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Baker, officials argue against hospital operating subsidy cut

Baker1ANNAPOLIS – Prince George’s County officials continue to fight for the state to provide what they consider full funding for the new regional medical center.

County Executive Rushern Baker, III traveled to Annapolis twice last week to speak before House and Senate committees regarding operating funds for the Prince George’s Hospital Center as it begins to transition to the Prince George’s Regional Medical Center. Gov. Larry Hogan is proposing a reduction of $15 million in the operating subsidy the state pays to the hospital in fiscal year 2018 as part of a package of budget cuts to address a deficit, but hospital proponents say that money is vital for their plans and should not be cut.

“This is going to be a hospital that serves not just Prince George’s County, but the whole southern region. And it’s the second busiest trauma unit. So this is important for quality healthcare, and you don’t play around with that,” Baker said. “I think it’s a shame and appalling that the governor did not include it, that he directly violated the law that said he must put this funding in there.”

Last session, the General Assembly passed the Prince George’s Regional Medical Center Funding Act of 2016, which required $30 million in operating subsidies in fiscal year 2018 (FY18) since a $15 million subsidy was not released as an amendment to the FY16 budget. In FY19, another $15 million was to be included, with $5 million each in FY20 and FY21. This year, the governor’s Budget Reconciliation and Financing Act of 2017 (BRFA) proposes to reduce that operating funding to $15 million for FY18, with $15 million provided in FY19, FY20 and FY21 and $2.5 million in FY22.

The BRFA is a separate bill from the state budget meant to change other state laws regarding funding levels in order to address a budget deficit which Secretary of Budget and Management David Brinkley told the Senate Budget and Taxation Committee March 1 totals $753 million.

“The Hogan Administration has championed fiscal responsibility and living within our means since day one. We recognize the state’s fiscal challenges and have been working to address them. That is why the new mandates you have passed last year, while not without merit, are basically zeroed out in this bill. These items have never been funded in the past, and now is not the time to create new spending,” Brinkley said.

Marc Nicole, deputy budget secretary, took a slightly less forceful tone and noted that the total state contribution to the hospital is the same as in the current law, just spread over a longer time frame.

“The DBM believes that the Budget Reconciliation and Financing Act as amended is necessary to ensure a balanced budget for fiscal year 2018 and to serve as a stepping stone for future structural budget balancing,” he said.

However Baker, joined by officials from the University of Maryland Medical System (UMMS), which will run the new regional hospital, and Dimensions Healthcare System, which runs the current one, said the money is needed now.

Neil Moore, president and chief executive officer of Dimensions, said the hospital has been working to build programs in cardiac surgery, orthopedics, trauma and ambulatory care, in conjunction with UMMS, to prepare for the new hospital. He said the state money is important for maintaining the current Prince George’s Hospital Center in Cheverly while those programs grow.

“In the meantime, in order to get us to the regional medical center, it takes a tremendous amount of resources to maintain that facility so that we can provide patients with care in a safe environment and at the highest possible quality,” Moore said. “The need to have the funding remain intact is very, very important so that we can continue to develop and improve the system.”

Josh Ashworth, a senior vice president at UMMS, said the state’s investment now would prevent future spending.

“Getting to the point where those services are in place so that when we open the regional medical center, we are in a self-sustaining process whereby we won’t be down here asking you all for money again. That was part of the deal,” he said.

Ashworth also said UMMS is taking a risk in moving forward with the hospital in light of potential changes to healthcare at the federal level, and the subsidy question just adds to that uncertainty.

“In the environment that we’re in right now, given the administrative changes in Washington, there are major questions out there about the risk that we take,” Ashworth said. “Of great concern is the potential that something could happen with regard to Medicaid. The thing to keep in mind is right now, the Prince George’s Hospital Center, 45 percent of the population served there is Medicaid or self-pay. That is a huge issue. So all those uncertainties are out there. Layered on top of that uncertainty is a cut in the operating money.”

Baker said developers and financers are “shaky” because of this uncertainty. He also said that Hogan should have vetoed last session’s funding bill if he didn’t agree with it.

Legislators on the committee voiced concerns about the fact that Hogan’s office did not consult with them before proposing to cut all of these mandates and change funding formulas. Sen. Nancy King (D-Montgomery County) said passing bills is the only way legislators can put things into the budget, since the General Assembly can only move money in the budget, not add to it. She said conversations about the cuts should have happened before the BFRA was introduced.

“We as legislators, listening to our communities, have to be able to put things in for the public that we’re listening to. So the frustration here is, no matter what we put in, it’s considered a mandate,” she said. “It would be so much easier if we were working together even up to when the session starts, as far as being able to decide what it is going to include and what isn’t.”

Brinkley said he “acknowledged” King’s concern, but the budget has to deal with the reality of the state’s finances.

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