November 20, 2000

What's the optimum mix of people, personalities and professions to provide oversight and leadership to a 21st-century academic health center?

That's the question the Health Affairs Committee Working Group is striving to answer.

The working group consists of 17 individuals representing a variety of professions, but all with an interest in health and health care, and the Health Center in particular. The group, assembled by Health Affairs Committee Chair Claire Leonardi, is charged with looking at the composition of the committee; examining how the committee does its work; and assessing the relationship of the committee to the University's Board of Trustees. The group will also look at questions of size, structure, governance and reporting relationships.

The Health Affairs Committee is a sub-committee of the Board of Trustees, and serves as the Health Center's direction-setting, policy-making and oversight board.

After deliberating, the working group will make recommendations to the Health Affairs Committee.

"Oversight and value-added input from a board is essential and requires diverse points of view as well as fields of expertise," says Leonardi.

"The current structure of the UConn Board of Trustees is built around a strong committee structure. While the overall board has final authority for the Health Center, the Health Affairs Committee is the only group that is intimately involved in the oversight and policy direction of the clinical, academic, and research operations at the Health Center," she says.

"We would like to have a committee working structure in place, that will assist management by providing relevant feedback in a timely manner, and ask difficult questions that need to be asked to make this an even stronger institution."

Most American academic health centers - graduate schools educating physicians, dentists and other health professionals and providing patient care in hospitals and clinics, as well as conducting scientific research - are finding themselves in financial difficulties, and the Health Center is no exception. Several factors contributed to the crisis, including reduced federal payments for Medicare and Medicaid, and the new economics of health care and declining reimbursements from managed care companies.

The financial problems underscore the importance of leadership and boards and provide new impetus for institutions to reexamine their oversight structure.

"The question we want to answer is: 'Do we have the operational structure that best meets the needs of an academic health center, particularly one in a difficult financial environment?'" says Scott Wetstone, assistant dean, School of Medicine, and chair of the working group.

The expertise members bring to the working group is widespread and far ranging. It includes faculty, staff and student representatives and administrators from the Health Center, a patient, a donor, representatives of the state medical and dental societies; a Farmington Town Council member, and the president and chief executive officer of Gaylord Hospital.

"Boards fulfill many functions," Wetstone says. "Usually they are the employer of the chief executive. If carefully constructed and properly used, a board can bring to an organization expertise it needs and may not have, as well as a point of view that otherwise might be missed.

"In the Health Center's case, the board is the Health Affairs Committee which provides objective oversight, particularly at the strategic level," he says. "We want a committee that will take the initiative and help us solve complex problems."

The Health Affairs Committee currently consists of five members: Leonardi, James Abromaitis, Michael Cicchetti, Lenworth Jacobs and Michael Martinez, all of whom are trustees. This group addresses issues ranging from quality of care and patient satisfaction to the budget and strategic planning. The growing market complexity requires more planning and oversight, Leonardi says.

She says she called the working group together to look at creating a working structure that, while still very strongly linked to the University, represents diverse viewpoints and skills that will provide valuable input and oversight to the Health Center.

"We would like to have a committee that will be a very strong advocate of the institution. This will help us with fund raising, corporate partnerships, relationships with other institutions, and relationships with the state and federal governments," she says.

"We believe that this will require having more and perhaps different people involved, to provide the viewpoints and skills and also to accommodate the increasing workload of the committee."

No deadline for deliberations to conclude has been set. The working group convened in October and is scheduled to meet through December.

Pat Keefe