Letter Dr. Walter Young

Rickey Stokes

Viewed: 1595

Posted by: RStokes
[email protected]
3347901729
Date: Nov 04 2024 8:21 PM

There will be a proposed amendment on the November General Election ballot for the registered voters of Houston County to vote YES or NO on changing the appointment process of the 12 members of the Southeast Health Board of Directors. The Board Members serve 6 year terms. The appointments come up every two years on some of the 12 board members terms end. The 4 District Commissioners make the recomendation of their nominee but the entire commission votes to affirm

HOUSTON COUNTY: My name is Dr. Walter Young. I am a retired physician who took care of patients in Houston County for 39 years.

After reading Chairman Brandon Shoupe’s mass email to the community, much of which was unfairly critical of the Houston County Health Care Authority Board and inaccurate, I felt compelled as a private citizen with experience serving as a board member to respond. I will endeavor to address Mr. Shoupe’s criticisms in the order they appeared in his email.

If this is the first time you are hearing of this matter, please do your research on Amendment 1 which will appear on the ballot on November 5 in Houston County. What will appear on the ballot is written to mislead.

What’s at Stake?

The proposed constitutional amendment would:

Change the way the Houston County Health Care Authority (HCHCA) board is appointed. The existing state law is meant to limit political influence and corruption on volunteer hospital boards.

Require 8 of 12 appointed board members to be replaced immediately, giving Commissioners control of the health system.

Give the Commission full control of the board appointment process without any input from the health system.

The proposed law does not require board members to be residents of Houston County. Future appointees could have conflicts of interest, work at a competing hospital and of course, they can be top campaign contributors.

Give the Commission unprecedented powers that the statewide law does not allow.

Make no mistake, the proposed amendment is not good for the hospital, not good for transparent government, not good for health care in this region, and certainly not good for Houston County residents.

I respectfully urge you to vote “NO” to Amendment 1 on November 5^th.

_______________________________

I. The Timing of the Email

Mr. Shoupe began his email explaining that he and his fellow Commissioners recently approved a policy which guides how the Commission (and the Commission alone) will recruit members of the Houston County Health Care Authority Board. I find the timing of this policy quite telling given that the voters of Houston County do not vote on whether to change the Health Care Authorities Act, which has been on the books for almost 40 years, until November. It seems clear that Mr. Shoupe is confident that the majority of the citizens of Houston County will do exactly what he tells them to do. I personally think that Houston County residents are smarter than that and when they hear what is really going on they will want nothing to do with changing the law.

Please note that the policy that Mr. Shoupe mentions is just that – a policy. Policies can be changed with a simple vote of the same Commission that created the policy in the first place. Notice that none of those policies that he feels are so important are found in the actual law that he wants you to approve. The law that they are pushing, the law they want you to vote “yes” for in November, gives the Commission absolute discretion to put literally any person they want on the Authority Board.

II. What is the Question?

Mr. Shoupe frames the “essential question” at issue as whether the taxpayers should have some oversight into the County’s health care system? What Mr. Shoupe neglects to tell you is that, under the law as it currently exists, the citizens of Houston County already have oversight into how the Authority is run through their elected County Commissioners, who have the power to make the Board appointments. But that power is not unlimited. When the Legislature created the Health Care Authorities Act, it built into the process checks and balances. Neither side had absolute power to control the appointments. The Authority Board was given the power to find prospective members, vet them, and present a list of 3 nominees to the County Commission which in turn had the power to select any one of the nominees it wanted. Every single member of the Authority Board at one time or another was picked from a list by a County Commissioner. Until recently, this process, which is followed by countless other Health Care Authority Hospitals and County Commissions in this State, was satisfactory to our County Commission. The problem began when certain County Commissioners insisted that the Authority Board put the people they wanted on the Board, including a campaign contributor and an individual who actively supported our competitor hospital. Only when the Board resisted and insisted that the Commissioners follow the process set out in the Health Care Authorities Act, did we see an effort to change the law so that they would have all the power.

Brandon Shoupe states that, in reality, the Board presents only one real option, ensuring that the one the Board wants is the only one willing to serve. For my district, I can tell you that the Commissioner was presented with an Internal Medicine Physician, a business owner, and myself as nominees, all of whom were willing to serve. The Commissioner refused to select any of these three qualified nominees, apparently assuming that the voters of Houston County would give him all the power he needs in November to appoint anybody he wants.

III. Who is Following the Law?

Mr. Shoupe stated in his email that the appointment process would work great if the Board followed the law. This may be the most ironic statement in his entire email. The Authority always has and always will follow the Health Care Authorities Act. It is this simple fact that has so frustrated certain County Commissioners. They feel the current law does not give them enough power. They don’t want a check and balance. They don’t want to select from a slate of nominees. They want to be a law unto themselves, free to wield unprecedented powers that no other City or County Commission in the State of Alabama will have.

Every Citizen should ask himself or herself, why is this new law coming in the form of a constitutional amendment, rather than a lawfully passed piece of local legislation? It is simple. A proposed change to the Health Care Authorities Act just for Houston County is unconstitutional! Without the citizens literally changing the State Constitution to give the Commission these unprecedented powers, they legally could not do it. This is nothing but a power grab by the County Commission that should not be tolerated.

IV. Lack of Accountability

Mr. Shoupe stated that the Health Care Authorities Act allows the Authority to operate without accountability. Ask him how many times he or any other commissioner has asked to address the Authority Board, asked for information from the Board, or showed even the slightest interest in what goes on at the hospital. The Authority sends emails to the Commission several times a month on health care trends, other health care systems around the Country, and how it is performing compared to peer hospitals. The Board routinely shares with the Commission all the great accomplishments, accolades, awards, and successes of the hospital, the medical school, the Foundation, and more. Rarely does the Board get a positive response from a Commissioner. The only time we see them is when there is an opportunity for them to get their photographs taken.

V. Diversity

Mr. Shoupe criticizes the Board for not having enough women on the Board, suggesting it is not diverse enough to represent the interests of the community. Admittedly, the majority of the current Board is made up of white males, but there are also two African-American men and an African American woman. The last time I checked, the County Commission was exclusively male with only one African American. Mr. Shoupe stated that the Authority has only allowed one woman to be appointed in recent years. Mr. Shoupe failed to mention that the Authority Board nominated nine women to the Board over the last ten years, but the County Commission only selected one of them. I would respectfully submit that our Board has the most dedicated group of Board members I have ever seen. For no pay, they meet several times per month, including very early in the morning and late at night, to support the hospital’s mission of taking care of the health needs of Houston County citizens. Where have we failed in that mission? Southeast Health is among the best hospitals in the state of Alabama, financially strong (when many others are failing and closing), with modern facilities and equipment, and some of the best physicians, nurses, and staff anywhere. Mr. Shoupe could only dream of running the County as well as Southeast Health is run.

Mr. Shoupe brought up in his email recent efforts by a certain Commissioner to put Dr. Kelsey Steensland on the Board. Make no mistake, Dr. Steensland is an excellent physician and a fine person. Unfortunately, she was exploited by that same Commissioner to promote the agenda that Mr. Shoupe now promotes. He took advantage of what was meant to be a frank discussion of ideas about a prospective member and secretly recorded the conversation with the goal of releasing it to the public. Is this the kind of behavior Mr. Shoupe condones? What Mr. Shoupe failed to mention in his email is that the Commission’s efforts to get Dr. Steensland on the Board came on the heels of Mr. Shoupe telling our Board Chairman in no uncertain terms that he would systematically replace every board member until he got a Board that would get rid of Rick Sutton, our CEO and president of ACOM. No Board member being intellectually honest and faithful to his/her oath to act in the best interests of the hospital could support getting rid of a CEO who made the hospital financially sound again, recruited top-notch physicians and administrators, weathered the COVID nightmare without laying off a single employee, invested millions back into the hospital without incurring a single penny of debt, and helped the hospital win countless awards in the process. Don’t be fooled. None of this has to do with Rick Sutton or any particular Authority Board member. This is an effort by the Commission to seize control of the Authority Board and pack it with people who will finally do their bidding.

VI. More People with Medical Experience

Mr. Shoupe is critical of the Board for not having more physicians represented. He makes the statement, without any proof, that the Authority prefers members with little medical knowledge to avoid being challenged on their decisions. What decisions does he mean? I have been a member of the Southeast Health Medical Staff for 40 years and a member of the Authority Board for 19 years. The Board also includes the president of the Medical Staff (also a physician), who changes every two years. I can not think of a single instance where either myself or the Medical Staff president has been discouraged from challenging or criticizing the decisions of the Board. My unique perspective as a physician has always been celebrated and encouraged, not criticized or marginalized. Mr. Shoupe is simply uninformed. And by the way, should this amendment pass in November, I will be replaced as well.

The Authority Board is also involved in the selection and hiring of the Southeast Health Administrative team, which consists of 5 women and 6 men. Three of them are nurses and one of them is also a physician.

VII. Self-Appointed Board?

Mr. Shoupe stated that he does not believe in so-called “self-appointing boards” who tell the Commission “to appoint who we tell you to appoint.” He compares us to Communist China. Mr. Shoupe uses a lot of quotes in his email, but never gives you the source. I certainly have never told a Commissioner to appoint who I told him to appoint and would be very surprised if any other member of our Board did the same. Surely if such a comment had been made a certain Commissioner would have a secret tape recording of it. Regardless, the Authority Board is not self-appointing as Mr. Shoupe well knows. The Commission makes the appointment from a slate of nominees vetted and presented by the Board, exactly like the Health Care Authorities Act requires. The real reason he and other Commissioners do not like the current process is because they do not have all the power to make the appointment. When certain Commissioners did not get exactly who they wanted, under highly questionable circumstances that violated the Act, they threw fits like petulant children. When they heard that their efforts were not legal under the law, instead of trying to follow the law they simply ignored it and then got state legislators (some of whom are not even from Houston County) to help them change the law just for Houston County. And he wants to lecture us on Communist China?

VIII. The Authority Chairman

Mr. Shoupe contends that the Authority’s current chairman holds significant influence over the Board and that other Board members (presumably me) get side-lined if they disagree. He stated that Board members have been locked out of meetings if they disagree. Once again, Mr. Shoupe has no idea what he is talking about. Board members have a fiduciary duty to disagree and will disagree when appropriate. I have never seen nor heard of a board member getting locked out of anything. It is insulting to me and the Board to be told we do not have minds of our own and are controlled by the Chairman. Whatever Mr. Shoupe may think of the Chairman, I can tell you unequivocally from years of knowing him personally and as a fellow board member that he has always acted in the best-interests of this hospital. Ironically, the only reason the Chairman is still on the Board is because a certain Commissioner refused to select his replacement from the slate of nominees presented to him months ago. He would rather ignore the existing law (even though he swore an oath to uphold it) in order to make a point.

IX. The “Good ol’ Boy” System

Mr. Shoupe stated in his email that the “good ol’ boy” system is at work in the Authority Board. He forgot that he is chair of a Commission made up entirely of male politicians. Ask Mr. Shoupe how this proposed constitutional amendment made it onto the ballot. How local legislators, some of whom are not from Houston County and most of whom got campaign contributions from Flowers Hospital or its parent company, made sure that this proposed constitutional amendment went unopposed in the legislature so that it would be voted on by only Houston County residents, not the residents of the State at large (which would have triggered opposition from other Authority Hospitals).

X. Buying Awards

Even more audacious than his characterization of the male Authority Board members and our female Colleague, Dr. Pettway, as good ol’ boys, is his statement that the Authority spent hundreds of thousands of dollars to acquire awards and promote itself. This is not only demonstrably false, it is insulting to the hard-working nurses, administrators, environmental staff, physicians, and countless others who worked tirelessly to make this hospital system a leader among its peers. That hard work was rewarded with many awards and recognitions, including U.S. News & World Report Best Hospitals; Stroke Honor Roll Elite Plus Silver Quality Achievement Award; Number One ranking in Alabama for Clinical outcomes; “A” Grade for Social Responsibility, Patient Outcomes, Clinical Outcomes, Patient Safety, and Cost Efficiency; Forbes Best in State Employer; Continued Certification as the Region’s only Level II Trauma Center; Continued Accreditation as a Chest Pain Center; Leap Frog Hospital Safety Grade of “A”, achieved goal of making Dothan Alabama’s first Heart Safe City; and many others. Not one of these was paid for by anybody. If Mr. Shoupe and other Commissioners spent more time supporting this hospital, and less time trying to tear it down, they would know this.

XI. Scaring the Community and Hospital Employees

Mr. Shoupe accuses the Board of alarming the community and hospital employees by claiming the Commission is trying to take over the hospital. The employees and community do not need the Board to make them alarmed by the actions of the Commission. They see for themselves the actions of the Commission in trying to seize more power than any other commission in the State while weakening the laws that are meant to protect the hospital and the Commission. There is a reason the Legislature so long ago put in place the current appointment process – to keep politics and politicians out of health care. Changing the Health Care Authorities Act to give the Commission the exclusive power of appointment is unprecedented and dangerous. Even if the current Commission does not misuse their power, who knows what the next commission might do. Once they change the law there is no going back and nothing to stop a rogue commission from packing the Board with campaign contributors, competitors, or those who want to sell this hospital.

XII. The “Saga.”

Mr. Shoupe states that this “saga” began because of concerns brought to him by unknown individuals in the community. When pressed about who these people are and the exact nature of their concerns, he gets vague and never really has an answer. In his email he mentions the hospital’s “abandonment” of the SANE program. Southeast Health did not abandon the program. During the COVID pandemic, when nurse burnout was at an all-time high, we could not maintain enough staff to cover the program which required a small group of specialized nurses to take call 24/7. To be successful and sustainable, it needed the Community’s involvement and collective support. Southeast Health has always and will always continue to support the program financially and otherwise. Mr. Shoupe also talks about the loss of specialty services, while ignoring the fact that our hospital has grown and strengthened its services and has recruited more specialists than any other hospital in the area. For example, the hospital expanded Oncology services, expanded Stroke and Neuroscience Services, expanded Women’s and Children’s services (it is the only hospital in Dothan offering inpatient pediatric services and a Level III neonatal ICU), expanded Cardiology Services, added numerous additional diagnostic testing equipment (including MRI and CT), developed a Medical Park, expanded primary care clinics (including ACOM’s Ashford and Taylor clinics), and expanded its ER capability (and is about to add a $50,000,000 ER expansion). This is not to be outdone by the Alabama College of Osteopathic Medicine or the Hospital’s Internal Medicine Residency Program. Finally, Southeast Health provides about $25,000,000 in uncompensated care and charity care to citizens in the region and has annual operating expenses of about $455,000,000 (for which it receives less than 1% in tax revenue).

XIII. Who is Getting Replaced?

Mr. Shoupe wants you to believe that only four board members will be replaced should the voters approve the constitutional amendment he is pushing. I encourage you to look at the actual amendment, not the misleading, generic blurb the voters will see on the actual ballot. It requires all board members who have served more than one 6-year term to be removed from the board within 30 days of the vote. Of the 12 public board members, there are only 4 who have not completed a 6 year term.

CONCLUSION

If I come across as passionate about the Houston County Health Care Authority Board and what the Commission is trying to do with this constitutional amendment, it is because I care deeply about this hospital and its patients. This Authority Board has been unfairly attacked and demonized by a Commission that at best is misinformed and, at worst, has an agenda for the future of this hospital that should give us all pause. I will restate, the proposed amendment is not good for the Houston County Health Care Authority, not good for transparent government, not good for health care in this region, and certainly not good for Houston County residents. Wake up Houston County! We are at risk of allowing politics and politicians into our health care and we will all be worse for it.

I respectfully urge you to vote “NO” to Amendment 1 on November 5^th.

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