2004 State of the County Address
Hennepin County Board Chair Randy Johnson
Hennepin County Medical Center, Minneapolis
March 10, 2004
Welcome and introductions
Welcome to Hennepin County’s annual State of the County Address.
We are pleased to see so many people here with different backgrounds and interests . . . business and labor, health care, not-for-profit agencies, the academic community, Hennepin staff, concerned citizens – and, of course, the property taxpayers who fund one-third of Hennepin’s budget.
I especially want to recognize those people who hold elected office. Would all of the local and other elected officials please stand so we can recognize your service and contributions to our communities?
I also want to thank our county staff, led by County Administrator Sandy Vargas and Deputy Administrator Richard Johnson. Our nearly 11,000 employees work hard every day to make Hennepin County a better place for all of us.
And, a big thank you to Jeff Spartz, the administrator of Hennepin County Medical Center . . . and Dr. Michael Belzer, HCMC’s medical director, our hosts here today.
I would like to introduce you to my colleagues on the County Board and our other elected county officials.
The 1st District Commissioner is Mike Opat, who represents the northwest corner of Minneapolis and the north suburban area. He received a master’s degree from Harvard University’s Kennedy School of Government . . . and is the only commissioner who has been a county employee – as a supervisor at the Adult Corrections Facility – prior to his election.
2nd District Commissioner Mark Stenglein is the vice chair of the County Board. Mark represents parts of north and northeast Minneapolis and some western suburbs. His background is in private business, and he has a master’s degree in international management from the University of St. Thomas.
The 3rd District Commissioner is Gail Dorfman, who represents southwest Minneapolis and the City of St. Louis Park, where she served as mayor for four years. She received a master’s degree from the Kennedy School of Government at Harvard University.
4th District Commissioner Peter McLaughlin represents the southeast portion of Minneapolis and Fort Snelling. He received a master’s degree from the Humphrey Institute of Public Affairs at the University of Minnesota . . . and he is a former state legislator.
6th District Commissioner Linda Koblick represents the southwestern part of the county. She is a graduate of the University of Minnesota . . . and she served eight years on the Minnetonka City Council and prior to that four years on the Minnetonka City Planning Commission.
The 7th District Commissioner is Penny Steele, who lives in Maple Grove and represents the far western area of the county. She graduated from St. Olaf College and has taught music.
Our Hennepin County Attorney is Amy Klobuchar. She graduated from the University of Chicago Law School and practiced with the Dorsey and Whitney and Gray, Plant and Moody law firms before being elected in 1998. She serves as the chief prosecutor of adult felony and juvenile crimes in the county, and is responsible for providing legal counsel to the County Board and county departments.
The Sheriff of Hennepin County is Patrick McGowan – the chief law enforcement officer in the county. Sheriff McGowan was formerly a Minneapolis police detective and a Minnesota state senator.
And, Kevin Burke is the chief judge of Hennepin County District Court. He recently received the prestigious 2003 William H. Rehnquist Award for
Judicial Excellence from the National Center for State Courts. Kevin graduated from the University of Minnesota Law School in the class one year after me – that was probably the last time I managed to do anything ahead of Kevin!
Hennepin’s elected leaders reflect a wide range of political beliefs, Republican and Democrat, liberal and conservative, and we disagree on a lot of issues. What we share is a strong belief in the importance of education and a commitment to provide for public safety and improve our quality of life.
This is my fifth State of the County message as chair of the Hennepin County Board. And, (this is probably the only certain “applause line” today), I promise that this State of the County Address will be the simplest and the shortest ever!
Hennepin has nearly 30 different lines of business, and they are all important. Today, however, I want to focus on our finances, health care, public safety and technology
Hennepin's financial condition
Hennepin County today is financially sound. We fully expect to retain our top triple-A bond rating for our next bond issue. Only 20 other of the nation’s 3,100 counties have the top triple-A bond rating from all three rating agencies. That top rating indicates not only Hennepin County’s strong economic base and our ability to pay our bonded indebtedness, but it also reflects very sound financial management.
Although most of us do not eagerly embrace the thought of big government, the fact is that 1.1 million people live in Hennepin County – nearly one quarter of Minnesota’s population. Hennepin also is – by far -- the largest unit of local government with $108 billion in assessed valuation . . . an annual budget of $1.7 billion . . . and almost 11,000 employees. That makes Hennepin a larger operation than nearly a dozen states.
While Hennepin County can engage only in activities that are mandated or authorized by the state and federal governments, our responsibilities are wide-ranging. As former Commissioner John Derus put it, "Hennepin County does literally everything from brain surgery to ditch digging.” That includes health care, law enforcement, courts, transportation, solid-waste management, suburban libraries, licensing and records, and a variety of human services.
At Hennepin County, we take very seriously our role as stewards of the public’s assets . . . made even more difficult in light of the $100 million in state reductions that were handed down to us in 2003 and 2004.
We recently finished the most difficult budget session in my 25 years on the County Board. It is the first time I can remember the budget and property tax levy passing with the support of only four commissioners . . . I voted for the budget, but I have not been shy about pointing out that I did not like a lot of what I believed we were forced to do.
Hennepin’s 2004 budget is actually 3.43 percent less than in 2003 . . . while our net property tax levy is up only 2.1 percent – the smallest increase in the past decade. We have 750 fewer fulltime equivalent employees now than 16 months ago. Nevertheless, the county’s share of property taxes on the average valued home went up 6 percent because of changes in state law shifting taxes from commercial and industrial property to residential . . . and because our property values are increasing so rapidly.
Hennepin is going to continue to face huge challenges involving money. This means that we are going to have to find ways of working even smarter . . . and make the hard decisions about which services are most important to our residents.
Many Hennepin programs are recognized as the very best in the United States. Some are basic to survival. Others enhance the quality of life here . . .which is often ranked at the top -- or near the top -- in the nation.
There are many reasons why this cold, flat place on the prairie – Hennepin County and our metro region – continues to grow and prosper, and clearly be the dominant Upper Midwest economic center of the North American continent.
The high quality of programs, services and opportunities provided by Hennepin County contributes to making this the place where people choose to live and work. Here in Hennepin County and our metropolitan region, our predecessors made the commitments and investments that today make this place different from Omaha . . . Des Moines . . . Sioux Falls . . . and Fargo. Those are all fine places, but I see very few young people eagerly seeking to move from here to there. The brain drain is in our direction.
The future of Hennepin County Medical Center
While Hennepin County overall is financially sound, I have special concerns about Hennepin County Medical Center – Hennepin’s largest single business.
Over the past 10 years, Hennepin Board chairs have sometimes selected various venues for this State of the County address because they wanted to highlight particular programs. We have been to Harvest Preparatory Academy, General Mills, Minneapolis South High School, the Mall of America, Normandale Community College.
I selected HCMC because I want to emphasize my absolute commitment to the mission of HCMC: recruit and train the nation’s top medical talent and entice them to stay in Minnesota . . . and provide quality medical care for all, regardless of their finances -- and do this at a reasonable cost to Hennepin County property taxpayers.
I represent Bloomington, Eden Prairie and Richfield . . . and some people in the suburbs still ask me why I am such an outspoken supporter of the hospital that they think is only for poor people from the inner city.
The fact is that HCMC is truly a world-class hospital . . . with a world-class staff. HCMC is one of the premier teaching and research hospitals in the United States. It is Minnesota’s first Level One Trauma Center. U.S. News & World Report ranked HCMC as one of the nation’s best hospitals for the sixth straight year. It attracts and trains some of the top medical talent – doctors and other health professionals – in the world. And those health professionals, once they make it through their second Minnesota winter, tend to decide to stay here – and we all benefit.
HCMC is Minnesota’s largest public hospital . . . a nationally known center for newborn intensive care . . . pediatrics . . . cardiology . . . oncology. . . trauma . . . diabetes care . . . hyperbaric medicine . . . and burn treatment . . . according to benchmark studies and publications.
HCMC’s Emergency Department is the most active ER in the state . . . with 100,000 urgent or emergency patient visits and 50,000 ambulance runs each year. Half of the state’s doctors received at least part of their training here.
And, although HCMC is the state’s largest provider of care to the indigent . . . it derives 95 percent of its revenue from patients and insurance companies . . . and is truly the hospital of choice for a majority of its patients.
The Minneapolis Medical Research Foundation is the research arm of HCMC. The third-largest nonprofit medical research organization in Minnesota, the foundation ranks in the top 10 percent of all institutions receiving research funding from the National Institutes of Health. Working in the academic environment here at HCMC, the foundation emphasizes patient care, research and teaching that will offer patients better care now and hope for improved health care for all in the future.
We must ensure that this world-class hospital remains viable in today’s competitive health-care market . . . providing the highest quality of care for all of our residents, including those who cannot afford it. We must make sure that HCMC is stable . . . and providing opportunities for our very talented staff and employees.
HCMC is not just a challenge or burden for the county to bear. Instead, it is an asset for all of us – even if we do not use HCMC as a primary source of health care.
The women and men who work at the medical center are the backbone of our operation. They and their representatives are and must be full partners toward a long-term solution to how we keep HCMC viable. Together, we can move to find the right solution – one that works for those who receive care, those who provide care, and for Hennepin taxpayers.
In order to help chart the future course of HCMC, the County Board last year -- at the urging of Commissioner Mike Opat -- appointed a governance task force. With the leadership of Irv Weiser, the retired CEO of Dain Rauscher – and an HCMC patient by choice . . . the task force recommended that HCMC could better meet its unique mission under a different governance structure than the County Board.
While the county would retain ownership, the task force identified the need for a governing board and structure similar to those that oversee other hospitals in the region. This new board would oversee a hospital operation that positions HCMC as a provider of choice and ensure that the hospital remains an employer of choice as well.
Changes are coming in how medical care is delivered in our nation and in our community. Decisions are not going to be popular or easy, but we need to make them before far more onerous choices are forced upon us.
I am recommending that the County Board appoint an implementation advisory board to address key considerations that are essential to any governance change. Irv Weiser has agreed to lead this group to make detailed recommendations to the County Board. I expect the County Board will vote on this important governance decision this fall, after the opportunity for public hearing and input.
The overall goal is to enable HCMC to continue as one of America’s best hospitals and retain its top-flight staff . . . while increasing revenues and reducing costs . . . so we can continue the historic mission of HCMC.
This is very important. I want to assure the employees and staff of HCMC that whatever we do about governance, it will not reduce pension benefits. I will not support – and I am sure no commissioner will support – any change in the value of pension benefits assured by the Public Employees Retirement Association for all current employees.
It also is imperative that adequate state and federal funding be made available to safety-net institutions such as HCMC . . . which serves patients from every one of the 87 counties in the state.
If the state and federal governments continue to cut millions of dollars for indigent care, HCMC may have to explore options that have been considered and implemented in other states and by other safety net hospitals. Options include volume-driven uncompensated care formulas . . . or more restrictive admission and treatment policies for persons living outside Hennepin County.
Of course, we will abide by state and federal law for anyone who presents acute symptoms, but we cannot continue to carry out our core mission to the people who live and work and pay taxes in Hennepin County . . . if we provide extended health care for everyone from anywhere, without sufficient reimbursement.
One more thought about HCMC and the future and affordability of medical care. If we look at where our national, state and local news media have devoted so much of their attention for the past four months . . . we would have to conclude that going to Canada for prescription drugs would solve most of our health care problems in Minnesota.
While a majority of our Board, including me, supported Governor Pawlenty’s “Canadian Meds” Web page for health care in Minnesota, that is not a solution . . . or even a strategy to deal with health care needs in Minnesota. It is, at most, a tactic to question why our nation – among the 30 or more affluent nations – should bear such a disproportionate share of the research and development costs of new medicines. A problem here is that the fixation on less expensive Canadian drugs diverts attention from the much more important and complex health care decisions before us.
Hennepin’s relationship with the University of Minnesota
Hennepin has a rich history of working with the University of Minnesota, one of our nation’s great land grant universities, dating back more than a century.
The university is an outstanding research institution . . . a major economic engine for the state and region . . . with potential to do much more.
Hennepin’s initial relationship centered on the Extension Service, the university’s outreach arm that provides crop, livestock and home economics information to the people of Hennepin County.
Hennepin County Medical Center has had strong ties to the university for many years. HCMC was the first teaching hospital in the state associated with the university’s Medical School. Today, more than 160 University of Minnesota residents and medical students are here every day for clinical experience. And, all fulltime faculty at HCMC who teach residents and students -- virtually all of the 275 Hennepin Faculty Associate members -- have academic appointments at the university Medical School and are members of the Medical School’s teaching faculty.
Hennepin also has informal ties with the university’s Humphrey Institute of Public Affairs, the Law School and the Carlson School of Management.
I believe that Hennepin should work even more closely with the University of Minnesota.
It is time that the county and university expand on these and other programs by creating a full-time position to link services within all county departments to the resources of all of the schools within the university. It simply makes sense to join the massive resources of the university with the largest county in the state. This approach holds great promise for both institutions.
Commissioner Linda Koblick has initiated expanding our partnership with the university, and I have asked her to continue this work with President Robert Bruininks and Vice President Sandra Gardebring.
Public safety and homeland security
Another challenge . . . especially in the wake of the 9-11 terrorist attacks . . . is public safety and homeland security.
Many county operations – including the Sheriff’s Office, Emergency Preparedness, HCMC and Community Health – are working together, and with other jurisdictions, to ensure the safety of our citizens.
For example, staff from Community Health and Emergency Preparedness, Sheriff’s officers, firefighters, hospital worker, FBI agents and others have participated in mock terrorist drills to test emergency procedures. The most recent exercise was the week-long “Operation Snowball Two” in late February.
While the popular news media attention has been on exotic attacks, here in Hennepin, we have moved to an “all hazards/all incidents” approach to public safety . . . what we plan to do in case of a flood or tornado, and if applicable, for a terrorist attack with weapons of mass destruction.
Most of our emergency preparedness is important but a little mundane. Drills . . . practice . . . exercises . . . they are all key to public safety and security. In July, we will have the first full-scale evacuation of the Hennepin County Government Center in a decade. We will plan as well as we can, but the purpose of the drill is to learn our weaknesses . . . so we can do well if ever we face a real threat.
One example of our changing world and the role of county government and law enforcement is the formation of a Homeland Security Unit by Hennepin County Sheriff Pat McGowan. The new unit is a unique, multi-purpose group that will coordinate preparedness for a number of situations.
Coordinated, trained and contained within the unit will be a new, multi-agency tactical team, trained and equipped to respond to various weapons of mass destruction events. The group will also coordinate the activities of the Sheriff’s Office Emergency Services Unit and direct the Sheriff’s Office response to large events such as major sporting events, community celebrations or civil disruptions. The unit will seek funding through state and federal grant monies to provide Hennepin County regional preparedness for homeland security situations.
I had hoped that by now the County Board would have considered the report of the Building Security Committee chaired by John Stanoch. As that committee soon learned, these issues are complex, and we expect their report next week. I will wait for the report, but my initial response is different from what I thought two years ago. Instead of airport-style weapons screening at both Government Center towers, I think we can spend the same or less money more effectively using security cameras and other technology.
Another aspect of homeland security is our preparedness for bio-terrorism. Recent local and national bioterrorism drills indicate that America’s hospitals are not prepared to deal with the large number of casualties that emergencies might generate.
Hennepin County Medical Center is the designated regional hospital resource center for the Twin Cites area. Under HCMC’s leadership, the medical community is working closely with disaster preparedness officials at the state, county and municipal levels to identify current weaknesses in the emergency-care infrastructure within the region . . . and then plan accordingly.
For example, of the 4,000 hospital beds in the metro area, only 275 beds could be made available within the first 24 hours of a disaster to accommodate a sudden surge of casualties. The preferred approach to managing a sudden influx of patients is to treat those needing care within the walls of current hospitals.
If casualty figures number in the thousands, however . . . or in instances where large numbers of patients with an infectious disease need to be isolated . . . the community will need an off-site facility to serve as an alternative hospital. Emergency preparedness officials are currently working to identify regional sites for an off-site facility that could also be used as a large-scale shelter if a disaster displaces thousands of our residents.
A sudden surge of patients would increase demand for supplies and equipment far beyond the normal capacity of our regional health care system. Grant money has been distributed to area hospitals for medical supplies to support hospital preparedness. HCMC and its research affiliate, the Minneapolis Medical Research Foundation, continue to work with local businesses to acquire supplies to increase our surge capacity.
Hennepin also is looking for health professionals to serve in our new Medical Reserve Corps -- part of a national initiative to mobilize and coordinate communities so they can better respond to public-health emergencies of all kinds, including terrorism.
Needed are practicing or retired epidemiologists, health educators, physicians, nurses, pharmacists, dentists, respiratory therapists, social workers and interpreters. If you are interested in volunteering, or know of people who might be, please visit the Medical Reserve Corps’ Web site at www.mrc-hennepin.org.
Many of you know that I am a strong supporter of technology
Technology has played a prominent role throughout the history of Hennepin County. In some areas, Hennepin is world class. In others, we are not utilizing technology as fully as we can.
Hennepin County is . . . by definition . . . a “place-based” entity. Geographic Information Systems, or GIS, computer mapping can provide the tools to analyze and display location-based information, including population demographics, economic and market-development opportunities, human services needs, and trends in criminal activity. This technology has tremendous implications for strategic planning, budget analysis, planning Hennepin’s many services in the field, and other activities.
I have a long-standing challenge to county staff and the public: “If you can find a function in Hennepin County government that does not use . . . or could not be improved by using . . . GIS technology – I will buy you a free lunch.”
We are reorganizing many different GIS systems in Hennepin County under Pat O’Connor, our director of Taxpayer Services, who has appointed Scott Simmer – on a mobility transfer – to head this effort.
We have had some impressive successes in implementing new technology in Hennepin County. Let me mention several of them.
Adult foster care licensing, working with Hennepin’s IT Department, created a mobile office information system with hand-held technology (hold up RJ’s PDA). Our workers now have a hand-held electronic briefcase that contains address and datebook information and full reference material for licensing functions. This synchronizes with desktop computer applications so that data needs to be entered only once. We believe that this is a “first in the nation” software application, and it saves us time and money.
In the County Recorder’s Office, all paper certificates have been converted to electronic format. All processing is completely computerized. The time it took to enter a document into the official record was as long as 400 days. Now, even with the highest volume of recordings in history, that 400-day time period has been reduced to just 22 days. The next goal is to pilot the first electronic submission of real estate documents.
And, our suburban Library System continues to surge in use – with nearly 12 million items borrowed last year – and more than three million searches at the library’s electronic data bases. Self-service, computerized check-out has freed up librarians’ time to devote to professional services.
We will need to continue to implement technology aggressively as we open the new Brookdale Library on May 6th and the new Eden Prairie Library this fall. That means that we will have four libraries providing service seven days a week during the school year and six days a week in the summer.
An important part of “working smarter” by using technology is Hennepin’s implementation of the Balanced Scorecard management system. Moving to meaningful electronic measure of performance on a real time basis will enable managers to manage much more efficiently. And it will force us to set priorities as we continually ask ourselves, “What are we really trying to accomplish here?”
We must continue to invest in technology hardware and software . . . and we also need to continue to re-emphasize education and training for our most important and valuable resource – our employees.
I want to mention two projects in which Hennepin is a major player – Hiawatha light rail transit and our proposal for a new Twins baseball park.
The Hennepin County Regional Railroad Authority has been a major force in making light rail transit a reality in the Twin Cities, with the strong advocacy of Commissioner Peter McLaughlin. Minnesota’s first modern LRT line – the Hiawatha line – is scheduled to begin carrying passengers from downtown Minneapolis to Fort Snelling soon. Service to Minneapolis/St. Paul International Airport and the Mall of America in Bloomington will follow after January 1st.
LRT will provide a new transportation option for many citizens as it will serve several large employment centers along its 12-mile route . . . including this hospital, with the Metrodome station located only a block away.
I want to say something more about transit. I do not know any more about the Metro Transit bus drivers strike than what I read in the local newspapers, so I am not going to venture into whether the employer’s offer is fair or whether the union is reasonable in its demands. What I will say is that when left-wing groups make screwball claims, I like to make fun of them. So, equal treatment to the right-wing screwball assertion like the one that the transit drivers strike somehow “proves” we don’t need transit from the Taxpayers League.
Hennepin County staff worked hard – very hard and creatively – to deal with no transit as it affects our employees and clients. The solution is temporary and very fragile.
The most bizarre -- news of the weird – policy idea came from the Taxpayers League when they suggested diverting transit funds to used cars for the poor. OK, Taxpayers League, watch what happens when the blind, teenagers and the severely disabled show up to drive used cars!
New Twins ballpark
At the invitation of the Governor, Hennepin is a partner with the City of Minneapolis in what is clearly the best proposal for a new Twins ballpark -- in the historic Warehouse District of Minneapolis. Ours is a sensible and fiscally sound plan. We believe that Hennepin County provides the most solid, dependable financial base possible – and the only one – that can make the ballpark a reality quickly and at much less cost to the public.
If a large amount of public funding is to go into a ballpark to be owned by the public, it must be built in the right way in the right place. The Twins have agreed in principle that upon a sale of the team, the increased value of the club . . . because of a new stadium . . . will be shared with the public.
Commissioner Mike Opat is leading our ballpark effort. The next step is up the Governor and Legislature.
In conclusion, Hennepin County today is in good shape. Hennepin continues to be a county where people choose to live and work.
One of our most pressing challenges is ensuring the viability of our world-class hospital. Traffic congestion is growing. The demand for almost every one of Hennepin County’s services is increasing. The state, no doubt, will continue to visit its financial problems upon us.
We will meet these challenges. Hennepin has survived many difficult times since it organized as a county 152 years ago. But, like the people who lived here before us . . . we will make the difficult decisions, and we will try to continue to be long-term thinkers.
As I have said before, we want to be sure that when our children and grand children look back on our decisions, they say, “Mom and Dad, Grandma and Grandpa, did pretty well in meeting the challenges of their time . . . and we’re glad to live in Hennepin County.