What started as a presentation of a 20-point plan detailing how two Fayette County health groups can work together to spend $11.7 million to aid the sick turned into a brief but testy exchange Thursday over why things haven't worked out so far.
Cooperation, or lack thereof, between the Lexington-Fayette County Health Department Board of Health and the board of HealthFirst has been cited by health officials as a barrier to spending an $11.7 million federal grant aimed at expanding health care for the poor in Lexington. The dispute has lasted more than a year, and a September deadline to spend the grant looms.
One significant issue is that HealthFirst recently proposed staying at its current location, a building owned by the health department, and the health department denied that request.
HealthFirst, a primary-care clinic, serves about 17,000 patients a year, and that number is expected to increase because of changes in national health care. The health department oversees programs such as restaurant inspections, health education, disease prevention and immunizations.
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Lexington Health Commissioner Dr. Rice Leach presented a plan to the HealthFirst board Thursday to resolve the problem with the building and other financial issues. The plan included:
■ Allowing HealthFirst, which separated from the health department last summer to become its own non-profit, to continue operating a clinic at its current location, 650 Newtown Pike.
■ Offering to lease a health department-owned building at 2433 Regency Road to HealthFirst for a clinic on the south side of Lexington.
■ Asking for assurances that HealthFirst personnel would assist the health department as needed in case of a public disaster or health emergency.
Most of the HealthFirst board asked no questions following the presentation, but board member Tom Burich vented some frustration.
"We have been working diligently trying to find a location," he said. "Why has it taken the board of health so long to present us with a solution?"
Burich said that as a new organization, HealthFirst is hampered by a lack of credit, something the 100-plus-year-old health department could help with.
Leach then asked why HealthFirst can't seem to find a suitable real estate deal on its own.
"There's lots of empty space in this town, and a lot of money in this town (to borrow)," Leach said. "Why can't somebody else help you?"
In response to further questions from Burich, Leach, who formerly led the clinic operation, said that while the department has supported the clinic for more than 30 years, such support is not part of the department's mandated duties. "You are an option," he said.
HealthFirst board chairman Thomas Lester asked whether the board of health would hold an emergency meeting to approve Leach's proposal, which isn't binding until voted upon. Leach said he couldn't speak for the board. The next scheduled meeting is May 15.
HealthFirst board member James Sleet emphasized the need to remember the primary purpose of both groups, citing an African proverb. "When two elephants fight, only the grass gets hurt," he said.
HealthFirst, which has an annual budget of about $10 million, and the health department, which has an annual budget of about $17 million, are funded primarily through federal, state and local tax dollars, including $35 million since 2005 from a health tax collected by the Lexington Fayette County Urban Government.
The $11.7 million grant was awarded in 2010 as part of a federal stimulus bill.