Broward Health Board’s failure to provide any effective oversight into the activities of Corporate Counsel’s legal department has allowed Broward Health’s legal czar Barrett to weaponize the IRO process against those she feels are against her in the organization. The cost of Barrett’s misuse of Broward Health’s legal resources is humongous – in the millions of dollars. Details are largely unavailable because various public records requests relating to her spending go unanswered.
“IRO” stands for “Independent Review Organization.” Its purpose is to spot check Broward Health’s compliance with the terms of the “Corporate Integrity Agreement.” As part of the agreement, the IRO is given unfettered access to everyone and everything at Broward Health. Because IRO firm was selected and is paid by and through Lynn Barrett’s discretionary authority, it is natural – even predictable that the IRO reviews would be particularly responsive to direction, winks, nods, and smiles from Barrett.
As the following IRO reports show, the IRO operates exactly as the Spanish Inquisition did – but without the physical torture. Once, set on a target – the IRO does an exhaustive, even ad-nauseum narrative of its so-called voluminous investigation.
The intrusive nature of the IRO’s investigative process on the Broward Health organization is itself a penalty to those it touches and is counterproductive for both compliance with the CIA and the establishing of a positive reporting cultural environment.
Before I get to what I believe the process should be, let me share some documents. The first is July 10, 2017, IRO report (highlighted). The central theme of the report (a nice way to put an allegation of wrong-doing) is that money was spent that was not properly authorized. The target’s of this so-called “investigation” were a couple of senior executives who as a result of the “investigation” left the employ of Broward Health, but not without a significant severance package ensuring their silence.
To digress to an important point. The severance agreement for separated tier 1 & 2 (management) employees incorporated a confidentiality clause providing that if the “retired” employee talked about the circumstances surrounding their severance from Broward Health, they would not receive any remaining severance payments. Naturally, these payments were conveniently scheduled over a period thus ensuring their silence over time. The Board, some time back, instructed an end to this practice, but with so much Board turnover, and little or no oversight of the legal department, the banned severance agreements continued to be given.
The second document consists of raw data including copies of original emails containing authorizing signatures, and much more which tend to refute the findings of the IRO. Of particular import to this article is the fact that the employee targets of the IRO happened to have had the audacity of questioning Lynn Barrett and objecting to some of Barrett’s actions (and I’m being kind by using the word “objecting..”
Here are the two companion documents. 7/10/2017 Broward Health IRO Report7/10/2017 Broward Health IRO Report
Some Original Exhibits to the 7/10/17 IRO Report
If you spend hours going back and forth between the documents, you will find that numerous “findings” by the IRO are refuted by the actual documents he was provided with at the time of his investigation. Even when an issue is inconclusive between the allegation and the supporting documents – the IRO appears to make findings consistent with Lynn Barrett’s internal political objectives. Some would suggest a mere coincidence, but I find it concerning.
The IRO’s most recent report is in the context of a significant division between Barrett’s legal department and Capasso’s operations. See my article INDICTMENTS, AND BREACHES OF ETHICS ARE ENDEMIC AT BROWARD HEALTH. The clear target of the IRO report is CEO Capasso and the Chief Financial Officer. While I have yet to research the IRO fully, I am skeptical. Certainly, some of the IRO’s observations have merit – but all?7/24/2018 Broward Health IRO Report
Broward Health Commissioner Berry placed the most recent IRO on the Boards Jun/July meeting and at the end of the meeting a discussion ensued. The Board was justifiability nervous at both the tenor and the implications of this recent IRO report and instructed CEO Capasso to carefully review the report and address those issue with which it agreed, and identify those findings with which it did not agree by the time certain of the next Board meeting. See the discussion at the end of the 2nd half meeting video.
Jun/July 2018 Broward Health Meeting – Part 2 Video
The context of these IRO reports demands that we be cautious before blindly accepting their findings on face value. Also, there is a process problem with the entire IRO relationship.
First, leaving the factual basis of the IRO report aside for a moment, one must ask how the IRO even knew of the very circumstance he was investigating. Did he stumble upon it as part of an unrelated or other continuing inquiry – or was he tipped or directed to look into the matter. I make no apologies for believing Barrett directed him to the issue, but I could be wrong.
Second, if the IRO were tipped or directed to the subject matter – where was Broward Health’s own compliance department’s investigation?
I believe the proper IRO process goes something like this:
- Broward Health’s Compliance department gets a tip or an inquiry and investigates.
- If Compliance finds a violation, the information then is transmitted to CEO Capasso for appropriate review and action.
- CEO Capasso or her designee transmits the findings, investigation details, and any corrective actions taken to the IRO.
- The IRO takes appropriate action in oversight of compliance and the conduct of Broward Health in the matter.
Just to be crystal clear, no one is suggesting that Broward Health take a permissive approach – quite to the contrary. I am saying that once an issue has been uncovered that appropriate senior staff should be given the opportunity to investigate and address it, and then be judged how well they comply to the CIA by the Board, the IRO, the Inspector General and the public. The alternative and current process is every error improperly condemn the entire system – which is neither true nor fair and the thousands of Broward Health employees know it! The exception is not the rule.
At Broward Health, people will make mistakes in a large organization, and there will be reportable events in the future, but the health and the integrity of the organization will be how these issues are handled. It is the administration’s job to address the problems and it is the Board’s job to see that they do. The Broward Health Board needs to start doing its oversight job and establish clear policies that heal, grow and protect the entire Broward Health organization and that includes addressing this IRO runaway train that Counsel Barrett appears to have weaponized.