Letters to the Editor, Aug. 11, 2012
To: the Editor—
First of all, I want to thank everyone who has ever helped BIHS in any way. The medical center is a very special place and needs to remain strong for all the patients who depend on it.
I’d also like to thank those of you who have given me support over the last few weeks.
Let’s clear the air on what happened to me at BIHS (although I cannot discuss the terms of a severance agreement or stray from facts):
On Monday morning, July 16, at 8:15 a.m., three officers of the board of directors came to the medical center to meet with me. One of the officers said to me in so many words: “I have the unpleasant task of informing you that this is your last day as an employee at BIHS.” The verbal reason provided was “lack of performance.” I was given a severance agreement to consider and a copy of a prepared press release. My keys and a corporate credit card were requested, I was given the opportunity to take personal things or return on another day, I provided some information critical to current operations that day and walked out of the center with one of the officers.
Since then I have tried to cooperate with requests for information to help the organization. I signed the agreement the following week.
Looking back, I received periodic performance reviews as finance director from 1997 until 2005. I was not reviewed again for five years, until December of 2010, six months after new leadership took office. At that time, the review was managed by the human resource committee, which is chaired by the board president’s spouse. The review presented to me then included practically no recognition for accomplishments from 2006 to 2009. A final review was provided in April of 2012.
I believe I had two separate job descriptions from 2006, when I took over as executive director (ED) as well as keeping my finance director role, until the annual meeting in June of 2010. Then, new officers asked me to sign a single ED position description, although responsibilities for finance and administration continued.
A new job description is now being developed for an ED. In the meantime, there is an interim ED, the treasurer is responsible for financial management and an accountant or bookkeeper began working for the center the day I left or soon thereafter — three people, two of them volunteering their time.
Last week’s BI Times came out on Friday, Aug 3, with a letter from the BIHS board that listed specific numbers on BIHS operational deficits: $31,325 as an average for the past 10 years, and $52,585 on average for the past three years.
My first reaction was this: An Aug. 1 town meeting was preset to focus on the financial condition of BIHS. At it, a board member said that because of short notice, they were not prepared to present financial information. Yet that letter, with those very specific operational deficit numbers, were submitted to the paper prior to the meeting. Furthermore, those numbers make it appear that BIHS was losing money for the past 10 years — which reflected poorly on the center’s financial management. I will suggest to you that those figures likely include a non-cash depreciation expense of approximately $30,000 to $50,000 a year, and that the center is in better condition than made to appear.
Similarly, financial graphs prepared for a retreat in the fall of 2010 by a board officer (not by me) painted a less than favorable financial picture. Then an assessment by a consultant in August of 2011 provided a different story — and BIHS had not just made a miraculous turn-around in the prior year.
The center’s strength does not mean that BIHS is not dependent on grants, donations and fundraising. Endowments need to be maintained and should grow over time in order to provide non-profit institutions with operational funding that keeps pace with inflation and rising costs. I always tried to make fair requests to the Town of New Shoreham minimizing the taxpayers’ burden, and never included non-cash depreciation as an expense for consideration at the financial town meeting.
By the way, I agreed with the concept of aligning with a strong mainland partner, particularly as a way of instituting electronic health records. I saw advantages in a working relationship with Thundermist, but was concerned about costs for all the services being considered, and was suggesting it was beneficial to consider other mainland alternatives.
I don’t walk on water, do make mistakes, did not steal money, am not a criminal, and always try to do the right thing. My biggest mistake was accepting too much responsibility, which made it difficult to get things done, especially given an increasing number of distractions over the past couple of years. The BIHS board (currently nine members) includes good people who have sacrificed time to volunteer and are faced with difficult decisions; however, too much control in the hands of two or three can have adverse effects on the workplace.
Old Center Road
To: the Editor—
The Times has asked us to comment on a statement it says is contained in a letter from Monty Stover to be published in this week’s paper. We have not seen the letter, and do not wish to respond without a complete understanding of what has been said. The topic the Times described concerns financial operating deficits at the medical center and we would like to take this opportunity to talk with the community about the financial health of the medical center and the environment in which we are operating.
Essentially, the center provides medical services in a very constrained environment. We face seasonality constraints that require us to staff for peak summer utilization, with low utilization for the winter months. We face isolation constraints that require us to staff for emergency coverage 24 hours a day and seven days a week, when most of the time, that level of service is not needed. These constraints mean that the cost of the care provided at the center is high on a per visit basis. Like all medical service providers nationally, we also absorb the cost of service for uninsured individuals, some of whom are not able to pay standard fees.
On the revenue side, we have very little pricing power. The reimbursement we receive from third-party payers like Medicare, Blue Cross, Medicaid and other private insurers is set by those agencies. Unlike many other entities, we are not able to increase our prices to cover increasing costs. We would very much like to increase use of the center for primary care by all island residents, but here we face competition from mainland providers, some of whom offer specialized services and others who have longstanding relationships with their island patients.
To put the operating environment in perspective, it may be helpful for the community to understand that only about one-half of the cost of providing medical services is covered by the revenue we collect for those services. The rest comes not from revenue, but from what is usually described as “other income” such as donations, membership fees, town support, fundraising events and income from the BIHS endowment. Our goal as an organization is to operate in a way that assures that we will be able to provide medical services well into the future. To do that, we must address changes in health care reimbursement being driven by national cost containment goals. These changes mean that we must convert to electronic medical records and be able to demonstrate the effectiveness of the medical treatments that we provide. If we are able to adapt, we will be eligible for the highest level of reimbursement available, helping us to keep our cost coverage as high as possible.
Like most island organizations, the medical center faces a unique set of challenges. The support of the community is essential to the financial health of the center. We urge you to consider these factors as you decide about your own personal support.
Block Island Health Services Board of Directors
[This letter was corrected from the original version that ran in print, which incorrectly stated "one-third of the cost of providing medical services is covered by the revenue we collect for those services." The Times regrets this error.]
To: the Editor—
Like many of my island neighbors and friends, I attended the joint work session of the Town Council and Block Island Health Services Board.
I came away from that meeting disheartened. Our own medical center board had “lawyered up” and offered no information about the firing of Monty Stover and the appointments of Peter Baute (husband of board member), Pete Tweedy (board member) and Jim Hinthorn (husband of board member). I strongly object to the cost of and the need for an attorney. BIHS is financed by generous contributions from the community and tax payers.
Even more, I object to the siege mentality of the BIHS board, which could not face friends and neighbors for an honest discussion without a highly paid mouthpiece. I would also like to question the presence of two uniformed police officers. They must have better things to do. Again, I refer to siege mentality.
The members of the audience expressed intelligent and cogent concerns and received no answers. Perhaps the lawyer was a silencer rather than a “mouthpiece.” We all came to find out WHY Monty Stover was fired. The BIHS asks for trust. I believe trust is earned, and they haven’t earned mine yet.
To: the Editor—
This is a brief thank you to the Block Island Health Center. One of our employees was injured a few weeks ago and they were professionally treated and cared for by Liz, Linda and the resident from Brown University. We were discharged within 90 minutes after triage, cleaning, stitches, bandaging and a tetanus shot. Your care and professionalism are greatly appreciated.
Sven and Laura Risom
Corn Neck Road
To: The Editor —
Dr. David Gifford, MD, MPH, the head of the R.I. Department of Health, visited Block Island two years ago at the request of the Deer Task Force. He began his tick disease presentation with a humorous anecdote about his one and only prior visit to Block Island: As the newly appointed R.I. State Health Director, he was given the responsibility of traveling to Block Island with the news that Mary Donnelly, then a 30-plus year veteran of the state’s outreach nurse program, was being asked to resign.
Advances in medical care delivery and financial expedience were the rationale for eliminating all outreach nurse positions. But Mary Donnelly proved to be the exception. Dr. Gifford returned to Providence after his meeting with Mary, Monty and others, with his mission not accomplished!
Dr. Gifford had the intelligence and the insight to recognize that Block Island had a unique and enviable culture, which would fight for a service that was trusted and effective. He had the humility to accept the wisdom of Block Island residents in supporting a capable, loyal, committed practitioner.
And he also had the courage to risk his own appointment as new health director for the state to articulate to state leaders the folly of dismantling a service that worked in the name of “progress.”
Dr. Gifford did not lose his job — he continued to serve as top medical official for the state until recently being appointed as the director of the American Health Care Association. Our Block Island political leaders and healthcare board should exhibit intelligence, insight, courage and humility, and listen to the pleas of a community that has been given no reason to believe that removing Monty Stover at this time would well serve our community.
To: the Editor—
I trust that I am not the only one concerned about the State of Rhode Island asking the federal government to give a $900,000 grant to Cape Air to fly from T.F. Green Airport to Block Island?
Why was New England Airlines excluded? Answer: Sounds like political connections. As a July 21 BI Times editorial pointed out, the Rhode Island Airport Corporation (RIAC) lied when claiming that New England Airlines was not interested. This is Rhode Island politics as usual. This subsidy/grant will pay part of the airfare and the advertising. Wouldn’t every business like this?
New England Airline is our lifeline. They are a part of our community. If they are hurt financially, what then? What if New England Airlines says no more winter flights due to a loss of business? This government largesse could backfire and hurt our island economy. Where are our state representative and our state senator? Just like they favored more taxes on tourism, they are not looking out for us. They do not represent our best interests.
Is our Chamber of Commerce going to bat for New England Airlines? I hope so. It’s time for Block Islanders to have a say. Let’s contact our representatives in Providence and let them know.
Amy Dodge Lane
To: the Editor—
The family of Meg Millea Snyder would like to offer its profound thanks for the generous outpouring of support at the July 7 fundraiser. This has buoyed Meg’s spirits tremendously as she battles cancer in Portland, Oregon.
Thanks also to the business community for donating raffle prizes, specifically the hotels, restaurants and shops listed here: Aldo’s Restaurant, Ballard’s Inn, The Beachead, Bethany’s Airport Diner, Bird’s Nest, Block Island Flag, Block Island Times, Block Island Trading Company, Captain Nicks, Club Soda, Dead Eye Dicks, Driftwood Cottage, Finn’s, Froozies, Harbor Grill & Restaurant, Manisses, Mohegan Café, National Hotel, The Oar, Photo Dog, Poor People’s Pub, Red Bird, Rose Schaller Photo, Sharky’s, 1661 Inn, Star Department Store and Water Colors.
Thanks also for the donations from Meg’s many Block Island friends, who will each receive a personal note of thanks.
Dan & Rosemary Millea, Rose & Jamie Schaller, Amy & Per Vaage, Meg & Tom Snyder, Laura & Steven Hester
To: The Editor —
I am very pleased to announce that the 2nd Annual Block Island Medical Center 5k Beach Run, held this past Sunday morning, was a great success. We exceeded last years’ 169 participant level with 208 people participating in the event. As with other island fundraising events, it was successful due the contributions of many.
First, I’d like to thank the participants which turned out to be a nice blend of year round, partial year around, vacationers and day trippers. The second group I’d like to thank are the 19 sponsors who helped make the event a profitable one: Ballard Hall Real Estate, Phillips Real Estate, Attwood Real Estate, Sullivan Real Estate, Finn’s Restaurant, Dead Eye Dick’s Restaurant, The Oar Restaurant, Aldo’s Restaurant, Bethany’s Airport Dinner, The Beachead Restaurant, Ballard’s Restaurant, Diamond Blue Sports, Golddiggers Jewelers, Block Island Sports Shop, Mig’s Rig Taxi, John S. Babcock Plumbing & Heating, Blue Cross/ Blue Shield of Rhode Island, Monica’s Taxi and the Block Island Times. I hope to see all of you again next year.
I’d also like to thank the Town of New Shoreham for co-sponsoring the event. And, of course, these events do not run themselves — there were members of the Medical Center board (and their spouses) and staff who contributed to our success.
Race Director, Medical Center 5k Beach Run/Walk
To: the Editor—
Sincere. Charismatic. Generous. These are just a few words that come to mind when describing the late Andrew Leone and his contagious smile.
On behalf of the Leone Family, the parents of Andrew Leone have decided not to continue with the annual benefit dinner to support the scholarship fund in Andrew’s name. It has been a very difficult time for Bobby and Lisa Leone, as well as the entire extended family, to move on emotionally in the healing process of this devastating tragedy.
We are still accepting and greatly appreciating donations made to the Andrew Leone Scholarship Fund. His generosity lives on through this fund. Any donation that can be provided will go to help the Block Island Medical Center as well as help aid a Block Island High School senior on the journey to college.
Contributions can be made to: Bobby and Lisa Leone, c/o Andrew Leone Scholarship Fund, P0 Box 985, Block Island, Rhode Island 02807.
We express our sincerest gratitude to you in advance for your understanding and committment to the Andrew Leone Scholarship Fund.
The Leone Family