Shift of Hamilton County health funds to support private provider up for a vote

Hamilton County commissioners will vote Wednesday on Mayor Weston Wamp’s plan to shift $250,000 budgeted for the county Health Department to help fund a private medical provider’s new dental clinic for underserved Latino children.

When the idea came up at last week’s meeting, some commissioners questioned the shift of public funds to support a private medical practice.

“Just because the county hasn’t done this frequently before in no way means it’s not the right way to do business,” Wamp said in a phone interview Tuesday. “In fact, I would argue that a lot of the county’s budgeting practices have been on autopilot for some time.”

Wamp noted that he and the current set of commissioners were not yet in office when the 2023 fiscal year budget was approved and implemented.

Because the Health Department has not been able to fill numerous budgeted positions, he said there are county funds sitting unused that could support a one-time allocation toward Clínica Médicos’ plans to begin offering pediatric dental care by 2024.

Clínica Médicos is Chattnooga’s only comprehensive bilingual primary care clinic that specializes in treating the region’s underserved Latino population.

Most Clínica Médicos patients are young families who live below the federal poverty level, according to Dr. Kelly Arnold, the clinic’s founder and medical director who was named the 2020 Family Physician of the Year by the Tennessee Academy of Family Physicians.

Roughly 50% of the clinic’s patients are uninsured and about 30-35% are on Medicaid, the state and federally-funded program that covers primarily low-income children, pregnant women, new mothers and their families, Arnold said in a Monday interview.

While it’s too soon to say for sure, she anticipates the dental clinic’s patient mix will mirror the medical clinic’s, with 85% living below or at the federal poverty level.

Private practice

Wamp said his proposal would reallocate a “small percentage” of the Health Department’s unused funds to “support a nonprofit entity that is doing important health care work in underserved communities.”

Clínica Médicos is a private medical practice. The county money would go to the Médicos Mission Fund, a nonprofit organization that according to its website formed in 2021 to fund Clínica Médicos’ new dental and behavioral health facility across from the Montague Park Sculpture Fields on East 23rd Street — a quarter-mile from the main Clínica Médicos medical practice.

A matching grant of Chattanooga city funds is also under consideration.

Arnold said in an emailed statement that the mission fund also supports health care for the uninsured and education of physicians dedicated to caring for underserved communities.

“The Médicos Mission Fund is only a year and a half old, and the support has been overwhelming. In that short amount of time, MMF is building staff and growing towards supporting social services and behavioral and mental health,” the statement reads. “Currently, the foundation is able to afford to pay rent to service the mortgage and maintenance. A future goal would be to negotiate the purchase of the building (but right now the real owner is the bank because most of the mortgage payments go to principal).”

Current funding requests are focused on ensuring the future dental practice, Clínica Sonrisas, because that clinic has more significant capital needs to move forward, Arnold said.

In addition to private contributions, Médicos Mission Fund is slated to receive roughly $1.36 million in state funds for the project, which is estimated to cost about $5 million.

Wamp said in Tuesday’s interview that Wednesday’s resolution will make it clear that taxpayer funds go toward providing health care services, not capital investment.

“If we don’t provide basic clinical services and dental health services in our most underserved communities, those problems will only grow over time, and they’ll wind up in our emergency rooms,” Wamp said. “They’ll tax our ambulance system and have cascading effects across education in our community.”

County services

Though the county Health Department already provides dental services for both children and adults, Arnold said the new clinic will help catch patients who are falling through the cracks.

“We have a 4-year-old with Medicaid who has pediatric dental coverage and comes to our office with a jaw abscess because the mother couldn’t get in — in a timely way — to have the cavity filled, and then we have to send them to the emergency room,” Arnold said. “Why is that happening? There’s a disconnect.”

A grant application for the funds submitted to Hamilton County after last week’s commission meeting states, “While we appreciate the efforts of the Hamilton County Health Department in meeting the needs of the underserved, as of Friday, May 3, only two of the three Health Department (facilities) have dentists to see patients. Appointments are over a month out, and only one appointment per day per two locations is available for acute dental care or dental emergencies.”

However, Dr. Andy Thomas, the Health Department’s dental program manager, said via email Tuesday that on May 3 three of the five Health Department locations had dentists available to see patients.

“Currently, the Third Street, Homeless and Ooltewah clinics have a dentist on site,” Thomas said. “The Sequoyah Health Center’s dentist position is vacant at this time. All Health Department dental clinic locations accept walk-in patients for both routine and emergent care.”

According to Thomas, all Health Department dental clinics, other than the Homeless Health Care Clinic, offer preventative, restorative and emergency care to patients ages 4-20. Dental care is also available to adults but limited to emergency care, he said.

The homeless clinic offers the same dental care to anyone 18 and up and is working toward offering dental services to patients ages 4 and up in the future, he said.

The Third Street clinic treats more than 40 patients per week, while the Ooltewah Health Center’s dental clinic treats 15 patients per week, and all of the Health Department’s dental clinics provide treatment to anyone, regardless of their ability to pay, Thomas said.

“The Ooltewah dental clinic has recently expanded back to five days a week, since reopening after the pandemic. The clinic is openly accepting patients, and patients can be seen within the same week,” he said. “We work alongside Hamilton County Schools to bring our dental services to the community’s pediatric residents. From July 1, 2022 – May 16, 2023, our dental program has visited 23 Hamilton County Schools and has provided over 9,178 teeth sealants to students.”

A Health Department spokesperson said via email that the unused $250,000 was budgeted for the salaries of two physician positions: a family practice physician and a pediatric physician.

“The Hamilton County Health Department, like every health care facility, is feeling the effects of the national shortage of physicians and health care workers,” the spokesperson said.

Other providers

Other local safety net dental providers that offer bilingual services to uninsured and low-income children and adults include Erlanger Community Health Centers, Cherokee Health Systems and Cempa Community Care.

They were not given an opportunity to compete for the money proposed to be given to Clínica Médicos, but Wamp said no other health care groups have requested county funds. Wamp added that he’s “very open” to supporting other local organizations that provide clinical care to underserved communities.

Arnold said she views the other providers in town who serve underserved populations as partners, including the Hamilton County Health Department, and essential pieces of the puzzle.

“We would just like to be an additional piece,” she said.

(READ MORE: Clínica Médicos works to close gaps in maternal care for Hispanic women)

Wednesday’s proposed fund shift is the second time Wamp has tried to shift money from a public agency to Clínica Médicos. In January, he proposed taking money from the county’s wastewater authority which he said was unneeded. That turned out not to be the case, and the plan was dropped.

In 2022, local lawmakers redirected around $725,000 earmarked by Gov. Bill Lee for Chattanooga’s River City Co. to Clínica Médicos and the Tivoli Foundation in equal parts.

Contact Elizabeth Fite at efite@timesfreepress.com or 423-757-6673.