County Fee to Hospital Is Eliminated, Ending Weeks of Controversy

Gazette Senior Writer

The subcommittee charged with managing an unusual contract between the county and the Martha's Vineyard Hospital voted last night to eliminate a controversial fee from the contract - and the county manager issued a brief apology for setting up the fee in the first place.

"What I will say now is that I am sorry that I set up the [separate] contract [to have the county collect a $49,500 fee]. I believed I was saving the towns money," said county manager Carol Borer.

"In Carol's defense, she is totally obsessed with and devoted to saving the towns money," said county commissioner Robert Sawyer.

The comments came at a meeting of the emergency medical services procurement committee, a special subcommittee charged with managing the contract between the hospital and the county. Set up through an inter-municipal agreement approved by the six Vineyard towns last year, the contract allows the towns to send some $500,000 in taxpayer money to the hospital.

The money is intended to help defray the cost of emergency services at the hospital.

About a month ago it was revealed for the first time that in addition to the contract between the county and the hospital for $495,000, Ms. Borer had executed a separate contract with the hospital. The separate contract calls for the hospital to pay the county a $49,500 fee to administer the contract.

News of the fee caused a small furor among county and town officials, who knew nothing about it.

At a meeting of the subcommittee last night in the county administration building at the Martha's Vineyard Airport, the committee took steps to eliminate the fee, making it clear that the six Vineyard towns will be billed only for incidental expenses in connection with the contract.

And all bills must be first approved by the emergency services procurement committee.

Committee members continued to express concerns about the sloppy handling of the entire matter.

"I think that this committee should have been aware of this and I am very displeased about how this was handled. This money that we all pulled together goes to the hospital," said Roger Wey, a Dukes County commissioner and Oak Bluffs selectman who is also a member of the procurement subcommittee.

Cynthia Mitchell, a West Tisbury selectmen and newly appointed member of the subcommittee, made pointed reference to an independent legal opinion obtained by the West Tisbury selectmen two weeks ago about the fee and the separate contract.

In a written opinion, town counsel Ronald H. Rappaport told the selectmen that the county did not have the authority to execute a separate agreement with the hospital for the fee because it contradicts the terms of the inter-municipal agreement.

The inter-municipal agreement calls for the towns to be billed for administrative costs in connection with the contract.

Ms. Mitchell noted sharply that Ms. Borer had failed to mention Mr. Rappaport's opinion at a county meeting two weeks ago - when the fee was hotly debated - even though she had received the opinion before the meeting. Ms. Mitchell also noted that Ms. Borer had failed to circulate Mr. Rappaport's opinion to any of the other towns.

"It seems to me that since five of the six towns engage Ronald Rappaport as their counsel, that they might be interested in knowing what he has to say about the legality of this," Ms. Mitchell said.

"The money [for administrative costs] can never come from the hospital to the county," Ms. Mitchell said, in her own summary of Mr. Rappaport's opinion.

Ms. Borer began to silently laugh, and Ms. Mitchell questioned her humor.

"Carol, do you disagree?" she said.

"No, I don't agree or disagree," Ms. Borer replied.

"This committee doesn't have the authority to amend the inter-municipal agreement," Mr. Wey concluded.

"Chilmark voted $96,000 to give to this project. That is the money we voted to give and that is all we want to pay," said Chilmark selectman Warren Doty, who is a member of the subcommittee.

"The hospital will abide by this committee's recommendation and we will live up to the terms of the contract. And we will pay the fee if that is what the committee says we should do," said hospital chief executive officer Kevin Burchill, who attended the meeting.

Mr. Burchill and Ms. Borer were apparently the only two people who knew about the separate contract for the fee.

Two weeks ago Ms. Borer called it a side contract, but last night Mr. Burchill said he preferred to give it another name.

"What's been characterized as a side agreement I would prefer to call a concurrent agreement," he said.

The contract between the county and the hospital has been marred by other problems. Among other things, the emergency medical services procurement committee has not kept proper minutes of its meetings for the better part of a year.

Last night Mr. Sawyer, who is chairman of the committee, announced at the outset that a person was present who will be paid to keep minutes of the committee meetings.

In the end last night, the committee voted what amounted to a clarification of the contract and any administrative fees. The committee agreed that all incidental fees, including fees for legal expenses, minute-keeping and travel will be charged to the towns, and also that all bills to the towns will first require approval from the subcommittee. All other costs, including costs associated with producing activity reports in connection with the contract, will be paid by the hospital.

Also last night the committee set up a smaller, three-member subcommittee to meet with Mr. Burchill and review the reporting requirements associated with the contract.

There was general agreement that while the committee wants to have some reporting from the hospital in connection with the contract, that the administrative part of the contract was never intended to be a huge burden.

Mr. Burchill said eliminating the fee is good news for the hospital.

"We just made $49,500," he said.

Mr. Wey said the main point is that the money was intended for the hospital emergency room.

"The hospital should have as much of the $495,000 as possible to spend on emergency room service," he said.

Mrs. Mitchell agreed.

"The $495,000 should go to care and not administrative costs," she said.