Ethical Safety Net Providers

• Author: Robin Mathews
• DOI: http://doi.org/10.1111/puar.12721
• Published date: 01 March 2017
• Date: 01 March 2017

Ethical Safety Net Providers 309

Public Administration Review,

Vol. 77, Iss. 2, pp. 309–309. © 2017 by

The American Society for Public Administration.

DOI: 10.1111/puar.12721.

Ethical Safety Net Providers

Robin Mathews works in the financial

industry and resides in Virginia. She has

firsthand knowledge of the ways in which

free clinics are funded due to her work

experience within the medical safety net

community. Robin is passionate about

helping others and continues to advocate

for ethical, quality healthcare for those

most in need.

E-mail: robindmathews@gmail.com

Communication

I am writing in reference to this article that was

published in the Public Administration Review .

I have additional questions with regards to two

statements that I was unable to find a reference for.

These are “Free clinics do not receive any public

funding and thus face reduced government regulation”

and “Free Clinics do not receive any federal funding;

instead, they rely on community-based or faith-based

financial or other support from private individual

donors, foundations and corporations.” Where did

you obtain this information from?

The clinics you included in your study do receive

public funding, including state and federal

funding. They are “passed through” other agencies/

organizations—for example, the Virginia Department

of Health, the Virginia Healthcare Foundation,

and the Virginia Association of Free and Charitable

Clinics. All the clinics are subject to state and federal

regulations.

It is a requirement that all federal funding allocated to

the clinics be reported on their 990 tax filing forms.

This can be found under Part VIII, Statement of

Revenue 1E Government Grants. In 2013, Fan Free

Clinic reported $1,029,154 received in government

grants.

The 2013 Virginia Acts of Assembly, Chapter 806,

item 297: funds were allocated to support free clinic

operating costs for services provided to uninsured

clients to the Virginia Department of Health, which

are then disbursed to the Virginia Association of Free

Robin Mathews

Author’s Note: This is a response to the authors of “The

Health Care Safety Net and the Affordable Care Act:

Implications for Hispanic Immigrants” that appeared

in Public Administration Review volume 73, issue 6.

and Charitable Clinics. In order for a clinic to receive

any of this funding, it has to be a “member” of the

association, pay membership dues, pay “administrative

fees” equal to 5% of the total amount of funds

received, and submit a quarterly report that specifies

the total number of patients served with the funds.

For 2015, $14 million was allocated by the General

Assembly.

There is a memorandum of agreement (MOA)

between the Virginia Association of Free and

Charitable Clinics and the Virginia Department of

Health, and the Virginia Association of Free and

Charitable Clinics has a separate MOA with the

clinic. The MOA states clearly that the funds can

only be used for services provided to “documented,

legal residents.” Since no audits or monitoring is done

by the Virginia Association of Free and Charitable

Clinics, the clinics that receive these funds utilize

them to treat all patients, including those who are

undocumented.

Also, in 2013 and currently, patients at Cross Over

and Fan Free are required to provide proof of income.

If there is no earned income in the family, a notarized

letter from the person providing food and shelter is

required.