Archive for Saturday, March 31, 2007

Simons: As deadline passes, will St. Luke’s seek other affiliations?

March 31, 2007


By now, Rich Hastings, president and chief executive officer of St. Luke's Hospital; Irv Hockaday, a successful Kansas City business leader; and Bill Hall, a senior representative of one of Kansas City's major philanthropic entities, should be working on travel plans to Boston, St. Louis and Houston.

Hastings, a couple of his St. Luke's partners, Stowers Institute representatives, Hockaday and Hall set a deadline of March 31 for the Kansas University Medical Center and KU Hospital to work out a definitive plan for an affiliation or collaboration with St. Luke's hospital. In a recent Journal-World article, Hastings said, "in recent years, St. Luke's twice approached KU Hospital about partnering for cancer care with no mutual interest emerging."

He said that this cold shoulder from KU led St. Luke's to hold discussions with potential out-of-town partners, including Dana-Farber Cancer Institute in Boston, M.D. Anderson in Houston and Washington University in St. Louis.

He added, "The agreement deadline (between KU's medical school, KU Hospital and St. Luke's) of March 31 is coming soon. For 13 months, St. Luke's has been unable to move forward with its cancer care plan. It is clearly time for our organizations to commit to collaborative terms or move on. One local partnership won't dramatically change St. Luke's, but one local partnership might unite Kansas and Missouri in amazing ways for the benefit of Kansas City and the life sciences. After March 31, St. Luke's must look to the future and move on."

Fortunately for the KU medical school, KU Hospital and the state of Kansas and its residents, March 31 has arrived and there is no definitive agreement for an affiliation or collaborative effort with St. Luke's. It will be interesting to watch the actions of Hastings, Hockaday and Hall, along with KU Chancellor Robert Hemenway and Executive Vice Chancellor Barbara Atkinson, all of whom have been working so hard - at the beginning, in secret - to jam this agreement down the throats of KU Hospital officials.

Many of the reasons suggested by St. Luke's boosters and Hemenway and Atkinson as to why the affiliation was necessary have proven to be hollow and weak. There is a sound answer for each of their arguments. Now, we'll see whether the threat of moving negotiations to Boston, St. Louis and/or Houston was equally hollow.

Various observers say the soonest any definitive agreement might be reached is May 31. Then, it must be approved by a majority of the KU Hospital board of directors.

Based on the hospital board's 15-3 vote this week to turn back the efforts of Hemenway, Atkinson and Provost Richard Lariviere to name a temporary replacement for KU Hospital CEO Irene Cumming, it is far from a sure bet that the hospital board will approve an agreement that might weaken the KU Hospital or strengthen its competitor, St. Luke's. The board is not a rubber stamp for the chancellor or the governor.

Tuesday's vote, while sending a strong message to KU leaders, also is interesting because Lariviere and Atkinson voted against a permanent replacement while Hemenway voted in favor, even after working so hard against such an action. What does that say, and what should faculty and the public think about the chancellor and provost casting opposite votes on this matter? Although those at the board meeting may know or try to guess why they voted the way they did, does it send a peculiar message to the public and/or university faculty members?

Speaking of the hospital board, there is reason to question whether Lariviere should be a member of the board. According to the state statute creating the KU Hospital Authority, a nominating committee of the board shall assemble a slate of not less than two nor more than three people for each vacancy and forward that slate to the governor. The governor then appoints one board member from each slate and forwards the appointments to the Senate for confirmation.

The board's nominating committee followed these instructions and sent proposed slates for board members to the governor but did not nominate Lariviere. The governor requested a revised slate of her own selection. This is how Lariviere became a member. The board mistakenly accepted her revised nomination. There are various opinions as to what should be done about this, but clearly the governor did not follow the state statute.

Now, there is speculation Sebelius may try to place Lt. Gov. Mark Parkinson on the board even though the selection of nominees is up to the nominating committee, not the governor. The statute was set up this way to keep any governor from packing the board with IOU's or individuals who will vote as the governor wishes.

Lawmakers have learned a lesson about how a governor can pack the Kansas Board of Regents and did not want to make a similar mistake with the hospital board.

The statute also makes it clear who the ex-officio members of the hospital board are. They are: the KU chancellor, the executive vice chancellor of the Medical Center, the executive dean of the medical school, the chief of staff of the KU Hospital medical staff, the president of the hospital authority and the dean of the KU School of Nursing.

There is no provision for the KU provost to be an ex-officio member of the board.

The hospital mess is far from over.

Those who conceived the St. Luke's plan did so behind a veil of secrecy. They had hoped to have the deal completed before the start of the legislative session in January.

Word began to seep out about the secret meetings and suspicions were raised about a possible giveaway. KU Hospital and many KU medical school staff members were deliberately left in the dark. So a new deadline of early February was circled. The more the public and Kansas legislators such as House Speaker Melvin Neufeld and Rep. Jim Morrison learned about the plan, the more they realized Kansas lawmakers should know what is going on rather than be blindsided by the chancellor, Atkinson and a couple of high-powered Kansas City business and philanthropic leaders.

The new, drop-dead deadline of March 31 is here, and there is no definitive agreement. There is talk about "general principles," but there is no firm plan in print for all interested parties to examine and comment. This is a necessity!

It will be interesting to see whether cancer researchers in St. Louis, Boston or Houston are as interested in an affiliation with St. Luke's as those in Kansas City claim and whether any of these hospitals intend to supply medical residents and give their brand name to St. Luke's, as St. Luke's has demanded from KU.

It's a sad, disappointing and, in a way, embarrassing situation that didn't have to become such a mess. Why would KU employees be making such an effort to strengthen St. Luke's at the expense of KU and Kansas? The chancellor and Atkinson should be focusing on how to make the KU School of Medicine as good as possible (polls show the school has slipped in recent years ) and to do everything possible to make the KU Hospital the best such facility in the country. It already ranks as the 11th best in quality (based on safety, mortality, effectiveness and equity) among 81 leading academic hospitals around the country and No. 1 in patient satisfaction in greater Kansas City.

That doesn't sound as if making money is the only goal of KU Hospital, as some in Kansas City have suggested. Hospital officials have offered to give the medical school $400 million over 10 years to help the medical school meet its needs, but Atkinson turned down the offer saying there were too many strings attached.

The No. 1 question in the minds of KU Hospital board members, state legislators and the Board of Regents should be: Is an affiliation, merger, collaborative effort or whatever it may be called a good thing for the hospital, the medical center and Kansas? Why should KU give away its branding and what do the school, the hospital and the state get in return?

It should not be a one-way street, a giveaway merely to strengthen St. Luke's, which is losing market share in Kansas City and has seen its cancer care numbers decline.

Likewise, it should not be done merely to please some Kansas City friends or power brokers.


robert_lewis 11 years ago

Unlike Hasting, Hockaday and Hall, Hemenway and Atkinson have a fiduciary obligation as members of the board of the Hospital to place the Hospital ahead of themselves. By conducting secret negotiations behind the backs of other board members of the Hospital, they have clearly breached their fiduciary obligation, and should be removed from the Board.

Since they hold their seat on the Board ex officio, the only way they can be removed from the Board is to be replaced in their positions as Chancellor and execuitve vice Chancellor of the Medical Center.

For their acts of disloyalty, Hemenway and Atkinson should immediately be removed from their positions at the University. Further, the Hospital should direct its legal counsel to initiate a lawsuit seeking $100,000,000.00 in damages against Hememway and Atkinson personally for their breach of fiduciary obligations.

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