Family planning clinics hard hit by budget cuts

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About 15 percent of Houston-area clinics that received state funding for family planning services closed their doors because of budget cuts last fiscal year, and another 30 percent have reduced service hours, according to a study published this week.

Following a political firestorm in the 2011 legislative session, state family planning funds were cut from $111.5 million to $37.9 million for the biennium, cutting services to as many as 180,000 women in Texas a year, according to state health department officials. The number of clinics funded by the Texas Department of State Health Services has dropped from 300 to 136 since the Legislature slashed funding, state officials said.

"Ostensibly, the purpose of the law was to defund Planned Parenthood in an attempt to limit access to abortion, even though federal and state funding cannot be used for abortion care anyway. Instead, these policies are limiting women's access to a range of preventive reproductive health services and screenings," a team of academics from the University of Texas at Austin's Population Research Center wrote in the New England Journal of Medicine article.

7 local clinics close

Seven Houston-area clinics are among 53 Texas clinics that closed between last September and this May. Thirteen clinics in Houston reduced their hours, according to interviews that researchers conducted with providers. Names and addresses of the clinics that have closed or reduced services were not included in the report because researchers granted providers anonymity.

But none of the 11 clinics operated by Planned Parenthood Gulf Coast closed because of the funding cuts. More patients are being asked to pay for services out-of-pocket, resulting in a slight decline in medical visits and increased anxiety among patients, spokeswoman Rochelle Tafolla said.

"Those cuts have had a devastating impact on low-income, uninsured women who desperately need preventative health care," Tafolla said.

Many clinics, including Planned Parenthood, have started charging patients higher fees or restricting access to highly effective birth control, such as IUDs and implants, because of the state funding cuts.

"Some providers have started waiting lists for IUDs and implants in the unlikely event that they can purchase them with money left over at the end of a funding period. In addition, as more women are steered toward contraceptive pills, they are being provided with fewer pill packs per visit, a practice that has been shown to result in lower rates of continuation with the method and that may increase the likelihood of unintended pregnancy - and therefore that of abortion," according to the research.

Cost consequences

A study released last year by the Guttmacher Institute concluded that every $1 of government money invested in contraception saves $3.74 in Medicaid expenditures for pregnancy-related care related to births from unintended pregnancies. It could take years for all of the unintended consequences of these cuts to surface, researchers said.

"Cuts to family planning hurt Texas families. They mean higher costs to the state in births and unintended pregnancies," said Kristine Hopkins, a UT research assistant professor of sociology who helped conduct interviews for the research. "And low-income women aren't able to actualize their desires for their family size, and I believe that's a basic human right."

'New breed of clinic'

Rachel Bohannon, spokesperson for Texas Right to Life, said the state money is simply being redirected to clinics that don't promote or refer to abortion services. "Women are being better served in the long run," she said.

Bohannon touted a new clinic, the Source for Women in Spring Branch, which opened earlier this month under a partnership with Houston's First Baptist Church. "They're kind of like a new breed of clinic that will offer all the same services as Planned Parenthood minus abortions," Bohannon said.

University of Texas Medical Branch in Galveston saw its family planning allocation fall from $4.4 million in 2011 to just $1.6 million this year, potentially meaning nearly 10,000 fewer women will receive cancer and STD screening, physical exams, counseling and contraceptives, according to estimates provided to the Chronicle earlier this year.

Peggy Smith, head of the Baylor College of Medicine Teen Health Clinic, said state budget cuts wiped out 25 percent of her clinics' budgets. They covered the shortfall through fundraising and even plan to expand. She does hope politicians restore funding for family planning.

"I'm cautiously optimistic," she said.

jennifer.radcliffe@chron.com