Behind the Scenes: KVH Commissioners

Libenow Altman

We sat down with KVH Commissioners Matt Altman, President, and Erica Libenow, Secretary, to learn more about the work and role of the five-person board in serving and representing the community.

What is the Board of Commissioners at KVH?

Matt: It’s easy to say what we’re not, right? We are not running the hospital. We don’t hire and fire anybody except the CEO. We task the CEO with running the organization. We form the strategic goals of the organization, and oversee the administration as they accomplish or implement those goals.

Do you have different areas of focus or interest?

Matt: We take on areas based on our interests. Erica’s is community engagement. As a local doc with a small business, Bob Davis has perspective on how the business is run. And with my background in medical ethics and health care policy, I bring that interest to the board. So we each bring a certain expertise, with different perspectives.

Being able to follow your passions must make it more rewarding to serve.

Erica: It does, and the amount of material that we have learned—it’s been an education in and of itself. Just looking back on how far I’ve come is gratifying. It’s been a long process.

Matt: You learn a bunch of stuff, then you figure out that there are five other things you don’t understand, so then you go and learn that stuff. And then each one of those has five other things…

Erica: Rabbit holes in every direction.

You’re both busy individuals, why add board service to your lives? And how do your feel your backgrounds have prepared you to do this work?

Erica: I saw a need for a new perspective on the board. I asked my friends who I thought would be really good at it, but they were all very busy or had other interests they were pursuing. I thought, somebody has to do this. And then I realized that I was somebody! So I put my name in the hat.

You have your own health care background, Erica?

Erica: Not clinical, but I worked in dental and oral surgery for several years in patient relations, billing, and insurance. Now I’m going to nursing school. When I graduate in December, I’ll be looking at emergency care. Making a difference for someone in their time of need is a soul moving experience. 

And you, Matt?

Matt: I teach medical ethics to premed students at Central, and occasionally to med students at Pacific Northwest University of Health Sciences. I have an interest in issues around doctor-patient relationships, healthcare, and various other medical ethics topics. I was on the ethics committee at KVH for six years. I’ve also published a bit on healthcare. But personally, I realize how important the hospital is to the community. Both my kids were born here. I want to support it as best I can. This is my community and I want to invest my time and energy in contributing to the community; this seemed like the best way I could do that, given my background.

What does it mean to you to serve in an elected position?

Erica: I’m constantly listening. I try my hardest to be a voice for all who approach me. It’s about representation and working with my fellow board members to encourage improvement across the organization. We always strive for improvement.

Matt: We have things like Coffee with a Commissioner, where people can come and talk to us about concerns that they have. We try to represent their views as their elected representatives. But we also do what we can to shape the organization, to serve the needs of the community. We do our best to maintain high quality and keep KVH as a strong, independent community hospital.

One of our strategic plan areas is access. And so we’re trying to expand the number of services and access to those different services. We opened the clinics to new patients for the first time in many years. We’ve expanded therapy services. We have dermatology now, and occupational health and wound care. These are all attempts to serve the needs of the community as best we can.

Having all clinics open to accepting new patients is a major, visible accomplishment.

Erica: I’ve heard community members say they’re happy we’re accepting new patients. My perception is that we are approachable as commissioners and people seem to feel at ease talking with us. That’s so important, to remain receptive to people’s thoughts and ideas. It’s important to keep our ears open.

Matt: When we’re talking about fiscal responsibility, there are a couple of different ways to do it. One is to cut back and reduce expenses. But another is to expand services to meet needs and to try to keep people in the community getting quality care here rather than going elsewhere. That’s our approach, and that’s Julie’s (Petersen, CEO) approach – to tap into an untapped market, and try to keep people in the community, getting the high quality healthcare that we can offer.

How does the board help to fulfill the mission of KVH?

Matt: Well, one way is to establish the mission, right? A couple of years ago, we put together a new mission, vision, and values. The four pillars of that mission really encapsulate what the board is interested in. (1) Providing access to the community with new services and access to existing services. (2) Overseeing the financial sustainability of the organization so we can remain independent and focused on the community, as opposed to just an outpost of some larger organization. (3) Collaborating and partnering with all local providers rather than competing with them. Working together to provide the community with what it needs. (4) Engaging with the community, finding out their needs and then serving them as best we can.

Erica: When we did strategic planning and formed the mission, we sought input from the organization and community. People are invested in their ideas, so it just naturally flows that they would uphold a mission they helped create with their input. That’s a lot easier than determining a mission with no outside input and then hoping people will embrace it.

Matt: And each member of the board is tasked with overseeing one piece of that mission. We get together regularly with our partners in the administration who are carrying out the specific tasks that will accomplish those things.

What are the challenges of being a commissioner?

Erica: On a national level, health care is a bit of a swinging pendulum – it can be hard to keep up with the changes. On a local level, we must consider how change affects our organization and what we do as board members, while remaining nimble. It is a real challenge.

Matt: You have to have some decent grasp of finances, but you also have to have a decent grasp of politics and where healthcare policies are going, as well as a decent grasp of good science and what care we should be providing. You need to have some sense of HR and hiring practices, too.

Erica: It’s really highlighted to me how important it is to be a part of a team that you can trust. I’m very grateful that we have expertise in all our departments, people who know what they’re doing and can convey their understandings to the board in a way that makes sense to us.

What are the rewards of being a commissioner?

Matt: You’re actually doing something that has an impact on the community and on people’s lives. Personally, it’s rewarding because I’m learning so much and can bring my academic interest to bear on my work at KVH. What I learn here also informs the work I do on campus with students and other faculty and in my research. But the main reward is in serving people.

Erica: Serving patients, staff, and our community, knowing that the board is a way that they can have their voice heard. That’s why I set out to do this; to put it into action is rewarding.

Matt: It feels really good to work with competent people. If the board has questions, we’ll get those questions answered, clearly, in a timely manner. We know that when things come down from the CEO or the board that the people involved are going to do a good job of carrying those things out. And that amount of trust is really valued by the board.

What does it take to be a commissioner? What advice would you give on that?

Matt: Listen to what people have to say. Be inquisitive, and if you don’t understand something or you don’t agree with something, be ready to ask questions. You don’t want to be overbearing, but you also don’t want to be passive, because we do have a role to play as an elected board. Negotiating that balance can be difficult.

Erica: I agree with Matt.  Also, don’t be afraid to ask about “alphabet soup.” Maybe more than anybody else on the board, I’m like, “What does this acronym mean?” There are acronyms for acronyms! 

That’s something you have in common with many of us.

Erica: You just need to keep an open mind, ready to fill it with information. There’s so much to learn, and I don’t anticipate that that’s ever going to change. Every encounter I have as a commissioner, there’s tons of learning going on. And that’s the way it should be.

How would you like people to remember this board’s accomplishments and your service here?

Erica: As the board that was devoted to serving the community. I hope we are remembered for improving and increasing opportunities and services so people can stay local for care. We have a lot of talent here that people outside of KVH might not be aware of. When I was running for commissioner, there was this concern that KVH was going to be swallowed up by a larger entity. The community was very clear that we should stay independent, and I intend to hold that banner up as long as I serve.

Matt: One of the things that’s been a guiding principle from the beginning is an appreciation of what people do on a day-to-day basis. Those who do the work to give patients the excellent care that they deserve. Nurses and housekeeping and doctors and lab technicians and everybody else – the organization can’t function without them. So, one of the things that I want to accomplish as a board member is to turn the focus back on staff and away from administration, who are also important but already pretty visible in the community.

Erica: Can I cosign that? It’s true. And I feel that deeply – an appreciation for frontline staff and less visible heroes of the organization.

Matt: If we want to talk about strategy, I think the board is going to be remembered for being able to operate in a financially responsible way, and, as Erica said, maintain that community focus and the independence of the hospital in a time of great challenges in health care.

I was just at an American Hospital Association meeting in DC, and there are independent community hospitals all over the country that are closing. It’s incredible. There’s this great pressure to consolidate, to be swallowed up by large organizations, but we’ve hired a CEO with a very good strategy for growth and financial sustainability. We’ve increased the footprint of KVH in the community with some strategic building purchases, and we’ve increased and expanded services. So I think that our big legacy is maintaining independence while growing services in a challenging time.

Not just surviving, but thriving. Right?

Matt: Yes. And if you want to attribute that line to one of us when you write up this interview…

Anything else that you would like to add?

Erica: Just an expression of gratitude for this organization. I feel fortunate that of all the places to serve, this is the board I serve on.

It is a great place to work. Thank you both for your service.