Controversial group reconvenes behind closed doors to discuss Nashville General Hospital's future

A controversial group convened by Meharry Medical College to make recommendations about the future of Nashville General Hospital met Wednesday amid criticism about its secretive approach to addressing the fate of the publicly-funded safety net hospital for low-income and uninsured patients.

The secrecy of the group’s meetings has come under fire from one of its original members, Metro Councilwoman Tanaka Vercher, who stepped down in protest before the panel ever convened after learning that meetings weren’t going to be public.

On Wednesday, a reporter was turned away from the meeting by Mariah Cole, Meharry's director of program management, who said the group would work on a "communications plan" at Wednesday's meeting. 

The Rev. Jay Voorhees, pastor at City Road Chapel United Methodist Church, was also asked to leave minutes after the meeting got underway. Voorhees attended as Vercher's designee. He said he was told Meharry officials wanted Vercher's spot to be filled by a Metro councilmember.

More:Nashville General Hospital owes more than $6 million in unpaid bills to Meharry Medical College

Patrick Johnson, senior vice president for institutional advancement at Meharry would not respond to several requests for basic information about the group, including its meeting dates or whether its membership, after Vercher's resignation, had changed. 

But he defended the group's private meetings, saying that Meharry was "a private entity and just like every private entity we don't hold meetings in the public forum, nor are we required to."

Mayor Megan Barry in November made a surprise announcement about plans to end all inpatient care at the north Nashville hospital. Neither the chief executive officer of the hospital, nor members of its governing board were informed in advance, they said.

Barry relied in part on the recommendations of a volunteer consultant who, according to the mayor's office, produced no written or public report about his recommendations.

The stakeholder group was proposed in November by James Hildreth, president of Meharry Medical College after Barry's announcement.

Hildreth proposed in a letter to Mayor Megan Barry that the group would "present a recommended model for care to you, the Hospital Authority and the City Council."

Barry accepted the offer, making clear she would rely on the recommendations of the group in setting policy going forward. In a November letter to Metro Councilmembers, Barry said she was confident with the "guidance and insight of this team, our city would come to an agreement on Nashville General Hospital that is the best way forward for all involved."

More:Mayor Barry slammed over handling of Nashville General Hospital plans

More:Council members propose requiring inpatient care remain at Nashville General Hospital

More:Hospital landscape in limbo as questions swirl over Nashville General's fate

But in defending the group's private meetings, Johnson said "we're not proposing public policy; that's not what we do."

Experts on the state's open meetings laws said, while it is not atypical for a mayor to rely on a stakeholder group meeting privately to offer recommendations, it is unusual for such privately convened groups to make policy recommendations to two public bodies: the Metro Council and the Nashville Hospital Authority.

"I do think since the group’s proposal will be very significant, that the group needs to be proactively transparent during its process, and inviting the public into hearings and meetings would facilitate that," said Deborah Fisher, executive director for the Tennessee Coalition for Open Government.

"In the end, what you would want to avoid is a recommendation that seemed like a “done deal” without public input or understanding, and the mayor and Metro Council will need to protect against that, as well as the stakeholder group," she said. 

Vercher was pointed in her criticism of the group's private meetings.

“If we’re going to discuss community wide solutions as it relates to Nashville General Hospital, it needs to be a public meeting where the public can be included,” said Vercher, who chairs the council’s Budget and Finance Committee. “They at least need an opportunity to hear the dialogue first-hand in this process.”

Vercher, who has criticized the mayor’s office over the transparency and optics of the administration’s hospital proposal, raised her concerns in a letter to Hildreth in December.

Hildreth defended the decision in a Jan. 4 letter in response to Vercher.

“I am deeply disappointed in your decision not to participate,” the medical school president and CEO wrote, adding that he believes council representation on the group is “critical to successful completion of the charge.”

Addressing Vercher’s concerns about closed meetings, Hildreth said some of the participants “may not be comfortable with the added pressure of a public meeting.”

“Any of their suggestions, questions and commentary could be made the subject of media scrutiny,” he wrote. “I am of the opinion that transformative change only occurs when people have the freedom of expression without fear of judgement and retribution.

“I have charged the work group with the task of recommending a health care system that responds to the needs of our community; and have challenged them to be exploratory and visionary in their thinking,” he added. “A public forum would not support this process.”

Voorhees attended the group's first meeting on Dec. 18. In an email to Vercher summarizing the December meeting, Voorhees expressed concern that the group set an April 1 deadline to come up with policy recommendations ahead of the city's budgeting process.

On Tuesday, two Nashville Metro Council members announced they plan to slow down Mayor Megan Barry's proposal to end inpatient care at the hospital by requiring that those services be maintained through June 30, 2019.

At-large Councilwoman Erica Gilmore and Councilman Steve Glover, an unlikely duo from opposite ends of the political spectrum, announced the filing of legislation that would force the hospital stay open for the next year and a half. 

Reach Anita Wadhwani at awadhwani@tennessean.com, 615-259-8092 or on Twitter@AnitaWadhwani.