A widely supported program to create 1,000 mostly entry-level jobs at Johns Hopkins and other local hospitals was dealt a blow Wednesday when state regulators recommended against letting the facilities raise their prices to fund it.
Administrators at Hopkins and other hospitals conceived the program to address the hopelessness expressed by many in Baltimore's toughest neighborhoods during the unrest of April.
But staff members of the Health Services Cost Review Commission, which controls what hospitals charge for services, expressed reservations about passing on the $40 million cost to public and private insurers.
"All parties have acknowledged the importance of jobs in reducing economic disparities," the commission's staff wrote in a preliminary report. "However, there are critical differences in thinking about how creating job opportunities should be addressed and who should provide the funding for the job creation."
The proposal, introduced in September, set up a conflict between activists, politicians and hospitals, led by Hopkins, and government and private insurers, led by CareFirst BlueCross BlueShield, the state's dominant carrier.
Those who would benefit from the new jobs and their backers flooded the commission hearing room Wednesday to show support for the proposal. They expressed disappointment at the recommendations, which called for diverting existing funding or seeking outside sources instead of raising rates.
Antoine Smith, who said he grew up in public housing in Baltimore, is a certified nursing assistant who is studying to be a nurse. But after what he described as a minor brush with the law — he says he was charged with resisting arrest — he fears when he's ready for the new job, he will be passed over.
That's a common problem in the toughest city communities, from which the program aimed to hire.
"And what if you don't have any training at all?" he said. "If not for me, I want someone else to be able to get a job."
Smith joined a group from the interfaith community organization Baltimoreans United in Leadership Development, or BUILD, in calling on insurers and regulators to sit down with them to compromise on funding or help identify other means of launching the jobs program.
Supporters said the funding requirements were modest, at about $40,000 per job created, to pay for training, benefits and salaries likely starting at $13 to $15 an hour.
The positions are crucial to lifting up poor neighborhoods, many of which are in the center of the worst crime wave in years, said the Rev. Glenna Huber, a BUILD co-chair.
The unemployment rate in some neighborhoods reaches 17 percent — more than twice the citywide rate of 7.4 percent, and three times the statewide rate of 4.9 percent.
Some of the new hospital positions would be for community health workers to help connect residents with needed care.
Just having a job can improve a person's own physical and mental well being, Huber said. And jobs generally could reduce crime.
"If you walk down the street and ask the men dealing drugs what would get them off the streets, they say if they had a job and could support their families, they wouldn't be there," she said. "Without viable economic opportunities, people create their own."
The Health Services Cost Review Commission sets rates for all the state's hospitals each year under a unique system set up with federal regulators.
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Hopkins has already used money within its budget to hire 130 disadvantaged people, including some ex-offenders, for new positions. But without permission to bump up rates, a spokeswoman said, the broader jobs program is in jeopardy.
The "recommendations fall significantly short of the overall goal intended by the Health Opportunity Job Program, which is to create 1,000 new jobs targeted at disadvantaged communities," Hopkins spokeswoman Kim Hoppe said in a statement. "Without new and permanent funding, there will be no opportunity to fill the need that our community so desperately needs."
CareFirst declined to comment Wednesday, but the League of Life and Health Insurers of Maryland said the commission was right to consider the financial burden of increasing hospital rates.
"The league supports the concept of this initiative, which is intended to improve community health while addressing long-standing economic issues, however, we cannot support the proposed initial funding arrangement which would increase hospital rates by $40 million, through new permanent funding," said Kimberly Y. Robinson, executive director of the trade association.
"Every additional increase in hospital rates has a direct impact on premiums paid by individuals and employers in the state of Maryland," she said. "The staff proposal seeks to balance the community need with the financial implications to purchasers and payers by redeployingexisting funds to meet this need."
The commission board is expected to vote on the recommendations in December. The commission continues to accept public comment.