Monroe County loses $200,000 grant after closing health clinic due to staffing problems

Correction: This post was updated to correct the number of patients the clinic has seen recently.

Monroe County health officials have learned a contract, which has funneled about $200,000 in federal dollars annually since 2006 to the county's Futures Family Planning Clinic , will be terminated.

For nearly two decades, the clinic has provided health services, such as pregnancy and birth control counseling and breast and pelvic exams, to some of the most underserved members of the community. The clinic, in the lower level of the Health Services Building, at 119 W. Seventh St., was shut down Monday because of lack of staff.

The clinic has been funded primarily with dollars from the U.S. Department of Health and Human Services, via the nonprofit Indiana Family Health Council .

County attorney Molly Turner-King on Friday sent an email to county commissioners, county council members, health board members and others to let them know that officials with the IFHC “informed the participants in the call that the contract … will be terminated.”

What, exactly, that means was unclear Monday. Neither county officials nor the IFHC agreed to interviews. They declined to answer questions via email.

While the clinic is now closed, Dr. Stephen Pritchard, the health board president, said via email Monday, “We have reason at this time to believe that this situation (no clinic) is temporary,” though he declined to provide details.

Lack of staff: Futures clinic director vacancy never listed

Pritchard told the Monroe County Board of Health in a special meeting Wednesday the clinic would have to close because of lack of staff, and the closure could threaten the $200,000 IFHC contract.

After the former clinic director, Evan Theis, was dismissed in mid-April, remaining staffers said they urged local officials to fill the position, because the additional administrative duties were causing them undue stress. When those pleas went unheard, Debbie Deckard, a part-time clinical assistant, gave her two-week notice recently. That prompted Christine Brackenhouse, the clinic’s licensed practical nurse, to turn in her notice four days later.

Given those developments, the board last week instructed the county health officer, Dr. Clark Brittain, to let go of the last remaining staff member, Emma Rice, a nurse practitioner. Rice's last day was Thursday.

Pritchard told board members last week the department has not been able to fill open positions despite advertising for them for months.

However, Brackenhouse said, and the county’s human resources department confirmed, the county never posted a job opening for a clinic manager after Theis’ departure months ago.

County officials mum on Futures clinic's demise

Pritchard and Lori Kelley, the health department's administrator, would not answer why the county never posted the job.

Other county officials also declined, for the most part, to answer questions.

Of the three county commissioners , only Penny Githens responded to an emailed inquiry, though only to refer questions to Pritchard. Githens and fellow commissioners Julie Thomas and Lee Jones, who appoint most of the health board members, did not reply to an inquiry seeking their reaction to what happened, how it happened, whether they were pursuing alternatives and when they became aware the county was in jeopardy of losing the grant.

Kelley, Brittain, the health officer, and Turner-King, a county attorney, referred questions to IFHC.

“There are logical explanations to the questions you have posed; perhaps these can be addressed at a later time with approval from IFHC,” Kelley wrote.

Pritchard said he would not respond to specific questions because of the board’s agreement with IFHC “to allow them to respond to media inquiries.”

“I will say that while the Commissioners may have been aware that the Futures Clinic was having challenges, they were only recently informed by myself and our vice president that the situation was more serious,” Pritchard wrote.

IFHC President and CEO Kristin Adams would not answer emailed questions including why the nonprofit was canceling the contract with the local clinic, what level of support the nonprofit has provided in the last few years or how often the nonprofit cancels contracts.

Adams said via email, “We are not making a formal comment at this time. We will issue a release tomorrow.”

IFHC has financially supported the clinic since 2006. From 2013 to 2022, the nonprofit provided the local clinic with an average of $195,000 per year, according to IRS records.

Data also show the level of support fell by 24% from 2020 to 2022, when the local clinic received less than $168,000, about $53,000 less than it had two years earlier.

An audit of IFHC also shows the nonprofit lost money in 2022 and 2023, including a loss of $129,000 in 2023. In that year, total expenses rose by $65,000, while revenue, at nearly $7.9 million, fell by $11,212.

Monroe County council member 'disappointed'

Monroe County Council member Marty Hawk, one of the county officials who was directed to refer questions to IFHC, said Monday she was “very sad” and “very disappointed” to see the clinic close.

She recalled the clinic’s origins and how hard Bob Schmidt, then-administrator of the health department, worked to secure the federal dollars that helped fund the clinic.

Hawk said the closure would hurt especially the low-income patients who rely on the clinic and may have difficulty going elsewhere.

She said the council had not been made aware of the clinic’s troubles.

“It was not on our radar,” Hawk said.

Health department directs clients to other providers

Local health officials have been telling the clinic’s patients to seek services with other providers, such as Planned Parenthood, HealthNet or Pace in Bedford. Brackenhouse said the clinic was seeing about 80 to 100 patients a month, though Kelley said the number of individual clients was lower.

According to data provided by Kelley, the clinic saw an average of 79 individual clients in each of the first seven months of 2022. That fell to about 51 this year.

Theis, the clinic manager who was dismissed in April, said Friday the clinic's closing would be "devastating" for patients and the timing was unfortunate given the return of Indiana University students for the fall semester. For many of them, Theis said, services such as free condoms, pregnancy and birth control counseling, and emergency contraception can prove life-changing.

Spanish interpreter encourages health board to save clinic

Jane Walter, who has served as a Spanish/English interpreter for the clinic’s clients, wrote a letter to health board members last week encouraging them to “do all you can” to save the clinic.

“The low-to-zero fees based on a sliding scale as well as the guarantee of excellent medical care opened access to vital services that this immigrant population would not have been able to obtain otherwise,” she wrote.

Walter also said she was “greatly saddened and disappointed” to learn the staff would be leaving.

“It is hard to understand how such competent and caring nurses who have learned so much about their job responsibilities … who provide such excellent medical care, and who seem to love their jobs can be leaving these crucial positions,” she wrote.

The department and health board in 2022 and 2023 dealt with significant turnover. The staffing exodus began shortly after Kelley took over from long-time administrator Penny Caudill, who retired.

First, health department employees left. Now board members are resigning

Walter, the interpreter, said so far this year, she already had eight more consultations with patients than all of last year and would have to cancel five more consultations scheduled for the next three weeks.

“One of those consultations would have been with a new patient to replace her birth control method that is significantly out of date,” Walter wrote. “She had been so thankful to obtain her appointment at Futures! I am dreading my conversation with her and the other four patients.”

Boris Ladwig can be reached at bladwig@heraldt.com.

This article originally appeared on The Herald-Times: Monroe County loses $200,000 grant after closing health clinic due to staffing problems