Seward City Hall close up

Responding to concerns about restrictive language in a resolution approving the Seward Community Health Center’s 2020 budget, the City Council on Monday took up the matter again, replacing the offending section with an anodyne provision requiring compliance with “all applicable laws.”

The resolution when passed Aug. 26 contained a section that appeared to forbid the health center from hiring staff to provide behavioral health services – although city officials at various times have said that the section only laid out the city’s position, rather than having any binding effect.

For its part, the health center said at the time that such a provision would likely draw negative attention from the Health Resources and Services Administration, the federal agency that oversees the health center program. The Seward Community Health Center receives over $1 million in grants from HRSA.

Pat Fairchild, a consultant jointly hired by the city and the health center, offered the same warning in an email to health center Executive Director Craig Ambrosiani on Aug. 28, adding that the penalties could eventually include termination of the grants. 

The provision appeared to be an effort by the city to defend its view of the co-applicant agreement between the city and the health center, which contains a clause that has historically been viewed as a prohibition on competition with other local providers.

At Monday night’s meeting, the council voted unanimously to reconsider the resolution, a procedural maneuver requiring a two-thirds vote that brings the item back before the body for further discussion. Council Member Suzi Towsley filed the request for reconsideration.

The council also suspended the rules and asked Ambrosiani to address the issue, who had also submitted a packet of information ahead of the meeting in an effort to support the reconsideration. That packet included the email from Fairchild outlining her concerns with the budget resolution.

Ambrosiani summarized the problem as described by Fairchild, each of whom appeared to be referring to requirements in the health center program compliance manual.

“The health center board has to have the final say in programs,” Ambrosiani said. “So forbidding the health center from hiring certain providers is basically telling the board what they can and cannot do.”

HRSA has produced a list of “required authorities and functions” that health center governing boards must fulfill. That list includes adopting policies on the “scope and availability of services” provided.

The agency also forbids arrangements which allow another entity “to reserve approval authority or have veto power over the health center board with regard to the required authorities and functions.” 

“HRSA dinged our grant,” Ambrosiani added. “We have about 40 days to resolve this. If we don’t, they’ll take us to the next level.”

After hearing from Ambrosiani, the council offered time for other interested parties to speak, but no one did so.

Subsequently, Council Member Towsley proposed an amendment striking the restrictive language and replacing it with a pledge by both the city and the health center to “abide by the co-applicant agreement and all applicable laws, regulations and governing policies.”

The amendment and the amended resolution both passed unanimously.

The author’s spouse works part time at the Seward Community Health Center.