The Jefferson Parish Council is giving parish-owned East Jefferson General Hospital, pictured here, and West Jefferson Medical Center more power to seek and evaluate professional service contracts. Good government advocates, however, are raising questions about the move. (Photo by Times-Picayune archive)
"We don't know yet where this lands us." -- Janet Howard, Bureau of Governmental Research
The Jefferson Parish Council is moving to give the two parish hospitals more control over the evaluation and hiring of professionals, including engineers, financial consultants and attorneys. That's raising questions among reform advocates, who said it's too early to determine whether the move will bring more transparency and less politics to the hospitals' contracting.
Council members last week unanimously gave the boards at East Jefferson General Hospital and West Jefferson Medical Center more power to seek professional services on their own and to evaluate responses from vendors. The boards are appointed by council members and the parish president.
The new ordinance exempts the hospitals from parishwide technical evaluation committees that rank offers for a host of professional services. The council gave the hospitals two months to propose their own evaluation mechanism, which will need council approval.
Several council members Monday said they expect the new process to rank vendors, using scoring set by independent technical committees that meet under the state's open meetings and open records laws. That's a similar process to the parishwide evaluation committees.
Janet Howard, president of the watchdog Bureau of Governmental Research, said until the details of the new hospital contract process are known, the public can't judge whether the move marks progress. But Howard, whose entity has been pushing for contracting reform in Jefferson, said the approved ordinance already keeps the council's discretion to select professionals without having to pick the top-ranked firm. That's something BGR opposes.
"This leaves the unfettered discretion of the council to select professionals," Howard lamented.
Council keeps discretion
Councilman at-large Chris Roberts said he proposed changing how hospitals hire professionals so the hospitals could set their own priorities when it comes to hiring specialized services. Roberts said the parish's committees that evaluate proposals for services often lack specific health care expertise, which may hinder the hospitals.
"I don't think our guys who do streets and public works should be the ones evaluating proposals for an emergency room," Roberts said.
The ordinance Roberts originally drafted would have given the hospital boards even more discretion to select professional services. That original draft said the council would still select vendors, but that "the selection shall be based" on the recommendation of the board. The BGR's Howard said that essentially would have required the council to pick the highest-ranked firm every time.
The final version of the proposal, which was amended after talks involving several council members, said, "The selection may be based" on the hospitals' recommendation. Howard said that keeps the status quo, allowing the council to ignore the technical rankings.
Council members Paul Johnston and Cynthia Lee-Sheng, whose districts include the hospitals, said they have been selecting contractors based on the recommendations of the hospitals anyway. They said the new ordinance is no different from what the council does now in that regard.
Expertise is the issue, council says
Roberts said the council should retain the power to ratify the board's recommendations and to pick among qualified firms, not automatically the top-ranked company. He said the public holds the council accountable for its decisions, and that surrendering all discretion to the hospital boards could lead to the kind of problems the parish has now with the Jefferson Housing Authority. The authority, which can hire contractors on its own, is mired in a mismanagement scandal.
But Howard said that if the argument for changing the hospitals' contracting process is the need for specialized expertise, then the council should not make the final decision. None of the council members is a health care administrator or has specific health care expertise. "If this is about expertise, then why leave the discretion to the council?" she asked.
At Johnston's urging, the council also amended the ordinance last week to require the hospitals to propose a new evaluation process and submit it for council approval. Howard said the details of that new process will be crucial.
Howard said the hospitals should have technical committees with independent experts, who should conduct open evaluations and score professional firms to produce rankings. The committee meetings should be open to the public and the evaluation documents public records, as is the case for the parishwide evaluation committees, she said.
Roberts, Johnston and Lee-Sheng all said they expect the hospitals' process to do just that. Johnston said he'd prefer that experts be appointed based on nominations from metro area universities. Lee-Sheng said she wants the committees to have industry-recognized experts.
Lee-Sheng said she agreed that the process should be conducted in the open, but noted that the open meetings law allows hospitals to discuss certain strategic business matters behind closed doors to protect their competitiveness. That could result in less transparency than having hospital vendors evaluated by the parishwide technical committees.
Those uncertainties make good government advocates wary of passing judgment on the council's actions regarding hospital contracting. "We don't know yet where this lands us," Howard said.
Source: http://www.nola.com/politics/index.ssf/2012/11/jefferson_parishs_changes_to_p.html
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