Shands Jacksonville, which provides care to the city’s poor, is in a crisis situation after suffering an operating loss of more than $20 million during the fiscal year that ended June 30, the hospital’s president said Wednesday. The cost of treating uninsured and Medicaid patients has created the financial hardship for Shands Jacksonville and other safety net hospitals in the state, Jim Burkhart said in a Times-Union interview shortly after a panel discussion at the Caring Community Conference, an annual gathering to talk about health care policy on the First Coast.