By Lily Bohlke
bohlkeli@grinnell.edu
Since Central Iowa Family Planning (CIFP) closed on Nov. 7, 2016, there has been a gap in reproductive health care resources for Grinnellians. However, last Monday, Nov. 20 from 3 to 7 p.m., Primary Health Care’s mobile clinic arrived in Grinnell for the first time.
When CIFP closed suddenly, it came as a huge surprise to the community. The closing forced College staff and community members to think up ways to make sure Grinnellians would continue to have access to affordable and confidential reproductive health resources. CIFP approached the College’s Office of Community Enhancement before it closed. However, the College’s help could not keep the organization financially solvent. Having had these conversations before its closing, the Office of Community Enhancement and Engagement began to brainstorm.
“We’ve understood that there is interest in access to a full range of reproductive health care services that are both affordable and confidential. Considering the range of patients in Grinnell — different age groups, different family situations, some on-campus, some off-campus, there might be some patients more in need of the affordable aspect, others the confidential aspect. Primary Health Care offers both,” wrote Monica Chavez-Silva, assistant vice president for community enhancement, in an email to The S&B.
The first step was to find a clinic that either already held or could apply for a Title X grant. Primary Health Care (PHC), a health care provider out of Des Moines, fit this model. PHC “has been providing medical and dental care to underserved individuals and families living in Des Moines since 1981,” according to their website.
PHC has offices in Des Moines, Ames and Marshalltown. Their office in Marshalltown stood out as the most accessible, confidential and affordable resource for Grinnellians immediately following CIFP’s close. The College began offering a shuttle to the Marshalltown clinic; however, not a single person has used it.
“Again we started to think about how to make it easier for people in Poweshiek County because quite honestly, that’s a good amount of your time — 45 minutes to Marshalltown, then maybe a 30-45 minute office appointment, and then 45 minutes back … especially if you are a full-time student, working, that’s a lot of time to take out of your day,” said Sarah Smith, program manager for the office of community enhancement and engagement.
“The good news is that we’ve learned that more Grinnellians are using the Marshalltown clinic using their own transport, so there’s reasonable indication that people are aware of this Marshalltown option and finding ways to get there,” Chavez-Silva said.
The next step became figuring out how to bring reproductive health care resources to Poweshiek County. Originally, PHC had a Title X grant in Des Moines, which they expanded to their other offices. They have applied for grants as other reproductive health care facilities have closed down, like CIFP, which closed down in part as a result of the privatization of Medicaid in Iowa. PHC considered opening another Title X funded clinic in Grinnell; however, they found out that in order to do so they would need to offer their full range of services, which extend beyond reproductive health care. PHC decided that would be more than they are able to take on at this time.
“Overall, the national uncertainty with regard to health care policy is making it difficult for an organization like Primary Health Care to engage with new commitments. Because the outlook is uncertain in terms of rules, regulations and reimbursements, it’s hard to predict the financial implications of new operations and services,” Chavez-Silva wrote.
However, they purchased a mobile unit and converted it into a mobile clinic. It has two examination rooms and a waiting room as well as heat, air conditioning and water. When not being used as a reproductive health care clinic, it is used for mobile HIV testing in Des Moines.
The mobile clinic is staffed with an advanced registered nurse practitioner and a licensed practical nurse. It will eventually be able to provide annual reproductive exams, contraceptive methods, reproductive life planning, STI testing and treatment, pregnancy testing and diagnosis and treatment related to sexual health, for example for yeast infections and urinary tract infections. They can also do cancer screenings, including breast exams and pap smears, according to Natalia Trimnell, marketing and community relations specialist for PHC.
“Because it is a van, the space is pretty small and it will have to be adapted for our use. It is a work in process,” wrote Claudia Beckwith ’77, nurse practitioner specialist in Marshalltown, in an email to The S&B. Beckwith started working at CIFP in 1989, and worked there until it closed.
The mobile clinic will be in Grinnell on selected Mondays from 3 to 7 p.m. between now and the end of January. At that point, they will reevaluate hours of operation based on how frequently it is used by Grinnellians.
“If the clinic is well-utilized, demonstrating a local need, Primary Health Care would consider adding additional hours here locally. On the other hand, if the clinic is not used, Primary Health Care will have no reason to continue the service,” Chavez-Silva wrote.
The current dates for which it will be available are Dec. 4, Dec. 18, Jan. 8 and Jan. 22. The clinic is located behind the Light Center for Community Health at 306 4th Ave.
“People will go into the light clinic waiting room, check in, and then when it’s time for their appointment, they’ll be taken in just like any other patient would be in the light clinic, except they’ll go all the way through the hallway and into the [reproductive health care] clinic. We just want to make sure people know that it’s still very private … so people should feel comfortable going,” Smith said.
At the first occurrence of the mobile clinic in Grinnell, according to Trimnell, the clinic saw two patients. Although walk-ins are welcome, Smith suggests making an appointment with the Marshalltown PHC office, which manages the mobile clinic and can be reached at 641-753-4021 or www.phciowa.org/family-planning-mt.
