Perpetuating Perpetua

Cascade Medical Center's clandestine negotiations to keep the Stibnite workforce perpetual (aka "continuous"), is news to the district's voters

Happy belated Thanksgiving, dear readers. Ever focused on our primary goal to get you to embrace irreverence with a laugh, we replace our customary cartoon with this holiday thought from the political commentator Matt LaBash (find him on Substack): “We (must not) lose sight of what Thanksgiving has historically been about: gluttony, and the tryptophan-activated couch snooze we fall into while watching men in helmets and tights inflict traumatic brain injuries on each other, and celebrating that we’re all still here enjoying our God-given bounty after swiping our land from the Indians so that we could rid ourselves of perfectly harmless buffalo and pave nature over to put up an endless array of vape shops and Dollar stores — just like Chief Sitting Bull would’ve done if he’d had a little more get-up-and-go and some good old-fashioned American ingenuity.

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And now on to the business at hand…

When a struggling public hospital district takes on a major new obligation—like running a 24/7 medical clinic for the private Perpetua Resources mining company—district taxpayers have every right to be in on it. Yet the Cascade Medical Center board has been negotiating with the miners for a year and a half. Almost nothing has been shared with the taxpayers: not the staffing burden, not the potential liabilities, and not the possible impact on local services. If a survey were to be taken of the district’s voters, it would show that almost none of them know this is even going on.

Three months after it first appeared on the CMC board’s August, 2024 meeting agenda, the throttle was already fully open. The October ‘24 agenda contained the item: “Update on Landscaping, Stibnite Mine Clinic.” Yet, there was no mention of the project in the district’s 2024 annual report. Recently, the administrative staff distributed a draft contract to the board, completely out of the public eye. Last week, the board authorized the expenditure of staff time—and presumably pricy legal counsel billing hours—to produce a finished contract.

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CMC is the same outfit, mind you, that had to be roundly spanked by their electorate twice for asking for a new hospital a few years ago. The electorate’s first resounding “no” wasn’t good enough. The board actually had such disrespect for their constituents’ wishes to come back the next year asking for twice as much money as before. This time the district voters shouted, “hell no.“

“Without a replacement hospital,” CMCs administrator said in 2022, “we will be unable to accommodate the growing demand for local health care.” Critics of the district’s hyperbole presciently wondered if that demand existed. They were right. All the district’s efforts after the hospital was shot down has been to drum up business, not be overwhelmed by demand. CMC opened an urgent care clinic in Donnelly at significant, and as yet unrequited, start-up costs and now this venture in Stibnite. The administrator insists that these will pan out. But, as we just pointed out, his prowess as a market analyst would get him fired in a firm that depended on credibility.

Too often voters find out something is wrong only when services shrink, staff get stretched thin, or hours are cut at the local clinic. When you mix a volatile business like gold mining with a board who doesn’t grok the word “no,” what could possibly go wrong?

How many times have you talked through a tough decision with a friend or your spouse and suddenly realized, “You know, you make a really good point—I hadn’t thought of that”? And it completely changed the way you were thinking. It’s odd that a health agency would be so hostile to open, healthy discourse.

There is a doctrine called the Presumption of Openness. It’s more than an ethic—it’s a culture, a vibe...that encourages public interest because it assumes every comment has the potential to improve decision making. Sharing real details about a pending contract with the public isn’t an inconvenience; it’s an insurance policy and an obligation. It is not the public’s responsibility to follow a board’s every move like a puppy being housebroken.

CMC should aggressively court public opinion about the Perpetua clinic because it protects both the community and the district itself.

And that doesn’t mean a public relations snow job. The board should provide the local press with the draft contract and the details of the project. The press, in return, should give it a critical eye and ask questions on behalf of their readers instead of just printing what they are told. That is the only way any kind of objective reporting of the facts will get out. They should do this immediately before any more expense is incurred to finalize the deal.

Just. Sayin’.

And for transparency advocates (which we hope is everybody) there’s more…

In a related vein, the CMC board also spent 20 minutes at its November meeting rehashing a leftover from October...namely, whether advisory committees should comply with state law. Yeah, yeah, dear readers, we see your eyes glazing over, but please humor us. Open meetings are not the sexiest topic but if you value government openness at all, this tale shows what an uphill climb it is for those of us who try to deliver this essential element of public process to you.

A couple months ago, we pointed out that CMCs advisory committees were violating the Idaho Open Meeting law. The board appears to be on the brink of accepting that fact. To her credit, the board chair consulted with the Valley County Prosecuting Attorney to get his guidance. But when we obtained the advisory letter from the prosector, we found that her description of his advice to the board bore little resemblance to what he actually said (see the Nerdist Colony section for the actual quotes). What happened next surprised even this crusty pair of old salts who think we’ve seen it all.

There was much protestation about how inconvenient to the board “allowing” public access would be, along with the usual parade of irrational, boogie-men-hysterics that were given outsized attention (enumerated in Afterthoughts). Some board members became so intent on locking the public out of their process that they actually considered stripping the advisory committees of their advisory capacity and amending the bylaws to make it happen! Instead of “advising” the board, which makes them subject to the Open Meeting Law, the committees would turn into research assistants who dump a bunch of paper on the board and let them slog through it.

Really, they did that :)

We have written two comments to this board with factual counters to what the chair and the administrator were telling them about open meetings. There is no evidence that the members have even seen them. If they haven’t, they should ask the chair for them. They present a side they haven’t considered.

The most destructive decisions are ones that are made out of ignorance of the arguments against, not out of knowledgable commitment to a point of view.

Will there be dawn after the darkness?

Thankfully, there are some blessed souls in CMC’s boardroom who show some glimmer of logical thinking. They bought more time by punting the topic (for the fourth consecutive time) to the December meeting. If the energy this group has spent handwringing this thing had been put to the very simple task of cleaning up the violations, the problem would be fixed by now and they would retain the benefit of their committees’ sage advice.

But, 1. The actual letter from the prosecutor was either not shared with the board or they didn’t read it if it was. 2. our written public comment was withheld from them because the chair says they don’t accept written comment as a matter of policy...what?). 3. they don’t post individual email addresses on their website to interact with their constituents. These three truths mean that CMC’s public might have to continue to be literally locked out of such policy building discussions as finance. And good luck dragging out anything the board or the administrator doesn’t think patrons deserve to see (like contracts). Does it really have to be this way? No. Should voters email them in protest? No, that would be a waste of time because they don’t accept written comment, remember? And without email addresses, who would voters write to?

What we can’t seem to get through to this bunch is that openness helps them build trust. If they open up, they aren’t going to be stampeded with citizens pelting them with questions, as they fear. Citizens speak at the ballot box. That’s the point. Didn’t those resounding spankings on the hospital measures tell them anything? When doors are closed and shades are drawn, citizens will speak with their votes. Is the board aware that voters’ eyebrows raised when they spent a pile of money on an employee parking lot, instead of applying the funds to the list of dire inadequacies of the existing facility touted as unacceptable conditions in the two new hospital proposals? That moving target of “needs” surely will also factor into those voters’ evaluation of future financing requests.

The standard retort boards always give is, “we were elected to make these decisions.”

First of all, most of them weren’t “elected.” They were appointed or retain office by default (no opposition). Second, as the failed hospital bonds clearly show, their opinion of what is best almost never is shared by the people they represent.

When owners entrust their keys to a property manager, does that mean the property manager owns the house? That’s what the CMC board’s actions say they believe. Their volunteer service is deeply appreciated. Their misguided sense of empowerment is not.

Here are the alarm bells the board should be hearing: ⭐️ In May, the CMC district had its first contested trustee election since anybody can remember. A largely unknown challenger who didn’t campaign at all, came within a tiny nine votes of defeating a more well-connected incumbent. ⭐️ At some point, CMC is going to have to ask their voters for money. Their facilities are indeed aging. The government subsidies that have been bailing them out, come, go and change. ⭐️ The electorate showed they don’t trust the board because they tried to sell them an Emerald City hospital when a well appointed, Kansas style farmhouse fit their needs.

Is building more distrust by adopting a “Presumption of None of Your Business” worth the “inconvenience” of letting some sunshine into your decision making process? That is the tradeoff this board is facing.

And there’s even more! A Line In the Parking Lot

Editors order their reporters to “never leave a meeting before it is over,” because they might just miss something juicy. That was good advice for Tuesday’s CMC board meeting, where the comments at the end of the meeting included the hospital administrator issuing a non-negotiable edict to his employers.

A few months ago, we wrote a whole post about a CMC neighbor’s quest to reroute traffic from the hospital’s employee parking lot to keep headlights from flooding through his picture window (see the Links section). He made the request again last week, now a full year after his initial ask. He even offered to buy a sign and help install it. At the end of the meeting, one board member requested that the topic of the parking lot sign finally be added to the December agenda.

The administrator laid down the law. The alternate route includes a 100’, 6% grade that can get slick in the winter. He said that poses a hazard to hospital employees. To put this in perspective, a 6% grade is standard for safe inclines on freeways. If a rig can’t negotiate a 6% grade in snow country, how do these employees get to the grocery store? He said he has told employees to use the sloped driveway to exit “when it’s safe to do so, but if it’s not, (use) the other way.” Then he drew an imaginary line in the parking lot and dared the board to cross it: “And that (meaning my policy) is not going to change.”

Translation: “You’re not the boss of me. I’m willing to die on this 6% hill.”

This blatant challenge to the board’s authority did not deter the board member who requested the agenda item. That, again, shows that there is hope for this group. The board did not show offense by the administrator’s dictatorial announcement that hospital policy is his to determine. Maybe it happened too fast for them to catch it. But it tells CMC voters a lot about what is going on in that boardroom. We heard his ultimatum with our own ears. We have a recording. Why has this neighbor’s simple little request taken over a year to even get on the agenda?

We’ll say this with our trademark delicacy:

Like the “Presumption of Openness” policy, this board and its humility-challenged administrator make molehills into Hellholes. Meanwhile, the mountains (the clinic at the Perpetua mine) present no obstacle. Voters have told them in the past that the only elevation they want is a higher standard of sensitivity to public opinion. It starts with simply opening meetings and treating citizens not as nuisances, but with concern and respect—just the way that the very talented and dedicated health care providers who work for them do.

Maybe in December, the citizens of the CMC taxing district will see a significant change in attitude. Maybe they will share with their electorate the details of the mine clinic. Perhaps the “Presumption of Openness” will be adopted, and, gawd forbid, the neighbor might get his sign and a commitment to enforce it. That would be a very Merry Christmas present indeed—greater for the board’s credibility than for the citizens. They ultimately have the power of the vote in their hip pockets and have the moxie to show the limit of their patience.

Scroll down for the Afterthoughts, Nerdist Colony and Links, after these commercial breaks:

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Afterthoughts, Observations and Authentications

• There’s nothing daunting about adopting the “Presumption of Openness” mentioned earlier. Thanks to citizen activism, McCall Memorial Hospital District now does a really nice job posting meetings of its three standing committees, along with packets of materials the group is to consider. The city of McCall has 10 advisory committees and they all dutifully comply with the law. Ditto for committees that advise public agencies (which CMC is) across the county and around the state. So what’s the problem, CMC?

• The parade of horribles: One CMC board member said complying with the law would be “potential chaos,” and would make the committees “dysfunctional.” This negative puffery has no foundation. Citizens are no more likely to tell their employer, “I need time off work to go to the CMC finance committee meeting” than they are now. And even if a crowd does show up, they can’t speak unless invited. Another board member said compliance would “impede open, honest discussion, and everyone’s going to check what they have to say and choose their words carefully.” Well...exactly! Translate “open, honest’ to mean “I want to be able to say anything I want and not be held accountable for it.” In a post devoted to public access (see Links section) we told the story of what happened when a recording of a closed door session got into the hands of the press. The content wasn’t pretty. Loose talk has no place in the serious business of public policy. Executive sessions are the mechanism for sensitive topics. Otherwise anything said in a public meeting should be suitable for public consumption.

• Talking behind someone’s back isn’t good even when it is in public. The parking lot neighbor left the meeting after the comment period, understandably thinking there would be no discussion. But, as we reported above, the board had plenty of comment later, which conveniently only took place after he had left. A lively discussion broke out while the next meeting’s agenda was being considered. The chair should have simply accepted the board member’s request for an agenda item. The discussion should have taken place at the December meeting under that agenda item where the citizen it most concerned could be present. As it was, the late-meeting exchange clearly constituted a deliberation that could factor into a decision that was not on the agenda. That violates the Idaho Open Meeting Law. Nobody has spent more time on the Open Meeting Law than CMC and they still don’t get it. The work of an open meeting advocate is never done :)

Nerdist Colony

• CMCs advisory committees are finance, quality/compliance, strategic opportunity, and strategic planning. The Idaho Open Meeting Law applies to committees “with the authority to make decisions for or recommendations to a public agency regarding any matter.” Each of the committees clearly fall into that category. That means posting agendas and minutes on the district website so their constituents can see when they meet and what they talk about. They must allow the public to attend. The CMC committees are doing none of that, they are operating completely out of the public eye.

• From a transcript of the meeting, here is how the CMC chair interpreted the county prosecutor’s advice to the board: “The prosecutor) said, ‘It’s not actually my job to advise you legally, so I can’t. I don’t really want to give you a lot of information.’ (but he) said, ‘When in doubt, it’s always good to have more transparency than less, but you should talk to your own attorney about this issue.’ “ Below is what the prosecutor actually said. The county’s fleet of snowplows, standing side-by-side, could fit between those two statements, no?

“I cannot give you legal advice . . . (but) I have and will continue to recommend...that advisory committees should adhere to the Open Meetings Law with very few, if any, exception. Even though the committee may not meet all the technical requirements to require it to be open to the public the spirit and goal of the law is to promote transparency and openness in government. From my perspective that is how the best decisions are made and how government should operate.”

Links

• The neighbor’s treatment by CMC. In the closed-circuit world of specialty taxing districts, it could happen to anyone.

• What happens in closed door sessions. Search for phrase: In 2019

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Reader Glossary

YGWUPF (ya-guh-upf) You Get What You Pay For. Def. — used to qualify a statement I'm pretty sure is fact, but would take countless hours of research to verify as indisputably certain. Since this blog is free, ain’t gonna do it. YGWUPF.

About me: Tom and Tomi Grote owned/published The Star-News for 40 years (1983-2022). We sold the paper and are now retired on an acreage near Lake Fork with two horses and a Basset Hound named Gidget.

Be sure to drop by the digital archives

Searchable digital archives of The Star-News and its predecessors, The Cascade News and the Payette Lakes Star are available online. Up until the creation of this free public service, people had to paw through volumes of the original print editions housed at the public libraries. Thanks to the generous assistance of the Laura Moore Cunningham Foundation, the conversion of these archives was accomplished. You can find the archive here. It is worth bookmarking in your browser for future reference.

The mini-civics lessons in this column will eventually be housed with the archives for a complete community reference resource.