Author: P Hasselbacher

KentuckyOne Poised To Announce Layoffs of Senior Executives.

I have been advised by two sources that KentuckyOne Health will soon announce the elimination of several system-wide or senior executive positions designed to improve efficiency, reduce costs, and emphasize local leadership.  The as-yet unconfirmed names of the individuals currently in those positions include clinical and operational executives at the highest level.  I am unaware if the names of included leadership comprise a complete list or represent the tip of the iceberg of things to come.  Perhaps as an early indicator, the senior physician executive at Jewish and Sts. Mary & Elisabeth Hospitals left that position a few weeks ago.  As a company outsider, it is impossible to know all the reasons for changes in personnel.  These often include the personal career plans of the employee, but also concerns about the fit between employer and employee in meeting the goals of the particular corporation.  KentuckyOne may well once again be feeling financial pressures that cannot be denied. It has laid-off employees in the past to decrease expenses – a strategy that in the longer run was not entirely successful at University Hospital.

On the other hand.
One of the most common complaints I hear from my University of Louisville colleagues reflects what is considered to be unwanted and disruptive outsourcing or other “outsider intrusion” on the part of Catholic Health Initiatives or KentuckyOne management that does not allow for appropriate local initiative or control, or which treats all hospitals the same no matter where they are located, or fails to acknowledge the particular needs of their patient population. From this perspective, a diminution of the role of system-wide executives might be considered a worthwhile result. On the other hand, I suppose it is possible that a state-level KentuckyOne system control might be replaced by even more direct CHI control from Colorado!  The desire for local control is, however, at odds with current national and local policy, or financial pressures for hospital and health system consolidation and coordination.  The health of KentuckyOne and its partnership with the University of Louisville is a matter of critical concern for Jefferson County and the Commonwealth.  Things have not been going well so far. Continue reading “KentuckyOne Poised To Announce Layoffs of Senior Executives.”

Special Meeting of UofL Foundation Canceled at Last Minute.

University of Louisville Foundation goes rogue.

foundation-bld-9-2016An unexpected special meeting of the 5-member Executive Committee of the University of Louisville Foundation that was to be held at 5 PM today (Labor Day) was canceled at the last minute. I and several members of the traditional print and broadcast media arrived to cover the open session only to find we were the only ones there! It was anticipated that the meeting would initiate the hiring of an external firm to perform the forensic audit demanded by the James Graham Brown Foundation, and execute the separation of Foundation President James Ramsey and Kathleen Smith from the Foundation. It was reported by Andrew Wolfson on the Courier-Journal’s website that the cancellation was consequent to a letter by University of Louisville Board of Trustee Chairman Larry Benz. However, it was later reported by Chris Otts of WDRB, that today Acting University Chairman Neville Pinto had also sent an email to Foundation Chair Robert Hughes and other Board members expressing polite but strongly worded objections to the Foundation’s plans. Unbelievably, neither President Pinto nor Chairman Benz, both of whom are on the Foundation Board, had been consulted about the meeting nor informed about what was to be discussed or enacted. Copies of the emails from Chairman Benz and President Pinto to Chairman Hughes are attached. Continue reading “Special Meeting of UofL Foundation Canceled at Last Minute.”

Attorney General Finds University of Louisville Violated Open Records Law In NCAA Basketball Scandal.

Last February, I submitted an open records request to the University of Louisville for documents and information used by then-President James Ramsey underlying his decision to withdraw from postseason basketball play in 2016.  [I was reacting to media reports and a formal statement by UofL that University President Ramsey had received updates and information upon which he acted.  I asked for that information.]   My request was summarily dismissed and I filed an appeal with the Attorney General of Kentucky.  After much back and forth between that office and the University, it was determined that the University had indeed violated the requirements of Kentucky’s Open Records Act.  Even before I was able to read the opinion, it was being published by traditional media including the Courier-Journal, and WDRB. Here is the best summary to date. Here is another.  A shorter version from the Associated Press appeared in dozens of newspapers nationally before the end of day yesterday.  Because of the presumed general public interest in this matter, I believe it is appropriate to explain my motivation and make to make public the correspondence and documents that led up to the AG’s decision.

The decision may have been correct.
Let me say at the outset, I have no opinion about whether the decision to withdraw was appropriate or not.  It may well have been the best path forward.  I did not have any interest in learning the names of any of the students involved nor would I have made their names public. [Similarly I am not interested in any salacious details.]  I do however have an interest in how the University does its business.  I have written often over the last few years about the lack of appropriate transparency and accountability within the administration of Dr. Ramsey.  I have argued that many of the University’s problems, and certainly those of its its public relations image stem from its penchant for non-disclosure or secrecy.  Discussions with traditional journalists and my own experience led me to believe that the University is often a reluctant participant in the Open Meeting or Open Records requirements. Continue reading “Attorney General Finds University of Louisville Violated Open Records Law In NCAA Basketball Scandal.”

A Batch of Bad Heroin Arrives in Louisville.

top-1000-mapBad heroin is an oxymoron, but over the past week, several dozen opioid overdoses appeared in local emergency rooms or were rescued by emergency medical technicians.  At least one died.  It is being reported that some 300 overdose cases were reported in our region.  Since these patients responded to the opioid-specific rescue drug, naloxone, it is assumed they overdosed on one opioid or another.  Toxicology studies are pending, and public health authorities are not overstating what they know, but we can reasonably assume the substances injected or otherwise consumed contained an unexpectedly high amount of heroin; the powerful synthetic opioid fentanyl; or carfentanil, the new-to-the-scene, elephant-strength, fentanyl look-alike.  For decades, heroin available to end-users has been cut, or diluted with a variety of non-opioid substances – some more benign than others.  In recent years, the availability of higher quality heroin from Mexico has both driven down the price and increased the potency of street heroin.  Presumably both sellers and users have been adjusting their practices to account for the greater potency.  Uncertainty about the purity or safety of available heroine products is said to be the reason that addicts in southern Indiana chose the prescription drug Opana as their opioid of choice.  This of course did not protect them from an accompanying epidemic of HIV infection and viral hepatitis.

Really-bad heroin.
For reasons not fully known to me, for the past year or more, heroin preparations used by addicted individuals have been shown to contain fentanyl.  It is apparent that these augmented preparations can catch whole communities of users by surprise.  The arrival of heroin with augmented lethality is signaled by an increase in overdoses and deaths within a confined geographic area.  While I was there in the summer of 2015, such an outbreak of heroin-associated deaths occurred in Washington County, Pennsylvania.

Whether the offending additive was fentanyl or its cousin carfentanil is relevant not just to law enforcement, but for the rescue community.  Unexpectedly high doses of naloxone are required to wake up individuals who have ingested these super-opioids.  The appearance of such overdose outbreaks caused by more highly purified heroin or other opioids announces to a community that their problem with drug addiction is worse than they thought.  I take that to be the message for us in Louisville. Continue reading “A Batch of Bad Heroin Arrives in Louisville.”