Recent (and not so recent) events have led the county to where she is. A staggering sewer debt layered in back door deals and kick backs that have led to the conviction and incarceration of a line of public officials longer than my wind, coupled with the repeal of the county's occupational tax has left this county of Jefferson in a financial tail spin. But now, trouble is on the horizon for the county's residents. A threat looms. And that threat comes in the form of legislators (mostly Republican) who wish to close Cooper Green Hospital.
Cooper Green was established to assist with the provision of health care for the residents of Jefferson County. Most importantly it serves as a life saving service for the uninsured and under-insured residents of the county. Thousands of residents depend on the vital and life saving services provided by the fine physicians, nurses and staff of Cooper Green. And almost since its very establishment the hospital has been forced to fight off attacks by outside forces who for one reason or the other disagree with its existence. The most recent attack against this saint of hospitals is being led by Republicans in the state legislature who wish to 'cut funding' to Cooper Green.
Opponents of Cooper Green blame some of the current fiscal distress on Cooper Green by claiming that the hospital 'duplicates services' provided there and at the county's health department. To be sure, the doctor's at the Jefferson County Department of Health do a fine job caring for the disadvantaged of the county but they are not duplicating services that are performed at Cooper Green. The Cooper Green patient tends to be one with more medical problems, more medicines, more hospitalizations, require more procedures and more referrals than the average patient at the health department. To be plain, the Cooper Green patient is sicker. If you so happen to be one of the wonderful patients requiring care provided by the health department and you develop a complication or need a surgery you will be promoted too...... You guessed it! Cooper Green. Also, the health department has no hospital beds. So if you require an overnight stay in the hospital guess where you will be going? To Cooper Green. Doesn't sound like duplication of services to me.
The next thing is Cooper Green's fiscal status. A recent article written by The Birmingham News' Barnett Wright alleges that Cooper Green needs "$75 Million over the next five years from the general fund of Jefferson county to cover a current operating deficit and capital needs" according to a consultant hired to examine the county's finances. The problem is this. Cooper Green operates on an accrual basis and not a cash basis. In other words, monies that are designated to go to Cooper Green from the sales tax that feeds the indigent care fund don't go directly to Cooper Green. They first go to the county and then Cooper Green must request the funds from the county and wait on the county to disperse those funds. Why does that matter? Let's say that on your job instead of a check being given directly to you or being direct deposited into your bank account it went to some other 'holding service' that held your money. When the first of the month rolls around and it's time to pay the mortgage or the auto loan instead of picking up your check book and mailing a check to the mortgage company you had to wait on the holding service to give you your money. What if the holding services was slow and held your money for months? Wouldn't that make your debt compound? That's what the county does to Cooper Green on a regular basis and it often makes it appear as if the hospital is operating in a deficit. That is, at least, until the end of the year and the hospital gets the money it's owed and they then operate in the black because they are able to pay all of their bills. The Barnett Wright article makes it seem like the county is rescuing or helping the hospital when in fact the county is giving the hospital the money it owes to them. Are you surprised that the county doesn't pay its debts on time?
Don't be fooled by the political gaming we are seeing from those who wish to exterminate Cooper Green and the services it provides to the residents of this county. It's the same song we have heard for decades, just a different verse. And I assure you as long as those in this county and state continue to do business the way they have been doing it, the county will be broke if there is or is not a Cooper Green Mercy Hospital.
Hernando Carter, MD
Birmingham, AL
