Monroe County Health Department: Futures Family Planning Clinic

• 2025-04-24 Personnel: Job posted. Health Services Director position is posted as a 35-hour a week PAT D position with compensation starting at $57,458 [HSD job posting] [Monroe County job posting page]

• 2025-04-22 Personnel: Org chart issues. Monroe County council rejects request for reclassification of Health Services Director position in the health department. BSB coverage

• 2025-04-17 Board of health response to public comment. Board of health member Dawne (Aurora) DiOrio: "The requirement for cross-training that was mentioned has truly nothing to do with the family planning clinic. This was a Monroe County, all-county, all department-wide initiatives. Cross-training was required of all employees because as we learned during COVID, you cannot run any business if several people are out and another person doesn't know how to answer a phone, or how to, you know, how to take care of basic stuff. So, that wasn't Lori’s decision or initiative. It wasn’t a Title X. It had nothing to do with the Board of Health. That was a Monroe County government initiative." Board of health member Stephen Pritchard: "I am sorry that some employees feel that they were unfairly treated. I'm not convinced that that is the case." [meeting video]

• 2025-04-17 Public comment to board of public health. Monroe County board of health meeting. Public comment from: Christine Brackenhoff, Debbie Deckard, Jane Walter, Chris Husted (former Futures Family Planning Clinic employees); Ashley Cranor (former board of health member); and David Henry (Monroe County councilor). Henry notes that the health services director role, on which the council would be voting to reclassify the following week, was at one point contemplated as merging with a position that would have overseen the Futures Clinic. Brackenhoff: "During a May 2024 health board meeting, Dr. Pritchard described Futures staff as resistant to cross-training in accordance with their job descriptions. As the last LPN of Futures, I recently obtained my personnel file from county HR, which contained neither a poor performance review nor a corrective action plan. Then, I asked Dr. Pritchard and Lori Kelley to elaborate on which part of my job description I resisted. Neither of them provided a response to this request." According to Kelley's note in Brackenhoff's personnel file explaining the reason for Brackenhoff's departure, "Employee not interested in cross-training to assist with front office duties." Brackenhoff rejects that claim. Cranor: "[Brackenhoff's] questions have largely gone unanswered, echoing what happened during the last major leadership transition, when we lost six long term staff members when they raised concerns and were shut down and out by this administration. We are nearing 35–40 employees that have either resigned or been terminated in the last couple years. This is a serious loss, especially in this particular field where training, relationships and institutional knowledge are critical. Let me be clear, as Christine mentioned, there is no law preventing the board and speaking with department staff. That's a choice that you all are making." Deckard: "I worked the front desk and came to understand and know our patients... I wanted to request my file, because it says I am not eligible to rehire part time, 24 hours a week. [To Lori Kelley ] Then you said, you'd correct it. Then I got this one—I am eligible to rehire. How many others have you done this to that haven't asked for their final?" Husted: "You may recognize me as the former clinic manager for futures from January of 2015 to October of 2022. ... One of the major reasons that I left is, frankly, due to Lori's leadership or lack thereof." [Jane Walter commentary] [Ashley Cranor commentary] [Christine Brackenhoff commentary] [meeting video]

• 2025-02-10 Title X oversight. Bloomington Family Planning Center opens, operated by IFHC. [news release]

2024

• 2024-12-18 Leadership change. County Commissioners confirm Sarah Ryterband as Monroe County health officer to replace Clark Brittain. Ryterband: "Good morning commissioners, and I will say all three of my friends, you appointed me two years ago to sit on the health board. And when my fellow board members asked if I would step up into this new role, I thought about it long and hard and considered what I could do to serve the community in bigger and better ways as the health officer for Monroe County. And so a week ago, my fellow board members unanimously and enthusiastically appointed me as their new health officer, and I'm here before you to confirm that and ask you to bestow your blessing on that." [CATS video recording]

• 2024-12-11 Leadership change. Monroe County Board of Health meeting. Stephen Pritchard steps down as president, Dawne (Aurora) DiOrio is elected new president. Pritchard: "I want to thank the board for their support during that last year and a half. They haven't been the most pleasant at times, but overall, I feel like the department…we guided the department through some of the very difficult times and I feel like it’s on sound footing. And I’ll give a lot of the credit to Lori, who I think is an amazing administrator, and she’s had to put up with a lot of things, well from me and from the public.” [BSB coverage]

• 2024-12-11 Leadership change. Monroe County Board of Health meeting. Clark Brittain resigns effective Dec. 31, 2024. Board of health recommends commissioners appoint current board of health member Sarah Ryterband as health officer. [BSB coverage]

• 2024-10-21 Board action. An after action review meeting is held to go over events that led to the closing of the Futures Family Planning Clinic. Attendees included: Julie Thomas (county commissioner), Lori Kelley (county health administrator), Elizabeth “E” Sensenstein (Monroe County HR), Steve Pritchard (board of health), Sarah Ryterband (board of health), Dawne (Aurora) DiOrio (board of health), Trent Deckard (county councilor), John VanderZee (CJAM moderator) [after action report for public release]

• 2024-10-01 Personnel: Org chart issues. Added to the Monroe County council's personnel administration committee (PAC) is an item that forwards to Waggoner, Irwin, Scheele & Associates (WIS), a request for reclassification of the health department's director of health services position. Councilor Marty Hawk: "For some whatever reason, there was a comment made by a member of the [health] board, hopefully it wasn't something that Ms. Kelley believed, was that we were fully aware that they were going to lose this grant for family planning. We were not fully aware. And to my recollection, every time the health board brought us something, we had to work with them, we wanted to work with them to make sure that their requests were in-line so that they could get the right kind of information back from WIS. And so, to allow the public to believe that this county, the PAC meeting, was in some way responsible in any way that we lost that grant for the family planning, is just unconscionable and not appreciated at all. And I just felt like there was a time to say that, and this is the time to say it.”  Councilor Geoff McKim: "I received an email from a member of the public, who is concerned about the statements that were made. I actually responded to that with a detailed list of links to public meetings, public meeting minutes, public meeting videos that will dispel that myth, that PAC or County Council was responsible for the collapse of the clinic or was aware.” [meeting video] [meeting agenda]
• 2024-09-30 Board response to public comment—Response from electeds. County councilor Peter Iversen writes in response to a question from former Futures Clinic LPN Christine Brackenhoff, "Sadly, I had no foreknowledge of the clinic closing. As a long term liaison to the Health Department and a former employee of the School of Public Health, this closure surprised and saddened me. Rest assured that the County Council did not have a role in closure of this clinic. Had it been within the fiscal oversight to save it, we would have had a very public conversation to this end."

• 2024-09-24 Personnel: Org chart issues. Herald-Times reports: "Kelley, the department administrator, has said the department could not post a job because 'we did not have a county approved job to post.' She said the department had been asking the Personnel Administration Committee and Monroe County Council for a new position—director of clinical operations—but was told it could offer that job only if it reclassified the existing clinic manager position. 'That process has been going on most of this year,' Kelley said. 'Since all clinic jobs were being reworked, we had no jobs we could post, except (a) temporary part time job'." [HT coverage]

• 2024-09-19 Board response to public comment. Monroe County board of health meeting. Board member Sarah Ryterband responds to Charlotte Zietlow, saying about county councilors and commissioners, "They were aware, Charlotte, leading up to this, what was going on...They were aware, leading up to the removal of the grant from our hands, what was happening and the struggles we were having with the clinic. It came as no surprise to them. They were just as distressed as all of us are." [meeting video]

• 2024-09-19 Public comment to board of public health. Monroe County board of health meeting. Christine Brackenhoff, Charlotte Zietlow, Jane Walter (long-term English-Spanish interpreter for Futures), and David Henry gave public comment." Brackenhoff: "Dr. Pritchard stated 'this clinic hasn’t been running to sufficient standards and up to the standards it had been previously run, and that’s for most of this 2024'. Other than critically low staffing, I did not hear him specify the clinic’s unmet standards. However, it is worth noting that Futures had a completely new staff at the start of 2024, compared to the start of 2023, and did not have a clinic manager during its final 4 months of operation." [meeting video]  [Christine Brackenhoff public comment]

• 2024-08-27 Title X oversight. IFHC news release states: "Due to continued staffing challenges encountered by the Futures Family Planning Clinic operated by the Monroe County Health Department, the Indiana Family Health Council (IFHC) will assume responsibility for the clinic under its Indiana Family Planning Centers structure. The new clinic will be named Bloomington Family Planning Center." [copy of news release]

• 2024-08-23 Title X oversight. IFHC informs Monroe County Health Department of termination of contract with Futures Family Planning Clinic. According to Elizabeth Sensenstein, who is Monroe County’s personnel administrator, the tally as of this week shows that 21 full-time and 7 part-time employees have left the county department since June of 2022. Based on the county’s 2024 salary ordinance, a full complement of staff for the entire health department, full- and part-time, is around 50. [BSB coverage] [copy of former Futures Clinic employee Jane Walter letter to board of health]

• 2024-08-22 Title X oversight. HealthNet Bloomington Health Center manager emails Lori Kelley and Stephen Pritchard, stating that HealthNet would not be able to make a decision about "the Title X program" until "after the first of the year". [copy of email message]

• 2024-08-21 Board action. Board of health votes to announce a 30-day closure of clinic, pending decision from IFHC about continuation of grant. The last remaining employee an NP is terminated through a vote of the board. [BSB coverage]

• 2024-08-13 Title X oversight. IFHC president Kristin Adams emails Lori Kelley in response to shifting duties like billing, to an NP working as a sole clinical staff member: "I am concerned about having the majority of the burden of these tasks put on an NP; while she does need to know how the clinic operates—she has a responsibility to the care of her patients and also needs assistance—an IUD placement requires 2 people—she needs an assistant so she can stay sterile during the process." and "It does not seem things are running efficiently and I am ultimately concerned about the stability of Futures without a thorough game plan...I believe the clinic provides quality care, but at this point we may see quality decline if the stressors to the system are not relieved". [copy of email message]

• 2024-08-09 Personnel: Morale Futures Clinic LPN Christine Brackenoff submits her two-week resignation notice to health administrator Lori Kelley, with Aug. 23 as final day of employment.

• 2024-08-08 Personnel: Morale Futures Clinic LPN Christine Brackenoff sends email to board of health members Dawne (Aurora) DiOrio and Sarah Ryterband: "I'm not sure if you are aware, but morale among the Futures staff has been low" and asks if it would be possible to meet to discuss concerns. DiOrio responds: "Board members will not have meetings with Health Department employees unless Lori is in attendance. In this situation Dr. Brittain would also need to be there."

• 2024-08-05 Personnel: Morale On this day or shortly thereafter, Futures clinical assistant Debbie Deckard submits her resignation notice.

• 2024-07-19 Title X oversight. Email thread shows that MCHD administrator Lori Kelley was in back-and-forth with Shelley K. Sallee, Center Manager at HealthNet, about transferring Title X services to HealthNet. [copy of email messages]

• 2024-07-09 Personnel: Org chart issues. The county council's personnel administration committee (PAC) hears a request to create a new position: Clinical Services and Case Management Director. PAC votes to send the position to Waggoner, Irwin, Scheele & Associates (WIS) for review. [meeting agenda] [meeting video]

• 2024-06-24 Title X oversight. IFHC president Kristin Adams sends email to Lori Kelley about meeting grant recipient requirements for outreach: "As a reminder you are under contract to conduct a minimum of two outreach events per quarter. This is actually in our work plan that states each sub-recipient will do this. I am currently submitting our year 2 progress report and am attesting your agency has not met this goal. Please ensure the next 3 quarters of year 3 your agency will meet this goal." [copy of email message]

• 2024-06-01 Personnel: Friction with management. Outreach event that did not include Futures Family Planning clinic is held at downtown Monroe County Public Library. [copy of event posting]

• 2024-05-30 Title X oversight. IFHC president Kristin Adams sends email to Lori Kelley stating that "there are several identified areas where the [MCHD] Board has concerns about the Futures Family Planning Clinic yet no one has approached us as the funder. I believe, based on what is documented, is a false misrepresentation of how we view the clinic". Adams also writes: "I am concerned that you have reported one male visit with STD testing—this could potentially be a violation of HIPAA since there is only one patient—you have identified location, male, and service rendered. IFHC does not support data like this to be released unless there are a minimum of 5—we would prefer 20." Kelley responds to Adams: "Thank you for reaching out and bringing this to my attention. We typically do not report on that information, have not historically, and will ensure that any board reports in the future are general information, with specifics left to internal department record keeping purposes only." [copy of email message]

• 2024-05-30 Personnel: Friction with management. Lori Kelley sends email to population health and outreach manager, Kathy Hewett: "Were you and Melanie speaking with Futures again about community outreach? It seems the topic came up again yesterday. Please stop." [copy of email message]

• 2024-05-17 Personnel: Friction with management. Lori Kelley sends email to population health and outreach manager, Kathy Hewett: "If your area was looking for someone to split the outreach time with Brandon I wish that would have been discussed with me before asking anyone in Futures, especially as now this will further complicate short staffing issues because it will pull at least one of them away from a working day." [copy of email message]

• 2024-05-16 Personnel: Clinic performance and cross training. Monroe County board of health meeting. Clark Brittain states that the remaining Futures staff members are "seeing more patients now...they're scheduling more patients, they're working on the schedule, they're interested in maintaining the clinic". Stephen Pritchard claims that Futures staff are resistant to cross-training for duties in their job descriptions. Pritchard: "I don't understand what the resistance is to cross-training positions. I mean, everyone in every organization, you have people that are gone for one reason or another, if there's illness or whatever. And somebody else has to fill in and help with that job. Well, you know, it's really advantageous if you've had training in that area already. But, we're also meeting some resistance to cross-training down there. 'Well' you say, 'this wasn't my job before.' 'Well, it was in your job description. Yeah, maybe we weren't asking, but if you look at your job description, yes, this is part of your jobs'. So, change is never easy, they haven't been required to do these things in the past, so it's not like everything's just rosy down there." Pritchard describes clinic staff as having a perception that they should have unlimited time to do intake visits. [meeting video]

• 2024-04-29 Personnel: Cross training. MCHD administrator Lori Kelley proposes job description changes. Kelley sends LPN Christine Brackenhoff an updated job description to review. According to the review form, the reclassification was "due to change in duties, responsibilities, work conditions, etc." The form state that revisions constituted "additional duties and responsibilities since the adoption of the existing job description". The form also states that included job functions were, at that time, performed by the Clinical Manager and Financial Manager. [copy of email message]
• 2024-04-29 Personnel: Efficiency. In an email exchange, IFHC president Kristin Adams and MCHD administrator Lori Kelley discuss efficiency of clinic visits. Kelley writes: "We are trying to increase the number of visits we are seeing daily. I've suggested trying to schedule shorter visit types in between the longer annual/initial visits and I'm not sure what other suggestions you might have for increasing our efficiency? We were used to being able to see 6-8 patients a day in the past and the board of health would like to get back to that as a normal standard (especially knowing the high volume of no-shows we get)." [copy of email messages]

• 2024-04-22 Personnel: Morale Lori Kelley, Stephen Pritchard, and Clark Brittain have end-of-day meeting with Emma Rice (NP) and Christine Brackenhoff to share concerns about patient numbers and clinic finances. LPN Christine Brackenoff learns that Futures Family Planning Clinic no longer has a clinic manager. Evan Theis (former clinic manager) is no longer employed by MCHD.

2023

• 2023-04-30 Leadership change. Thomas Sharp resigns as Monroe County health officer. Clark Brittain is appointed by the health board as the new health officer. [BSB coverage]

• 2023-02-15 Leadership change. County commissioners vote to remove Ashley Cranor retroactively as a health board member. [BSB coverage]

• 2023-02-08 Leadership change. Outside of a public meeting, county commissioners remove Ashley Craner from board of health before she can resign, appointing Sarah Ryterband as Cranor's replacement. [BSB coverage]

2022

• 2022-12-10 Personnel: Morale News breaks of several health department resignations or terminations [BSB coverage]

• 2022-10-xx Leadership change. Futures Clinic manager Chris Husted resigns. At the April 17, 2025 board of health meeting, Husted states, "One of the major reasons that I left is, frankly, due to Lori's [Kelley's] leadership or lack thereof."
• 2022-07-15 Leadership change. Lori Kelley starts as Monroe County health administrator. [CATS video recording]

• 2022-06-22 Leadership change. County health administrator Penny Caudill introduces Lori Kelley to county commissioners as her replacement, who will start on July 15, 2022. [CATS video recording]

2006

• 2006 Founding. Futures Family Planning Clinic is founded by Monroe County Health Department administrator Bob Schmidt. [2014 Monroe County Health Department annual report]