Cincinnati Mayor John Cranley spars with health department over bid for federal grant

Letter cited in closing Neighborhood Health Care

CINCINNATI – Mayor John Cranley is mad at the city health department and could block it from applying for a federal grant that Neighborhood Health Care lost when the health department undermined its bid to renew it last year.

Last week, Cranley cited a "spiteful" letter about NHC from the health department to the federal agency considering NHC's application for the grant.

The hard feelings could boil over this week, with the health department and city council facing a Wednesday federal deadline to submit the bid. Council's Budget and Finance Committee takes up the matter Monday.

Last week, Cranley directed Interim City Manager Scott Stiles to research and answer 24 questions about the health department's request to apply to the federal Health Resources and Services Administration for the $1.4 million grant to replace NHC services. Most of Cranley's questions addressed the city's liability and possible impact on the city budget.

Neighborhood Health Care closed its seven health centers on Dec. 30 after losing the grant. The "service area competition" is open to federally qualified health centers (FQHC).

In a letter to city council, Cranley said he doesn't think the health department should expand services when the city faces a budget deficit and local non-profits like Talbert House and HealthPoint are willing and able to take over.

"Our number one concern in addressing the current health service area grant should be the 20,000 patients who lost access to health care (when NHC closed)," Cranley wrote to council. "We know that both Talbert House and HealthPoint have applied for the grant and are capable of providing service to these patients. Since a significant number of the patients live outside of the City of Cincinnati, it makes sense for a regional healthcare entity to provide this service."

NHC operated in Harrison and Norwood as well as Walnut Hills/Evanston and Downtown. It also had school-based health center programs at Rockdale Academy, South Avondale and Hughes Center.

"Despite increased revenue and the promise of further increases from the Affordable Care Act, the Health Centers are currently subsidized by roughly $9 million per year from the General Fund. This means the average General Fund subsidy of our six clinics is $1.5 million per year. The empirical data from our Health Department indicates adding 20,000 patients would incur several millions of dollars of additional liability to our General Fund," Cranley wrote.

"We face serious budget problems and the only reasonable conclusion is that acceptance of this grant will increase our deficit. It is time to get serious about the budget and prioritize our scarce resources on our own residents."

Cranley's spokesman Jay Kincaid, played down the impact of the "spiteful"  letter, but he acknowledged that "it didn't look good."

"You've got 20,000 people harmed by this (when NHC closed) and we don't want to see 20,000 people harmed," Kincaid said.

Neighborhood Health Care  lost the grant after the city health department protested NHC's plan to merge with HealthPoint, a Covington-based health provider.  Under the plan, HealthPoint's CEO, Chris Goddard, would have run Neighborhood Health Care. He had already been named interim CEO when the city health department intervened.

On Oct. 14, Joyce Tate, assistant city health commissioner, signed a letter with CEO's of Cincinnati FQHC's complaining to the Health Resources and Services Administration that federal money assigned to Cincinnati shouldn't go to an agency headquartered out of state.

On Nov. 10, Noble Maseru, city health commissioner, sent the draft of a similar protest letter to Bishop Bobby Hilton. The subject line of his email read:  "Draft Letter to Cincinnati Hamilton County Congressional Delegation RE Neighborhood Health Care."

In the e-mail, Maseru asked Hilton, senior pastor of Word of Deliverance Ministries for the World, to "make edits."

"Once you approve the draft," Maseru wrote, "we'll have a courrier (sic) bring the approved letter for your, Donna and Jim's signature."

On Nov. 27, a letter signed by Donna Jones Baker, president and CEO of the Urban League of Greater Cincinnati, and Jim Clingman, president of the Cincinnati NAACP chapter, was sent to Sen. Sherrod Brown, D-Ohio.

In the letter, they told Brown:

"We have concerns about:

➢ "Ohio's federal dollars going outside of Ohio to Kentucky;

➢ "The potential negative health consequences of an out of state based entity with no significant experience delivering health services to an urban population having been offered this primary care responsibility."

On Dec. 17, Health Resources and Services notified Neighborhood Health Care it lost the grant, according to Sher McClanahan, NHC board chair. No reason was given.

McClanahan included those letters in a 30-page report to the Budget and Finance Committee for Monday's hearing. She said she submitted the report after Charlie Winburn, the committee chairman, asked her to participate regarding the grant.

McClanahan told WCPO

she hopes HealthPoint wins the grant competition.

She vouched for Goddard, saying he spent $200,000 helping Neighborhood Health Care work through financial difficulties - developing a viable budget for 2014 and a five-year financial recovery plan to service all debt.

"When approached by (Winburn) … our question was how will this (participating in Monday's hearing) benefit our patients we no longer serve?" McClanahan said in an email.

"The answer is we have experience with HealthPoint.  We know their leadership is committed to our patients.  HealthPoint was side by side with NHC as we developed an achievable financial recovery that would have maintained services."

"HealthPoint has the skill and expertise to be successful in care delivery," she wrote.

"We can ask the leadership of the City of Cincinnati to support the HealthPoint application."

The city health department plans to use the grant to expand services at its Burnet Avenue site, at no additional cost to the city, according to Rocky Merz, department spokesman.

The Burnet site already handles STD patients and would add primary care, Merz said. The city health department would contract with another provider for Harrison.

The city health department clinics serve 33,000 patients per year, Merz said. He said the city has been serving about 330 former Neighborhood Health Care patients since NHC closed.

Cranley could kill the city health department's bid for the grant by blocking a council vote before the Wednesday deadline.

The Budget and Finance Committee could kill it by not recommending a vote.

Council members Chris Smitherman, Chris Seelbach and Wendell Young appeared to surprise Cranley when they introduced the motion at the end of last Wednesday's meeting, after a long discussion and vote about parking meters.

They wanted council to vote on the spot, but Cranley nixed that.

"This is a gigantic, long-term decision we're told we're being rushed into because of a grant," the mayor said at the meeting.

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