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Agencies leave federal program



Valley News Staff Writer
Monday, August 19, 2019

WHITE RIVER JUNCTION — Planned Parenthood and the state of Vermont announced on Monday that they would stop accepting federal family planning money to avoid having to comply with new rules from the Trump administration that prohibit health care providers from discussing abortion with their patients.

Vermont, which receives about $1 million in so-called Title X funds annually, has committed state money to ensure such services as breast and pelvic exams and cancer screening; sexually transmitted disease screening; and pregnancy diagnosis and counseling continue to be available to low-income people in the state. The federal money never included abortion-related funding, but the new restrictions would prevent providers from even discussing abortion options if they take Title X funding.

With the state funds, Vermont officials aim “to preserve our high-quality family planning network and ensure that health care providers will be able to continue to offer ethical patient care to Vermonters,” Vermont Commissioner of Health Mark Levine wrote in an Aug. 15 letter to the U.S. Department of Health and Human Services.

The new rules from Washington, Levine noted in his letter, would require the Vermont Department of Health — which serves as a pass-through for the Title X funds — to act in violation of Vermont’s recently enacted Freedom of Choice Act that recognizes “the fundamental right of every individual who becomes pregnant to choose to carry a pregnancy to term, to give birth to a child, or to have an abortion.”

In New Hampshire, where Title X funds provide about $1.6 million annually, the state budget the Legislature passed this spring and Gov. Chris Sununu vetoed in June included funds to support the continuance of services. “With that veto that funding isn’t able to go into effect,” said Derek Edry, communications manager for Planned Parenthood in New Hampshire.

Sununu spokesman Benjamin Vihstadt said in a Monday email that Sununu is ready to work with legislators on a budget deal. “The only thing standing in the way of this supplemental funding and delivering a fiscally responsible budget are the legislators in Concord who have insisted on raising taxes — something Governor Sununu and the people of New Hampshire will never support,” Vihstadt wrote.

For now, Planned Parenthood will use its own emergency funds to support the continuance of services in the Granite State, Edry said.

Planned Parenthood, which provides services using a sliding-fee scale, has two clinics in the Upper Valley, one in White River Junction and another in Claremont. The White River Junction office saw 2,203 patients last year, 58% of whom had incomes of $24,280 or less annually, according to information Edry provided. The Claremont clinic saw 929 patients last year, 72% of whom had incomes at or below that threshold.

While Planned Parenthood is the sole provider of Title X services in Vermont, the services are also provided by other clinics in New Hampshire. In the Upper Valley, until recently that included the Mascoma Community Health Center in Canaan.

The Mascoma clinic had to let go a part-time nurse educator, who was able to take time to meet with patients to discuss reproductive health issues, when it stopped accepting Title X funds in June. “It’s a net loss to the community,” said Scott Berry, the Mascoma clinic’s volunteer executive director. “Unfortunately, (it) wasn’t something that we could sustain.”

Though other providers at the health center — which opened in June 2017 — continue to provide family planning services that were previously covered by Title X, those providers have less expertise and time to focus on these issues, Berry said.

The clinic’s providers opted to forego the federal funds, which helped to cover the cost of the service for low-income patients, because they felt the new rules represented an intrusion on the provider-patient relationship, Berry said.

The U.S. Department of Health and Human Services said that Planned Parenthood affiliates knew months ago about the new restrictions and suggested that the group could have chosen at that point to exit the program.

“Some grantees are now blaming the government for their own actions — having chosen to accept the grant while failing to comply with the regulations that accompany it — and they are abandoning their obligations to serve patients under the program,” the department said.

The National Family Planning & Reproductive Health Association, an umbrella group for family planning clinics is suing to overturn the regulations.

About 4 million women are served nationwide under the Title X program, which distributes $260 million in grants to clinics. Planned Parenthood says it has served about 40% of patients.

Lucy Leriche, vice president of Vermont public affairs for Planned Parenthood Northern New England, said that for some, Planned Parenthood is where they get their primary care and the focus should be on ensuring that individuals, including those with low incomes, have the “ability to have agency over their own lives and determine the trajectory of their lives in terms of family planning, basic health and health care.”

Planned Parenthood was one of a dozen Vermont health care organizations who signed on to a statement opposing the rules as they were initially proposed last year. Others included Bi-State Primary Care Association, Blue Cross and Blue Shield of Vermont, MVP Health Care, The University of Vermont Medical Center, Vermont Association of Hospitals and Health Systems and the Vermont Medi cal Society.

Though at least for the short-term patients should see no interruption in services or a change in the fee schedule, officials are looking to Washington for a long-term solution. Leriche said she hopes that Vermont’s Congressional delegation will “continue to be champions in Congress” and work to “restore the program to its original state.”

For her part, U.S. Sen. Jeanne Shaheen, D-N.H., who issued a statement on Monday, said she would continue to push for women’s health care.

“The Title X gag rule, which has forced these clinics to withdraw from the program, has a clear motive: to go around Congress and the will of the American people to implement this partisan agenda that cuts off vital care to women and attacks their constitutional rights,” she wrote.

Material from the Associated Press was used in this report. Valley News Staff Writer Nora Doyle-Burr can be reached at ndoyleburr@ vnews.com or 603-727-3213.