by Max Brantley
The proposed combination of the University of Arkansas clinical operations at UAMS with St. Vincent Health was not on the agenda for today's University of Arkansas Board of Trustees meeting today in Monticello, but it turns out that a draft collaboration agreement was given to members of the board today.
UAMS has provided a copy of the so-called term sheet for the proposed "network" to us.
It remains somewhat hazy, particularly as to direct management responsibility for what are now two general service hospitals and whether those would continue in that form in the future.
It provides for shared support and some collaborative services (such as cancer and cardiology operations), plus potential new joint services. It also provides for each partner to operate independent services.
Both Parties may retain or develop separate programs and activities that are not part of the Network Collaboration (e.g., the UAMS School of Medicine’s basic science research enterprise, and the provision of certain services that may be restricted or prohibited in Catholic organizations). UAMS will continue to provide services needed by Arkansas communities, as determined under the leadership of the University of Arkansas Board of Trustees and UAMS executives and medical staff.
The Parties acknowledge that SVHS, as a Catholic organization, shall not be involved in any way in certain services or activities in any way. UAMS shall not impose unacceptable requirements on SVHS, and SVHS conversely shall not restrict the services that UAMS can provide outside of and apart from the Network Collaboration. In this way, each organization will continue to be faithful to its mission, values, and the needs of its respective community.
I've yet to see addressed the question of equal benefits and employment protection for employees providing shared services that will in effect be supported by public taxpayers.
It calls for a governing board comprised of 50-50 representation from each organization. This, St. Vincent board member Baker Kurrus said recently, could potentially be problematic because it gives no way to decide a close question. The term sheet provides a mediation procedure for disputes, ultimately decided by a five-member group including one neutral, independent member.
The two parties will maintain ownership of respective buildings and contribute equal amounts of capital. A key element does seem to build a platform to grow the medical operation beyond its existing size in one unit that could bring some efficiency to purchasing and administration. A statewide organization is contemplated.
Noted in the draft, written by a law firm, the intent to:
Provide world-class care to communities throughout Arkansas, and do so in a manner that is accessible, responsive, and respectful of the dignity of the individual human being.
The current Arkansas legislature comes to mind immediately at the mention of "human being." The words are debated in the political, religious and scientific context, particularly in a blended operation with institutions that hold different views on providing service related to in vitro fertilization, contraception, conception ability of male and female, abortion, treatment of pregnant and potentially pregnant women and more.
UPDATE: I have UAMS Chancellor Dan Rahn's memo to staff about the first draft. He emphasizes it's a first draft. It mentions, too, the budget problems being faced by the institution ( he didn't say, but I will, thanks to a legislature concerned more with fetuses, women's vagina and tax cuts than services for children already here. Read on:
Dear UAMS Family,
In our ongoing exploration of a possible strategic alliance with St. Vincent Health System (SVHS), today at the University of Arkansas Board of Trustees meeting in Monticello we shared a first draft of an agreement our lawyers prepared regarding how this alliance might work.
I want to emphasize that this is only a first draft and is intended to be a starting point as we consider such an affiliation.
Be assured that UAMS and SVHS would continue to be governed independently. The Network Collaboration would focus on shared support services, collaborative clinical support services, and consolidated clinical services in such areas as cancer and cardiovascular care.
Also at this Board of Trustees meeting, we talked about continuing uncertainties that prompted us to consider this alliance in the first place. Federal budget cuts, uncertainties regarding state policies and funding and the desire to simultaneously improve patient care quality and reduce costs all must be considered in our strategies for the future. A possible collaboration could enable us to share certain operational, support and administrative services to save costs and improve efficiency while still supporting the delivery of the world-class care for which UAMS is known.
As I have said before, I want there to be transparency in this process. The draft document on possible terms for a UAMS/SVHS agreement is posted here. Please feel free to review it if you are interested in this continued discussion. Thank you for your work on behalf of the people of Arkansas.
Dan Rahn, M.D.