Union County Council approved the first reading of an amendment to its ordinance regarding the makeup of the hospital district board at its Tuesday meeting.
The amendment is following in line with a change to the 1946 law recently approved by the South Carolina State Legislature and Gov. Mark Sanford pertaining to the hospital board’s makeup which originally required three physicians to sit on the hospital district’s board. At the same time, however, a 1913 state supreme court decision citing old English law says conflicts of interest exist when a board member is also an employee or agent. A similar situation would exist if a teacher were to be elected as a school board member and continued in both capacities.
Most local physicians, including sitting board members Dr. Christopher R. McWhorter and Dr. Robert A. Yannetti whose terms technically ended March 31, are employees of the district and therefore could not be reappointed to the board as the original law read.
County supervisor Tommy Sinclair brought the conflict of interest issue to the attention of council members in January. Council began discussing the matter and formed a committee composed of its members, hospital district board members and the general public to put forth a recommendation on how to solve the issue.
That committee came back to council with a recommendation of a hospital board comprised of seven members from the general public appointed by council who would have voting privileges and three non-voting members who would be from the hospital district’s pool of physicians in an ex-officio capacity.
County council members approved that recommendation and sent a request to the legislature to amend the 1946 law. Now that the amendment to the law has been approved at the state level, the county must amend its ordinance. Council members must approve two more readings to make the amendment official.
In the meantime, council will begin interviewing the prospective 14 candidates for the four open seats on the hospital district board on Monday, April 19, at 3 p.m. at the courthouse. The seats up for reappointment this year include McWhorter’s and Yannetti’s along with those of current hospital board chairman Tim Svedlund and board member Jeff Cannon.
Who will appoint the three ex-officio physician members, according to Sinclair, will be up to council members to decide.
“The ex-officio members process is still a matter of discussion,” Sinclair said Friday. “I have discussed with council and with members of the medical community that it be position driven, i.e. chief of staff or other position based people. The issue with that is continuity because some of those positions change annually. Ex-officio selection and ratification is still open but I think from the council’s point of view the identification process is primarily a process within the hospital district.”
The change in the hospital board’s makeup has caused physicians in the district to struggle with the fact they no longer would have a vote — in a traditional sense — on the board.
Dr. Fred Barker came to Tuesday’s council meeting to report while there has been some division on the issue among the district’s medical staff, he and his colleagues have reached “unanimous accord” on certain issues.
“With the amendment to the state law eliminating mandatory physician board seats on the hospital board for the first time since 1946, the medical staff believes it is a critical time to work hand in hand with the county council to make the most informed and appropriate appointments to the hospital board,” Barker told council members.
Sitting behind him were several members of the medical community among audience members at Tuesday’s meeting — some of whom have applied to be appointed to the hospital board.
“The medical staff respectfully requested the council receive input on nominees from the medical staff and hospital,” Barker said. “We believe the use of an application to qualify candidates can provide consistency and serve as a tool to receive input from the medical staff executive committee and hospital board on nominees.”
The council has been provided with an application similar to those used in other hospitals.
Barker’s message, however, was more than simply asking for the medical staff’s involvement in the selection of those three ex-officio physician board seats. He told council now, more than ever, is a time to work together to move Union County’s medical community forward.
“The hospital district has changed significantly since 2006,” Barker said. “The medical staff has been stabilized through employment and the creation of Carolinas Health Associates. Excellent physicians have been recruited to join us. Hospital staff, management and the medical staff have worked well together achieving patient care quality that is in the top 10 percent in the nation. Health care is more complicated than ever. We need expert management and leadership more than ever.”
No changes will be made to the hospital district board until after the final two readings of the amended ordinance are approved by council and interviews have been held with each of the 14 prospective candidates for those four open seats have been completed.
“Council takes the selection process seriously and realizes that hospital appointments in many ways may be some of the most important selections it makes and has taken the many and various screening processes offered by the medical community into account,” Sinclair said.
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