Last-minute bill would make it harder for Hennepin County to take back control of HCMC

The Minnesota Legislature is poised to jump into the tangled debate over how to best oversee Hennepin County’s medical facilities, including the state’s largest safety-net hospital.

A last-minute bill debated Tuesday in the House Finance and Policy Committee would make it harder for the County Board to dissolve Hennepin Healthcare System, the nonprofit created in 2007 to run HCMC and other health facilities.

Nurses, EMTs and other workers have been pushing the County Board to get rid of Hennepin Healthcare because they say its leadership has not done enough to address their concerns over insurance changes and workplace safety that make it harder to retain and recruit staff.

The ongoing calls for a dramatic change in HCMC leadership have unsettled some lawmakers at the Capitol in St. Paul.

“We need to maintain the stability of this institution,” said Rep. Tina Liebling, DFL-Rochester, chief sponsor of the bill she acknowledged would likely need to get tacked on to other legislation in the waning days of the session to become law. “The threat of dissolving the board or the corporation, for me, is a bridge too far.”

Currently, the County Board could dissolve Hennepin Healthcare without a reason if a three-fifths majority of commissioners agreed. Liebling’s proposal requires specific reasons for a dissolution, prescribes an investigative process and requires a future oversight plan to get rid of Hennepin Healthcare.

Board Chair Irene Fernando supports the intent of the bill, but said she wants county leaders to be more involved in the final details. The County Board has not taken a public position on whether it wants to take back control of HCMC.

“The County Board needs to be able to take timely action to address the corporation’s performance — with respect to its public mission, its finances, or its workforce — not only when there is criminal conduct or malfeasance,” Fernando said in a statement.

Nurses, EMTs and other union members turned to the County Board last year after they say Hennepin Healthcare leaders did too little to address their concerns. They noted that CEO Jennifer DeCubellis got a pay raise while staff benefits were scaled back.

They eventually called for the county to take back control of HCMC and the county’s other health clinics.

In response, hospital leadership said modest insurance changes were needed to help address a $127 million shortfall in their $1.5 billion budget. They’ve said hospital leadership compensation is competitive for the industry.

Janell Johnson Thiele, an HCMC nurse and union leader, said the bill discussed Tuesday would limit important oversight by the County Board and lead to less accountability and transparency from HCMC leaders.

“As the only public safety-net in Minnesota, we need to do better,” Johnson Thiele said.

Recently, a group of doctors have joined hospital leaders in the push against dissolving Hennepin Healthcare. While they acknowledge their colleagues’ concerns, they argue conditions are not as dire as described and are not to the point of dissolving the organization’s governance board.

They note the ongoing financial and staffing struggles of hospitals nationwide in the wake of the coronavirus pandemic.

“What is happening at Hennepin is happening everywhere in health care,” Dr. Meghan Walsh, chief academic and research officer for HCMC, told lawmakers Tuesday. “Dismantling our leadership structure or removing the people in it will not erase these challenges.”

But some other HCMC doctors feel hospital leaders have been overzealous in their pushback against nurses’ concerns and demands. They agree Hennepin Healthcare leadership needs to be more transparent and responsive to workers.

“I hope that the Legislature, and members of this committee, will listen to the majority of workers when they say that things are not right at HCMC. And things need to change,” Dr. Max Fraden, a faculty physician at HCMC, wrote to the House Health Committee.

It will likely be months before county leaders decide on the best way to proceed with the oversight of the nearly 500-bed HCMC and other county-owned clinics. County leaders, with the help of the Legislature, created Hennepin Healthcare System in 2007 so the County Board could get away from the day-to-day headache of running a hospital.

In December, in response to concerns from nurses and other workers, the County Board added new oversight to Hennepin Healthcare as part of its budget approval. That included asking county staff to examine its finances and probe the impact of insurance changes on workers.

In April, the board received a financial analysis of HCMC from its financial consultant. Last week, the board scheduled meetings with hospital leaders into June to better understand the organization’s challenges.

Modifications of the county’s oversight of the hospital system from the Legislature, if they are going to happen this year, would come much sooner. The proposed changes to what it takes to dissolve the Hennepin Healthcare Board would need to be approved before the Legislature adjourns May 20.