Let’s have a community digital rectal exam on what constitutes core public services, including the Northfield Hospital


I was encouraged earlier this month when I read this Northfield News article, Task force to recommend review of hospital ownership.

A council-appointed study group on Tuesday will recommend a thorough review of the future of the city-owned Northfield Hospital, including a look at the facility’s ownership. The Ad Hoc Finance Study Group, charged with reviewing potential revenue streams for the city, made the recommendation after more than a year of discussions with the Hospital Board. It’s expected to discuss its findings during next week’s City Council meeting and ask that a task force be appointed to conduct the in-depth review.

LWV observer Jane McWilliams reported on the March 13 Council meeting:

In addition to selling the hospital, other options the study group has discussed include establishing an annual contribution to the city from the hospital, similar to that approved earlier this year, and creation of an alternate ownership while retaining local control…

How the task force and the hospital board might work together was a concern. Councilor Betsy Buckheit said it should be clear that the city is instigating this.  Councilor Ivan Imm who serves on both the council and the hospital board said cooperation shouldn’t be forced, but the council should ask for the opportunity to work together. The city administrator and hospital president will support the task force in its work and it is possible they will contract  “outside resources.”

Jane included this comment with her report:

What are core city services? The work of the Finance Advisory Group appears to be guided by their collective understanding of what constitute core services. This is a topic the council has not discussed, and thus has not given the advisory group direction on this important value. It is a topic we need to think about as citizens in evaluating the work of the council as it struggles to adjust to difficult financial times.

I don’t have an informed opinion about Northfield Hospital ownership but I like what the Ad Hoc Finance Study Group has done thus far so their recommendation to have council-appointed study group look at the issue seemed a good one.  But for some reason, even talking about the issue is troubling for some people. In yesterday’s Nfld News: Hospital study on hold, pending conversations between leadership

“This has been very disturbing for us at the hospital,” said Crow. “This has been very disturbing for our staff. There’s a devaluing of what we do just by having this discussion.” Speaker after speaker asked — even implored — the City Council to take care when studying such a valuable community asset. The hospital, owned by the city for nearly 80 years, showed a net profit of $2.7 million in 2010.

Hospital President Mark Henke likened the process to a digital rectal exam, saying “there’s only so much you should fight.” “We’re trying to run a $75 million company … and we’re going through a lot of distractions. As we go through our exam, it remains to be seen if we will need sedation,” he said.

See the links to the video archive of the Council discussion in this KYMN blog post.

I’m with Jane McWilliams. Why not have a Council-led community discussion about what constitutes core public services, including the Northfield Hospital?  After all, real men don’t fear the finger.

275 | Exam fear-33-w-shirt-198x250

29 thoughts on “Let’s have a community digital rectal exam on what constitutes core public services, including the Northfield Hospital”

  1. some history: at the time that the Friends of Way Park group was trying to get the land that the former hospital was built on to return to its original dedicated use as parkland, we got pretty knowledgeable about the relationship of the City and the Hospital, as represented legally by the Hospital section of the Charter, and some of the original documents surrounding the Hospital’s use of that parkland.

    What impressed us then, and impresses me still, is how brilliant the City Council of that time was in structuring a relationship that valued the hospital so highly, that it wrote a structure that did not allow the City to ever ‘plunder’ the finances of the Hospital.

    I think this was brilliant because given the health care ‘industry’ at that time one could not foresee that the Hospital would financially outgrow the City by many times over.

    But the other thing that was brilliant was that those ‘city fathers’ knew the value to the community of providing health care to its citizens; they understood the core emotional, as well as actual physical role that the Hospital would play in the growth of the community they cared so deeply about.

    Pretty cool, eh? Let’s not allow it to get messed up now…

    1. I agree, Kiffi. I think some of the problems that arise when this is discussed is the fear that a highly value community service/asset will be co-opted by either evil intention or well-intentioned but easily misled, overworked city council-types who we see constantly buffaloed by “consultants.”

  2. I just hope that if this becomes a “bottom line” analysis that the bean counters consider not only the income stream but also the depreciation. In 30-40 years, when serious money is needed to repair and update the facility, and after passing through a time of demographic and political challenges, a time that is expected to nearly destroy the health care industry, I hope the money has been banked and not diverted to fix other immediate concerns. If the charter is really clear that the city cannot raid the hospital nest egg then we may still have a hospital after the shake-out, unless the city abrogates this contract like they seem to want to do with other agreements. Long term planning should not be left to politicians, who respond far too quickly to short-time needs (one of the dynamics of democracies that being a republic was supposed to cure, if we had been able to keep it).

  3. Why should the Northfield Hospital STILL be considered a core public service of the City? It surely was when it was created, but I’m trying to understand why, given how health care services are now generally delivered in Minnesota, it should remain so.

    I’m also trying to understand in what ways is the Northfield Hospital is now different than other city-owned, city-run entities, eg, the Northfield Public Library, the Northfield Liquor Store, the Northfield Ice Arena.

    1. Griff: the difference is significant and crucial to be understood in the context of the current ‘fracas’ in this very important way.

      The other entities you mention are actually controlled by the City and are either city departments or in some way integrated into the city budget,i.e. the city make make money on them, or assume part of their revenues, as well as have to provide for some of their expenses.

      The Hospital is totally different. Read Chapter 14 of the City Charter; it’s very short , and makes it abundantly clear that the City’s budget/income/ expenses and those of the Hospital are NEVER to mingle in the way the other entities you mention do interface.

      The city fathers who set up the separation of Church, OOPS!!! City and Hospital, made sure that the City would never be able to raid the Hospital for money to supplement the City’s budget. ( this seems to be the main point of contention now, and indeed any structural relationship to the separation of $$$ would require a change to the City Charter).

      I think this was a brilliant tenet to construct, given they could have had no idea that the Hospital’s operating budget would in the future, as it has now, become 7 or 8 times that of the City.
      Their goal was simply that a future city council NOT have the ability to weaken the Hospital by plundering its coffers.

  4. Jane (Moline), I tend to be a little more lenient when people are sarcastic towards me, but you were really over the top with your most recent comment so I’ve removed it.

    I genuinely am trying to understand this issue, as I’m sure others are so it would help if you were straightforward with your arguments.

  5. Okay, Griff, I will try again–but I believe I was WAY less offensive than the disgusting “humor” (which is about 5th grade level if it weren’t an insult to 5th graders) regarding an important community asset-the Northfield Hospital.

    Look around–what vital, vibrant Minnesota communities exist without a hospital? It is a core service–health care is necessary for everyone–even those who cannot pay and have little choice on how they recieve it–

    The sale of the hospital would be a permanent solution to a temporary financial problem–not very smart governing or planning.

    We need a hospital just as much as we need roads, clean water, sewer service, fire and police protection, or phones or utilities. We should be protecting the hospital–if it were sold it will result in higher health care costs for all Northfielders. “Privatization” would quickly lead to disconnect the administration and the public.

  6. Griff- I think Kiffi and Jane are spot on. Trying to turn the Hospital into a “cash cow” for the city would be like killing the goose that laid the golden egg.

    1. John, from the article, the City of Sandstone got into a financial hole with the hospital 15 years ago and asked Essentia Health to buy them out or take over management. Essentia did the latter with a lease to buy option that Sandstone now doesn’t like.

      I don’t think there are parallels here since with its current profitable situation, Northfield would be negotiating from a position of strength.

      Again, I’m not arguing that we should sell the hospital. My uninformed opinion is to keep it as-is. But why be afraid to discuss it? If anything, it could reaffirm the community’s commitment to it.

    2. Griff- If the city wants to talk about selling the hospital, who would be the recipient of the proceeds from the sale? Since this item was put on the table to discuss, with no apparent reason other than to get some money, it seems to have put the whole Hospital staff in disarray. To what good purpose is that going to lead? I think they need to take that possibility out of the equation.

  7. I have no informed opinion on who should properly own Northfield’s hospital. As a bleeding-heart (maybe not the best metaphor in context) liberal I’m inclined to favor public investments in such public goods. But legitimate questions do arise. Indisputably, we all need medical care, roads, sewers, water, police protection, phones, food, etc. But it’s not axiomatic that the City — as opposed to the State, the Feds, private industry, etc. — should provide all these things, as indeed it doesn’t. And of course the City now provides some services, as at the Muni and the Library, that could be argued (not by me, probably) to be less universally essential.

    In any event, here’s a purely informational question: In what sense(s) does the City now “own” the hospital?

    Presumably the City owns the land and the building(s); that’s simple enough. But are hospital employees, like doctors and nurses, also City employees? Does the City own the medical equipment? Is the City liable for, say, malpractice suits, or the costs of treating uninsured patients?

    1. Paul- This is an opinion I have heard, of which I agree, that the question is not so much who owns the Hospital and who is liable, but how can the city get a larger portion of the $2.7 million of last year’s profit. I think it is good to call a spade a spade.

      1. John,

        Yes, let’s call a spade a spade. But what does this have to do with questions I raised? Am I missing something?

      2. Paul- I will defer to Kiffi’s comment

        All of the operational costs, and revenues from practice, are separate, and may not be mingled.

        which I think answers all your questions. My opinion addresses what I think is the motivation behind the council’s actions.

    2. Paul: Fritzy said to tell you to read Chap 14 of the City Charter, very short and clear. All of the operational costs, and revenues from practice, are separate, and may not be mingled.

      1. Kiffi,

        Thanks for the pointer. Yes, the Charter does say quite clearly that income from hospital operations are to be kept separate. I don’t see anything in the Charter that’s equally clear about segregating hospital expenses from other City expenses, but perhaps that’s implicit elsewhere in Chapter 14.

        In any case, I don’t see answers to my main questions I raised in 9.1; e.g., are hospital employees actually City employees?

  8. I am absolutely appalled at the online article at the NFNews which ‘reports’ on the hospital Board review of the Hospital CEO, Mark Henke.
    The implication is that Mr. Henke caught some disapproval from the Board, or some of its members, related to the language he used at the recent Council meeting.

    Now, first of all, that was a closed meeting, and if the newspaper is going to make a statement about the content of that closed meeting, they need to make a source attribution. The comments from the Hospital Board Chair, Dixon Bond, seem to be a response to a NFNews inquiry.
    A little journalistic clarity, please.

    But the much larger issue to me is any criticism of Mr. Henke’s language which he used when speaking to the Council. It was graphic, no doubt … but that night the Council chambers was packed to overflowing with hospital employees, staff, board members… as had been the previous week’s work session dealing with the matter.

    Obviously their was a tremendous amount of concern raised about what was the actual intention of the Council in their exploration of the City/Hospital relationship (financial) as handled by the Ad Hoc Financial Advisory Group.

    I have witnessed Mr. Henke in a number of various meetings in recent years , and he is unfailingly laidback, calm, and reasonable. He has taken difficult questions with grace and patience.

    What might have caused this previous behavior to be abandoned for an expression guaranteed to get the attention of the Council?
    What might have been communicated from the Ad Hoc Finance Group, the City staff leading/directing (?) that group, and the communications from the Mayor/Council to arouse all those people to attend the two meetings, and push the hospital CEO to use such clear language?

    Hooray for Mark Henke, who chose to ‘sit in the front pew’, and from there speak his piece!

    1. The Nfld News article: Review suggests hospital CEO build relationship with city

      Not only does he have some “small problems with authority,” but the board has asked [Mark] Henke to work on his relationship with the folks at City Hall, said the chair.

      [Dixon] Bond said there was a feeling from the city’s Ad Hoc Finance Study Group that Henke was less than cooperative in their talks. The study group, appointed by the council, has been looking at alternative revenue sources for the city and last month recommended the council approve a study of the hospital’s ownership, a suggestion that has caused a great deal of angst among hospital supporters.

      Bond also noted that while Henke was right to support his staff when addressing the council March 20 about the anxiety the proposed study created, the board felt that Henke could have communicated better with city leaders. Doing so, said Bond, wouldn’t have left Mayor Mary Rossing feeling blindsided.

  9. Today’s Nfld News: Politeness, no decision on how to fashion study of Northfield Hospital

    The tone of Tuesday’s council meeting, much more amicable than last month’s discussion of a proposed study of the hospital’s operations, stopped short of promising that the city won’t sell Northfield Hospital, an entity it’s owned for nearly 80 years.

    Hospital Board member Gina Franklin, who is expected to assume its chairmanship, was direct in asking the council to take the hospital sale off the table.

    The thought of a sale has distressed hospital employees, said board member Dr. Michelle Muench. Among the concerns, she said told the council, are job security, retirement benefits and changes to a successful business model.

  10. Nfld News: Northfield Hospital board chair resigns

    Former city councilor and community leader Dixon Bond resigned this week from the Hospital Board, saying his departure is an effort to change the dynamics of the hospital and its relationship with city government…

    Bond, who smiled as Franklin surprised the audience with the news, has been criticized for comments he made to the News last week about Hospital President Mark Henke’s recent performance review…

    Bond confirmed that those remarks and his actions weren’t well received and helped lead to his resignation. “There was too much consternation,” he said after Tuesday’s meeting, “and I’d been trying to keep Mark (Henke) in line.” Bond said his comments to the News were intended to force action.

    1. I don’t get it.

      Former City Councilor Dixon Bond, chair of the Hospital Board, criticizes Hospital President Mark Henke publicly in order to force some action. What action? What “dynamics of the hospital” was he trying to change? What’s been the nature of its “relationship with city government” that he’s trying to change?

      His fellow Board members don’t like his public remarks (designed to provoke?) and so he resigns because “there was too much consternation”? Dixon provokes, the Board reacts, he quits because they’re provoked?

      Something doesn’t add up here.

      1. Ditto i.e.,”something doesn’t add up here” and if you listen to last night’s Council joint work session with the Hospital Board… you may have some more questions.

        My take on the meeting was that the members of the HB that spoke were quite direct, and really spoke to the issue of the bad beginning (caused by the Ad Hoc Finance Committee ??) but the Council didn’t seem to be able to be as plain spoken… even when the Chair of the HB asked for the Council to “frame the question”, so the Board could at least try to answer.

        Councilor Buckheit says it’s not about selling the Hospital or even getting $$ from them to support the City’s ailing finances, but just her goal for them “both to thrive”.
        But then Councilor Nakasian, by Skype from London, suggested a need to find a way for the Hospital to give money to the City, without hurting the Hospital’s finances, and Councilor Ganey seemed to thnk that if the Hospital gave $$ to the City it would cure childhood obesity! His comments were so obscurely un– focussed, I wouldn’t know how else to categorize them.
        It got even messier, and it didn’t anywhere nearly get the conflict resolved.

        Unfortunately, the conversation went from bad to worse with the next agenda item which was for the Council to approve the Hospital’s purchase of the Cox construction building on Riverside Drive, to re-fit for their EMS service which has for many years been housed on Second street, next to Way Park.
        The Council, now having the “upper hand” of having to give approval for that purchase, seemed to relish making it a difficult process.

        Although the need to provide a larger more adequate facility for the growing EMS services was clearly explained, and also included the long wait the EMS has tolerated, and the now ‘perfect fit at a great price’ which would allow them to be operating out of the new facility by fall … the Council was balky.
        Especially strange was Councilors noting that the property would be coming off the tax roles; isn’t that what happens with the Cowles property just across the street when/if the Council builds a Police facility there?

        All in all.. a lot of things don’t “add up”.

  11. LWV observers Jane McWilliams and David Emery have a very thorough and helpful report on the April 10, 2012 Northfield City Council and Hospital Board Joint Meeting.

    Jane’s comments at the end:

    As there had been at the other meetings when the Ad Hoc group’s recommendation was under consideration, at this meeting, the room and hallway were packed with hospital staff and employees. The discussions have created great uncertainty and concern in that community.

    Perhaps communication problems between the hospital board and the city council resulted in the tension evident during the joint meeting. Communication problems seem to have created the response to the hospital’s request for approval of a capital purchase during the second item on the agenda as well. The problem in the first instance may have arisen because the discussions about how the hospital might help alleviate the city’s financial problems were conducted between the Ad Hoc Finance Advisory Group and hospital staff and board, and not between the council and the board. Because these discussions were not subject to the open meeting law, and thus there are no minutes or observers at the meetings, it is hard to know what transpired.

    LWV President Bonnie Jean Flomm has sent a letter to the council asking them to make the work of the Hospital Strategic Task Force as public as possible. Now that the council seems to have changed course, and may instead establish a joint hospital board/council committee, the LWV request should apply to the new group. Maybe transparency will alleviate the anxiety created by the unknown.

  12. Yesterday’s Nfld News – Councilors: Opportunity for collaboration missed on Northfield EMS site choice

    What appeared to Northfield Hospital leaders to be a routine approval Tuesday became more of a lesson on who’s the boss. The conversation at times bordered on testy as city leaders and hospital officials talked about the hospital’s planned purchase of property for a new EMS station off Hwy. 3 S across the street from land the city plans to buy for a new Safety Center…

    Mayor Mary Rossing, echoing the council’s frustrations, said she the lack of contact has left her unable to answer residents’ questions about why the EMS and Safety Center can’t be co-located. “Were there some efficiencies of scale? I can’t answer that because we weren’t invited to be part of (the conversation),” she said.

    Zweifel added that the council needs to be brought into such conversations early on as it’s the decision-making body. “This is very new to us,” said Mary Crow, hospital chief operating officer, referring a switch from the hands off approach the city has long taken with the hospital.

  13. Nfld News editorial: New home for EMS service makes sense

    The only hurdle that remains for this long-overdue move to happen is the City Council’s approval of the purchase. We recommend that the council wastes no time in doing so for a number of reasons:

    It moves the existing facility out of a residential area, where there have been some noise complaints and where pedestrian traffic could be a concern. The larger facility (11,500 square feet from 3,606 square feet) would create suitable space for ambulances and paramedics, and also provide much more training space. Studies show that response times wouldn’t be affected. The new location would give EMTs better access to the city’s main arteries.

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