Santa Fe County commissioners have signed off on an unconventional arrangement to boost Medicaid dollars for Christus St. Vincent Regional Medical Center.

At its April 26 meeting, the Board of County Commissioners voted unanimously to approve the agreement, which allows University of New Mexico Hospital to lend $1.1 million to help Christus draw down $5.6 million in federal funding for Medicaid.

Because the state advanced Christus that money last September in anticipation of working out this deal, if the BCC refused to sign, Christus would have had to return the $5.6 million. But Commissioners Kathy Holian and Liz Stefanics balked at the idea of signing when they first heard of the agreement in early April, citing concerns over its legality and the continuing lack of financial accountability from Christus.

The first concern was allayed somewhat by the time of the BCC meeting because New Mexico Human Services Department acting general counsel Mark Reynolds wrote an email stating there is "no financial risk to the counties signing this," County Attorney Steve Ross reported. When speaking with SFR after the meeting, Holian and Stefanics did not back down from the concerns they originally raised about the agreement, but said the Reynolds email would release the county from responsibility if the arrangement is later deemed illegal or improper.

"By Mark putting that in writing for us, it basically makes the state hold us harmless…[HSD] are the ones that have to make things good because, if something happens, we just say, 'You held us harmless,'" Stefanics says.

Holian says she also voted for it because the money had already changed hands anyway.

"It was just sort of using the county as a pass-through," Holian says. "Even though I had concerns about the way this was done and the nontransparency with which it was done, I felt they had already gotten the money, and I wasn't willing to vote no so that the money would be taken back."

Commission Chairwoman Virginia Vigil tells SFR she had no qualms about signing off on the arrangement as long as there were no legal issues because, she says, "as long as health services are provided," the money is being put to good use.

"When there is an opportunity to bring in more federal dollars that have a benefit to health care and our hospital, I'm a strong supporter of that," Vigil says. "So long as we've cleared that with all our legal beagles, there's absolutely no reason not to support something of this nature, in my mind."