Comments - July 1991

The Hennepin County Medical Center is one of the finest public hospitals in the country. The Hennepin County Board’s recent decision to acquire most of neighboring Metropolitan-Mt. Sinai Medical Center (MMS), which is closing the major part of its hospital services July 1st, will go far in enhancing that reputation.

I believe there were several compelling reasons for the Board to take this action. The closure of M-MS could damage HCMC’s ability to continue to meet present demand for services. For the past 16 years a number of HCMC programs and support services have occupied approximately 200,000 square feet of space owned and operated by M-MS. This space is not available in the HCMC facility, and many of HCMC’s services were in jeopardy.

These include support services essential to the operation of a hospital and medical programs essential to meet the current demand and maintain the current level of care.

HCMC currently buys support services from M-MS that include warehouse and storage, loading dock, mail room, and central sterile supply accounting for 80,000 square feet.

HCMC patient care programs that exist partly or primarily in M-MS space include radiation therapy, perinatal services, magnetic resonance imaging, cardiology, and head and spinal cord rehabilitation. The cost of losing or relocating these services could be significant. To relocate the magnetic resonance imaging center, for example, would exceed $1 million assuming space was even available that meets the stringent demands of the equipment.

Relocating other services such as radiation therapy and rehabilitation therapy would also be expensive and would jeopardize the quality of care HCMC provides. The rehabilitation services, for example, are critical for many HCMC inpatients who have suffered spinal cord or severe head injuries.

Some have argued that there are already enough hospitals to take care of additional patients caused by the closing of M-MS. Yet, administrators from other hospitals wrote to the Board urging us to approve the purchase of M-MS because not to do so would put other institutions at risk of overcrowding in certain areas and would decrease their ability to maintain high quality services.

The areas of service that are especially vulnerable in the hospital community are emergency departments and inpatient psychiatry units. Two years ago, an independent consulting company (Ellerbe Becket, Inc.) identified serious space deficiencies at HCMC (that was before the additional crunch resulting from imminent closure of M-MS).

These deficiencies were most serious in the emergency room and the psychiatry unit. Last year HCMC’s emergency room handled more than 88,000 patient visits. Many people endure long waits as the life-threatening and serious cases take precedence. M-MS’s emergency room handled more than 19,000 visits. You could safely assume that at least a portion of those patients would not come to HCMC’s already overburdened emergency room. The inpatient Psychiatry unit alone refers 600 patients a year to other hospitals because its own beds are full.

The County Courts also refer patients to HCMC who must then be referred elsewhere. Last year these referrals cost nearly $1 million at institutions with higher daily rates than HCMC.

HCMC’s outpatient clinics are similarly stressed. Since 1985, patient visits have increased by 22 percent. Several are beyond capacity. If physician and support staff offices were moved to space at M-MS, more space could be freed up for exam rooms in HCMC’s current clinics. We clearly have immediate space needs.

When Ellerbe-Becket, Inc. identified HCMC’s space problems two years ago, the solution they recommended was construction of an entirely new facility to house HCMC’s outpatient clinics at a cost of approximately $128.5 million. Needless to say, this met with little enthusiasm in the midst of already tight budgetary constraints in Hennepin County.

However, we can now accomplish much of what Ellerbe-Becket recommended at less than one-third the cost. HCMC administrators have been conservative in their proposals, projecting that the purchase price would be offset by increased revenues generated through additional patients that could be accommodated in the additional space. They have not asked for or suggested that additional property tax would be necessary. Furthermore, their projections are based on existing demand and are not dependent on attracting large volumes of new patients.

I believe acquiring M-MS is a benefit to both patients and taxpayers. Hennepin County is fortunate to have one of the finest and most self sufficient public hospitals in the country. During the past 10 years, HCMC has required less local tax support than 90 percent of the nation’s public hospitals. In 1991, just 7.7 percent of the hospital’s operating budget is supported by County tax dollars.

For the average homeowner, that amounts to less than $10 a year, a small price to pay for the availability of trauma services second to none, poison information services, crisis intervention, emergency medical services coordination and training, and the advanced training of physicians who staff the area’s clinics and private hospitals.

HCMC is one of our community’s strongest and most valuable resources, and with the acquisition of M-MS we are preserving and strengthening it for the future.