Missouri got millions to fight COVID-19, but 50 health agencies haven’t seen a penny
By early May, the federal government had delivered hundreds of millions of dollars to Missouri to fight the spread of the coronavirus.
But three months later, dozens of Missouri county health departments have not received a penny.
As August arrives, the number of positive COVID-19 cases in Missouri has exceeded 50,000 and more than 1,240 people have died across the state, which was described last week by a doctor at the University of Kansas Health System as one of the region’s “hot red spots.”
In the past two weeks, Missouri has had the second highest rate of new cases in the country, second only to Connecticut, according to the COVID Exit Strategy.
Against this, local public health agencies across the state are trying to ramp up testing and contact tracing but say their hands are tied because the state delivered the federal aid not to them, but to their local county commissions. And the county commissioners in many places have held up the money.
Some counties have paid outside advisers to manage the funds, have put private businesses first or have considered just giving the money back to the federal government.
Such delays have continued for months since the CARES Act, a $2.2 trillion stimulus package approved by President Donald Trump in late March, funneled about $2.4 billion to Missouri, with $527 million going to local governments, according to the Missouri State Treasurer’s Office.
On May 4, Gov. Mike Parson’s office announced it would distribute the federal aid to county governments.
But in at least 50 counties, the local governments haven’t passed money down to their health departments, according to a survey the Missouri Department of Health and Senior Services sent to local agencies in mid-July.
Bert Malone, a member of the Missouri Public Health Association, said it was frustrating that money was allocated to county commissions, which in several cases have been in conflict with their health departments.
It appears some commissions have made decisions based more on politics than public health, Malone said.
“It will go for whatever the county commission has as a priority,” he said. “In a number of cases, it will not go to public health because they resent public health agencies for the message that they have continually espoused of wearing masks, don’t go out, wait to open things up.”
Malone said it was “ridiculous” that we are six months into the pandemic and some agencies have only recently began hiring contact tracers.
Gov. Parson on Monday emphasized the importance of contact tracing and said the work depends on local public health agencies.
“That is why it is important for our local health departments to receive the federal CARES Act funding to build their capacities for testing and contact tracing,” Parson said.
“So far, not enough of the money has got to the people that are doing front line public health response.”
Even so, Randall Williams, director of the Missouri Department of Health and Senior Services, on Monday defended the decision to allocate funds through county governments.
“The county commissioners are the holistic governor of their county, and there are other needs other than public health — we certainly recognize that — around COVID-19 funding.”
Kansas City has been in a dispute with Jackson County over CARES Act funds, but received money weeks ago from Clay County. Elsewhere in the state, local health departments have been left on their own.
Of Missouri’s 114 counties, only 17 local health agencies reported receiving aid. Thirteen said they did not apply for funds and another 34 did not participate in the survey.
Some of the survey’s responses revealed a sense of strife.
A health official in Randolph County, north of Columbia, where at least 52 people have tested positive, said a process for applying for the funds through the county hasn’t even been established.
“So I’m spending money on a promise that I probably won’t get any,” she commented on the survey.
In Dunklin County, in Missouri’s Bootheel region, at least 239 people have contracted the virus and four have died. The county has a population of about 29,000.
A health official there wrote on the survey that, “This money should have been given to the LPHA’s (local public health agencies) not the commissioners.”
Cheryl Eversole, Dallas County health department administrator, summed up the feelings of local public health officials dismayed at the holdup:
“I have felt hogtied.”
Platte County
Platte County sits on the northern edge of the Kansas City metropolitan area, which again hit a record number of new cases Thursday.
The health department there has received no federal aid.
“We recently met with our County Commissioners to inquire about the CARES Act funding and were met with highly escalated emotions, accusations that WE have killed businesses, families, the economy and the tax base,” Mary Jo Vernon, the director of the Platte County Health Department, wrote on the state survey.
“We were accused of government overreach for the shut down orders early on and now for the masking mandate.”
Health officials in Platte County report they sent the county commission on June 30 an itemized spreadsheet of expenses and an estimate of costs through the end of the year.
On July 10, Vernon sent an email asking for an update.
Three days later, she attended a meeting and was told by the commission that they did not have any information.
Vernon said in an email Tuesday that the number of cases in Platte County is “dramatically increasing.” The county has a total of 520 cases with 307 of those residing outside the limits of Kansas City.
The federal dollars would help continue free testing that will otherwise expire August 15, Vernon said. It will also help with contact tracing and PPE.
“We are in need of the CARES Act monies,” she said.
According to The Platte County Landmark, the county commission has given more than a dozen grants with CARES Act funds to local businesses, including $226,000 to a cruise company.
Commissioner Dagmar Wood declined to comment. Commissioners Ron Schieber and John Elliott did not respond to requests for comment.
Rural areas
Eversole, the health administrator in Dallas County, said the commission hired a manager to oversee the CARES Act funds. The manager asked for invoices and bank statements to verify reimbursements Eversole was requesting. So, she scanned and sent those July 8.
“But I haven’t heard anything,” she said Tuesday.
The first phase of funding was to cover costs from the early months of the pandemic. The health department asked for about $38,000 in reimbursements for PPE, sanitizer, thermometers, desk shields and staff overtime.
“That is expense that we have incurred directly because of our COVID response,” Eversole said.
Dallas County, which has a population of about 16,900, according to a U.S. Census estimate, has had 44 cases and one death. While that figure is low compared to urban areas, Eversole said there are only seven full-time employees in the health department.
“So when we get an influx of two or three or four new cases, it sets us over the top,” she said. “It means nothing else gets done that day. So we’re not getting our regular day-to-day work done because we have to stop and drop everything, and I can’t afford to hire someone if I can’t be reassured that I’m going to get that as a reimbursement.
“I believe that most county commissioners have very little true understanding of public health and what it entails.”
Presiding commissioner Kevin Sharpe said the county has not yet distributed any funds, and that he wasn’t concerned that the health department has not received any aid.
“We are in the process of doing so,” he said, adding that the health department will see money “probably within two weeks.”
Two counties to the west, Dade County Health Department administrator Pamela Allen said the agency has not been able to provide testing because it lacked the resources. CARES Act money could change that.
“We’re just waiting,” she said.
Allen said earlier in the pandemic, when there were no cases in the county, a commissioner considered returning the funds to the federal government, but she urged him not to.
Now the county has had 14 cases and Allen said it has taken a lot of work to keep the number low.
“It has been hard on us and it’s stretched us very thin as far as finances and trying to be able to help everybody out,” Allen said. “It is a little frustrating because I feel like we’re on the front lines.”
County commissioner Randy Daniels initially said some funds had already been disbursed to the health department, but then said the checks go out Friday.
“We’re going about as fast as we can,” he said. “There’s a lengthy process to it.”
“Several of them that might be complaining about not having gotten any money yet, we’ve had to go back to them numerous times to get the documentation that’s required. So that’s on them, not on us.”
Kansas City
Clay County is one local government that has proven well able to distribute CARES Act money.
The Clay County Health Department received $2.9 million on May 18. Some of that funding has gone towards contact tracing efforts. The department recently hired nine tracers.
The Clay County Commission also distributed $1.15 million in June to the Kansas City Health Department. Some of that money has been used for disease investigation, including six additional staff members for contact tracing, spokeswoman Michelle Pekarsky said.
But so far, no aid has come from Jackson County, where most of Kansas City’s residents live.
Kansas City Mayor Quinton Lucas originally said the city deserved $54.6 million of Jackson County’s CARES Act money.
Email records obtained by The Star through an open records request show that Kansas City submitted its first COVID-19 spending plan to the county on July 10, but County Administrator Troy Schulte said it “would not survive a federal audit.”
The city’s revised $18.88 million proposal was submitted on July 24 and approved by Schulte on Tuesday, and next goes before the city’s finance committee next Wednesday. If approved, the council will have their say on Thursday.
The plan budgets just over $8.6 million for the health department.
“Kansas City’s ability to mitigate the spread of COVID-19, keep our economy moving and reopen our schools will be largely supplemented by the CARES Act funding we receive from each of our counties — particularly from Jackson,” Lucas said in a statement. “This funding will be used to pay for vital PPE, testing and contract tracers for our Health Department.
“We first requested this type of support from Jackson County more than two months ago on May 18 and need the legislature to provide vital CARES Act funds to Kansas City so we can keep our community safe and healthy.”
