Matt Ready

I don’t have a full record of the March 5, 2014 commissioner meeting, but I do want to share several items I brought up to the board during the board business portion of the meeting.  Please note, these are not exact quotes, but are paraphrased from my recollection and the statements I had prepared and brought with me to the board meeting.

Item 1:  Board Policies and Bylaws Transparency

The first issue I raised was regarding the publication of board policies and bylaws on the hospital district website.  I said something to this effect:

“I think it is important that this board operate in a transparent and open manner so that the public can best understand what we are doing and why we are doing it.  With this in mind, I think we should publish our board policies and bylaws online.  These documents inform virtually every action and decision this board touches upon during these commission meetings.  Moreover, I know we are considering revising these documents and as such, isn’t it appropriate for the public to understand the current policies so they can appreciate our discussions of how to change them?  I would like to know my fellow commissioners thoughts on this.”

The other commissioners made some remarks, but I do not have their exact words, so I do not want to attempt to paraphrase them in case I misunderstood.  We did not take action on this suggestion during this meeting.

Item 2:  March 21 Special Session Questions

Next, in reference to the March 21st special session I said:

“I believe the March 21st special session is largely being scheduled in response to my request for information and discussion which I stated during our board retreat and at the following board regular session.  With this in mind, I wanted to make certain everyone understood clearly what questions I am hoping for us to focus upon.  I am more than happy to meet with and work with the facilitator who is planning that special session to help make this happen.  My questions are:

1. What is the current organizational view of community health needs- which it has been using to guide major policy and decision making including the ESS building project?
2. What is the current organizational priorities amongst these recognized community health needs?
3. How will the new building project impact/ benefit the community?  (This might be titled a “Community benefit Analysis” or “Community Health Needs Impact Analysis”)
   1. What will be our mechanism’s for evaluating the building project’s effectiveness regarding community benefit?
   2. What are the building projects measurable objectives re community benefit?”

The other commissioners made some remarks, but I do not have their exact words, so I do not want to attempt to paraphrase them in case I misunderstood.

Item 3:  Community Health Needs Questions

The 3rd major issue I raised were questions about the Community Health Needs Assessment which the hospital is participating in collaboration with the Health Department.  I said:

I propose we formalize in policy this organizations relationship to community health needs assessments.  I think this will help us moving forward.

Questions we will benefit from asking and answering clearly include:

1. Why are we participating in a community health needs assessment?
2. Who is responsible/accountable for the successful completion of a community health needs assessment?
3. Is the community health needs assessment important for the board to effectively govern and for JHC leadership to successfully strive to fufill the hospital districts mission?
4. How often should a community health needs assessment be done?What is to be done with the community health needs assessment upon completion?  Based on my research, there are 3 things that can happen after a community health needs assessment.  First and most common is NOTHING.  This, Dr. Locke reminded us is far too often the result.  But the two very positive constructive things that can happen are a Community Health Improvement Plan, which would be done in collaboration with other community stake holders, and a community benefits report, in which the hospital would clearly state its plans to take action to positively impact the health needs of the community.  Which of these choices will we make?
   1. Will we participate in a community health improvement plan process?   If so, how often?  Who will do it?  How will it’s effectiveness be monitored and evaluated?
   2. Will we require a community benefit plan be drafted for JHC?  If so, how often?  Who will do it?  How will it’s effectiveness be monitored and evaluated?
5. Does the current JHC mission statement adequately affirm that our policies integrate and reflect the public interest in our meeting our responsibilities as a public hospital district?  In other words, does our mission statement clearly state our simple responsibility to “identify and meet the healthcare needs of our community?

I have found some models used in other healthcare institutions that answer the above questions which I am considering consolidating into an amendment proposal for this board to consider.

There was no discussion following the above remarks.

Item 4:  Charity Care and Collections Policies

Regarding hospital charity care and collections practices I said,

“I have some concerns that our charity care and collections policies and practices are not as fair and reasonable as they could be- and as the board might expect them to be.  I met with a private citizen this past week who had done some interesting research into our collections practices and it was very thought provoking.  I suspect we have some strong opportunities for improvement.  I also think it is appropriate for this board to set very clear expectations about our hospital district charity care and collections policies, perhaps even if it is merely to say, “The charity care and collections policies of this hospital district will be fair, reasonable”  and perhaps even “compassionate.”  With this in mind, I am considering drafting an amendment to our board Ends policies regarding our charity care and collections practices and how we might monitor such expectations.”

There was no discussion following the above remark.

Next Commission Meeting:  March 19, 2014

I will keep this blog updated as I continue to work with the commission towards action on the items above and more.