Editorial: City, county should retain hospital board appointments

December 16, 2018

With its acquisition of St. Mary’s Medical Center complete, it’s understandable that Cabell Huntington Hospital would want to streamline its governing structure. With the purchase basically giving it three boards (Cabell Huntington, St. Mary’s and Mountain Health Network, which oversees both hospitals), it makes sense to move toward just one board now that Cabell Huntington is the sole owner. As Cabell Huntington board President Dr. Kevin Yingling told city officials at a meeting last month, the current board structure is “clunky and difficult.”

But what’s not so clear is why Cabell Huntington Hospital is now asking both the Huntington City Council and the Cabell County Commission to cede their current authority to each appoint three people to the hospital’s 18-member board of directors. The hospital has proposed to give the city and county $1 million each in exchange for relinquishing that right, and the county commission already has approved doing so.

The city council has not taken any action yet, and some of its members say they want more information. The county’s approval can’t take effect without the city’s assent.

In assessing the hospital’s request, it’s important to consider how the city’s and county’s current appointment powers came to be. Cabell Huntington was founded as a hospital owned by the city of Huntington and Cabell County, opening its doors in 1956. In the mid-1980s, however, hospital officials asked the city and county to allow its conversion from a public hospital to a private, nonprofit hospital. Hospital officials said the change to private status was necessary for the hospital’s long-term future because as a public entity it was limited in what areas it could serve and how it could compete with other health providers.

After some controversy, including an unsuccessful petition drive seeking a referendum on the proposal that gained about 5,000 signatures, the city council and the county commission agreed to transfer the hospital’s assets to the private corporation. That was completed in 1988 without any compensation to the city and county. But part of that transfer agreement gave the city and county authority to appoint three members each to the hospital board.

As is evident now, the hospital has grown exponentially in the subsequent 30 years, to the point that it was able to purchase St. Mary’s and certainly extend its reach beyond Cabell County. It’s difficult to see how having the city and county appoint a third of the hospital’s board has had a detrimental impact.

Another consideration is some of the concerns that grew out of Cabell Huntington’s plan to buy St. Mary’s when it was announced a few years ago. The Federal Trade Commission alleged that the acquisition would lead to a monopoly situation in the local health care market. Cabell Huntington countered with its argument that several other health care providers operate in the region and competition would remain. Eventually, state lawmakers acted to block the FTC’s involvement, and the state approved the deal.

However, Cabell Huntington Hospital, with St. Mary’s Medical Center now under its wing, is the health care behemoth in Huntington and Cabell County.

Besides the “clunky and difficult” reasoning given by Yingling, a hospital spokeswoman explained the hospital’s push to end the city and county appointments as trying to assure that the board is filled with “members with the necessary competencies to manage the newly formed enterprise.”

That could be viewed as an insult to the residents of the city of Huntington and of Cabell County to say there are few people outside those known to the Cabell Huntington board and members of the medical community who can understand the complexities of health care. The 12 people elected to the Huntington City Council and the Cabell County Commission - who make the appointments - also might take the same interpretation.

The City of Huntington and the Cabell County Commission enabled Cabell Huntington Hospital to exist as the original owners of the hospital and agreed to loosen the reins 30 years ago so that the hospital could flourish. But both entities should continue to have a hand in appointing people to the hospital board. Those entities and the people they represent still have a stake in the hospital, and they should continue to exercise it.

Surely, Cabell Huntington Hospital can streamline its board operations without eliminating city and county representation.

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