Closure Looms Over Hospital System
With No State Deal, Pr. George's Weighs Options

By Rosalind S. Helderman and Ovetta Wiggins
Washington Post Staff Writers
Tuesday, April 10, 2007

Prince George's hospital executives plan to meet within days to weigh the closure of the system, which treats 180,000 people every year, after the collapse of negotiations between state and local officials to approve a massive funding plan intended keep the county hospitals alive.

In the absence of a deal, the president and chief executive of Dimensions Healthcare System, which runs the hospitals, said the hospitals' board of directors will be forced to choose between bankruptcy and closure, an option health officials have warned would be a catastrophe to health care across the region as patients flood crowded emergency rooms at other facilities.

G.T. Dunlop Ecker said he would recommend closure to the board at an emergency meeting this week because he thinks the system does not have enough cash on hand to keep paying vendors during bankruptcy proceedings.

"Unfortunately, we don't have an agreement," said County Executive Jack B. Johnson (D) close to midnight. "I'm extremely disappointed."

State and local officials had spent the final hours of the last day of the Maryland legislative session locked in negotiations to save the system, which is anchored by the Prince George's Hospital Center in Cheverly. Aides to Gov. Martin O'Malley (D) and Johnson said in the early evening that they had reached an agreement on a $320 million package to stabilize the system. Prince George's County Council Chairman Camille Exum (D-Seat Pleasant) released a statement that the deal was "flawed" and told a Senate committee that she could not sign off on the proposal.

In an absence of council approval, lawmakers said a deal was not possible.

As a result, the governor and Lt. Gov. Anthony G. Brown (D) released a statement late last night saying that "an orderly closure appears unavoidable."

"In the end, the State of Maryland came as far as we could and made a number of concessions," the statement said. "However, we could not enter into an agreement that did not bind the County Government beyond the current four-year term."

It was unclear throughout the day whether the two sides would reach a compromise, but legislative leaders offered pessimistic predictions. "I'm doubtful," Sen. Ulysses Currie (D-Prince George's), chairman of the Budget and Taxation Committee, said in the late afternoon.

But not long after, Brown popped into the Senate to pull Currie aside and brief him on a new hope. Brown said at the time that there was "an agreement in concept."

The hospital system is owned by the county but managed by Dimensions. It has been losing money for years, kept afloat by emergency payments from the county and state.

Last week, O'Malley offered to pay $175 million over eight years to provide financial stability to the hospital if the county provided $229 million. O'Malley's offer was contingent on the General Assembly passing a bill to create a state-appointed authority to oversee a change in hospital management. The authority would negotiate with companies interested in buying the system.

But O'Malley warned that without an agreement from the county to provide more than half the funding, he was prepared to accept the "orderly shutdown" of the facilities.

Prince George's officials balked, saying O'Malley was requiring too much of the county.

The two sides worked all weekend and into yesterday to reduce the contribution needed from the county. In the early evening, aides to O'Malley unveiled a proposal under which the county would pay $170.3 million over eight years and the state would pay $158.7 million. If the county failed to make a payment, the amount would be deducted from state aid to the county.

Johnson told a Senate committee in the evening that he was "pleased generally" with the offer, but Exum said she had just received the bill and could not pledge the council's support.

Council member Thomas E. Dernoga (D-Laurel) said that the council's lawyers said the bill was poorly crafted and that members were concerned about how the county would be credited for transferring the land and buildings to an authority.

"It was clear to the council that we were putting at risk tens of millions of dollars of valuable assets," he said.

The negotiations were complicated by the number of players -- the governor, the House and Senate, the county executive and the County Council.

About noon, Sen. President Thomas V. Mike Miller Jr. (D-Calvert) declared that a deal to keep the hospital open was unlikely, pinning blame on a "recalcitrant" County Council, which he said was unwilling to guarantee county appropriations.

"Quite frankly, they've been very disrespectful to the governor," Miller said.

The system treats many of the region's poor and uninsured. More than 80 percent of the system's patients hail from Prince George's.