The lack of a trusting relationship between the Wrangell Medical Center (WMC) leadership and that of City and Borough of Wrangell is a “crisis” in the community, according to a report written by a private consultant hired by WMC.
To not improve this relationship is to “fundamentally risk the health and welfare of the community,” states the report, which was recently released to the public and written by consultant Marv Erisman, Ph.D.
Erisman conducted interviews with WMC staff and Wrangell’s mayor and assembly members last fall. The report Erisman wrote based on those interviews is not only critical of the relationship between the hospital and the city, but also cites concerns with WMC leadership.
WMC Chief Executive Officer Noel Selle-Rea called Erisman’s report “fair.”
“Nobody likes to see they have any faults,” he said. “But I fully recognize that I have much to improve on in my job and the relationship with the city.”
Erisman wrote a “positive and professional partnership” between the city leadership and WMC leadership is not in play, and there is a lack of trust between the two entities.
“The fundamental structure of trust so necessary to a positive, dependable, and professional working relationship, and one critical to the building of a new hospital, is not in place between the mayor and the CEO or between the medical board and the assembly,” the report states.
A partnership between a community and its hospital is one of the most valued, and easiest to develop and maintain, Erisman states in the report. He said it is “both intriguing and disturbing” that such a relationship does not exist in Wrangell.
Selle-Rea said the hospital hired Erisman to help resolve “what is clearly a problem,” between the city and hospital. The report aims to try to find some “middle ground” of how the two can work better together, Selle-Rea said.
In his report, Erisman listed numerous recommendations of how the city and WMC could improve their relationship, which include creating a structured and ongoing venue for “significant” dialogue between Selle-Rea and Wrangell Mayor Jeremy Maxand, a former WMC employee.
While Maxand said he believes it is important to have a good working relationship with the WMC board members, he disagrees with some of Erisman’s comments and recommendations in the report.
Maxand said the issue is not that there is a lack of trust between the City and Borough of Wrangell and WMC. The problem is how the public hospital is being run, he said.
“The report is wrong about there being a crisis in trust. There is a crisis in management at Wrangell Medical Center,” Maxand said. “This is not a spat between individuals, this is an issue that goes to the fundamentals of how our community hospital is being managed and being led.”
Maxand said WMC is the only “political subdivision” in the Borough where there are so often problems with staff and management.
“You don’t see that in any other department. You see that routinely there is crisis at Wrangell Medical Center,” Maxand said. “It’s a red flag.”
Another one of Erisman’s recommendation was to plan a retreat for the Borough Assembly and WMC Board of Directors to create a common vision, defined roles and clear expectations for the future.
“This should include the development of a professional code of conduct to ensure positive engagement across the isle…,” the report states.
A retreat is something WMC Board has suggested, Selle-Rea said. He said he would like to have a facilitator present, paid for by the hospital, to prevent any “bullying” or inappropriate behavior.
Selle-Rea said it is important for Maxand and him to improve their relationship, given their positions in the community and with a new hospital project in the works.
“You just want change, whatever that is, whatever the solution is, and not continue this ongoing situation,” he said.
However, a retreat is not the answer, and will not help to create trust, Maxand said.
“Trust is something you create by actions,” he said. “If there is an issue of trust, it is because certain people have not taken actions that create trust.”
In the recent process to build a new hospital in Wrangell, Maxand said, “with 100 percent confidence,” the city staff and Borough Assembly have done what is necessary to be transparent and protect the public’s money.
The city has followed all necessary laws and procedures in the project to build a new hospital, Maxand said, and that’s why it doesn’t matter if individuals of the assembly trust WMC board members and staff.
“Even if I don’t trust Wrangell Medical Center or they don’t trust me, the public knows that the public business is being done in a legal and transparent way,” he said.
During the planning for the new hospital, the City and Borough of Wrangell experienced a switch in mayors. Current Assemblyman Don McConachie stepped down as Borough Mayor in 2010, and Maxand stepped into the role.
This transition created a discontinuity in the style of engagement between the mayor and the WMC board and Selle-Rea, Erisman’s report states.
McConachie had a more casual style that included verbal agreements for how the new hospital project would move forward. Maxand, however, wanted more structure, clearer roles and accountabilities, the report states.
“This more formal manner of engagement was frustrating to the medical center board and the CEO,” Erisman wrote.
McConachie agrees with the Erisman’s comments.
“I had a completely different style of mayor position than what [Maxand] does,” he said.
McConachie said he put his faith in people that when they came to him with an idea, they proceeded and did their “due diligence” to get the job done.
“I was kept informed what was going on,” he said. “But, as far as being proactive and instigating things, I didn’t do that. I allowed them to get what needed to get done, done.”
This part of Erisman’s report Maxand said he does agree with.
“When I became mayor, things did change,” he said. “It’s because I don’t think a $30- million hospital project built with community money should be based on a wink and a nod. It should be based on the law, it should be based on procurement code, on ordinances, and it should be based on a vote of the people.”
Another aspect of Erisman’s report addressed issues members of the WMC staff and city representatives have with the hospital administration. The issue of perceived nepotism between Selle-Rea and his wife, who also works at the hospital, was mentioned numerous times during Erisman’s interviews, according to the report.
Mari Selle-Rea is the director of quality and development at WMC, and Erisman wrote this has created an “emotionally charged issue” and remains to be a widespread source of cynicism. The issue also caused Maxand to resign from WMC in 2010, before he became Mayor.
In his report, Erisman suggested having Mari Selle-Rea report to the WMC chief financial officer, instead of to her husband, the CEO. The WMC Board voted in favor of this change in reporting responsibilities at it’s January 25 meeting.
Erisman’s report was issued to WMC staff, administration and the city in January. After the WMC Board of Directors received a freedom of information request from a citizen, the report was made available to the public.
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