Adair County supervisors hear proposal to regionalize public health services with Guthrie County

Adair County Board of Supervisors on April 29 heard a briefing from Adair County Health System staff on a possible regional model that would combine county public health services with neighboring Guthrie County.

The presentation, given by Philicia Hancock, Stephanie Claussen, Catherine Hillestad and Matt Haley, outlined a state-level push toward county-combined public health services and described a Region 4 plan that would include Adair and Guthrie counties. Staff said the model under discussion would use an RFP process to award a five-year contract funded through grants, with a lead district or fiscal agent coordinating hiring and purchasing while each county retained its own Board of Health.

Why it matters: county leaders and staff said regionalization could address staffing shortages and administrative complexity—particularly grant management—but could also change local service delivery and costs. Supervisors pressed for clarity on how services such as mental-health supports and elderly in-home assistance would be preserved and funded under a regional arrangement.

Adair County Health System staff told the board that local public health staffing is currently thin—“primarily one person, with Lisa assisting alongside hospital duties”—and that Stephanie Claussen’s last day is May 12. Matt Haley, the system’s CFO, provided handouts outlining the proposal and fiscal considerations. Staff described how some counties already operate under interim combined arrangements, with one county serving as fiscal agent to manage grants and administrative tasks for neighboring counties.

Board members raised several financial and service concerns. Supervisor Hoadley pointed out reduced tornado-related funding compared with earlier expectations. Supervisor Wedemeyer noted that costs could decline under a shared model but asked for details; Walker voiced concern about potential large bills moving to Adair if services were consolidated. Questions were raised about whether the county’s existing contribution level (an example figure discussed was $90,000) would continue or change; that amount has not been finalized.

Catherine Hillestad, serving as chair of Adair County’s Board of Health, cited difficulty securing 24/7 in-home care in one instance and said collaboration could produce solutions. Raedean Bigelow and other health staff described how prior partnerships (for example, work with Everystep) have helped the county meet needs despite budget constraints.

Officials noted that Guthrie County already provides some environmental health and EMA services that Adair does not and that regional cooperation could allow Adair residents access to those services. Staff said a formal proposal could arrive before the board in July; Adair County Public Health plans to meet with supervisors in advance.

The briefing was informational; no formal vote on regionalization was taken. The board did authorize county staff to proceed with personnel steps requested by the county treasurer and set other routine matters during the same meeting.