Valley Medical Center commissioners spent eight hours Monday and Tuesday nights initially reviewing a landmark alliance between the medical center and UW Medicine.

Their lead negotiator, attorney George Beal, will return to the negotiating table next week with their suggestions for changes, some routine and some that UW Medicine may reject.

Then, later this month, a final agreement will come before the commissioners for approval. However, it could take three to five years before the new and enhanced medical services are available to patients at Valley Medical because of the time needed to integrate business and medical services covered by the agreement.

Trustees with UW Medicine and the University of Washington also must approve the alliance.

Typically, an elected board will review a contract in an executive session, so that its bargaining positions are not known to the opposing side. However, the medical center opted for the unusual open sessions so that the public could see for itself the draft agreement.

“It goes beyond what is normally done,” said Beal.

Beal told the commissioners that a final agreement remains “very close.” He and the rest of the negotiating team will meet with UW Medicine for a three-hour session Wednesday.

Commissioner meetings are recorded and available online within days for viewing at Valley’s web site, valleymed.org.

Four of the five commissioners were at the board meeting Tuesday; commissioner Aaron Heide, a neurologist and stroke specialist, had already told the commission his medical duties would prevent him from attending the meeting Tuesday or the ones Wednesday and Thursday that were canceled later.

However, during a comment period, Dr. Bob Thompson, a primary care doctor and a medical center vice president, said Heide “must have known” there would be meetings he would have to attend.

Thompson said he meets such obligations by having a  fellow doctor cover his patients.

Monday night before the review began, Dr. Wayne M. Lau, chair of the Medical Executive Committee, read a letter from the committee, made up of the hospital’s medical staff, declaring “full, enthusiastic support for the strategic alliance.”

The letter also expressed disappointment that much of the “negative commentary” about the alliance has come from Commissioner Anthony Hemstad and Heide.

“We find that many of the statements from Comm. Hemstead (sic) and Heide carry little merit, and appear to be misleading, distracting, and disingenuous.”

In another preliminary matter, the board referred to the hospital district’s legal counsel a recall petition filed by Chris Clifford of Renton against commissioner Carolyn Parnell.

In his petition, Clifford claims Parnell “committed an act of malfeasance” by providing Valley CEO Rich Roodman a gift of public money by approving a retirement lump sum of $1.7 million for Roodman in 2009.

The board also voted to excuse Heide’s absence from the April 18 after learning his child was at the emergency room.

The strategic alliance agreement, technically between the University of Washington and Public Hospital District No. 1, has 13 articles that spell out how the alliance would work.

It clearly delineates the responsibilities of a new 13-member board of trustees that will oversee the medical operations of the medical center.

Among the 13 members are the five elected hospital district commissioners and five appointed by UW Medicine. Commissioners pressed to have four or five of those appointed trustees  come from the hospital district itself. The draft calls for all five to come from the larger service area.

Commissioners favored a stronger presence of district residents because as Hemstad said, “they would have skin in the game.”