By Zach Jensen,
Mary Raatz, RN, cares for a client’s toenails at Winneshiek County Public Health’s Happy Feet Clinic. (Photo by Zach Jensen)
Winneshiek County residents are aging, and as a result, the number of clients using the Happy Feet Clinic — Winneshiek County Public Health’s foot-health service — has grown exponentially since 2023. Officials there say the steady growth in numbers demonstrates an increasing need and appreciation for the more-than-30-year-old clinic.
“Some people could argue that it’s not a required service, but it is a needed service in the community,” said Winneshiek County Public Health Administrator Krista Vanden Brink. “The fact that we’re booked out two months really says something about the service we provide and how much it’s needed and appreciated.”
The foot-health clinic, which focuses on clipping toenails, originally began in 1994 through a collaboration with then-Public Health Administrator Marlene Fenstermann and Dr. Craig Sullivan, a podiatrist at Gundersen Clinic’s Decorah location.
“People needed their toenails clipped, but insurance wouldn’t pay for it,” said Lois Frana, who has been with public health since 1985. “Insurance will only cover the service at a doctor’s office if the patient is diabetic or if they have another foot condition, and that’s only a certain number of times per year.”
Happy Feet doesn’t provide the same service as a doctor — nor does it provide pedicures, Frana said, but for $30, clients can soak their feet and have their toenails clipped and filed before receiving a “mini-foot-massage” over the course of one 45-minute session. And, the clinic isn’t just about toenails, either. Vanden Brink said public health’s nurses also assess a client’s overall foot health by checking under
the toenails,
looking for in-grown nails, swelling and ulcers.
“People like the attention,” Vanden Brink said. “They like the foot soak, they like how we trim their nails, but they also really like the mini-foot-massage afterwards. Our nurses do really well with that foot massage, so you feel really relaxed before you leave. It’s the whole package, and people appreciate that. Some people think they’re being pampered, but we’re really just providing a health service for them.”
The service is available to anyone of any age and any level of ability, Vanden Brink said, although those who typically use the service often have limited mobility, vision impairments or they’re just not as flexible as they once were.
“There are always a number of individuals who cannot get their toes to their nose,” she said. “Maybe they have some limited mobility issues — like from a bad back or a new joint that’s been put in — so they just don’t have that flexibility. There are also individuals with visual impairments, and if they try to cut their toenail, they’re going to cut a chunk of their skin off, which opens it up to bleeding and possible infection.”
Vanden Brink said seniors often choose to retire in the Decorah area, which she said may contribute to the community’s aging population. She said many of those seniors become Happy Feet clients, because Medicare and other insurance no longer pays for the service.
“Medicare has changed the rules about who can go to podiatry for their toenails and have it covered by insurance,” Vanden Brink said. “If you are diabetic and if you have a known foot problem, you can go to a podiatrist to have your toenails cut and have it paid for by Medicare — which means most of us can’t go doctor to have our toenails cut.”
Between July of 2023 and July of 2024, Happy Feet provided a total of 465 individual in-office foot-care sessions, generating almost $14,000 in revenue for Public Health. And those numbers are still increasing.
“We’ve talked about possibly increasing how much we charge,” said Frana, “but some of the people who come in are very, very poor, and they save so they can come in every two months, because they can’t afford coming more often.”
And Vanden Brink indicated she and her staff wouldn’t want to see a decrease in the number of people they assist in staying healthy.
“I love my work,” said Mary Raatz, one of the Happy Feet nurses. “I’m helping people with a part of life they’re not able to take care of themselves. It makes them feel good again, and that makes me feel good.”
For information, or to schedule an appointment, visit winneshiekhealth.org/happy-feet-clinics or call 563-382-4662.
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