MORGANTOWN – Leadership with the Monongalia County Health Department was breathing a little easier Friday morning after receiving a “substantial deposit” of funds from the state.
And none too soon.
Just 24 hours prior, MCHD Chief Financial Officer Devan Smith told the board of health that the department’s cash reserves had reached “a point of concern.”
“We have not been getting paid on many of our state grants for quite some time. We’re owed over $800,000 from our grants,” he said, later adding, “We generally maintain a $1.2 million cash balance in our checking account. About $800,000, I start getting nervous. We’re at $350,000, which will cover two payrolls.”
While MCHD Executive Director Anthony DeFelice said Friday’s deposit has alleviated the immediate concern, the episode serves as the most glaring example of a recurring issue – delays in getting grant agreements finalized with the state.
For example, the federally funded WIC program grant cycle runs from Oct. 1 through Sept. 30.
Smith said the grant agreement for that program was finalized on March 23. MCHD received its first proceeds from the grant Friday.
“The big one is our WIC agreement. We spend $110,000 a month, $120,000 a month for that program. We just got our agreement on Monday of this week, which is halfway through the grant cycle,” he said, explaining the MCHD’s decision to move away from quarterly advanced grant allocations to a reimbursement drawdown method further complicated the issue.
The switch was made to bring the health department into better compliance with grant regulations pertaining to how much federal cash agencies should be holding at any given time.
“The federal government doesn’t want us to draw down a bunch of money and earn interest on it. They’re funding a lot of that through debt, so they’re paying interest on us drawing down our funding, and then we’re earning interest on it. They don’t like that,” Smith explained. “With that said, the state hasn’t really implemented a lot of mechanisms that would allow us to comply with that. We switched to operating on a reimbursement basis, as we were authorized within our grants to do, but they hadn’t really planned for people doing that.”
DeFelice explained further.
“Here’s the issue is that WIC’s effective date each year is (Oct. 1). It takes them four to five months to get us an agreement, and then to get it signed by both parties so it’s fully executed might take a few more weeks. So that’s where the first delay comes in. You’re four to five months out from even getting an agreement, and this year has been longer than normal,” he said. “And then I think the second issue that popped up is, when we submitted our invoices, they didn’t know how to process them.”
Both Smith and DeFelice said they believe they’ve worked through what will hopefully be a one-time reimbursement processing hangup with the state.
The delays in finalizing grant agreements are an annual concern.
“It does happen every year. There are some delays,” DeFelice told The Dominion Post, explaining it’s not uncommon for an agreement authorizing WIC payments to be finalized three to four months after the effective date of the grant.
During Thursday’s board of health meeting, it was explained that the issue with WIC funding was statewide.
And for the MCHD at least, it wasn’t isolated to WIC.
Monongalia County Board of Health Chair Toni DiChiacchio said she doesn’t believe the issue is isolated to health departments either.
“I know from grants at the university, same thing. Is anybody working with the state to do, like, a quality improvement process, or at least talking to them? I can’t imagine they don’t know there’s delays, but can we fix the delays?” she asked.
“Well, the new Cabinet Secretary [Arvin] Singh is supposed to be a QI guy. So, you know, I don’t know if that’s on the top of his list. But you would think that if he wanted to improve the processes, this would be one that would be on top of the list,” DeFelice responded.
Speaking of federal grants, like WIC, DeFelice said he doesn’t know if the states are facing delays out of Washington, or if the issue is the result of a lack of manpower and experience at the state level.
Smith said he believes the latter is playing a significant role.
“The solution … I mean, I’m going to speak out of turn here and assume. I know what their problem is. They can’t hire staff, just like we couldn’t hire staff, and we can’t hire staff under the [West Virginia Division of Personnel] framework,” he said. “The solution is hard. It’s fix your staffing model and pay people what the market demands.”
Ultimately, MCBOH member Sam Chico said, people are depending on the health department to do what it must to keep the services running.
“For the public, you know, we’ve been criticized over the years about why we keep so much money in reserve. It’s because we can’t function, provide critical services, without a reserve because we don’t get paid for six months at a time,” he said.
