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Issues shed light on BayCare board

Economical, ethical and health care concerns push the largely unknown members into a harsh spotlight.

One is a sponge king from Tarpon Springs. Another is an activist nun in Brooklyn. A third is a contractor once dubbed "Mr. Clearwater."

These are some of the civic leaders who joined BayCare Health System's board to help lead the region's network of 10 non-profit hospitals.

Now the board members find themselves in the uncomfortable spotlight as they sort out the financial and political problems rocking Tampa Bay's biggest health care system.

Despite the members' crucial role, few know who sits on the 23-person board. BayCare officials refuse to identify them, citing an interest in maintaining their privacy. The handful of directors who talked with the Times said they could not recall all of their colleagues' names.

How much the public should know about the operation of BayCare is one of the issues its executive board will discuss at a meeting Monday. The board must also tackle a growing number of concerns. For starters, about 500 jobs are being cut at Bayfront Medical Center and St. Anthony's Hospital. Doctors are scrambling to reassure patients they will continue to get quality care at those two South Pinellas hospitals.

And St. Petersburg's city leaders are angry that the group's secular hospitals bowed to their Catholic partners' doctrines and restricted abortions at Bayfront. The hospital sits on city property, so local leaders believe Bayfront is violating its lease because Catholic doctrine is dictating medical policies.

Hospital leaders, meanwhile, are holding staff meetings to address concerns about jobs cuts. In a letter to employees, Joy Gorzeman, chief operating officer of Bayfront-St. Anthony's, said 34 people who lost their jobs have already been placed in new positions within BayCare. And though she empathized during a meeting at St. Anthony's with workers who may be saddened and even "grieving" at the loss of their fellow workers, she urged them to move on.

"This can be a new beginning," said Gorzeman, who urged employees to "think out of the box."

In discussing the hospitals' losses, Gorzeman said in her letter that average payment per patient has declined 14 percent, or $34-million, since 1997. Uncompensated care of $34-million represents 14 percent of the two hospitals' total expenses. While expenses are up, admissions are down an estimated 5 percent this year.

BayCare's board members said the job cuts are essential to maintain the two hospitals, which now lose about $1-million per month. "There is no light at the end of the tunnel," said Dr. Larry Davis, a Bayfront pathologist who serves on the BayCare board. "You've got an economy that's cranking while the health care industry is in a tremendous financial depression."

When BayCare was formed two years ago, many of the changes were not disclosed to the public. Local communities were told only that the network would mean greater savings from combining back-office operations.

One of the biggest concerns today is how much the Catholic partners, who run St. Anthony's as well as St. Joseph's Hospital in Tampa, dictate medical policies.

Board members say they were aware the alliance would bring change. "We understood that there would be a recognition of the ethical standards of our partners," said George Rahdert, a St. Petersburg attorney who is vice chairman of the BayCare board. "I don't think it meant a substantial change in the way we do business, maybe 10 (abortion) cases per year. A couple of cases in the scheme of things is very small."

Davis, on the other hand, said he can't recall any discussion of the abortion issue, nor does he remember when he learned Bayfront's policy had changed.

BayCare was organized into three geographically clustered hospital groups, each with its own board: Bayfront and St. Anthony's in south Pinellas; Morton Plant Mease in north Pinellas and North Bay Medical Center in Pasco County; and St. Joseph's/South Baptist in Hillsborough.

Members, all of whom serve on local hospital boards, say they are unsure of how they were selected for the BayCare board. "I think it was a consensus sort of thing," said John Welch, a St. Petersburg insurance executive who was chairman of Bayfront's holding company during the transition. "All I know is that four of us (from Bayfront) were selected, but I really couldn't say who chose us."

Bayfront board members who didn't make the cut _ either to BayCare or even onto the merged Bayfront-St. Anthony's board _ got the message rather abruptly.

Ross Roeder, who had raised questions about loss of local control after BayCare merger, said he was told his 12 years on the Bayfront board were over when he called to say he'd be late for a meeting.

"Sue (Brody, president and chief executive of Bayfront-St. Anthony's) said I didn't have to come, then she read me the new list of board members and I wasn't on it," Roeder said. The winnowing of the board, he said, "was all done in secret."

The BayCare board seats were divided according to financial clout: the hospitals with the most money got more seats. The board has eight representatives from Morton Plant Mease hospitals; eight from St. Joseph's and St. Anthony's; four from Bayfront; and two from South Florida Baptist hospital in Plant City. Frank V. Murphy, BayCare's president, also sits on the board as a voting member, bringing the total number of members to 23. Murphy is paid as company president, but board members are not paid for their service.

Many of the board members could not be reached or declined to return the Times' phone calls. But several members described the board as strong and active in shaping BayCare's strategies.

"There are non-profit boards that abdicate their responsibilities, but this is not one of them," said James Harper, an insurance executive in Clearwater. "The board members are all active in their communities, and every one of them has a driving concern about the health care in their community and raising the quality of that care."

Michelle Ligon-Smith, a St. Petersburg attorney who sits on BayCare's board, said of the meetings, "There is candor at all levels. There's a common interest in making sure the highest quality of care and efficiency is in place."

BayCare board members, who each also sit on a local board, said the goal was always to leave as much decisionmaking as possible at the local level.

The local boards set their own budgets and make capital spending requests, said Rahdert, who also is on the Bayfront-St. Anthony's board. "It's a real checks and balance system to make sure we don't outspend our resources," he said.

The entire BayCare board meets every other month, but subcommittees, especially those dealing with finance and implementation, meet monthly. When the whole board convenes, the agenda is generally determined by the subcommittee work or items from the local boards, rather than being set by BayCare's president.

"It's really rare that we simply vote on items presented to the committee by Frank (Murphy)," Rahdert said. "Typically 90 percent of what we deal with comes through (sub)committees."

Davis said Murphy does a good job of pulling together diverse groups and giving each a say in the outcome.

Board members said BayCare has saved local hospitals millions of dollars, but it may not be enough.

"We can't save money through consolidation faster than the federal government is cutting revenue," Harper said. "So we're always behind the curve."

The concerns about BayCare have spread to City Hall, where a number of city leaders are suggesting that Bayfront Hospital is violating its lease with the city if Catholic doctrine is dictating medical policies. City officials are concerned, among other things, that hospital employees receive a brochure stating that they must "follow the Ethical and Religious Directives of the National Conference of Catholic Bishops as they apply to your institution."

Brody met with Mayor David Fischer last week on the issue, and on Wednesday, the city sent Bayfront a letter reiterating its position.

"The mayor informed Ms. Brody that any religious entanglement in the operation of Bayfront Medical Center must stop," wrote City Attorney Michael Davis. "That, in a nutshell, is our position."

_ Times staff writer Kelly Ryan contributed to this report.

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