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Lesson from Lee County 

Health initiative funding needs oversight.

MONEY FOR HEALTH: Sen. Tracy Steele (left), who'll sponsor the bill for clinics, watches as Gov. Beebe signs new tax law.
  • MONEY FOR HEALTH: Sen. Tracy Steele (left), who'll sponsor the bill for clinics, watches as Gov. Beebe signs new tax law.

Part of the $86 million that Gov. Mike Beebe wants spent on a number of health programs would go to the state's Community Health Centers, non-profit, federally funded clinics created during the so-called War on Poverty in the 1960s. The clinics will receive $5 million for capital improvements and $10 million for budget needs in the 2010 fiscal year.

About 120,000 Arkansans are seen yearly at the 12 centers, each a separate non-profit with a board of directors from the communities they serve, and their 47 satellites. Patients are seen whether they have insurance or not — and 43 percent don't — and are charged according to a sliding scale. Ninety-three percent earn below 200 percent of poverty level; 73 percent are below the poverty level. Uncompensated care in 2006 came to $16.5 million.

Clinics in Fountain Hill, Holly Grove and DeValls Bluff have had to close. That five more would have to shut down was one of the major arguments House Speaker Robbie Wills, D-Conway, made in fighting for passage of the tobacco tax that will fund the health initiative.

But how will the state determine if the $15 million appropriation is being well spent? How will money be given out? Who will provide oversight?

The question is brought into high relief by the Lee County Cooperative Clinic in Marianna, which serves Lee and a portion of St. Francis and Phillips Counties. The clinic — the state's first CHC, founded by a VISTA worker in the 1960s — was nearly shut down by the federal agency that funds the clinics last year. The problem: Big debt and big pay to its top five employees.

On its amended 2004 return filed with the Internal Revenue Service, the non-profit reported receiving $2.6 million in government grants but ended the year with a negative asset balance of $1,006,978. Meanwhile, its highest-paid employees enjoyed what would be considered generous salaries for a non-profit agency: $273,650 to the chief executive officer, Cleola Bursey; $149,944 to the human resources manager, Alice Morganfield; $119,068 to “maintenance supervisor,” Napoleon Gillespie. A lab coordinator was paid $114,578. The clinic's medical director was paid slightly more than the “maintenance supervisor” — $124,444.

By contrast, CABUN Rural Health Center, a community health center based in Hampton, reported on its 2008 IRS form that it paid its executive director $79,441, a sum in line with other centers.

The negative balance has been on the books for years, and reflects mortgage debt on a low-income housing project the clinic started in the 1980s.

In December 2007, the Health Resources Service Administration, the federal agency that awards grants to CHCs, disapproved the clinic's annual grant application for fiscal year 2008. A spokesman for HRSA told the Times that “for the 12 months that followed that decision, HRSA provided LCCC with sufficient grant funding to continue to provide services and to close out its grant program.”

The spokesman said the decision to quit funding the clinic “was based primarily on the assessment of the Objective Review Committee that reviewed LCCC's application. The committee noted many deficiencies, most of which had also been noted in previous years' applications. Further, LCCC failed to correct the deficiencies noted in the previous application reviews.” The spokesman did not specify what the deficiencies were.

In June 2008, Bursey and Morganfield retired. A new board of directors was seated.

Last December, the clinic won a competitive regional one-year grant from HRSA. The clinic must submit monthly financial statements to support the withdrawal of grant funds.

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