SPRINGDALE — It took just one face-to-face meeting last week for the leaders of two Northwest Arkansas counties to go from an impasse on funding for an HIV clinic to the prospect of a regional partnership.
Elected officials from Washington and Benton counties said after Thursday night’s sit-down that a number of misconceptions surrounding the Washington County HIV Clinic had been shattered.
This included a previous sticking point of whether a 501(c)(3) nonprofit should be formed.
“Just hearing this discussion has cleared up so much confusion,” said Candy Clark, a Washington County justice of the peace.
Washington County officials have said they fear they are vulnerable to a lawsuit if they continue offering the county clinic’s services to a significant number of patients who live outside the county without fair compensation.
The Washington County Quorum Court’s Budget Committee invited the 13 members of the Benton County Quorum Court to Thursday’s meeting, and six justices of the peace from the north showed up.
“What I’d like y’all to start thinking about is a partnership,” said Steve Zega, chairman of the Washington County budget committee, adding that a so-called interlocal agreement to run the HIV clinic together was what his side had in mind.
“I’m asking you tonight to hear what we’re up against, and ask you to help us,” Zega said, adding that HIV/AIDS is a communicable disease that threatens the public health without respect for county borders.
The two sides agreed to formally ask the Benton County Quorum Court’s Finance Committee for about $17,000 that Washington County says it needs from its neighbor before June 30 to pay for a position at the clinic. Zega also will address the full Benton County legislative body in regard to the proposed regional agreement for the HIV clinic.
Benton County Justice of the Peace Shirley Sandlin said she would like to see others in the two counties included in the regional agreement as well.
“Has anyone approached the cities?” she asked. Others suggested that more hospitals should likewise be asked to fund the clinic, since this could conceivably reduce traffic to their emergency rooms.
CLINIC HISTORY
The Washington Countyowned HIV clinic started in 1992 at a time when the county had one of the highest HIV infection rates in the state, County Attorney George Butler has said.
The clinic, funded by a mix of public and private money, offers medication, treatment and counseling.
A few years after opening, the clinic began seeing patients from Benton and Madison counties. Over the years, Benton County’s cumulative share of patients served reached 38 percent.
Officials in both counties have said they didn’t know how it came to be that Washington County didn’t attach a residency requirement to clinic visits long ago.
In April 2002, the Arkansas Democrat-Gazette reported that Washington County extended the HIV clinic services to Benton and Madison counties in 1996 because the then-St. Mary’s Hospital in Rogers had provided some money.
But when St. Mary’s, now Mercy Medical Center, ceased its funding sometime around 2000, services to the two outside counties continued, according to the newspaper. The HIV clinic was reporting at that time it had lost funding support from other providers and that it needed $100,000 to avoid service reductions.
Officials then also suggested seeking support from other cities, more counties, hospitals and charitable groups, and then-Benton County Judge Gary Black suggested the clinic formally request money from his county’s Quorum Court.
“I think in Benton County that it is time we partner up with Washington County,” Black was quoted as saying at the time. “We’d be proud to do that.”
CURRENT FUNDING
In 2009, Benton County gave $34,000 toward the clinic, but only agreed to half that for the current fiscal year. Quorum Court members tabled the other $17,000 and made funding for the second half of the year conditional on the clinic or its supporting foundation attaining 501(c)(3) nonprofit status.
When its in-kind amounts are included, Washington County is projected to contribute at least $80,993 to the clinic. This includes donating 2,290 square feet of clinic space with an estimated market lease value of $36,640, paying the clinic’s utilities, waiving administration fees it typically charges to its county departments, and $38,806 in cash.
The clinic’s other major revenue source is $78,500 from the nonprofit Washington Regional Medical Center in Fayetteville, according to county records.
With $171,588 in projected cash revenue and $183,572 in expenses, the clinic needs the other $17,000 from Benton County by June 30 so it can make payroll, Washington County officials contend.
Washington County has projected roughly $86 million in revenue for its general fund for this year, with an estimated $68 million available to spend, Butler said.
Benton County has budgeted nearly $34 million in revenue for its general fund for the year, with nearly $28.1 million in expenditures, said its comptroller, Richard McComas.
FIRST IN THE STATE
Thursday night, the doctor who runs the HIV clinic told the two counties why it seeks more help.
“The important thing is to treat this disease so it can’t spread to others,” said Dr. Linda McGhee , a family practice physician and an associate professor in the University of Arkansas for Medical Sciences’ family and preventive medicine department.
The HIV clinic is heavy on case-management, she said, adding that patients are seen several times a year for evaluation “to make sure their bodies are not being damaged by the medication.” If so, different drugs are tried.
Clark credited McGhee with lowering AIDS mortality rates in the region.
“Dr. McGhee has been fighting a hell of a battle for many years,” Clark said.
FINALLY THEY MEET
Justices of the peace from both counties said they believed their joint meeting was a first.
The Quorum Court members said the HIV clinic issue had become so testy in the past because they hadn’t had such a meeting of elected officials - with their communication coming only through the news media, via e-mail, or by dispatching county employees to meet with officials from the other county.
Several expressed happiness and relief that the two sides didn’t appear to be as far apart on the issue as previously thought.
“From my perspective, it seems like there’s a lot of history ... that I’m trying to catch up with,” said Benton County Justice of the Peace Tom Allen, adding that it would have been helpful to have had all the information gleaned from Thursday’s sit-down much earlier.
Allen said he voted for the first $17,000 payment for the 2010 budget year, and is inclined to do so again, and added that Benton County wanted the 501(c)(3) status because it sounded like a good way to attract private funding to augment the government support. Officials said they couldn’t understand why it seemed to be taking so long to get the status change.
“We were frustrated because we thought: ‘Are they jerking our chain or what?’” Allen said, adding that the dialogue Thursday had proved helpful for him.
Butler had explained that turning the clinic itself into a 501(c)(3) was “not an option.”
Such a move would cause the clinic board to lose its tort immunity, requiring purchase of expensive liability insurance, Butler said. Also, it would make the clinic more dependent on private funds, and Washington County had determined the grant funding is not out there in the market to support that.
Butler said that Article 12, Section 5 of the Arkansas Constitution prevents a county from directly giving money to a 501(c)(3), though he said a county could contract with such a nonprofit to provide services.
That constitutional provision reads that, “No county, city, town or other municipal corporation, shall become a stockholder in any company, association, or corporation; or obtain or appropriate money for, or loan its credit to, any corporation, association, institution or individual.”
Butler also explained that rather than change the status of the clinic itself, Washington County officials incorporated a clinic-supporting foundation, Northwest Arkansas HIV Community Support Inc.
The foundation has applied for 501(c)(3) status for itself but has not heard from the Internal Revenue Service, he said.
Zega told those gathered that he’d like to see regional cooperation on the HIV issue which is “at the forefront,” but that he hopes the two counties will come together on other regional issues as well.
Arkansas, Pages 7 on 06/21/2010