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Local health centers brace for cuts to Title X family planning funding

MIDDLEBURY — As President Trump attempts to alter rules surrounding distribution of Title X healthcare funding, Vermont’s Planned Parenthood health centers are preparing for serious challenges to providing patients with health services they have historically offered.
In late May the Trump administration proposed changes to the Department of Health and Human Services rules on the use of family planning grants that come through Title X, a program that among other things supports family planning organizations. Under the new rules, which are under review and could go into effect next month, Title X-funded organizations, including the Planned Parenthood health center in Middlebury, would no longer be allowed to discuss abortion options with patients nor refer them to abortion providers.
“The gag rule would prohibit any provider from being able to openly and honestly discuss the full range of healthcare options someone has in the case of an unwanted pregnancy,” said Lucy Leriche (pictured), Planned Parenthood’s vice president of public policy for Vermont. “It’s a clear violation of medical ethics to withhold vital and in some cases life-saving information from your patients.”
Federal Title X funding is distributed around the U.S. to support an array of healthcare services that include cervical and breast cancer screenings, birth control resources, contraceptive education, testing and treatment for sexually transmitted disease and HIV testing. Title X funds do not fund abortion procedures and education, which make up just one of the many family planning and health services provided by Planned Parenthood health centers such as the one in Middlebury.
Rather than moving through Congress, the new rules would simply be enacted as an administrative change to the official policy of the Health and Human Services. The rule will either be approved or denied by Secretary of Health and Human Services Alex Azar following a public comment period that ends July 31.
What does this mean for health centers such as the one in Middlebury? If the gag rule passes, Planned Parenthood health centers will essentially have to choose between two options: either turning down the federal money and continuing to counsel patients about abortion options or taking Title X funds and curtailing the counseling that center workers offer, Leriche said.
Title X money accounted for $754,387 of Planned Parenthood of Northern New England’s (PPNNE) total funding for Vermont health centers for fiscal year 2016, the last year for which data was available, according to Vermont Department of Health spokesman Ben Truman.
Leriche says Vermont’s Planned Parenthood health centers will continue to provide the services they always have in the face of the potential changes. If funding falls through, they will turn to other sources such as philanthropy rather than compromise long-standing practice.
“Middlebury is a Title X health center,” Leriche said. “If the gag rule moves forward in its current form, we feel very certain that we will not be able to accept Title X funds. In other words we have decided that we will have to forego participating in the Title X program so that we can continue offering comprehensive healthcare to our patients. The most important thing is to provide quality healthcare to our patients, and Title X, as it would stand under the new gag rule if it’s enacted, would keep us from being able to do that.”
Planned Parenthood clinics in Vermont do receive funding from other sources — mostly philanthropic ones, according to Leriche. The organization’s financial reports show that total grants and contributions for all PPNNE health centers came to $5,093,613 in 2016, the most recent year for which data was available.
Title X funding accounts for a large portion of Planned Parenthood’s total funding for Vermont health centers.
Leriche says the amount of Title X funding PPNE gets is far from inconsequential, and that funding would vanish if the gag rule passes. This presents a serious obstacle to low-income Vermonters — migrant workers from Latin America, low-income white residents in rural areas and others such as young students returning home to Vermont after finishing school out of state — seeking basic Planned Parenthood services such as sexually transmitted disease tests and cancer screenings. Low-income patients (those who earn less than $24,000 annually in a household of one) make up 58 percent of all Planned Parenthood patients in the state, according to Planned Parenthood Vermont Communications Director Eileen Sullivan.
Title X funding helps this demographic by allowing health centers to provide free and discounted care: the Planned Parenthood Health Center in Middlebury provided its patients $35,219 subsidized care in 2017, according to a document provided by PPNNE. Any loss in funding hurts people unable to pay for care who rely on free and discounted services, Leriche said.
“This is the really unconscionable part of all of this,” she said. “Access is having the right service at the right time in the place that you can get to, but access also includes whether you can pay, can you afford it. What Title X does is help us with that ‘can you afford it’ part because we’ve done pretty well otherwise with access in terms of geographic distribution of health centers.”
While Planned Parenthood health centers make up just 13 percent of all Title X-funded health organizations nationwide, PPNNE is the only organization in Vermont that receives Title X funding, according to Sullivan.
Although the potential changes are alarming, Planned Parenthood’s Vermont staff is fighting the proposed rule changes as hard as they can. Leriche said that closing health centers is not an option and that every step will be taken to keep them open regardless of the outcome of the comment period.
“We’re hoping that this will have a very minimal impact,” Leriche said. “We’re doing everything in our power to push back on this rule and other bad policies of this administration hostile to both women and men.”
Until the comment period ends on July 31, Americans have the opportunity to affect Azar’s final decision through contributing to comment threads online. Leriche urges people to speak out against the rule change by going to plannedparenthoodaction.org and signing a petition calling HHS Secretary Azar to strike down the proposed law.
“We’re trying to get as many comments as possible before the July 31 deadline on this rule,” she said.

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