The center was founded in 1999 to provide primary health care to the uninsured, underinsured and socio-economic disadvantaged residing in Madison County. Current task force members acknowledge that in 2002 the health center entered into a contract with the task force that provided services to shelter residents under a $7,500 grant from the Madison County Community Foundation.
Under that agreement, the center would use a sliding fee scale to provide basic medical services including medical samples, discounted prescriptions and referrals. A key element of that agreement stated, “The homeless shelter directors do not accept any financial liability for payment of expenses incurred.”
An unwritten understanding developed by which homeless patients were to receive services without paying for them, task force representatives said.
Based on minutes from task force meetings, in February, the health center sought a $25,000 grant from the United Way of Madison County. As proposed, the health center wanted to bill the United Way for medical services involving task force agencies. However, task force members balked at the idea, saying the arrangement would place homeless people in a different category than people who were uninsured.
In March, a new memorandum of understanding from the health center was presented to task force members where funding sources, i.e. the United Way, would be sought in finding grants to cover health care services. The shelters would be responsible, through the task force, for payment of health center services. Task force members said they did not want to be part of the health center’s “accounts receivable department.”
In April, a shelter representative reported that a resident was “treated poorly” at the health center. Another task force member said a client with post-traumatic stress syndrome was seen by the center, given one month’s worth of medicine and “not allowed to return.” The task force considered contacting local hospitals to discuss how to treat clients unable to receive health center services.