MINNEAPOLIS (AP) — The Hennepin County Board of Commissioners has approved a budget that will mean job cuts at Hennepin County Medical Center in downtown Minneapolis.

The facility is planning to reduce its workforce by as much as 4 percent next year. The elimination of up to 275 full-time positions is aimed at balancing the hospital's budget and keeping the opening of a new ambulatory and outpatient surgery center on schedule for 2018.

One longtime patient worries about the impact to patients. Commissioners rejected Peter Zeftel's request for public hearings.

Hospital leaders have bemoaned the high share of patients who are covered by the state's Medical Assistance program. They contend the state program for the poor and disabled reimburses hospitals and clinics below the cost of caring for patients.