Sarasota County Public Hospital Board, Central District, Seat 1: Vicki Lynn Nighswander

Age: 73

Current Occupation: Retired from career in public health

How long have you been a resident of Sarasota? Bought in 2003. Moved here full time since 2006

Why are you running for office? 

I feel there is a great need for at least one public health person to be a voice for community health needs and to provide input and support to our public hospital in these times and uncertain future.

My background and experience makes me a needed candidate: communicable disease and community health, needs assessments and programming keeping effectiveness and efficiencies using evidenced based and peer reviewed scientific studies, health promotion and disease prevention.

Have you ever run for public office before? If so, for what office? 

In 2014, I ran for Charter Review Board.In 2020, I ran for the SMH Hospital Board.

What experience and/or special skills do you have that make you a better candidate than you opponents? 

In the last couple of years of my public health career I was a health services supervisor overseeing many programs, including substance abuse, mental health, worksite wellness. 

Prior to that, I was the first supervisor and coordinator of the HIV/STD program and clinic in the initial days of HIV in Washtenaw County, Michigan, which included Ann Arbor. I wrote all the initial operations procedures. 

I chaired a regional planning group for 10 years and served on various state committees, securing various grants to serve the needs of the community. Those early days were full of community fears and deaths, not so unsimilar to the COVID pandemic.

Through my own initiative, I was able to get residents from the two competing hospitals to work at our clinic.

Besides my frontline knowledge of communicable disease management and partner notification most specifically of HIV and STDs, I have program planning and evaluation experience for addressing community health needs. I served on the Human Services Advisory Board for two years and on the Sewer and Water Advisory Council. I have spoken at numerous local public hearings regarding health and safety issues.

Early in my public health career I developed and ran a mosquito awareness and control program during an encephalitis outbreak in Ohio. I have written and obtained grants to meet community health needs and have been a grant administrator. I have social marketing training in public health from the University of South Florida and was the administrator of a large social marketing substance abuse prevention grant geared toward middle school students. 

Besides my MPH from the University of Michigan, with a major in health behavior and health education, my minor was in administration. I also have a Master’s of Arts from Miami of Ohio University in teaching secondary sciences, enabling me to work across many areas of public health. That experience would be an added benefit to the SMH Board. 

I also earned a B.S. is in biology from Heidelberg College in Tiffin, Ohio, where I was a member of the Biology Honorary. As you can see, I have a broad lens of community health to bring to the SMH Board. No one on the board, nor other candidates has such background or experience which fills a void particularly at this time.

What do you see as the top three or four priorities that the hospital board needs to address? And how should those priorities be addressed? 

We need to maintain and continuously improve our excellent public hospital.

The hospital must stay abreast and adjust to the latest evidenced-based peer reviewed research on hospital operations, technology and new initiatives on best practices in an effective, transparent and efficient manner. Procedures that are professional and support transparency respecting public input should be considered and established.

Remaining public will maintain SMH as extremely relevant to the health and safety of our community. Private hospitals put a higher priority on profit motive versus addressing community health needs — bad for us!

The hospital at present has a lot of tentacles in the community and lots of community partners in various initiatives. However, a meaningful local ongoing health assessment is not what it could and should be. 

It’s not to say that SMH should lead this, but it does mean that SMH has a role and is a partner as part of community preparedness, health promotion and disease prevention. 

Community health data and ongoing monitoring is not what it should be to best address community health needs. As an example,  the county publishes crash data every two years. I believe vehicle crashes are a public health hazard here that deserves attention. How many crash victims are treated at SMH and other local hospitals as an example of community health assessment?

Fiscal responsibility is of the essence. The pulse on best practices for both monitoring and anticipating future fiscal needs strategically must be professional and ongoing.

We need to keep our largest county employer attracting the best and brightest employees, doctors and nurses as well as retaining them. Staff should have voice in their job satisfaction while being committed to the overall mission and rules of the hospital and individual programs. Staffing concerns require ongoing attention.

On a scale of A to F, with A being excellent, what grade would you give the performance of the current SMH executive team? Why, and what if anything should change in the way SMH leadership operates the SMH system? 

Until recently, I would give the SMH executive team an A as evidenced by the numerous awards SMH has received and its ongoing high ranking on a number of pertinent evaluations. 

It may be time to review and update some procedures to deal with our changing times and needs.

After attending a number of public hearings and the need for transparency being brought up on multiple occasions, I believe this area deserves attention.

The hospital’s property-tax millage rate has been 1.042 mills. In 2023, that generated $81.9 million in property-tax revenue, accounting for 58% of the hospital system’s surplus over its expenses. What is your position on the hospital’s millage rate — should it remain 1.042 mills; should it be reduced or increased? Why? 

I would keep it the same at this point. There is no identified need to increase it, and SMH uses about half of the millage rate allowed by law. The pulse on indigent care needs to be ongoing along with monitoring the expansion needs while sources of income could be in flux, as well as federal and state funding.

A faction of Sarasota County citizens contends the hospital should be sold and privatized. What is your position on this and why? 

Our public hospital needs to remain public to meet the health needs of our growing and diverse community. Turning our public hospital into a profit motive facility would have deleterious effects on our highly rated community. There would definitely be a negative domino effect on the health of our community. 

Those programs that are needed but maybe not as lucrative to the hospital would be diminished or gone. The usual program attacked is reproductive health. Who would pick up the pieces in this community?

Regarding COVID-19 vaccines, the hospital board recently rejected a motion from Board Member Victor Rohe to add on the SMH website, among other points, the following: “to fully inform the public of the lack of pre-authorization safety data, the evidence of probable risks of these injections and of [Florida Surgeon General] Dr. Joseph Ladapo’s recent call to immediately halt the use of these COVID-19 mRNA injections. … Further, all staff and employees should be instructed, when they interact with patients or other members of the community who make inquiries about the COVID-19 vaccine, to refer those patients or community members to the information available on the SMH website concerning the risks and lack of safety data, rather than simply referring those individuals to local pharmacies that continue to dispense these potentially dangerous injections.” 

Instead the board unanimously voted to support the following: “That the Board will continue to respect and honor every patient’s right to make [his/her] own health care decision within the patient-physician relationship, and using all resources available to them to inform the discussions surrounding those decisions … [T]he Board will continue to endeavor not to invade the physician-patient relationship or mandate treatment regimens for patients to its physicians.”

Do you agree or disagree with the board’s decision, and why?

As I indicated at the public hearing, I give qualified agreement to the board’s response in support of the patient-physician relationship. Transparency in the present process for review of this proposal was missing in my mind. 

I feel this proposal is an example of why procedures should be updated with the changing times and needs. COVID opened up a can of worms, and there is little doubt there will be further such challenges in the future particularly since we live in a petri dish. 

I feel this proposal did not meet the criteria of a serious professional proposal that could impact on the hospital’s operation and reputation. I would suggest a procedure for such proposals to include: 

• A completed cover sheet including the author of the proposal and other identifying information 
• Depending on the substance of the proposal, a diverse qualified committee be formed to review the proposal, paying attention to resources used and validity. A review would be done by this group and scores provided. 
• This review and scores would then be given to the Quality Committee for further review and discussion and an addendum added to the report. 
• During public hearing, the proposal and report should be presented. 
• At a second public hearing, public comments would be welcomed. 
• The Board would meet to digest and consider the public comments. 
• At the next public hearing, the status of the report would be addressed and a vote taken.

These are suggestions to address the quality and transparency of such proposals along with respecting the public. 

In the case at hand, most left unsatisfied for one reason or another. Whoever heard of a major highly regarded organization changing a component of their modus operandi with a document with no author, not fully vetted references and recommending controversial community advice without a multi-step rigorous review? 

Yes, the patient/physician relationship is of utmost importance but also must be weighed with the best available information and attention to communicability.