COLUMBIA, Mo. — Dan Mika had a question about the troubling financial situation at . That’s the name of the nonprofit that runs the Boone County Hospital, a health care system in central Missouri that was established in 1921.
Like many public hospitals throughout Missouri, it has a board of trustees that is publicly elected. Over the years, as the operations of county hospitals have changed, the systems have often contracted with private entities to run day-to-day operations.
Last year, amid layoffs at Boone, Mika filed Sunshine Law requests seeking documents on the financial condition of the public hospital. Mika, a journalist, was working on a master’s degree at the University of Missouri-Columbia that he has since completed.
The hospital system, which had answered Sunshine Law requests before, refused to give up the documents. It used an argument that has become commonplace among Missouri public hospitals that want to avoid public scrutiny. The elected trustees are clearly public officials under the law, but they also serve on a separate board of directors that manages most of the hospital’s affairs. As a result, the hospital system says they don’t have to answer Sunshine Law requests.
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Last week, Mika’s editor, Mark Horvit, called the hospital’s bluff. He in Boone County Circuit Court alleging a violation of the Sunshine Law. Horvit, and investigative editor at the Columbia Missourian digital newspaper, is a former executive director of the industry group Investigative Reporters and Editors.
“Defendants’ denial of the records request is improper as Missouri law is clear that a governmental entity may not avoid Sunshine Law requests by claiming the records are in the possession of a private corporation that is engaged in activity that the government entity would otherwise undertake,†alleges the lawsuit, filed by St. Louis attorneys Michael Nepple and Alex Weidner of the Thompson Coburn firm.
The case is at least the second of its kind making its way through Missouri courts. I reported on the other one — in Perry County — last year. In that case, an elected member of the Perry County Memorial Hospital Board of Trustees, Joe Hutchison, is suing his own hospital system for refusing to share documents he sought in a Sunshine Law request. At the time he asked for records, the hospital was considering a merger with Mercy Health that has since gone through.
“They’re asking us to sign off on this (proposed merger) and they won’t even show us the financials or the audit. I have 50 questions to figure out what to ask once I see the books, and they don’t want me to have access to the books,†Hutchison told me last year. “It’s a nightmare.â€
In court documents, attorneys for Perry County Memorial Hospital have argued that the documents should not be public. Attorneys for Boone County Hospital haven’t yet responded to the lawsuit against it.
In both situations, the folks seeking records appear to have Missouri case law on their side. In 1998, in a case involving a Kansas City hospital, the Missouri Appeals Court ruled that a public body can’t create a separate entity that enters into contracts and then hide those contracts from the public.
“Contracts entered into by governmental entities are precisely the type of records the Sunshine Law seeks to provide to the public,†the court wrote.
But that’s what is happening in Boone County, Horvit told me.
“The core issue here is that the system that has been set up at Boone Hospital provides a way for basic documents about the hospital and its financial health to be shielded from public view,†he said in an interview. “That system can’t be allowed to be OK.â€
As rural hospitals have closed and consolidated across the state, increasingly contracting with the state’s largest hospital systems for services, financial transparency has become even more important, the lawsuit in Boone County alleges.
“Healthcare is a significant concern for many Missourians, and information regarding hospital funding may affect the decisions of the public in numerous ways,†the lawsuit argues.
If those public hospitals are losing money and cutting services, why? And if voters are electing public boards to run those hospitals, why should those officials be shielded from the scrutiny that other elected officials face?
For Horvit, the issue is bigger than what’s happening at hospitals, in an era when many public bodies contract out services to private organizations.
“Part of the concern would be that if this kind of setup isn’t challenged, it could become more prevalent,†Horvit says. “What’s to stop any other public body from setting up a similar organization and then keeping their business out of the public eye?â€