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Fran Hagerty

Feds bypass the state on Title X funds

Very interesting.

The federal government announced [Monday] that it would no longer award a large slice of federal family-planning funds to the state of Texas. Instead, the feds will award the $6.5 million grant to the Women’s Health and Family Planning Association of Texas, a coalition of providers led by Fran Hagerty, to distribute to clinics for birth control, wellness exams, STD screenings and other family planning services.

The Observer reported in November that the coalition would apply directly to the federal government for the grant—called Title X (Title 10).

Before today, the sole grantee for Texas’ Title X funds had been the Texas Department of State Health Services. The health department had in turn distributed the grant money to family planning providers statewide. In 2011, the Title X grant had been part of $111.5 million available to the state for family-planning services.

But the 2011 Legislature slashed family planning funding by two thirds, causing more than 60 clinics to close and cutting in half the number of Texans receiving services through Title X, according to an annual review by the Texas Department of State Health Services.

The collateral damage wrought by this decision has been widespread. Many of the providers in Hagerty’s coalition had lost state family-planning funds and are struggling to stay open. Though they still received other government health funding, the loss of Title X grant money had been keenly felt. Unlike other state funding streams, the Title X grant had allowed providers to cast privacy protection over all of their clients. This is especially important for teens that would otherwise need parental consent to access birth control. The Title X grant also allowed clinics to buy pharmaceutical drugs at a steep discount, and gave them the flexibility to invest in staff and infrastructure. Losing the Title X money and the flexibility that came with it had seriously destabilized the family planning safety net across Texas and reduced low-income women’s access to birth control and preventive care.

The federal government in turn decided that Hagerty’s group would be a better steward of Title X.

The Texas Department of State Health Services had sponsored 40 providers that operated a total of 122 clinics. Hagerty’s coalition will distribute the Title X money to 34 contractors operating 121 clinics across the state, beginning next month. Hagerty said in an email that she doesn’t yet know how much the three-year budget will be due to uncertainty over federal budget cuts.

“WHFPT and [the Department of State Health Services] must work together to improve the health status of all Texans,” Hagerty wrote. “We are all ready and eager for this opportunity to provide family planning care for Texas families.”

Trail Blazers, the Trib, and the AusChron also reported on this, with the latter recapping some more of the history of this coalition and noting that Planned Parenthood is a member of it. I blogged about the Observer’s reporting in November as well. Not surprisingly, the powers that be in Texas didn’t take this well.

Gov. Rick Perry on Tuesday called a decision by the Obama administration to send a $6.5 million federal family planning grant to a Texas coalition of women’s clinics, rather than a state agency, “a clear attempt to circumvent the will of the Texas taxpayers and impose their own values on the people of Texas.”

His criticism of the White House at a Texas Faith and Family Day rally at the state Capitol was echoed by Lt. Gov. David Dewhurst, who claimed the decision would “line the pockets of Planned Parenthood.”

[…]

egarding the grant announced this week, Fran Hagerty, CEO of the Women’s Health and Family Planning Association of Texas, said she believes her group won the competition because it demonstrated it could serve more women than the state agency’s program. The association promised to serve some 160,000 women next year, while the state’s program reached only 65,000 last year because of rules limiting what kinds of health entities could access the funds. She also said that only two of the 34 clinics in her association are affiliated with Planned Parenthood.

“Nobody is making money off of anything,” Hagerty said. “It’s not possible. People do this work because they care.”

Hagerty noted that in 2011, the Texas Legislature cut $73 million from the budget’s family planning programs, forcing some 50 women’s health clinics across the state to close. Health and Human Services Commission analysts have estimated the family planning cuts would result in 24,000 more births to low-income mothers, at a cost of as much as $273 million more in spending by the state, mostly in Medicaid expenses, over the next budget cycle.

“We are hoping to go back and reopen clinics,” she said. None of the 34 clinics that will get the grant money provide abortions. “They provide high-quality family planning.”

Blake Rocap, legislative counsel for NARAL Pro-Choice Texas, praised the decision by the Obama administration and argued that rules adopted by the Legislature should not apply because “it’s not Texas’ money.”

“They submitted a more competitive bid than the state agency,” he said. “Is the state afraid of a little free-market competition?”

Ouch. As I said back then, this is good news for the coalition since it will not have to put up with the state’s BS for these funds. Lord knows, with the way the Lege continues to screw with Planned Parenthood and women’s health in general, any degree of freedom is good. I wouldn’t count on it long-term, since there’s no guarantee the federal government won’t someday be as reactionary and anti-woman as the 2011 Lege was, but it’ll do for now. The hysterical reaction from Perry et al is strong evidence that this was the right call.

A family planning end run?

This is interesting.

Texas lawmakers have spent the past two years attacking family planning services in the state, cutting funds for programs that provide women with birth control and wellness exams. Now family planning advocates are fighting back.

A coalition of providers plans to bypass Gov. Rick Perry and the Texas Legislature and apply directly to the federal government for family planning funds. If the coalition wins the federal grant—called Title X (Title 10)—a slice of Texas’ family planning money would no longer go to the state health department—and would no longer be subject to the whims of the Legislature. Instead, the coalition, organized by Fran Hagerty of the Women’s Health and Family Planning Association of Texas, would distribute the money to family planning providers statewide, including perhaps Planned Parenthood, and restore services to tens of thousands of Texans.

Since 1982, the Department of State Health Services has received Title X grants in Texas, though any group can apply to the federal government for the money. The department then distributes the money, alongside cash from other federal and state grants, to providers delivering family planning and preventive care. The Title X grant is worth $14.5 million per year, part of the $111.5 million pot of money the state had to spend on family planning.

[…]

At $14.5 million per year, the Title X grant comprises only a small slice of Texas’ annual family planning budget. But it’s worth much more than its dollar value. That’s because Title X money comes with a confidentiality clause not always attached to other funding streams. This means that providers need only $1 from Title X to cast privacy protection over all their clients, especially teens who would otherwise need parental consent to access birth control.

Similarly, Title X recipients get a discount on pharmaceuticals. With this discount, clinics can buy drugs at half the wholesale cost. Again, just $1 of Title X casts this discounted rate over every drug purchased by the clinic. That often helps clinics prescribe the more effective, yet more expensive, types of birth control.

The protections afforded by Title X demonstrate how complex and delicate clinic funding arrangements are. Having it means that some providers, whose clinics teeter on the edge of financial viability, could continue operations. “When providers lost Title X funding, they lost much more than just the money,” Hagerty said. They also lost their patient confidentiality, discounted drugs and the more discretionary spending that Title X allows. Restoring those protections to providers is what Hagerty said gave her the impetus to take the project on.

There’s more, so go read it and when you’re done go back and read the earlier story about the devastating effect of the family planning cuts on Texas health providers. This isn’t a panacea, nor is it a guaranteed funding source going forward – among other things, as with any other government program it is subject to the whims of the prevailing political sentiments; I for one have a hard time believing this would have survived four years of Romney/Ryan budgeting intact – but if it can help the clinics that need it, it’s a good effort. We’ll see how it goes.