By ANDY GARDNER
North Country Now

MASSENA -- Opinions over which institution Massena Memorial Hospital should choose as an affiliate took center stage at a Monday night public comment session at the MMH Board of Managers meeting. About 30 Massena hospital employees and community members attended, plus representatives from the town, village and county boards.

It included a Canton-Potsdam Hospital urologist butting heads with board members over what he perceives as secrecy surrounding the affiliation and privatization process, and the chief financial officer taking issue with a controversial new MMH board member’s characterization of the hospital’s financial picture.

Dr. Melchior Buscemi, a CPH urologist, told the board he thinks they have been too secretive about their affiliation deliberations and accused the CEO of being a conflict of interest. The MMH CEO, Charles Gijanto, is a part-time interim in Massena while also working as part-time CEO of Claxton-Hepburn Medical Center in Ogdensburg.

In December, the MMH board announced they want to pursue an affiliation with CHMC/Crouse Hospital. Although Town Council members have not publicly voiced a preferred affiliate, MMH board members and employees have said they prefer St. Lawrence Health System, which operates CPH and Gouverneur Hospital.

"I just know that for the last two years now or greater, there's been this debate of going to privatized,” Buscemi said. "There's been some secrecy. No one's allowed to know what's going on.”

"It was in the agreement between the potential affiliates that it couldn't be discussed outside,” replied Dr. Bedros Bakirtzian, MMH board member.

Buscemi accused Gijanto of working to sway the board towards a Claxton-Crouse affiliation, but board members said he hasn’t participated in those discussions.

"You're never going to hear anything negative about the CEO of Hepburn about the association between the two hospitals,” Buscemi said.

Town Supervisor Steve O’Shaughnessy also accused Gijanto of bias.

"Who do you think he's going to push? He did it at this meeting,” the supervisor said.

"The medical department did a survey ... and of all the information ... I have a packet here of all the surveys,” MMH board chair Sue Bellor said. "Their top choices were UVM, Crouse and Upstate. Nobody else was mentioned."

She provided a document to members of the press that included comments from MMH board members, although it does not say which specific member made each comment.

The comments included “No trust that CPH will not close services. Crouse and Claxton seen as collaborative, CPH seen as predatory.” Also, “Crouse model supports local involvement and governance, CPH indicated takeover in their presentation” and “CPH has not been open w/MMH.”

"I just want to clear something up for you. Chuck has not influenced us in any way,” MMH board member Loretta Perez said. "He has stayed out of it."

She said the MMH board wasn’t fond of the idea of sharing a CEO with Claxton, but were in dire straits after their permanent CEO resigned in June and they had to hire an interim prior to Gijanto who was paid $40,000 per month.

"We don't like that idea either but it's saving us money,” Perez said. "It took us two years to find a CEO before.”

The MMH doctors recently among themselves had a debate over who should be their preferred affiliate. Buscemi said the docs voted 30-3 in favor of SLHS, but MMH Dr. Henri Gaboriau spoke up and said they later voted to rescind their decision.

He said the original SLHS vote followed a presentation on SLHS from Dr. Michael Maresca, who is now an MMH board member. He has been criticized for bringing a conflict of interest to the board.

Bellor earlier this month said his company, St. Lawrence Radiology, benefits financially from a contract to provide services at MMH. He is listed on CPH’s website as chair of their imaging department. She also criticized him for not living in the MMH service area. Maresca confirmed that his residence is in Hannawa Falls.

"We (MMH doctors) talked to each other and said 'why did we vote that? We had no information at all,” Gaboriau said. “We all agreed ... to sit down, just the doctors and figure out how we feel about that vote.”

He said they collectively agreed that their original decision was not based on “true informed consent,” which is a bedrock concept of medical ethics.

“We voted that previous vote … was null and void. Twenty-four were present, 19 said yes,” according to Gaboriau.

A large group of MMH employees are voicing a preference for Claxton-Crouse affiliation. Mary Mittiga, an MMH registered dietician, presented the Board of Managers at the meeting with a petition indicating their preference. Bellor said there were 166 signatures, a little over 1/3 of the 430 or so MMH employees.

"We urge the town supervisor and his board members to consider the interest of MMH employees,” Mittiga said.

Maresca later in the meeting started going over the MMH financial and statistical report for January, which showed a $527,860 loss for December and $5.5 million loss for the year. He asked what the hospital has for outstanding liabilities, which include short-term and long-term combined. Long-term would include their debt to the state pension system.

MMH Chief Financial Officer Pat Facteau said they have about $25 million combined, but they would be relieved of any future debt to the pension system once they privatize, leaving about $11 million in “trailing liabilities.” He said they have a grant application submitted to the state that, if approved, would take care of the remaining $11 million.

“That's enough to pay these liabilities off and start the new corporation,” Facteau said.

O’Shaughnessy voiced concerns that all of the public MMH-town drama could have a negative effect on their application in Albany.

"Department of Health is sitting in Albany and they're reading all this stuff going on,” the supervisor said. "You think they're going to jump out there and say 'We've got to save Massena’?"

While Maresca was going through the financials, Amy Batten, an MMH employee, chimed in and said they are aware of the financial picture and want solid answers for what the two possible affiliates are offering.

"Do you think we're ignorant to all of this? We know we are sinking. We need someone to save our asses."

"We know where the numbers are going, and I find it really hard to believe Mr. O’Shaughnessy, and you either, have any open mind for both candidates,” Batten emphatically said. “We don't want to hear your numbers anymore … We want to know Crouse’s plan to fix it and what is CPH?"

MMH employee Kerry French, a former president of MMH’s CSEA chapter, also said she is frustrated that the workers don’t know more about what the two have to offer.

"It really upsets me as an employee here at this hospital ... that there is so much bad press going on right now … everybody’s got every opinion,” French said. "What are the pros and cons of Crouse ... of Canton-Potsdam? What is the truth about it?"

O’Shaughnessy, who said he sat in on presentations from both Crouse and SLHS, said he also wants to know more about the two and repeated his claim that the MMH board hasn’t been sharing enough info with the town.

"We got this little Powerpoint presentation but this really doesn't narrow it down,” O’Shaughnessy said. "I encourage the Board of Managers to get out there and give us the whole story.”

The town and MMH are in the process of finalizing an asset transfer agreement, which MMH needs in order to function as a non-profit entity. Their new privatized corporation is set up, but has no assets or employees.

O’Shaughnessy said he wants to see three things before the town will approve an asset transfer - no debt be transferred to the town, a “bridge” for union employees to keep retirement benefits for which they’ve already paid and "make sure the town board thinks the taxpayers of Massena are getting the best deal.”