ANNAPOLIS – With more than half of the legislative session over, state and local lawmakers from Prince George’s County are still groping for a solution to the financial woes of the county-owned Prince George’s Hospital Center, which has been plagued by years of mismanagement.
The 283-bed hospital in Cheverly has been in a steady decline for years. The hospital and four other Prince George’s health care facilities are managed by Dimensions Healthcare System, which serves about 80,000 patients a year, mostly from the county and Southern Maryland.
The health care system needs $9 million to stay afloat until June, including a $4.7 million pension payment that is due in April. What might normally be an issue for only Prince George’s officials to deal with has become a matter of statewide importance because of the role Prince George’s Hospital Center plays in the region’s health care system. The hospital serves mostly Medicaid patients and poor people, and employs about 1,500 unionized hospital workers.
State lawmakers are scratching their heads trying to figure out how to take ownership of the hospital system out of the county’s hands and avoid having to periodically dump millions of dollars into a health care system that is in the red year after year. The state has provided over $15 million in funds to the hospital system since 2004 to avoid closure.
“Continuing to do what we’ve been doing is not a viable option,” John M. Colmers, Secretary of the Maryland Department of Health and Mental Hygiene, told a meeting of Prince George’s senators last week.
Members of the delegation, as well as the county council and county executive Jack B. Johnson make no bones about the fact they are looking to the state government for at least part of the solution – and part of the money – to bail out Prince George’s Hospital Center.
“The state is responsible for ensuring that the hospital gets money to pay for the services provided for the underserved,” said Joanne C. Benson, D-Prince George’s. “The state of Maryland is no longer interested in the Band-Aid approach. The sate has an obligation to make sure the hospital stays open.”
In addition to Prince Georges Hospital Center, the health care system which makes up Dimensions includes Laurel Regional Hospital, Bowie Health Campus, Gladys Spellman Specialty Hospital and Nursing Center, The Senior Health Center and Larkin Chase Nursing and Rehabilitation Center.
However, the issue has become the subject of a political struggle between and among members of the county council, Johnson, and members of the Prince George’s General Assembly delegation, which includes some of the legislature’s most powerful figures.
Still, Johnson and the council are managing to present a united front, at least in public.
“We are united in this effort,” Johnson said. “We believe that it’s a regional problem at least, but certainly a state problem.”
At a meeting in Annapolis on Thursday, Johnson said he would deliver a proposal to state lawmakers within the next week that would keep Prince George’s Hospital Center open. He did not disclose the details of the plan but would only say that he had a deal in the works and planned to meet with Lt. Gov. Anthony Brown, also from Prince George’s, to discuss it.
State legislators representing the county have submitted their own proposal that would create a hospital authority to take over the health care system. The proposal would require the hospital authority to negotiate with the county for the facilities and the land, and requires the county to raise property taxes to payoff the debt.
Delegate Doyle L. Nieman, D-Prince George’s, who sponsored a proposal on behalf of the House Prince George’s delegation, said it was “very likely” that the hospital will close if no agreement is reached on how to solve the problem.
The proposed hospital authority would have the power to sell bonds to generate enough cash to wipe out the $150 million debt accrued under Dimensions’ management. Even though the authority has the power to sell bonds to payoff the debt to make the system more attractive for buyers, the county is responsible for the debt.
Nieman’s proposal stipulates that the hospital authority will only assume the Dimension’s debt on the condition of a commitment of funding from the state, county or some other source or finalized agreement to transfer the title and control of the facilities to another operator.
But county representatives voiced opposition to the delegation plan.
“We are looking for the state to step up and assume the responsibility,” said Camille Exum, chair of the Prince George’s County Council. “While we believe the taxing authority can work, I don’t believe that the taxing authority taking the county’s land, taxing the county’s citizens and then saying we’re going to decide what happens after you pay for it, is the proper way to handle that.”
Another proposal to save the health care system was submitted by Delegate Victor R. Ramirez, D-Prince George’s, which would force the University of Maryland to take over and operate the system. Several delegates said the bill is not being seriously considered, though.
“Shotgun weddings make bad marriages,” Nieman said.
Despite differing opinions on how to resolve the matter, some legislators remain optimistic that the issue can be resolved during this legislative session.
“The issue stands a better chance of being resolved this session than in previous ones,” said Delegate James W. Hubbard, D-Prince George’s, who worked on the issue for many years. The last two administrations had neglected opportunities to resolve the problem, he added.
“I feel much more positive about a long term solution than putting a Band-Aid on it and watching it fester and come back,” Hubbard said.
A task force was formed in 2002 during the administration of Gov. Parris N. Glendening, who was also from Prince George’s, to evaluate the Dimensions system and to make recommendations on how to stabilize the system. The task force listed high hospital rates, the large number of Medicaid and poor patients and large payouts for physician subsides as reasons for the health systems financial problems.
In 2005, an eight member oversight committee was formed to again assess the state of the health care system. By this time, Dimensions had amassed more than $54 million in debt because of poor management and leadership, a lack of revenue and providing services to the poor, according to the committee’s final report.
Even though the state and county share similar agendas, to keep doors open at the hospital, some lobbyist and legislators say politics could get in the way.
“It has been the unique politics of the matter that have precluded a resolution of this entire matter over these past many years,” said Bruce C. Bereano, a lobbyist for Dimensions.
But despite politics, lawmakers said they realize that they must find a way to work together to rectify the hospital issue.
“It’s got to be resolved,” Benson said.” We don’t have a choice. Either we can go into bankruptcy or the hospital will close. That for me would be very devastating.”