Health Gap CEO kept minority health office from ever opening, former health commissioners say

CINCINNATI -- Center for Closing the Health Gap President Dwight Tillery often criticizes the city for not providing better health services to minorities, who face lower life expectancy than white residents.

But some former health commissioners say Tillery is actually to blame for the city missing out on more than a half million dollars in state funding to solve those health disparities.

Tillery successfully lobbied Cincinnati City Council in 2008 to quash a plan for a state-funded minority health office in the city, according to three former Cincinnati Health Board members.

That years-old dispute paved the way for the Health Gap to take the lead on minority health issues over the last decade and collect $3.8 million in city funds since 2007.

And now, nearly a decade later, the Health Gap is in the spotlight again because of a city investigation into how the nonprofit spends taxpayer dollars to address those issues.

The city launched its probe into the nonprofit last month after a WCPO investigation found the Health Gap was spending most of its city funding on salaries, consulting fees and subcontractors. WCPO found out the Health Gap is also not operating as many healthy corner stores as mandated in its city contract.

Meanwhile, every major city in Ohio benefits from thousands of dollars in state funds yearly to operate a minority health office -- except Cincinnati. 

“I think it’s a travesty,” said Jerry Bedford, who served on the Cincinnati Health Board in 2008 when the health department tried – and failed – to establish the office. “It’s a travesty that one person can have so much of an influence on people to keep things from happening for the betterment of the community.”

The 2008 controversy left Cincinnati without a minority health office, led council to strip the health department of a $250,000 state grant to launch the office, and caused the city to miss out on state funding every year since then – which adds up to at least $560,000 in state funding to date.

Tillery, who responded to WCPO's request for comment with an emailed statement, said that council made the right call back in 2008. The minority health office, he said, would have duplicated the Health Gap’s services and jeopardized its support in the community.

“The Health Gap had fully developed programs and services ingrained in neighborhoods throughout the city,” Tillery’s statement read. “The decision in 2008 was the right one and the nearly decade since has proven that out. Our work has helped tens of thousands of people in the city and our partnership with Cincinnati’s health care community has never been stronger.”

Statement From Dwight Tillery by WCPO Web Team on Scribd

Last year, the city granted the Health Gap a $1 million grant. Tillery has requested council give $750,000 to his nonprofit’s cause next year.

Room for everybody?

Former Health Board Chairman Stephen Wilson was “shocked” in 2008 when a seemingly routine vote to accept a state grant turned into a controversy. 

“Nobody thinks that when the state’s giving you free money that people would turn it down,” said Wilson, a medical practitioner in Forest Park.

But that’s what happened.

In 2008, the Ohio Commission on Minority Health offered money to create new minority health offices within urban health departments. The commission invited seven major cities, including Cincinnati, to apply for a $250,000 start-up grant.

Wilson said Cincinnati’s health department had strong resources – medical staff, health clinics and decades of citywide research – to make headway on minority health disparities had the new office been launched. Plus, only city health departments were eligible for the grant.

“I thought this office was going to provide an opportunity to give some funding to the neighborhood councils, to actually look at data on life expectancy in various neighborhoods and then come up with strategies on how to close those gaps,” Wilson told WCPO in an interview last month. 

The Health Gap, however, was already working to improve minority health here. A lawsuit between the city, a group of hospitals, and the University of Cincinnati created the Health Gap as a safety net to help the poor and uninsured in 2004.

As health department leaders tried to launch a minority health office with state funds in 2008, they vowed to include the Health Gap in their work.

“There is room for everybody,” an assistant health commissioner told the board in a March 2008 meeting.

Wilson believes the Health Gap could have partnered with – and benefited – from the new office.

Both organizations were interested in tackling infant mortality and life expectancy issues in Cincinnati’s most diverse communities, such as Avondale.

In Columbus, the minority health office works with dozens of local nonprofits and community groups to educate minorities – from the gay community to Latinos – about pervasive health issues. The office is under the watch of the Columbus Health Department.

“We can’t do this work by ourselves,” said Ryan Johnson, the director of the Office of Minority Health in Columbus, which gets $52,500 annually from the state. “We need to have key stakeholders and community advocates at the table … the health department gives us that credibility in the community.” 

But Wilson said Tillery wasn’t interested in working jointly with the health department on this.

“There was a clear sense that this was about the dollars. Mr. Tillery thought this was going to be competition, particularly for resources, and I don’t think he wanted this office of minority health to have the resources,” Wilson said.  

Ultimately, City Council backed Tillery.

In 2008, council ordered the Health Department to cancel the $250,000 grant and indefinitely postponed opening the state-funded office.

While Toledo, Akron, Dayton, Columbus, Cleveland and Youngstown opened minority health offices – and continue to operate them as part of their health departments today – Cincinnati did not.

Some City Council members were concerned that the office would duplicate the Health Gap’s services. Others worried about a $100,000 required match to open the office, but the health department had the money on hand and wasn’t requesting additional city money for the program, Wilson said. 

Mayor John Cranley was one of the 2008 council members who had those concerns and voted to strip the health department of the grant. 

"I believed spending tax dollars to establish a second office with duplicative services would not have be an efficient use of limited tax dollars," Cranley said of his vote at the time, in an email to WCPO Monday.

Tillery, who went on to co-chair Cranley's 2013 mayoral campaign, also acknowledged that the minority health office would have been competition for the Health Gap.

“Some of the local hospitals who were not part of the lawsuit settlement but supported the Health Gap indicated that they may pull out should the local office be approved – jeopardizing the significant positive momentum of the Health Gap built over four years of operation,” Tillery wrote in a statement to WCPO last week. 

The city cannot recoup the money it gave up nine years ago or open a state-funded office now.

“The commission is no longer accepting applications for (a) new local office on minority health grants from local health departments,” Ohio Commission on Minority Health Executive Director Angela Cornelius Dawson wrote in an email to WCPO last month.

Letter Commision on Minority Health by WCPO Web Team on Scribd

‘This is politics’

Wael Safi, a Cincinnati drug expert and former health board member, said he agreed to a lunch meeting with Tillery in 2008 – just a day before the board had planned to vote on accepting the state grant for the minority health office.

“He said, ‘Here’s what I need from you: I need you to strongly consider not establishing this minority office in the health department,’” Safi told WCPO in an interview last month.

Safi said Tillery told him that if the health department established the office “people who are supporting me today will question why they’re giving me money." 

Wilson, too, recalls getting a phone call from Tillery, who asked him why he had voted to accept the minority health grant.

As the chairman at the time, however, Wilson said he faced added pressure over his vote.

While the minority health grant was up for vote, Health Gap supporters called for Wilson to step down in letters sent to the city manager and commentaries published in a local newspaper, he recalled. At issue was that Wilson, who worked and treated patients in Cincinnati, didn’t live in the city.

“There was a letter that was circulated by a number of ministers who support the Center for Closing the Health Gap, who said I should be dismissed by the board because I didn’t live in the city,” Wilson said, adding that he paid income taxes to Cincinnati at the time.

Despite the pressure, the health board voted to accept the grant.

But City Council, which must approve all grants, had the final say. In March 2008 council postponed the office's opening indefinitely and months later forced the health department to return $69,000 it had already received from the state.

How council voted on minority health office in 2008 by WCPO Web Team on Scribd

Nine years later, Safi, Wilson and Bedford all said they still worry the city’s minority residents were deprived of an opportunity that might have narrowed the health gap here.

“After understanding the (heath) gap we have in Cincinnati, I felt extremely disappointed that certain council members voted against accepting more resources toward such an obvious problem,” Safi said.

He continued: “That’s when I realized, ‘Wow, this is politics."

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