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Hospital board selection process should be reconsidered

Posted: Wednesday, April 06, 2011

While the mayor's task force on the future of Central Peninsula Hospital continues to ponder the question, one fact has become crystal clear: the overwhelming majority of area residents, who own the hospital, wish no compromise whatsoever of local control and ownership of CPH. No joint venture. No sale. That, however, is not to say that the governance of CPH couldn't be improved, and toward that end we and the task force would do well to consider making Central Peninsula General Hospital Inc., the board that currently runs CPH, an elected rather than a self-appointed position. At present, board members appoint new members.

It is argued by some that making the board an elected body would somehow introduce politics into the governance of CPH, but that argument falls flat for a number of reasons. First, politics are always present whenever people come together in a joint venture. Currently the board of Homer Electric Association are elected positions, as is the hospital's Service Area Board, the school district, the borough assembly and more. All such elected bodies seem to be doing quite well, politics notwithstanding.

Second, self-appointed boards, such as CPGH Inc., are problematic. According to a Wikipedia article, self-appointed boards "often feel that a judgment of a manager, particularly one who has performed well in the past, should be respected. This can be quite legitimate, but poses problems if the manager's judgment is indeed flawed." Because the same board members who appoint a CEO are the same people who must henceforward oversee the CEO's performance, it becomes "difficult for some directors to dispassionately evaluate the CEO's performance."

Third, self-appointed boards "rely on management to report information to them, thus allowing management to place the desired 'spin' on information." As the Wikipedia article concludes, all such factors and more "can contribute to a culture of 'not rocking the boat' at board meetings."

On the other hand, an elected board is and must be held accountable directly to the electorate. As is evident in the current campaign for the HEA board, candidates must appeal directly to the pubic whom they wish to serve. Candidates for an elected board must first convince voters that the candidate promises qualities such as openness to the public, technical knowledge and ability, responsiveness to the public, and a responsibility to the area's future.

Both forms of board membership -- elected or self-appointed -- have strengths and weaknesses. A self-appointed board, though problematic as noted above, does have the potential to bring together a group of committed people based on mutual goals. An elected board, however, has the advantage of ensuring board members answer directly to the people they serve. Given the current, near-total disconnect between the hospital board's perception of CPH's need for a joint venture and public sentiment wanting to retain local ownership and control and board's continued inability to present a rational let alone convincing case for their position, it is time to consider making Central Peninsula General Hospital Inc. elected positions.

John Nelson, Soldotna



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