Dispute over role of hospital service area group stirs controversy

Board drops resignation hints

Posted: Friday, March 31, 2000

Members of the Central Kenai Peninsula Hospital Service Area Board say they want their powers clarified, so they can decide whether to resign their seats.

The Kenai Peninsula Borough Assembly originally gave the board two charges, said board chairman Jim Clark. Those were a careful look at the service area budget and a broad look at community health-care needs.

Last week, though, the assembly struck all references to a broad look at community health needs from the board's proposed bylaws.

"What I hired on to do is to look at that broader question," Clark said. "If it's not part of what you want us to do, then I'd opt out of the process."

The 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 $40 million hospital under a contract it signed in 1997. The assembly created the elected service area board in 1997 to advise on service area matters.

The assembly passed a resolution in 1998 directing the board to:

n Review hospital financial statements;

n Make recommendations to the assembly on requests from CPGH Inc. or other groups for service area money;

n Make recommendations on CPGH Inc. proposals for improvements costing more than $100,000, which, under the corporation's contract, require assembly approval.

Guidelines the assembly attached to the resolution ask the board to identify available health-care services and unmet needs and to help find ways to meet the latter.

In its proposed bylaws, the board stated its mission as promoting improvement of community health by serving as a catalyst to define public health policy.

Its goals and objectives included hiring consultants to inventory existing health-care services, identify unmet needs and analyze sources of funds.

Assembly members Pete Sprague of Soldotna and Tim Navarre of Kenai drafted changes the assembly adopted last week. A vote on the amended bylaws could come during the assembly's meeting Tuesday in Soldotna.

Sprague said he replaced the mission statement with a preamble, since there are no mission statements in bylaws of other borough service area boards. The new preamble 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."

He said he and Navarre struck the board's goals and objectives and also provisions for the service area to contract for services because they felt those did not belong in the bylaws. They might go in separate documents, he said.

"It's not that its gone forever, and you can't bring it back," Navarre said. "We're just not going to deal with it at this time."

The changes do not preclude the board from hiring a consultant or conducting a needs study, Navarre said, but he does not want its bylaws to be a blank check.

"You have to go slow, and you have to bring it to us one step at a time," he said.

Sterling assembly member Grace Merkes said that before the elected board was created, the assembly approved the service area budget and large hospital purchases.

"That is what I thought the service area board was going to do," she said.

She said she does not understand how the service area board can be looking into contractors and needs studies. That sort of work should come from the hospital operating budget, she said, not from service area funds.

"This service area board is taking on way too much," she said.

However, board member Pat Hawkins said the board should be a catalyst, bringing other groups together to focus on community health needs.

"That's why I'm here," he said. "If the rest of the borough assembly feels like Grace, that basically you take a look at the quarterly statements and once a year you do this, I'm out of it, because it's a waste of my time."

Assembly president Bill Popp of Kenai urged the board to put off debating the need for a broad look at community health care and agree on basic bylaws the assembly could approve Tuesday. Nikiski assembly member Jack Brown plans to introduce a new resolution Tuesday to clarify the board's roles and responsibilities, he said.

"If we can get past these bylaws, we can get to the meat of the issue," he said.

No agreement emerged on the bylaws, though.

Clark moved that the board accept the amended bylaws, reluctantly, contingent on revival of provisions for the board to look into unmet health-care needs. However, board member Michael Druce said he would rather hear the assembly's intent free of pressure from the board. Clark's motion failed 3-3.

Then, board member Susan Jelsma moved to accept the amended bylaws. Her motion died for lack of a second.

The resolution Brown placed in Tuesday's assembly packet would resurrect provisions for the board to assess existing health-care services, identify unmet needs and recommend how to address them. However, Brown said he would ask the assembly to postpone voting on that until May.

He invited the board to write its own version and promised to introduce that in place of his. He said he would make sure the board's proposal receives a fair hearing before the assembly.

Popp thanked the service area board for its efforts.

"I want you to know that we definitely respect you as elected officials," he said. "I definitely want to work with this board to find clear direction for you, and I hope no one sees this as an effort to minimalize or marginalize this board."

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