Elwell facing uncertain future

Leadership of the county corporation responsible for Wishard Memorial Hospital may be changing.

With less than six months left on his contract, Douglas Elwell, president and executive director of the Health and Hospital Corporation of Marion County, said he will be undergoing a review process

"It's the normal time to be looking at that," Elwell said.

But sources said Elwell has told several people, including some on his staff, that his contract will not be renewed when it ends in November.

"To some extent, I'm sure [my employees have] gotten that impression from me," Elwell said. "As we get closer to the end of my contract, speculation grows."

Elwell said he enjoys his job and wants to keep it, but also has been preparing in the event he doesn't.

"I have talked to key members of my staff to say, 'I want to make sure you know everything I know,"' he said.

That transfer of knowledge is necessary for "a continuity of leadership," he said, whether or not his contract is renewed. "I could get hit by a bus tomorrow."

As president and executive director, Elwell is responsible for a public corporation with an annual budget of $416 million. About $325 million of that is spent on Wishard, the county's public hospital responsible for making sure medical care is provided to those who can't afford it, with the remaining $91 million paying for Marion County Health Department operations.

The job also ranks as one of the highest paid in local government, at $229,320 annually.

The Health and Hospital Corp.'s critical relationship with the Indiana University School of Medicine may be a key in whether Elwell returns.

Health and Hospital contracts with the medical school to manage Wishard and provide hospital physicians. The Health Department, meanwhile, works with a variety of city agencies on housing, public health threats and other issues.

Health and Hospital Corp.'s relationship with the School of Medicine has had its ups and downs in recent years. Elwell and Indianapolis City-County Council President Beurt SerVaas contemplated the purchase of Winona Memorial Hospital in 1999, for instance, but IU officials balked. They were not interested in managing a second hospital for the Health and Hospital Corp.

SerVaas also has pondered whether Marion County should seek additional state funding so county taxpayers do not bear such a large share of the cost of training future physicians at the School of Medicine.

And Elwell has not always seen eye to eye with IU officials, according to one source.

"It's not the best relationship in the world," said the source, who spoke on the condition of anonymity. "Doug's responsible for some of that."

Matthew Gutwein, chairman of the Health and Hospital board, said Elwell's contract is a personnel matter that can't be discussed in public and that the subject is premature, anyway.

"His contract runs through the end of November," he said.

Mayor Bart Peterson has more than a passing interest in the corporation and who holds the executive director position. The Health Department works on an array of housing and other problems the mayor has made priorities.

The Mayor's Office appoints three of the seven members of the Health and Hospital board; the Indianapolis City-County Council appoints two and the Marion County Commissioners appoint two.

The Health and Hospital Corp. may have drawn some unwanted notice from the Mayor's Office recently after a longtime director of the Health Department's Bureau of Environmental Health was dismissed.

Alan Moberly's firing prompted several neighborhood groups to protest, and to share their concern with the mayor.

The bureau is responsible for housing code enforcement, boarding of abandoned buildings, illegal dumping enforcement and other neighborhood issues.

The city's code-enforcement initiatives and services the Health and Hospital Corp. provides to county residents are the main reasons the mayor is so interested in who runs the corporation, according to Chief Deputy Mayor Mike O'Connor.

But there is another reason: Health and Hospital Corp.'s affiliation with IU.

"There is a connection we believe is [important] for the life sciences initiative," he said.

O'Connor said he has been told the executive director's job will be discussed in executive session at the Health and Hospital board meetings later this month and next month. Elwell will be a part of those discussions, lie said.

It was also his understanding, he said, that "Doug hasn't sought reappointment."

Elwell had been a hospital administrator with Ancilla Systems Inc. when he signed a four-year contract as president and executive director of Health and Hospital Corp. in November 1998.

Since taking over the job, he has drawn praise for his ability to find additional sources of funding for programs at both Wishard and the Health Department.

Marion County spends about $50 million annually on indigent medical care at Wishard, and the demand for services there has strained the building's capacity. The Health and Hospital Corp. board is working on a long-term plan for the hospital and Elwell said he expects the discussion about his future to center on the leadership desired for that plan.

"I think we're going to go through with a very objective process," Elwell said, and the result may be a conclusion that "I don't have that skill set."

Stephen West, a Health and Hospital Corp. trustee appointed by the county commissioners, said he has not heard anything about Elwell's contract not being renewed.

"He'd be very hard to replace if he did not accept a continuation of his contract," he said.