Five members of the Southside/Dodson Avenue Health Centers (SSDA) board that was dissolved by Erlanger Health Center officials criticized Erlanger's action and backed Will McInnis, executive director, who was terminated along with three other administrators.
Erlanger officials said the health centers had suffered over $2 million in losses and needed re-structuring. They said patient care would not be compromised with the change.
A statement hitting the Erlanger action was issued by Carmen Ware, Cora Lanier, Felix Beasley, Maeola Shropshire and Robert Shaw.
It said, "In response to Erlanger’s press release regarding its self termination as a federally qualified health center (FQHC), there were numerous fallacies mentioned in the multiple newspaper articles released by Erlanger concerning the recent restructuring of and personnel changes at the Southside/Dodson Avenue Health Centers (SSDA). I would direct anyone who desires truth and facts to research the 19 Requirements for Federally Qualified Health Centers (FQHC) and the Health Resources and Services Administration (HRSA) Federal PIN 2014-01. You will find that it clearly identifies the Southside/Dodson Avenue Community Health Center’s Board as the Governing Board; not an advisory board as suggested by Erlanger CEO, Kevin Spiegel. The SS/DA Board was empowered to make decisions on behalf of the operations of the Southside/Dodson Avenue Community Health Centers as well as hire and fire the Executive Director of the Community Health Centers.
"The termination of Mr. William McInnis, the Executive Director of the Southside/Dodson Avenue Community Health Centers, under the direction of Kevin Spiegel breached the current Co-Applicant Agreement in place between Erlanger’s Board of Trustees and the Governing Board of Southside/Dodson Avenue Community Health Centers. The issue between the two Boards and the executive team of Centers was not one of poor management on the part of Mr. McInnis and his executive team, but rather Erlanger’s unwillingness to accept the independent authority of the governing board.
"Erlanger never acknowledged and willfully disregarded this federal mandate despite having received numerous citations outlining the noncompliance. It was Erlanger’s willful refusal to implement and/or abide by the necessary corrective actions, which led to the unfortunate split.
"See below excerpts where the HRSA Federal PIN requires FQHC health centers to establish an independent governing board and that no other entity aside from that board has the authority to select or dismiss the Executive Director.
"III. GOVERNANCE REQUIREMENTS Governance requirements for health centers have been set forth in statute, regulations and through various HRSA policies. This PIN clarifies HRSA’s policies in implementing the statutory and regulatory governance requirements of the Health Center Program. Per section 330(k) (3) (H) of the PHS Act (42 U.S.C. § 254b), as amended, all health centers must demonstrate the establishment of an independent governing board that assumes full authority and oversight responsibility for the health centers. The health center’s application must identify and document the members of this governing board that have or will assume full authority and oversight for the health center.
"VI. ADDITIONAL CONSIDERATIONS FOR HEALTH CENTER GOVERNANCE
"No other entity aside from the health center board may have the authority to select or dismiss the CEO/Executive Director. This prohibition includes cases where health centers combine the CEO position with that of any other key management staff.
"Prior to the organizational changes to the Centers enacted unilaterally by Erlanger, Mr. Spiegel did demand that the Governing Board of Southside/Dodson Avenue Community Health Centers terminate its Executive Director, Will McInnis. In response, the Board requested documentation establishing cause for termination as well as sufficient time to consider the information and the request. However, rather than providing the requested documentation and time, Erlanger chose to breach the Co-App Agreement then in place and step outside the guidelines of the HRSA Federal PIN 2014-01 and dictatorially terminate the Executive Director, the management team and the Governing Board. Up until the termination, the Executive Director and the Management Team acted as directed by the Governing Board of Directors, subject to the HRSA requirements, in the best interest of the Health Centers, which at times were unfortunately adverse to the interests of Erlanger. During Mr. McInnis’ tenure, he and his management team brought multiple solutions to the Governing Board of Directors to turn the financials around.
"However, many of those solutions were rejected by Erlanger, who at most times were operating in its own best interests, as one would expect, at cost and detriment to the Centers. Erlanger’s Board of Trustees has willfully elected to be out of compliance with the Federal Government (HRSA) and now face the potential of returning large sums of money back to the federal government because of Erlanger’s unwillingness to follow Federal Regulation. I see this as a tragedy and one that Erlanger attempts to assign blame to the now defunct Governing Board of Southside/Dodson Avenue Community Health Centers.
"The financial support from Erlanger is about 25 percent of the Health Centers' overall budget. However, it is estimated that the Health Centers save Erlanger millions of dollars in Emergency Room costs. Despite these savings, Erlanger only focuses on the dollars over budget within that 25 percent of support. When Mr. McInnis came to the Health Centers, there were already annual financial losses totaling over a million dollars, which had existed for many years.
"Mr. McInnis had two years to turn around the Health Centers financials, which, again, had been ongoing for many years. These losses were made worse by the most recent Erlanger vs. Cherokee fiasco, which caused the Health Centers hundreds of thousands of dollars. It is not surprising that Erlanger had problems with the new executive director. Erlanger has had difficulty working with nearly every Health Center executive director in the past several decades.
"If you check back over the history of the Health Center’s directors, you will find a common thread of attempts at unfettered control and domination by Erlanger. The timing of the unilateral actions by Erlanger in terminating the executive team and authority board could not have been worse, coming during the midst of National Health Center’s Week and only days after Mr. McInnis and his Executive team were encouraged and acknowledged along with other exemplary staff of the SS/DA Health Center. However, Erlanger chose this time to overshadow not only the importance of community health centers nationwide, which were celebrating 50 years of existence, but to publicly tarnish the 47 years of work by the Health Centers here in Chattanooga .
"We would like to show our appreciation and gratitude to Mr. McInnis and his executive team for staying true to their commitment to the Chattanooga community by assuring access to quality healthcare through its determination to adhere to the HRSA regulations and the vision of the SS/DA Health Centers Governing Board. Mr. McInnis and much of his Executive team traveled across the country to come to Chattanooga. They brought with them a clear understanding of HRSA regulations; an exemplary work ethic; and a heart for the patients in this City. Because the Health Centers were a Federally Qualified Health Center (FQHC), we were fortunate to have people on the executive team with FQHC experience as well as knowledge of HRSA and PIN requirements. Mr. McInnis put together an executive team willing to implement the vision of the governing board while struggling to meet the mandates of the federal HRSA and PIN requirements during a time when Erlanger and its Board of Trustees presented major obstacles to the implementation of these mandates.
"Mr. Albert Barnett III, a native of Chattanooga and the former Finance Director has more financial experience with Federally Qualified Health Centers than anyone on the Erlanger staff. Mr. Barnett has masterfully served with several previous Health Center Executive Directors, including Joanne Favors and C.C. Henderson.
"Mr. Aaron Maxey, former Compliance & Quality Manager, traveled from Pasco, Washington. When Mr. Maxey began his position with The Health Centers, the Centers were going through HRSA review. Mr. Maxey worked closely with HRSA to bring the Health Centers into compliance. Because of Mr. Maxey’s previous experience with the HRSA review process, the Health Centers were able to go through the procedure quite smoothly.
"Glenna Lawrimore, former Health Center Operations Manager, had managed three FQHC community healthcare clinics in Coolidge, AZ with 26 direct reports including front desk staff, referral clerks, medical assistants, and registered nurses. Ms. Lawrimore had been with the Health Centers only long enough to ensure that she was onboard with the overall vision of the SSDA Health Centers in providing access to quality healthcare to the communities we serve regardless of the ability to pay and had began to implement that vision.
"We are grateful to each of them for their dedication and perseverance and saddened at the cost each had to pay for endeavoring to do the right thing.”