The north Baton Rouge emergency room that residents and politicians made their rallying cry in the spring has finally been packaged into a deal between state government and Our Lady of the Lake.

Commissioner of Administration Jay Dardenne and Our Lady of the Lake announced Friday that the hospital system signed a formal agreement with the state to add an emergency room to their extensive LSU Health North Urgent Care facility on Airline Highway, a few blocks from the old LSU Earl K. Long Medical Center. The state expects to give the hospital system $5.5 million to build and staff the expansion, which will have to meet certain physical and staffing standards to qualify as an accredited emergency room, Dardenne said.

Political leaders and residents in north Baton Rouge have pushed for an ER for months. Gov. John Bel Edwards eventually joined the chorus of voices who said they wanted to see an emergency room in north Baton Rouge, and Our Lady of the Lake quietly submitted a proposal over the summer showing how they could add emergency physicians and expand lab services at the location.

"For the past year we have been studying the needs and available access to services and now with the support of the State, the addition of an ER to the North Baton Rouge location will provide even greater access and complement the already successful urgent care center on Airline Highway," Our Lady of the Lake CEO Scott Wester said in a statement. "Housing an emergency department in the same location as an urgent care clinic could also reduce follow-up visits to the ER. Our top priority is preserving the good health of families in our community.”

He also said the emergency room would be an extension of Our Lady of the Lake's main campus. The urgent care facility will remain on Airline as well, making it home to both urgent and emergent care.

The urgent care facility on Airline Highway already sees more than 100 patients a day, Our Lady of the Lake reported. They said the combination of urgent care and the emergency room in one place will allow for education about when to seek one type of care versus the other.

State Sen. Regina Barrow, D-Baton Rouge, and State Rep. Ted James, D-Baton Rouge, both celebrated the announcement of the project. Barrow said the emergency room "can't get done fast enough," and James called it "a step in the right direction."

"People are going to be more encouraged that their voice is being heard, and this is one of the things that people had been really asking for and had been inquiring about," Barrow said.

North Baton Rouge has lacked an emergency room since Baton Rouge General closed its ER in Mid City a year-and-a-half ago, which provided the bulk of emergency health care in the area after the state shut down the LSU Earl K. Long Medical Center in 2013. After Earl K. Long closed, Our Lady of the Lady essentially became the public hospital in Baton Rouge, providing care for uninsured patients through a contract with the state. 

Baton Rouge General and other hospitals said operating in north Baton Rouge without a government subsidy was nearly impossible because so many patients lacked insurance and hospitals were forced to swallow tens of millions of dollars in medical bills.

The deal for Our Lady of the Lake to be the provider of an emergency room in north Baton Rouge seemed unlikely this past spring despite the hospital holding the state hospital contract. As residents decried their lack of emergency health care services in the area, Our Lady of the Lake administrators said a stand-alone emergency room in the area was not the right answer.

Wester told The Advocate's editorial board in the spring that it was a myth north Baton Rouge needed an emergency room. Our Lady of the Lake's Vice President of Mission Coletta Barrett said in late June to the Rotary Club of Baton Rouge that the northern part of the city might be better served by more primary care services.

Louisiana Emergency Response Network officials also repeatedly emphasized the difference between a trauma center and an emergency room.

LERN pointed out that people who had been shot, those who were in grisly car wrecks, and people who were having heart attacks and strokes would be diverted to the closest trauma center, which is located at Our Lady of the Lake's main campus on Essen Lane. And they said that even if a victim of those traumas was closer to a stand-alone emergency room, only a specialized center would likely have the capabilities to take care of them.

Barrow said the past statements from Our Lady of the Lake officials have led some to question the organization's commitment to north Baton Rouge.

"It is something they are going to have to win over with people that they are committed to the project," she said. "It may seem like they were more pressured into doing it as opposed to them just being willing to do it."

Metro Councilwoman Chauna Banks-Daniel, who created the #NBRNOW Blue Ribbon Commission to study how to bring health care and economic development to north Baton Rouge, expressed more pointed disappointment, slamming the governor and Our Lady of the Lake for the plan.

The #NBRNOW Blue Ribbon Commission advocated to both the local and state governments to open an emergency room at Champion Medical Center in Howell Place off Harding Boulevard. Champion is run by a for-profit company based in Texas, and the hospital currently focuses on specialty surgeries.

Banks-Daniel continued to back the Champion proposal on Friday, saying Our Lady of the Lake was the wrong choice.

"The governor has no understanding or interest as it relates to north Baton Rouge, he felt this was a way to shut up the request of the people and the negative press," Banks-Daniel said, adding that Edwards "obviously has zero respect or interest for" the people in north Baton Rouge.

The governor's spokesman Richard Carbo fired back.

"Gov. Edwards' sole commitment to the people of north Baton Rouge was to work with the legislative delegation to get an emergency room opened to serve the needs of the people," Carbo said. "The councilwoman is both misinformed and out of line in her accusations. The governor stood by his promise and has delivered for the residents of north Baton Rouge.”

Executives from Champion's owner company, Next Health LLC, said they could build out the existing facilities at Howell Place and have an emergency room there up and running by 2017. But the price tag was $7 million over the next two years to build the facility and subsidize the health care business there, and an additional expected $3.8 million a year in operating subsidies.

Champion also would have needed to gain approval from the Centers for Medicare and Medicaid Services to accept their reimbursements. And the emergency room there would have required a transfer agreement with one of the full-service hospitals in Baton Rouge.

Carbo said Champion's inability to accept Medicaid and the need for a transfer agreement made their plan problematic.

James took the governor's side as well.

"Chauna is more concerned with Champion than she is with providing access to care," James said. "The governor has stayed focused on the issues and not the personalities driving the conversation. This is a win for all of our constituents, she should focus on that."

The governor said in June that he was not ready to commit to a specific plan for a north Baton Rouge emergency room, with both the Champion plan and Our Lady of the Lake draft on the table.

The next month, Department of Health Secretary Rebekah Gee said her marching orders were to ensure there was an emergency room in north Baton Rouge. Gee said then that the Department of Health was "in active discussions" with Our Lady of the Lake about an emergency room, but had not received a commitment yet.

Dardenne said more information about the plan should become available next week.

Advocate staff writer Mark Ballard contributed to this report.

Follow Andrea Gallo on Twitter, @aegallo.​