A Vote for Accountability: Should Citizens Have Input Into Their Public Hospital?
A Vote for Accountability: Should Citizens Have Input Into Their Public Hospital?
Today, the Houston County Commission voted to approve a policy which dictates how it will recruit and appoint members of the Houston County Healthcare Authority, which oversees Southeast Health. This issue, which has brewed in the background since the 90’s, will finally be decided this fall. The essential question is: Should taxpayers have some oversight into the county’s healthcare system? Or should an unelected, self-appointing board be able to raise our taxes, spend our tax dollars, and make major healthcare policy decisions for our area with zero input from the citizens?
How It Is Supposed to Work vs. How It Actually Works
The current process leaves the people of Houston County with no real choice, allowing the Hospital Authority to operate without accountability. We've raised concerns over the years, but the board’s leadership has dismissed them.
In theory, the County Commission appoints hospital board members from a list of three provided by the Hospital Authority. In reality, the board presents only one real option, ensuring the person they want is the only one willing and able to serve.
[True story] When I was the District 4 commissioner, I received three names for appointment consideration:
The incumbent authority board member who they wanted reappointed
A teacher from Houston Academy who did not have time to serve
A physician who did not want to serve
I know both the teacher and physician were not interested because I called them and neither returned my call.
The policy we approved today seeks to do two things:
Improve the makeup of the board, which isn’t very reflective of the hospital’s workforce or the general population of Houston County
Ensure citizen oversight of our local healthcare system
Ladies, Do You Feel Well Represented by This Board?
Since 2014, 48 men have been put before the commission compared to just 9 women. The Authority always tells us who to appoint through a “recommendation,” with 21 men recommended and only 1 woman.
Women make up over half of our county’s population, yet the Healthcare Authority has only allowed 1 woman to be appointed to the board in recent years. While I don’t subscribe to the diversity, equity, and inclusion mantra, I do believe women’s healthcare is a crucial part of our system. It’s hard to believe that, in all of Houston County, we can only find one woman to serve on the board.
Commissioner Herring wants to appoint Kelsey Steensland, a mother and retired anesthesiologist who worked for years at Southeast Health. She has provided direct patient care and understands the daily challenges hospital staff face. She’s exactly the type of person we need on the board. But Chester Sowell dismissed her, saying she wasn’t qualified because she was a “girl” with a "boatload of kids." Instead, he recommended three candidates, including himself and two of his friends. I won’t defend Chester’s comments, as they are reprehensible. But I believe the “boatload of kids” was just an excuse. The real reason is that the current leadership prefers people with little healthcare knowledge.
More People With Medical Experience Needed
The Hospital Authority's leadership not only disregards elected representatives but also voiced a lack of respect for physicians. Former Dothan Mayor Chester Sowell once told me, “physicians aren’t capable of running their own business, so they don’t belong on the Hospital Authority board.”
The leadership bristles when we suggest adding more people with healthcare experience. We've tried and failed on multiple occasions. It seems the Authority prefers members with little medical knowledge to avoid being challenged on their decisions.
More Representation for the Workforce
The nurses and ancillary staff at the Hospital need someone with their experience at the table. Because, at the end of the day, they are the ones providing almost all of the patient care. Commissioner Adams’s has already decided on a retired female nurse if this referendum is successful.
The Healthcare Authority is Too Powerful to Not Have Community Input & Accountability
I don’t believe in self-appointing boards. The County Commission isn’t self-appointing, and neither should the Healthcare Authority. Despite this, two commissioners were told their job was to "appoint who we tell you to appoint."A system like this may work in China, but not in Houston County. That’s why the County Commission strongly believes citizens should have some oversight in the selection of Healthcare Authority board members.
The Current System Leads to Groupthink & Makes It Easier to Mislead a Board
In the current system, the Authority’s Chairman holds significant influence over the board. This is because they appoint the committee that decides who gets recommended to the County Commission for appointment. If an Authority member disagrees with the chairman, they could be sidelined when it comes to names being placed on the list. As a result, members are more likely to go along with things just to keep their seat at the table.
There have been instances where board members were locked out of meetings and blocked from committee positions simply for disagreeing.
The Bar Should Be Very High for Board Members
As it stands now, a current board member almost fought with a legislator in Birmingham. The same person cursed me at a ribbon cutting and was also recently escorted from a dental office for arguing with his dentist. This person is making decisions that directly impact your health, so changes are clearly needed.
This good ol’ boy system is NOT what local healthcare needs. The commission’s vision is to have a hospital board that represents both the community and the hospital workforce. We want successful businesspeople from diverse backgrounds working alongside those with deep healthcare experience to oversee the hospital.
While this may seem like an easy decision, the referendum will likely be close. The Hospital Authority is spending hundreds of thousands of dollars to acquire awards and promote itself to convince you to vote against the referendum. One person even said, “I know the board is a good ol’ boy system, but they’ve spent a lot of money with my company, so I’m not sure how I’ll vote.”
They are alarming the employees and the community by claiming the commission is trying to 'take over the hospital.' In reality, we appoint members to several boards, but our involvement is generally minimal. But as the people’s elected representatives, the commission does provide input on significant issues when necessary. Since this is a county-established and county taxpayer-funded hospital, the taxpayers deserve at least some input.
How We Got Here
This entire saga began because of concerns that were brought to the commission. Those concerns were the abandonment of the Sexual Assault Nurse Examiner program, the hospital constantly being on diversion, and the loss of specialty care physicians. As the county’s elected body, we felt these issues needed looking into as our citizens expect their representatives to respond to their concerns. Some of those issues may be real issues that need addressing. Some may be the result of them being best option in an ocean of bad options. In truth, the commission doesn’t know because the authority won’t have meaningful conversations with us about them.
Only 4 Board Members Will Be Replaced
Only four board members will be replaced, with two of them set to be replaced regardless of the referendum outcome. So, the fears of a 'county government takeover' are exaggerated and designed only to scare people.
I have disagreed with many of the people being placed back on the board on at least one issue. I know this may be shocking to a few members of the Healthcare Authority Board, but disagreement is 100% normal and can also be constructive towards a better outcome. But we feel the members we plan to place back on the board are those that can sit down with us and have a conversation without the histrionics seen from the board’s leadership. And, at the end of the day, that’s what the county needs; for its leaders to be able to sit down and discuss issues.
Ultimately, the voters of Houston County will decide the issues on the November ballot. And I strongly encourage you to vote “Yes” so our community can get the accountability in medicine that we all deserve.
P.S. In case you were wondering, here is the language that will be on the ballot:
Relating to Houston County, proposing an amendment to the constitution of Alabama of 2022, to authorize the elected members of the Houston County Commission to appoint members of the Board of Directors of the Houston County Health Care Authority to ensure the public interest of the residents of Houston County.