BIHS board meeting draws 90 islanders
At another highly charged meeting, 90 people came to hear the Block Island Health Services board at its delayed open-session meeting Monday evening, Sept. 24. Members of the public spilled out into the corridor and an adjacent room and, as the meeting advanced, it became clear that many had come intent on doing some talking, too.
The Town Hall meeting ping ponged between open and closed sessions. Following a closed executive session that began at 6 p.m., an open meeting at 7:10 was followed by another closed session, after which the board met briefly in open session with Peter Saxon, a legal advisor for ousted former director Monty Stover. The board said it had decided on a revised severance package for Stover, Saxon reported, and would send it to the board’s lawyer. Stover was still waiting to see the terms of the offer by press time Thursday.
After thanking the audience for coming out on Monday evening, Hinthorn laid out the manner in which the board would proceed. She said members would respond to a number of questions that had been raised by the community. These “deserve our response,” Hinthorn said. “We’re taking this opportunity to address… issues… we’ve heard about most often.”
Reading from a letter addressed to the island community in which both questions and responses had been previously scripted by board members (the letter also appears as an ad on page 9), Hinthorn read the first question: “Why have we not scheduled an open meeting with the Town Council to discuss Monty Stover’s departure from the Medical Center?”
Referring to the written response, Hinthorn read: “The state of Rhode Island has very strict laws to protect the privacy of employees in matters related to employment separation. It is our policy to observe that law completely. Furthermore, we had no desire to embarrass a former employee or invade his privacy.”
She added, “We’re acting on the Town Council’s request for us to meet with them, but we’ve been waiting for a waiver from Mr. Stover.” Hinthorn said Stover had changed his mind about the waiver, initially agreeing to sign it and later declining.
Stover separately confirmed this to the Block Island Times.
The parties are engaged in talks, she said, and “Mr. Stover is hoping to receive a satisfactory settlement from BIHS, and once he has, no meeting will be necessary. Without a waiver we cannot meet with the council and discuss Mr. Stover. We are not foot-dragging or stone-walling. We are simply following the requirements of the law as we believe they apply.”
As to why the board has not followed the Town Council’s recommendation to consider mediation, Hinthorn pointed out, “We felt there was no need for mediation.” Agreeing that mediation is “a good process for some disputes,” the board felt in this case the “parties were already engaged in private talks and hopeful of a settlement acceptable to both parties.”
Board member Millie McGinnes responded to a question on open meeting laws. She noted the board was as concerned about transparency as the community. She added, “We do have a section in our bylaws related to open meeting laws, but at this time we aren’t subject to the same rules.”
She added, “When we drafted our bylaws, we voluntarily elected to hold our regular monthly meetings in public… We are willing to discuss the pros and cons of a bylaw change and understand that there are advocates for full adoption of the [Open Meeting] Act. But we do our best to be as transparent as possible and to provide documents.”
Private or public?
Secretary Kay Lewis addressed the question of whether or not BIHS should be a private or public facility, pointing out that “this is not a question for this board.” When the board was established, she said, “The town decided it to be private… possibly as a liability shield for the town.”
Reiterating her point at an earlier meeting with the Town Council, she said, “A model [for a public facility] exists; it can be done, but it’s not for us to say what should be done. The town owns the property, the town leases the property and the town can decide at any time. That’s a decision that can only be made by the town.”
Regarding access to documents, Lewis said they weren’t available because, “There is no secretary for the executive director or the board.” Because the medical center is “managed by an unpaid board of directors,” it depends on “a volunteer labor pool.”
Lewis added, “If the Medical Center became a public entity, its entire operating cost would be borne by the taxpayer.” She concluded, “It would be more expensive to run the medical center.” Later she observed that the town has a clerk at many of the board and committee meetings and suggested the town might want to adopt that practice with BIHS.
On a question of the disposition of funds held by the BIHS board in the event of dissolution of the agreement with the town, Lewis said their incorporating document assures that the monies would go to the town or to a tax-exempt charitable body. “There is no need to worry about the endowment in any way,” she added.
A question of morale
Interim Executive Director Peter Baute said, “One thing that’s bothered me is the question of morale” that had been raised. Noting it had been “an unusually busy summer,” he said that he and the board had been impressed by the staff, “working as a team, providing exceptional levels of care in response to the needs of residents and visitors alike.”
The board’s statement on this issue read: “They [the staff] were upset to lose a friend and colleague, but were most upset over suggestions that the quality of care might suffer as a result of the change in management. Currently working with Dr. Baute, the staff is productive, engaged and excited with new projects and initiatives.”
He added, “What I’m seeing is morale is good, as this process is winding down, I hope.”
Letter to the public and financials
Hinthorn concluded the review of questions by announcing, “What you’ve just heard is a letter we’ll place in the Block Island Times this week.” She then asked the board to vote to accept the document and its placement in the island weekly, which it did.
When asked by Bill McCombe, “When was all this put together?” Hinthorn replied that several days earlier she and board member Judith Cyronak had worked on the letter and then asked the board to look it over.
In a review of financial statements, Treasurer and interim Finance Director Pete Tweedy suggested that there was a “lot we need to clean up about the process” of tracking accounts receivable. He added, “We need to see how to clarify items open in our accounts that go back to 1999.”
Noting collecting unpaid bills was “an ongoing problem,” Tweedy added, “This is an area that needs to be shored up.”
Baute pointed out that they were not referring to persons unable to pay. He added, “We’re willing to work with them — to work out partial payments,” if needed.
Tweedy assured the public that financial reports would be made available, although not during the meeting because he didn’t have enough copies. The board’s position stated in its letter read, “Monthly financial reports are available at each regular monthly meeting of the board,” as were “annual audited financial reports.” Tweedy said the public could access these annual reports at the medical center, the library or Town Hall “when completed for fiscal 2011.”
Search committee at work
Lewis said the search for a new executive director had begun, with the special committee assigned the task having met three times. She said they were busy reviewing applications and “having exploratory conversations with potential candidates.” The committee, of which Lewis is chair, is comprised of Susan Bush, Mark Emmanuelle, Robert Hayden and Laura Risom.
Lewis assured the audience that she would recuse herself from voting with the search committee to select a candidate, but only vote to confirm one with the board. She asked the audience, “If you know people who are interested and have the basic qualifications, please suggest they apply.”
When asked how many applicants had been considered to date, Lewis said she could not provide that information because she didn’t have the permission of the search committee. When another audience member shouted out, “I don’t understand why the number of applicants needs to be confidential,” Lewis repeated that she could not just say anything without the approval of the search committee in which the board has put its trust.
Arlene Tunney asked Lewis, “Weren’t you meant to make a decision by October second?” Lewis acknowledged the process would take longer than that.
Noting that the board had recently met with the Town Council in a review of the management agreement between the two bodies, Hinthorn observed it had been “a very productive work session… a good clarification of a document that had been pretty vague.” She said there was general agreement on most issues between the two groups, with some areas remaining to work out.
One place in the contract that the board still had difficulty with, Hinthorn said, was the “obligation to turn over documents to the town when asked. Our position when we spoke about this before was we’d like the [document] to be less restrictive.”
As an example, she referred to a “time this summer when there was talk about turning over consulting documents. I do think turning over financial reports is appropriate, but not necessarily other kinds of documents.”
Keeping the town in the loop
However, Tweedy saw it as “keeping the town in the loop, and I think in a situation like the one we’re talking about, we might make the town [aware of what] we’re doing.”
Richard Weisbroat asked Hinthorn, “Why wouldn’t you want to give the town whatever they asked for?”
Lewis responded, “There’s a lot involved in making those documents available. It would make it necessary to have people making copies; we would need more staff.”
Hinthorn asked, “Do they really want us to tell them when we’re engaged in contracting out a number of services?” At that moment, Gaffett interjected, noting that idea had already been rejected at the joint work session. Requests would be for more significant kinds of information, Gaffett suggested.
“As a private entity, obviously, we’re not required to do so,” Hinthorn responded.
The people’s medical center
More and more as the business of the board proceeded, audience members broke in to either counter the board’s positions or support them. McCombe said, “This town is different. It’s very unique. This is the people’s medical center. I think if you follow open meeting laws, if you worked in the open, I don’t see anything wrong with it. I think if we follow these rules, it will be much better for everyone.”
Weisbroat suggested that “Block Island has to do what’s good for Block Island. If it takes an extra expense to make this happen, then it will eliminate a certain amount of friction that now exists.”
Lewis countered that it wasn’t as though “the meetings have not been open. We’ve had an event that’s drawn people’s attention.” McGinnes added, “We can make efforts to keep up with the postings. I know there is some conflict in our bylaws as they are right now.”
To Weisbroat, however, it wasn’t just “how many open meetings you’ve had; rather it’s how many closed ones you’ve had. My sense is that it’s very important for that to be included in the management agreement.”
Edith Blane proposed that the management agreement be set in place for three rather than five years.
Confrontation and contradiction
With the intensity of people’s concerns clearly building as they took turns airing their views, Weisbroat rose to read a letter he had addressed to the BIHS board, in which he highlighted many of the issues being raised during the open meeting.
One of his most prominent contentions was the number of closed meetings the board has held, which have resulted in “a belief that you know best what is good for the community and do not need any feedback on vital issues and policies.”
His letter further took issue with the board’s failure to pursue mediation with Stover (see letters, page 17).
Another of Weisbroat’s concerns was staff morale at the medical center and his depiction of it in his letter created direct repercussions at the meeting. In his letter, Weisbroat wrote, “According to members of the staff, you [the board] have excluded them from participating in meetings in which they could inform you of information relevant to their responsibilities… There is a belief among the staff that you are attempting to micromanage the care and treatment of patients…”
In direct contradiction to those observations, Nurse Practitioner Liz Dyer said, “In Richard’s document, I was not asked. I want an addendum indicating I never said my morale was down.” She indicated further she agreed with none of Weisbroat’s conclusions.
Bob Fallon said, “I think I’ve heard from the board that they’re committed to going forward to abide by open records rules. We need not be always biting the dog.”
Get it all behind you
Bob McLaughlin urged the audience to consider “what a great organization the [BIHS] is. My wife was flown off a month ago for appendicitis and I’ve been taken off many times. If it weren’t for Linda [Closter, RN] and Mary [Donnelly, RN], I’m not sure what would have happened. I hope you all realize what a great facility you have. I say, ‘Get it all out of the way! Get it all behind you! Get on to something else!’”
Terry Mooney asked, “Does this board take any responsibility for the actions that have raised so much concern?”
Taking issue with the suggestion that the board acted in other than in the town’s best interest, bord member George Henault said, “We acted in good conscience, in good faith — plain and simple — and I’m standing by my guns.”
Concurring, Fallon added, “Everyone assumes that what the board did was wrong, but what the board did was to protect the medical center.” As discussion developed on the potential of being designated a rural health center, Fallon continued, “Kay [Lewis] talked about rural health centers, which might result in reducing our costs, but we haven’t even gone there because we’re muddled down in this process.”
Addressing Fallon directly, Pat Doyle said, “The process that you’re referring to, Bob, would not have taken place except for what happened. The catalyst was the way in which an employee — who was also a friend and neighbor to many of us — was treated. I think if there had been some recognition from you [addressing board members], this wouldn’t have had the traumatic impact it has had. You’re a medical board and have good hearts. But a good heart was not in place when a man who had worked for 16 years was led out the door like a criminal.”
Elections and membership
Turning to other business, Lewis explained that two public slots on the board were due to be filled and announced that Susan Hagedorn and Bill McCombe had come forward as candidates for those openings, which carry four-year terms. The medical center’s election will coincide with the national one on November 6. Lewis made clear the vacancies were created by the resignation of Betty Lang and by the expiring term of George Henault.
The next membership election would take place in May, Lewis said, when Cindy Baute, Cyronak and Tweedy would have completed their terms. She added that they could ask to continue on the board and be re-elected. “In the past,” Lewis noted, “we’ve taken someone who’s already served as a volunteer for BIHS.”
Physicians advisory committee
Baute reported on the new composition of the physicians’ advisory committee, of which he is chair. He noted that in addition to himself, its members included the following physicians: Albert Casazza, Robert Greenlee, Peter Jokl, Mitchell Dreismann and Albert Puerini.
Baute explained that most recently the group “came together on the holiday weekend [Labor Day] to review some cases. It is great to work with these colleagues.” He quipped, “And I will try to get more work out of them.”
Buildings and grounds
Board nmember Shannon Morgan reported that earlier that day she, Judith Cyronak and David Kane did a full walk-around the facility’s property, making a list of needed improvements. All the buildings, she said, needed foundation grading, channeling water away from structures.
Among innumerable repairs she identified were repair of a skylight, dismantling the old X-ray room, interior painting, duct work and carpet replacement. “A big issue,” she pointed out, was an overhaul of the air conditioner, at an estimated cost of $10,000.
Eventually, Morgan said, “Dr. Miller’s house needs to be done: it needs new insulation, foundation work. It is a beautiful historic house needing restoration.” Morgan indicated the scope of the project was enormous. For the doctor’s house alone, she estimated potential costs at $100,000, since no work had been done on it in at least 15 years.
Closter extended her appreciation to Kane and Herman Mast, who she said had worked hard to keep up with ongoing repairs. Baute added his praise, noting that both were “wonderful individuals who will tackle any kind of job.”
As people filed out, emotions still appeared to be at a high level, with conversations outside the building that in some cases turned into shouting matches.