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State funds for health care are funneled to a housing group, which defends its budget.
By LEONORA LaPETER
© St. Petersburg Times, published January 14, 2001
ST. PETERSBURG -- From the start, one non-profit group had the inside track to spend a $288,000 grant for Front Porch Florida.
Neighborhood Housing Services, an established group devoted primarily to promoting home ownership, served as Front Porch's fiscal agent. It was designated by select members of the Front Porch Council as the only agency to do the job.
But the grant has nothing to do with housing. Its mission is health care.
"This is health care -- not housing services," said Chrisshun Cox, a member of the Front Porch Governor's Revitalization Council of South St. Petersburg. "Why is the health department not doing it? Why is a housing service doing it? It's whacked."
Some say that's not only an unorthodox arrangement but also a conflict of interest.
"I believe you need to do one or the other, be a fiscal agent or a grant manager," said Faye Jackson, former liaison for Front Porch in St. Petersburg. "To me it's a conflict of interest when you're directing dollars to yourself. Who's going to monitor those dollars when you're directing them to yourself?"
As Gov. Jeb Bush's Front Porch community revitalization program enters its second year of grant-spending, it would seem the lessons of the past year haven't sunk in.
The health grant was given to Front Porch insiders with little opportunity for others to compete. The grant budget is liberally sprinkled with big-ticket items such as computers and printers and fax machines. And there is still poor state oversight over how the money is spent.
A review of the approved budget for the diabetes prevention grant shows that about $69,000 will be used for travel, rental space, telephone service, Internet service, office supplies and equipment, such as computers, printers and fax machines, a TV/VCR, a video camera and copier for the various partners in the grant. Another $126,500 will go toward salaries and fringe benefits for employees hired by NHS to spend the grant.
Officials with NHS and its three partners -- the Sickle Cell Association of America, the Interdenominational Ministerial Alliance and the St. Petersburg Pregnancy/Family Resource Center -- said that the majority of the money will be used to provide health education to minority residents in neighborhoods served by Front Porch.
The program, they said, is expected to reach at least 500 people who may participate in exercise, cooking and nutrition classes, health screenings and health fairs all geared toward educating them about diabetes prevention.
It was only last June that Gov. Jeb Bush signed the Patient Protection Act, which allocated $5-million for "Closing the Gap," a grant program designed to reduce racial and ethnic health disparities in Florida. Front Porch communities were to receive 20 percent of the money.
Front Porch, Bush's bottom-up community revitalization program, had gotten off to a rocky start that same month. Racing to meet a state deadline, the Department of Juvenile Justice had handed out thousands of dollars in questionable grants, even giving money to a convicted felon in St. Petersburg.
As the program attempted to recover from this debacle, local officials were trying to formulate a plan for how they would seek the health care grant.
Rodney Bennett, then chairman of the Revitalization Council, said initial documents provided by the Department of Health were confusing and failed to identify how Front Porch communities should go about applying for the money.
"NHS was selected from Day One, because of the way the guidelines were written for the Closing the Gap," Bennett said, adding that the only candidate for lead agency on the grant ". . . was NHS because they were the fiscal agent of Front Porch." As fiscal agent for the St. Petersburg group, NHS doesn't decide how the money is spent, but it does handle the funds and keep the books.
"We had no choice," Bennett said.
But evidently the Revitalization Council did have a choice. Anyone could have applied for the grant, said Melvin Herring Jr., director of Equal Opportunity and Minority Health for the Department of Health.
Bennett said that by the time officials with Front Porch and the Department of Health clarified that anyone could be an applicant, it was too late. NHS had already been written into the grant and it was due in 10 days.
The Revitalization Council approved the grant on Sept. 21 -- four days before it was due -- but several members said recently they didn't realize they were approving NHS as the lead agency on the grant. They thought it would simply serve as keeper of the funds.
"I don't think they went into details of who the lead agency would be," said council member David Welch, an accountant and former City Council member. "How did (Interdenominational Ministerial Alliance) get in there? Let me tell you my thinking. I thought this would come under the auspices of Front Porch itself and they would be the lead agency for it."
In fact, NHS' role in the grant still seems to be foggy to some.
Askia Muhammad Aquil, executive director of NHS, and officials with the Department of Health said NHS would spend the grant and report on its progress to the state. NHS would be responsible for administration and executing contracts. Employees hired to implement the grant -- a coordinator, administrative assistant, nutrition consultant, exercise consultant, nurse consultant and health promoters -- would be NHS employees.
But Dr. Carrie Nero of the Pinellas County Health Department said an independent steering committee headed by her is in charge of the grant, a fact that is also written into the grant application. Nero said that her steering committee is in charge of selecting the grant's employees. NHS will serve only as fiscal agent.
"They're just a vehicle," she said.
Whatever the arrangement, some council members think the community would have been better served by someone in the health care arena.
Maria Scruggs-Weston, a candidate for St. Petersburg mayor who works at St. Anthony's Hospital and whose application for a Closing the Gap grant was rejected, said she sees it as another example of certain organizations being given opportunities over and over.
"You will see a pattern," Scruggs-Weston said. "Programs targeted for African-Americans, there's just some relations that continue to blow me out of the water. It's a glaring, glaring, glaring concern. Even as fiscal agent, they have to have some knowledge of the subject area. Whereas NHS has done a wonderful job at housing, I'm not sure about health."
Aquil said that NHS, which was created in 1980, is not devoted only to fostering home ownership.
"We do a number of different things, all of which pertain to quality of life issues in the community," Aquil said. "Our agency, like sister agencies across the country, is committed to comprehensive neighborhood revitalization. That spans a number of different issues."
Still, some like Jackson, see NHS' role as a conflict of interest, even though a lawyer for the state Department of Community Affairs did not see it that way.
The Health Department's Nero said that her steering committee would take responsibility for how every dollar is spent. The project coordinator, hired last week by that committee, will be an employee of NHS, but will report to the committee. The committee includes a representative of NHS.
Officials with the Department of Health are not concerned about the confusing management arrangement, saying that others involved in the grant will provide the necessary health care experience.
But the Department of Health, which has approved a 19-month budget for the grant, is unable to answer questions about how NHS would be paid for its work and how portions of the grant would be spent.
Bonnie Gaughan-Bailey, the Health Department's contract manager on the grant, referred those questions to NHS' Aquil.
"I don't know about the grant administration fee," she said.
She could also provide little explanation for some expenses she approved, including a $16,568 cost titled simply, "Other: indirect."
"There's nothing in this budget that looks out of sorts to me, and I approved it," she said, adding that she will be meeting with NHS about the grant soon.
Aquil initially couldn't say how much his agency was getting for its work on the grant or whether his agency was the grant administrator or the fiscal agent. He later acknowledged the $16,568 would probably go to his agency in the form of a fiscal agent's fee. As fiscal agent, he said, NHS is supposed to get 10 percent, or $28,800, but there probably wasn't enough in the grant to generate that much for his agency.
NHS, which has received just $2,900 for its role as fiscal agent to the local Front Porch program so far, deserves to be paid for its work, Aquil said.
"Our president thinks we ought to be negotiating for an administrative fee plus," Aquil said.
But NHS isn't in it for the money, Aquil said.
"It's the issue," he said. "My father was a diabetic and he died last year. It's the issue."
Asked about budgets that failed to identify expenses, Aquil said it was too early to say exactly how money would be spent in some cases; it could change several times between now and the end of the grant.
He bristled when asked repeatedly about budget line items that said "see itemization below" with no explanation provided and said he would be holding a budget workshop on the grant soon.
"We're saying we're involved in this because we're concerned about issues that impact this community and its wide range of issues," he said. "For anyone to call us and grill us about money, money, money, you might think we're an investment company or something."
Proposed budgets for the grant sought four computers and printers. In addition, the Sickle Cell Association asked for a copier, fax machine and Internet service; St. Petersburg Pregnancy/Family Resource Center wanted a TV/VCR and fax machine; and NHS' budget includes money for a video camera and a $5,000 Powerpoint field data collection system.
Carole Alexander, director of St. Petersburg Pregnancy/Family Resource Center, said her organization needed a $1,750 computer/printer for record-keeping, a $600 TV/VCR for training events and promotions and a $300 fax machine for communicating with others. Another $1,500 in travel for her organization alone (NHS and the other partners have budgeted a combined $8,000 for travel) is necessary for training and other meetings out of town, she said.
"All the resources are going to make sure the grant is accomplished," Alexander said. "It's a way to give us to operate. If we need to make adjustments in the way the resources are allocated, we will."