photo by: Lawrence-Douglas County Public Health Board

The Lawrence-Douglas County Public Health Board met Tuesday, Jan. 17, 2023, and members talked about the health department's plan to pass family-planning services off to another community health care provider.

A plan to transition family planning services from Douglas County’s health department to another community health care provider seems to be moving forward, despite concerns expressed by the Douglas County Commission last week.

Lawrence-Douglas County Public Health’s plan is to pass family-planning — or Title X — services off to Heartland Community Health Center. In a letter to the County Commission earlier this month, Heartland CEO Julie Branstrom said the clinic’s board of directors plans to consider applying for a Kansas Department of Health and Environment grant that funds services like sexually transmitted infection testing, breast and cervical cancer screenings and access to contraceptives at its meeting on Jan. 31.

But the proposal wasn’t very popular among county commissioners at their meeting last week. The commissioners don’t make the decision on whether the plan goes ahead, but they had a number of questions for health department director Dan Partridge — including why the health department has proposed such a plan when Partridge has announced his intent to retire in June of 2023.

Partridge told the commission last week that the department’s strategic planning process had been moving more slowly recently, and that that was why the Title X changes were announced when they were. He said that he was trying to be deliberate about the strategic planning process and not leave too much of his “stamp” on it for the next director.

At the health department board’s meeting on Tuesday, Partridge told board members that answer might not have been a satisfactory one for commissioners.

“What I do not want to leave as my legacy here is a damaged relationship with Douglas County,” Partridge said.

County Administrator Sarah Plinsky asked another fairly direct question last week — how the health department will work to ensure equitable access to health care services like Title X if it’s not doing anything to provide them.

Commissioner Patrick Kelly went a step further and told Partridge that he wanted to hear a commitment — not just from him, but directly from the health department’s board — that if Heartland failed to receive the KDHE grant or chose at some point not to provide Title X services, the health department would continue to provide those services itself.

Partridge, in previous conversations with the Journal-World and at the commission’s meeting, has said the health department’s work should be about connecting people to health care resources, rather than being an actual health care provider.

Health department board members didn’t make many concrete statements on Tuesday about whether they’d take over Title X services if Heartland or another agency decided not to provide them. In such a situation, board member Hugh Carter said he thought future boards would work to either find another organization to take on Title X services or have the health department pick Title X back up.

But another board member, Erika Dvorske, said she didn’t feel like she could make such a commitment right now.

“I think it’s challenging to comment on the hypotheticals,” Dvorske said. “This is a current conversation, exploration.”

Dvorske also said she agreed with Partridge that the health department’s work to ensure Title X services are delivered doesn’t necessarily mean the health department has to deliver those services itself.

There were some other actions Partridge said he thought the health department needed to take stemming from commissioners’ comments last week.

One of those is getting feedback from people who use the health department’s clinic for family planning services. Partridge said the health department was planning to conduct some sort of focus group facilitated by a third party that asks a group of respondents why they chose to visit the health department’s clinic for Title X care. County commissioners had mentioned that the Title X changes seemed to have been made without consulting the people the clinic serves, 57% of whom are at or below the federal poverty level, according to the health department.

But Partridge also said that the focus group might take more than a month to complete, and it seems the process of moving Title X services will march on regardless of that feedback.

Partridge said he met with Heartland last Friday, and he expects the clinic will send commissioners some of its own data, including demographic information and data on how many patients receive care on the same day that they requested it. Commissioners expressed concerns about Heartland’s ability to offer same-day Title X services while it’s already in high demand as a health care hub for other services for low-income residents.

The health department will also pass along the results of an employee survey that it’s conducting this month about its workplace environment. The survey follows a spate of resignations that former health department clinic nurses have told the Journal-World were related to the plan to move away from offering Title X services.