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Published: 19 June 2018 19 June 2018

[Editor's Note: This is part 3 of a multi-hour-long combined work session and regular meeting on June 12, 2018. It features the process of choosing two to fill vacancies on the Gila Regional Medical Center Board of Trustees.]

By Mary Alice Murphy

After a special meeting the week before, when Grant County commissioners clarified the process to be used in choosing two to fill general vacancies on the Gila Regional Medical Center Board of Trustees, in the middle of the June 12, 2018 meeting, the agenda item came up.

Chairman Billy Billings said that the final five as chosen out of the nine applicants would have up to 10 minutes to speak and answer the five questions that had been posed to them for this meeting.

The five questions were: 

1. What do you think are the most important characteristics of a successful trustee?

2. Tell us about a time when you had to challenge the prevailing consensus of a group, how you went about doing so and what was the end result?

3. Tell us what you foresee as the role of a community hospital in the healthcare of the future in the United States?

4. What experience of collaborative leadership do you have and what role did you play on the team?

5. How much time do you anticipate you will have to devote to the board in order to be a successful trustee and what specific activities do you anticipate spending those hours on?

The first to speak was incumbent Tony Trujillo. "I am interested in serving the hospital board again. For my personal statement, I am a lifelong resident. I have a strong personal commitment to our local hospital. I have more than 40 years in management in the copper mining industry, and I have served on numerous boards over the years. For the past 30 years of my career, I have been doing government relations for the mining industry. I continue to consult under my own LLC."

In answer to the first question of the most important characteristics of a successful trustee, Trujillo said each trustee must have integrity, knowledge of management as well as a basic knowledge of health care. "The trustee must have a clear understanding of the difference between governance and management, a willingness to learn—one thing I've learned is that health care is a very complex business—a passion for the cause, a strong knowledge of and commitment to confidentiality, willingness to prepare for the many meetings, be able to work cohesively to arrive at decisions to help the administrative team, a sense of responsibility, and a vision to think beyond today."

He said something he had to challenge in "this very room was the decision on the Cancer Center. I was the only No vote, because I felt the whole process was flawed and I was concerned about the lack of transition between the two providers. But I continued a positive working relationship with the other board members, and we moved forward to where we are today."

Another issue he differed on was the Meditech conversion. "I was the first on the board to challenge the costs. At the beginning, it was going to cost $2 million. It rose to more than $10 million. I finally got the group to reach consensus to go live and not spend any more money."

On the third question, he said he sees in the future a community hospital that needs to continue to be governed locally. "Gila Regional Medical Center just created a strategic plan to address financial issues and to maintain quality."

On the topic of collaborative leadership, Trujillo said he spent 12 years as a regent at Western New Mexico University, working with a group and spending eight of the years as chairman of the Board of Regents. "The Gila Regional Board of Trustees is not a once-a-month meeting. We have committee meetings. I was the chairman of the Quality Improvement Committee and am now the chairman of the Human Resources Committee. Also, there are special meetings that take place, auditors come in and they want to meet with trustees. It takes a lot of time."

"It truly has been an honor to serve for the past three years," he said. "I'm proud and humbled to be associated with a skilled administration, the best caregivers and staff and the most qualified physicians at GRMC. I appreciate your consideration of reappointing me."

The next to speak was Edwin Wilmot. "I ask you to participate in a shortened version of what I prepared. We'll take a virtual ride down the elevator. I will give you a straight-forward sentence for each question."

He said he served as the co-chairman of the Los Alamos Medical Center Board. "I noticed a thread in these questions about collaborative leadership. That is clearly the essence of everything we're going to do as a County Commission, as a Board of Trustees, as a hospital. We have to expand our perception of what's out there. We have to broaden our perspective. This whole effort requires collaborative leadership. In my mind the position requires not management of the hospital. It requires overseeing, watching what's going on and trying to gather input," Wilmot said.

"Question 2, when I was volunteer manager of a utility on a barrier island off the coast of South Carolina I was against the consensus of the state and of the group. We went into voluntary negotiations for over a year. That collaborative process did not result in success, and we had to go to binding arbitration."

"I'm excited about future planning," he continued. "I worked with a creative person. Change and improvement requires discomfort. Every time I wanted to do something, she questioned how other large companies, especially internet ones, would deal with them. I believe our hospital has to be the community entrance to the web of health care and scientific knowledge, and that's where we have to develop collaboration. I was happy to hear Mrs. Arias this morning talk about that. I would love to see a robotic surgeon in Boston operating on someone here, with a local surgeon overseeing it. I see a tremendous number of opportunities."

He said on collaborative leadership, he was part of a think tank in Idaho that took on a project that no one else had been able to figure out. "A team of 15 took it upon themselves to address it. It was in a public employee setting. We failed, but we had a heck of a good time working together. We ran up against something we couldn't get past."

When he was on the Los Alamos Board, he said, although he was working 60 to 80 hours a week, he still found time to give at least 10 hours a week to the hospital. "Here, I'm retired. I'm thinking I need to put in 20 hours a week to immerse myself and learn everything I need to. Then it will be a minimum of 10 hours a week."

The third applicant called up was Raymond Goellner, retired Gila Regional pharmacist.

"I believe it's critical to have board members, who have worked in hospitals, and especially in hospital management," Goellner said. "I spent 47 years in hospitals, with 39 in management, 11 of them here as director of pharmacy and chief of clinical services."

He said he cares deeply for the community and the 500 plus Gila Regional caregivers. "Without caregivers, there is no hospital. The best people I've ever worked with are here at Gila Regional Medical Center."

Goellner noted that under CEO Brian Cunningham, they spent millions on billing, "but, to my knowledge, nothing come from it. I have questions and concerns on the current contract and want to make sure the new contractor HRG (Healthcare Resource Group) is producing the results promised. I'm against removing any employee."

"If chosen, I would speak with each hospital employee monthly to hear their concerns and to help morale," he continued. "I advocate for a monthly Gila Regional newsletter to be shared with the community."

As for the most important characteristics, Goellner said he thinks a knowledge of hospital operations is key in order to ask the right questions. "I think transparency with the commissioners and the administration and employees is important. A board member has to have the willingness to be available, has to be honest, open and fair to all is essential and to be a team player."

A challenge he faced was that he did not support the mil levy held several years ago. "I am referring to the mil levy in 2016. I expressed my opinion to the C-team. I said putting it on property owners was a bad mistake and I thought it would fail. Property owners aren't the only ones who use the hospital. Everyone, even visitors, uses the hospital. I advocated for a broad-based tax that everyone pays."

"I see health care as the wheel, with the community hospital as the hub," Goellner said. "The spokes represent the services that have to be referred out, because they are not available at the community hospital. It's the first stop in health care, with referrals out to specialized services. The challenge is recruiting those who provide services to minimize referrals outside."

While chief of clinic services, he was in charge of departments, including the pharmacy, labs, pulmonary services, imaging, rehabs, infection control, housekeeping, laundry and facilities. "I had to stay within budget, maximizing revenues and minimizing costs."

He said he expects to put in anywhere from five to 20 hours a month. "I would like to serve on the committees that address employees and finance. It would be an honor to serve our hospital on the board. Since I'm retired, I can put in as much time as needed."

Renee Despres, the fourth applicant to speak, said: "I live and breathe health systems and health policy. It's what I do. You have my CV and it stands on its own. I will spend most of my time answering your questions."

[Editor's Note: She has a soft voice, did not speak directly into the microphone and was difficult to hear at times.]

On the first question about characteristics, she said excitement about the future of the hospital, excitement about the role government plays, a willingness to learn, especially about the management of the hospital. "I believe a board member needs to know about health care overall. A member is responsible for maintaining the quality of care at the hospital and creating an environment of caring. I have an absolute commitment to ethical behavior."

On the issue of challenging a group. "As a facilitator, I build consensus. I rarely find myself in a place of challenging a group, although I was part of a decision to upgrade a fire system. I refused to vote on the issue until the money for it was found."

On the role of a community hospital, she said with health care in flux, she believes with technology, much of the care will be presented in homes. "I would also push back on technology because I know many nurses and physicians feel like tech is taking over. There is an increasing knowledge of social determinants that we must address. I see the future of a community hospital as challenging and exciting."

Despres said she spends four to six hours a week in Doña Ana County on a collaborative project.

"This is my hospital. I live here," she said. "I am overjoyed at waking up and being able to run the trails. My daughter was born at this hospital. We've both been treated there. I would be honored to bring my skills to the hospital."

The last applicant among the five was Wayne Mosteller. "I worked at Gila Regional for 31 years as a pharmacist. I retired on May 25, when the pharmacy changed hands to Cardinal. I was the interim director four different times, went through successful JCAHO (Joint Commission on Accreditation of Healthcare Organizations) and I updated the pharmacy policies."

He said he believes the characteristics for a trustee are enumerated by ICARE, Gila Regional's values of integrity, compassion, accountability, respect and excellence. "These can be said of any good person. However, I think a trustee should have understanding to appreciate the opinions of others, perseverance to get to the core of issues and to the solutions, strength to be able to hold to what is right, and equity to forge a relationship between the board and the administration."

"I have been on the board of a New Mexico non-profit, a consensus-based community for 34 years, one year of which I served as president and the rest as treasurer," Mosteller said. "I trained in communications and as a board member also had to work on general maintenance.

"As for consensus, it usually means spinning your wheels a lot, because every member has to agree to a decision that is made," he continued. "In the early day of our community, a new member would become a member, because they were accepted. Many became members, then got disgruntled and dropped out. I was responsible for communications. I made it a rule that each member would have to spend six months working with a member and getting to know the community. Since that time no one has given up a membership. We've increased the time to one year, before a new member is fully accepted."

He said he knows that many community-owned hospitals are becoming corporate owned or just shutting down. "I echo the comments from many in the public today, I'm hoping we can keep our hospital as community owned. Before we think about selling the hospital, we should investigate other designations—critical access hospitals, sole community hospitals, disproportionate share hospitals, and I don't know which we would qualify for or which would be to our best advantage. If those don't work, think about hiring a management company or, if necessary, lease it to another entity, so as not to lose control of the facility forever."

Mosteller estimated he would spend 20 to 30 hours a month researching, reading and digesting materials. "That does not include time spent in meetings. I would, as a trustee, want to investigate why, even with our 4-star quality and A ratings, some people choose to go to another facility. We need to build our reputation to match our quality awards."

With no discussion, Commissioner Gabriel Ramos made a motion to accept Wilmot and Trujillo.

Commissioner Brett Kasten said he found himself in a quandary: "I see three good candidates, but I will second the motion."

Browne said what he was really hoping to explore were partnerships. "The trustees need to have a strong understanding of health care. I nominate Despres and Wilmot."

Ramos said the reason he chose Trujillo was because he was part of the group who created the financial improvements. "I want his experience to continue to move the hospital forward."

Commissioner Alicia Edwards echoed Browne and the broad viewpoint of Despres. "Mr. Trujillo has done a great job, but we have learned that the national picture will affect how we move forward."

"Before I was a commissioner," Chairman Billy Billings said, "I saw transparency from Mr. Trujillo. A January 2016 email from him led me to realize the serious financial problems at Gila Regional. I was impatient that things weren't going faster. I will support Trujillo."

By a three to two vote, Wilmot and Trujillo were chosen to be trustees.

The next article will cover a bond presentation and other county business.