Under the knife 

Flathead family planning crosses county lines

Glacier National Park isn’t the only thing separating Flathead County and Glacier County. A quick look at census numbers reveals the gap: In 2000, Flathead County’s median income was $34,466; in Glacier it was $27,921. Glacier had a poverty rate of 27 percent in 2000, compared to 13 percent in Flathead.

By both measures, Flathead County beats the state average, while Glacier fares worse.

There is also some disparity between state averages and Glacier County when it comes to sexually transmitted disease (STD) and teen pregnancy rates. Glacier County has an STD rate of 944 per 100,000 people, compared to a state average of 160 per 100,000, and a teen pregnancy rate of 98.8 per 1,000, compared to 36.9 per 1,000 statewide.

In 2001, Flathead County Family Planning began a satellite program in Glacier County that attempts to bridge the divide, and help curb soaring teen pregnancy rates and STDs in Glacier County. But the program, due to expiring federal funds, may be in trouble.

To start the satellite program, Flathead County Family Planning applied for, and received, federal funding aimed at providing family planning services, including contraception, STD prevention, female reproductive health exams and counseling, to remote areas that cannot afford their own family planning services. With the federal dollars, the county established the satellite office in Browning, on the Blackfeet Indian Reservation in Glacier County. The need for such a program in Glacier County was clear, according to Wendy Doely, Flathead County’s family planning director.

When the satellite office set up shop in Browning, the federally run Indian Health Services (IHS) program had already been providing contraceptives and information on teen pregnancy and STDs to residents of the reservation. But, Doely says, there’s a long waiting list to receive such services through IHS. And according to her, surveys of the satellite program’s patients show that many prefer it to the IHS program because visits to the satellite program are kept confidential.

The satellite program, which served 298 patients last year, has been “getting a lot of people that fall through the net,” Doely says.

Beth Benjamin is the Flathead Family Planning physician’s assistant who administered the satellite program for the last year. She says she feels welcomed on the reservation.

“The patients know I’m from Kalispell,” Benjamin says. “They seem to not have any problem with it. I feel I’m well received.”

Doely feels the same way.

“The tribe has been absolutely supportive,” she says.

Calls for comment on the program to the Browning IHS office and to Browning residents working with the satellite program were not returned.

Unfortunately, the satellite program faces an uncertain future. Money provided by the federal government to start up the program was intended to do just that—start it up. The idea was that once started, the program would become mostly self-sufficient, as in the case of Flathead County Family Planning, which currently gets 36 percent of its funding from government sources, and the rest through donations.

But the Browning satellite has not become self-sufficient. Last year, the program took in less than $25 in donations. That meager amount, says Doely, is likely caused by the higher poverty rate in the area. Adding to the pinch caused by tepid financial support from the satellite’s clientele, federal funding ran out at the end of 2003. When that money ended, the state of Montana kept the program going by allotting it a portion of its federal family planning dollars. Those funds have now dried up as well.

Doely has applied for another $14,000 in federal grants to keep the program running, but doesn’t yet know if these will be awarded. If that money doesn’t come through, she will ask Browning’s Community Health Representative, a branch of IHS that deals, in part, with preventative care, if they will foot part of the bill. If that doesn’t work, she’ll have to ask the county board of health to make a decision: continue the Browning program with the use of Flathead donations, or end it.

“I hate to think about how much of a drain this is on the [Flathead] program, but I don’t want to give it up,” Doely says.

It has taken time, according to Doely, to establish the trust of the Browning community.

“It would be a shame to close it,” she says. “To get started and then say ‘the money’s gone, you’ll have to go somewhere else.’”

“Teen pregnancies and STDs affect everyone in the state,” Doely says, and the likelihood of a teenage girl going on to find a good career and be able to support herself declines when she has children. Likewise, someone suffering from a debilitating disease is more likely to have a difficult time finding a career. People having trouble supporting themselves are more likely to turn to the state or federal government to make ends meet.

Providing family planning services is Flathead Family Planning’s strategy for breaking this cycle, and bringing down not only STD and teen pregnancy rates, but the poverty rate as well.

If the federal money doesn’t come through, Doely hopes people in Flathead County will be supportive of the program and not put pressure on the health department to cut it.

Benjamin shares Doely’s wish.

“I hope that people grateful for the service we provide here would wish the same for everyone in the state,” Benjamin says.

But Flathead City-County Health Department Public Health Officer Joe Russell isn’t sure that the county will support Flathead funds going to Glacier County.

“I wouldn’t expect the Flathead County board of health to support a Glacier County family planning program,” Russell says.


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