Frustration between the Municipality of Skagway and the Dahl Memorial Clinic over issues regarding the Health Resources and Services Administration grant date back over a year. But as of last week, conditions placed on the grant have been lifted – for now.
HRSA issued its Public Information Notice (PIN) 2014-01 in Nov. 2014, changing requirements for clinics to qualify for the grant. The PIN required the clinic board to be solely responsible for hiring and firing and to have the final say on decisions. But the Dahl Memorial Clinic is unique in that it is a municipally owned community health center.
Because the municipality owns the clinic, it is liable for the clinic itself and its employees. Because of the liability, borough attorney Bob Blasco said the overall authority should remain the municipality, not the clinic board.
“There are numerous reasons why the assembly is the highest authority when it comes to city clinic matters,” Borough Manager Scott Hahn said.
Mayor Mark Schaefer said Blasco modeled the updated municipal code after Santa Clara, CA., whose clinic has a similar situation to Skagway.
“One of the things that has been frustrating is that the clinic board has the same lawyer as we do, and they are not listening to his advice,” Schaefer said.
DMC Board of Directors President Cory Thole said the board just wants to be compliant, and to be compliant the board needs to be in control.
“That grant is incredible and important in terms of quality of life for this community,” he said. “If HRSA says we need to do it one way, it’s my opinion that we need to do it that way, even though it might not fit our situation exactly.”
Last week HRSA sent an email to the board notifying them that their conditions had been lifted. However, HRSA plans to make a site visit to the clinic this summer to look at the issue again. Thole said he suspects they want to talk about the issue face to face, rather than continue discussing it over email. He said it is possible that they will reinstitute the condition once more.
But Hahn said there is nothing to support having a condition there.
“At this point it is lifted because Bob [Blasco] is correct. We are a different form of clinic,” he said. “Here we have a condition that the clinic is the city the city is the clinic. There is no difference. Until HRSA says differently, the fact is the conditions are lifted.”
Should HRSA reinstate the condition, Hahn said they would inquire about their rationale and respond like they have in the past.
The HRSA grant provides $1.3 million annually to operate the clinic and provides funding for year round employment for six individuals, two seasonal positions, expanded health services and a sliding fee scale for those who live below the 200 percent of the federal poverty line.