An account of how a large Catholic medical center has lost its way. Go to pmmdaily.blogspot.com to see recent updates.

Tuesday, March 14, 2006

Tom Carroll's Letter to Bishop Jenky---September, '2003


Sunday, 21 Sep 2003
To: Bishop Jenky
Cardinal George
Monsignor Rohlfs, Monsignor Campbell, Monsignor Soseman, Monsignor Watson
Diocese of Peoria Parish Pastors

(Other recipient names were not included.)

An update on Haitian Hearts and OSF:

As most of you know, Paul Kramer, Executive Director of Children's Hospital of Illinois, contacted the American Consulate in Port Au Prince, Haiti, last December to inform them that OSF would no longer approve medical visas for Haitian Hearts' patients. After John Carroll and others picketed OSF administration in January reminding them that "Respect for Life Includes Haitians", the hospital, in decidedly un-Christian fashion, responded by officially suspending the Haitian Hearts program.

The program's suspension and the accompanying ban on visas for John's Haitian patients have never been lifted. Despite my brother's many attempts in the ensuing months, including his offer to pay 100% of Haitian patient's hospital bill, and the intervention of the Diocese of Peoria, John has been unable to obtain permission for any medical visas from St. Francis.

In July, the Haitian Hearts program was dealt another severe blow when the Diocese of Peoria withdrew its support and OSF subsequently announced that it, too, had officially dropped Haitian Hearts. The Peoria Journal Star reported that OSF claimed its medical staff was supportive of and had participated in the decision to abandon the Haitian Hearts program. Dr. William Albers, retired chief of Pediatric Cardiology at OSF, was quoted as saying that the program failed because John Carroll was "unwilling to negotiate". In this letter, I will question the reasoning and the motivation behind the decision to drop Haitian Hearts and the hospital's accompanying public statements.

The hospital's refusal to accept more Haitian patients last December was a severe blow to the patients and families who were waiting prayerfully for our help in a country that lacks the medical facilities to care for them. John, at that time, had identified 18 patients, 16 of them children, all of who would be candidates for heart surgery at OSF. They are not allowed to come because the hospital will not approve of their visit. It's sad to realize that, despite the critical medical problems these patients represent, there were only two meetings in the last six months involving all three organizations (Haitian Hearts, OSF and the Catholic Diocese of Peoria). Haitian Hearts members were surprised and disappointed when Monsignor Rohlfs announced at the February 7 meeting that the next team meeting would likely be scheduled for May. There was no need or reason to wait three months before meeting again.

As it turned out, our next meeting didn't take place until July. Before discussing the meetings, let me point out that Dr. Albers did not attend either meeting, was not on the committee, and has not communicated with John in the last six months. He would have, therefore, no first-hand knowledge of John's "willingness to negotiate". (Dr. Albers: I would still like to know what basis you had for saying John was not willing to negotiate on behalf of his Haitian patients. Do you believe that your statement is consistent with John's past behavior regarding his program? Has John typically been willing to sacrifice his patients by refusing to negotiate on their behalf or would you regard him as a good advocate for them? Please give these questions and your answers to them some careful thought before making any more public judgments regarding my brother.)

One of the tasks John was assigned by Monsignor Rohlfs at the February meeting was to obtain assurances from various members of OSF's medical staff that their support for Haitian Hearts would continue. Haitian Hearts has, of course, always received an incredible amount of support from the surgeons, cardiologists, intensivists, etc. who have donated their services without charge. John asked for promises of support and, without exception, was assured by the doctors of their willingness to continue working for the program. Why then would OSF state that the doctors involved with the program participated in and supported the decision to cancel it? Several doctors intimately involved with Haitian children care over the years have since told us that they were informed that the program had been cancelled but definitely were not involved in the decision to cancel it. Could it be that OSF administration wanted to portray the false impression that their decision to cancel a charitable program was actually made by "the medical staff" because it helps justify that decision in the public's mind?

The hospital's dissemination of misinformation is very injurious to the Haitian Hearts program and to my brother. It reflects a mean-spirited attitude that is contrary to the Sister's mission statement which calls for open and honest communication. I maintain that OSF and Dr. Albers have a moral obligation to correct any misinfonnation they have allowed to propagate. I would hope that a Catholic institution would never choose to propagate false or misleading information and I expect that Dr. Albers would certainly not either. My family and I are waiting for a public correction or retraction from both parties.

At the February 7th meeting, Bishop Jenky emphasized the importance of both OSF and Haitian Hearts working together to arrive at an agreement or contract so that Haitian Hearts could continue. He said that it is sometimes difficult for friends to agree to a contract, but that a contract was exactly what was needed.

In March, OSF submitted a proposal for a contract. This proposal included no financial contribution to Haitian Hearts from the hospital, no "cap" or maximum amount Haitian Hearts could be charged, a return to Haitian Hearts paying 45% of medical charges, and a list of restrictions that seemed designed to make it very difficult for John to obtain the hospital's permission or approval for the patients. The hospital's proposal also stated that the Diocese of Peoria would be responsible for any unpaid hospital bills incurred by the Haitian patients. Why OSF would attempt to place this financial responsibility on the Diocese is anyone's guess. Not surprisingly, the Diocese was unwilling to agree to this part of the contract offer.

Several days after receiving the hospital's proposal, John and other members of Haitian Hearts responded by submitting a counterproposal. John's counterproposal asked for:1.) an annual allowance from the Sisters to help defray hospital charges, and 2.) maximums or "caps" on the patients' medical bills.
Patricia Gibson told John that Sr. Judith Ann and Joe Piccione had reviewed the counteroffer and seemed to view it as reasonable. Oddly enough, Sue Wozniak said in July that she had not seen, or read, this counteroffer from Haitian Hearts. Haitian Hearts members were disappointed to learn this. Sue was a critical member of OSF's negotiating team. If the hospital were truly serious about negotiating a contract, it seems that Sue Wozniak should have, at a minimum, read our counteroffer. It seems to me that the failure to do constitutes a reluctance or unwillingness on the hospital's part to negotiate.

In April, Monsignor Rohlfs told John that the Sisters had revised the hospital's proposal to include an annual $200,000 discount on medical bills with Haitian Hearts paying the remaining hospital charges at a 45% rate. We were, of course, very encouraged and grateful that the Sisters were offering a financial contribution to the program. There was still no provision for a cap or maximum amount that Haitian Hearts could owe. At this point, Monsignor Rohlfs told John that Haitian Hearts would have to accept or reject the Sisters financial offer before any other points of the contract could be negotiated. John acknowledged the Sisters' offer was generous but felt that other aspects of the financial package, such as caps and maximum liability, needed to be negotiated and understood by both sides before accepting or rejecting them. It would be irresponsible for Haitian Hearts to prematurely agree to any financial offer without both sides fully understanding the terms of that agreement. Since Haitian Hearts is a relatively small organization with a finite amount of fundraising ability, the issue of caps or maximum liability is, of course, crucial to its financial survival. With no cap, Haitian Hearts would run the risk of financial ruin with every patient. Strangely enough, Monsignor Rohlfs did not agree with the logic of this position and insisted John must "accept or reject" the Sister's financial offer before any other issues could be negotiated.

I can't emphasize enough that accepting a financial offer, no matter how generous the amount, without a cap on medical bills is a major problem for a small organization like Haitian Hearts. Our program's debt and its financial solvency are, of course, critical concerns to us. Last January, OSF administrators announced to the media that they were suspending Haitian Hearts because the program owed the hospital over $500,000 in medical bills. The hospital's announcement prompted a fair amount of public criticism of John and his program. Several days later, the hospital claimed that Haitian Hearts's debt amounted to "over $400,000" and their statements to the newspaper later described the debt as being "almost $400,000." This means the hospital initially overstated the debt by more than $100,000. More than one-fifth of the debt initially claimed as justification for suspending a charitable organization apparently never existed. The hospital administrators did not bother to explain how or why they had overstated our debt by such a large amount. Since the public criticism caused by their initial statement only hurt John and Haitian Hearts, the hospital apparently never felt it necessary to correct or explain their error. Sr. Judith Ann was contacted by a Haitian Hearts member who respectfully asked her to explain the accounting of the debt since our figures actually showed we had a positive balance rather than a negative one. Sister responded by referring her to Paul Kramer.

Sister, I must say I am very disappointed that you did not clear this matter up. If the hospital decides to state publicly that we owe it over half a million dollars, it only seems fair for the hospital to be willing to back up that claim with hard figures. Don't you agree? Please let me know if there is any possibility for reconciliation on this matter. I believe that Haitian Hearts has been dealt with unfairly and that the hospital should publicly correct its previous statements. I would expect nothing less from a Catholic institution. Please prayerfully consider my request, Sister, and let me know your decision.

Without caps providing an upper limit on financial liability, it is easy to envision a scenario wherein John and the Haitian Hearts program would once again be held liable for huge medical bills if one or more of the program's surgical cases developed complications. If that happened, it is possible that OSF administrators would make an honest effort to accurately compute the amount of that debt before announcing it to the media, but, based on their actions in January, I certainly wouldn't expect fair treatment. OSF administrators and spokespeople dragged John's name through the media spotlight in January. I can only assume that, given the opportunity, they would repeat this behavior in the future. Haitian Hearts could be forced into insolvency or bankruptcy in such a situation. Would the Sisters be willing to stand up and protect the reputation of Haitian Hearts and John Carroll in this situation? The Sisters did not stand up to protect Haitian Hearts reputation against the false statements of their administrators last January. Would anyone expect them to in the future?

The Haitian Hearts program has been quite successful at raising funds: we raised over $1.1 million in the last few years, all of which went to Children's Hospital of Illinois. Combined with the Sister's generosity the program has successfully brought over 90 Haitians here for life saving surgeries. However, no small organization should be forced to subject itself to unlimited financial risk without being permitted to even discuss the option of caps. Monsignor Rohlfs, why did you mandate that Haitian Hearts could not negotiate any points of the contract without first agreeing to a financial offer? Would you, as Vicar General, allow our Diocese to accept a financial offer if there were no discussion allowed ofthe resulting financial liability? You don't really have to respond to this question, Monsignor. I already know the answer. Of course you wouldn't.

Some additional comments about the second, and final, Haitian Hearts / OSF / Diocese meeting on July 17th:

At an earlier meeting with two representatives of Haitian Hearts, Sue Wozniak, OSF's Chief Financial Officer, distributed a draft of a proposal wherein Haitian Hearts would be responsible for 45% of hospital charges up to a preset limit, and 30% 'of the charges after that. At the July 17th meeting, we asked about this lower, 30%, charge and were told that the offer did not exist. We were told ''that was only a draft." It seems that we on the Haitian Hearts committee should have known or been able to guess which of the hospital's offers were serious and which were not. Joe Piccione and Dr. McShane stated early in this meeting that "the Haitian Hearts program would begin afresh (or anew) each year", implying that the debt owed by Haitian Hearts would be forgiven at the end of each year. Later on in the meeting, Sr. Diane stated that Haitian Hearts's debt would not be forgiven but would be carried over from each year to the next. Joe and Jerry did a quick reversal and suddenly agreed that our debt would not be forgiven. I stated that the financial "offer" was confusing, had changed at least twice in this short meeting, and I requested that, with only a few remaining minutes in our allotted hour, we schedule a future meeting to discuss finances. My request was refused by Monsignor Rohlfs.

Before the meeting ended, Joe Piccione said that my brother's statements and/or actions towards ''the Sisters" were arrogant. The next day the Diocese and the hospital announced their withdrawal from participation in the Haitian Hearts program.
The stated purpose of the July 17th meeting, as expressed in the written invitation from the Diocese, had been to discuss many issues concerning the proposed agreement between OSF and Haitian Hearts. There was no indication, based on the written invitation, that further negotiations would be contingent on our accepting or agreeing to a not-well-defined financial offer. The time limit for this meeting was set by Monsignor at exactly one hour. It came as a genuine surprise to me when Monsignor Rohlfs began the meeting by saying John must accept or reject the Sister's financial offer before any other issues could be negotiated. When asked why we were being forced to agree to a financial arrangement before negotiating any other issues, Monsignor Rohlfs replied that it was "because I have decided it". He also stated that he did not believe John was ever going to agree to any contract- with the hospital and wanted to save everyone the time and trouble of negotiating. I couldn't believe my ears. This statement came at the beginning of the very first negotiating session between OSF and Haitian Hearts. It took Haitian Hearts almost 6 months just to get this negotiating meeting with the hospital. Monsignor, do you really believe John was not going to agree to a contract with OSF? What possible benefit would there be to Haitian Hearts if we refused to agree to a contract? Monsignor Rohlfs, there were over 30 Haitian patients whose very lives depended on our negotiating a contract with the hospital. Why would you start out the meeting by saying that you didn't think we would ever agree to a contract? Did you think that saying this would help facilitate the negotiations? John has successfully fought his way through bringing more than 90 Haitians to the US for surgery. There are now more than 18 additional patients waiting for surgery. How could it possibly help these patients to refuse a contract with the very hospital that helped so many previous patients? What benefit would there be to spending much time negotiating with and then refusing to agree to a contract with OSF? More communication, not less, is obviously what was needed -- why, near the end of the last meeting, did you turn down my request for another meeting to work on the financial issues? Is your time, or the hospital's, so valuable that you were unwilling to risk spending another sixty minutes on a topic that literally means life or death to Haitian patients? If it were your heart surgery that was in jeopardy would you have been willing to schedule one more meeting to discuss it? What do you think will happen to the Haitian heart patients if other hospitals follow OSF's lead and likewise refuse to help them?

Bishop Jenky, do you approve of the restrictions on negotiations imposed by Monsignor Rohlfs? Is this the Diocese's usual method of fostering agreement between people? Also, why did the Diocese remain silent while John was blamed for being "unwilling to negotiate"? Why did it remain silent in January when the alleged amount of Haitian Hearts debt kept changing in the media from day to day? Is this open and honest communication on the part of the Diocese? I don't think so.

I believe that Monsignor Rohlfs did not conduct this meeting in a good-faith manner.
The meeting appeared to be a formality meant to ease the hospital's withdrawal from a program that it no longer has the moral courage to support. The primary concern was preserving the hospital's image. The people who will immediately suffer from this are, of course, the Haitians. Hospital administrators and ethicists have done a decent job of spinning the public's perception of their cold and calculated decisions. However, I don't have to be an ethicist to know that, in the end, we are all judged on our actions -- not on speech.

For the record, let me say that OSF's actions and statements regarding my brother and Haitian Hearts are deeply disturbing to me and have profoundly affected my opinion of a once-proud, Catholic organization. I have watched as John has been called arrogant and stubborn because he insisted on quality care for his Haitian patients. Those very characteristics are deemed highly desirable in a physician if one happens to be the patient benefiting from the improved level of care. Not everyone has the luxury of being paid to sit in a comfortable office while criticizing the actions or words of others. Mr. Piccione, if you would care to take the time, I will be happy to meet with you and explain the true meaning of the word "arrogant". Let me point out that we in central Illinois are blessed with everything we need to provide care for the least of our brethren: a superb medical facility, physicians willing to donate medical care without charge, foster families who open their homes to the Haitians, and a generous community that has donated a large amount of money to help pay for the childrens' surgeries. The only thing lacking is permission from the hospital administration to provide these surgeries. We have everything else. All we need is the moral strength and leadership to do the right thing.

This is my third letter to the Diocese in the last 18 months. I have not received answers from the Bishop to my first two letters. I will respectfully ask once again and I will continue to ask for a response to my concerns. The issues I raised are very important and will not go away. It's important to note that my brother John has asked Bishop Jenky for a tribunal to investigate a conflict of interest involving OSF Medical Center. His request has also gone unanswered. Bishop Jenky, don't you have an obligation to respond in a timely manner to a request for a tribunal, especially one that deals with a matter affecting the public good? Has the volatile subject matter of this tribunal influenced the hospital or the Diocese's decision to withdraw support for John's program, Haitian Hearts? I believe that it has.
I will await an answer to this letter.


Tom Carroll

(My brother never received a response.)

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