The surprise resignation of seven of the nine members of the Hi-Desert Health Care District Community Health Care Clinics Governing Board, the CHC, Thursday raised questions about what led to the action. Former CHC Board Chair Susan Madavan issued a statement that the CHC board resigned because of the forced resignation of Executive Director Ron Stewart. Madavan said the CHC board and Stewart were forced into a corner by the elected District Board. She cited questionable closed sessions; violation of an agreement between the District, the clinics, and HRSA (Health Resources and Services Administration), the federal funding source; and insulting the intelligence and competence of the CHC board. She alleges the elected District board wants more control and profit, so they presented Stewart and the CHC Board with a plan to open their own clinics, designated RHC, rural health clinics. She said this would have forced the center to shut down. Stewart was expected to assist in a 60-day implementation plan, which would be a HRSA violation as his salary is paid through HRSA funding. She said all these things put the CHC at risk of losing federal funding, and since the district would run the centers as rural health clinics, they would lose the free and extra services provided through the HRSA funding.
STATEMENT FROM SUSAN MADAVAN
Regarding mass resignations for the Morongo Basin Health Care Clinics Governing Board.
My name is Susan Madavan. I have been on the Morongo Basin Community Health Center’s Governing Board for six years and in the position of chair for several years. I am a patient of the clinics.
Approximately two months ago the Healthcare District announced the need to pull money out of savings for the first time. This was due to the $500,000 purchase by the District for the mobile unit and for an unknown reason the District has decided that this need to withdraw money from their savings was due to actions of the Health Center Board and the Executive Director.
I received notice that the Health Center’s Executive Committee was to attend a closed session meeting of the District Board. On the publicly posted agenda the topic was listed as “Trade Secrets” and I was led to believe they wanted to consult with us about what to do should the Service Area Competition grant not be funded. This topic was confusing to us as we know that should HRSA funding end, so would the need for the Health Center Board.
While that topic was briefly discussed, District Board members proceed to insult us saying things like “we don’t like the fact that we are a patient-driven board,” that “we don’t know what we are doing given we aren’t elected like they are,” and that “patients aren’t capable of obtaining degrees and we aren’t educated enough.” And, they then began to question the performance of our Executive Director and suggested that the District’s need to dip into savings was due to him.
During this meeting the District Board asked questions of us that had to do with clinic operations and District financials – this was very confusing because the Health Center Board has zero control over anything to do with District finances and therefore, we had no answers. With these statements out, the District Board summarized their points saying that all of this goes back to the recent need to withdraw money from savings and that they wanted one of their members to be seated on the Health Center board.
A week later I invited the District Board President (Bob Armstrong) to a one-on-on meeting with me. I provided him with answers to all the questions asked of us related to clinic operations. All the answers were the same – that the issues of concern he presented are under the direction of the District CEO, not the Health Center Executive Director. And, I told him we felt it would be conflict of interest to have one of them sit on the Health Center Board given the way the Co-Applicant Agreement is written.
On 10/5/18 I received a text from Bob Armstrong that was very confusing and when I requested clarification, he did not respond and has not responded to this day.
On 10/15/18 I called a closed session of the Health Center Board to informally review the work done by the Executive Director and reaffirm where the Board stood as to his performance. The entire Board reaffirmed that he was doing a stellar job and exceeding expectations. When the Board asked why I needed to have this conversation I told them about the meeting with the District Board and how they had expressed a number of issues. After outlining the issues, the Health Center Board consulted the Co-Applicant Agreement and requested that we initiate Step One of the Grievance Resolution Process. Step One calls for a joint meeting between both Boards. We drafted a letter and made the request (see attached). At the direction of the District CEO, the minutes of this meeting were changed by the Board Clerk the following day.
On 10/19/18 our Executive Director was called to a meeting by the District CEO where she informed him that the issue boils down to the District Board not having control over 80% of the District’s programs and that she has been given direction by the District Board to start Rural Health Clinics within the next 60 days – clinics that are not under the HRSA’s watch. Our Executive Director was given work to do in support of the RHC plan and I was concerned about this as his salary is paid 100% from HRSA funds.
To provide an alternative plan that would provide the District Board with greater control over the Health Center, our Executive Director presented the District CEO with a reorganization plan that would have the District CEO as the direct report of both boards. He tells me this structure was briefly discussed back in the fall of 2016 when he was working for the District CEO as a consultant.
I called another special meeting of the Health Center Board on 10/26/18 to listen to the reorganization plan. Ultimately it was the consensus of the board that in order to ensure patient care continues and to keep the clinics moving forward they would agree, but very reluctantly, to the reorganization plan. Prior to the start of this meeting the District CEO hand-delivered a response from the District Board regarding our request to begin Step One of the grievance process. They declined and instead wanted to have a meeting with a select few people. The Health Center declined this meeting and insisted on Step One. While we are unsure if the meeting invitation was accepted, the District CEO stated she wanted to postpone this meeting till January and after the public elections.
This has been a very trying time for the Health Center board of the clinics. The District Board has been deceitful and has attempted to manipulate us. Their behavior under the cloak of Closed Session can best be described as unethical. We firmly believe they have violated the Brown Act and purposefully ignored the processes outlined in the Co-Applicant Agreement executed by both Boards.
Our main point is that the District (a public entity that gets money from tax payers and from leasing their hospital) puts excess profit in front of the community and they violate their own mission and vision statements.
Therefore, our Board expressed their conscience by agreeing to seat the District CEO as the Executive Director and then seven of the eight members present for the November 1, 2018 meeting resigned from the Health Center Board on November 1, 2018. One member was absent and I believe he will be resigning shortly.
