One NEO tries to be REALNEO

Submitted by lmcshane on Sat, 07/18/2026 - 14:58.

 https://1neo.org/about-us/

1NEO’s founders are not power brokers with a political agenda. A couple of us have played parts in past discussion of collaboration, but, as a group, we are just retired citizens who love Northeast Ohio and want to make it better for future generations. We believe that getting our myriad communities to work together will make our region more efficient, equitable and prosperous. 

Our goal is not to campaign for a specific solution, but we do want to build a large, much more diverse following that grabs the attention of elected leaders across the region and moves them to pursue transformative change.

We are:

PHIL FOGARTY

Phil, a Geauga County resident, has worked in the lawn-service industry since 1984, first by purchasing a company, later establishing Scott’s Lawn Service, and, in 2000, starting Weed Man’s Cleveland-area franchise office. He has long served with organizations that aid the poor and homeless in Greater Cleveland and is current board president of the Village Collective, a nonprofit dedicated to creating affordable housing and providing coaching for young adults in Cleveland.

Quote: “I love bragging about Cleveland wherever I go, but the suburbs where I have worked and lived are full of redundancy, waste and other barriers.  We have lost major companies over the years and will continue to struggle until we learn the value of cooperation.  How do we compete for the world’s best talent when we are too busy competing with each other?

DON HARLEY

Don, a Willoughby Hills resident, graduated from Shaw High School in East Cleveland, received a degree in civil engineering from Purdue University and returned home to start a career in the construction industry.  He was a senior superintendent with the Higley Construction Co. and was involved in major projects throughout Northeast Ohio.  

ROBERT JAQUAY

Bob, who lives in Highland Heights, retired as associate director of The George Gund Foundation and is now a senior fellow at Cleveland State University’s Levin College of Public Affairs and Education. 1NEO will benefit from that experience, as well as his work as an urban planner, executive assistant to former Cleveland Mayor George Voinovich, municipal lawyer and prosecutor, congressional committee staffer and neighborhood activist. 

Quote: “Throughout my career, I have promoted local government and economic development collaboration. That is why I couldn’t resist getting involved with 1NEO.”

DENNIS KANE

Dennis, 1NEO’s convenor, worked more than 40 years in sales, sales management and general management, primarily in the foodservice industry. A lifelong resident of the Cleveland area, he has lived in the Hillcrest community for 43 years, volunteering during that time with his church and local youth sports.  

Quote: “I am a huge proponent of the Cleveland area. I hope we can persuade the community at large to look at the benefits of regionalization, so my children and my children’s children can reap the benefits the area has to offer.” 

BILL McCARTNEY

Bill graduated from St. Ignatius High School and received undergraduate and graduate engineering degrees from Cleveland State University.  He held engineering positions for several companies and started MIR Technology, producing equipment for crystal and semiconductor manufacturers around the world.  An Army veteran, he volunteers visiting patients, often those with military backgrounds, at the Hospice of the Western Reserve.

TOM OTT

Tom was a journalist in Northeast Ohio for more than four decades. He spent half of that career with The Plain Dealer and cleveland.com and covered discussion of regional collaboration during one of the dialogue’s periodic spikes. He grew up in Euclid and lives in Willowick, where he was a longtime youth sports coach and served on the civil service and charter review commissions.

Quote: “Greater Cleveland and Northeast Ohio boast a wealth of world-class assets, but the area does not receive the attention it is due. Our parochialism is a major stumbling block. By thinking and acting as one, the region can gain prominence.”

KAREN POELKING 

Karen is a lifelong resident of Cuyahoga County’s Hillcrest area and has served on the leadership team of One South Euclid, the city’s nonprofit community development corporation. She taught middle and high school in private and public systems, then spent 40 years in administrative positions at Notre Dame College in South Euclid, retiring as vice president for board and community relations.

Quote: “Local governments cannot continue business as usual while financial constraints mount, aging infrastructure breaks down, outdated technology leads to vulnerability and shortages of qualified staff persist. Regional collaboration provides the pathway for small communities to achieve resiliency and sustainability.”

 JAMES TOBIN

Jim, a graduate of Shaw High School and Cleveland State University, retired from Ohio Bell/AT&T after 47 years in positions ranging from cable splicer to area manager of network planning for fiber optic deployment in a three-state region. He served 30 years as a part-time paid firefighter and EMT in Willowick and has been a longtime member of the city’s Civil Service Commission.

Quote: “I have always been an advocate for honest, effective and efficient government, especially at the local level. I joined 1NEO to help effect change and efficiency in Northeast Ohio.

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MetroHealth needs HELP

 Can MetroHealth survive? I asked GROK

Yes.
Several U.S. public safety-net systems—often county- or city-owned or governed—have demonstrated relatively sustainable models through operational efficiency, care integration, diversified funding, quality focus, and leadership accountability, even while providing large volumes of uncompensated care.
Notable Examples
Denver Health (Colorado’s primary safety-net system, with deep public roots) is frequently cited as a high-performance model for sustainable public healthcare. A Commonwealth Fund case study highlighted it as a “learning laboratory” for other systems. Key features include:
System-wide integration of hospital, primary care, specialty, and public health services for continuity and cost-effectiveness.
Adoption of lean manufacturing principles (Toyota-inspired) via Rapid Improvement Events to cut waste in areas like access, patient flow, OR processes, and billing.
Major investment in IT (centralized data warehouse integrating clinical and financial data; shared electronic records).
Strong workforce development, culture of continuous quality improvement, and leadership accountability.
High performance on quality metrics (e.g., immunizations, process measures) despite serving a high proportion of uninsured/Medicaid patients and delivering hundreds of millions in uncompensated care annually.
It continues to operate as a comprehensive integrated system focused on efficiency and community needs.
Harris Health System (Harris County, Texas; includes Ben Taub and LBJ hospitals) serves as a large public safety-net provider for uninsured and Medicaid patients.
 
It has pursued strategic planning around quality (Magnet nursing designations, Leapfrog improvements),
value-based care adaptation,
population health,
ambulatory services, and
capital/fundraising efforts to support long-term viability.
Other longstanding public systems such as Parkland Health (Dallas County) and major systems like NYC Health + Hospitals or Cook County Health operate with similar safety-net mandates.
 
Sustainability efforts often involve
local tax support,
Medicaid/DSH payments,
operational reforms,
and (increasingly) environmental/operational efficiency measures.
Outcomes vary with local politics, payer mix, and state policy.
Common Elements of More Sustainable Models
Successful approaches typically combine:
Care integration and population health focus** — Coordinating primary, specialty, hospital, and preventive services reduces costly emergency/inpatient use and improves outcomes.
Operational efficiency** — Lean processes, staffing/process redesign, site-of-care shifts (more ambulatory/outpatient), and waste reduction (staffing, length of stay, admin functions). Broader hospital financial sustainability guidance emphasizes optimizing high-value operations and aligning sites with value-based payment.
Technology and data** — Robust EHR and analytics for real-time coordination, quality tracking, and financial management.
Diversified revenue and policy support** — County/city taxes or subsidies, Medicaid (including targeted rate or DSH adjustments), commercial payers where possible, grants, and partnerships. Some states explore alternative payment models (e.g., global budgets for rural hospitals) or transformation programs for safety-net facilities.
Leadership, culture, and accountability** — Continuous improvement culture, risk-taking with course correction, and metrics-driven management.
Adaptations for context** — Urban systems leverage scale and specialization; rural/county hospitals may expand high-demand services, partner with larger systems, or use critical-access designations and operational assessments.
Challenges and Realities
True long-term sustainability is difficult. These systems face thin margins, high uncompensated care, workforce pressures, and dependence on public funding that can fluctuate with budgets, Medicaid policy, and the uninsured rate. Many rely on ongoing local/state support rather than pure self-sufficiency. Environmental/green sustainability (energy efficiency, waste reduction) is a growing parallel focus that can also yield cost savings, but financial/operational viability is the core issue for “sustainable county hospital models.”
Rural and smaller county hospitals often face steeper challenges and may pursue affiliations, specialty service expansions, or state innovation models for stability.
In short, models exist and have been studied (Denver Health being a prominent documented case), but they require disciplined operations, supportive policy environments, and ongoing adaptation rather than a one-size-fits-all blueprint. Success is relative—delivering high-quality care to vulnerable populations while remaining financially viable enough to continue operating.
 
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 Cuyahoga County and City of Cleveland need to SAVE MetroHealth . https://localgovtracker.com/#how-it-works