The leader of the board that oversees HCMC stepped down Friday, after tensions over comments she made singling out Somali immigrants as a cause of the medical center's budget challenges became public.

Babette Apland, who led the Hennepin Healthcare Board of Directors, previously acknowledged the comments she made during the closed portion of an August budget meeting were wrong and harmful. She said she apologized and wanted to learn from her mistake.

Hospital officials said Friday evening that Apland has stepped down. Board Member Mohamed Omar will serve as interim chair.

County Board Chair Irene Fernando and Commissioners Angela Conley and Debbie Goettel had previously admonished Apland, calling her comments hurtful, racist and xenophobic. Fernando and Conley said her apology and hospital leaders' reaction was insufficient.

"I don't feel like she is in a position to continue to be chair, until some major work is done," Conley said Tuesday. "You can't apologize for racism. You got to get that out of your system. Until I see that work being done, it doesn't hold any weight."

Apland's comments came during the nonpublic portion of the August 8 joint meeting with the County Board and hospital leaders, when finances and other issues were discussed. After the meeting, Apland sent emails to commissioners and later to staffers apologizing for blaming the Somali population for the rise in uncompensated care costs.

"Ironically, I meant it as a point of pride, that we are taking care of our community; that was what was in my heart and mind," Apland said Tuesday in an interview. "But I apologize for saying it. I'm truly committed to learning from this experience and gaining greater cultural sensitivity."

The County Board declared racism a public health crisis in 2020 to ensure HCMC "holds values, presents data, and engages in decisions that are not contrary or harmful to our missions," Fernando said in a statement. Suggestions that "immigrants are a burden on our healthcare system are inaccurate, and such misinformation causes harm and results in unsafe environments for workers, patients, and their families," Fernando's statement said.

In a separate statement, Goettel agreed. "Targeting the Somali community for a broad set of economic challenges that face the medical industry right now is not only ignorant and hurtful," she said, "but it's a distraction from the important work we do daily as a safety net hospital to offer the highest level of care for all people, including our immigrant neighbors."

In an email to hospital leaders obtained through a public records request, Fernando, who also sits on HCMC's board, questioned whether hospital staffers played a role in characterizing new immigrants' impact on HCMC's budget.

HCMC CEO Jennifer DeCubellis said management does not negatively characterize the community the hospital serves and that Apland's comments were intended to provide context about why HCMC needs county help paying for uncompensated care.

Hospital officials noted that all employees are required to take antiracism training. Similar training is available to board members, but not required.

"We are doubling down to say our job as the safety net hospital is to get racism out of health care and that means all of us doing our part," DeCubellis said.

Tension over finances and oversight

As the county's safety net hospital, HCMC treats all members of the community, regardless of their ability to pay. It receives a taxpayer subsidy from Hennepin County to help cover the cost of uncompensated care.

The latest clash between the County Board and hospital leadership comes at an important time. Both entities are in the process of crafting budgets for 2025.

County Administrator David Hough proposed a budget Tuesday that would increase the property tax levy by 5.5% to raise roughly $55 million in new money. About $10 million would be dedicated to uncompensated care at HCMC, increasing the taxpayer subsidy of the hospital to $38 million a year.

County and hospital leaders are also preparing to again ask the Legislature to convert the 0.15% sales tax that helped fund Target Field to focus future proceeds on hospital expenses. Hennepin County's sales tax raises about $54 million a year and under the plan, $40 million would be dedicated to hospitals, $10 million to stadium upkeep and $4 million to youth sports and libraries.

County leaders said this summer that mixed signals about the future of HCMC's governance doomed the effort to convert the tax. If lawmakers don't act, the tax will sunset next year when the stadium construction debt is repaid.

Also Tuesday, Commissioner Heather Edelson proposed developing a protocol if the County Board ever chose to dissolve the board that oversees HCMC, an idea that was met with skepticism from most of the board.

Hennepin County created Hennepin Healthcare in 2007 to run HCMC and its other clinics as a public benefit corporation, a type of nonprofit. Previously, the hospital was a county department.

Commissioners have not signaled any intent to eliminate Hennepin Healthcare. But the idea upset doctors and state lawmakers when unionized hospital workers suggested it earlier this year.

Union members called for the County Board to reassert control over HCMC because they said rising insurance costs and safety concerns were making it hard to recruit and retain nurses and other workers.

Hospital leaders have downplayed those claims, saying benefits were among the best in the region and work was being done to address safety and other workplace concerns.

In response to workers' concerns, commissioners added increased oversight of the health system as part of its 2024 budget. County officials have also spent much of this year probing the organization's finances and operations.