If you are a leader in the healthcare industry, you are most definitely going to encounter ethical dilemmas. The question is, will you handle it like an amateur, or like a pro? Judy Young, executive director of the Rutgers Business School Institute for Ethical Leadership, wants to make sure that you and your team are well trained to handle ethical matters.
Young has organized the Rutgers Institute for Ethical Leadership’s Conference on Ethical Leadership on Thursday, April 30, from 9 a.m. to 4 p.m. at the Hyatt Regency in New Brunswick. $200. For more information, visit www.business.rutgers.edu. Speakers and panelists at the conference include Jennifer Velez, former commissioner of the state Department of Human Services, and current vice president of strategy and planning at Barnabas Health; Robert C. Garrett, CEO of Hackensack University Health Network, and Michael Ullmann, general counsel for Johnson & Johnson.
Young was raised in Point Pleasant. Her father worked for RCA in Harrison as an associate engineer and her mother spent her time raising Young and her five sisters, and ran a part-time babysitting business. She majored in communication at Montclair State University and got a master’s degree in corporate communication from Seton Hall. Over her 25-year career, she has worked in leadership development at various hospital systems, for management consulting firms, and for Johnson & Johnson.
“Ethics and respect are really a cornerstone to developing effective organizations,” she says. “This conference brings to the core a lot of things I did in my past, and it certainly brings together my core values. Ethics is something I’m very passionate about.”
Young had to deal with ethics early in her career when she was working for hospitals. “I was new to a position, and I was only there for about 30 days,” she says. “The organization that I worked for had a regulatory agency coming in to do a site visit. When you’re in training and development, you have to show regulatory agencies that you have done a certain amount of programs, safety programs, and a variety of different programs. Before the inspection, my boss walked into my office and she had an attendance sheet in her hand. She had all these signatures on it and said, ‘You need to sign this.’ I looked at it, and there were classes on it that I did not conduct, which she wanted me to sign saying I had conducted the classes.”
The inspection was important for the organization, and by not signing the document, Young was sure to displease her boss, who had the power to fire her on the spot. The hospital needed to have had a certain number of classes conducted to pass the inspection. “Physically, I felt heat up and down my body,” she says. In that moment, she thought back to what her parents had taught her about being honest. “I handed her my pen and paper back and said I didn’t feel comfortable doing that,” she says.
Young says it was the boss who lost her respect that day, not the other way around. “She had shown me exactly what kind of a leader she was, and a leader who does not act with integrity is not somebody I want to follow.” A day later, she was looking for another job. It took her two years to find one, but Young says she was happy to leave an organization where she could not respect the person she was working for.
Young says learning good ethics is an important part of any business leader’s education. Rutgers requires business students to take a course called Business Forum, and ethics training is a big part of the course. The institute Young works for also holds frequent forums on ethical leadership, and operates an “ask the ethicist” hotline for students and staff.
Young says the April 30 forum is a good opportunity to see a diverse group of speakers discuss the ethical problems facing the healthcare industry today. “It’s important for leaders and for all people in healthcare, whether it’s providers, manufacturers, or community members receiving healthcare, to discuss the issues, make sure they are ahead of the innovation curve so they can be competitive, and to make sure they can positively influence their healthcare system,” she says.
Young says the goal is to have participants walk away better ethicists than when they arrived.
“We really hope that after folks spend the day with us, they will have the opportunity to construct their own plan for ethical leadership in any of the work they do,” she says. “We want them to walk away with an action plan. We want to connect with professionals and students committed to ethical leadership and help them when it comes to critical thinking and critical decision making. It’s not a matter of if, but when, an unethical situation will come across someone’s desk.”
#b# Sidebar: A Fellow Conference Panelist#/b#
Ethical problems in healthcare aren’t always so obvious as whether or not to falsify records. More often, administrators are faced with the job of allocating scarce resources. A budget for any healthcare organization can be viewed as a moral document, in which leaders decide who gets treatment, where they get it, and at what quality.
Jennifer Velez faced many such tough decisions as commissioner of the state’s Department of Human Services from 2007 until her retirement earlier this year. She has gone on to become senior vice president of strategy and planning for Barnabas Health, a West Orange-based hospital network that boasts 4,600 doctors and 18,200 employees (About the same size as the DHS). Velez will appear at the forum on a panel of speakers.
Velez doesn’t see the issues she faced as ethical ones. “I think the largest issue we faced was de-institutionalization,” Velez says. “We closed a psychiatric hospital and two developmental centers. It’s really a cultural shift in moving our institution-based care to community-based care.”
Velez oversaw the closure of the Hagerdorn Psychiatric Hospital in Hunterdon County, and two institutions for developmentally disabled people: the North Jersey Developmental Center in Passaic County, and the Woodbridge Developmental Center in Middlesex County. There were 415 residents at the two developmental centers, and about 255 mostly geriatric psychiatric patients at Hagerdorn.
In most cases, the clients of the facilities were transferred to group homes where their routines were less controlled than before. “It was phenomenal. The institutional setting is very regimented out of necessity. But when they’re living in their own home or in a group home with other individuals, they can pick the color of the bedroom, sit outside in their own yard, or in neighborhoods with plenty of support from providers and agencies. It’s one of the most gratifying things I experienced in my role as commissioner.”
Many families of clients of the institutions did not see it that way. Velez faced consistent criticism over the closure of the Hagerdorn and the two developmental centers from activists, as well as relatives of developmentally disabled people and psychiatric patients. Critics noted that the waiting list for residential facilities was thousands of people long, and that Velez’s department had done little to clear the backlog. They also questioned the rationale for closing the centers, and whether group homes would truly be prepared to take care of people who had spent most of their lives in institutions.
Velez defended her decision, saying that maintaining the institutions on campuses that sprawled over hundreds of acres was prohibitively expensive. “If you could take that money and invest it in community-based resources, the quality of life for people improves dramatically,” she says.
But theory often differs from practice. “The devil is in the details and that’s where things get problematic,” Velez says.
Velez says she has saved letters from families who had started off as critics, but who had been won over by how the transfer had turned out. “Those letters don’t come in droves, to be honest,” she says. “But it can happen, and it does happen as long as investment follows closures, or if it occurs in advance.”
Throughout the closures, and the budget crises that ensued from the Great Recession of 2008-2009, Velez says she maintained a good relationship with the governors she worked under. She was appointed by Corzine, a Democrat, and finished her tenure under Christie, a Republican. She praised Christie for expanding Medicaid under the Affordable Care Act, a move which benefited the largely low-income clients served by the DHS.
Velez knows what it is like to provide those services, but also knows firsthand what it’s like to rely on them. She grew up in South Hackensack, where her mother, a secretary and her father, a blue-collar worker, lived in a trailer park, for a short time on welfare and food stamps. She majored in economics at Drew University, and earned a law degree at Rutgers, but never forgot how she grew up. She left a law career for the state government, partly out of a desire to help families in similar circumstances to her own.
“Many of the programs my department was responsible for were the same ones I benefited from growing up,” she says. “It was very meaningful for me to get there. I never imagined being commissioner, but the two are very tied together.”