A highly divided Miami-Dade County Commission Tuesday approved a new and smaller board to run Jackson Health System after intense debate.
The drama included a 6-5 vote and then a last-minute flip-flop by a commissioner in the hope she can overturn the result later.
At issue: a resolution to replace the temporary seven-member Financial Recovery Board appointed last year to watch over a system suffering from massive losses. That board is scheduled to end in May, with the old 17-member board set to resume then.
In what was most likely his last major act before he leaves office, Commission Chairman Joe Martinez proposed keeping the seven-member structure, reappointing the existing members and setting up a nominating council that would include a majority of the Jackson board to select its own future members. Nominees would have to be approved by the County Commission.
Martinez, who lost the county mayoral race in August, said he viewed the creation of a new board to run Jackson as an important legacy, since he believes a small, nimble board can operate quickly without undue interference from politicians.
Commissioner Barbara Jordan was opposed, saying the present board had yet to come up with a strategic plan to turn the hospital around and had managed to pull the money-losing system into the black this year only by drastic cuts to the workforce. She worried about creating “a board for life” that would keep re-nominating itself.
“What is the rush to do this?” Jordan asked, noting that action didn’t need to be taken until next spring and that new commissioners will be elected next month.
She made a motion to defer the item but it failed, 6-5. When the board took up the proposal, Jordan changed her vote, deciding to support the item, making the final tally 7-4. Jordan then noted that as a supporter of the motion, she could ask that it be reconsidered at a later meeting.
Commission rules allow a motion to reconsider no later than the next regularly scheduled commission meeting — which Martinez said he is unlikely to attend . “This could be totally out of my hands,” he told The Herald. But his term runs to Nov. 20, and veteran county observers expect him to attend the next meeting on Nov. 8.
Martinez was the mastermind behind the creation of the temporary Financial Recovery Board last year after many criticisms that the 17-member Public Health Trust Board often dithered in lengthy discussions that came to nothing.
In recent weeks, Martinez kept modifying his concept for a permanent board to appease critics. His first plan was to have a board that was totally self-perpetuating, to keep Jackson out of political control. In later versions, he added politicians to the nominating committee, including the mayor, head of the Miami-Dade legislative delegation and the commission chairman. On Tuesday, he added a local leader of the AFL-CIO.
“I heard what people were saying,” Martinez said after the meeting. “I figured this was too important to be held up by minor points.”
Martha Baker, president of SEIU Local 1991, representing Jackson’s nurses and other healthcare professionals, was adamantly opposed to the Martinez proposal. She called the Tuesday vote “a very well orchestrated power grab” by Jackson Chief Executive Carlos Migoya and the board...” She added that “the community Jackson serves will be locked out of having any say about their public hospital for years to come.”
The present chairman of the recovery board, Marcos Lapciuc, had strongly supported a smaller board. In an email to commissioners last week, he wrote, “This smaller, more engaged and more nimble design provides strict management oversight while also empowering talented professionals to act and react quickly to changing conditions on the ground.’’
The new board, he wrote, would “send a clear message to our employees, physicians, business partners, patients and — most importantly — Jackson’s taxpayer-owners; you can tell them that the years of chaotic turmoil are truly over.”
Since the recovery board started in May 2011, meetings have been shorter and the group has moved more quickly, without the frequent delays caused by the old board, which often requested more information, clarifications or alterations.
Migoya has said at board meetings that a smaller board allows him to more easily conduct meetings with individual board members to discuss difficult matters outside public meetings. That’s often meant less disagreement between the board and executives at the public meetings than used to exist under the old, larger board.