Rural Health’s Smith blasted verbally and fiscally
by Human Services Advisory Board members
BY TERRY SCHMIDA
Leadership at dozens of local nonprofits were all smiles last week, basking in the halcyon glow of a 10 percent funding increase from the county this year.
But amidst the giddy enthusiasm at the Human Services Advisory Board’s May 26 meeting, a disturbing diagnosis was made: certain members of the five-person panel, which is tasked with analyzing 501(c)(3) needs and dispensing this year’s $1.9 million funds pot accordingly, appear to have lost a good deal of faith in the Rural Health Network’s Chief Executive Officer Dan Smith.
Board members David Paul Horan and Bob Johnson repeatedly lambasted Smith for what Chairman Michael Ingram suggested were “egregious inefficiencies” in Horan’s view, at Rural Health, arguably the most critical health organization in the county.
Smith came to the meeting looking for $400,000 for his agency, which projects expenses of $3,434,039 for the year ending 2015.
Instead he had to swallow the bitter pill of receiving a tongue-lashing, and just $136,000 in funding, an amount that won’t even cover his own personal compensation package.
Horan and Johnson took Smith to task for his seeming inability to hire an Obstetrics and gynecology (OB/GYN) doctor, as he is required to do to satisfy a mandate of a federal Health Resources and Services Administration grant won by the RHN three years ago.
“You have the ability to contract with these OB/GYNs,” Horan told Smith. “You have the ability [through the Federal Tort Claims Act] to . . . knock down their cost of providing the services.”
The pair also questioned some of Smith’s supporting documents, including the CEO’s claims to have received grant money from other nonprofits.
“Rural Health says that they were working with the Rotary Club and they were getting a contribution of $3,107 from the Woman’s Club in Key West,” Horan went on. “So I call and find out, ‘oh no, Rotary Club hasn’t worked with Rural Health for two years.”
Smith protested “That’s not true”.
But Horan didn’t let up.
“And then I get a letter from the Woman’s Club that says ‘no, I don’t know anything about a $3,107 contribution. The only thing we contributed was, I think, it was $1,000 last year, but we haven’t made a $3,107 contribution.’
“And all the times that I ask, ‘are you telling me that you are forced under this federal law to duplicate services?’ And you’re not.”
Horan was referring to a statement Smith made at the previous year’s HSAB meeting that Rural Health was unable to collaborate with another local nonprofit, Womankind, through a proposed Memorandum of Understanding, and that Womankind staff would have to become Rural Health employees, and the federal government thus required Rural Health to duplicate gynecological services.
“I have spent countless hours on this,” Horan continued. “There is in fact no reason to duplicate services. You can do it under contract, and why aren’t we doing it?”
Horan, who has served as a volunteer on the HSAB board for years was also clearly unimpressed with Smith’s earnings at RHN.
“How about letting me know and letting these folks know, how much do you . . . bring out of Rural Health per year, including your salary and benefits?”
Smith replied, “It’s in the proposal there. I think it’s like $130,000 or something.”
Horan shot back, “Yeah. It’s $149,459.”
Smith countered, “That would be with health insurance, and everything, all the benefits, listed. Yes. If that’s what’s in there, that’s what it is.”
Board member Johnson was even more scathing with Smith. Their exchange went like this:
“All right, Mr. Smith, I’m pretty much concurring with where David Paul was going all the way through. Part of my problem with your application, and quite frankly sir, with some of your statements that you’ve made to this committee in the past, is what you’re going to do. You’re going to get a contract with a GYN; you’re going to open a clinic, two years ago. I asked you, when are you going to open your clinic in Tavernier? ‘Oh, it’s two weeks away you said.’ I recall that distinctly. Last year, when are going to open, ‘oh, we’ve got a dentist coming.’ You know, and as of yesterday, there’s a sign on your Tavernier office that says ‘go to Marathon.’”
“That’s correct,” Smith replied.
“So, I guess one of my questions to you, I’d like a yes or no answer, do you currently have any contracts in hand with an OB/GYN?”
“I have unsigned contracts, I just got through stating, with four OBs.”
“An unsigned contract isn’t a contract, sir. How is that a contract? Do you have any signed contracts, valid contracts with an OB/GYN?”
“No sir, I do not.”
“Thank you.”
But Johnson saved his harshest criticisms for his closing statement.
“To be real honest, after reading your application, I feel like I just walked off a used car lot,” he told Smith. “You’re all over the place in it, and there’s a lot of language but to get to the substance seems difficult.
“The cause of all the suffering and pain . . is hurricanes and the sewer system. The sewer system in Key West has been there for 50 years. It’s just that language that you use that is always couched . . . with no substance to it.
“When you make these statements and you make these claims, and part of them are not accurate it reflects on the credibility of your entire application, wouldn’t you say that would be correct?” Johnson asked.
“If they were not accurate I would,” Smith answered.
“You’ve got in your application this year that you’re going to have a woman’s center.”
“That’s correct.”
“How can you have a new woman’s center if you don’t have an OB/GYN? You don’t have a contract?”
“We have a woman’s center that’s started right now.”
“That’s something you’re going to do, right?”
“No, the OBs we’re going to be adding into it, but we have a woman’s center right now where we’re doing gynecological exams, the nurse practitioner has just gone to one course to add birth control, she’s going to be going to another course to add birth control into it, so it is in development. I cannot hold a gun to someone’s head, which would be the four OBs and bring them in and force them to sign a contract.”
“With the dental clinics alone, in your financial statements, you’ve carved out about a quarter of a million dollars for the Tavernier dental clinics over the last two years. The Tavernier dental clinic is not operating. What did you do with the money? That’s a half-million dollars. What did you do with that money?”
“During 2014 the Tavernier dental clinic was operating to the capacity that the people wanted to make appointments. During 2014 the Tavernier dental clinic lost over $100,000.”
“When you asked for funding two years ago we weren’t talking about the capacity, you were going to open a dental clinic.”
“Yeah, and it was open.”
“And you were going to offer the people of the Upper Keys a service.”
“It was offered.”
“For a short amount of time . . . “
“There’s a little term called supply and demand.”
“I just have a hard time believing anything that’s in this grant,” Johnson finally said. “You’re not going to like my recommendation, but it is what it is.”
Smith didn’t return several phone calls requesting comment.
The Rural Health Network “is dedicated to the mission of providing the residents and visitors of Monroe County with access to affordable quality healthcare with unrelenting attention to clinical excellence, patient safety and unparalleled passion and commitment to those we serve, while respecting the dignity and equality of all those we serve,” according to its website.
The agency operates sliding-scale dental clinics in Marathon and Key West, and primary care services in Key West, at its Federally Qualified Hospital at 3706 N. Roosevelt Blvd.

 

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