Title X defund to Planned Parenthood was to divert funding to local health departments. Proponents stated that the contraceptive needs of low-income women could be satisfactorily met through these providers. For the women of Miami County, Kansas, that theory is already proving false. The women of Miami County have been denied access to their contraception.
This article was updated to include new information about the County Commission’s meeting called to “fully vet” their original decision. That update is found at the end of the story.
We’ve heard about a lot of dangerous sexist and economically discriminatory policies being pursued at the state level to deny low-income women access to necessary health care, including low-cost contraception. Texas stands as the most egregious perpetrator of such injustice against women.
Last session, the state of Kansas passed a budget that excluded Planned Parenthood of Kansas and Mid-Missouri. This budget measure was granted a judicial injunction after a court challenge was brought in opposition. So, for now the women of Kansas still have access to their beloved health care provider. Ever the consistent and festering thorn in women’s sides, Governor Brownback has seen fit to include this unconstitutional measure in this year’s budget as well.
The stated intent of eviscerating Title X has been to divert funding to local health departments. Proponents stated that the contraceptive needs of low-income women can be satisfactorily met through these providers. For the women of Miami County, Kansas, that theory is already proving false. They’ve already experienced the cuts and been denied access to affordable contraception, as the result of a 3 to 2 vote by Miami County Commissioners to decline Title X money from the state.
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Commissioner Danny Gallagher made a motion to approve the grant applications excluding the $9,000 that would have been used for contraceptives. The total amount of the family planning grant would drop from $31,306.74 to $22,306.74, with most of the remaining money going toward staff salaries.
According to sources, the county will, in all probability, lose the entire $32,000 grant because the guidelines do not allow for cherry picking. Miami County Health Department volunteer Kelly Fritz stated the following to the Miami County Republic:
Fritz said Miami County’s program serves 151 women, 116 of whom do not have insurance. She also said that statistics show that 85 percent of women who are regularly sexually active will become pregnant within one year without family planning services, and she estimated that 98 of the 116 women without insurance would become pregnant if the services were no longer provided.
The community is organizing against the measure and held a rally over the weekend. Again from the Miami County Republic:
Nearly 100 individuals from across Miami County marched through the heart of Paola on Saturday morning in protest of the Miami County Commission’s recent decision to eliminate contraception from a grant funding request.
One person held a sign that read ”Miami County, where women’s health care is controlled by farmers.” The sign was commentary about Miami County Commissioner Pretz, who received $85,000 in farm subsidies… you know…”government money.” Mr. Pretz cast a vote declining the Title X funds stating that he doesn’t believe taxpayers should be paying for contraceptives to be given out at the health department.
Commissioner Wise also weighed in with his vote and these words…
“If these people want contraceptives, than they need to purchase them,” Wise said. “If they get pregnant, than they need to take care of the child.”
The grassroots activists at the rally in Miami County brought a message to Commissioner Wise with t-shirts that stated, “Take A Stand, It’s More Than Sex.” The shirt listed the numerous health conditions beyond pregnancy prevention for which the pill is commonly prescribed.
It remains to be seen if this will be the beginning of a trend that will spread to other Kansas counties, fueled by the national GOP hatred for contraception. “Religious conscience” has morphed into “government conscience.” But Kansas women know the truth… many elected officials in Kansas know no conscience, which is grossly apparent from the legislative attacks on women’s health. In 2012, we have seen definitively, swiftly and decisively a war that moved from abortion to a war on contraception for those that need it the most.
The Miami County Commission met again to reconsider acceptantance of the Title X funding. The following is from the Osawatomie Graphic…
Callie Benton of Paola said birth control is covered under county employee health plans, and she asked commissioners why they didn’t address that coverage. Although the two sides of the debate may never agree, she added, the commissioners should be able to agree on fair treatment.
Paola resident April Bright said she used the health department to obtain birth control after her husband lost his job. As a social welfare student at the University of Kansas, she also works with women who use services like the county’s health department.
Gina Sallman, Holy Trinity Catholic Church youth minister, said she would rather pay to support children than birth control.
Commissioner Pretz stated…
That he supports the use of contraceptives to treat disorders such as endometriosis, but he questioned if there are other options to support family planning at the health department that would allow the county more control over who gets contraceptives and what they’re used for.
The commission decided to stand by its original decision. The women of Miami County will no longer be able to obtain contraception from their county health department.
The anger and frustration is being felt by many residents, one of which stated in a private email to Rewire…
The chairman of the Board allowed out of county residents to make 5 minute statements. If this isn’t religious seizure of ones government, then one of you are going to have to explain to me, the difference.
Garfield County is eschewing a successful contraceptive program in favor of the Personal Responsibility Education Program (PREP), which focuses on “abstinence-focused comprehensive sexual health education.”
The same Colorado county that recently nixed a $1,500 grant for Planned Parenthood is now refusing to join a statewide program that has proven to be among the nation’s most effective in reducing teen pregnancy and abortions.
Garfield County is not part of the Colorado Family Planning Initiative, which is credited in large part for decreasing the state’s teen pregnancy and abortion rate by nearly 50 percent over six years despite continual Republican opposition to the program’s funding. The initiative provides intrauterine devices (IUDs) and other implants at low or no cost, but only in participating counties.
“[Garfield] Public Health has never administered this program because it would be a duplication of service,” Garfield County Public Health Special Projects Coordinator Carrie Godes wrote in an email to Rewire. “Though no agencies in Garfield County run a state (CDPHE) Family Planning program, Mountain Family Health Center and Planned Parenthood provide family planning services.”
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“We refer clients to these other providers if they come to us seeking family planning services,” Godes wrote. She did not respond to question about who was responsible for the decision to not be part of the state Family Planning Initiative.
Only Title X clinics can participate in the Family Planning Initiative. Since that does not include the providers cited by Godes, they do not have state funding to offer long acting reversible contraception (LARC) for free or reduced cost to low-income women and teens.
While Colorado’s teen pregnancy rate decreased by half from 2009 through 2014, Garfield’s rate increased from 13.6 percent to 19.6 percent from 2010 to 2013, then dropped to 9.6 percent in 2014, according to state data.
In an editorial, the Post Independent called on Garfield County commissioners to join Colorado’s pregnancy prevention program.
“Garfield County should embrace the state’s success and work to prevent more teen pregnancy, which drops the abortion rate, saves money and keeps teens from making their lives and their ill-conceived children’s lives immensely more difficult,” stated the editorial. “That’s pro-life, that’s fiscally sound, that’s level-headed leadership — unlike the symbolic political step of blocking a tiny grant and exacerbating division.”
Garfield County Commissioner Tom Jankovsky, a Republican who led the local Planned Parenthood defunding effort, did not return repeated phone calls seeking comment. But he’s stated that family planning services are available in the area.
Most people would consider it unusual to pick a corrections facility if they were in the market for a breast exam. But that’s exactly what is suggested by a new website launched last month by 17 of the nation’s most prominent anti-choice groups.
The receptionist at the clinic at Washington D.C.’s Correctional Treatment Facility seemed baffled to receive a call last week from a reporter asking whether she could schedule a breast exam at the facility.
“This is a jail,” the receptionist said. The reporter asked whether people from the community could nonetheless make appointments at the facility for a breast exam, a Pap smear, or a test for sexually transmitted infections. “Ma’am, this is a jail,” she said again, before suggesting that the reporter contact doctors’ offices nearby.
Indeed, most people would consider it unusual to pick a corrections facility if they were in the market for a breast exam. But that’s exactly what is suggested by a new website launched last month by some of the nation’s most prominent anti-choice groups.
The site, GetYourCare.org, is registered to the Alliance Defense Fund, a deep-pocketed fundamentalist Christian group based in Phoenix, Arizona, now known as the Alliance Defending Freedom. Other sponsors of the site include Concerned Women for America, the Susan B. Anthony List and the Family Research Council. Together, these groups have played leading roles in either promoting or bankrolling some of the most significant anti-choice, anti-LGBTQ campaigns and lawsuits of the last few years.
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The new site was launched on September 28, the day before Cecile Richards, president of Planned Parenthood Federation of America, testified before Congress about the discredited claims that her organization profits from fetal tissue donation. The claims were made in a series of surreptitiously recorded and deceptively edited videos. Though they were the focus of a media frenzy over the summer, no evidence has been found to substantiate them, despite multiple hearings and both state and federal investigations.
Planned Parenthood serves an estimated 2.7 million people throughout the United States per year, many of them students, parents, and low-income individuals reliant on Medicaid for health care. GetYourCare.org is a not-so-subtle effort by anti-choice groups to double down on their repeated claims in Congress and the media that women’s health care would be largely unaffected if federal and state governments stripped Planned Parenthood of public funding. The site features a green map of the United States, covered in a spray of thousands of yellow dots, each of which is supposed to represent a health-care facility that could ostensibly fill the vacuum left by Planned Parenthood’s absence. The site says it draws its information “primarily from two separate lists: Federally Qualified Health Centers (FQHC) and Rural Health Centers (RHC).”
“GetYourCare.org was created to show that women have real choices when it comes to health care,” the site says. “All across America, thousands of low-cost health centers offer women and their families high-quality health care.”
A press release from the Alliance Defending Freedom claimed that the facilities listed on the map “typically offer the full range of women’s health services without all the scandal of Planned Parenthood.”
But in an investigation into the facilities, Rewire has found that these “real choices” include hundreds of elementary, middle, and high schools; clinics that provide care for homeless people; nursing homes; pediatrics centers; and even the D.C. jail. Rewire called and emailed hundreds of the facilities listed on the map, and discovered that many of their spokespeople were bewildered by the notion that women would be directed to their facilities for reproductive health services.
School officials, in particular, were confused that they would be asked to provide reproductive and sexual health services to the general population. The GetYourCare site explains that there are over 600 schools listed because they “have been identified as providing girls’ and women’s health care services at ‘school-based health centers’ on location. Thus, the school serves as a very real option for girls and young women in the area who need healthcare.”
In fact, virtually none of the 60 schools Rewire contacted from the list said they provide health care to girls and women in the community.
That includes Wearwood Elementary School, which sits nestled at the foot of the Great Smoky Mountains in Wears Valley, Tennessee. Wearwood, which teaches students from kindergarten through eighth grade, is part of a rural farming community—and not the first place you might think to go for an STI screening.
Instead, the clinic is like many other elementary school nurse’s offices, where a full-time school nurse provides limited care to the 190 students in attendance.
The nurse primarily tends to the school’s one diabetic student, the principal, Jon Manning, told Rewire in a phone interview. She can also treat scrapes, fevers, and headaches, although the district has a telemedicine program for more serious ailments.
Principal Manning described the school as “remote;” the nearest commercial district is nine miles away in Pigeon Forge, Tennessee. If women need to make an appointment for a breast exam or a birth control prescription, Wearwood Elementary is certainly not the place to go.
“We just don’t have the equipment or the staff,” Principal Manning said, when asked if women from the community could make check-up appointments there. “What we have to offer really wouldn’t be feasible. One thing is, normally, we don’t allow strangers in during the school day for security reasons.”
Of the 60 elementary, middle, and high schools Rewire contacted across six different states, only two said they provided health services to women in the community. Both were based in Sneedville, Tennessee, and are funded by the East Tennessee State University’s college of nursing, according to a receptionist at the clinic. She said the school-based clinics provide care to students during school hours, but are open to the general public after hours and on weekends. They do provide Pap smears, breast exams and STI screenings, and they accept Medicaid patients, she said.
But many respondents at the schools were mystified by the question of providing sexual and reproductive health care.
“You called an elementary school,” a receptionist at the Heritage Hill School in Springdale, Ohio, said.
“To women?” asked a receptionist at the Delhi Charter School in Delhi, Louisiana. “No ma’am, we just do the children here that go to this school.”
“We don’t have a school-based clinic and we never have,” the receptionist at the Abiquiu Elementary School in Abiquiu, New Mexico, told Rewire.
Other types of centers explained that they did not provide services to the general population.
Rewire attempted to contact more than 20 clinics that provide health care for homeless people listed on the map. Many facilities that we contacted did not return calls or emails seeking information about the care they offered. Of those that did answer calls, several said that they did provide some type of primary health care, but in some cases those services were available only to people who met their criteria for homelessness. For a facility in El Paso, Texas, that meant providing a referral letter from a homeless shelter. For the Jessie Trice Community Health Center in Miami, Florida, a receptionist said that treatment consisted mainly of primary care for residential drug treatment patients, and not for the general public.
Similarly, the pediatrics centers we contacted were puzzled by the notion that they could offer comprehensive reproductive and sexual health services to women and girls. For instance, the receptionist at the pediatrics clinic on Marco Island in Florida—the only facility listed by the map in the area of Marco Island—confirmed that they could see girls for general pediatric complaints, but for anything involving reproductive or sexual health issues, they would need to refer patients out. She told us that the closest facility was in Naples, some 30 miles away.
It should come as no surprise that so many of these facilities do not offer comprehensive sexual and reproductive care. The official government document that explains what is included in the list that the anti-choice groups used to populate the map does not specifically mention sexual or reproductive care. Rather, it enumerates some more general forms of care—such as physician services, “other ambulatory services,” and some screening treatments—that could potentially encompass sexual and reproductive care. But the list also explicitly includes services that seem to be unrelated, such as nursing home care and diabetes self-management.
When informed of our findings, the Alliance Defending Freedom was unperturbed.
“GetYourCare.org includes clinics serving different populations and demonstrates that Planned Parenthood is very rarely the only option even for the very limited services Planned Parenthood actually provides,” wrote spokesman Bob Trent in an email. “Even if Planned Parenthood were to stop providing these services, it would hardly be a blip.”
The notion that shuttering Planned Parenthood could be done without affecting access to care for those patients has been widely rejected by academics, experts, and the nonpartisan Congressional Budget Office, which concluded that 15 percent of current patients would immediately “face reduced access to care” should Planned Parenthood cease providing family planning services. That conclusion focused on “services that help women avert pregnancies,” and not the many other services, such as cancer screenings and STI testing, that Planned Parenthood provides. The CBO also concluded that the move would result in more births, and therefore greater costs to Medicaid.
But that hasn’t stopped prominent anti-choice politicians and groups from sticking to the claim.
Louisiana Gov. Bobby Jindal, who is running for the Republican presidential nomination, made that argument in court filings over his state’s efforts to strip Planned Parenthood of state reimbursements for services it provides to some 5,200 patients. When the federal judge hearing the case questioned why Jindal and his lawyers had included dentists and ophthalmologists in their list of facilities that could pick up the slack, Jindal’s administration had to back down and acknowledge that a dentist’s office is probably not the right place to go if you’re in need of a Pap smear or other reproductive health service.
The groups backing GetYourCare.org are no small-bit players. The Alliance Defending Freedom is a key architect behind legal strategies to frame anti-LGBTQ laws as protections for religious liberty. It had $35.5 million in assets, according to its 2014 public tax filings. The Family Research Council has been designated as a hate group by the Southern Poverty Law Center for its homophobic vitriol. It reported assets of more than $4 million and revenue of $13.7 million in the fiscal year ending in 2014. Concerned Women for America and the Susan B. Anthony List both clock in with around $4 million in revenue according to their most recent tax filings. Each of these groups actively campaign to end access to safe and legal abortion in the United States, as well as to restrict access to contraception. Another sponsor, Americans United for Life, generates hundreds of the model laws that have been used by state and federal legislators to further the same goal.
Based on efforts to contact hundreds of the roughly 11,000 facilities that appear to be included on the map, Rewire found that many locations did say they could provide the services we requested. Facilities in Arizona and Ohio were more likely than those in Nevada, Oklahoma, northern California, or Oregon to be able to make appointments within the next week. For those other states, wait times were typically until late December or early January. A receptionist at a facility in the northwest quadrant of Washington, D.C., said that since the clinic wasn’t taking any new patients until January, she wasn’t able to schedule appointments at this time. In Kansas and Nevada, receptionists suggested looking to facilities nearby, often more than an hour away, to schedule well-woman visits. Many voicemails and emails simply went without a reply.
Insurance coverage was also patchy. Some facilities said they accepted Medicaid and others said they charged on a sliding scale, depending on ability to pay. However, other facilities said they did not accept the types of insurance that a reporter cited.
Rewire’s reporting, though not a scientific study, strongly supported the conclusions of numerous experts who found that closing or limiting Planned Parenthood services would have a dramatic impact on women and girls—especially those in low-income communities and communities of color.
Writing in the Health Affairs Blog last month, Sara Rosenbaum, a professor and founding chair of the Department of Health Policy at George Washington University School of Public Health and Health Services, argued that defunding Planned Parenthood would be a disaster for women and girls: “Unable to access the contraceptive care they need, women would be left to pay the price, as more unintended pregnancies and abortions result.”
Rosenbaum, who is also a commissioner on the Medicaid and CHIP (Children’s Health Insurance Program) Payment and Access Commission, concluded:
[A] claim that community health centers readily can absorb the loss of Planned Parenthood clinics amounts to a gross misrepresentation of what even the best community health centers in the country would be able to do were Planned Parenthood to lose over 40 percent of its operating revenues overnight as the result of a ban on federal funding.
Based on Rewire’s reporting, not even the nation’s elementary schools, homeless shelters, and nursing homes could fill that gap.