Oct 04 2011

The Battle for Title X – Part 1

Posted by Steve Ross in Shelby County, State Politics

The political fight has been going on for months now. Since February as a matter of fact. But it all really culminated with an attempt at the state level to prevent Planned Parenthood from receiving funds for Title X Family Planning.

This could either be the most frightening, or happy day of your life.

The move was thwarted, amid calls of sabotage, and perhaps folks felt comforted by Harwell and Ramsey calling on all parties to just say bygones and move on.

While some may have thought it was over at that, the administration of Governor Bill Haslam still sought to send all the Title X funds to the Shelby County Health Department rather than contract directly with Planned Parenthood of Greater Memphis, as they had in previous years.

In the wake of the political posturing that would have prevented PPGMR, and its Davidson County counterpart from receiving Federal dollars through the state the Governor began an effort to pressure local officials to take the funds, even though local capacity didn’t exist. They were eventually accepted, with the condition that the local Health Department could contract with PPGMR.

An RFP was issued, and three organizations: Planned Parenthood of Greater Memphis, Christ Community Health Center, and Memphis Health Center submitted responses.

In mid-September, the winner was announced, and it was not Planned Parenthood. This caused a bit of a stir at the County Commission a few days later, as they chose to defer voting on the contract until some questions could be answered.

I was at the County Commission that day, and observed as some called legitimate concerns surrounding this issue “political posturing”. Family Planning has been politicized, but not just at this point in the process. It’s been politicized for decades. What’s happening here is just one more stop on a long journey that has not only put the future of Title X funding in question, but the health of the thousands of women who benefit from the Family Planning services provided.

The Issues

Aside from the national and statewide issues surrounding the politicization of Title X, there are quite a few issues that pertain to the local funds that would go for that service. Today, in the first of a series of posts, some of these issues will be introduced. Most of them deserve and will get a deeper look in the coming days.

But before we get in to the specifics of proposals, scoring methodologies, and the politics of it all, I think its important to understand what Title X is, and more importantly, what it isn’t.

Here’s what HHS says it is:

The Title X program also supports three key functions, authorized under the Title X statute aimed at improving the quality of family planning services and assisting clinics with responding to client needs. These functions include: (1) training for family planning clinic personnel through ten regional general training programs and three national training programs that focus on clinical training, enhancing quality family planning services for males, and/or coordination of training activities on the national level; (2) data collection and family planning research aimed at improving the delivery of family planning services; and, (3) information dissemination and community based education and outreach activities. These functions help to ensure that family planning services are evidence-based and of high quality. (Source)

Title X funds are bound by the Hyde Amendment, meaning they cannot be used for abortion. However, because abortion is a medically accepted and legal procedure, clinics that utilize Title X funds are required to refer patients to clinics that provide abortion if they make a request. That doesn’t mean the Federal government will pay for the abortion. It just means they’re required to make a referral.

Of the three organizations that made proposals to the Shelby County Government, only Planned Parenthood provides abortion services. Abortion opponents charge that because Planned Parenthood offers abortion services, any public dollars spent are by default supporting abortion. What these advocates ignore is that Family Planning services are not exactly money makers, as Shelby County CAO Harvey Kennedy noted in his presentation to the County Commission about this issue on September 21st. Further, no one using Title X funds can suggest abortion as a default. The patient must request an abortion referral. It is also important to note that family planning is the single best way to prevent abortion, a fact that is often conveniently ignored.

The reality of all this, in a county that has massive poverty, that family planning is a big deal. Unwanted pregnancies are preventable via many means. Preventing unwanted pregnancies is an effective measure to stem the tide of poverty. All too often, particularly with teens, an unplanned pregnancy means the end of their education, which can significantly limit potential. Title X family planning funds seek to help women and men make the right choices to not only prevent unwanted pregnancies, but also slow the rate of STD infection, which is unacceptably high, and rising as more and more teens engage in unprotected sex.

You may be asking yourself why all this family planning money hasn’t been more effective to date. There are no easy answers, but the politicization of the issue plays a role. By continually shifting focus from proven methods, to methods that rely on people to fundamentally act out of character, specifically for a political purpose, the entire franchise of family planning, and the lives of people who could most benefit from it, are put at risk.

This reality is something that should remain in the back of your mind as this discussion moves forward.

In a series of forthcoming posts we’ll take a look at the RFP, and the proposals submitted by the two highest scoring agencies, PPGMR and Christ Community Health Center and do a little compare and contrast, highlighting the services each agency seeks to provide.

Stay tuned…