This summer, when Bloomington Hospital announced it was closing the Title X family planning clinic it has run since 1998, community members stepped forward to make sure the 1,450 patients who visit it annually wouldn't lose the only health care service most of them receive.

"It was a broad, vocal support," said Indiana Family Health Council president Gayla Winston.

In September, the Indiana Family Health Council, a private, non-profit corporation in Indianapolis, accepted the Monroe County Health Department's proposal, ensuring the estimated $200,000 annual family planning grant will stay in Monroe County.

For Ellie Rogers, who volunteered to write the proposal, the need for a family planning clinic in Bloomington is clear. Former director of Community Health Access Program (CHAP), a private nurse-managed clinic, Rogers, a registered nurse, calls the plight of the working poor in Bloomington "a vicious cycle."

"They make too much to qualify for Medicaid but not enough to pay for the necessities they need to survive in this community," she said, emphasizing the need for the local family planning clinic.

While the Monroe County Health Department has never offered direct clinical services, administrator Bob Schmidt said the department felt it was important to keep the program active in the community. Schmidt said the new clinic will continue providing the same high quality services that are currently offered, while working on its public image.

"One of the things we would like to do is to make the public more readily aware of the clinic," he said.

In addition, the clinic will offer set office hours to become more accessible to the community, with two evenings a week devoted to patients who work during the day and eventually a Saturday schedule. Rogers said appointments are recommended but walk-ins would be welcome. The clinic will be hiring three health-care professionals, including a nurse practitioner and a physician to oversee the clinic.

"We're very happy that the health department has taken this bold move to provide health services to the families of Monroe County," said Winston.

The Monroe County Health Department's clinic will target 6,700 women between the ages of 14 and 44 who are 100 percent below the poverty level and are eligible for the services at no charge. A variety of services for men also will be available.

The clinic will continue to provide basic gynecological care; contraceptive services; screenings for breast cancer, cervical cancer and sexually transmitted diseases; infertility services, and reproductive health education and referrals.

Charlotte Zietlow, economic development coordinator at Middle Way House, a shelter for battered women in Bloomington, said the basic health screening and referral system that occurs at the clinic is critically important because it opens up avenues for other health care opportunities.

"For many low-income and young people the clinic is the gateway to health care," she said. "It seems to me a shame that this was not part of (the hospital's) core mission."

"There are tons and tons of people who are going to the emergency room for their primary care," Zietlow added. "Whatever we can do to change that I want to make sure that happens."

Currently about 1,450 men and women visit the clinic annually. That's 40 percent below its full operating level of 2,500. In June, Bloomington Hospital told the Herald-Times it couldn't continue to provide the family planning services because of this low level of growth and because CHAP offers some of the same resources.

Of the clinic's patients last year, 80 percent were eligible for free services and the rest were charged reduced rates according to a sliding-fee scale based on income. Only about 25 percent were enrolled in CHAP.

"I think the major shortfall is that the program has not been able to achieve seeing the amount of people the Indiana Family Health Council wants them to see," Rogers said.

Cindy Hobbs, community health services manager at Bloomington Hospital, defended the hospital's decision not to continue the clinic.

"We have limited resources to handle all of these grants," she said. "Bloomington Hospital has offered to partner with (other) entities; we just don't want to oversee the grant."

The Monroe County Health Department's next step is to find a location. Rogers is hoping the city of Bloomington will be willing to assist the health department in this venture.

"The ideal place is to have a location that is very visible," she said.

The new clinic will begin services in February, when the contract with the Bloomington Hospital ends.

"Our goal is that there will be no break in services," Winston said. "We are looking forward to getting a new clinic going in the area."

Sarah Core can be reached at score@indiana.edu.