HAMMOND— The five-member board overseeing North Oaks Health System begins its fiscal year on May 1 without one of its veteran members and, for the first time in memory, without a physician serving on the board.

The Board of Commissioners of Hospital Service District No. 1 of Tangipahoa Parish wants to add a physician to its ranks as an ex-officio member, but the Tangipahoa Parish Council, which holds appointing authority to the board, has decided to seek a state attorney general’s opinion on the propriety of that move.

Dr. James Nelson, who long served on the board, was denied reappointment by the Parish Council on Feb. 25.

At the council meeting, representatives for a standing-room-only crowd of North Oaks doctors, administrators and employees asked the council to reappoint Nelson to the board. Each speaker argued for the necessity of having a trained physician seated on the board and emphasized that Nelson had practiced medicine for more than 30 years in the community.

But the council voted 6-4 to appoint Hammond lawyer Ron Macaluso to succeed Nelson.

Afterward, the commissioners decided they would invite an ex-officio member to participate in the board’s deliberations.

That action prompted the council to decide at its April 22 meeting to seek an attorney general’s ruling on whether the commission could add a “sixth man.” The council also instructed the board that this person would be prohibited from casting votes at meetings until the attorney general issues an opinion.

North Oaks attorney John Derenbecker said the commission’s action in attempting to add a physician as an ex-officio member was not meant to be a gesture directed at the Parish Council in retaliation for its refusal to reappoint Nelson.

“It is important that a physician be on the board, and it is unheard of for a hospital service district commission to not have a doctor among its members,” Derenbecker said.

Ex-officio members of hospital boards serve at the pleasure of the five appointed commissioners and have a status that differs from that of appointed members, even though they retain a right to vote on issues, he said.

Although commissioners asked Nelson to serve on the board ex-officio, Nelson declined, Derenbecker said.

But the Parish Council itself admitted the necessity of having medical expertise on the commission while discussing the appointment on Feb. 25, Derenbecker said.

“Councilman (Nicky) Muscarello held up a copy of the hospital service district’s bylaws and said that the commission could get medical advice from its ex-officio member who is connected with the hospital,” Derenbecker recalled.

The council’s role in management of the hospital is primarily to create the service district and then appoint members to the board of commissioners, Derenbecker said.

The hospital was established by voters of the parish’s Ward 7 in 1960. Known at the time as Seventh Ward General Hospital, now North Oaks, the facility was then tendered to the board of commissioners, which has since overseen the hospital’s administration.

Under state law, once a hospital service district is established, it is recognized as a corporate entity and has the authority to establish its own bylaws, Derenbecker said. This is necessary, he said, because hospitals are a competitive business and must be allowed to act as a corporation.

Although the hospital would have to get council permission to seek funds through a bond issue, the council lacks authority to tell the hospital how to manage its day-to-day operations, Derenbecker said.

“Once the council appoints commissioners, governance of the hospital is entrusted to their appointees,” he said.

Derenbecker said he looks forward to a harmonious and mutually beneficial relationship with the council in the future.

“This is not a game of tit for tat. It’s not about retaliation or ill feelings. It’s about bringing the absolute best medical (care) we can to the clients we serve,” he said.

The commission is ready to move forward and will consider the attorney general’s opinion, which Derenbecker said is only advisory in nature, whenever those findings are forthcoming.

Macaluso, the lawyer appointed to serve in Nelson’s place, said in an email: “Since my appointment … the hospital’s management, employees, medical staff and others have, without reservation, welcomed, encouraged and facilitated my participation.

“The hospital’s leadership has expended considerable time and effort to begin my familiarization of the hospital’s operations.

“The professionalism, competence and friendliness has been exceptional,” Macaluso said. “I publicly extend my thanks and appreciation to each and every person I have had the opportunity to work with.”