Jefferson County Proposes to Establish a Health Care Authority Over Indigent Care

Jefferson County Commissioner Sandra Little Brown (Source: Solomon Crenshaw Jr.)

Jan. 25, 2018 – The Jefferson County Commission today authorized the county manager to begin discussions with the University of Alabama at Birmingham about establishing a health care authority to operate Cooper Green Mercy Health Services.

The move came in response to a consultant’s report that recommended building a new building for multispecialty outpatient service clinics and entering a partnership with a healthcare authority to make more decisions about how indigent care is handled in the county.

“The challenges are we have an old building and we have an operating model that is still essentially a remnant of an in-patient facility,” said Tony Fiori, managing director of Manatt, Phelps and Phillips. The county hired Manatt Health, a division of that firm, to study health care for indigent and low-income residents.

“We need to bring the facility and bring the operation into ambulatory care in a multi-specialty group practice model. We can’t continue to operate in an in-patient staffing structure and an in-patient facility,” Fiori said.

The Manatt report recommended that:

  • The county build a new facility with multispecialty outpatient service clinics.
  • The county enter a medical and administrative services agreement with a UAB-established University Health Authority to operate the new outpatient care center.
  • The authority convert the indigent health care operation into a multi-specialty group practice with comprehensive primary and specialty care services. This would be at the proposed new facility.
  • The county optimize the use of the $50 million Indigent Care Fund by paying the authority on a per-person basis rather than per-claim.
  • The authority change existing contracts with other Jefferson County providers to reflect a highly integrated, primary care-based managed care model for indigent clients.

After hearing the report during a commission meeting at the Bessemer Courthouse, commissioners authorized county manager Tony Petelos to begin discussions with UAB about establishing a University Health Authority.

During his presentation, Fiori told commissioners they had made “the right decision” several years ago to shift to outpatient care at Cooper Green.

“We’re putting our indigent care first,” Commission President Jimmie Stephens said. “This gives us a plan, a vision for the future. And it gives us options we haven’t had.”

Said Commissioner Sandra Little Brown: “We are not doctors. We are not experts in hospital care, so I think it would be a great idea to put it under the people who have that expertise.

“We want to make sure life is better,” Brown continued. “We want to make sure there is better health care for the indigent.”

Petelos said Manatt liked the plan the county had for demolishing part of the parking deck at the current Cooper Green building and using that space to build a new, county-owned ambulatory care facility. That plan would allow patients to be seen at the current location until operations move to the new facility.

A “for sale” sign would go up at the current Cooper Green building when that move is made.

Petelos said that, while a healthcare authority would manage the programs, doctors and care in the new facility, Jefferson County would not abandon the health care operation.

“We’re still going to be involved,” he said. “A health care authority does make sense. I think the Manatt report states that.”

Petelos and deputy county manager Walter Jackson said a new facility could open the door to Cooper Green serving not just indigent clients, but also the general population and, Petelos said, “have paying customers.”

“In a newer facility, it will be much easier to attract more of the paying customers,” the county manager said.