SEARHC Health Council Charter
Dear Editor: The Health Council Charter was negotiated by SEARHC and the CBS as part of the Sitka Community Hospital sale. Council’s role is advisory; it “has no authority to bind or represent SEARHC.” Charter directs Council to collect and analyze diverse information, and interact with SEARHC on “the clinical and healthcare needs of Sitka, patient satisfaction, quality of care and quality improvement” (SEARHC News Release). Charter is a four-page legal document with two pages devoted to a complicated, layered system of Council member selection, qualification, appointment and removal.
Council comprises nine at-large members and two big shots: SEARHC Vice President and Chief Medical Officer Dr. Elliott Bruhl, and “the chief administrative officer of the City and Borough of Sitka” John Leach. Charter sets different rules for initial and replacement appointments. Initial at large (AL) members were chosen to represent specific political interests. The Assembly appointed two for Sitka and three for the SCH Board; SEARHC appointed two, and Sitka Tribe two.
Charter sets AL term limits of one, two or three years, and Council controls replacements. Vacancies can also be created by resignation or termination. Council may remove a member for a “conflict of interest, inability to attend meetings, or other good cause (Council defined).” Replacements funnel through a Nominating Committee (John Leach, Dr. Elliot Bruhl and “an AL member appointed by Council”), who identify and “fully vet” candidates using detailed Charter criteria. They prepare a list of unanimously approved candidates for Council, who elects new members to three-year terms. Replacements must “Have a commitment to act in the best interests of SEARHC and community (and shall not be a representative of a political or individual interest).” This is the opposite of Charter’s initial approach, and a broadly impossible standard that Council can use to reject anyone.
Council’s assigned “Duties and Responsibilities” are to collect and analyze community input, advise SEARHC on strategic planning, health care quality, patient access to desired care and patient experience, review “clinical policies and practices and recommend changes”, provide input on “specific geographic, social, health and welfare needs,” recommend “policies and courses of action to further the health needs of the people treated in the Service Area” and, “once a year, a portion of the Council meeting is open to the general public for its input.”
To do so Council must: 1) Collect broad-based community comments and concerns about SEARHC’s performance as Sitka’s sole medical provider. 2) Compile and analyze these data. 3) identify important issues and common themes. 4) Compare these data/themes to SEARHC’s policies and practices. 5) Recommend courses of action to better meet the health care needs of Sitkans. 6) Evaluate SEARHC’s responses (if any) to requested changes. And 7) Continue to collect and analyze community and SEARHC input, and make or revise recommendations over time based on SEARHC’s changing policies and performance and community comments.
Besides the annual public hearing, Council members learn about SEARHC practices from personal and family experiences, and Sitkans’ stories/complaints. This year Council restricted public testimony to 15 persons with three minutes to speak in an online Zoom session. Subsequent Sitka discussions have focused on whether that closed process complies with Charter guidelines. Charter authorizes Council to meet “by means of a conference telephone or similar communications equipment…”, (i.e., this successful gambit was prepared long ago).
Council cannot meet its assigned responsibilities without collecting, analyzing and following through on broadly representative community input. Although SEARHC’s home health care closure is a hot topic, Sitkans have other concerns, e.g., billing transparency and the sky rocketing costs of SEARHC health care.
SEARHC collects patient comments internally, controls access to internal information of any kind, and uses it selectively as a political tool. Charter directs that “A written report of the Council, approved by SEARHC, shall be made available to the public on an annual basis.” I sent SEARHC an email requesting copies. After 16 days of silence, I don’t expect a reply.
Charter defines ‘‘minutes and other records of the Council (as) confidential business records of SEARHC,’’ and requires Council members to “abide by SEARHC’s confidentiality and conflict of interest policies.’’ Controlling the flow of information is a basic political ploy, and political power games flourish behind closed doors. This can make subsequent public processes frustrating for participants, and produce pre-determined political conclusions (e.g., Council’s recent Zoom meeting).
Although about 150 Sitkans attended the December 2023 women’s group meeting on Home Health Care closure, it failed because SEARHC refused to participate, and the group has no formal authority or responsibility. The recent Council “public hearing” failed because Charter gave Council the tools SEARHC wanted to control public input. Charter is a remarkable negotiated document in terms of how thoroughly it acts for SEARHC’s political benefit. Presumably SEARHC Council now controls all membership and group decisions, and SEARHC controls access to the annual public reports.
Council members rely on SEARHC for internal information and analyses. Council collects and analyzes diverse input and makes comments and recommendations to SEARHC, who churns them around internally, and responds back to Council. This hidden merry-go-round will continue to spin until SEARHC decides to end it. After four years, Charter directs Council “to determine if it should continue to exist or sunset.” Termination requires a “majority vote of the Council…and written approval of the SEARHC CEO.”
In sum, negotiators carefully designed Charter to give SEARHC the secrecy and control it desired, and provide an effective firewall between concerned Sitkans and well-paid SEARHC big shots. It does not read like a hard-fought compromise between opposing political sides.
I’m afraid this discussion is both lengthy and incomplete. I would encourage Sitkans to obtain a Charter copy from CBS offices and review the details for yourself. Two unanswered questions are: “Who negotiated and approved the Charter for Sitkans?” And, “Why is it so one-sided?” I presume the Assembly ultimately signed off on it as part of the SCH sale.
I would describe Council as a carefully crafted political black hole, with legitimate reservations on Sitkans’ side about SEARHC’s motives and commitment to the community. It is important to remember that SEARHC has always had (and rejected) the option of acting like a good neighbor.
Dave Hardy, Sitka
Card of Thanks
Dear Editor: The Borbridge family would like to say thank you to our amazing hometown of Sitka, for taking us under your wing following the loss of Darren and Sayer.
First, the U.S. Coast Guard continues to provide exemplary service whenever called upon.
Thank you, L.B., for the use of your vehicle for out-of-town family. What a blessing!
The meal train, visitors, phone calls and messages provided support for the family.
Thank you so very much. Memories of Darren will easily include these gestures of prayer, hugs, along with the kind words of encouragement, strength and genuine caring.
I’m happy to call Sitka home, thank you all.
Jim Borbridge Family, Alan, Kay, Alan M., Rebecca C., et al
