The Shadow King

Joe Greer, the medical director of Camillus House, is even more blunt. "I think it is an embarrassment that we live in a community where so many people are not being taken care of and the Public Health Trust is just sitting on hundreds of millions of dollars that it refuses to spend," he says. "How can you justify that? How is that acceptable?"

Why isn't the trust, for instance, doing more to set up school-based health clinics? Why isn't it doing more to counter the spread of AIDS in this community? What type of outreach does the trust have in place to serve migrant farm workers in South Miami-Dade?

Plainly stated the biggest problem with the trust is that its members, by and large, are mindless sheep who for years have done whatever Clark wanted them to do. There is a prestige that comes with sitting on the trust, and it appears that many simply want the title of "board member" but aren't really interested in any of the responsibilities that come with it. "They have a very earnest but compliant board," says Katy Sorenson, who has been one of the commission's representatives to the trust for the past two years. "There is no doubt, though, that Ira Clark runs the board. All of their decisions are very carefully orchestrated by Ira Clark and the hospital's staff."

Ira Clark: King of the Health Trust hill
Ira Clark: King of the Health Trust hill

Last week Sorenson met with trust board members following the commission's raid on its budget. Sorenson made it clear the commission's action was appropriate because the trust had shirked its responsibilities. As a result the trust withdrew a resolution that would have asked the mayor to veto the budget. I'm sure most trust members hope the entire affair will quickly fade from public view.

The time, however, seems right for a communitywide debate about the role of the trust. And the commission needs to play an active and aggressive part. People sometimes forget that the Public Health Trust was created by the county commission and its rules and procedures are spelled out in the Code of Metropolitan Dade County. Specifically those rules are outlined in Section 25A, and it might do both the members of the trust and the county commission good to read them sometime. For instance the code states that

the Trust shall submit recommendations to the County Commission for annual and long range, five-year plans for the delivery of countywide health care services....

It continues:

The Trust shall formally present its annual countywide planning recommendations ... at an annual, joint meeting to be called by the Chairperson of the Board of County Commissioners and to be held between the Commission and the Trust no later than July 1st of each year.

In the seven years I've been covering the county commission, I cannot recall a single joint meeting between the commission and the trust. They just don't happen. And that should change. The trust should be required to justify its existence and describe its long-range planning. There should be an annual joint meeting between the entire county commission and all the members of the trust in which those long-range plans are discussed, and the public should have an opportunity to comment on those plans. That meeting should be broadcast on the county's cable television station. For that matter why aren't all of the trust's monthly meetings being broadcast? It's time to shed a little light on the trust.

And if the members of the trust need some incentive, perhaps they should read the portion of Section 25A that states:

The Board of County Commissioners shall, after examining the Trust's annual report and accounting, determine whether there is net income ... at the end of the fiscal year. The Board of County Commissioners may then appropriate such net income into the County's general revenues or leave such net income with the Trust for continued use in effecting the public purposes of the Trust; however, in the event the Commissioners decide to leave such income with the Trust, the Commissioners shall still retain the right to withdraw such income at any future time.

It sounds to me that the county commission has the authority to draw even more from those reserves. Perhaps Ira Clark should think about that the next time he decides to play a game of hide-and-seek with commissioners.

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