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Women’s Health and Family Planning Association of Texas

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.

Trying to find a way with the WHP

I admire and applaud the effort. I abhor the fact that it was needed.

Leading Houston Democrats in favor of a seemingly doomed health care program for low-income women are pushing to bypass the state to keep federal money flowing to Planned Parenthood.

U.S. Rep. Sheila Jackson Lee and state Rep. Garnet Coleman said Monday they are negotiating with U.S. Health and Human Services in hopes of finding alternative funding for the program, which provides health screenings and contraceptive services to 130,000 Texas women on Medicaid.

“It would be a look-alike program but not be the same thing,” said Coleman.

The Medicaid Women’s Health Program is due to end in Texas on March 31, the result of the state’s decision to exclude clinics affiliated with abortion providers, even those that do not provide abortions. Federal regulations say a state can’t exclude qualified providers from the program.

Coleman and Lee said the alternative might involve the federal government allocating money to local entities, such as counties, hospital districts or federally qualified health clinics. They noted that school districts have been allowed to apply for federal grants independently rather than through the state.

U.S. Rep. Gene Green said he will look at alternatives but acknowledged that “I doubt I could do much with this Congress.” He said he’s hopeful things will be more favorable after the election.

The main way that this would differ from Perry’s empty promise is that it would allow the existing providers (read: primarily, but not exclusively, Planned Parenthood) to continue doing their work instead of forcing thousands of women to find new doctors who may or may not ever materialize to take on that un-lucrative business. It also ensures that we don’t have to depend on Perry’s alleged commitment to women’s health, which was something he certainly did not have last year when it counted.

Last spring, I watched with dismay as the Texas House, led by Republican lawmakers, slashed – from $111 million to only $38 million – the only other program providing contraception for poor Texas women, administered by the Department of State Health Services.

Perry stood by silently as GOP lawmakers took the ax to the program, despite budget analysts reporting that the program would save the state millions of dollars by preventing unwanted children who would be delivered into this world on Medicaid’s dime.

[…]

Perry hasn’t really had an epiphany that contraception for the poor is a worthwhile, even “cost-effective,” program. He’s warring with President Barack Obama because the federal government won’t go along with his administration’s attempt to prevent Planned Parenthood from participating in the program.

“Why would the Obama Administration take away access to health care for low-income Texas women?” Perry asks on his website. “Because this administration puts funding for abortion providers and affiliates ahead of funding for women’s cancer screenings and other preventative health care.”

He conveniently fails to mention that no money that goes to Planned Parenthood can be used to provide abortions. It’s already illegal.

The money pays only for cancer screenings and contraception that poor women need. But Perry, the governor who is against the government picking your health care provider, has decided he gets to pick the health care provider for poor women.

That would be because, as the sonogram saga showed, Perry thinks women are incapable of making these decisions on their own. Women may disagree about that, but who cares what they think? Not Rick Perry, that’s for sure.

The bottom line is simply this.

Fran Hagerty, the head of the Women’s Health and Family Planning Association of Texas — which represents non-Planned Parenthood providers in Texas, including clinics, hospitals and medical schools — said she seriously doubts Gov. Rick Perry will be able to keep the pledge he made last week to maintain the roughly $30 million-per-year program without federal help. She said the “monstrous” family-planning funding cuts of the last legislative session, made before the Women’s Health Program was jeopardized, have eroded trust and have forced clinics to shut their doors.

“The funds made available to family planning providers through the Women’s Health Program is what is keeping most of them going at this point,” she said in a statement. “No one trusts Gov. Perry to find state money to fund them at the same level as the Medicaid program.”

Emphasis mine. No one should trust Rick Perry to care about funding the Women’s Health Program. His record on this issue is quite clear and has been for a long time. Once the spotlight is off and he no longer has to pretend he’s the good guy and the Obama administration is the bad guy, he’ll revert to form. Indeed, he already is, with his ludicrous funny-money funding proposal. Burka, who agrees with this assessment, and Trail Blazers have more.