Adair County health staff discuss regional public-health model, possible partnership with Guthrie County

Representatives of Adair County Health System told the Adair County Board of Supervisors on April 29 that the state’s revitalization of the public-health model could soon push counties toward combined service districts and that Adair may partner with Guthrie County under a Region 4 plan.

Adair County Health System presenters — Philicia Hancock, Stephanie Claussen, Catherine Hillestad and Matt Haley — said the state is moving toward establishing service system districts and that the plan under discussion would use an RFP, a five-year contract period and grant funding. Under the proposal, a lead district could act as a fiscal agent to manage hiring and purchasing for cooperating counties while counties retain their own local Boards of Health, Hillestad said.

Staff emphasized limited current capacity: Steph (identified in the presentation as a public‑health staff member) will leave May 12, and the office currently relies on one primary employee with help from hospital staff to balance duties and the budget. Haley, identified as the health system’s CFO, provided handouts explaining how grant funding has fluctuated; he and staff said COVID-era grants produced strong revenue but that current grant funding is lower and grant management can be nearly a full-time task.

Presenters described benefits of regional collaboration, including shared administrative capacity, access to services Guthrie already provides (for example, environmental services), and the possibility of keeping some local presence in Adair on specific days. They said an initial arrangement could be interim before becoming permanent, and that contract terms could be used to limit sudden cost increases.

Supervisors and staff discussed concerns about service continuity and taxpayer impacts. Supervisor Hoadley noted that tornado-related funds had been lower than expected and urged attention to county budgets. Wedemeyer and others asked whether costs would decrease under a shared model; presenters replied that some costs could be reduced, but long-term savings and service availability depend on final contract terms and grant funding. The board also discussed differences between public health and home-care services; presenters clarified home care is separate and that Guthrie provides some home-care services Adair does not.

Board of Health Chair Catherine Hillestad described local challenges securing 24/7 in-home care but said past partnerships (including work with Everystep) show collaboration can produce solutions. Raedean Bigelow and other staff noted that while public-health operations previously ran at a loss, grant support has improved finances in recent years.

Adair County Health System indicated it will return to the board before July with a potential proposal for consideration. No formal action to change public-health governance was taken at the April 29 meeting.