Healthcare

Commissioners to reconsider board structure for Jackson Health System

 

County commissioners are scheduled Tuesday to reconsider shrinking Jackson’s board after it was narrowly approved in October.

jdorschner@MiamiHerald.com

Struggling to find the best long-term solution on how Miami-Dade’s public hospitals should be governed, county commissioners are expected Tuesday to reconsider a resolution that a deeply divided commission approved six weeks ago to permanently shrink the Jackson Health System’s governing board to seven members.

The motion passed in October, pushed hard by Commission Chairman Joe Martinez, with the key vote 6-5 in favor. Martinez left the commission in November, and as soon as he left the board brought up the issue of reconsidering.

Marcos Lapciuc, Jackson board chairman, has urged commissioners to keep the board at seven because it would be “more engaged and more nimble.” Martha Baker, president of SEIU Local 1991, blasted the proposal as a “power grab,” because the majority of the nominating council would be current board members, with the nominees then being approved by the County Commission.

Chief Executive Carlos Migoya, while not formally endorsing any board proposal, has said previously that a smaller board makes it easier for him to brief members by meeting one-on-one with each of them before public board meetings.

“That’s Sunshine 101,” Migoya said at one board meeting, referring to the state law that bans private meetings between two or more members of a public governing body.

Jackson’s board used to have 17 members, an unwieldy number that often resulted in 12-hour meetings with a lot of talk and delayed decisions. In the spring of 2011, Martinez pushed through a temporary Financial Recovery Board of seven members to help the financially troubled system get back on secure footing. Meetings became much shorter and decision-making faster. The FRB was scheduled to end in May until Martinez proposed making the board permanent.

Under the FRB, the general practice has been for Migoya, Chief Operating Officer Don Steigman and Chief Financial Officer Mark Knight to meet with each board member for an hour, a day or two before the monthly board committee day. The board members have commented at public meetings that they are happy to have the briefings.

Baker, who represents Jackson’s nurses and other healthcare professionals, says the results of the briefings are apparent in the public meetings: “The amount of open discussion is greatly reduced which causes a very concerning lack of transparency.”

Barbara Petersen, president of the First Amendment Foundation in Tallahassee, says that if the briefings are intended “to avoid discussion of the issues at a public meeting, or is relaying information from one board member to another, that’s a potential violation of the Sunshine Law, not just the spirit of the law.”

Migoya issued a statement Tuesday: “The board members, all of whom are volunteers, have expressed that one-on-one briefings help them understand the complexities of healthcare policy and the nuances of our recommendations. This helps them have thoughtful and informed public discussions that adhere to both the letter and the spirit of Florida’s sunshine laws.”

Migoya is not alone in his use of one-on-one meetings. Commissioners at the city of Miami -- where Migoya was city manager -- and Miami-Dade school board members, among many others, receive regular pre-meeting briefings.

Jon Kaney, general counsel for the First Amendment Foundation, calls the one-on-ones a difficult issue. “Every manager or director follows the practice to some extent. Up to a point, it is necessary and appropriate. But when the meetings... supplant public discussion, there is a problem. Of course, the members and executive always swear there was no polling of the members or relaying views from one to the other.”

Sometimes briefings backfire, as they did at last month’s Jackson committee meetings during a discussion on contracting with an outside pharmacy service. When Baker said the service could be provided better and cheaper with Jackson pharmacists, board member Joe Arriola complained that he had not been “totally informed” in his executive team briefing. “It is very troubling,” he said. He voted against the item.

Linda Quick, president of the South Florida Hospital and Healthcare Association, said that briefings make sense for any board, public or private. “Any book you pick up on board communications and board management recommends that managers have individual conversations with board members prior to board of director meetings.”

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