The Ramsey County Board has agreed to lease Bethesda Hospital in St. Paul and turn it into a homeless shelter, despite neighbors' objections.

Commissioners unanimously approved the 18-month lease with Fairview Health, totaling $1.2 million, at its meeting Tuesday morning.

The hospital building, just north of the State Capitol in the Frogtown neighborhood, will provide a 24-hour shelter and services for 100 homeless people. It would be a low-barrier shelter, housing people who have been unsuccessful in other shelter settings and are often battling addictions.

Residents in the area say they're worried about public safety, including drug dealing and a homeless camp popping up on the hospital grounds. The County Board delayed approval of the lease for a week to address the neighborhood's public safety concerns, and County Manager Ryan O'Connor said Tuesday the lease had been amended to address those concerns.

There will be 24-hour security on site and regular patrols of the property, which includes a private park as well as a hotline staffed 24 hours a day that neighbors may call to report problems.

O'Connor said the county also plans to open an indoor COVID-19 testing site at Bethesda.

Fairview Health announced earlier this month that it will close Bethesda and eliminate 900 jobs across its network of hospitals and clinics to stem financial losses.

All seven commissioners spoke Tuesday in favor of the lease before the vote.

"This is something that is necessary as far as protecting people from the harsh Minnesota winter," said Commissioner Victoria Reinhardt.

The number of homeless people sleeping outside in St. Paul has surged close to 400 this year, according to counts taken by the city. The county and city have been searching for a site to operate a new homeless shelter for months.

Commissioner Rafael Ortega, whose district includes the Bethesda site, emphasized that the county is committed to safety and working with the neighborhood to quickly address problems when they arise.

"Moving forward, we need to make sure we stay engaged with the community and we address their issues of safety and security," Ortega said.

But he said it was only the start of many difficult conversations, similar to others happening across the county, as the east metro grapples with surging homelessness made worse by the pandemic and its economic fallout.

"We are going to have to engage community on very difficult issues of this type," Ortega said.

Ramsey County's lease agreement for 110,000 square feet of space at Bethesda starts Dec. 1. Fairview is charging the county $1 per square foot a year for rent, with the remainder going toward utilities and operational costs.

On Monday, the Minnesota Nurses Association expressed its displeasure about the hospital closure and delivered a list of demands to the County Board, including adequate security for the neighborhood.

Commissioners emphasized that they weren't part of Fairview's decision to shutter Bethesda. Reinhardt said she'd like Fairview to report on the status of jobs and services in the community, but acknowledged that was not part of the lease.

"Fairview's commitment to the health of Ramsey County remains strong," Fairview said in a statement. "Our dedicated COVID-19 care center, currently located within Bethesda Hospital, will move to nearby St. Joseph's Hospital and will house our COVID-19 cohorting care for as long as community need requires."

Fairview said that St. Joseph's will continue to house its mental health inpatient beds and that it will continue to serve the east metro area through St. John's Hospital in Maplewood, Woodwinds Hospital in Woodbury and in several clinics and programs in St. Paul and around the east metro.

Shannon Prather • 651-925-5037