The ongoing discussion on the fate of Cooper Green Hospital continued Tuesday night at the Vestavia Hills Public Library. Members of the Jefferson County government, which owns the indigent care facility, were invited, but were still nowhere to be found.
Jefferson County Manager Tony Petelos was invited to be a part of the panel at Tuesday night’s community discussion, but neither he nor any member of the county commission were present at the meeting.
The panel at Tuesday’s forum consisted of Mickey Trimm, an associate professor of healthcare management at the University of Alabama at Birmingham as well as a consultant for the commission, and Dr. Mark Wilson, the healthcare officer for Jefferson County and the CEO of the Jefferson County Department of Health.
Wilson spent 20 years at Cooper Green, three of which he served as the chief of staff, and is well aware of the crucial role the hospital has played in the community for decades now. “There are about 105,000 uninsured people in Jefferson County. That’s about 16 percent of the population. These Medicaid patients often have difficulty accessing healthcare. Cooper Green, the Health Department and Birmingham Healthcare, as well as other providers, have been very important for the Medicaid population,” Wilson said in front of an audience of about 40 concerned, mostly Over-the-Mountain residents and healthcare professionals.
Cooper Green, Wilson explained, was operating over budget for some time and after much deliberation, the Jefferson County Commissioners decided to close inpatient service and stop the bleeding. “In the middle of that process there was a lot of confusion, a lot of communication gaps, and a lot of the doctors that were at Cooper Green got nervous and left.”
The importance of Cooper Green extends beyond the patients who depend on the hospital to provide them with affordable healthcare. The hospital has for some time been a vital component for the entire healthcare structure of Birmingham. “Cooper Green traditionally has been a very important lynchpin in UAB’s teaching program. It’s one of the things that has made UAB a world class medical school and gave it a very strong residency program,” Wilson said.
Whereas no solid solutions for the crisis were presented at Tuesday night’s forum, ideas were being thrown around about possible remedies. One of those possible solutions is creating a healthcare authority, a group of officials elected under a state statute that allows not-for-profit organizations to be set up. This will allow a county or municipality to move that organization into the healthcare structure so that a board of trustees will oversee the healthcare operations, as opposed to the county commission.
“What a healthcare authority does is allow for a structure for the board of trustees, who are businesspeople, who have healthcare experience and who have only an interest in the operations of that organization. There is no conflict of interest,” Trimm said. When you have politicians overseeing the county hospital system, it essentially is turned into an employment agency for the county commissioners looking to secure votes, Trimm went on to say.
What is now halting the progress of forming a healthcare authority is a majority vote from the county commission. “In order to create an authority, we have to have three out of five votes from the county commission. Right now we know that two of the county commissioners support this idea and would be willing to vote,” Trimm said.
Vickii Howell, organizing the Cooper Green forums, explained the significance of why the meeting was held in Vestavia instead of downtown Birmingham, where most of the hospital’s displaced patients live.
“We wanted to make sure that a meeting like this took place in the district of one of the county commissioners who is not supportive of the plan that is going to be put in place to deal with this issue,” Howell said.
“This situation affects everybody,” she added. “This really affects everybody, and at the end of the day this will have an impact on all of us financially. This is not something you can just say is just Birmingham’s problem. This is our problem. It doesn’t matter if you’re black, blue, yellow or purple. It doesn’t matter if you’re Democrat or Republican, if you’re a human being and you need medical care, our county’s forefathers decided that they needed to make sure the people of this county got the healthcare they deserve.”
Jefferson County is the only county in Alabama that supports its own hospital healthcare system. “There is no other county in Alabama that has an indigent care fund like we have,” Wilson said. “My counterargument is, just because nobody else does it that way, doesn’t mean that’s the right or wrong way to do things. Alabama in general, in terms of access to healthcare, is a bad situation where there are a huge number of people who don’t have insurance.”
A study conducted by Families USA between 2005-2010 concluded that there were 2,668 deaths in Alabama due to lack of healthcare coverage. If Cooper Green closes, these numbers are sure to rise, many officials believe.
“There is a state law in Alabama that says that each county is responsible for the healthcare of its indigent population. It’s never been enforced and I doubt it will be,” Trimm said.
With the lack of participation by county authorities, the possibility of having a public discourse on a solution for the looming crisis is becoming increasingly difficult, according to those opposed to the county’s Cooper Green plan.
Trimm suggested that a solution beyond what the county plans will not be easy. “We are already down. We’re going to have to change the system. We are going to have to improve and get much more efficient than we were in the past. We are fighting a battle with one arm tied behind our back.”