Oversight changes coming for Hennepin County Medical Center

Hennepin County commissioners have the votes to take back control of HCMC, but are waiting until next week to make a final decision, in case hospital leaders can come up with a better fix.

The County Board is one formal vote away from dissolving the Hennepin Healthcare System board of 14 community members that was created in 2007 to oversee HCMC and its related clinics.

It’s a controversial move that’s been applauded by union workers at the Minneapolis safety-net hospital and criticized by health system leaders who say they are dealing with systemic financial challenges.

“It’s not a secret we are in need of greater financial oversight,” Mariah Tunkara, a nurse at HCMC, told the County Board during a public forum Tuesday. “It’s clear the path we are currently on is not working.”

Commissioners are citing the hospital’s ongoing financial struggles – including the possibility it could greatly reduce services and staff or close – as the reason to step in.

“Hennepin County has an obligation to keep this hospital open. This is an emergency,” said Commissioner Angela Conley. “It’s the right thing to do, to save a critical asset for the entire state.”

The board voted 6-0, with Commissioner Marion Greene absent, to advance the proposal to their Aug. 12 meeting, when a final vote is expected. Before that vote, health system leaders will meet with county officials to see if there is an alternative last-minute solution.

“The hospital has a financial problem. It does not have a governance problem,” Omar said. “We are very disappointed, but we are also working very hard to influence this decision.”

Omar and Mitchell Davis Jr., a fellow board member, asked county leaders to slow the process down and gather more community input. They held a news conference Monday and said they plan to continue to rally community support against the takeover.

“When things are under siege, that doesn’t mean we take kneejerk reactions,” Davis said. “It means that we sit down and really talk about it.”

Hospital leaders say HCMC faces a $35 million budget gap by December because of the growing number of patients who are uninsured and unable to pay for their care. To close the gap, the health system’s leaders are considering cuts to staff and patient services and asking the community for help.

“We should have a chance to dig in and see if we have different solutions to provide,” said Board Chair Irene Fernando, who also is a member of the hospital board.

The county increased oversight of the health system’s $1.6 billion budget in 2024 and increased taxpayer subsidies while hospital leaders have been working to increase revenues. But neither effort has been enough to offset the growing deficit.

There are big implications for taxpayers. The health system is a subsidiary of the county, which owns all of its infrastructure and is responsible for its debts.

“They have to be able to make payroll. If they don’t make payroll, we have to make it for them,” Commissioner Debbie Goettel said of the hospital’s fiscal relationship with the county.

There is also a lot at stake for patients. In addition to being a safety-net hospital that cares for anyone, regardless of their ability to pay, HCMC is a level-one trauma center and where about half of new Minnesota doctors are trained.

The hospital’s union workers have been calling on the County Board to take back control of the hospital for more than a year. They say the current leadership lacks transparency and has not done enough to address concerns from workers about discrimination and retaliation.