Future of HHCC uncertain

The future of Healthy Henry County Communities is uncertain after Henry County officials were advised that donating money to a nonprofit is a violation of the Iowa Constitution.

Concerns about HHCC, which is a 501c3 nonprofit, arose on July 1 when it fell under the county umbrella along with Public Health and were directed to the state Auditor's Office by county officials.

'Based on the auditor's opinion, the county should never have given money to Healthy Henry County,” said Henry County human resources manager Paul Greufe during a board of health meeting on Tuesday, Oct. 30. 'They cannot use private taxpayer money as a gift to a nonprofit organization. This might have an impact on other organizations within the county as well.”

There is no penalty against the county for giving money to HHCC in the past, although county auditor Shelly Barber said the county will cease and desist moving forward.

Since 2012, the county has contributed $11,000 a year to HHCC. Additionally, HHCC has received between $65,000 and $80,000 a year from the hospital, Greufe said. The hospital is no longer planning on contributing money to HHCC as of fiscal year 2019, which begins July 1, 2019, he said.

It is unclear how HHCC would continue to run without the financial support of the county and the hospital.

The board of health briefly discussed with Greufe whether it would be possible to continue financially supporting HHCC through a 28E agreement with HHCC and the county. While Greufe said it could be possible, there would still be HR issues because the HHCC director would be a part-time county employee with Public Health and a part-time HHCC employee.

'We get into issue of the benefits,” Greufe said. 'There would have to be multiple steps to amend the handbook if we have a part-time employee we're giving full-time benefits for. It gets to be pretty muddled pretty quickly.”

'Until research is done, we're just spinning our wheels,” board president Buzz Bezoni said.

HHCC has had a memorandum of understanding with Public Health since January as Public Health prepared to become a county department.

'The things being done by Healthy Henry County are absolutely Public Health related,” Greufe said. 'But the issue is, because it's set up as a nonprofit, no county taxpayer money can be gifted to that organization.”

HHCC was setup as a nonprofit to obtain grants, said HHCC treasurer Ed Kropa, who filled out the 501c3 form himself.

Greufe also voiced concern about whether it was a violation of the state's constitution for the county to be named the fiscal agent for the $1 million, three-year HRSA grant HHCC received in the fall of 2017.

Three network partners are required for the grant. Originally, the lead applicant was Henry County Health Center (HCHC) and transferred to the county over the summer. The third network partner is Public Health.

Henry County is one of 53 counties in the U.S. and the only county in Iowa to have received the HRSA grant. Kropa said HHCC's success in being awarded this grant is because of the strong collaboration HHCC has with the county and public health.

The way the HHCC's board is set up is also a concern of Greufe's.

HHCC's board is made of up to 25 members from all areas of the community including education, human services and health care. The members are appointed by the HHCC executive board and then voted on in board meetings.

Other boards within the county like the Conservation Board or VA Commission are made up of members appointed by county supervisors.

'I know there's a lot of talk about costs, but when you look at the benefit there's a lot of return on investment,” HHCC Director Kelly Carr said.

HHCC has brought in over $9 million to the county since 2002. The money has gone on to benefit many areas of the community. It has purchased computers, printers, cabinets, TVs and shelves for new county offices; population health software for Family Medicine, which is increasing the mammogram rate; Stop the Bleed kits for all 14 county schools; a vision screening device for Public Health to use at county schools; RSVP free medical transportation; SEIBUS free medical transportation; and the list goes on.

'To my understanding, everyone thinks highly of this program,” Greufe said. 'It's a strong, community-based organization that does a lot of work. No one is saying this isn't a worthwhile organization … How are we supposed to fix this?”

HHCC's relationship with Public Health is something that has made the organization unique around Iowa, said HHCC board President Anita Hampton, who was present at the board of health meeting.

'The way I looked at it … as part of Public Health, (HHCC was) the more preventive approach,” Hampton said, vouching to maintain HHCC's relationship with the county. 'Whereas the other part of Public Health was more treatment. We did the health and well-being, health and safety issues, the doers behind the policies. We've always been an integral part of Public Health.”

The conversation will continue during a Board of Supervisors meeting in November. The meeting is tentatively scheduled for Nov. 20 at 1 p.m. at the Henry County Courthouse.

The next Board of Health meeting is Nov. 13 at 12:30 p.m. at Public Health.