Health Clinics Caught in the Crossfire

In an overt attempt to punish Planned Parenthood for offering abortion care services, state lawmakers have proposed a new funding formula – tucked away as a rider in the massive Senate budget draft – that would push the provider to the back of the line when breast and cervical cancer screening funds are doled out (See: "Defund Planned Parenthood ... Jeopardize Lives," Feb. 13). However, contrary to the stated ideological wishes of conservative lawmakers, the move will also impact clinics unaffiliated with the abortion provider.

"It's unnecessary and burdensome not only to the department but to the providers and the low-income clients that we serve," said Carole Belver of the San Marcos-based Community Action Inc. of Central Texas. Testifying before the Senate Finance Com­mittee in late February, Belver vehemently urged lawmakers to refrain from adopting the tiered system. The formula prioritizes funding for state, county, and community health clinics, Federally Qualified Health Centers, followed by "non-public entities" that provide screenings as part of comprehensive primary and preventative care, and lastly, "non-public entities" that provide specialty care. The community-based nonprofit of 50 years has offered un- and underinsured patients in Hays, Caldwell, Bastrop, and Williamson coun­ties low-cost breast and cervical cancer screenings for 20 of those years, often picking up where overburdened FQHCs (Tier 1 clinics under the plan) cannot. But because it is a "non-public entity" that offers specialized services, not comprehensive care, Commun­ity Action Inc. will join Planned Parenthood at the end of the BCCS funding line. Asked by state Sen. Kirk Watson, D-Austin, if the center performs or is affiliated with an organization that offers pregnancy terminations, Belver responded flatly, "No sir, we do not. We never have and never will."

Belver was joined by other clinic leaders opposing the funding scheme. Among them was Martha Zuniga, executive director of the South Texas Family Planning and Health Corporation, whose clinics will be reclassified as Tier 2 recipients, despite also being unaffiliated with Planned Parenthood. Zuniga noted the irony of the proposed plan, saying she was contacted by the Depart­ment of State Health Services to be part of the BCCS program in 2008 specifically because her provider network specializes in reproductive health services and can often move patients through the BCCS program more swiftly and efficiently; today they are suffering for it.

If the plan passes, Zuniga and others guarantee patients will experience longer wait times and diminished access. Recalling the destruction to the women's health care network after the Lege similarly re-tiered family planning funding in 2011 to hurt Planned Parenthood, Zuniga said she stands in disbelief that lawmakers could consider a similarly "devastating" plan. "Don't jeopardize a woman's ability to access cancer services and treatment while she's fighting for her life – and depends on you, the elected leaders, to support her in her greatest time of need."

Watson – who peppered the testifiers with questions to highlight the incidental harm – said the debate is far from over this leg­is­lative session. "I continue to be appalled at the willingness to sacrifice health care and in this case, women's health care, in the name of pure politics," he told the Chronicle. "This is an effort to subvert one organization; that's the intended consequence. But the assured consequence is collateral damage to so many good organizations that truly save women's lives." Watson said he'll fight to prevent the plan from passing in the face of some colleagues who "turn the other way" when intentionally damaging women's health care. He continued, homing in on the potential impact, "Women across this state are going to be made ill as a result of this, and probably, in some instances, are going to die."