By Jane Zebrack
The World Health Organization deems lack of access to reproductive health care to be one of the key factors of poverty. Although this issue is primarily seen on a global scale in comparing low-income countries with more developed areas, reproductive health care nevertheless affects the health and wellbeing of our community in Nevada. And, one of the biggest contributors to reproductive health care access is funding itself.
Title X is a bipartisan-supported family planning program enacted in 1970 under President Nixon. As an addition to the Public Health Service Act, Title X has provided funding for reproductive health care to patients, specifically underinsured and uninsured individuals with low income.
Annually, more than four million patients rely on federal Title X funding nationwide for access to free or low-cost basic primary and preventive health services, including wellness exams, cervical and breast cancer screenings, birth control, contraception education, and testing for STDs.
On June 1, 2018, the Trump-Pence administration proposed the domestic “gag rule,” which went into effect on Aug. 19, 2019. Under the gag rule, Title X-funded health centers are banned from providing abortions, with the exception of cases of rape, incest or medical emergency. Furthermore, these clinics are unable to discuss the option of abortion with patients or refer them for abortion care to other centers not funded by Title X.
Under Gov. Steve Sisolak, Nevada was one of 21 states to file a lawsuit challenging the constitutionality of the gag rule on Title X. In February 2020, the 9th Circuit Court of Appeals voted to uphold the gag rule, causing Planned Parenthood and other health centers wishing to continue providing and speaking about abortions to withdraw from the program.
This Is Reno spoke with Daela Gibson, Director of Public Affairs for Planned Parenthood Mar Monte. Gibson administers media relations, community outreach and advocacy.
Gibson said the gag rule did not have a large financial effect on Planned Parenthood health centers in Nevada because they had not been applying for or using federal Title X funds. According to the Planned Parenthood Mar Monte FY18 Annual Report, four percent of their funding comes from government grants/contacts. Their government funding has only decreased by one percent since 2014, and thus has been relatively unchanged as a result of the gag rule.
Gibson noted, however, that “what [the gag rule] does affect is patients in the area and other organizations in the network.” It is “stunning” that people getting care from Title X-funded centers aren’t able to “have an honest conversation with their doctor about reproductive health care,” she said.
The call by some to “defund Planned Parenthood” is miscommunication, according to Gibson. The organization does not receive “special money and/or funding,” as they are “not a line item in the federal budget.” Rather, she contends that people with this mindset are talking about “blocking [Planned Parenthood] from being a resource to patients that they trust and giving care that is the same standards as other community health centers.”
Gibson said, “We are Planned Parenthood, and sometimes that makes us a target.” However, “we are health care providers just like our other community health care providers. We all do different services; some overlap, but we all participate in and contribute to the health and welfare of our community,” she said.
To hear from a clinic that does qualify for and use Title X funding, This Is Reno reached out to Kelly Verling, the Public Health Nurse Supervisor for the Family Planning program at the Washoe County Health District. Verling coordinates clinic services and administers the Washoe County Title X grant for Family Planning Sexual Health services.
The Family Planning Clinic provides many of the same services as Planned Parenthood, such as well woman exams, pregnancy testing, contraception services and testing and treatment for STDs. However, as “the majority of [their] funding is from Title X,” they do not “perform or refer patients for termination services (abortion).”
When asked what the protocol is if a patient comes in seeking care that is not offered at the Family Planning Clinic (i.e. abortion), Verling acknowledged that they can only “offer clients a comprehensive pregnancy referral list, which includes a list of providers that serve pregnant women.”
Both organizations contribute to community outreach. Gibson mentioned that Planned Parenthood Mar Monte has participated in health fairs as well as the Women’s March, Pride events and Earth Day. They provide voter education, with the current focus on census forms. Their various education programs help provide information to the community about reproductive health. Gibson called attention to their homeless youth education program, which strives to “make sure everybody has access to being safe” so they can “keep their bodies healthy and well.”
The Washoe County Health District website supplies a link with a Community Resource List. They also point to other local affordable primary care medical services and other programs for support, including Community Health Alliance, Access to Healthcare Network, and Northern Nevada HOPES, WIC (Women, Infants, and Children) Program and Department of Health and Human Services Division of Welfare and Supportive Services.
As we are now in an election year, Nevada residents may wish to consider where candidates stand on reproductive health care and health care in general. While the gag rule on Title X has not had a large effect on Planned Parenthood Mar Monte, it does impact the funding of other Planned Parenthood health centers across the nation as well as the services and physician-patient conversations at Title X-funded health centers.
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