Proposal important for hospital stability

January 13, 2019

As chair and vice chair of the Board of Directors for Cabell Huntington Hospital, Inc. (CHH), we feel compelled to respond to The Herald-Dispatch’s editorial published Dec. 16 whereby the editorial board took the position that the hospital board should not choose its own appointments. We are concerned by the editorial board’s uneven presentation of the matter and seek to provide facts, clarify misunderstandings and inform the community.

CHH has requested that the Cabell County Commission and City of Huntington authorize changes to the CHH board organizational structure to allow the CHH board to have a greater role in its composition. It was the expectation of the hospital that its contribution of $1 million to the development of the respective neighborhoods where CHH and St. Mary’s are located would act as a catalyst for other investments in revitalizing these historically important areas of the city. A similar agreement has been approved by the County Commission.

In order to understand why this organizational change is necessary, a little background is helpful. In 1987, Cabell Huntington Hospital, Inc. was created to acquire the assets of Cabell General Hospital, a public county-city hospital. The transition occurred to broaden CHH’s ability to expand and follow the national trend whereby city and county governments were no longer liable for multi-million dollar hospitals. As part of the 1987 agreement, CHH agreed to:

• Invest $3 million (the same amount the City and County provided for the creation of Cabell General Hospital in 1956) for the construction and equipping of a building to house the office practices of Marshall University Joan C. Edwards School of Medicine staff physicians for the provision of ambulatory care. By completion, CHH invested almost $10 million into the facility known today as the Marshall University Medical Center. This support has helped grow the medical school to a well-established and highly recognized program

• Provide uncompensated hospital and outpatient care for indigent patients, including inmates of the Cabell County jail, having a value of $4,500,000 per year for a period of 20 years.

• Assume all debts of Cabell General Hospital, including those guaranteed by the city and county.

• Continue training and educational programs for health care personnel.

Why is changing the CHH board organizational structure important? First, the CHH board currently has little input in selecting board members who are essential to guide the hospital in today’s complex, highly regulated and rapidly changing health care environment. Second, financial markets are skeptical of hospital management structures that are subject to political influence. CHH operates in a national and global financial system. Providing stability, predictability and meeting the expectations of market participants are not optional. Failing to do so is irresponsible as it could impede CHH’s ability to raise

capital for the expansion of the healthcare system, thus negatively affecting the economy of the city and county. This is no reflection on the current City Council or County Commission, but certainly important to consider for the future.

Next, West Virginia state law requires that 40 percent of board membership of all not-for-profit hospital boards is representative of the following four categories: small business; organized labor; elderly; and persons whose income is less than the national median income.

Therefore, eight of CHH’s 18-member board are and will continue to be representative of these categories. That will not change.

Next, under the proposed agreement, CHH’s composition would include three members who are residents of the city from three separate city districts and three members who are county residents. Also as part of its composition, the CHH board is obligated to have representatives of its medical and dental staff and members of the Marshall School of Medicine. In summary, the Cabell board will continue to be representative of a broad cross section of the city and county. Regardless of the process whereby members are appointed to the board, each member has a fiduciary responsibility to act in the best interest of the organization.

As explained by Mayor Steve Williams, we believe council and the public understand that with the acquisition of St. Mary’s, the value of the assets, as well as the board’s responsibility, has nearly doubled and that they will recognize that members of the board who routinely devote numerous hours to CHH’s business are in the best position to evaluate the board’s needs at any given time.

Since 1987, CHH has grown exponentially. CHH and St. Mary’s now provide access to specialized medical care for patients throughout the region, not just Cabell County. In fact, 73 percent of patients are not from Huntington, nor Cabell County, meaning the majority of patients travel from southern Ohio, eastern Kentucky and throughout West Virginia for care.

CHH’s growth and stability over the past 30 years have made possible many improvements, including assuring that the two outstanding Huntington hospitals would remain under local control. Our goal is to become a world-class health care system making available to the patients it serves the best cost-effective health care possible; to expand specialty services available locally so that patients will not endure the hardship of extensive travel or defer or forego necessary treatment; and to make a meaningful difference in such conditions as heart disease, cancer, diabetes, obesity and opioid dependency. CHH will continue to operate as a non-profit hospital providing care to patients without regard to their ability to pay. The proposed agreement allows for the hospital to have flexibility in organizing and operating as a system, poised for future growth and making Huntington a regional health care destination.

Dr. Kevin Yingllng is chair of the Cabell Huntington Hospital Board of Trustees, and Beth Hammers is vice chair of the hospital’s board.

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