R9U - Discuss Big Beautiful Bill

Discussion Items - R9 U

COMMISSION MEMORANDUM

TITLE:

DISCUSS THE BIG BEAUTIFUL BILL PUBLIC HEALTH IMPACTS.

RECOMMENDATION

The City Administration (Administration) recommends that the Commission discuss the information provided.

BACKGROUND/HISTORY

On July 23, 2025, at the request of Commissioner Kristen Rosen-Gonzalez, the Mayor and City Commission (“City Commission”) approved a resolution via agenda Item C7 AC to direct the Administration to provide an update on the impact of the recently enacted federal "One Big Beautiful Bill" on public healthcare clinics and programs in our City and provide potential options for City funding to close the budgetary gaps created by this legislation at the September 3, 2025 City Commission meeting.

ANALYSIS

City Managed Public Health Facilities – (None)

While the City of Miami Beach does not directly operate clinical care facilities, it manages various federally funded public services through the U.S. Department of Housing and Urban Development (HUD) and public health collaborations such as:

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Community Development Block Grant (CDBG)  The City receives approximately $800,000 annually from HUD. At least 70% of these funds must be used to support services that benefit low- and moderate- income residents, which may include programs such as health education, services for seniors and youth, or preventive health initiatives.

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HOME Investment Partnerships Program (HOME)  Also funded by HUD, the City receives approximately $400,000 through the HOME Program, which supports affordable housing initiatives for eligible Miami Beach residents. These efforts address key social determinants of health by providing stable housing options for vulnerable populations.

Although these city-administered federal programs support organizations that provide health- related services, the City of Miami Beach is not currently funding any direct healthcare providers through its CDBG or HOME allocations.

The City does provide some recurring grants to public health facilities that provide services in the city as listed below:

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Miami Beach Community Health Center (MBCHC) - $22,000  MBCHC Public Benefits and Outreach and Enrollment Coordinators will educate and enroll eligible clients into Medicaid, Children's Health Insurance Program or Health Insurance Marketplace.  Covers part of the salary of the Public Benefits Coordinator. Douglas Gardens Community Mental Health Center (DGCMHC)- $22,000  Operate an Aftercare program for individuals transforming from Inpatient hospital care. This includes individuals experiencing an emotional/psychiatric crisis considered of emergency proportions. The transition to the community is supported by the Aftercare provider to assist individuals facing challenges after a crisis.  Waive consumer medication co-payments for prescriptions filled at DGCMHC on behalf of low-income elderly and disabled Miami Beach residents. Psychiatric stability through medication management with prescribed medications is only for those medications specific for mental health treatment.

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Federally Funded Public Healthcare Providers (Non-City Managed)

These providers are operating as Federally Qualified Health Centers (FQHCs) or health systems with possible federal funding in Miami Beach:

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Miami Beach Community Health Center, Inc. Administration – MBCHC  Located at 710 Alton Rd, this facility is a federally funded FQHC, receiving HRSA grants and participating in the 340B Drug Pricing Program. It provides sliding scale primary care regardless of ability to pay, along with dental, behavioral health, preventive services, and pharmacy support via a Walgreens contract. The City has been in contact with the County and are awaiting a response.

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Care Resource Community Health Centers, Inc. Care Resource Community Health Centers, Inc.  This is a non-profit FQHC with a clinic on Michigan Avenue in Miami Beach. Offers comprehensive primary care, LGBTQ+ care, behavioral health, HIV prevention, and more.

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Borinquen Health Care Center, Inc. Borinquen Medical Centers |  FQHC serving low-income and uninsured residents, works very closely with our Homeless Resource Team to be able to provide mental health support to our City’s homeless population.

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Mount Sinani Hospital  Mount Sinai Medical Center is a hospital located at 4300 Alton Road in Miami Beach, Florida, and is the largest private, independent not-for-profit teaching hospital in Florida. Mount Sinai, as a nonpublic hospital, may benefit from the Medicaid Hospital Direct Payment Program (DPP), which leverages local assessments to secure federal matching funds to help bridge the reimbursement gap for Medicaid services. Mt. Sinai is still analyzing the impacts of the legislation.

Please see attached report from Ballard Partners, the City of Miami Beach’s federal lobbyists, on the impact of the recently enacted federal "One Big Beautiful Bill" on public healthcare clinics and programs.

FISCAL IMPACT STATEMENT

None known at this time.

Does this Ordinance require a Business Impact Estimate?

(FOR ORDINANCES ONLY)

If applicable, the Business Impact Estimate (BIE) was published on: See BIE at: https://www.miamibeachfl.gov/city-hall/city-clerk/meeting-notices/

FINANCIAL INFORMATION

CONCLUSION

It is not expected that the new federal legislation will have a material impact of the City of Miami Beach’s budget as the city does not operate public health facilities. Public health facilities operators are still working to determine the short-term and long-term impacts to their budgets.

Applicable Area

Citywide

Was this Agenda Item initially requested by a lobbyist which, as defined in Code Sec. 2-481, includes a principal engaged in lobbying?

If so, specify the name of lobbyist(s) and principal(s):

Department

Finance

Sponsor(s)

Kristen Rosen Gonzalez

Co-sponsor(s)

Condensed Title

Discuss Big Beautiful Bill Public Health Impacts. FN

Previous Action (For City Clerk Use Only)