He said the process couldn’t have been any more different than the one the Brooks-TLC Hospital System board is using in its quest for a new hospital building. The Utica process

“I went there in 2009. St. Elizabeth’s Hospital started in 1866,” Ketcham said in an interview Thursday. “I was their first lay CEO ever. I replaced a nun.

“One of the challenges that immediately became apparent was that St. Elizabeth and the other hospital in Utica, Faxton St. Luke Medical Center, were struggling. Utica is a lot like Dunkirk and Fredonia, it’s a larger city but with similar challenges … it had the industry, but it left. There were five hospitals at one time. Faxton and St. Luke were separate hospitals that merged, a couple closed.”

St. Elizabeth’s was a Catholic hospital, while Faxton St. Luke’s was secular. Ketcham said when the hospitals’ boards decided to meet jointly for talks, they had never done any sort of joint planning. “We got together and people felt ‘We really ought to look at the whole spectrum from sharing services to integrated,'” he said.

Richard Ketcham.

That led Ketcham and Scott Perra, his counterpart at Faxton St. Luke, to make the same conclusion: They needed community input into their decision-making process — and a lot of it.

“Scott and I met, it wouldn’t be an exaggeration to say, with at least 50 community organizations within 20 miles. Lions Club, Rotary, the newspapers, the TV stations and more,” Ketcham said. “Never once did we have an attorney speak for us or even have an attorney present, ever. We thought it critical that the administration of the hospitals be there, not a hired law firm.

“We explained the histories of the hospitals, the challenges in health care and why the boards ultimately came to the decision that we needed to change what we were doing, consolidate and ultimately build a new facility.

“We didn’t make our decisions in private. We didn’t present it as a fait accompli.”

Ketcham said all of the community stakeholders they talked to ended up signing a document agreeing that the boards were taking an appropriate course of action. It was signed “by the bishop, the insurance companies, the foundations, the media, the unions from the hospitals, the New York state Department of Health and Planned Parenthood … agreeing that this was the best course of action for health care in the community.”

In the merger agreement between the two hospitals, forming the Mohawk Valley Health System, Perra stayed on as CEO and Ketcham retired.

Mohawk Valley Health System is now in the process of getting governmental approval of a $480 million project to build a 672,000-square-foot hospital on a 25-acre campus in downtown Utica.

Ketcham concluded about his time in Utica: “I’m still as certain as can be that there would have been a zero percent chance of success if we had followed a closed door process.”

‘A different approach’

Back here in northern Chautauqua County after his time out in Oneida County, Ketcham is watching another hospital struggle with a changing health-care industry and aging facilities. But he says the hospital here is doing things differently than the ones in the Mohawk Valley were. In addition, he thinks Brooks itself used a different approach in the past, when he was its leader.

“In the early 1990s, we considered an affiliation with Buffalo General Hospital,” he said. “What we did was got the Dunkirk Middle School auditorium … and invited the entire community and we listened to people. Ultimately at that time we decided not to affiliate, but we got the stakeholders involved, we got the community to speak.

“This current board has taken a different approach, which is not to engage with the community,” he continued. “I think a lot of their problems they are experiencing are related to that.”

Ketcham stressed that he thinks Brooks-TLC board members do want a positive result for the community.

“I know most of the people that are on the board. They’re good folks. They truly, honestly believe in the best interest of the community. I don’t believe comments about where they live making them be against Dunkirk. I do wonder and question the approach that they’ve taken to communicate, or more appropriately, not communicate, with the public.

“As a private not-for-profit, they don’t have to engage the community,” he continued. “But most, if not all, of the challenges they are facing are of their own making because there hasn’t been this community involvement. Brooks is a community hospital and has been since it was founded, so it’s important to talk to a broad cross section of the community for their views to be heard.

“For it to be successful, people have to view it as their community hospital. But right now, that bond has been broken.”

Ketcham was asked if he thinks he hospital should stay in Dunkirk, go to the proposed site or move somewhere else.

“I don’t know enough to know,” he said. “I can’t say factually if the decision (to move to Fredonia) was made in error or not … I have not been informed in any way about it. My uninformed bias is that it stay in place, and really be replaced. I don’t think it can be renovated. I guess I would like to be convinced that it couldn’t be replaced in place.”

His preferred spot for a move would have been to a Route 60 location, somewhere between the Thruway exit and the Jamestown Community College North campus.

Ketcham said that when the 1989 addition to the current hospital was erected, the annex was constructed so four more stories could be added on.

“The long range plan was to go up there and then build out into the parking lot,” he said. “I’m sure that was considered by the (current) board, but responses like ‘Well, it’s too expensive’ are, to my mind, not sufficient. Again, I thought there would have been a community meeting to lay out their options.”

Looking ahead

According to a OBSERVER article Feb. 19, the Brooks-TLC board “will be meeting with a number of community leaders later this week to discuss its plan.” That didn’t impress Ketcham much.

“I read the headline (‘Brooks sets meetings with community’) and said ‘Maybe two years too late, but I guess it’s OK.’ But then I read the article, it didn’t say anything about community engagement. It said the hospital is engaging with community leaders in the future. Who that is or when that is, they don’t say.”

Ketcham closed by offering the Brooks-TLC board encouragement — and frank advice.

“I know there’s good people on the board, trying to do the right thing. I do truly wish them well. But I would encourage open dialogue at every opportunity and I don’t mean some hand-picked group.

“Particularly since the site has been selected, I can’t see the harm in holding a forum at say, Dunkirk High School. Say ‘Here’s the reasons we couldn’t rebuild on this site … here’s the reasons that we focused on the sites we did.’ Again, it’s a little late, but at least you could explain it.

“I fear the board may not understand the depth of concerns that are out there,” he concluded. “I don’t want to see themselves shoot themselves in the foot. Have a meeting next week. But they need not one public meeting, they need 10.”