Both Florida Hospital and Orlando Health offer charity care to patients who otherwise wouldn’t be able to afford to get their needs met. Most of the recipients of the free services are low income and under or uninsured patients.  Under these programs medical care is extended to people regardless of their ability to pay for their bills. Last fiscal year Florida Hospital had $131,607,175 of unreimbursed charity care, and Orlando Health had $76,826,908.

The state of Florida provides a "Low Income Pool" to provide financial support for charity care providers for the cost of uncompensated charity care.   The Letters of Agreement (one on behalf of Orlando Health and one on behalf of Florida Hospital) between the City of Orlando and the Agency for Health Care Administration (“AHCA”) are the first step in a process whereby certain charity care providers within the city limits will be assessed by the City in order to generate funds to transfer to AHCA so that providers can draw down more funding from the Low Income Pool for the costs of uncompensated charity care.

The Letters of Agreement are non-binding, and do not obligate to the City to actually transfer any dollar amount to AHCA.  As AHCA states, there are no penalties or other issues for not contributing any funds from the Letter of Agreement (LOA).   Rather, the LOA is a voluntary agreement that sets the ceiling on the amount the City could transfer after collecting them through any special assessment, and if the City decides not to do a special assessment, the City does not transfer any amount to AHCA.  Any special assessment imposed by the City would be adopted pursuant to City policy and applicable law.