Clark County Board of Health adopts resolution to expand prenatal access for Medicaid clients

The Clark County Board of Health on Sept. 24 adopted a resolution committing the county to address persistent gaps in prenatal access for Medicaid (Apple Health) clients and to develop a work plan for local and legislative action. The board passed Resolution 2025-09-09 by voice vote; the motion was seconded and the chair announced the motion carried.

Kaylee Pickus, family initiatives coordinator with Clark County Public Health, told the board the resolution and associated work plan grew from data and community meetings held after local WIC partners alerted the county to access gaps. Pickus said the board asked staff to translate findings from a policy summit and a provider scan into concrete priorities and a legislative agenda.

Dr. Alfred Seacamp, an OB-GYN and chief medical officer at Vancouver Clinic, described the local delivery system and the access problem. “We deliver about 2,000 babies in Clark County every year. About 600 of those are Medicaid patients,” Seacamp said. He said Vancouver Clinic employs about 20 OB-GYN physicians and 20 midwives and that the clinic “loses money on every Medicaid delivery that we do” and therefore must limit the number of Medicaid patients it can accept. Seacamp said a local federally qualified health center’s decision to stop hospital deliveries left roughly 500 Medicaid patients having difficulty finding prenatal care, and that stress has affected both prenatal clinics and hospitals providing deliveries.

Seacamp advocated for piloting group prenatal care (centering) led by midwives, which he said offers longer, cohort-based visits focused on education and peer support. He cited published studies showing “lower rates of prematurity,” reduced cesarean deliveries and higher breastfeeding rates from group prenatal models, and said the model can continue into early pediatric care for families.

Sheryl Montani, chief hospital executive at PeaceHealth Southwest Medical Center, said her hospital also provides about 2,000 deliveries a year and voiced support for regional collaboration. “Early and regular prenatal care is such an important strategy for reducing pregnancy complications and preterm birth,” Montani said, and she urged shared, cross‑system efforts because no single health center can solve the problem alone.

Pickus and presenters said next steps include convening health-system partners, identifying funding sources, and preparing legislative asks. Pickus noted the resolution’s implementation language directs the county to “prioritize seeking new funding and allocating existing fund sources to support efforts for access to pregnancy-related care,” and that partners will work to specify dollar amounts and funding mechanisms before programs begin.

During public comment, Emily Estes, vice chair of Clark County’s Public Health Advisory Council, described her personal difficulty obtaining timely prenatal care while insured by Medicaid in 2022 and urged the board to adopt the resolution. “Medicaid saved my children’s lives, but I believe we can do better for Clark County,” Estes said, describing a delayed prenatal diagnosis and subsequent neonatal intensive care for twins who required multiple specialty services.

The resolution was introduced by staff as Resolution 2025-09-09 and then put before the board for a vote. A councilor moved the resolution and Councilor Belcott seconded; the chair called for those in favor and the motion was carried by voice vote. The resolution directs public health to lead a county work plan, convene partners, seek funding, and return with specific proposals for program design and legislative priorities.

County staff and presenters repeatedly emphasized that program design and funding levels still need to be specified and that the county’s role would include serving as a neutral convener. Vancouver Clinic and the hospitals signaled willingness to participate in program design, and the resolution notes support received from Vancouver Clinic, PeaceHealth Southwest and Legacy Salmon Creek Medical Center.

The board signaled the item will return in future meetings as staff develop the work plan, funding requests and pilot details. Speakers suggested that potential county actions include allocating existing local funds where feasible, seeking state-level funding, and partnering with community providers to pilot centering/group prenatal visits and strengthen midwifery services.