In this episode of Fireside Chat, we sit down with Steve Huebner, Board Chair, SCL Health and Board Member, Intermountain Healthcare to talk about supporting management during a crisis, how he defines priorities as board chair, and tips for how to have a successful virtual board meeting.
Please note: The number of COVID-19 cases and the situation referenced in this episode were based on reported data at the time of the interview and are subject to change.
Transcription
Steve Huebner 0:04
I think the thing that’s most rewarding, Gary, is just working with a really good group of individuals. As you know, not for profit boards: if there’s any compensation at all, it’s very modest. You really have to be committed to the purpose. You have to be committed to governance and you have to be committed to that board. I found I thoroughly enjoy the boards I’m on. I think it’s a committed group of people really focused on governance and wanting to be the best that we can be in fulfilling our responsibilities.
Gary Bisbee 0:34
That was Steve Huebner Board Chair SCL Health, Board Member, Intermountain Healthcare, and interim CFO Seattle Cancer Care Alliance. He is speaking about the most rewarding aspects of serving on a health system board of directors. I’m Gary Bisbee and this is Fireside Chat. Steve has had a distinguished career with KPMG and Arthur Andersen, where he worked closely with the boards of directors of client health systems. He’s been on the SCL and Intermountain board since two 2012 where he’s had the opportunity to be on the inside of health system governance. Steve reviews the importance of the board and supporting management during the Coronavirus pandemic, how he defines priorities as board chair, and he provides tips for how to have a successful and productive virtual board meeting. He reviews the COVID-19 related policies at each health system, the challenges presented to the Board of Directors during the crisis, and their unique responsibilities. Steve is a thoughtful and experienced healthcare professional and health system chair and board member. Let’s welcome Steve Hebner to the show.
Well, hi, Steve, thank you for joining us on Fireside Chat.
Steve Huebner 1:39
Thank you, Gary. Looking forward to this.
Gary Bisbee 1:41
We go way back to your KPMG days and now you’re a board member of course at SCL health and Intermountain Healthcare. Why don’t we kick off Steve. You’re in Seattle of course and that was where the first national awareness of Coronavirus hit. How is Seattle doing these days?
Steve Huebner 2:02
Well, I think Gary, we’re dealing with all the same things that everyone else is. We probably just started dealing with them earlier. I would say certainly over the weekend, and early this week cases continue to grow. Every day that I look at the paper, we have a few hundred more cases. Hopefully, we’re not growing exponentially, but we certainly are continuing to grow. And we’re dealing with everything our governor just came out last evening with a stay at home proclamation, which is quite restrictive. Unless you’re an essential business as we are with healthcare. I think people are taking it seriously and really trying to stay off the road, stay out of business, and really comply with it. We may be ahead a little bit but I think other major cities are catching up and surpassing and we have to keep doing the things we need to do.
Gary Bisbee 2:50
Oh, I was gonna ask how are you adapting but with this new stay at home policy, so will you be going in? I mean, you’re working in essential healthcare industry?
Steve Huebner 3:00
I will be going in some, but virtually all of our meetings are being done virtually. So with that in mind, we feel like as best we can the executive team should be complying as well. There are certain things that we may have to be in office for, but it’s very limited.
Gary Bisbee 3:16
There’s a question on the table, which is, well, all of these changes and movement toward more virtual meetings and so on. Is that going to change our whole work environment going forward?
Steve Huebner 3:26
I would hope it would, Gary, because we’ve been talking about this for some time. We look at space costs, we look at travel, we look at all the other factors. And we’ve been on the verge of saying we think we could do it, some companies have done it quite effectively. But it’s pushed many of the rest of us to say, actually, this works pretty well and we should be giving longer-term consideration to this. And there’s no question we all experience cleaner air, we have better traffic, and we wouldn’t expect it to always be like it is now. But there’s a lot to be gained by first furthering what we started here.
Gary Bisbee 4:01
Yeah, that absolutely feels right, Steve. Well, onto your personal background. Grew up in Montana made your way over to the University of Washington business and accounting major. So why accounting?
Steve Huebner 4:12
Well, I would say accounting, I was probably influenced as much by an older brother of mine that was working with Price Waterhouse at the time that I had entered college. And the other factor was accounting was one of the few professions that you could get a job in in the early 70s. So coming off the farm, I was fairly practical and knew that having a job was a pretty important thing coming out of school.
Gary Bisbee 4:36
A good lesson to learn early in life, isn’t it?
Steve Huebner 4:39
That it is.
Gary Bisbee 4:40
After a distinguished career with Arthur Andersen and then KPMG were you in healthcare at both Arthur Andersen and KPMG?
Steve Huebner 4:48
I was. I started out in banking very early in my career, and it didn’t take me long to figure out that I liked the people and the mission in healthcare better. And so I spent the majority of my career with both Arthur Andersen and KPMG in healthcare and played leadership roles at both firms that have always been committed to the healthcare industry.
Gary Bisbee 5:10
After leaving KPMG, we’ll be talking to you in a moment about your board chair roles, but you’re now the interim CFO at Seattle Cancer Care Alliance. Which is an interesting position for you? For those that aren’t aware. Can you describe Seattle Cancer Care Alliance for us, Steve?
Steve Huebner 5:28
Yes, Seattle Cancer Care Alliance is a consortium owned by three different entities in the Seattle area: University of Washington medicine, which is the medical side of the University of Washington, Seattle Children’s Hospital, and Fred Hutch Cancer Research Center. They started this consortium about 20 years ago, and I’ve had a unique history with them because all three of them were clients of mine when I was at Arthur Andersen, and when they formed the Seattle Cancer Care Alliance, it was a client of mine for the first 10 years. Until I had to rotate off in my role as a partner. So I’ve had a long history with Seattle Cancer Care Alliance, and they needed an interim CFO. And I thought that was a good place for me to make a contribution. I’ve been here since last April, most likely will continue in my current capacity through the better part of this year.
Gary Bisbee 6:19
What are the policies at Seattle Cancer Care Alliance relative to COVID-19?
Steve Huebner 6:25
Well, there are a number of policies and this is one of the things that we learn as we experience it. But one of the things I think we can all be thankful for in healthcare is that we all have very proactive “Incident Command” efforts in place. And this is when they get tested, and this is when you see how they really work. The first thing I noticed is, and this has been many weeks ago now, our Incident Command efforts kicked in and the executive team was on calls. We now have two calls a day, but they were certainly having calls every day back then and then have expanded that. But, coming out of that group and coming out of the incident command process; we have very active COVID testing and screening. For example, all entrances into our clinic building or being screened. Anyone that’s symptomatic is pulled aside for further evaluation, and certainly no visitors. Now, we’ve been doing this for some time. I know many hospitals are doing this now. But that’s obviously very important. And then immediately, we moved into work from home policies. We’ve had a number of individuals, a number of employees that have been working from home for close to a month now. And that’s the challenge of making sure that everyone has computers available. And all those things, Gary, that you touched on, how can you really effectively work from home? Once you get over that, then you see this is certainly something that could be done by many people on an ongoing basis. But around that, you have to make sure that you have protocols for meetings and make sure people can be productive in their new environment. So that becomes important as well. We have policies, we’ve had them in place for weeks, most of the management team is working from home. But we do have policies that no more than five people in a room and when they are social distancing is practiced, very stringently. If you have any more than one person in a room, things like that, and then certainly policies around virtual meetings, as I mentioned before, that’s really the norm not the exception anymore. And then what we found back to work policies, we have had employees that may have been exposed or may test positive. And if those that have been exposed, and maybe asymptomatic, when can they come back to work and under what circumstances? And is there ongoing testing if you have employees that are back to work? These are some of the things that certainly play out. We’ve looked at sick pay and PTO policies, again, how do we take care of our employees the best way possible, the very last area is financial policies that we may touch on more. But this is a time to be prudent and conservative and tighten the belt any way you can.
Gary Bisbee 9:05
Sure. Well, let’s move on to your responsibilities on boards. As we mentioned, you’re the board chair at SCL health and a board member at Intermountain Healthcare. When did you first join those two boards, Steve?
Steve Huebner 9:20
I actually joined both these boards in 2012. When I retired from KPMG, I knew that I was not done working. KPMG has a mandatory retirement policy at 60. And I knew I wanted to continue to work and had planned to continue to do consulting, in order to not have a conflict. I did not go on any boards in the northwest, but chose to go on a board in Utah and a board in Colorado. That way, I didn’t have conflicts. I could do the consulting that I do on a day to day basis. But joined both boards back in 2012.
Gary Bisbee 9:52
You work with health systems for many years. Why did you want to join the board of directors?
Steve Huebner 9:57
Being a healthcare guy, which I really am, and as many of us that have been exposed at the board level for years, and really enjoy governance and commitment to governance and really wanting to work with a team to make governance better, has really been my impetus to want to be involved in the board. Both the boards that I’m on and continue in that role to work more effectively to improve governance.
Gary Bisbee 10:19
During your time now, about eight years on the boards, what have you found to be the most rewarding, Steve? About being on the board?
Steve Huebner 10:27
I think the thing that’s most rewarding Gary is just working with a really good group of individuals. As you know, not for profit boards. If there’s any compensation at all. It’s very modest. You really have to be committed to the purpose, you have to be committed to governance and you have to be committed to that board. And if you don’t enjoy the people that you work with and don’t enjoy the process, it’s probably not a good place to be. I found I thoroughly enjoy the boards I’m on. I think it’s a committed group of people really focused on governance and wanting to be the best that we can be in fulfilling our responsibilities.
Gary Bisbee 11:03
So you’d work with boards through the years. And now you’re actually on the board looking at it from the inside. Is there anything different than you expected?
Steve Huebner 11:12
I’ve been around boards for many, many years. And I’ve worked with boards extensively. And I guess it would be like anything else you’d say there’s nothing like being there in the middle of all the action. So it’s probably a little different when you’re actually functioning day in and day out as a board member as a board chair. But I don’t think anything was too surprising, pretty much as expected, but probably more gratifying being on the inside and really being able to influence from a board level to make things happen.
Gary Bisbee 11:39
How would you view the primary responsibilities of a health system board member?
Steve Huebner 11:44
The primary responsibility is our fiduciary responsibilities, and then also to provide strategic oversight and to stay at a strategic level and to provide oversight and help management manage the key risks of the business. Along with that, just because it makes for a much higher functioning board is just to make sure that we have good communications, not only within the board but with management so that management can do its job.
Gary Bisbee 12:09
If you think about fiduciary responsibilities are certainly an aspect of finances, there’s an aspect of risk. When we have something like this COVID-19 outbreak, we have certainly a risk attached to that we have an effect on finances, how active is the board in thinking about those two responsibilities?
Steve Huebner 12:32
That is the key job of the board when you’re in a crisis situation like this. One is certainly to make sure we’re communicating with management. But as you know, this is a time when management is really focused on, in many ways, much more crucial things and taking care of our patients and looking out for employees. But still, the board does have a role and that is probably a time to step back and take pause and really understand if we’re really addressing the key risks that we should be. Because these risks aren’t ones we see every day and all of a sudden we’re facing new risks. That comes around to, as you mentioned around financial issues. This is a time that we need to make sure we’re looking at liquidity. There’s no question from any healthcare system I’ve seen, as well as my own experience in Seattle Cancer Care Alliance. Revenue is falling off quickly. If you stop elective surgeries, we’re going to experience a significant revenue shortfall. So these are all things that are the primary responsibility of management, but in the board’s role in managing risk and really looking at strategic efforts, these are very important things to communicate between the board and management around.
Gary Bisbee 13:41
That’s right. And I know because we’ve talked about this, the safety of the caregivers and employees, as well as patients, is certainly uppermost in your mind as a board member.
Steve Huebner 13:50
Yes, certainly. My experience has been on the board calls I’ve been on recently. It really is how is the management team holding up? How is this current crisis impacting us directly? We talked about some of the policies that we should have in place. Capacity issues. How do we increase capacity? And then just disaster recovery. I mean, this is the time we all have disaster recovery processes, but they’re being tested now. And how are they working? Do we have the backup and the kind of support systems we need?
Gary Bisbee 14:21
As a board chair, Steve, what other responsibilities than a board member non-chair board member? What other responsibilities do you feel as the board chair?
Steve Huebner 14:31
I would say generally, Gary, as the Board Chair, I think it’s the chairs job just to manage the board overall. And we all have the same fiduciary responsibility. That’s no different from the board chair’s role as well as the other board members. And we all have the same right to provide input and ask questions and do the things we do. But I think we do know that different board members have different styles and they all go about fulfilling those responsibilities. differently. So I think the key role of the board chair is to bring the board together and try and help each board member fulfill their individual responsibilities, but then collectively, to be able to develop a clear message and send that message to management. So the management isn’t getting mixed signals, and they’re not dealing with 15 different opinions, but they’re dealing with the collective thinking of the board as a whole. And then they can respond and you can have good dialogue around key strategic issues that are focused at the right level.
Gary Bisbee 15:32
How do you set your personal priorities as a board chair?
Steve Huebner 15:36
Much of that is done really in working closely with management and working with committee chairs. And following the overall strategic framework that we have in place. So much of the board’s activities, we should stay strategic, that’s the kind of thing we establish a strategy in my experience. That is their key focus and much of our meetings are spent around key strategic issues. So that often is the number one priority. But then as you know, other things will surface in other committee work, or in working with the CEO or other key executives, they will help you identify issues. And that pretty much drives priorities.
Gary Bisbee 16:15
So as we’ve talked about, we’re in the middle of both of a public health crisis as well as an economic one. And you were at KPMG when we went through the recession, on 08/09. Do you see any parallels there, Steve? Or are there any lessons learned from what we went through?
Steve Huebner 16:31
Well, the challenge and as you reflect back on that, Gary, the thing that does feel similar, is a few weeks into it a month into it, we’re in a crisis. And there are a lot of unknowns. I think back to 2009. There were really a lot of unknowns, and it was quite scary. But in 2009, that really was the financial crisis. banks were failing. Companies were going out of business, financial institutions were going out of business. And that really put a crimp on business as a whole in economics as a whole. But that was very much a financial crisis. This is different, we may not have the liquidity issues that we had back in 2009, because the banks are pretty healthy these days. But we may end up with solvency or bankruptcy issues as this drags on, I’d say, we have the advantage of having hindsight to look back to 2009 as we’re making our way through this current crisis, with all the unknowns. Currently, the one thing we do know we’ve been through things like this before, and we’ll make it through this. But there are a lot of unknowns and we have to be flexible. We have to be able to pivot and do the right things to respond to these kinds of issues as they come up. Now, clearly, this is a health issue, a clinical issue, a public health issue, and you can’t look at it independent of the economic issues, but the priority right now is taking care of our patients and taking care of frontline employees.
Gary Bisbee 16:54
Following that point up. What are the policies at SCL and Intermountain in terms of remote work, social distancing, and so on?
Steve Huebner 18:05
Well, very similar. As I mentioned, and I went into much more detail on the Seattle Cancer Care Alliance, because we’ve been doing that for some time. They are following the same things there a few weeks behind us, but they are following it every bit as much around screening and testing and work from home and remote meetings. I know the last board meeting that I had last week was a day and a half remote meeting. I have an executive committee meeting coming up tomorrow morning on another board and that will be remote for the foreseeable future. That will be the current mode of operation.
Gary Bisbee 18:40
We’ve covered this a bit. But let’s go back and ask the question explicitly, which is: during a crisis like this, what are the key responsibilities of the board in everything from, how they should act, how they should interact, what kind of influence they ought to have on the health system?
Steve Huebner 18:58
To start with the responsibilities of the board are really close coordination with the CEO and the executive team. And in some ways, it’s a matter of staying involved, but also a bit staying out of the way. I think in doing that, we still have a governance responsibility that is every bit as important or more important now than ever, so we have to be able to do our job, but also pay attention to, like I say other things that may actually be even a little more important than the height of the crisis here. But we’re looking at it, it is a matter it’s a board decision, I think to determine the frequency of board communications, meeting logistics, postponing meetings, and in fact, on one board, and I think there’s maybe something learned longer term from this, really restructuring the entire board meeting so that instead of a day and a half meeting, we cut it down to about four or five hours. But really focusing on what are the key issues that we need to do here? As you can imagine, that’s pretty important to give management the time back, they need to deal with these kinds of issues, but also to allow the board to address the issues that we should be dealing with at this point, but in a much more concise and vocally equally effective manner.
Gary Bisbee 20:16
Right. You brought up the length of board meetings. Have you found when you’re having virtual meetings, that you have shorter board meetings?
Steve Huebner 20:24
Well, my personal experience has been in the few that we have done yes, we have had shorter meetings. And I think we’ve been able to accomplish the essential business, but I think everyone’s conscious of time and everyone’s conscious of the protocol. But actually, I do think that might translate into a little bit shorter meetings and just as effective, probably cuts out some of the discussion that maybe we didn’t need to have anyway,
Gary Bisbee 20:49
As you go through your virtual meetings, any tips for the rest of us who were just entering the virtual meeting zone?
Steve Huebner 20:57
I think the first thing I’d say is normally when you get a diverse group of board members on, they tend to not be technological geniuses. So you will find you’re starting at a pretty basic level. But it’s amazing how quickly they learn and, and I’ve had other board members sharing with me, they’re now taking their newfound skills for virtual board meetings home and visiting with their children and grandchildren and others. So maybe there’s added benefit from here. But I think there are some very practical tips. If you can connect on video, it’s much more effective. And that connection allows you to access presentations and other kinds of things. It just makes it much better. So the board is all on the same page. You may have your board book and you have various documents and readings and everything. It’s very difficult for whoever’s facilitating the meeting to keep everyone on the same page. So if everyone’s dialed in on their computer, that certainly helps with that and then the key is shut off your video and shut off your mic. And you’ll probably have an even more effective meeting because you don’t get the cross talk. You don’t get the backup noise. And you find you don’t have to be looking at 15 pictures of other board members. Usually, the one person to stay on video as the board chair or the committee chair, whoever’s actually facilitating that meeting, along with management, because I found if management is actually in a room where they can control the presentation and other things, there are little tidbits like that, that I think actually for a pretty effective meeting and they go just fine.
Gary Bisbee 22:26
Well as the board chair, if you’re on the video a lot, you need to make sure you comb your hair that morning, I guess, right, Steve?
Steve Huebner 22:32
And you can’t be in your pajamas.
Gary Bisbee 22:34
Well said what kind of questions do you find the board members are asking about the coronavirus outbreak?
Steve Huebner 22:41
I think the question is you’re really touching on some that maybe I’ve done in other places, but they really are concerned about management. They are concerned about how we’re holding up? How are our employees doing? Are we really giving the quality care that we need to be giving to our patients because there’s no less need for quality in this current time of crisis? And they are concerned about testing and what our policies are. As you know, it’s been so limited that we can’t even test some frontline employees. So there’s a very high level of concern. And there’s a very high level of concern on the part of our employees because they don’t know who they’re being exposed to. And we just know how this disease spreads. So the board I think, is very concerned about the welfare of our employees and whether we’re doing the right thing. And then certainly, we’re all concerned about the impact on our business, if we can’t maintain our business in a healthy way. And some systems are certainly much more vulnerable than others. But if we can’t maintain our liquidity and to some extent our earnings, we may not have the system that we need to really look out for patients and employees. Anyways, although finances aren’t the first thing on our minds, we no longer think that it has to be considered other issues like supply chain capacity, and what is the impact on the broader economy. All discussion points that the board certainly I’ve had on the board meetings I’ve been on. And I think they will continue for some time. And that discussion will evolve over time, depending on how everything else evolves that we’re dealing with here.
Gary Bisbee 24:14
Well, as you well know, the saying in healthcare is “No margin, no mission.” Very important. This has been a terrific interview. I really appreciate your time, busy times for all of us. But just, in summary, any tips or final comments, Steve, that you have for fellow board members?
Steve Huebner 24:31
I’ll just try and summarize a few things. Gary. Most of us remember 2009. And it was a very scary time. And it went on for months. And we just couldn’t see the light at the end of the tunnel. And although the market came back in a relatively short period of time, maybe 18 months or so. The economy took a very, very long time to come back. And I think we see that we’re on the verge of this again. But right now we still have more unknowns than not and we don’t have all the answers. We don’t have all the facts. So we have to take it a step at a time, and I think the concern is whether this is measured in weeks or months, I think we’re beginning to believe in one form or another, it’s more months. And as things change, we’re just going to have to look at it probably in two-week increments. And we’ll make decisions from there. We keep talking about flattening the curve. For those of us in healthcare, flattening the curve means a whole lot more than to other people and other businesses, because if we’re overwhelmed as a health system, then we’ll be dealing with things and protracted consequences that we probably don’t want to face, in our business, doing what we’re asked to do. Staying at home, shelter in place, we have a responsibility to reinforce this in our communities. Just so that we can get through this. And then beyond that, I’ve touched on some things about focusing on liquidity. We found that back in 2009, we thought we had liquid assets, but some of those things weren’t as liquid as we thought, even the best of health systems. found that they were focused on liquidity, making sure that they had access to lines of credit, various other financing vehicles that would get them through this. And that’s a big deal. Now, like I say, some systems aren’t as strong as others. So it becomes even more important for them to track the business impact. I talked a little bit about just being prudent rather than tightening the belt. We want to protect our employees. I know we’re scrutinizing all hires, we obviously need to pay attention to our clinical people and frontline caregivers, but we’re really looking at all new hires, just to make sure that we’re not making commitments to new hires and can’t take care of our employees, as we see revenue falling off. And then it’s just, I think we as board members, staying aware, the quarterly board meetings that we normally have aren’t going to do it. So we’ll need at least monthly updates, and maybe weekly updates depending on what we’re dealing with. But I would come back to that balance. I don’t think we want to be over-informed so that we’re taking time away from management on things that they should be more focused on. And then I think this could very well turn into a global recession. We have to look at it as a global recession. And what would we do in terms of planning and longer-term efforts? If it does turn into that? I think the last thing I’d say, Gary, is if you think you’re making really tough, austere measures, if you’re making those decisions today, then you’re probably doing the right thing. And you’ll probably be glad that you did. And I think that’s kind of where we’re all at today. And tough decisions today. We may have to make tougher decisions tomorrow, and we’ll just have to be prepared to do that.
Gary Bisbee 27:36
That’s great advice and a good place to land. Steve, you’re a terrific representative of the health systems you’re involved with. We appreciate your time, and thanks again for being with us.
Steve Huebner 27:45
Well, my pleasure and thank you, Gary.
Gary Bisbee 27:48
This episode of fireside chat is produced by Strafire please subscribe to Fireside Chat on Apple podcasts or wherever you’re listening right now. Be sure to rate and review fireside chat so we can continue to explore key issues with innovative and dynamic healthcare leaders. In addition to subscribing and rating, we have found that podcasts are known through word of mouth. We appreciate your spreading the word to friends or those who might be interested Fireside Chat is brought to you from our nation’s capital in Washington DC, where we explore the intersection of healthcare, politics, financing, and delivery. For additional perspectives on health policy and leadership. Read my weekly blog Bisby’s brief. For questions and suggestions about fireside chat contact me through our website, fireside chat podcast dot com, or Gary at hm Academy dot com. Thanks for listening.
Transcribed by Otter
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