Erlanger soon will be keep you -- and us -- even more in the dark than we all were before.
On Wednesday, the Erlanger Health System became, officially, what it essentially already was: A done-deal barrelling toward privatization. Hamilton County commissioners unanimously approved a resolution that will allow Erlanger Health System “to move forward” in transitioning from a government entity to a private, nonprofit corporation.
The shorthand for moving from a government entity to a private, nonprofit corporation is that our public hospital will no longer be "public" and therefore will no longer be subject to the sunshine laws that give you -- via news organizations, public meetings and minutes or agendas of those meetings -- a window into the health system's finances, operations and policies.
But the truth is that the board of Erlanger and the County Commission and County Mayor Jim Coppinger have been keeping things hushed already for more than a year. Consider this timeline:
› Feb. 9, 2022 -- Erlanger Board Chair Jim Coleman announced the board was looking to transition the public hospital to a nonprofit model "to level the playing field" with the hospital's private competitors. By leveling the field he meant "public" would go "private."
He also said that "after nine months" of due diligence, the board began approaching stakeholders, including Mayor Coppinger.
That would put this Erlanger/public official planning -- never mentioned in a public meeting before -- back to about July 2021.
› Aug. 17, 2022 -- On the day the county commission approved the transition plan, Coppinger thanked the board and the attorneys who represented the county in the "eight-month negotiation process of constructing" the county's resolution.
That would put the county's involvement -- with no public meetings -- back to December 2021.
Only this month did we get a synopsis of the county's and Erlanger's agreement.
In the county's resolution to OK the transition plan, there are 13 "covenants" the new nonprofit organization must adhere to once the health system becomes really private. Primarily among the promises are to maintain the mission of Erlanger being a teaching hospital and to continue to provide charity care to area residents "consistent with similarly situated tax-exempt safety net providers in Tennessee."
Will there be oversight? Not really. Currently the County Commission and the local delegation of the Tennessee General Assembly appoint 10 of the 11 Erlanger board members. (The 11th is the hospital's chief of staff.) If there is a problem, elected officials can lean on the board. That won't be the case after the transition. Instead, before the transition's closing, the county will submit a plan for the organization of a three-person Oversight Monitor Board that is to ensure Erlanger upholds the covenants for 15 years. Erlanger will have its own private board, and the oversight monitor board will be just -- a "monitor."
Are you feeling like a mushroom yet -- in the dark more every day?
It's true you didn't get much of a window before. But you did get some.
For instance, in early May 2019, physicians fed up with three years of unanswered questions about patient safety at Erlanger's emergency department took the extreme action of making a "no confidence" vote on the hospital's top management, specifically hospital CEO Kevin Spiegel and two of his aides. Nearly four months later, at a "special" called public Erlanger board meeting, the Erlanger Health System Board of Trustees finally decided to talk about it, briefly.
Nothing came of that brief talk, however, because the board tabled the discussion. They probably wouldn't have said or done that much had the no-confidence vote and the physicians' letter not become public just a few weeks after the no-confidence vote -- thanks to whistleblowers and the dogged determination of Times Free Press reporter Elizabeth Fite and her editors.
In September, Spiegel was gone.
Let's review: The no-confidence vote was in May, the newspaper story broke in June, the board finally talked about it briefly in public in August. Spiegel was out in mid-September.
He was the same guy hired by the board in April 2013 during a 16-minute meeting after trustees returned from a 45-minute closed meeting they said was about "parliamentary procedure." With no discussion about any of the three candidates, one board member threw out Spiegel's name and in a 5-3 vote the board hired him for $680,000 a year. About half of the meeting was spent at the end taking another vote to have the meeting minutes state the Spiegel vote was "unanimous."
By the time Spiegel was gone, his annual salary had been raised to $964,000 -- plus six-figure performance incentives in the years along the way.
From here on out, you'll likely know none of this sort of thing. But you can bet it will go on.