05/27/15 — WATCH on list for cut

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WATCH on list for cut

By Steve Herring
Published in News on May 27, 2015 1:46 PM

Appropriation: $0.

Dr. Clark Gaither, WATCH medical director, said he was disappointed, but not surprised, on Tuesday when he received a letter from the county finance office that the agency would not receive any of the approximately $220,000 requested from Wayne County for fiscal year 2015-16.

The $220,000 represents about a third of the WATCH (Wayne Action Teams for Community Health) budget, and its loss could mean the closing of at least one of its clinics.

The final decision on how much, if any, WATCH receives rests with Wayne County commissioners, who have previously declined comment on how they might vote on the funding.

County Manager George Wood has declined to comment on any specifics of the proposed budget until after he presents it to commissioners Thursday morning.

The first public mention of the cut came Tuesday afternoon during the City Council's budget discussion meeting during a review of the city's agency funding.

Finance Director Kaye Scott said WATCH asked the city for $40,000, but "we're recommending allocating $20,000."

"I don't have any problem keeping them at $20,000, but I do know since I sit on the WATCH board the county's cutting $200,000 -- they're cutting $200,000," Councilman Bill Broadaway said. "I mean they're cutting at least $200,000 away from WATCH. I mean, that means probably one clinic will close. But, again Mr. Mayor (Al King), we can't cover everything. It's not our responsibility."

If approved by commissioners, the cut will significantly impact WATCH's ability to care for patients and provide services going forward, Dr. Gaither said.

"We will have to scramble and try to make up the difference from some other sources," he said. "We have no guarantee we will be able to do that. The hospital has been very supportive. It may make up the difference. We have no guarantee that is going to happen."

In an earlier interview, Commissioner Joe Daughtery, who has led efforts to reduce funding for nonprofit organizations, said as a former hospital board member that he knows the hospital has more resources by far than the county to be able to sustain WATCH.

The hospital benefits from WATCH because it keeps people from using the emergency department for primary health care, Daughtery said.

"It's not personal," he said. "It is not anything against the hospital. It is not anything against Obamacare or anything else. It is just simply coming down to funding. We want to take those dollars and fund it into education rather funding that benefits the hospital."

Dr. Gaither said he does not understand why the county does not want to participate in the health care of its citizens.

"His point is there is a contract between the hospital and county," he said. "It says that the hospital would provide all indigent care. The question then becomes what is indigent because over half of the patients seen on the mobile unit have jobs, some of them two and three jobs. Are those people indigent?"

Dr. Gaither was referring the 1985 document that transferred the hospital to a nonprofit corporation. The agreement stipulates that the hospital is responsible for all indigent care.

The county's argument is a matter of "semantics and contract" rather than what should be done and what is possible to be done, he said.

WATCH plans to have someone at next week's budget public hearing to plead its case.

Wood said he had not brought commissioners in on one on one to talk about the budget and had not gone into any detail with them.

"I have not given any pre-briefing or anything like that," he said. "That is what this meeting Thursday is for, to brief them."

 The Thursday meeting will start at 8 a.m. in the commissioners' meeting room on the fourth floor of the county courthouse annex.

Commissioners will hold a public hearing on the budget on the morning of June 2 and a budget workshop that afternoon.

Commissioners say the issue boils down to the 1985 agreement.

According to the transfer agreement, "... the Corporation agrees to continue to furnish care to indigent patients at the level prescribed from time to time by the United States Department of Health and Human Services for hospitals to comply with their obligations under the Hill-Burton Act."

It adds that once those obligations have been satisfied, the corporation "shall continue to provide an appropriate level of care for indigent patients as determined by the County Board of Commissioners."

Daughtery said, "WATCH does a great job and we support the mission and what they are accomplishing because they are doing good work. It is just the funding of that should not come from tax dollars. That is the problem we have."

Daughtery said he believes one thing that brought the issue to a head was inmate medical bills.

"They were large," he said. "I want to say that is when we restated, 'Wait a minute. If in fact the contract calls for indigent care coverage (by the hospital) if you are in the jail and don't have health insurance and don't have the means to pay for the services undoubtedly that is the definition of indigent.'"

Also, Daughtery said he  thinks the issue is "not that contentious," and that the county and hospital could continue to work together.

News-Argus reporter Ethan Smith contributed to this story.