Jefferson County commissioners debated Tuesday whether a UAB-run health authority should take over the management of Cooper Green Mercy Health Services.

A county commission committee voted 3-2 to move the issue to Thursday’s agenda to ratify the vote.

Cooper Green, a county-owned health center which provides indigent healthcare services, stopped its inpatient hospital services in 2012. Currently, outpatient clinics operate in the building like Alabama Regional Medical Services, along with an urgent-care facility.

The UAB University Healthcare Authority would follow the provisions set out in a 2016 state law enabling universities with medical schools to create University Health Authorities. The commission’s proposal would mean the county would engage with UAB to create a healthcare authority and allow UAB to handle the management of the facility and the care of Cooper Green’s patients.

The authority would mean UAB assumes the risks of cost overages, that UAB and Cooper Green would share costs for lab work and pharmacy operations, that UAB would implement its IT system, and that UAB would have the advantages of a purchasing operation.

Currently, Cooper Green uses the Indigent Care Fund to operate, which is a fund derived from the county’s general sales and use tax and the county’s alcoholic beverage tax. In 2017, Cooper Green’s expenditures were over $7 million more than its revenues, according to Jefferson County Commission Chief Financial Officer John Henry. The center also has to follow the county’s operating structure. The authority would control how the indigent care funds were allocated and used.

According to commissioners who support the authority taking over the center, the model would allow Cooper Green to run more efficiently and UAB would bear the responsibility for Cooper Green’s patients and for the cost.

Of the seven members on the health authority’s board, three would be chosen by the county commission and four would be chosen by UAB. No elected officials, including commissioners, would be allowed to sit on the board.

Commissioners Sheila Tyson and Lashunda Scales voiced their opposition to the agreement. Tyson said the law allowing such partnerships was written specifically for UAB and that by creating an authority, UAB would have total control over the hospital.

Tyson said the commission, Cooper Green employees, and patients would have “no voice” in decisions made regarding the center, and that there would be no measures in place to protect those people.

The county attorney, who was present at the meeting, said the agreement was specifically set up for UAB to be able to take control of the center and manage daily operations, and determine how to best use its budget.

Commission President Jimmie Stephens said the “bottom line” is patient treatment. “Are we doing our indigents good care?”

Scales said she visited Cooper Green last week and called the situation “pure hopelessness” and said in addition to a dilapidated facility, employees’ morale is low. Scales, visibly emotional, she is worried the agreement could send the county into bankruptcy or startle liability issues.

Commissioner Joe Knight said UAB has always provided specialty care for Cooper Green patients, even when the hospital’s inpatient facility was still operating. Partnering with the university system was always “in the back of [our] mind,” he said. Allowing UAB to take over would mean giving patients world-class care and giving the “very best we can to those who need it the most,” he said. “UAB is not going to put their reputation on the line to fail.”

Knight continued, “Since I’ve been here eight-and-a-half years, we’ve never really had control of Cooper Green. Not really, not this commission.”

Commissioner Steve Ammons, Knight, and Stephens voted to send the issue to Thursday’s agenda.