Walker County Commissioner Shannon Whitfield has finalized an agreement to settle an $8.7 million debt with Erlanger.
The county will make 12 payments of $650,000 over the next three years, plus a final payment of $900,000, Whitfield said Thursday, Jan. 4, during a called meeting in which he signed the agreement.
The debt has been hanging over the county for nearly seven years.
"I feel real good about this agreement," the commissioner said. "It was time to settle this and they seem to be very happy as well that we have come to terms on this."
The debt stems from a loan commitment made by the previous Walker County administration. Former Commissioner Bebe Heiskell pledged taxpayer dollars to cover this loan from Erlanger Health System in 2011, as part of an intergovernmental agreement with the Hutcheson Medical Center board.
Erlanger eventually sued for repayment of the loan, which was made to keep Fort Oglethorpe-based Hutcheson Medical Center up and running. Under the loan agreement, Erlanger was tasked with managing Hutcheson.
Heiskell, arguing that Erlanger did not meet it end of the bargain, fought repayment of the loan, but a federal court ordered the county to pay Erlanger $8.7 million, plus interest and attorney fees.
Whitfield inherited that debt when he defeated Heiskell in an election and took office in January 2017.
Under the debt payment settlement, Erlanger has agreed to waive the interest and attorney fees. This will save the county $580,000, including $400,000 in interest and $180,000 in attorney fees, Whitfield said.
Whitfield, in order to pay off the debt, last year added a "public health facility" fee to property owners' tax bills. That fee will continue for three years, through 2020, and should keep the county from raising taxes again, Whitfield said.
A payment of $650,000 will be made each quarter, with the first payment on Jan. 20. The final, and 13th, payment will be made by the end of 2020 in the amount of $900,000, the commissioner said.
"I am deeply appreciative for the empathy shown by Erlanger toward the people of Walker County," Whitfield said. "Our citizens didn't get the county into the financial mess we are working to correct, but they are being asked to help dig us out. By allowing Walker County to pay off this debt over three years, we understand that Erlanger recognizes real people are making real sacrifices."
"I feel like this is a win-win for both Walker County and Erlanger to get this settled and work this out, where we can pay this out in a three-year term, which allows me to see that this is paid out
in my term," Whitfield said.
Erlanger President and CEO Kevin M. Spiegel, FACHE, said, "With Walker County's commitment to repay the full amount due today, Erlanger is pleased to conclude these negotiations and waive both the interest and attorney fees. We remain committed to caring for patients from Northwest Georgia and will continue to look for opportunities to partner with Commissioner Whitfield and the good citizen's of Walker County."
Jack Studer, chairman of the Hamilton County- Chattanooga board of trustees, also expressed his gratitude for the settlement agreement between Erlanger and Walker County. "I am appreciative of the leadership from both Commissioner Whitfield and CEO Kevin Spiegel for putting our two great organizations on more solid footing for the future," Studer said. "Erlanger is honored to serve North Georgia and looks forward to continuing to provide world-class care to everyone in Walker County."
Since 2008, when it opened a clinic in the building formerly occupied by the Walker County Health Department, Primary Health Care has been THE provider of affordable medical services in Rossville.
PHC offers primary medical, dental and mental health services along with health education and preventive services at 1430 Suggs Street.
"We're the only medical office in Rossville, " said Dr. Michael McCoy, who practices at the Scruggs Street facility. "If we have to close the doors, there will be no medical providers."
Steve McDaniel has frequented the clinic since opening day in 2008. He said his "regular doctor" quit accepting Medicaid and after having a complete hip joint replacement he could not return to his Rossville home until he had a doctor — something PHC provided.
McDaniel said he nearly died when fire consumed his house in 2010. Injured in the fire, he was taken to Vanderbilt hospital in Nashville for treatment. Though Georgia-based, PHC accepted McDaniel's TennCare insurance while he convalesced at a facility in East Ridge and waited for his home's repair.
"I'm not the easiest person to deal with but they've been with me all the time," he said. "I'm in a wheelchair most of the time — or use a walker — and it is great to have your same doctors continue seeing you. They have treated me like a family member, not just as a patient."
But the clinic's closure is a very real possibility as the working relationship between PHC and its landlord, Walker County government, has become more and more strained.
Commissioner Shannon Whitfield says the clinic has burdened county taxpayers over the past decade. He has faulted PHC's not paying for maintenance, for insurance, for utilities — even rent.
In November 2017, Whitfield said the clinic had cost taxpayers more than $1.06 million in rent, $110, 000 in maintenance and insurance and roughly $190,000 in utility bills since its opening. In addition, the commissioner stated the county had invested $400,000 to renovate the building.
Documents provided by the Georgia Department of Community Affairs (DCA) indicate the county, in 2007, was awarded a $465,913 redevelopment fund grant for "rehabilitation of the old Walker County Health Department in Rossville."
That grant was earmarked for installation of a new roof, replacing the HVAC system to eliminate mold problems, to make structural repairs and redo the interior. All this would prepare the facility to "house a newly-instituted dental program and other healthier services for low-
"We're the medical oasis in a health care desert."
— Dr. Jose Justiniano
to moderate-income individuals."
To secure state funding, the county provided $202,908 toward the building's lease ($141,500), utility and maintenance requirements.
In addition to a $668,831 total of public support, a $231,249 grant from the Georgia Baptists Healthcare Ministry Foundation was secured to help with the Rossville clinic's operating expenses.
As part of its original agreement with the state, Walker County, as landlord, must provide general liability, fire and theft insurance as well as cover the cost of building and grounds maintenance.
"What would it have cost the county if we weren't available," said Sandy Matheson, community liaison for PHC.
Noting that it is impossible to assign a monetary value to an individual, Matheson added, "We've saved lives. We've saved families."
While the disagreement over dollars spent and dollars due has sparked the recent controversy — who owes what to whom? — the reason for the clinic's existence remains unchanged: making comprehensive care available to anyone and everyone.
"We're the medical oasis in a health care desert," said Dr. Jose Justiniano, PHC's medical director.
In granting the request for state funding, it was noted that PHC brings a full range of medical and dental services to "individuals who ordinarily would not receive adequate health care services — the indigent or families with income at or below 200 percent of the federal poverty level and the uninsured or underinsured."
A special condition of the initial DCA community development grant is that the clinic in Rossville continue providing medical services to the community throughout the facility's life. Any changes will require public hearings and DCA approval.
There is no requirement in the grant application that PHC is the only health care provider that could occupy the 9,500-squarefoot structure.
But if the county changes the building's use, it must repay the grant — in full if done within the first five years of operation, otherwise by using 20-year straight-depreciation.
It is because it brings community-based health care to a semi-rural area that the Rossville clinic, in an area designated as "blighted," has continued receiving federal grants on an annual basis.
Those grants, while not sufficient to cover all operating expenses, make it possible to see those with Medicaid, those without insurance and those who, while having insurance, have such high deductibles that they visit doctors only when it is a matter of life or death, according to staff members.
McCoy said the effect of closing the Rossville office would be unbelievable and immediate.
"The ERs would be flooded," he said.
Andy Simpson, a family nurse practitioner, said it is difficult for Georgia Medicaid patients to get services —many offices refuse to accept new Medicaid patients.
On top of that, "Other offices won't refer, but we do," he said.
Simpson said the clinic is more than a doc-in-the-box type facility, that it has vertical integration within a health care delivery system. The Rossville office provides primary care, does lab work and screenings, partners with area mental health providers and acts as a go-between for specialists and local patients.
Matheson pointed out that in the recent cold spells, the Rossville clinic's staff are seeing the homeless, not as providers of medical service, but as liaisons with other social service agencies and programs.
And during the recent Affordable Care Act sign-up period, she said on-site navigators were" unbelievably busy" assisting individuals properly file forms necessary to obtain health care coverage.
In addition, case management professionals will help with nutritional planning, with filing claims and for helping apply for free or reduced-price drugs for PHC patients.
McCoy estimated that "probably one-half of my patients are diabetic" and noted that, for many, the cost of test strips, insulin and other treatment is beyond their reach. Because of that, clinic staff and case managers help enroll patients in drug companies' subsidized drug programs, making it possible for manage their condition.
"Patients to the doctor, get a prescription, go to a pharmacy, find out that can't afford it and that's the end of it," Simpson said. "We go the extra mile and help secure the medications.
The clinicians agreed that an integrated approach is needed to treat the patients that depend on the Rossville clinic as their one-stop-shop for medical care.
"Our providers walk hand-in-hand alongside our patients," Matheson said.
The original application for the community development grant noted another benefit of having the local clinic is that its staff come from the community it serves. From reception through examination and beyond, locals treat locals at PHC in Rossville.
The privately insured, those with Medicare or Medicaid, the underinsured and the uninsured (where an income-based sliding fee-for-service is used) — all receive comprehensive care at PHC, one of the few medical providers that qualify for federal assistance in this part of the state.
"We see everybody," McCoy said.
"I'm not the easiest person to deal with but they've been with me all the time. ... They have treated me like a family member, not just as a patient."
— Rossville resident Steve McDaniel
Authorities continue to investigate an officer-involved shooting that left a Walker County man dead and lingering questions about the emergency phone call that led to the fatal incident.
In the early morning hours of New Year's Day, a woman called 911 saying that a female at a residence at 147 Meadowview Lane in Rossville was threatening to kill herself and her children, according to the Georgia Bureau of Investigation, which is investigating the incident.
Three deputies arrived and announced several times that they were from the Walker County Sheriff's Department, authorities said.
Sixty-five-year-old Mark Parkinson was spotted in the kitchen carrying a handgun. Parkinson pointed the weapon at Deputy John Chandler, who then fired several shots, killing him Parkinson, authorities said.
Greg Ramey, special agent in charge at the GBI's Calhoun office, said Parkinson was seen in the kitchen, near a counter, and pointing a gun through a kitchen window at the deputy outside of the house, Ramey said.
Ramey said Parkinson was aware someone was outside the house.
Parkinson was in the kitchen 15-30 seconds before the deputy fired the shots, Ramey said. The encounter between Parkinson and Chandler was a quick exchange, he said.
Ramey said other family members in the residence were awake during the shooting and in relatively close proximity to the kitchen area where Parkinson was shot.
Ramey said lights were on inside the Parkinson residence, including the kitchen, at the time of the shooting. Also, outside motion-sensitive security lights were on, he said.
Chandler was less than a dozen feet
from the window when he fired, Ramey said. Another deputy was to Chandler's right at a side door, while the third deputy was at the front door, he said.
Ramey said Chandler was not banging on the window, as has been reported by news organizations. He was banging on the structure of the residence, which is standard procedure, Ramey said.
Ramey said Dorothy Gass, the mother-in-law to the daughter of the victim, placed the 911 call. Investigators now have to determine if the call was made maliciously or in good faith.
Deputies on paid leave
According to Walker County Sheriff Steve Wilson, all three deputies are on administrative leave with pay.
Chandler began his career with the sheriff's department in April 2017, Wilson said.
Chandler served six years in law enforcement prior to joining the Walker County Sheriff's Department. He served with the Chattooga County Sheriff's Department and the Polk County Police Department, Wilson said.
The three deputies will undergo critical incident stress debriefing, which is standard in such cases, Maj. Mike Freeman said.
The three deputies will remain on leave until the investigation is complete, Freeman said.
Attorney gives additional details
The attorney for a Parkinson's daughter, Amy Gass, said Amy was one of several family members inside the residence when three Walker County deputies arrived.
Attorney Larry Stagg of Ringgold is representing Amy Gass in her divorce from her estranged husband Steven Gass.
Stagg said that, at the time of the incident, five people were inside the house: Parkinson, his wife Diana, Amy and her two children, a 6-year-old and a 16-yearold. Amy and her children were staying with her parents during the divorce proceedings, he said.
Stagg said they were asleep when Parkinson heard their three dogs barking from inside the residence. Parkinson retrieved his firearm for protection, Stagg said. Parkinson and his wife Diana then went into the kitchen area and heard someone banging, Stagg said.
Within seconds, three shots were fired, with one striking Parkinson's jugular vein (throat area), causing him to bleed to death, the lawyer said.
Diana called for Amy to come downstairs and call 911, he said. Amy, a registered nurse, began to administer aid to her father by applying pressure to his neck, Stagg said.
Stagg said the family waited 3-5 minutes until paramedics and law enforcement arrived, believing that an unknown assailant had shot and killed Parkinson through the kitchen window. Stagg said no one in the family heard the knocking on the door or the three deputies announcing their arrival.
Stagg said Parkinson and Diana did not see law enforcement outside the residence and, to their knowledge, an unknown someone was simply banging at 3 a.m.
Stagg said Amy does not know why her mother-in-law called 911 and reported that she was threatening to kill herself and her children.
Stagg said family members say the three deputies did not enter the residence after the shots were fired. He said it's standard procedure, in such cases, for law enforcement to enter the residence to provide aid and secure the area.
When more law enforcement arrived after the Parkinsons called 911, no one told them it that a deputy had fired the fatal shots, Stagg said.
One hour later, Diana was taken to the Rossville Police Department to be interviewed, which is when she learned from the GBI that the shots that killed her husband came from Chandler, Stagg said.
"It's a horrible circumstance," Stagg said.
Past domestic dispute
Stagg said Amy's estranged husband, Steven Gass, is contesting the couple's divorce.
Amy was granted, in a hearing for temporary custody, full custody of the children, Stagg said. Steven was denied overnight stay with the children due to past erratic and abusive behavior toward his wife, he said.
According to an incident report by the Catoosa County Sheriff's Department:
A domestic disturbance occurred May 6, 2012, at the couple's residence on Cloud Springs Road in Rossville, in which Amy claims Steven was being aggressive late that evening, cursing her and began to grab her arm.
Amy told Steven he was hurting her, to which he replied, "I mean to" and began to push her, causing her to fall backwards and hit her arm on the kitchen counter.
Amy told police she was afraid of repercussions because her husband has multiple friends in Dade, Walker and Catoosa counties.
Damage to the residence was reported, including holes in the wall and damaged items inside the residence.
Police reported visible red marks and bruising on Amy. Due to pain following the incident, Amy had her arm X-rayed to make sure it was not broken.
The couple eventually reconciled, Stagg said.