CLEVELAND — Cuyahoga County Council on Tuesday unanimously passed an amendment to its 2023 budget that places additional safeguards on taxpayer subsidies going to MetroHealth, the latest chapter in the ongoing fallout from former President and CEO Dr. Akram Boutros' shocking firing just over a month before his planned retirement.
Metro's board of trustees voted to terminate Boutros amid allegations he gave himself nearly $2 million in unauthorized bonuses, a charge he denies. The hospital system traditionally receives roughly $32 million a year from the county in 12 automatic monthly payments, but under the new parameters, only the first three will be automatic this year while Council must approve the final nine months on a quarterly basis.
"County Council has consistently supported dedicating a substantial amount of Health and Human Services levy dollars to support MetroHealth in providing critically needed care to indigent patients in Cuyahoga County," Council President Pernel Jones Jr. said in remarks before the final vote. "Given the recent allegations about misuse of funds at MetroHealth, however, this council has a duty to fulfill its oversight responsibility."
An investigation commissioned by MetroHealth and conducted by attorney John McCaffrey of Tucker Ellis LLP claims Boutros' bonus payments came from self-assessments based on metrics he himself designed. Furthermore, the report further states the board did not delegate its own authority to authorize compensation and that Boutros did not disclose his metrics to the board, nor did he acknowledge the payments themselves "at other points in time in which such a disclosure would be relevant."
"This evidence, at a minimum, establishes the Board’s right to terminate Boutros's employment for Cause, as defined in the employment agreement," McCaffrey wrote. "And at worse, this evidence suggests that Boutros may face potential criminal liability for Ohio ethics violations, theft in office, and other related statutes."
Though he did self-report his actions to the Ohio Ethics Commission, Boutros has countered by alleging his firing was a case of "pure retaliation," telling 3News' Monica Robins he had acted as a "whistleblower" against the board when he accused them of illegally discussing candidates for his potential replacement outside of public meetings. The ex-CEO added he believed the bonus payments fell in line with company policy, and has since filed a lawsuit against Metro's board accusing members of "wildly reckless, illegal, and damaging actions."
Dr. Airica Steed, Boutros' successor as president and CEO, officially took office Monday about a month earlier than planned. Jones said that Council's new amendment "will ensure MetroHealth receives continuous funding through the first quarter of 2023, giving the new CEO time to come in and assess the operations of the health system and report back to this council."
"I anticipate that the full annual distribution will be authorized by Council for the remainder of 2023," Jones added, "but we will only do so once we are satisfied that county tax dollars are being properly managed."
In Council's Committee of the Whole meeting hours before the final vote, MetroHealth representatives presented the hospital system's proposed 2023 operating budget. Metro lobbyist Dave Greenspan, a former county councilman and state representative from Westlake, admitted Boutros had intended to ask for roughly $8 million more next year than the current subsidy outlines, and that without the agreed upon $32 million the system could be operating at a $16 million deficit.
"It's important to the hospital itself," Greenspan said of the funding, "but more importantly, it's important to the patients that we see who those funds help to provide medical services for."
Despite stressing their commitment to keeping MetroHealth viable, councilmembers also told Greenspan they would be keeping the pressure on the system and seeking more information as to where the money is going, especially considering the $8 million more Boutros wanted has since "disappeared from the request."
"As you probably can surmise, we're going to be needing a lot of answers," Councilman Jack H. Schron Jr. (R-District 6) remarked, "because there's going to be a lot more questions that are going to come forth from this body."