Be afraid, be very afraid!

A Recent Broward Health Board Meeting

As seen in the City News, a group of 10 neighborhood newsletters that go to about 60,000 affluent homeowners in, and around, Ft. Lauderdale, Wilton Manors and Oakland Park each month. Author Dan Lewis’ articles are regularly published in the City News publications. Contact them at citynews@bellsouth.net or call (954) 564-1308.

The Broward Health chairperson begins the board meeting in broken English with a call to order, followed by an unintelligible instruction to call the roll: Chair Rocky Rodreguez, “here”; Vice-Chair Christopher Ure, “here”; Beverly Capasso, “here”; Linda Robinson, “here”. So, begins the meeting in a nondescript room at the unimpressive west-central “Spectrum” headquarters of the 2+ billion-dollar tax-supported safety-net hospital system responsible for the healthcare of the majority of Broward County.

By law, there are supposed to be 7 board members for Broward Health, all appointed by the Governor. But for more than a year the Governor has not appointed members to fill all the board vacancies. Recently, after one Board Member refused to be re-appointed, and another resigned because of alleged misconduct by her fellow Board Members, the board only has 4 active members – the exact number required for a quorum to conduct the business of the 2+ billion-dollar health-care enterprise.

Rocky Rodriquez
Rocky Rodriquez
Linda Robison
Linda Robison
Beverly Capasso
Beverly Capasso
Christopher Ure
Christopher Ure

Because the number of board members equals the board quorum requirement, depending on whose legal opinion the board chooses to follow – either the board requires a unanimous vote (a majority of the Board legal argument), or three of the four active members to vote (a majority of the quorum legal argument) for an agenda item for approval. Remarkably, the board’s legal counsel advised that on a particular agenda item where one board member recused themselves due to a conflict (an all too common occurrence), only 2 out of the remaining 3 votes would be required to approve the item. Not surprisingly,  no experienced or past Broward Health legal counsel agrees with this board’s legal counsel’s advice here. Consider the ramifications of a hypothetical agenda item to privatize the system where one ethical board member wisely recuses themselves. According to the current board counsel, only 2 affirmative votes would be required to flush the system down the toilette.

The Governor needs to do all that he can do to appoint members to fill all the vacancies on the Broward Health Board. The voting uncertainty alone argues for urgency.

But I digress, back to the meeting.

The meeting room is filled with senior and mid-level staff, district employees and physicians who have come to watch the board spectacle but have little other purpose in attending. Each has way better things to do, but here they are anyway. By my count, the only other people at the meeting are a few vendors interested in specific agenda items, some low-level employees who have rightly been singled out for monthly honors, and, of course, John DeGroot – a self-styled curmudgeon who should have listened to the advice “Better to Remain Silent and Be Thought a Fool than to Speak and Remove All Doubt”.  Unfortunately for John, there is little doubt left.

I bring up Degroot because what happens next illustrates the point that even the relatively simple task of managing public comment appears to be beyond the abilities of this Board.

The Chair calls for “Public Comment” (an agenda item that gives anyone the opportunity to address the board on any relevant matter) and DeGroot swaggers to the podium, as if fulfilling some anointed obligation to harangue the board. A security guard quietly takes his post about 20 feet back. Degroot begins, as he usually does, with a factually unsupported assumption to which no one agrees, and then demands that a particular board member give a response to an angry question born out of an unhappy life.

meeting cartoon

What happens next, or rather what doesn’t happen next is the point. Silence. Silence, while board members check their phones for calls, emails, texts – and waits, the chair shuffles, uneasy in his seat and waits – refusing to look up. Degroot waits in silence holding the podium hostage. And waits, and waits. Finally, I could take it no longer, I said out loud what everyone in the room was thinking “Are we waiting for the 3 Minutes to expire? This is ridiculous!”. The Chairman looked up and I shrugged my shoulders and used my best hand gestures to signal “WTF”. Thankfully, just then, the very able Maryanne Wing – clerk to the board, announced that 3 minutes had expired and Degroot sat down with his pyric victory and petulant smirk!

The context to this incident is this. There is typically a 3-minute rule for public comments at most public meetings, and Broward Health is no exception. Except, the 3 minutes is not a grant of time. Rather the 3 minutes is a limit. In addition, well run meetings prohibit the back and forth debate between the public and board members as a slippery slope to meeting chaos. Again, Broward Health meetings are no exception. Degroot knew full well that meeting decorum rules prohibit any conversation or response to his question by the Board.

Here’s what should have happened, but didn’t. After Degroot asked his absurd question – the Chair should have immediately reminded him that the board would not respond, and ask if there were anything else – and if not, instruct him to take his seat or be removed.

I use this incident as a microcosm illustrating a fundamental problem at Broward Health with its current 4-member board. The board doesn’t understand the basics of why they’re there, what they’re doing, or who’s interests they represent.

Another example in this same meeting, was the item addressing the suspension of the CEO search efforts. Here’s what happened. At a Board Member’s recommendation and after paying more than $300,000 to recruit a new CEO to replace more than a year of “interim” CEO’s, and after interviews culled the candidate list to 2the board abruptly cancelled their CEO replacement activities to hire, instead,  a management company to tell them (the board) what, if anything, is wrong with the management organization at Broward Health.  Likely, after spending hundreds of thousands more of our tax dollars – the management company will report what everyone knows, that the root of the management problems at Broward Health is the board itself.

By common sense, relevant Florida Statutes, Broward Health’s charter, and specific prohibitions – the Broward Health board is not to interfere with the management or operations of the health system. The board’s job is to make policy, and supervise the CEO, Corporate Counsel as well as a compliance officer – not manage Broward Health!

It is specifically the CEO’s job to manage the organization (please see every text book about the function of CEO’s versus its Boards!).

Here’s what should have happened. The board should hire a CEO, give that CEO the support necessary to address all the management issues of the District. The board should remove itself from any involvement in the hiring and firing of district employees. The Board should support the CEO if he or she believes that he or she should hire a management company for areas in which the CEO may designates and that management company, if hired, should be responsive to the CEO – not the Board.

Instead, the board using a board member’s convoluted argument hired a management company to advise “the board” on the management of Broward Health. This advice demonstrates a complete lack of understanding about a public organization, its management, processes, functions, or this member’s role as a public fiduciary. What is both disappointing and a little unnerving is that the resume of this board member asserts his experience as a management consultant and wealth manager. Based on his Board actions, he’s the consultant who borrows your watch to tell you the time.

self-inflicted-woundThe current 4-member board doesn’t understand the basics of why they’re there, what they’re doing, or who’s interests they represent.

The active board members are a realtor, and insurance salesman, a nurse and a lawyer connected with a local lobbying firm known for its government practice.  Most observers and those “in the know” believe this board is being bullied by an out-of-control corporate counsel who’s conduct appears to be remarkably self-serving and designed to strengthen her political control of the organization. Supporting this group of misfits is the weakest senior staff in the history of Broward Health due to the ill-conceived political “purges” begun under the chairmanship of disgraced David DiPietro and continuing under CEO Dr. El Sanadi (who, you recall, committed suicide while under a cloud of investigations). (You can read my many articles published at the time – see the archives ). This menagerie is running a 2+-billion-dollar healthcare enterprise into the ground with (and I’m being charitable here) their best intentions.

A conspiracy type would consider all this through the lens of deliberate destabilization for the purpose of satisfying the Governor’s stated intentions to privatize public hospitals in Florida. Publicity shy, consummate lobbyist, Broward resident and close friend of the Governor – “Billy” Rubin’s name is often mentioned as the puppet-master.

I know and have great respect for Rubin and his abilities. While he certainly has clients with interest in Broward Health, I am not convinced by the conspiracy arguments or Rubin’s alleged part in that scenario. So what is driving this train wreck?

After going to the last few meetings, I am struck by the overt incompetence of the board and their complete failure to understand their role in the governance of Broward Health. I think the damage is largely self-inflicted.

Pick your cliché: deliberate destabilization, paralysis by analysis, stagnation by allegation – each is apropos and from any perspective, Broward Health’s Board conduct and actions seem to defy reasonable explanations and is an embarrassment to every taxpayer in its district.

The problem is most acute in the system’s governance – the Board, it’s hires and senior staff. Less problematic are thankfully the thousands of health care workers who daily deliver high quality service to the community. But the organization, at its most granular critical levels are not immune from the irresponsibility of the board and senior management. The longer that the board dysfunction and the Governor’s failure to appoint qualified people to a full board continues, the more avoidable and inexcusable damage will be done to the organization and Broward’s healthcare needs.

Broward Health March Board meeting, was I at the right meeting?

MeetingNeverHappenedAs is my practice, I attended the Broward Health Board meeting yesterday, and, except for a predictable push back and sad ad hominem attack on this successful blog through a weak attempt at character assassination, apparently orchestrated by Chairman David Di Pietro through John Degroot,  the meeting was remarkably professional and well run.

Absent from the meeting were the smug insider winks and nods of obscured agendas so characteristic of recent meetings, and discussions from the Board and CEO Nabil El Sanandi were both direct and on point.

Holy transformation – I kept looking around making sure I was at the right meeting.

The only clever gotcha that occurred was a carefully choreographed “walk on” item to restore the Pediatric Neonatal ICU at Coral Springs that was closed in 2013 for “fiscal” reasons, but not medical reasons.  Since this item was a walk on, and emotionally argued, the full reasons for the closure in 2013 were never presented by Dr. El Sanadi even though he certainly had the full report that served as the basis for the closure in 2013.  Nevertheless, if one separated out the emotional arguments, what was left was persuasive, and had I been on the board, I would have gone along with the unanimous vote to reopen the unit at Coral Springs.

This is a good segue way into an important discussion about this blog as a continuation of its purpose (Happy St. Patrick’s Day! Why this Blog exists) and scope (It’s none of your business! Really?).  Certainly, I intend this blog to have “red meat” posts that will open up insider double dealing, fast talking and clever maneuvers designed to obfuscate Broward Health’s true purpose.  Some of the posts will deal with the seemingly bad actors on the Board and CEO Dr. Nabil El Sanadi in direct and revealing terms, but whether it be criticism or praise – it is always about their official action or inaction.  The Broward Health Board members, and the officers they specifically appoint are public officials under Florida Law.  Only these public officials will be identified by name in posts.  Even further, their private lives are not relevant in posts on this blog, except to the extent that they involve the public actions and duties of their positions with Broward Health.

OuttaHereAs an example, Dr. El Sanadi is, by reputation, a fine physician and clinician.  His appointment as CEO and his actions as CEO, including potential conflicts with his other personal businesses, are relevant to this blog.  Any criticism of Dr. El Sanadi in this blog is directed to him as a CEO, a public official.

Another example, David Di Pietro, the current chair of the Broward Health Board is also an attorney.  I have witnessed his abilities as a lawyer, and can easily commend his legal services.  But, as is evident from many of my posts, I have a real concerns with his stewardship as a Broward Health board member, let alone as chair of the board.

This blog will continue expose how the “sausage” is made at Broward Health, and continue to stimulate a robust conversation on the purpose and practices of our Broward health public hospital.  Along the way, you should expect some really good “red meat” posts, and being human, from time to time, I will swerve off my path and address actions like the ad hominem attack on me by Mr. Degroot, even though his actions are less than a whisper in a wind storm.

Stay tuned.  Next week, a multi-part series of stories will be posted – likely one each day.  You won’t want to miss it. Lots of “red meat”!