Too often too many of us carefully stand on the sidelines hurling criticisms at the players (in this case usually the Board Members) without offering any constructive solutions to the problems presented.
I would like to dedicate this post to some suggestions and perhaps, some superficial arguments on their behalf. However, do not judge the suggestions merely on my supporting superficial arguments that by necessity must be uncharacteristically short. Each suggestion could be a post entirely in itself.
However well intentioned, the Board of Commissioners – lacking any intuitional memory, should never have replaced their governmental counsel with compliance counsel. Moreover, based on past District history, inside counsel versus a multi-disciplined outside firm has never worked for Broward Health.
Currently, Broward Health is misusing the highly respected Berger-Singerman governmental law firm. Contrary to the current arrangements with the ‘Audit’ committee, Berger-Singerman should be retained by the Board through their general counsel to provide governmental advice to the Board. Florida’s Attorney General has demanded 5 million from the District, which means the public – and we need to be both defended and protected. Discussions in anticipation of litigation are generally and appropriately held in the shade.
The Board of Commissioners need the advice of a Governmental Lawyer – Like Sam Goren, Mitchell Burger is one of the best. Let him continue to help the District, but elevate his assistance to the Board level.
Fog of War
The district is awash in rumors, allegations, name-calling, and conspiracies around every corner creating a “fog of war” condition over Board discussions and decisions. This must be addressed. Here is how it can be done.
- The Board should unilaterally revoke all current non-disparaging clauses in all severance agreements. This revocation should be noticed to every ex-employee currently receiving any kind of severance.
- The Board should unilaterally revoke all non-disparaging clauses in all vendor and/or service agreements currently active. This revocation should be noticed to every party to an agreement having a non-disparaging clause.
- The Board should establish a policy that no future agreements of any kind will contain any non-disparaging clauses, sections or prohibitions.
- Take your chief internal affairs or compliance person and establish them in the Florida Inspector General’s office for at least the next 12 months. Have them establish a confidential reporting function for any Broward Health employee, vendor, physician or other who wants to confidentially report criminality, corruption, or policy (non-medical) violations at the District. Have this person conduct exit interviews of every fired, work-place reduction, resigned, or retired employee of Broward Health. Insure anonymity and confidentiality for all contacts to the office. This office should forward allegations to the appropriate investigative agencies or departments. Once this process is established, no more internal investigations, no more rumor hunts – all allegations, etc. will be referred to the Broward Health office of the Inspector General. (It is noteworthy that the Berger-Singerman firm has experience in setting this process up for the Water District.)
The finances of the District have been mauled by incompetence, the District’s Bond Rating is in peril, and although the recent month of financial good news is welcome – the District is still on a perilous financial path as a result of weak leadership. Even if the District accelerates the recruitment of a strong outside CEO – it will be months, if not years before a new person can be hired and transitioned into the unique problems at Broward Health.
If only there were someone with the requisite experience, knowledge and financial ability who could step in and start work day one! But wait, there is.
Both CEO Frank Nask and Memorial’s CEO Frank Sacco are available and might be willing under the right circumstances to become an interim Broward Health CEO until such time as a new CEO can be hired and properly transitioned. Both know the District, both enjoy the confidence of the Bond Markets, and both are strong leaders who could begin to sort out the problems on day one. And neither would be interested in a long term assignment.
The Board should ask Commissioner Gustafson to make contact and see under what conditions either Nask or Sacco would be willing to briefly come out of retirement and become Broward Health’s interim CEO. Maybe they wouldn’t, but maybe one of them might! Commissioner Gustafson has a good relationship with both men and would be an ideal Board advocate in this matter. Worst case scenario is they both would say no. Swallow your pride and think of the public you serve.
The Board needs to address the very sad state of affairs in its weak purchasing policies. Before Dr. El Sanadi, the Board with its then governmental counsel Sam Goren was working on a comprehensive review and rewrite of these policies. I saw a draft of this effort and shared some ideas from my time a chair of the County’s management and efficiency study and Charter Review commissions. It was a good beginning step, but it needed some work. At the time and to his credit, Commissioner DiPietro was leading the effort. It is time to resurrect this effort and finish the job.
Centralized credentialing was supposed to be effective at the time of corporate’s move from Broward General’s historical location to the new facility at the Spectrum Center. It was an important first step to address the negative influence of rampant physician silos at each of Broward Health’s hospitals. Here how it was to work.
- All physician credentialing paperwork centralized at the new Corporate Headquarters.
- A new credentialing committee essentially comprised of the medical chief of staff of each hospital, and various other medical and compliance members.
- Physicians credentialed at one Broward Health Hospital would be at all Broward Health hospitals.
This strategy based on physician convenience would help drive and maintain patient admissions across the system while providing corporate with the ability to recruit needed area specialty physicians easily. Moreover, recognizing that the part of the credentialing fees that go to the various hospital medical staffs for their discretionary use would be lost or significantly reduced under this plan, it was important that an alternative method of funding the hospital medical staff’s discretionary budgets be found. Not an impossible task. Finish this initiative.
Let me finish …
This is directly to the Board. Knock it off, and get to work! Stop chasing rumors, allegations, or conspiracies. Start doing your job building for the future. Ignore but cooperate fully with any investigations. They will either materialize into something or disappear into nothingness. Have a real vision for building Broward Health into the finest public health system in the nation and let nothing distract you from that mission. Value your public, your physicians, your employees and the sacrifices of so many that put you in the position to do some good. There are smart people who are standing by to help you succeed. Seek them out and listen. Eyes forward.