A resolution to transfer $250,000 in funds that will not be used by the Hamilton County Health Department to fund an expansion at the privately owned Clinica Médicos appeared to have the support of nearly half of county commissioners Wednesday, but we would not recommend such end-of-year funds transfers as a practice.
Certainly, a county government funding a private business raises questions. On top of that, conspiracy theorists already have connected the dots alleging favoritism linking state Sen. Todd Gardenhire, R-Chattanooga, who has helped direct state funds to the clinic, to Wamp, who had the support of the senator in his county mayor race last year, to clinic founder and medical director Dr. Kelly Arnold, who was named to Wamp’s transition team when he won the office last year and has served as a medical advisor.
But we think, as long as such end-of-year transfers don’t become a habit, this onetime investment could pay dividends, especially with the underserved community.
Arnold told commissioners the money, if approved, would help the clinic’s estimated $5 million expansion. Much of that expansion, she said, would fund the build-out of mental health and pediatric — at least initially — dentistry services.
The clinic, she said, serves some 40,000 patients, most of whom are either uninsured or Medicaid patients. Serving them at the clinic, which is open on weekends, helps offload the burden on hospital emergency rooms. It also has become the go-to health center for many immigrants, legal and illegal.
Arnold called the clinic a “public-private partnership,” “a hybrid” and “the safety net to the safety net.” Although it is run as a private business, its nonprofit foundation arm, Médicos Mission Fund, would receive the county funds.
Wamp, who earlier in the year had tried to direct $250,000 to the clinic as part of $3 million in what he claimed would be unused wastewater treatment money, said with about 50 days left until the end of the fiscal year it was clear the health department would not be able to fully staff the positions it was budgeted for. Instead of letting the money go back into the general fund, he said, “these are dollars in public health we should spend.”
He said the transfer “is within the constitutional role of the county government” and assured commissioners “it is not … a recurring expense, nor do we intend it to be,” which is why the request wasn’t put in the upcoming fiscal 2024 budget. However, he said it was likely no Chattanooga nonprofit served more public school students than did Clinica Médicos.
The mayor said the city of Chattanooga is prepared to add some matching funds, though the matter has yet to be brought before the City Council. Commissioner Ken Smith, who also serves on the council, said the city would likely vote on whether to add “up to $200,000” from American Rescue Plan or contingency funds.
The state budget, which has yet to be signed by Gov. Bill Lee, also has $1 million in it for the clinic.
“The last thing,” Arnold told commissioners, would be for them “to view [the county contribution] for personal monetary gain.”
We see the wisdom for reappropriating unused public health funds for what, for all practical purposes, is public health. We see the importance of helping fund the health care of a population in order to keep emergency rooms from being ill-used. And we see the value in expanding a clinic familiar to the area’s rapidly growing Hispanic population and in an area where many of them live.
However, we hope two messages come out of the disposition of this resolution, which is to be voted on next week.
The first is that excess funds in any county department at the end of the year not become a free-for-all. We can imagine the private and nonprofit hands that would go out if other staff positions weren’t filled, if a finished project came in under budget or if a department decided it could do with the staff vehicles or current furniture it had instead of replacing them. Needs either should go in the budget or be considered as an emergency need by the commission (rather than as something nice to do).
The second is that we believe there ought to be closer coordination between the county health department and Clinica Médicos to assure there is no overlap. The health department says it already treats all citizens, is bilingual, and offers the dental and mental health services the clinic is expanding. Yes, one is fully public and one a hybrid, but since they are both largely seeing underserved populations, there must be ways in which the two could work together to serve more people more efficiently.
We suspect this resolution will pass, but we hope commissioners will look warily at such future requests.