By Philip Rucker and Ovetta Wiggins
Washington Post Staff Writers
Saturday, February 23, 2008; B01

Prince George's County Executive Jack B. Johnson met secretly with the county's delegates yesterday to present a long-awaited plan to bail out the county's financially troubled hospital system by transferring ownership to the nation's largest Catholic health-care system, a proposal that could run into trouble with state officials because of its cost.

Under the proposal, Ascension Health would take over the struggling hospital system beginning July 1. It would be subsidized by $495 million in public money, with $297 million coming from the state and $198 million coming from the county, according to several sources familiar with Johnson's proposal. The transfer would take five years and be overseen by an authority with seven members, five appointed by the county and two by the state, the sources said.

Johnson (D) declined to speak publicly about the negotiations, telling the county's delegation that he would brief them only if the meeting were closed to reporters. Several lawmakers confirmed details of his plan, but only on the condition of anonymity because they said Johnson swore them to secrecy.

Johnson said he has been negotiating with Gov. Martin O'Malley (D) and St. Louis-based Ascension and hopes to formalize a deal next week. But some Prince George's legislators said the state is unlikely to support the deal because it would require too big a state contribution amid an economic downturn and because the authority would be controlled by the county.

One delegate from the county went so far as to say, "It's the kind of deal the state will laugh at."

Further complicating the negotiations are concerns from some lawmakers that Ascension could prohibit doctors from performing abortions or distributing birth control at the facilities.

"It certainly could throw a monkey wrench into it," Del. Victor R. Ramirez (D-Prince George's) said, noting that most of the county's delegates and senators support abortion rights.

Ascension did not respond yesterday to several phone calls.

Johnson's plan is designed to help stabilize the hospital system, which is composed of Prince George's Hospital Center in Cheverly, Laurel Regional Hospital, the Bowie Health Campus and two nursing homes. The system, which is owned by the county and managed by the nonprofit Dimensions Healthcare Systems, serves about 180,000 patients each year.

The county's delegation is pressing forward with legislation to transfer ownership of the county-owned hospital system to a state authority, said Del. Barbara A. Frush (D), chairman of the county delegation.

"We can't take the chance of ending up empty at the end of the session," Frush said.

O'Malley told Johnson that he "would be happy to review the county's proposal," but is waiting to get input from fiscal and health-care experts before making a decision, spokesman Rick Abbruzzese said.

"Governor O'Malley remains committed to finding a long-term and viable solution for the Prince George's community hospital center that provides the county with the highest level of care," Abbruzzese said.

Johnson was scheduled to brief lawmakers during the Prince George's delegation meeting yesterday in Annapolis. But at Johnson's request, Frush made reporters and lobbyists leave the room, saying the meeting had changed to a "Prince George's County Democratic Caucus" meeting. She said caucus meetings are not subject to open meeting laws.

"The fiction, if you will, is that we went into Democratic caucus, but we only have Democrats in Prince George's County, and we adjourned one meeting and started another meeting with the same cast of characters," Del. Doyle L. Niemann said.

Then, Johnson entered through a back door to brief the delegation. When the meeting reopened, Johnson told a Washington Post reporter that he would speak about the hospital plan but immediately left through a back door without answering questions.

Johnson's spokesman, John Erzen, issued a statement a few hours later, saying the county executive came to Annapolis to brief only the delegation. "Due to the complexity of the negotiations and the presence of a confidentiality agreement, he did not want to speak publicly about the status of the negotiations with the state," Erzen said.

Several lawmakers said the state's finances this year make it difficult for the General Assembly to appropriate such a large amount to the project. Niemann called Johnson's plan "expensive, very expensive."

"The question the governor is going to look at is: Who's paying what?" Niemann said.

The union for nurses and other hospital workers said it wants any deal reached in an "open and transparent process."

"We need to get the County Council and politics out of the hospital business," said Ebs Burnough, political director of local 1199 of the Service Employees International Union.

Unlike previous attempts to find a solution, Johnson and the County Council appear to support of the same proposal. Johnson is "taking the lead," but the council backs his plan, County Council Chairman Samuel H. Dean (D-Mitchellville) said.

A deal collapsed in the final days of the 2007 legislative session after the council was unwilling to sign on to it. That proposal would have cost $329 million over eight years, with $170.3 million from the county and $158.7 million from the state.

During the special session in November, the state reserved $50 million for the hospital system. But that money will be available only if local and state leaders formally agree to a long-term solution.