In a straight party-line vote after two hours of heated debate, Chicago Democrats on the Cook County Board on Tuesday won approval of a proposal for Cook County Hospital to lease the University of Illinois Hospital for the next 50 years.
Democratic commissioners defeated Republican proposals to hold public hearings on the controversial plan, to exempt the county from hiring all 2,000 employees of the University Hospital, and to require that County Hospital be torn down and replaced only with a new outpatient clinic.
The affiliation agreement was approved by a 9 to 7 vote. Commissioner Rose-Marie Love was absent.
At one point, Board President George Dunne threatened to have Commissioner Carl Hansen (R., Mt. Prospect) bodily ejected from the meeting for ”failing to maintain order” after Hansen challenged a chair ruling by Dunne.
”You don`t have the power to eject me, Mr. President. Only the full board has that authority,” Hansen bellowed.
”I`m well aware of my authority, commissioner,” Dunne said.
The merger resolution, introduced by Dunne, calls for a 50-year lease of the hospital building for $1 a year and an affiliation agreement between Cook County Hospital and the university.
County Hospital`s medical staff recommended that the County Board postpone approval of the agreement.
Dr. Ashtok Patel, president of the medical staff, said Tuesday that the physicians were concerned that needed equipment was being removed from the University Hospital and transferred to Michael Reese Hospital and Medical Center, and that the university would have too much control over residencies at County Hospital.
”We fear that some aspects of the agreement could put our patients at risk,” Patel said.
Also on Tuesday, the House and Senate in Springfield failed to agree on the form of two bills that would implement the lease and a separate affiliation between the university and Michael Reese Hospital and Medical Center. Under the second agreement, Michael Reese would become the primary teaching hospital for the university`s medical school.
The House version would authorize the two agreements, to be implemented starting on July 1.
The Senate version includes two contradictory amendments-one that would delay implementation until Jan. 1, 1990, and one that would delay
implementation until 30 days after University of Illinois president Stanley Ikenberry stipulated that 11 conditions contained in a report, prepared by the Illinois Department of Public Health, had been met.
The conditions are intended to ensure the continuity of patient care. They require Michael Reese provide more care for high-risk pregnant women and remain in the city`s trauma network.
Although critics of the plan question the effectiveness of having Ikenberry, a staunch advocate of the affiliations, be responsible for making sure the conditions are met, the amendments also include a provision that Dr. Bernard Turnock, director of the state Health Department, must agree with Ikenberry before the affiliations can proceed.
Both the university and the state Health Department interpret the amendment to mean that Turnock has veto power over the affiliation.
The two versions went to a House/Senate conference committee Tuesday. That committee must come up with an acceptable version and get it approved by both houses before the legislature adjourns on Friday.
By a 14-1 vote, the County Board approved a resolution to make its affiliation with the university contingent on the 11-point state Health Department plan. Democrat Charles Bernardini opposed the resolution and Dunne abstained.
Commissioner Frank Damato, a Democrat, urged speedy action on the affiliation, pointing to the federal government`s threat to withhold $79 million of Medicaid and Medicare funds from Cook County Hospital if it does not improve infection control and solve other problems by July 18.
”The federal government has already cited County Hospital for numerous code violations, and pretty soon we are either going to have to knock the hospital down or take over the university hospital,” said Damato.
Dunne set several contingencies in the plan, all of which are likely to become caught up in the debate in Springfield over a tax increase. The contingencies are the following:
– The Illinois Department of Public Aid must increase its level of reimbursement to County Hospital for care of the indigent.
– The state must pay the $20 million it will take to remodel the University Hospital into a women and children`s hospital. The building also will house County Hospital`s burn unit and rehabilitation center.
– The state must pay an estimated $64 million to build a new outpatient facility to replace the aging Fantus Outpatient Clinic at County Hospital.
The County Board will still need more county or state revenue to pay the extra $61 million it is estimated that running the additional hospital will cost each year. The extra cost will come from a 50 percent increase in patients, most of whom are poor.
