Governor Chris Sununu has been a staunch proponent of the deal, a public-private partnership that he helped shepherd across the finish line, in spite of some lingering concerns raised by executive councilors during the council's last meeting of Sununu's tenure.

Cinde Warmington, the council's lone Democrat, was the only councilor to vote against the deal after raising a series of concerns, including whether New Hampshire children would be guaranteed priority access to care ahead of out-of-state patients.

She also said she was worried about the state's lack of enforcement mechanisms in the contract and the fact that there wasn't a minimum requirement for how many beds the hospital would need to provide.

"It's a good idea and I think it should go forward, but it's a half-baked contract, in my opinion," she said. "It just doesn't have the teeth in it."

She encouraged the council to postpone a vote on the contract to allow more time for further revisions.

Morissa Henn, deputy commissioner of the Department of Health and Human Services, said a provision would be added to the final contract reflecting that New Hampshire children would receive priority access to care at the hospital. She said there are sufficient enforcement mechanisms in the current contract, as the state will be represented on a joint commission, in addition to state licensure.

And she said the decision not to include a minimum number of beds was intended to give providers more flexibility.

"Resources may need to be shifted at any given moment toward the outpatient offerings that Dartmouth Health is offering," Henn said.

Sununu urged the councilors to move on the contract immediately, noting that a transition would typically take at least six months and the budgetary implications of operating the hospital during a year when the state is undergoing its biannual budget process.

"This is our team," he said of Dartmouth Health.