BRAINERD — The leader of Crow Wing County’s only reproductive health clinic says it’s continuing its core mission while taking on more expansive public health roles in a new, more visible space in downtown Brainerd.
WeARE The Clinic opened its doors at 615 Oak St. in November 2021, a move from the organization’s west Brainerd suite on James Street, which was tucked on the backside of an office building. The slightly larger location in downtown is near the heart of the city’s residential neighborhoods and close to Brainerd High School and Central Lakes College, making services more accessible to a wider population, said Becky Twamley, executive director.
“We certainly are increasing access to affordable care, and it can be free for some people,” Twamley said during an interview at the clinic in late January. “We are living in an area where there’s lots of uninsured, there’s lots of under-insured.”
In its fifth year of operation, the clinic continues to provide confidential reproductive health care, including sexually transmitted infection testing, pregnancy testing, birth control and emergency contraception, physical exams and breast exams. But it’s also expanded its presence within the CLC community, fostered an active youth advisory council, added a mental health practitioner and delved into free community COVID-19 rapid testing and vaccinations.
“I’m a person that does see the connection, that connects all those dots — I see the world from a public health lens,” Twamley said. “ … I think our community needs that and that makes for an overall healthier community. … I guess I’ll say it this way: I think there’s a bigger role for public health in our community.”
Two recent governmental designations make reproductive health services at the clinic even more available and affordable, Twamley said.
As an Essential Community Provider serving those who are high-risk, have special needs or are underserved, WeARE cannot be denied payment by insurance companies. This designation opens the door to more grant opportunities for the clinic and helps insured patients avoid out-of-network costs of care.
And access to the federal 340B drug pricing program means costs of birth control devices available at the clinic dropped by 50%-75% — a change of particular importance to those who don’t qualify for assistance programs or whose health insurance doesn’t cover contraceptives.
An IUD, the most effective form of birth control available, cost an uninsured patient $900 before the 340B program, Twamley said. Now, by passing on its savings to patients, the clinic charges $250-$300.
“That’s going to be a service that’s new for us and needed and probably hitting a different segment of the population: kind of those working, 25- to 35-year-old people who maybe already have children or don’t want to have children and just don’t have access to insurance to cover contraception,” she said.
Unfettered access to care emphasizing sexual health is critical in an area where statistics show high rates of teen pregnancy and STIs, the clinic’s leader said.
1/5: The waiting area at WeARE The Clinic Jan. 27, 2022, in Brainerd.
2/5: Office manager Hannah Johnson works at the front desk of WeARE The Clinic Jan. 27, 2022, in Brainerd.
3/5: Materials in the waiting area at WeARE The Clinic Jan. 27, 2022, in Brainerd.
4/5: Nurse Practitioner Sue Hadland looks through a microspoke at WeARE The Clinic Jan. 27, 2022, in Brainerd.
5/5: Registered nurse Sarah Fransen sterilizes instruments Jan. 27, 2022, at WeARE The Clinic in Brainerd.
In 2019, Cass County was seventh of 87 counties in the state for the birth rate among those ages 15-19, according to the University of Minnesota’s Healthy Youth Development-Prevention Research Center. The birth rate was 27.8 live births per 1,000 people who live in Cass.
When it comes to teen rates of chlamydia — a common STI that can cause permanent damage to a woman’s reproductive system — both Cass and Crow Wing counties top the list. In 2020, the rate of chlamydia diagnosis in Cass was 1,915 per 100,000, or third in the state behind only Hennepin and Ramsey counties. Crow Wing County reported 1,597 diagnoses per 100,000 among 15- to 19-year-olds, or ninth.
“For us in Brainerd, I think we’ve seen an increase — we certainly have high chlamydia rates right now. For many others, especially when they’re school-based testing or in that kind of environment, the STI rates are really low right now. And we think that’s because people aren’t accessing care,” Twamley said. “So we’re happy that we’ve been able to be here, and all through COVID, we didn’t ever close.”
WeARE also became a community partner in direct response to the pandemic by offering vaccinations at its clinic, providing rapid tests to the public for free weekly at CLC and conducting mandatory testing for both of the college’s campuses. During one of the rapid testing days in late January, the organization tested 56 people, 30% of whom turned up positive for COVID-19. That positivity rate wasn’t uncommon in January, Twamley said, as the omicron variant swept through the community.
Taking on these additional tasks wasn’t easy and it stretched the organization’s volunteers and staff members, especially when it came to traveling to Staples. But it is important, Twamley said.
“There just wasn’t anyone out there (in Staples) to do this work,” she said.
Filling gaps and improving access is a repeated theme in WeARE’s approach, one showing up again in the recent addition of a therapist in its clinic. Incorporating mental health care came in response to the needs of young clients, who shared their experiences of waiting anywhere from 30 days to three months to get an appointment. The therapist offers her services to the clinic on a pro bono basis, and Twamley said she’s in the process of writing grant requests to acquire funding.
“Often, you know, it’s LGBTQ or gender questioning sort of things that people are just having trouble with and want to see a counselor,” she said. “The person that does this work with us specializes in working with youth and is very inclusive in that way. So we feel good about that.”
With all of the changes over the years, those who keep WeARE going aren’t content to stop now. The organization’s board, employees and partners will engage in a strategic planning session in May with an outside facilitator.
One of the priorities is restructuring WeARE’s educational efforts, already underway with a new education coordinator.
“We’ll be out talking to people in the school systems, people working with at-risk teens. We’re hoping to partner and do some parent-child work — how to talk to your kid about sex, how to talk to kids in general about relationships. All those things that sometimes are difficult,” Twamley said. “ … Also, I think lots more work around diversity, inclusivity, gender. How do we be an inclusive community for all our folks? There’s lots and lots of work to be done there, too.”
CHELSEY PERKINS, community editor, may be reached at 218-855-5874 or
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