Let’s state the obvious: Running an $800 million hospital isn’t easy – especially an independent hospital like El Camino that has to compete with the likes of Stanford, Kaiser and Sutter for its business. That it has to compete in an increasingly difficult and complex health-care system makes the task all the more daunting.
It was in this context that the El Camino Healthcare District board last week expanded the hospital board to include two new appointed board positions. This is in addition to the three appointed seats added in 2012. This creates an 11-member hospital board, which includes the five elected district members. Concurrent with the action, the board kept the CEO as a hospital board member, but made it a nonvoting position.
As a compromise between adding the needed expertise but not diluting elected board members’ influence, the district board made a good decision. Although stripping the CEO of voting power creates the potential for a 5-5 deadlock, such a scenario is highly unlikely. On the other hand, a nonvoting CEO all but eliminates any perception of conflict of interest. The chief administrator’s role becomes much like a city manager’s relationship with a city council.
Proposals to add appointed members prompted fears that the public hospital was being given away to private interests. Often cited was the notorious 1992 decision to create an integrated delivery system and strip the elected board of authority. But business at the hospital has benefited over the past five years with the additional, appointed experts on its board. That’s a benchmark worth noting to justify last week’s decision. This is not a matter of giving away. It’s a matter of staying alive.