Leavenworth County medical director outlines EMS, health-department oversight and Title X limits ahead of contract renewal

The Leavenworth County medical director appeared before the Board of Commissioners at a work session to describe the medical oversight role for both the Emergency Medical Services (EMS) Department and the county Health Department ahead of a pending contract renewal.

The medical director told commissioners that state law requires a licensed physician to provide oversight when the county’s health officer is not a physician and that the medical director’s responsibilities include medical oversight of EMS certification and education, participation in quality-assurance and quality-improvement programs, authority related to pharmacy purchases (including interactions with the Kansas Board of Pharmacy and the DEA), and serving as clinical-laboratory consultant for CLIA compliance. The director also said the office supports the health department’s clinical work (including a physician assistant who sees pediatric patients) and that the county recently standardized contracts so multiple fire and first-responder agencies can operate under a common EMS medical protocol.

Why this matters: The medical director’s oversight shapes clinical protocols used by county EMS, the health department’s clinical services and lab testing, and the ability of local fire and first-responder agencies to operate under a single medical protocol.

What the medical director told commissioners - The medical director described a mix of ongoing duties: monthly education and in-person involvement with EMS, clinical consultation for the health department and acting as CLIA clinical lab consultant. The director said, in the meeting record, "I would follow the CDC guidelines" when asked whether the county would reinstate masking during a future similar outbreak. - On hours and staffing, the director reported being available in spurts and estimated she spends "at least 3 hours a month" personally on health-department issues; the department’s physician assistant (Paul) was described as working about 12 hours a week.

Family planning, Title X and minors - Commissioners pressed the medical director and health-department staff about the county’s Title X-funded family-planning work and what the program requires for minors. The medical director and staff repeatedly said they must follow federal and state guidelines. The meeting transcript records the federal program discussed as "Title X" (referred to in the record as "title 10"). The medical director said she is bound to follow the applicable federal rules and does not set or change those requirements. - Sarah Beaudry, identified in the meeting as the health department’s clinical manager, presented service-data pulled from the department’s electronic-medical-record system. She said the majority of Title X patients are ages 18–39, and that minors who come for services without parental involvement constitute fewer than 10 percent of clients in recent records. Beaudry said the department provides counseling and attempts to involve parents when appropriate and that the department provides emergency contraception or Plan B to established patients (those screened by the KU physicians who contract with the health department). She said the department also emphasizes education and pregnancy case management to reduce unintended pregnancies. - Commissioners asked whether the health department provides abortion counseling or referrals. Meeting participants stated that Title X funding, as discussed in the meeting, does not allow the county to provide abortion counseling or referrals as part of that program. Health-department staff said they provide "non-directive counseling" and refer patients to outside providers only when patients specifically request that information; Planned Parenthood was cited as a frequent referral when people ask where to go for abortion services.

Other clinical issues discussed - Commissioners and the medical director discussed masking and vaccination guidance during COVID-19. The medical director and staff told the board they followed CDC guidance at the time, and the director summarized the position in the record as: "We followed the CDC guidelines." The director also said vaccination recommendations are offered as professional medical guidance but that the health-department role is constrained by state and federal rules. - Abortion-pill reversal and clinical evidence were raised: health-department staff referenced professional bodies (the American College of Obstetricians and Gynecologists was named in the discussion) and stated that reversal treatments are not accepted evidence-based practice by those bodies, and that the county does not provide those services. - The medical director explained the county’s standardized cost structure for medical-director coverage of multiple rural fire/EMS providers so smaller departments could participate under an affordable umbrella agreement.

Data highlighted by staff - Clinical manager Sarah Beaudry said that, using available records through 2024, 18–39-year-olds are the majority of Title-X patients, minors without parental involvement were under 10 percent in the reviewed sample, and Leavenworth County’s abortion rate (as tracked locally) remained around 10 percent over recent reporting periods. Beaudry cautioned that the county’s EMR is antiquated and that staff manually reviewed records to verify the parental-involvement metric.

Process and limitations - Speakers emphasized the limits of the county’s authority: the medical director and health-department staff repeatedly said they are required to follow federal Title X rules and CDC/KDHE guidance and cannot substitute personal positions for federal or state regulations. - Commissioners asked for the medical director’s personal views on policies (including contraception for minors and whether the health department should counsel or refer for abortion). The medical director declined to offer a personal opinion in this public briefing, saying her role is to follow applicable regulations.

What’s next - Commissioners were updated in advance of a contract renewal for the medical-director role, and no contract vote or final decision was taken at the work session. The briefing was presented so commissioners could hear how the medical-director role interacts with EMS, the health department and first responders before action on a renewal.

Ending note: The work session combined a technical review of clinical oversight duties (DEA/pharmacy authority, CLIA lab responsibilities, EMS medical protocols) with questions from commissioners about Title X family-planning rules, minors’ access to contraception, COVID-era masking and vaccination guidance, and the county’s public-health referral practices.