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The chairman of Erie County Medical Center hopes to negotiate changes in a local law that would increase the authority of the hospital's board of managers.

A draft of the proposed changes was discussed Tuesday during a meeting of the hospital's board of managers.

In general, the proposed changes to a law approved by voters in 1988 would increase the power and size of the board and its control over budgetary and personnel matters. The law resulted after Vitalnet, the private management company hired by the county in 1986 to manage the public hospital, left at the end of its two-year contract.

Vitalnet's decision to leave prompted calls for an independent board with powers -- balanced by measures to maintain public accountability -- similar to those granted the private consultant.

Board members did not support provisions to add key administrators to the board as non-voting members. And a plan to add four voting board members recommended by the board was tabled.

Also tabled was a provision that would have continued the practice of the hospital's notifying the county executive and Legislature of any reduction or elimination of services requiring state Health Department approval but no longer requiring the hospital to "consult" with them over such changes.

Board members said they had problems with the word "consult."

"We don't wish not to consult. . . . We want to discuss that phrase; it's muddy and it needs to be defined properly," said Joseph E. Ryan, chairman of the board of managers.

Such a change would require a referendum because it cuts the power of the county executive and Legislature, board members said.

"I'm not inflexible. None of this is rigid and inflexible, it's all open to recommend new members.

"The source of nominations should be people who know the most about the needs of the community and the needs of this hospital," board member Richard Hauck said.

Ryan said the additional members are needed to make the board more representative and spread out the workload. Nevertheless, seven members of the 13-member board failed to approve the change, instead favoring negotiating the issue.

The board, however, supported placing a non-voting elected member of the medical-dental staff on the board. And it rejected language that would have given the chief executive officer, the medical director and the president of the medical-dental staff the same status on the board.

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