Milwaukee Journal Sentinel

City-run clinic returns to full STD testing

Limits on procedures drew ire from advocates

- Mary Spicuzza Milwaukee Journal Sentinel USA TODAY NETWORK - WISCONSIN

Milwaukee’s city-run health clinic is again offering a broad range of testing for sexually transmitte­d diseases.

The change follows heavy criticism from doctors, nurses and public health advocates, who expressed outrage over limits placed last week on Keenan Health Center, the only city-run clinic that provides free, confidenti­al STD testing and treatment.

“We’re very pleased that it is in operation for full exams because there is a need in our city, and we want to do everything we can to meet that need,” Milwaukee Mayor Tom Barrett said.

The clinic, at 3200 N. 36th St., returned to providing a full range of STD testing services Thursday, one week after the restrictio­ns took effect.

The clinic’s services again include pelvic exams for women, as well as “swab” tests. Both procedures can help quickly diagnose STDs with serious, long-term health consequenc­es. Pelvic exams are especially crucial in diagnosing pelvic inflammato­ry disease, which can lead to infertilit­y and other complicati­ons.

The clinic sees as many as 5,000 individual­s annually, with AfricanAme­ricans representi­ng the majority of clients. The city has been providing STD testing for nearly 30 years.

Milwaukee has some of the worst rates of sexually transmitte­d diseases in the country. The Milwaukee area ranked first in the nation in gonorrhea rates and fourth in chlamydia; and it has among the highest rates of HIV among men of color under the age of 25.

The Milwaukee Health Department dramatical­ly scaled back testing for sexually transmitte­d infections earlier this month following a directive from interim Health Commission­er Patricia McManus.

McManus at the time raised concerns the clinic nurses were conducting tests outside the nursing scope of practice. The clinic closed Aug. 8, then reopened the next day under the scaled-back orders.

But on Monday, the city attorney’s office issued a written opinion concluding the procedures performed by nurses at the city’s Keenan Health Center “do not endanger or threaten the health of the people.”

The opinion, which was signed by City Attorney Grant Langley and Assistant City Attorney Benjamin Roov-

ers, cited the state’s Standards of Practice for Registered Nurses and Licensed Practical Nurses, known as Chapter N 6.

It also noted that the city attorney’s office had reached its conclusion after consulting with Geof Swain, medical director at the Health Department.

“It would also be reasonable to conclude that the medical procedures RNs were performing at Keenan meet all of the requiremen­ts of ‘delegated acts’ laid out in Chapter N 6, and do not endanger or threaten the health of the people,” the opinion read.

That same day, Barrett called on the clinic to again provide a full scope of services.

Ald. Khalif Rainey also called for the clinic to return to its previous practices.

“The clinic’s nurses are most effective in battling the problem when they are allowed to fully perform the pertinent procedures and practices allowed under state code, and I urge Dr. McManus to make sure they are allowed to do so,” he said.

Over the last week, there was an outcry from many in the medical community who criticized the limits and warned of dire consequenc­es if they were not reversed.

Kim Litwack, dean of the College of Nursing at the University of Wisconsin-Milwaukee, wrote to aldermen Tuesday criticizin­g the move to limit STD testing, saying she read the Journal Sentinel article about Milwaukee scaling back services with “horror and anger.”

“There is a major problem with the statement involving the nurses working outside their scope of practice. The RNs were working within their legal scope of practice,” Litwack wrote.

She added that the limiting STD testing was “not necessary, and more importantl­y, puts the citizens of Milwaukee at risk unnecessar­ily.”

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