The St. Clair County Advisory Board of Health took no action June 17 on a recommendation from Medical Director Dr. Remington Nevin that the county not reapply for Title X family planning funding, following an extended and often contentious discussion.
The meeting featured roughly 40 minutes of public comment, multiple audience outbursts, repeated calls for order from board Chair Monica Standel and a 10-minute recess before proceedings resumed.
Title X is the nation’s only federal program dedicated specifically to family planning and related preventive health services. Established in 1970, it supports services such as contraception, pregnancy testing, sexually transmitted infection testing and treatment, and reproductive health screenings and counseling.
Nevin outlined his recommendation in a June 12 memorandum, citing staffing challenges, evolving federal requirements, concerns about long-term funding stability, and a need to refocus on core public health responsibilities.
Nevin framed the discussion around whether the county should continue participating in the Title X program.
Nevin argued that many of the services provided through Title X are available elsewhere in the community and that department resources should prioritize statutory responsibilities such as communicable disease prevention.
He also questioned whether family planning services — which are not required under state law — should continue to receive staff and infrastructure support.
Public comment was overwhelmingly opposed to the recommendation.
Elizabeth Sigafoose, a nurse practitioner who provides family planning services through the department, emphasized the program’s role in access to care.
“Public health is about meeting people where they are and ensuring that access to care is not determined by income or circumstance,” Sigafoose said.
Several residents questioned whether other providers could absorb current patients and criticized the lack of a clear transition plan.
“We can’t just stop a program based on Dr. Nevin saying they’ll probably take it,” Clyde Township resident Sherry Mercurio said.
Rachelle Bonelli of Port Huron added, “It’s not a plan, it’s more like a hope and a prayer.”
Board members echoed those concerns, repeatedly asking what would happen to patients if services were discontinued.
According to health department officials, the family planning program served 871 unduplicated clients in fiscal year 2025, up from 612 in fiscal year 2024.
Assistant Director of Nursing Rebecca Campau said the increase demonstrates ongoing demand, citing a recent case in which a staff member received services through the department within days after waiting months for a response from a community provider.
Health Officer Liz King acknowledged Campau’s point. She also reiterated through out the meeting that some patients may face barriers accessing care elsewhere.
Board members also raised concerns about continuity of care for patients using long-acting contraceptives such as IUDs and implants. Nursing and Community Health Director Amy Bishop said staff would need time to coordinate referrals and ensure patients do not experience gaps in care.
Standel questioned whether alternatives could fully replace services provided through the department.
“It’s great to say that you go to Walmart — Walmart can’t provide the services that a lot of these folks are looking for,” Standel said.
While she said she could support scaling back services in principle, Standel emphasized the need for a clear transition plan.
“I can get on board with the Health Department scaling down to core function if I know that the services are being provided in another manner,” she said.
Board member Paul Urben agreed.
“If we’re going to take services away, we have to provide them and we have to find the means to do that,” Urben said. “I’m not satisfied that we have actually done that.”
Financial concerns appeared less central to the decision. Finance Director Jeff Freeman said the program operates at roughly a break-even point through grants, insurance reimbursements and client fees.
Administrator Greg Brown said the department has historically avoided deficit spending and argued funding should not drive the decision.
“This decision really shouldn’t be wrapped around funding,” Brown said.
Despite the lengthy discussion, no board member introduced a motion. The advisory board ultimately took no vote and issued no formal recommendation before moving on to the next agenda item.
The Advisory Board of Health holds regular meetings at 9 a.m. on the third Wednesday of each month.
Meetings are held in the County Administration Building, 200 Grand River Ave., Port Huron, and are livestreamed on the county’s YouTube channel.
Contact reporter Andy Jeffrey at ajeffrey@usatodayco.com.
This article originally appeared on Port Huron Times Herald: St. Clair County health board takes no action on Title X recommendation
Reporting by Andy Jeffrey, Port Huron Times Herald / Port Huron Times Herald
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By Andy Jeffrey, Port Huron Times Herald | USA TODAY Network
