CHICAGO -- The Cook County, IIL, board Of commissioners on Wednesday approved a ply, to build a $642 million bond-financed county hospital to replace an aging institution on Chicago's west side.

The 14-to-3 vote sends the plan to the Illinois Health Facilities Planning Board, which must endorse all public hospital constraction projects costing more than $2.5 million.

Board commissioners who supported the plan said the new hospital will save the

county money while improving the quality of health care. Opponents contended that the county should not commit to building a hospital until Congress hammers out a national health care reform plan.

Richard Phelan, president of the county board, said the state planning board could consider the hospital plan in September. The 14-to-3 county board vote, he said, sends a strong message to the planning board, whose members were apllointed by Republican Gov. Jim Edgar. Phelan is a Democrat.

"When you look at where the votes came from, it should be very persuasive on the Illinois Health Facilities Planning Board," Phelan said. Four of the six Republican-county commissioners supported the plan, he said.

Woods Bowman, the county's chief financial officer, said that the $642 million of debt, which is expected to be issued as general Obligation bonds, will be sold in six annual installments if the health facilities planning board approves the plan. The first installment could be sold as early as next year, Bowman said.

The $642 million of bond proceeds would finance construction af a 464bed hospital, which would replace an existing 930-bed facility. About $72 million of the $642 million price tag accounts for capitalized interest and inflation over the six years needed to complete the project, county officials said.

Including financing and debt service costs, the county could end up paying about $1.5 billion for the six-year project, Bowman said.

Bowman said that a "modest" tax increase may be needed to support debt service on the new bonds. However, he said, most of the. bonds will be paid off with existing property tax revenues, as old bonds are retired.

Though the board's approval of the new hospital fulfills a campaign promise-Phelan made in 1990 when he ran for county board president, he will not be in office to oversee its development. Phelan, who lost a bid to become the Illinois Democratic gubernatorial candidate in March, did not seek re-election for the county board president seat so he could run for governor.

If the planning facilities board approves the hospital plan, financial and architectural details will be worked out after the November election, Phelan said.

County commissioner John Stroger, who won the Democratic nomination for Cook County board president, said he would complete Phelan's vision for a new hospital.

In a statement, Joseph A. Morris, Stroger's Republican opponent in the November election, said that he would not support a new hospital for the county if he is elected.

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