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Tennessee’s Version of Defunding Planned Parenthood, or Why Fewer Nashville Women Will Be Able to Access Family Planning Services

June 10, 2011

Tennessee’s recent budget included a provision to strip family planning funds from Planned Parenthood. These are non-abortion funds that paid for women to receive care such as birth control. There was a bit of political drama about it; I’ll refer you here to catch up.

Today, in the wake of this drama, it was announced that the Davidson County (Nashville) health department would take over the $335,000 federal grant that used to go to Planned Parenthood for family planning.

Honestly, I can’t even come up with a coherent response to this right now.


If I’m reading correctly the letter from William Paul, director of the Metro Public Health Department of Nashville/Davidson County, the Nashville area health department is accepting the funds that would have gone to Planned Parenthood with the understanding that they will not serve all of the women/patients who were previously being served.

The Memphis and Nashville departments have reportedly already stated that they did not have the capacity to absorb all of the patients who were covered via the funds to Planned Parenthood. That seems to be the entire point of the relationship, of having the family planning funds go through Planned Parenthood, leaving the local health department to focus their efforts and limited capactiy elsewhere. As explained in the news:

County health departments in all 95 counties provide similar services with Title X funding but in Shelby and Davidson counties, the health departments have told the state they cannot serve everyone who needs them. So the state contracts with Planned Parenthood in the two counties to supplement the public agencies’ work.

The letter reads, with my emphasis added:

This acceptance is based on our understanding that the increased funding is not linked to a specific number of additional clients, as per your letter of June 3rd. It was our understanding earlier that the funding was tied to a specific caseload, and the proposed additional funding would represent only partial funding for the required caseload. As you know, we do not have local tax dollars available to expand this program. This combination of factors precluded us from accepting the full amount of funding available to Davidson County as it was offered in previous years.

We are confident that over time we can serve nearly the same number of clients that are currently served, and we will do what we can to ensure that these important services are not lost or adversely affected in Davidson County by this realignment.

What this sounds like to me?

We’ll take the money into the local health department because we understand that you find putting any money through Planned Parenthood icky, even if it’s to help women actually prevent unwanted pregnancies. We hope you understand that we’re not going to serve all of those women who are currently being served. We hope to get there eventually. Please to give us the money now.

Right. Because it’s a decent public health solution as long as we can stick it to Planned Parenthood, even if fewer women actually receive public health services.


[hat tip to B]

17 Comments leave one →
  1. June 10, 2011 8:45 pm

    To me, it sounded like Metro was trying to say that they would take the money, but they wanted to be clear that women’s health would suffer so that they’re not to blame when it happens.

    It’s a mess. A terrible mess.

    • June 10, 2011 9:23 pm

      That’s exactly how I’m reading it – that they fully know they can’t even serve as many people as are currently served.

  2. June 10, 2011 8:47 pm

    Here’s the part I don’t understand [OK, there are LOTS of parts I don’t understand]:

    How is Davidson Co. taking over the grant tied to the state de-funding? Did the state authorize Planned Parenthood as the grant recipient, and this bill effectively sever that relationship? If not, I’m confused.

    • June 10, 2011 9:30 pm

      If I’m understanding it correctly (which I fully may not be!), it’s federal family planning money – Title X, I’m assuming. That can pay for family planning through public health departments, Planned Parenthood, or other entities. In many counties, which also don’t have Planned Parenthood, that family planning money goes to the local public health department for those services. In Nashville and Memphis, the state contracts some of it out to PP – the health departments in those counties have reportedly stated that they don’t have the capacity to take on all of those patients, so presumably there were some infrastructure benefits to farming that work out to PP. There are only a couple of counties where the state funnels some of the money out to PP, and only a few counties in TN where PP exists at all, so that’s one way Davidson County becomes involved.

      There has been a lot of controversy and coordinated effort in TN and many other states to strip PP of any funding – non-abortion, pregnancy prevention and cancer screening-type funding, which you’re probably already aware of. As best I can figure, it’s in the wake of that – including the whole Campfield mess – that Davidson co. health folks said, “Okay, fine, we’ll take that family planning money that you’re so determined to strip from Planned Parenthood.” Presumably there was some political pressure for them to accept the funds (especially in light of their previous statements and the bits of the letter that seem to be explicitly, “we’re not going to be responsible for the cut in services”), but the news reports I’ve seen so far don’t address that angle.

  3. Vvixen permalink
    June 10, 2011 9:31 pm

    Sad to say, Rachel, I think your interpretation is correct.

    Laura, up until this year, Tennessee Department of Health contracted directly with Planned Parenthood in Memphis and Nashville to provide Title X services. Yes, the state used to authorize PP as a grant recipient. In fact, TDH has never had any complaints about the way PP used the funding. Planned Parenthood in Memphis provides the required services at lower cost than the Shelby County Health Department does, saving county taxpayers about half a million dollars a year.

    But it’s not about using the funding efficiently and as Rachel points out, it is certainly not about providing the services to the women who need them…it’s really all about Ron Ramsey & the Republicans claiming a victory against the Great Satan–Planned Parenthood! The fact that “defunding” PP is going to cost taxpayers more to provide services to fewer women who really need them…apparently that’s not important to anybody at all…

  4. Kimu permalink
    June 10, 2011 10:02 pm

    In addition to being angry about this, I’m completely confused. I thought one of the requirements was that local health departments HAD to be able to absorb the capacity. Clearly the letter says that isn’t the case now & may never be the case. Was I wrong about there being some capacity requirement?

    The whole thing is just a ludicrous women-hating cheap shot.

    • June 11, 2011 7:54 am

      I think that’s the impression the health department was previously under as well; I can only assume that’s why they make it so explicit in the acceptance letter that they can’t. I don’t know if they previously misunderstood, or are misunderstanding now.

  5. June 11, 2011 7:43 am

    Well if that’s the case, then we should be angry with our local officials here in Davidson County, right? This whole thing is so strange to me.

    • June 11, 2011 7:52 am

      Yes, I believe we should. It’s hard to be mad at the health dept for taking money, but it’s problematic to me for public health people to take money knowing it means health services cuts, I’d certainly like to know more about the making of that decision and who was involved.

      Added: also, based on the letter being addressed to Susan Cooper, I think it’s at the state level that the funds either get provided to the county health departmemt or to PP, so it’s not clear to me how much local officials outsode the health department get a say.

  6. metromd permalink
    June 11, 2011 4:00 pm

    A few points about the Nashville situation. Planned parenthood will stay open for business. Some percentage of their current title X customers will remain with them and choose to pay the sliding scale fee. Those who can’t pay will be welcome at Metro. That percentage is unpredictable, which is one reason it is not possible for metro to commit to taking all the case load that PP now carries. Potentially the increase at metro opens up some new treatment availability overall in that case. The other reason is that the amount of funding doesn’t cover the costs of the service. Both PP and Metro now run out of the federal funds part way through the year. PP has been supplementing presumably with private donation funds. Metro supplements with local tax dollars. Metro can’t commit to spending more local tax dollars and so the will of the legislature in steering title X to metro has been in effect to create a “partially funded mandate” . As government solutions go, Metro runs efficiently and will have some economies of scale so the additional funds will come close to the cost of taking additional title X clients.

    • June 11, 2011 4:59 pm

      Thanks for your comment – although I wish you’d identify yourself more explicitly – from your info provided on the back end, your position is relevant to the discussion. I may be wrong, but there’s nothing in this comment that really reassures me that the same level of service will be provided, that the same number of women can receive services. Rather, it tells me that additional Metro tax dollars will need to be allocated in order to provide the same services (to the same # of people) PP was providing through federal funds and private donations.

      Additionally, I don’t think anyone specifically expressed a concern that Planned Parenthood would close, so that’s a bit of a misdirection. The concern was that political pressure led to the Nashville area health department accepting funds in the wake of somebody’s anti-PP political agenda, and in doing so acknowledged that said department might not be able to provide service to the same number of people who are currently being served by the funds in question.


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