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AltaPointe’s performance contract with the city was again in jeopardy Tuesday as the Mobile City Council worked to pass the city’s budget for the 2023 fiscal year.
Ultimately, despite vocal opposition by one council member, the city decided to keep the hospital system’s performance contract, worth about $600,000, which is used to provide services to the Mobile County Probate Court.
“What I see is a mental health organization that routinely and deliberately cuts mental health services to pad their profits,” Mobile City Councilmember Scott Jones said during the meeting.
Last week, the city council decided to keep the contract intact, after Jones proposed diverting $200,000 to Veterans Recovery Resources, another mental health services provider that focuses primarily on veterans and first responders in Mobile. The city ultimately decided to fund a performance contract to VRR by directing some funds away from the Azalea City Golf Course.
But today, in a surprise move, Jones proposed getting rid of AltaPointe’s contract entirely and allocating money to the city’s resiliency department, intended to be distributed to other mental health service providers in the city, though Jones did not say what those providers would be. The amendment failed, getting only two votes.
Jones cited concerns about AltaPointe’s finances, as well as past accusations of not providing indigent care. He said that, in 2018, AltaPointe made $7.4 million in profit, $7.2 million in 2019 and $11 million in 2020. He argued that the $600,000 contract was negligible compared to the rest of AltaPointe’s operating budget, which he said was around $125 million.
AltaPointe CEO Tuerk Schelsinger said the company’s operating budget is closer to $140 million. AltaPointe’s primary funding comes from state and federal grants. $600,000 would make a difference for other mental health providers in the city, but not so for AltaPointe, Jones argued.
“This is not their money, this is the taxpayer’s money,” Jones said during the meeting.
Schlesinger says that arguments about the health system’s profits are misleading. All of the yearly profit numbers Jones cited were exaggerated by about $1-2 million, he said. In addition, the company aims for a surplus every year, he said, in order to spend that money on infrastructure and wages. AltaPointe has 97 facilities that it has to maintain, he argues. In addition, salaries are increasing, Schlesinger said, so the company has to use its profits to raise wages.
In addition, Jones argued that AltaPointe has not been providing adequate indigent care services, as is its stated mission. He brought up a 2014 letter from Mobile County Probate Judge Don Davis, accusing AltaPointe of not providing care to patients referred for inpatient treatment from the courts. In that letter, a copy of which was provided to AL.com, Davis said that AltaPointe not accepting patients created a “dangerous public safety condition.”
Jones also brought up several anecdotes about people needing mental health treatment who were turned away from AltaPointe because they were unable to pay or did not have insurance. He said that AltaPointe has a number of beds reserved solely for patients with private insurance.
Schlesinger said that all health centers have had to turn away patients, particularly in recent years, as a labor shortage has made it more difficult to provide adequate care to patients. But, he said, AltaPointe hasn’t turned away anyone for not having insurance, and the hospital does not reserve beds for people with private insurance. He said that the issues raised by Davis have long been resolved.
“We’re seeing more and more and more patients every day, every week, every month, every year,” Schlesinger said. “All hospitals are dealing with shortages.”
Jones wasn’t alone in accusing AltaPointe of failing to provide adequate services. Thomas Holmes, president of the board of The Arc of Mobile County, an advocacy group for people with intellectual or developmental disabilities, told the council that AltaPointe has not provided day program services to people with those disabilities since the onset of the coronavirus pandemic.
In 2019, what was then known as the Mobile Association for Retarded Citizens merged with AltaPointe, and took over care for people with intellectual disabilities. Those services were suspended during the pandemic. In 2021, AltaPointe transferred day program services to Volunteers of America, though Holmes says he has not received any information from VOA about care for his son, who is intellectually disabled.
“We organized our group to be advocates only, but now we’re faced with the situation of ‘are we going to have to go into the service and delivery business,’ because people like AltaPointe have decided that, either they don’t want to do the services or they’re not capable of doing the services,” Holmes said after the meeting.
Schlesinger said that AltaPointe still provides residential care for people with intellectual and developmental disabilities, which Holmes does not dispute. Schlesinger said that the Centers for Medicare and Medicaid began discouraging group day programs for people with disabilities, and so, once pandemic restrictions eased, the company began a new program where patients are picked up in small groups and driven to various activities. However, Schlesinger said, only 77 people participate in this program, compared with 230 who participated in the day programs before the pandemic. The remaining day programs were transferred to VOA.
Councilman Ben Reynolds was the only other councilmember to vote for Jones’ amendment, though not because he supported taking the money away from AltaPointe. The city had already expressed interest in working with AltaPointe, he said, so moving the funding to the resiliency department would just mean that the city could pursue a contract with the health system if it wanted.
“Without AltaPointe here, I don’t know how we provide the level of care that we provide,” Reynolds said during the meeting. “I think it’s a public service to them.”
Councilmembers Joel Daves and William Carroll both voted against the amendment. Councilmembers Gina Gregory, Cory Penn and C.J. Small abstained from the vote. Although two council members were in favor and two were opposed to Jones’ amendment, the three abstentions means that a majority did not favor the amendment. Under Mobile city law, a supermajority – five of the seven council members have to support a measure before it will pass.
The city budget was passed shortly after, with all councilmembers but Jones voting for it.
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