Dean: Metro can't afford to help General Hospital

Board told to cut costs at indigent care facility By Michael Cass • THE TENNESSEAN • January 13, 2009 Metro must look for "more viable long-term options" to fund the city's cash-strapped safety-net hospital after years of costly subsidies and loan extensions, Mayor Karl Dean wrote in a letter to the hospital's board chairman. Dean told Metro Hospital Authority Chairman Waverly D. Crenshaw Jr. that his administration would look at ways to reduce Metro's expenses in the operation of Nashville General Hospital at Meharry. The city gave the hospital authority a $47.3 million subsidy — reflecting a 5 percent cut — for the fiscal year that started July 1. General Hospital regularly struggles to make ends meet because so many of its patients have little or no health insurance, making it tough to get reimbursed for many of the services it provides. "Today I have asked the Finance Director to begin looking at options that would continue healthcare delivery for our indigent and under-served citizens, but at a lower cost to the Metropolitan Government," Dean wrote Crenshaw in a letter dated Jan. 9. "I have instructed him that all options should be on the table." Crenshaw said he recognizes the economic reality and is pleased that Dean wants to keep funding indigent care. "We certainly agree that we need to be good stewards of the city's money," he said. "I'm encouraged that the mayor put all the options on the table." Councilman Jerry Maynard, the hospital's most vocal defender on the Metro Council, said he was disappointed Dean didn't consult him and other stakeholders before writing to Crenshaw. He also was disappointed in the letter's tone and content, he said. But Maynard, who criticized Dean's administration last fall for not offering more enthusiastic support for the hospital, said he would work with the mayor to find solutions. "This is an opportunity to work together to make sure every working family has access to high-quality health care," he said. Deficit is about $2M Dean also said the hospital authority must significantly cut costs or increase revenues over the next six months because the city doesn't plan to help the hospital finish the fiscal year. Metro gave the authority an $11.5 million loan extension last February so it could get through the previous year, running the authority's loan to nearly $32 million. "The City cannot provide additional revenues … this fiscal year to bail out the anticipated deficit," the mayor wrote. Metro Finance Director Rich Riebeling said the deficit is at least $2 million. The hospital authority runs General Hospital independently of the city's central government but receives funding from it. Crenshaw said the authority would look at other cities' hospital operations and the role of the private sector in those places; cut costs wherever possible and continue its marketing campaign. "There's nothing we will not look at," he said.