Judging by the report delivered yesterday to the North Broward Hospital District commissioners by an investigator, Commissioner Joseph Cobo is in deep trouble. Attorney Martin Goldberg, a former assistant U.S. Attorney, found five instances of possible misconduct by Cobo to be credible and that together they "may constitute a misuse of Cobo's public position," in violation of Florida law.
The investigation was launched based on allegations made against Cobo by the district's former acting general counsel, Troy Kishbaugh.
Broadly speaking, Kishbaugh has alleged that Cobo used his position as a North Broward Hospital District commissioner to help clients of and win business for his private firm, Florida Medical Management Consultants. The firm is retained by physicians looking to cut costs and gain business advantage. Cobo was president and chief executive officer of FMMC when he was appointed to the commission by Gov. Charlie Crist in 2007 and remains there today.
Let's start with the first allegation by Kishbaugh: that in January 2008 Cobo did a favor for a private client in his public capacity by helping derail employment contracts for a group of five orthopedic physicians in the Lighthouse Orthopedic Group.
Through FMMC Cobo has represented an orthopedic physician, Dr. Michael Reilly, since 1995, as well as Dr. David Gilbert. Anyone who's read this New Times feature by Bob Norman from March 2004 knows that Reilly was hostile toward the idea of commissioners contracting with at least one orthopedic group -- the one where Drs. Danny Kanell, George Caldwell Jr. and Erol Yoldas practice. (Norman's article is cited in Goldberg's report.) In his investigation, Goldberg found that Cobo attended meetings with Reilly where the physician made his opposition known.
What's less clear is whether Reilly had similar reasons to oppose contracts for Lighthouse and whether he enlisted Cobo's help to defeat them -- and this is a crucial point. Goldberg's report includes an assertion by Cobo that both Reilly and the other orthopedic physician client, Gilbert, both practice with health facilities to the south, Imperial Point Medical Center and Holy Cross Hospital, so they would not necessarily face competition from orthopedic physicians who would practice at North Broward Medical Center. But Cobo wasn't entirely accurate in those remarks -- Gilbert had staff privileges at North Broward when Cobo voted on the Lighthouse contract. Gilbert has maintained those privileges, only resigning them a few weeks ago, on April 22.
At the January 23, 2008 commission meeting Cobo expressed skepticism about contracting with Lighthouse based on the "need to be sensitive and strategic as to what physicians to bring on board," according to Goldberg's report. He also reportedly said he did not want to "alienate other loyal physicians."
The district's own Compliance Department investigated these same conflict-of-interest allegations last year based on a complaint from then-General Counsel Laura Seidman. But while that investigation cleared Cobo, Goldberg ruled that it was incomplete because it failed to examine closely whether Reilly and Gilbert had selfish reasons for discouraging contracts between the district and Lighthouse.
So while Goldberg deemed the allegation by Kishbaugh "credible" he stopped short of saying that by voting on the Lighthouse contract Cobo violated Florida statutes against conflicts of interest, saying "additional time is needed to conclude an appropriate review of the background facts." (Sounds like someone misses the subpoenas and sworn testimony he could call upon as a federal prosecutor.)
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At the very least, Goldberg found that Cobo ought to have erred on the side of caution, disclosing a conflict of interest on the orthopedic firm's contract and abstained from casting a vote.
Kishbaugh's allegations against Cobo have been complicated by charges of retaliation after Cobo was among those voting against making Kishbaugh the permanent general counsel last December. Also, Kishbaugh trashed the first version of a memo he wrote concerning Cobo and only re-wrote it at an investigator's request.
Another allegation by Kishbaugh, that Cobo distributed FMMC business cards while attending the 2008 Broward Days in Tallahassee as a commissioner was not substantiated.
But stay tuned for our next report: Goldberg's finding that Cobo's mingled his public role and private interests as he sought consulting work with Dr. Dimitrios Lintzeris. That encounter, writes Goldberg, contains "potential violations of law."