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How a political fight plays out in health care on Florida's west coast

The Florida Department of Health in Sarasota County employs four obstetricians and sees pregnant women from conception to delivery.
The Florida Department of Health in Sarasota County employs four obstetricians and sees pregnant women from conception to delivery.

The Florida Department of Health wants Sarasota County to privatize its prenatal care in the next three years. And that has its southern neighbors worried – after all, when Charlotte County privatized health care, residents started leaving the county for care.

Charlotte County Commission Chairman Bill Truex walks through a small, squat building that houses a lot of the government functions for the small town of Englewood. He points into a darkened room.

Here, the Charlotte County Health Department used to have a health clinic until it closed in 2013. Volunteers staff it two days a week for a couple hours in the evenings.

“And then we have this facility,” Trues said. “It’s a small facility and they do need more space.”

Truex said the state forced Charlotte County to privatize health care services. And that isn’t necessarily a bad thing.

“If you have them in proximity to your population,” Truex said. “Our problem here is we have one in the southern portion the county and this entire area over here is kinda left in flux as to where they’re going to get their health care.”

[caption id="attachment_53525" align="alignnone" width="400"] The Englewood Community Care Clinic is open two days a week in the evening to see patients .It fills a hole left by the Florida Department of Health.[/caption]

Where they get their care is an hour north in Sarasota County, and that includes pregnant women in particular. Truex is worried because state officials want what happened in Charlotte County to happen in Sarasota County.

“I think what happens in Sarasota County when they go to our model, which is being forced on them by the state as it was forced on us, is we get a larger void,” Truex said.

The grass is always greener in the other county
So what kind of public health system does Sarasota County have for pregnant women? In a word, robust.

Dr. Washington Hill helped build a clinic for high-risk pregnant women in Sarasota County. And now, the health department in Sarasota looks a lot like a private OBGYN practice.

It has four doctors on staff, and treats pregnant women from conception to delivery. Seeing high risk patients is a calling for Hill. He said some women see pregnancy as the reason to clean up their life.

“There are other patients we have to struggle with, to be honest,” Hill said. “They miss their appointments and when I go into the room I say where have you been? They have this excuse and that excuse. And I tell them nonjudgmentally that I need you to bring the baby in.”

[caption id="attachment_53533" align="alignnone" width="274"] Dr. Washington Hill helped found the high-risk pregnancy program for Sarasota County.[/caption]


The Sarasota County Health Department delivers one out of every five babies in the area. And it's able to run the clinic on a $17 million budget. It’s a government partnership with the private sector, and the state puts in less than $100,000 per year.

Chuck Henry, director of the Sarasota County Health Department, said 40 years ago, health departments started employing doctors and taking care of patients directly because there wasn’t anyone else to do it.

“It’s also the reason you hear a lot of conversations going on today from a standpoint of reevaluating that model to see is there capacity in our community to begin to hand off some of these services to other entities that can provide them at just as high a quality as the health department, and maybe at a lower cost,” Henry said. “And I think that’s our responsibility as a taxpayer entity.”

[caption id="attachment_53523" align="alignnone" width="400"] Chuck Henry is the director of the Sarasota County Health Department.[/caption]

State officials have put the county health department on notice that that the state wants it privatized in the next three years. And that scares Sarasota County Commissioner Christine Robinson.

Robinson and fellow commissioners have been challenging the shift since May.

“The thought of turning out 30,000 people or them not getting the proper care that they need in this county makes my knees shake,” Robinson said. “When I get the question of what’s the biggest issue that keeps you awake at night in Sarasota County, this is it.”

The Florida Department of Health in letters has said it will remain a partner in Sarasota County’s health care for now. But it also made clear it wants to change that, both in Sarasota County, and elsewhere in the state.

Statewide, only 28 of Florida’s 67 counties offer prenatal care. And it boils down to a philosophical question: Should government provide health care? State officials say the private sector can do better. Robinson disagrees.

“I just can’t imagine children and mothers and folks who can’t afford it not getting the health care they need because of a policy decision made in a vacuum,” Robinson said.

Robinson generally favors privatizing government functions – when it makes sense. Just this year, she worked to privatized Sarasota County’s transportation for disabled residents.

“I’ve been a lifelong Republican and been very active in my party, but you know what, you have to apply common sense to situation and this just does not make sense,” Robinson said.

Check here to see the full Pregnant and Poor series from WMFE.