Hospital Commissioner's Emails Reveal Personal Rivalries, Ethical Gray Areas

• Experienced: amen to that, enjoyed the conversation. SGF - you too

• SGF-and tap dancer; you make some spot on points. The truth is very very few people on this blog give a darn about real issues at the NBHD. If they did they would be screaming about issues like the $1,000,000 deficit at Home health, not about a few emails. Go read the BrowardHealth.org online board meeting minutes going back a few years, stay current with new meetings, then comment on the who, what, were, why, and how of the NBHD. After all, this is your tax money at work. An informed blog dealing with real issues could make a "real difference". Otherwise all this is just graffatti.

• SGF: hard to improve on your summary - you nailed it - so I won't try ;). And to prove your point, Bernstein did raise home health at public board meetings, as he should have. Everyone got the chance for input, and management got to respond appropriately. And while I think Bernstein crossed the line tecnically, it was in a no-harm, no foul kind of way, at least in this case. Totally unlike the others you mentioned. The charter provision is not a model of clarity when you try to apply it. It's hard to write laws that target only what's improper.

• I guess the point here is there is a line, and in this case, i don't think the intent of the charter was violated. Experienced Board Member: No need to get nasty with me. It is true the board member is appointed by the Governor, and I'm in no way suggesting he shouldn't come down on the CEO if he has a problem with what the CEO is doing. In this case, Bernstein offered his advice to the CEO. If the CEO opted to do something different, and the performance of the Home health Agency didn't improve, then Bernstein could, and should, hold the CEO accountable for the performance at a board meeting where the rest of the board could participate - which they also have a right to do. Tap Dancers: When a board member insists on the CEO directing money to his or her favorite charity; or when a board member insists on favors for his clients; or when a board member pushes to have an associate hired; or when a board member tries to involve themselves in contracts....those are all things that have apparently happened, and that is what the charter provision was intended to stop. In this particular case, the District was losing $1 million on a home health agency. The board member was apparently insisting on a corrective plan. Seems fair, and certainly not on the level of the other misdeeds by other board members. It would be better, however, for that board member to raise the issue at a board meeting, tell the CEO to bring a plan back, and then hold the CEO accountable to that plan. The language of the charter seems to indicate that the Board member is not supposed to direct the actions AND oversee them. That's understandable. If a board member tells the CEO to solve a problem a certain way, and the CEO complies, and the result is a bad outcome....then who is accountable? The CEO is. And it would be hard for the rest of the board to hold the CEO accountable if he was directed by another board member. That hardly seems fair to the other board members. They didn't have a say in what the CEO was directed to do, yet they are supposed to hold the CEO accountable. So, it may be unfair to direct the CEO without the rest of the Board having input. So...Experienced Board Member...though I understand your insistence that a board member has a right to express their views, it seems the proper venue for that is at a public board meeting - ALTHOUGH, it seems appropriate to provide input to the CEO however and whenever the Board member wants to. Its just that the CEO is also within his rights to thank the Board member for his advice, but not take it. The Board member can always call out the CEO at a board meeting if he is not happy with that outcome. This really is not that big a deal. The bigger deal is whether the Home health issue got solved. And I think we all owe a thank you to Commissioner Bernstein for raising it. For once...a commissioner who is focused on the operations of the district rather than which of his friends he can help. This is refreshing....

• We have no idea why Levine sent the e-mails to the Compliance Officer, or what the Compliance Officer thought about them. We do know that Nask's explanation makes no sense. The charter does say that oversight is to be conducted only collectively, and the only permitted direct contact is to provide information only and to forward citizen complaints. That does not leave any room for private, "tough" interraction of any sort. Providing information isn't "tough."

• Hey tap dancer, The compliance officer's obviously did not see it the way you do. Nask forwarded a bunch of emails to them and they did not say a thing about the emails violating the charter. And you are being a bit misleading when you say "Being tough with the CEO as an individual is exactly what the charter says he can't do". The charter does not say anything remotly close to that, nor does it imply anything of that sort.

• SGF: that was me, I used 'chain accounts' on the Morroccan bank acount on Norman's blog. experienced board member: Read the charter, he can, and should be as tough as he is, just in public, at the board meeting, grilling the CEO with the rest of the board. Being tough with the CEO as an individual is exactly what the charter says he can't do - that's oversight as an individual - the prohibited version

• SGF: Agree completely. Isn't it amazing when intelligent people can reason together ;). The charter provision does inhibit one on one dialogue with the CEO, which is a bad thing, but the drafters of the legislation apparently thought that having commissioners putting CEOs on the spot was worse. You don't have to be a cynic to imagine all sorts of conversations that lead to "if you want my support for "x" then I need a favor, and of course this conversation never happened." It's a shame it has to come to this, but the result is that all the strong opinions should come in public meetings. Sunshine laws are not always a good thing, but maybe in Broward they are a necessary evil.

• Hey SGF, Leave your number here and Bernstein will call you next time so you can tell him when he has given enough advise and when he should give more to the CEO. Oh wait, the Governor appointed him to make that decision, not you. Kudos to the guy. You are critisizing him for being a tough Board member. Well, as a taxpayer I say thank you to him. Unless someone has proof he has some unknown interest in a home health business, he should ask as many questions as he feels is appropriate. It looks like the morons running this place were losing a million dollars a year in this business. Why were other board members not also screaming about this! Amazing

• tap dancers, Point well taken. Generally, if a board member sees there is a problem, it is not a bad thing for the board member to share that information with the CEO. In this case, if there was a problem with the home health program, and a board member had some expertise, and the CEO asked for the Board member's input, then its totally appropriate for the Board member to offer it. The CEO does not have to take the advice. If the Board member is not happy about that, then they could certainly bring it up at a board meeting, but they, in no way, should try to force the issue with the CEO. The CEO is ultimately the person who is held accountable by the Board --- the board member, on the other hand, is not accountable at all to anyone. So, its not fair to try and strong-arm the CEO to do anything he/she is not comfortable doing, or he/she thinks is not the right strategy. If the board member doesn't like it, they can take it up at the board, and convince the board members to establish a policy. Then, at least the entire board has an opportunity to participate, which they have a right to do. So...I think your stricter interpretation is correct. Mr. Bernstein should have shared his opinion/advice and left it at that. By the way...a good CEO should want their board members' advice if the board member has relevant experience.

• More Spencer Levine articles please.

• SGF: you are of course correct that there's a big difference between Bernstein's conduct and the example you give, but the fact that the CEO can presumably ignore a commissioner is beside the point. The charter says you can forward information or a citizen complaint. That's all, and that's clear as a bell. One purpose of the provision is to make sure that no commissioner is doing anything behind the back of another commissioner, even if it's just a helpful suggestion. And don't tell me the CEO can just tell the others about the call. That puts the CEO in an awkward position. Nask doesn't even have a contract yet, and Bernstein keeps reminding him of that when he makes his "suggestions."

• "Looks Good" has it right. Here is the language directly from the charter... "Except for the purposes of inquiry or information, a member of the board of commissioners shall not give direction to or interfere with any employee, officer, or agent under the direct or indirect supervision of the President/CEO." The language goes on to read that nothing in the section shall be construed as to prevent the board member from providing information to the CEO. That said...the bottom line is the CEO does not have to do what the commissioner tells them to do. As in individual, the commissioner has no authority to direct the actions of the CEO. There is nothing in any part of the charter giving an individual commissioner the right to direct the CEO or anyone at the hospital district; and in fact the charter makes clear the board members can only act as a body. As to this case with Bernstein and Nask...it appears the Commish had a problem with what the CEO was doing. he voiced his criticism to the CEO. So what? The CEO filtered it, and decided he didn't agree with the Commish. If the Commish has a problem with that, he can bring it up at a board meeting, ask the CEO the tough questions, and hold the CEO accountable. Seems a far cry different than..."Hey Frank, will you please help me break in to a doctor's office and change the lock so my client can take over the practice....". or...."I can get you an income guarantee...just hire my consulting firm since that's how we do things....". Seems like that is the kind of crap the Charter is trying to prevent....

• looks good: I give up, what charter are you reading? it says the only thing you can do with the CEO is forward a citizen complaint or supply him or her with information. Providing "guidance" ain't on the list. Providing strong opinions on what the CEO should do is not only not on the list of exceptions either, but it's obviously an attempt to provide oversight as an individual, and that's prohibited, period - no exception for the CEO.

• There is nothing wrong with a commissioner doing this. If you read the language of the non-interference clause, it says the commissioner can't give direction to, or interfere with, anyone who reports directly or indirectly to the CEO. Point being, a commissioner can provide guidance to the CEO. If the CEO chooses not to follow the guidance, the board member can bring it up at a board meeting and get the board to take action. If he can convince the board of his or her position, and the board votes for it, or provides their consensus, then that is the policy and the CEO must execute it.. If the board member was asking the CEO to do something that was improper, then the board member would never raise it publicly. Bam.... That's how the non-interference provision works, and is intended to work. It gives the CEO the ability to say "no" when a politically appointed commissioner is out of line. The whole point of this is to allow individual commissioners to have input with the CEO, and a mechanism for when their input is either disregarded or inappropriate.

• Levine, the COO was just "informing" the CO to make sure the Sunshine Law was complied with? WTF? The CO doesn't do that. The e-mail is on the system and is there to be produced if requested. Sunshine Law complied with. Levine had to be asking the CO if Bernstein was crossing some line. The charter permits asking for or providing information. Bernstein thinks "discussing" an issue personally is his job? That's exactly what the charter prohibits, and his e-mails sure sound like he's "exercising oversight" by sharing his very strong personal opinions about what should be done. Isn't that what oversight is? He is supposed to do that with the other commissioners as a group, in public.

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