Why are you running for this office and what 3 major goals do you want to be measured by if you are elected?

I am a retired physician and entrepreneur. I would like to share my experience to help MCHD in three areas:

1. Fiscal responsibility 

2. improved processes

3. improved outcomes (healthier community)

Do you have any experience with EMS or medicine?

Yes.  I am an Emergency Medicine physician. I spent 4 years in the Air Force participating on both Critical Care Air Transport (CCAT) teams and Mobile Forward Sugical Teams(MFAST). In addition I have been the medical director for two EMS companies, worked in multiple hospitals, co-founded a company that builds small hospitals in partnership with larger health systems.

Should Disrtict employees take home District vehicles and if so for what purpose?

It depends on the role and responsibility of the employee. If the employee is on call and there are critical resources in the vehicle, it is impractical for the employee to drive their personal vehicle to MCHD before heading to the incident.

Should the Medical Director answer to the Board?

I am on several boards and typically the CEO answers directly to the board.  The medical director typically presents and participates in the board meetings, but reports to the CEO. The board holds the CEO accountable for managing the budget and executing the strategy approved by the board.  Maybe there are circumstances that would require the Medical Director to report to the board, but this would be atypical.  However, it is common for the board to interview and approve the CEO's candidates for the Medical Director (and other critical executive leaders).

Is it the responsibility of the Board to monitor the spending of the District and verify expenses?

It is the responsibility of the board to approve the budget (including expenses) and monitor through the budget cycle. I prefer to trust but verify. What systems are in place to ensure the organization is meeting budget expectations? I would spend my time looking at the systems the CEO and his/her team have in place verify/validate expenses. When there are outliers, a deeper dive may be necessary.

Should Board members have complete access to all areas of the District?  Why or why not?

A board member should have an understanding of what is happening within the district. There may be patient privacy issues (HIPAA) that prevent access to certain areas, but anything within the scope of MCHD's responsibility should be accessible to board members if concerns about that area arise.

Should Health Care Assistance Patients be required to have drug testing in order to receive assistance?

This is more complex than a simple yes or no. In order to answer the question, I would need to understand the magnitude of the problem. If it is only a small portion of patients, the cost of testing all patients may be cost prohibitive.  A better approach may be to have a policy that suspends services for a period of time if illicit drugs test positive. At the same time, it is important to guide the patient to services that can help with drug/substance abuse, and a pathway back into the program once drug free.

Do you believe Board members should be allowed to ride along with EMS crews and spend time with Alarm and other departments?

If board members want to ride along with EMS or spend time with other departments, it should be planned and coordinated.  Having a board member simply show up can be disruptive to operations.  In some circumstances, setting expectations and even training may be necessary.  Our EMS crews can deal with traumatic and tragic situations.  An understanding of roles and responsibilities in those circumstances should not be taken lightly.

That being said, I do think it is important for board members to have an understanding of what is happening on the front lines and the challenges our teams face daily.

The Board is to set Policy, should it have any say in procedures?

The board should be willing to pressure test the procedures tied to policy.  It is fair to challenge and question the leadership team on the effectiveness of the procedures, but the board should, for the most part, allow the leadership team to develop their procedures.  If there is specific knowledge or experience a board member has, the leadership team is welcome to invite him/her to participate in developing that procedure.

Should Board members attend the MCHD Budget workshops and hearings?

If board members want to attend in an observational capacity to understand the process, I think that is fine.  However, the board member should not try to drive the process.  It is valuable for the board members to have a greater understanding of how the budget is created.

Should salaried employees be paid overtime?

Overtime is for hourly employees.  If extenuating circumstances arise and salaried employees are having to work for unexpectedly long periods (hurricane/disaster), then spot bonuses are more appropriate. Typically, the CEO would bring the details of the situation to the board and seek approval.

The Board is not supposed to micro-manage, but should they trust and verify?

Absolutely.  It is the responsibility of the board to ensure approved budgets and strategies are executed (if they are not, they should know why). The level of granularity in understanding depends on the magnitude of the miss.

Is there anything in your background of an embarrassing nature that should be explained before your election? Arrests/Convictions? Bankruptcies?

No

Should District employees have open lines of communications with Board members, without fear of reprisal?  Why or why not?

Best practices are for employees to follow their grievance chain of command, in addition to having access to a compliance hotline. Grievances have the ability to reach the board based on the process and severity of the claim, but having a policy where any one can reach out to a board member with any grievance is a recipe for disaster.  Being able to do this without fear of reprisal is non-negotiable.

Should any first responder injured in the line of duty have their ambulance charges absorbed by the District?

This should be an easy answer "yes", but I would need to have a better understanding of the health insurance of our first responders. 

Do you believe the Board should have access to all MCHD reports and records, excluding patient records?

Within reason.

Is it better to build stand alone EMS facilities, co-locate with fire departments, or purchase existing facilities and modify them?

All three strategies can be effective.  Building stand alone facilities is probably the most expensive, but the facility is new and meets the specific needs of EMS and allows for standardization.  Sharing with fire is probably the least expensive, but comes with some challenges. My approach would be to determine where a facility is needed, then look at the available opportunities in that targeted area. Our company built small hospitals with EMS rooms and allowed them to stage trucks and crews for free. Instead of trying to have standardization facilities across the board by only doing it one way, I think having the flexibility to serve the community is not only fiscally responsible, but operationally strategic.  The standardization should not be focused on the facility, but on the specific needs of a crew/truck (accessibility, high speed internet, air conditioned break area, etc.).

Do you believe Board members should be allowed to ride along with EMS crews and spend time with Alarm and other departments? Explain your rationale.

If board members want to ride along with EMS or spend time with other departments, it should be planned and coordinated.  Having a board member simply show up can be disruptive to operations.  In some circumstances, setting expectations and even training may be necessary.  Our EMS crews can deal with traumatic and tragic situations.  An understanding of roles and responsibilities in those circumstances should not be taken lightly.

That being said, I do think it is important for board members to have an understanding of what is happening on the front lines and the challenges our teams face daily.

Should the Medical Director be an employee or a contractor?

I have seen it both ways.  The scope of responsibility, the anticipated amount of work, and expectations of the CEO can be factors in making the decision.  For MCHD and the scope of work, an employee with a defined term, is probably the most appropriate structure. However, there could be legitimate reasons for the medical director or the county to consider independent contractor status.

Should Board members have open lines of communications with all employees of the District?

Board members should feel comfortable communicating with any employee of the district, but that is very different than having open lines of communication with all employees.  Open lines of communication imply two way communication.  It is important for the chain of command to be a part of communication.  Ultimately, the employee may have direct communication with the board after following the appropriate chain of command.

Should District employees living out of the county take home emergency vehicles?

Depends on the circumstances.  Outside of the county could be one foot outside the county or two hours away. The critical nature of the employee's responsibility could also be a factor.

What is your opinion about Merit Pay versus COLA pay raises?

To remain competitive and limit staff turn over, we must keep the cost of living raises as a fundamental part of our annual compensation plan.  Merit (or pay for performance) is a great tool to motivate high achieving employees.  However, if the structure of performance metrics are not already in place, these can take time to develop for all the roles in the organization.  If you are going to use merit based increases in pay, they must be fair and based on objective measurable metrics.