A broad look at community health care needs soon could be back on the agenda of the elected board that advises on the Central Kenai Peninsula Hospital Service Area.
A compromise attachment to the board's proposed bylaws would direct it to develop, for assembly approval, a plan for identifying available health care services and unmet community needs, and for helping to find ways to meet those needs.
Board chairman Jim Clark said he liked the compromise language, suggested by Kenai Peninsula Borough Assembly member Tim Navarre. Navarre's proposal would give the board most of what it wants, Clark said.
"I'd say they moved closer to us than the other way around," he said.
The board agreed to the compromise language Wednesday. The proposed bylaws and attachment come up for approval at the assembly's May 16 meeting in Soldotna.
Navarre's proposal also directs the board to determine whether the service area should fund budget requests from health care organizations other than Central Peninsula General Hospital and to develop criteria for judging such requests.
The borough owns the hospital, and nonprofit CPGH Inc. leases and operates it. The service area raises about $1 million per year in property taxes to help support it.
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, goals and objectives and sent them for assembly approval in January. They proved controversial. Last month, the assembly amended the draft bylaws to eliminate references to any broad look at community health care needs.
It replaced the board's mission statement with a preamble that says the 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 assembly has not accepted the board's goals and objectives.
Last month, Navarre said the amended bylaws would not preclude the board from doing a needs assessment. However, the board would have to seek assembly approval. Some members of the service area board threatened to resign.
"What I hired on to do is to look at that broader question," Clark said then. "If it's not part of what you want us to do, then I'd opt out of the process."
On Wednesday, Clark said the proposal now on the table may not be everything the board wants. However, the board has spent too long debating the proposed bylaws.
"I think the greater good is served by trying to come up with a compromise," he said.
Board member Susan Jelsma said she thought Navarre's proposal would allow the board to do everything it might have under the bylaws it originally proposed.
"I don't see this as taking any of our powers away," she said.
Board member Pat Hawkins disagreed. Bylaws the board proposed allowed for the service area to hire an administrator or a contractor, subject to the mayor's approval and the assembly's appropriation of funds. The assembly's proposal deletes those provisions.
"I see that the assembly is squashing the powers of this service area board, and that's very unfortunate," he said.
Hawkins said the board put many hours into writing the bylaws the assembly rejected.
"We were doing something the assembly gave us the power to do," he said. "Within a couple of days, they took away our mission statement and our bylaws."
The board voted 5-1 Wednesday to approve the bylaws the assembly proposed, amended to incorporate Navarre's attachment. Hawkins cast the lone dissenting vote.
Navarre said he will present the package to the assembly and expects it to pass. Once it does, he said, he wants the board to write new goals and objectives -- this time, with more public participation.
His proposed attachment directs the board to, "In partnership with other public and private health care providers develop short- and long-term goals for the service area's community health policy, then bring these goals to the assembly for approval and direction."
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