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Hospital Commissioner Making Noise About Physician Contracts That Skip Past Committee

Clarence McKee
The Broward Health board has a new maverick. Clarence McKee was first to express reservations to the public hospital district's proposal to lease its assets to a nonprofit. And now McKee wants to reverse a trend whereby contracts for physicians, lobbyists, and other professional services are negotiated without oversight from the governor-appointed board.

McKee raised the issue at the district's Legal Review Committee meeting Wednesday, leading to a clash with the district's two most tenured members: Board Chair Rhonda Calhoun and Commissioner Joseph Cobo.

In making his case, McKee circulated a graph that showed how the Legal Review Committee, which he now chairs, has slowly faded over the past six years to the point that it seems to be ignoring the duties ascribed to it in the district's charter, such as reviewing contracts for professional services.

Rhonda Calhoun
In 2004, the committee met 11 times, ruling on 124 agenda items. The committee's activity has slowed in the five years since, bottoming out in 2009, when it met just once and considered only four agenda items.

McKee, who was appointed to the commission by Gov. Charlie Crist in January 2009, wanted to return the committee to its former place -- or else hear an explanation for why it's been neglected in recent years.

Calhoun's initial objection was based on concern that by assuming a role on district contracts, the commissioners would be lobbied by the physicians and companies seeking those contracts, creating what she called "a terrible appearance of impropriety."

In response, McKee suggested a dollar threshold to ensure that the committee isn't swamped with small contracts. Contracts under $250,000, commissioners agreed, should continue to be negotiated by the district's executive staff. But McKee wanted exceptions to be made for contracts that go to lobbyists, consultants, and physicians.

Brian Ulery
The district's vice president of physician services, Brian Ulery, stepped to the podium to declare his strenuous objection to McKee's proposal. Ulery described a three-point matrix through which the district negotiates contracts with physicians and told McKee that if physician contracts went before the Legal Review Committee, it would have a chilling effect on talented physicians' desire to team with the district.

"If we bring every contract here, then [physicians] have tipped their hands to their current employer that they were desirous to leave," said Ulery, who added that McKee's plan would put the district at a competitive disadvantage.

"I can assure you: That's not the issue here," said McKee with a wry smile.

The district's chief financial officer, Robert K. Martin, joined Ulery, saying that it would be cumbersome to have to wait for Legal Review before giving a contract. "You'll take away our ability to manage," said Martin.

McKee's argument: The district managed five years ago, so it should be able to do so again.

"But you weren't here," said Calhoun, as Cobo nodded his head. Both commissioners claimed that the Legal Review Committee of 2005 was riddled with politics and that the district has been better off by allowing staff to handle contracts.

Calhoun and Cobo didn't say it explicitly, but I believe they were referring to the hospital district's shameful history of political cronyism and kickbacks, which was detailed brilliantly in this Bob Norman feature.

McKee told his fellow commissioners that if they simply disclosed their contacts with lobbyists, then they had no reason to be concerned about appearances of impropriety.

I'm still trying to get in touch with Calhoun. At the moment, it's hard to understand how the current system of negotiating contracts through the executive staff has cured concerns about that process being too political.

If those contracts went to the committee, then at least there's more light shed on the political process -- and clearly, redactions can be made to deal with any details in a contract that put the district at a competitive disadvantage.

Ultimately, the commissioners decided to table the issue, then revisit it at next week's board meeting.

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Thomas Francis

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