Monroe County could face public health services gap as IU Health ends long-time contract

When IU Health stops providing key public health services under a contract with Monroe County’s health department at the end of 2025, it’s not yet clear how the department will satisfy its responsibility under state law to provide those functions.

Monroe County health department will have to find a different way to provide a raft of different offerings. Included are vaccinations, testing for communicable diseases, and contact tracing for those diseases. IU Health currently provides such services at the public health clinic operated at a location on Miller Drive, down the street from the city of Bloomington utilities customer service center.

At this Thursday’s Monroe County board of health meeting, the board got a briefing from health administrator Lori Kelley on the approach she will be taking to fill the services gap—which is to request one new staff position, and to revise the job descriptions for two other positions.

That personnel request appears on the draft agenda for the county council’s meeting next Tuesday (Sept. 23).

The news that IU Health is ending its 60-year arrangement for public health services first surfaced at the county board of health’s regular meeting in the third week of August. IU Health had conveyed the decision to Monroe County two weeks earlier.

In a statement to The B Square, an IU Health spokesperson said, “IU Health is redeploying resources in the area to serve the entire region.” According to IU Health, the health provider is documenting all the work procedures in writing and offering to meet with the local health department staff weekly during the five months when Monroe County’s health department is transitioning to an alternate way to provide the services.

At the board of health’s August board meeting, board member Stephen Pritchard pointed out that the decision by IU Health “puts [Monroe County] in the same position as every other county health department in the state” which means the department has to find a way to provide the services without a contract with IU Health. Providing the services is not optional—they’re required under state law in combination with state administrative code.

According to Kelley, the value of the IU Health contract for this year is $228,860. At its Sept. 10 hearing about the health department’s 2026 budget, Kelley told the county council that the IU Health contract money would be transferred from the services budget line, likely to a personnel line, to be able to provide nursing services in 2026.

There’s an urgency to deciding exactly how the public health services will be provided, if Monroe County’s health department chooses to provide them with its own staff. Based on the board discussion at this Thursday’s meeting, the kind of work that is involved is not a part of a general nursing background, and would require significant additional staff training.

The physical space that staff would use would be in the county health building at 7th Street and College Avenue—likely on the bottom floor, where the now demised Futures Family Planning clinic was housed.

Currently, three IU Health nurses provide the services in question. Kelley told The B Square the county health department would maintain the same capacity: “Our goal is to hire at least one new position starting out, and we would like to edit two other job descriptions that we have, to add in these additional duties.”

According to Kelley, one new position—focused on communicable disease—has been proposed, along with edits to job descriptions for two existing roles. The county’s behavioral health and wellness position would continue as currently budgeted, while the school liaison role, currently vacant and unfunded, would be restructured.

Kelley added, “But ultimately we’ll be relying on the county council to work with us on making those changes.”

It’s not automatic that the county council would approve new job descriptions and hires on the short timeline that would be needed in order to get the people in place in the next three and a half months. Faced with a $9 million deficit at the start of 2026 budget hearings, the council has managed to cut that amount to less than $4 million, but has talked about implementing a hiring freeze.

Already in place since mid-March is a suspension of any work by its personnel advisory committee (PAC). That means any personnel request comes to the full council without a recommendation from PAC.

The county council has two liaisons to the health department—David Henry and Peter Iversen. For his part, Henry told The B Square that he thinks finding an alternate contractor for the public health services could be an option, given that a contractor, namely IU Health, provided the service for 60 years. Henry thinks the health department should consider what vendors could provide the service. Under state law, providing required services under a contract is an option.

Iversen attended Thursday’s board meeting through a remote video connection. He told The B Square the possibility of approving personnel changes for the health department, to replace services now provided by IU Health, is under discussion and pointed to the draft agenda for next Tuesday’s county council meeting, when it would likely be considered.

County council president Jennfier Crossley told The B Square that there could be a scenario where additional county government staff are hired, to fill the gap in public health services that will be left by IU Health’s termination of its services. But Crossley said that is “definitely a full council discussion.”

Services provided by IU Health for Q1, Q2 in 2025

The numbers in the table above were provided by Monroe County's health department.