Monroe County has reached a milestone in community health care with the opening the county's new family planning clinic, according to Charlotte Zietlow.

Although most counties in Indiana provide health care services to their citizens, this is the first time Monroe has done so, the former county commissioner said. The Monroe County Health Department had contracted out virtually all health care.

"I am very excited about the fact that we now have real health services provided by the county health department," Zietlow said. "My long-range dream is that this will work so well that Monroe County will begin to think in terms of broader primary health care. Someone has to do it."

Zietlow considers this a very progressive step in our community.

The clinic, at 338 S. Walnut St., became operational in June under health Department Administrator Bob Schmidt. It is staffed by LPN Lauretta Ionoff and nurse practitioner Jackie Squires.

Services include breast exams, pap smears and birth control, as well as testing for pregnancy, sexually transmitted disease, blood glucose and anemia.

The clinic does not yet have a name. Squires likes "Choices." County Council President Sophia Travis suggested the name "Seasons," to symbolize the seasonal changes in women's lives.

The clinic was created to serve low-income members of the community, both women and men. Most patients receive services for free.

Originally run by Bloomington Hospital, the clinic was closed last year after the hospital let go of the federal Title X grant, which had paid for the clinic's operation.

Squires believes there is a growing trend in America for hospitals and pharmaceutical companies to "get out of the business of assisting the poor," even when grant funding can be secured to provide services.

But Squires emphasized that the clinic doesn't provide services to just the poor.

"There are many working people in our community who simply don't have health insurance," she said, "part-time workers, the self employed and young people."

Ionoff pointed out that there is a large sub-group in the community not getting its health-care needs met.

Both nurses said they see many women who have health problems that the clinic is not equipped to handle. Early treatment could prevent major illnesses in the future, but the patients lack health insurance, and their problems go untreated.

Squires expressed frustration because she often has no one to refer patients to for follow up treatment. The clinic is seeking doctors who will provide follow up services pro bono as well volunteers who can translate for Spanish-speaking patients.

Squires considers lack of health insurance to be the greatest risk to women's lives. "What are we doing to the people of our country?" she asked.

Regarding the new cervical cancer vaccine, Squires said it is unlikely that the clinic will provide it when it becomes available, as the vaccine must be administered prior to exposure to the human papillomavirus or HPV, the primary cause of cervical cancer in women.

Squires estimates that 80 percent of the adult population has been exposed.

Many doctors do not test men for HPV when they test for sexually transmitted diseases. Squires said this is a concern because the virus can be transmitted even when condoms are used.

Squires also expressed alarm about the shift over the last 10 years in the amount of sexual education provided in schools. She is concerned about the teenagers who have come into the clinic for services.

"Many of them seem very ignorant about their own bodies," she said, adding that the clinic intends to conduct outreach education at the local schools in the fall.

Amy Semler Gerston can be reached at amysemler@hotmail.com.