Changes in Soldotna shouldn't be allowed to hurt Homer hospital

Posted: Monday, August 09, 2010

With Central Peninsula Hospital officials studying a potential change to that hospital's governance structure, members of the Kenai Peninsula Borough Assembly and the administration need to keep a boroughwide perspective on the issue.

Specifically, they need to be able to answer: What effect, if any, will a change at the Soldotna hospital have on South Peninsula Hospital in Homer?

While the hospitals run independently of one another, they share the common characteristic of being owned by the borough. Both hospitals are leased to nonprofit corporations, whose boards govern the hospital. Separate elected service area boards make recommendations on capital spending and scope of services. The borough assembly must approve major capital decisions. A community voice in how the hospitals run traditionally has been valued by peninsula residents.

South Peninsula Hospital is not looking at changing how it operates.

The current arrangement at both hospitals might be a bit cumbersome -- as was evidenced recently when the assembly delayed action on a much-needed enclosure for a new MRI machine for South Peninsula Hospital. A consultant working with the Soldotna hospital has gone so far as to call the current structure "nonsensical," "antiquated" and "Byzantine."

It's also unique. We suspect there are lots of communities the size of Homer, Kenai and Soldotna that would appreciate having the kind of quality health care central and southern peninsula residents enjoy without a long drive or flight to a big city. Not to mention the measure of control residents have in the hospitals' operations.

While the current structure means the hospital boards are able to react less quickly to rapidly changing conditions, it means they are more able to put community and residents' needs above the bottom line.

That's not to say the options shouldn't be examined closely. It's a healthy exercise given the competitiveness and quickly changing face of the health-care industry.

The operating board of the Soldotna hospital has narrowed down its options to two: rewriting its current agreement with the borough to give the board full control over all business decisions and partnering with another institution that could help the hospital grow.

Early in the process, the hospital consultant made a suggestion that also deserves the attention of the assembly, both hospital boards and residents: combining Central Peninsula Hospital and South Peninsula Hospital under the same decision-making board.

"It makes no sense to have two hospitals on the Kenai with the same government structure that are competing with one another," consultant James Orlikoff said back in March.

While there's some cooperation between the two hospitals now, having one decision-making board likely would increase that cooperation to the benefit of peninsula residents.

There would be challenges to such a change. Both communities take great pride in their hospitals, and, for better or worse, each community likes to think of itself as unique and that it does things just a little bit better than the other one.

Nevertheless, the idea has merit and is worth a discussion all by itself.

There's still a lot of work to do before the Soldotna hospital board forwards a recommendation to the borough mayor and assembly about any changes to its governance structure. When that happens -- and perhaps before it happens -- the assembly should encourage both hospital boards to examine if their combined strength could do more good for the peninsula than either can do alone.

A strong model of cooperation and local control ultimately might be the perfect antidote to the competitiveness of today's health-care industry.

At the least, the assembly should make sure that any changes at Central Peninsula Hospital don't inadvertently hurt the operations of South Peninsula Hospital.

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