Just say No – How Not to Cancel a Meeting – Part 2

In “Just say No – How Not to Cancel a Meeting – Part 1” you learned that there were a number of initiatives underway to improve Broward Health’s services at the time David DiPietro, the Board Chair, seemingly orchestrated the ouster of Frank Nask followed by DiPietro’s apparently predetermined CEO choice and his wife’s fellow medical board member, Dr. Nabil El Sanadi as Broward Health’s new CEO.  See  “The Best Broward Health CEO contract politics can buy!”   and “Has the Office of Inspector General seen Dr. El Sanadi’s CEO Contract with Broward Health?”.   In Part 1, you also saw a remarkable paranoia of organizational transparency in an email chain that is a troubling indicator of how Dr. El Sanadi ostensibly sees his new public responsibilities.

The Saga Continues

After Dr. El Sanadi unilaterally cancelled a planned conference call without explanation,  it appears that he directed Broward Health’s corporate attorney to send me the following correspondence:NotQuiteAsAdvertised

From: Jacob G. Horowitz
Sent: Tuesday, February 10, 2015 5:09 PM
To: Dan Lewis
Cc: ‘nelsanadi@browardhealth.org’ (nelsanadi@browardhealth.org); Sam Goren
Subject: Broward Health

Good afternoon. Attached please find a correspondence from the Broward Health General Counsel’s Office in response to your recent inquiry to Dr. El Sanadi.

Thank you.
Jacob G. Horowitz

The following letter was attached to the Mr. Horowitz’s email.


Horowitz_Page_2As is my custom, I acknowledged receipt of the letter by email:

From: Dan Lewis
Sent: Tuesday, February 10, 2015 6:19 PM
To: ‘Jacob G. Horowitz’
Cc: ”nelsanadi@browardhealth.org’ (nelsanadi@browardhealth.org)’; ‘Sam Goren’; ‘David Di Pietro’
Subject: RE: Broward Health

Mr. Horowitz,

I am in receipt of your remarkable and disappointing “General Counsel’s Office” correspondence.  Certainly it calls for an equally remarkable response, which will be forth coming.

It seems to me that it may be a good time for a very public debate.

Let the sun shine in!

Dan Lewis

right to knowA few days later, I replied to Mr. Horowitz’s correspondence with my letter to Board Chair, David DiPietro (whom I felt responsible for this putative mess) and copied the entire Broward Health Board of Commissioners.

February 17, 2015

Mr. David Di Pietro,
North Broward Hospital District
Board of Commissioners
District 6 – At Large

Dear Mr. Di Pietro,

I have taken a few days to digest the district’s February 10th corporate counsel’s letter to me on behalf of Dr. El Sanadi in which you were copied. The letter was initially both infuriating and disappointing, then over time, just sad.

Some context

For the past three years I have attended virtually all of your open committee and Board meetings with the singular purpose of helping the system become the finest public hospital system in the country. This purpose emanated from a commitment I made after nearly losing my daughter to a rare medical syndrome and the systemic incompetence of both the emergency and ICU services at Broward Health. Instead of litigating these failures, I committed

to use my abilities and resources to be part of an effort to help the system leave its colorful past behind and improve the quality of health services it provides to the public it serves.

During this time, it should be noted that I have met with you, both past and current Board members, numerous senior staff, and most of the elected officials representing the city, county and state interests within the District boundaries multiple times on an evolving agenda focused on making the District one of the finest public hospital systems in the country. I have used my experience spanning over 30 years as a former elected official, past chair of multiple School Board advisory committees, past chair of the Growth Management Advisory Committee, the Management & Efficiency Study Committee and the past chair of both the Fort Lauderdale Charter review committee and Broward County Charter Review Committees.

Requested meeting

Imagine my surprise at receiving your Corporate Counsel’s letter which was in response to a simple request to meet with your new CEO. You will recall that you promised to facilitate this meeting which was first requested in December shortly after Dr. El Sanadi was appointed. In fact, Dr. El Sanadi himself promised to meet with me in March at a previous Board meeting.  So what happened?

First was my public objection to the Board’s position relating to the SFCCN, followed by my attendance at the SFCCN board meeting. At the SFCCN Board meeting, I spoke on the issue of public meetings, the impact of sunshine committees and public records in a misunderstood effort to help the District.

Then, following Dr. El Sanadi’s instructions – earlier this month, I called Mrs. Wing to set a time for a private meeting.  I was asked to propose a topic and agenda for this meeting which I did from my working notes. This resulted in a remarkable recorded message from Dr. El Sanadi which in raw terms foreshadowed your Corporate Counsel’s letter to me.

My proposed agenda“My purpose, and intent in meeting with you is to afford both of us the opportunity to get to know each other in a frank and useful exchange of ideas.  This exchange will help me understand the extent with which I will be able to work with him to fulfill what I hope is a shared commitment for excellence.Informal Agenda:

  1. Incomplete initiatives:
    1. Intensivist program
    2. Centralized credentialing
    3. Centralized EMR & CPOE training
    4. Multi-level alliance w/ the Memorial System for Health Care services to all public employees in the county including:
      1. County government
      2. Constitutional Officers
      3. Municipalities
      4. Taxing Districts
      5. Non Profits
      6. Unions
  2. Procurement Policy
  3. Board Liaison Position
  4. Broward Health as a Teaching & Research Hospital
  5. Internships
  6. The Nova strategy as extended to FIU
  7. The Ambassador’s Program
  8. Tri-County Physician Marketing
  9. Board Policies:
    1. Eliminate committees, conduct all business at meetings;
    2. All board questions through CEO to staff
    3. Audit Reports, like management reports, provided to staff for response before going to Board.
    4. Executive Officer liaison to Board to review all agenda items with individual board members prior to Board meetings.
    5. New procurement code.
    6. New policy on agenda items e.g. who can place items on the agenda, timelines for agenda items, etc..  All board members must be allowed to place items on the agenda.  Agenda items must be moved and seconded before discussion and motions.
  10. FLCCN

I hope that this agenda is sufficient for you to find time in your busy schedule to meet with me. I too have a busy schedule, but I will make the time to meet with you when it is convenient for you.”

Corporate Counsel’s Letter

“Strategic planning” as defined by Section 395.3035 F.S. and as applied is overly broad and in my opinion is being used to shield the District and Administration from important public oversight. While there is certainly instances where confidentiality is necessary, in most cases it is not.  This “behind closed door” mentality is significantly responsible for the misconduct of the past which is and has been the subject of numerous state and federal investigations into the District dealings.  For the Corporate Counsel to opine that “it would not be legally appropriate for Dr. El Sanadi” to discuss the matters on my proposed agenda is absurd and overly broad. Certainly a CEO of one to the nation’s largest public hospital system knows enough not to disclose sensitive or confidential information in the course of normal conversations. Persisting in this untenable position would beg judicial intervention and interpretation, and perhaps that would be a good thing.

Further, in what can only be taken as a threat on the basis of an intentional misinterpretation that I am a lobbyist, or that the Boards internal lobbying policy in anyway applies to me or my requested meeting.  The comment “We recognize that the policy may not apply to your current request” is akin to the admonition “with no disrespect” immediately followed by disrespect. It is what it is, it says what it says.

At this point, I am not convinced that Dr. El Sanadi shares my commitment, or has the ability to make Broward health the finest health care system in the country. From what I have seen thus far, he seems remarkable unprepared for such an effort.

Going forward

I believe that any meeting with Dr. El Sanadi would be unproductive at this point.  Instead, I will be making some comprehensive requests to Dr. El Sanadi pursuant to Art. 1, s. 24(a), Fla. Const. which establishes a constitutional right of access to any public record made or received in connection with the official business of any public body, officer, or employee of the state, or persons acting on his behalf.

In addition, shortly, you and some of your other Board Members will receive a comprehensive public records request from me on any correspondence, documents, and records you have or have received roughly consistent with the topics on my agenda above. Regrettably, because of the apparent secrecy in which your new CEO choses to operate, some of my 119 requests will be somewhat broader than the agenda.  (You will recall the requirement to respond to these requests are not only the responsibility of the organization, but also a personal obligations of holding office.)

I am doing my best not to prematurely draw conclusions from what I have seen and heard about the irresponsible damage being done to the Broward Health organization by what appears to be at best a well-intentioned but completely unprepared and inexperienced CEO.  I hope my fears are unjustified and that the records I will be requesting will show a very different picture. If my fears are justified then you should be very concerned.

Dan Lewis

After I sent my letter, I had an opportunity to attend the February Board of Commissioner’s meeting.  Three commissioners came up to me, acknowledged my letter and asked that they be kept in the loop.  This was in stark contrast to the throng of staff members, who regularly attend board meetings for no apparent reason, uncharacteristically distancing themselves from me (likely for fear of being seen with me by Dr. El Sanadi). A sad expression of understandable organizational fear.


Part 3 of this series “Just say No – How Not to Cancel a Meeting “ will focus on the public records request to Dr. El Sanadi and his curious response.  Stay tuned!

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