State seeks more county funds for dental clinic

MILFORD – A state official asked the Caroline County Board of Supervisors for an additional $39,000 to make up for losses sustained by the Caroline Dental Clinic, but the supervisors refused.

The clinic, which is operated by the state health department and primarily serves children in low-income families, was scheduled to close in late June. However, the Board of Supervisors voted June 11 to appropriate $30,000 to keep it open until supporters could find additional funding. State health officials have said they can no longer afford to keep it open.

Central Virginia Health Services (CVHS), which operates a federally-funded health clinic in Bowling Green, is seeking to take over the dental clinic. The board of directors of the CVHS voted June 18 to take over the clinic, but it will be some time before it is finalized – if at all.

Dr. Brooke Rossheim, director of the Rappahannock Area Health District (RAHD), which includes the Caroline County Health Department and the dental clinic, addressed the July 8 meeting of the Board of Supervisors. He explained how the dental clinic had lost tens of thousands of dollars each year since 2010. He then asked the supervisors to provide another $39,000 in addition to the $30,000 they allocated in June.

The clinic needs nearly $250,000 annually to operate, but it fell short of meeting expenses by $52,632 in 2010, $57,110 in 2011, $75,000 in 2012, and $41,488 in 2013, Rossheim told supervisors.

Patient visits tend to slump in the summer months, and the clinic is likely to lose even more money between July 1 and Sept. 30, according to Rossheim. He told the Board of Supervisors to either appropriate another $39,000 or face seeing the clinic temporarily close while CVHS seeks to take it over.

Supervisors Floyd Thomas hinted that Rossheim’s agency wouldn’t get even the original $30,000 if “you pull the clinic in July.”

“You find someone else to keep it open past Sept. 30, and you can keep the money,” Thomas said.

Roderick Manifold, executive director of the CVHS, told supervisors his agency will come to the board later this year and ask for free rent. The county health department pays about $100,000 annually in rent to the county government and $10,000 to $15,000 of that is for the dental clinic.

Manifold told supervisors,  “The magic you have in this community with the schools involved with transportation (of children to the clinic) and the equipment here and the (county) social services helping with getting children on Medicaid — all these pieces are in place, and that’s what makes us want to do this.”

The CVHS must get approval from the federal Health Resources and Services Administration (HRSA) to change the scope of CVHS services by adding the dental clinic.

The CVHS operates Caroline Family Practice in Bowling Green, one of 14 medical offices it has in 15 counties and three cities. It is organized as a nonprofit but receives federal funding, and its mission is to provide health care services to low-income people.

“We may be able to take over the clinic shortly after Labor Day (which is Sept. 2),” Manifold told supervisors, adding that he is gathering support letters to send to HRSA.

“We’ve never done a pediatric dental clinic,” Manifold told the board. “This is all new to us.”

Supervisors Wayne Acors questioned RAHD’s need for $30,000. “People have said $30,000 would keep it open the rest of the year,” Acors said. “The $41,000 you lost (in fiscal year 2013) is your loss. I don’t mind subsidizing, but I’m not willing to give you $30,000 and then another $39,000.” Acors said he might be open to appropriating an additional $9,000.

Supervisor Reggie Underwood said he couldn’t agree with giving RAHD a total of $60,000.

“In essence, we are asking for $69,000 for three months,” Rossheim said.

“We’d like this program to continued,” Thomas said, adding that Rossheim and supervisors need to talk more on the matter.

“We were willing to put in $30,000 and now you want $39,000 more for a loss in the previous fiscal year,” Thomas said. “Helping the Commonwealth balance its books —we can’t do that.”

Thomas told Rossheim to work with the supervisors and County Administrator Charles Culley “and we will come up with something.”

The clinic has lost money over the past four years partly because the patient load has dropped from 820 in 2009 to 600 in recent months. It treats youngsters from kindergarten to grade 12 with Medicaid or FAMIS and those without insurance, and they average two or three visits a year to the clinic, which operates in space at the county’s community services center in Milford.

Posted on Tuesday, July 16, 2013 at 4:41 pm