The Jefferson County Commission voted 3-2 to close the inpatient care unit at Cooper Green Mercy Hospital, following weeks of debate and protests from community leaders who have begged the county to continue operating the facility for the sick poor.
The decision was so quick that supporters of the hospital at first didn’t realize what had happened.
Commission President David Carrington and Commissioners Jimmie Stephens and Joe Knight, the majority who took office 21 months ago vowing to makes changes at the county-owned hospital for the poor, voted to close. Commissioners Sandra Little Brown and George Bowman opposed the move.
The decision came after weeks of protests from hospital supporters, months of questions from county commissioners and years of debate on whether the county should be in the health-care business.
Cooper Green must now cease admitting inpatients and close the hospital’s emergency room no later than Dec. 1. The hospital opened in 1972. It was unclear how many of the hospital’s 647 employees will lose their jobs as a result of today’s action.
“We’re going to proceed on a path to transition from inpatient care at Cooper Green to inpatient care at other area providers,” Carrington said after the meeting. “It means we’ll be able to expand the specialty outpatient services and hopefully expand primary care.”
The commission has three months to come up with a model for the delivery of cost-effective, quality health care to the indigent.
Dr. Sandral Hullett, Cooper Green Mercy Hospital CEO and medical director, said the decision will be devastating for the sick poor. The hospital had 41 inpatients in the most recent census, she said.
“People don’t know where they are going to go, what they need,” Hullett said. “It’s not the way we ought to do things. You shouldn’t leave people hanging out there like that.”
The vote came in a courthouse chamber packed with many of the same hospital supporters who had shut down the commission meeting two weeks ago when the majority tried to close the inpatient unit.
This time Carrington was prepared.
First, he offered a substitute amendment that included a $70 million fiscal 2013 operating budget for the hospital and required Brown and Knight to develop an inpatient transfer agreement with area health-care providers.
Brown asked Hullett to speak on behalf of the resolution.
“We have worked diligently in the last three to four months to show we can cut our budget, and we have,” Hullett told commissioners. With “the 50-bed inpatient (model) we will be able to meet some of the needs, most of the needs of patients and continue to do the outpatient part. I see no reason why we can’t do that. We have already drastically cut and we will continue to cut.”
The amendment failed 3-2 with Bowman joining Knight and Stephens voting against. Carrington and Brown voted for it.
Carrington then brought back the motion from two weeks ago to close the inpatient care unit and emergency room. He asked for a roll call vote. Brown and Bowman voted against the motion; Knight and Stephens voted for it. Carrington cast the swing vote in favor and quickly recessed the meeting as the board went into a closed-door meeting with lawyers to discuss an audit of Cooper Green’s discretionary fund.
The vote to end inpatient care left the protesters and most in the chamber confused and seemed to catch Bowman off guard.
Afterward, Bowman said the county has “no plan for transition of care. Absolutely none. They don’t know where the patients are going to go. They don’t know how the services are going to be transferred. What are they going to do about the contracts the county has already entered into?”
The commission also ignored an impact analysis from the county manager’s office that shows a $49 million cost to close the inpatient unit, Bowman said.
Knight said he saw a couple of figures in the document that raised questions.
“I think some of the numbers were inflated — scare tactics,” he said. “We have to get people to understand we’re not doing away with health care. You’re not going to have people dying in the street. You’re not going to have people left behind. We’re trying to make it better.”
Tuesday’s 30-minute meeting itself was not as chaotic as the one two weeks earlier that had been halted by protests. But the aftermath grew increasingly tense once some hospital supporters learned that the inpatient unit would close.
“They are vultures and they are picking the bones of the poor and the needy, and I hope they choke on them,” said Maralyn Mosley, a longtime hospital advocate.
Supporters milled around the chambers for nearly two hours after the meeting. Some went to the commission offices where they sang, chanted and screamed against the decision. Nearly a dozen sheriff’s deputies and courthouse security maintained order and eventually shut off access to the commission office suites.
Several state lawmakers attended the meeting, including state Reps. John Rogers and Mary Moore, D-Birmingham, and Rod Scott, D-Fairfield, and state Sens. Rodger Smitherman, D-Birmingham, and Priscilla Dunn, D-Bessemer.
Rogers said Democrats felt betrayed by the decision, and commissioners can’t expect financial assistance from the Legislature.
“They killed the hospital,” Rogers said. “The last card is always played in Montgomery. The County Commission has set up a roadblock as far as we’re concerned. If they want any dime out of Montgomery they have to find a way around the roadblocks.”
A majority of the commissioners have said the county can no longer afford to operate the hospital, which they said operates at a loss and has historically been subsidized by the general fund, including $10 million last year, and is expected to have a $6 million shortfall when the fiscal year ends Sept. 30.
The hospital’s supporters said the commission has abandoned poor residents who need the hospital the most and who have grown accustomed to the compassion at Cooper Green.