Rural Health would benefit from transparency BRADENTON HERALD EDITORIAL | Openness would boost public trust in reform

September 21, 2010 

When a government agency, private enterprise or any organization stumbles over questionable dealings and ethical concerns, it’s difficult to demonstrate contrition and reform by working in the shadows.

Manatee Rural Health Services Inc., shaken by revelations that board members, top executives and their family members are profiting handsomely from contracts with the nonprofit organization, announced reforms were under way to address conflicts of interest. The ethical issues became public knowledge after a Bradenton Herald investigation by reporter Duane Marsteller, with the first in-depth report Aug. 22 and another Sept. 5.

But a recent board meeting where change was discussed was closed to the public and media, and agency officials would not even disclose the time and place of the meeting.

While this private organization is likely not obliged to follow Florida’s strong transparency in government laws — although media-law experts cite ambiguity on that point — Manatee Rural Health is taking a beating in the court of public opinion. And rightfully so. As we opined earlier this month, by receiving millions of dollars from Medicare and Medicaid annually, this agency — which provides comprehensive medical services to hundreds of indigent, uninsured and under-insured people in Manatee, Sarasota and DeSoto counties — must be held to high standards.

Since board members are deeply involved in these ethical entanglements, this question naturally arises: Is the fox guarding the henhouse? Open meetings would go a long way toward a restoration of credibility.

In the aftermath of the Herald’s investigation, Walter “Mickey” Presha Sr., the chief executive officer of Manatee Rural Health, announced some positive steps at reform.

n An audit committee and compensation consultant will review executive salaries.

Presha earns $433,000 annually, the most among the state’s community health agencies. But he also directs Florida’s biggest federally qualified community health agency, with 400 employees and $45 million in annual revenues.

n A governance committee, which will include one non-board member, will examine the board’s role in agency decision-making.

Manatee Rural Health should strengthen its conflict of interest policy and end the exceptions that allows board members to engage in business dealings with the agency — like other community health centers in Florida.

n A construction, building and facilities committee will evaluate the agency’s procurement and contract bidding process, focusing on board- and employee-affiliated businesses.

That’s imperative since some $3 million in agency business has gone to businesses owned by agency officers, board members, employees or their relatives in the past six years.

While we’re encouraged that Manatee Rural Health is on a path toward improving its ethical standards, greater openness would boost public confidence that the agency is indeed determined to change.

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