city commissioners.

Adventist officials could not be reached Friday afternoon, and University Community executives had not read Hubbard's draft lease, said spokesman Peter Moberg.

The city wants to protect its business interests and also ensure that residents continue to receive the level of health care they have come to expect from Helen Ellis Memorial. The facility has to remain an accredited inpatient hospital with at least 168 beds, the draft lease states.

Revelations last year that Bayfront Medical Center in St. Petersburg had changed its abortion policy to appease its Catholic partners in the BayCare network concerned many residents.

Because Adventist Health System is an organization with a Christian mission, Hubbard included a clause to ensure that Helen Ellis remains a secular hospital.

Hospital policy "shall not . . . absolutely preclude the provision of abortion services, limit or inhibit the right of a patient to have a "do not resuscitate' order or prohibit or limit observance of the directions of living wills," Hubbard's draft states.

Adventist officials have said they intend for Helen Ellis to remain a secular hospital.

If the hospital fails to pay rent, turn over financial statements, perform other provisions of the lease or goes bankrupt, the city can end the lease, take the hospital back, sue for money it has lost and receive a $5-million payment for liquidated damages.

Hubbard and a Clearwater health care consultant are in charge of negotiating the deal based on previous comments from the public and commissioners. Hubbard said he is trying to schedule a meeting to work toward a lease both sides can live with.

Then the City Commission will vote it up or down. Because the city's residents ultimately own the hospital campus, they must also vote to approve any new lease.

Mayor Frank DiDonato and hospital administrator Joseph Kiefer originally foresaw that referendum in March or earlier, but it won't be that soon.

DiDonato doesn't see it happening until April or May _ maybe June. But he believes both sides are being reasonable, and he does not see the negotiations breaking down.

"They seem to be going along the line that I'd expect them to go," he said.

On the city's terms

Here are some of the items the city proposes in its draft lease for Helen Ellis Memorial Hospital:

+ Forty-year lease term.

+ Annual rent of $250,000, to increase each year with the cost of living.

+ Level of free care for the poor must begin at the current $1.5-million per year and escalate by 2 percent each year.

+ Hospital must remain non-profit.

+ Hospital must keep offering current level of inpatient services or higher.

+ City to appoint half of hospital board.

+ Choice Health Alliance must invest $20-million in improvements during next 10 years.

+ Hospital must remain secular and free of religious interference.

+ Abortion and end-of-life decisions must not be restricted.

+ Hospital must provide monthly, quarterly and annual financial reports to city.

+ Name will remain Helen Ellis Memorial Hospital.