The Kenai Peninsula Borough Assembly stands poised to rein in the elected board that advises on management of the central peninsula hospital service area.
In bylaws proposed to the assembly, the Central Kenai Peninsula Hospital Service Area Board made its mission "to promote community health by serving as a catalyst to define and coordinate public health policy within the service area."
On Tuesday, though, the assembly amended the draft bylaws to eliminate any broad look at community health-care needs from the board's goals.
The new preamble, suggested by Kenai assembly member Tim Navarre, says the service area board should advise the mayor and the assembly on "the service area, review and recommend the annual service area budget, and perform additional functions as the assembly may authorize."
The amended bylaws would not preclude the board from doing a needs assessment, Navarre said. However, they give no broad approval for the board to conduct studies still undefined.
"As far as the community health process goes, they are to come back to us with a defined plan, scope and cost, and come back to us on a case-by-case basis," he said. "It just gives them more oversight by the assembly."
The assembly passed Navarre's amendments on a 5-1 vote, with Drew Scalzi, Patrick O'Brien and Grace Merkes absent. It postponed a vote to approve the amended bylaws until April 4. Nikiski assembly member Jack Brown, who cast the lone dissenting vote, questioned the board's value if Navarre's amendments stick.
"I think what Tim should do is make a motion to abolish what the voters approved -- the service area board," he said. "If he's going to so restrict what they can do, why even have them?"
Board chairman Jim Clark said it is the assembly's call whether there should be an elected board that takes a broader view than the hospital of community health needs. However, he said, he would hate to see it reject that opportunity.
The service area board plans to discuss the amended bylaws Wednesday at 6 p.m. at the Borough Building in Soldotna. Clark said board members will have to decide if they are comfortable with the changes.
"If not, there may be people that feel they need to resign," he said.
The Kenai Peninsula Borough owns Central Peninsula General Hospital, and the service area raises about $1 million per year in property taxes to help support it. Nonprofit CPGH Inc. leases and operates the hospital under a contract it signed in 1997.
The assembly created the elected board in 1997 to advise on service area matters. In 1998, it directed the board to make recommendations on CPGH Inc. proposals that require assembly approval and on requests for service area funds from CPGH Inc. or other groups.
It also directed the service area board to identify available health services and unmet needs and recommend how to address the latter. The board wrote bylaws and goals and sent them for assembly approval in January.
The proposed goals and objectives included:
n Hiring consultants to inventory existing health-care services, identify unmet needs and analyze sources of funds.
n Requesting copies of planning documents, marketing studies and needs assessments the hospital has already conducted.
Clark said the service area needs copies of hospital plans and studies to make informed decisions about new services and to avoid duplicating studies the hospital already has done. CPGH Inc. president Diana Zirul questioned whether the board should do a needs study, since that may duplicate what others are already doing.
Tuesday's amendments eliminate the board's proposed goals and objectives from the bylaws and drop provisions for the board, subject to approval from the mayor and funding from the assembly, to contract for services.
The amended bylaws make no mention of the assembly's 1998 directive to assess unmet health-care needs.
"I don't want the service area board to create another borough entity that costs money unless the borough assembly approves it," Navarre said.
Zirul said the changes provide the clarification the service area board and CPGH Inc. asked for during the service area's March 15 meeting.
The amended bylaws mirror the intent of the ordinance that created the board, she said.
Brown said the service area board should proceed with a needs assessment. However, there is no need for it to oversee the hospital operating budget, he said. That is the borough mayor's job.
Assembly president Bill Popp said small-town hospitals find it increasingly difficult to compete with hospital chains, and the borough must keep a constant eye on available health care and who is providing it.
"I think CPGH Inc. and the service area board both have a roll in that," he said. "I hope things will come to a positive end at (Wednesday's board) meeting. Assembly members need to attend.
"There needs to be communication between the assembly and the service area board, because the service area board does serve an important roll."
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