A private specialty hospital at the Southern Indiana Medical Park II, proposed by Dr. Kamal Tiwari, sparked a six-hour meeting by the Bloomington City Council Wednesday that ended in a straw vote against the plan.

In the end, five council members voted early Thursday morning against Tiwari's plan to create a for-profit inpatient facility on the city's southwest side. The other four passed on the preliminary vote taken at 1:30 a.m.

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Those voting no were : David Sabbagh, Mike Diekhoff, Chris Sturbaum, Chris Gaal and Tim Mayer.

"I think it was the beginning of a powerful statement," said Dr. Owen Slaughter, chief of the medical staff at Bloomington Hospital, on Thursday. "The conversation needs to continue."

If the five nay votes hold, the medical park will not move forward in its current form. The debate returns to council chambers at City Hall on Feb. 25. A final vote will be taken at that time.

Until then, Tiwari said he'll be busy providing more information about his proposal and the larger health care issues behind it to council members.

"We haven't given up," Tiwari said Thursday evening.

If his specialty hospital proposal in Bloomington is turned down, however, he may try again somewhere else.

Tiwari operates the Bloomington-based Pain Management Center of Southern Indiana, which has five locations.

At the meeting Wednesday, hospital supporters stressed that their only opposition to the project was the inpatient beds.

If Tiwari scratched the overnight beds from the project, there would be no resistance to the outpatient care.

But Tiwari is not interested in eliminating the inpatient use, he said, calling it an integral part to the project.

"Outpatient facilities are already here," Tiwari said, referring to seven facilities in Bloomington, some of which are partially owned by Bloomington Hospital.

Council members voting against Tiwari's rezoning request said it offered no compelling reason for Bloomington to support a second inpatient facility in the city.

Bloomington Hospital, which opposes another inpatient facility, is the only entity that allows overnight medical stays.

Some on the council shared the fear of hospital administrators that such a facility would cut into hospital revenue and hurt its ability to provide services to the community.

"The hospital will do OK. The question is what will happen to the community if this ( a specialty hospital) goes on?" Slaughter said, who is medical director of the emergency department.

The guiding principle for councilman Sabbagh to vote against the project was an e-mail, one of many correspondences from the public he had received: "Above All Else, Do No Harm."

Sabbagh said he was concerned what sort of impact a competing facility would have on the Bloomington Hospital and its ability to provide a number of services, including the ambulance and CHAPS Clinic for low-income county residents.

He said he didn't want to see Bloomington become home to two weak hospitals instead of one strong one.

While council members called the land-use portion of the project a "home run," they said the driver behind the debate was public policy.

Many praised Tiwari for revising his original proposal — which had received approval from the plan commission — to preserve two-thirds of the site, near Ind. 37 and West. Tapp Road.

With councilman Dave Rollo, who serves on the plan commission, raising awareness of the environmentally sensitive nature of the land, any future proposal to rezone it will need to include green space, said councilman Gaal. The 101-acre site is zoned quarry.

Slaughter admitted on Thursday that Bloomington Hospital and opponents to the project did a disservice to Rollo by presenting another "piece of the puzzle" at the last minute.

He credited Rollo for working toward the green space.

An issue for some on the council that came out of Tiwari's preservation plan was shifting the cost of a future road to connect Tapp Road with Fullerton Pike to the public.

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People who filled the council chambers Wednesday came to voice either support for the Bloomington Hospital or Tiwari.

Patients of Tiwari said he helped them with their chronic pain like no one else could, including doctors at Bloomington Hospital. They asserted that his service, and more of it, is needed in the city.

While Tiwari runs off-site facilities, he still practices pain management at Bloomington Hospital.

Several hospital administrators said no one was questioning that Tiwari provided a valuable service.

Instead of starting a 30-bed inpatient facility, perhaps he should increase his outpatient services, suggested Diekhoff, council president.

Hospital staff and administrators agreed.

"We're all very supportive of Dr. Tiwari doing whatever he wants to do and wherever he wants to do it. What we don't want, what is bad for the community, is for Tiwari to open a for-profit specialty hospital," Slaughter said.

Whether his project is passed or not, Tiwari predicts at some point the Bloomington Hospital will have in-patient competition.

"I guarantee you it will happen sooner or later," he said.

Those who passed on the vote — Steve Volan, Jason Banach, Dave Rollo and Andy Ruff — said they wanted more time to sift through the stacks of statistics and resources given to them.

Reporter Sarah Morin can be reached at 331-4363 or by e-mail at smorin@heraldt.com.