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The purpose of this blog is to stimulate thought and discussion about important issues in healthcare. Opinions expressed are those of the author and do not necessarily express the views of CMDA. We encourage you to join the conversation on our website and share your experience, insight and expertise. CMDA has a rigorous and representative process in formulating official positions, which are largely limited to bioethical areas.
Not Your Mother’s Family Planning Program
September 6, 2018
by Christian Medical & Dental Associations®
In this week’s blog post, Jonathan Imbody shares how several federal grants awarded under a recent Title X funding opportunity illustrator the current White House Administration’s determination to ensure that faith-based and pro-life clinics, hospitals, pregnancy centers and sexual risk avoidance programs get a fair and legal chance to compete for federal funding.
Several federal grants awarded under a recent Title X funding opportunity illustrate the current administration’s determination to ensure that faith-based and pro-life clinics, hospitals, pregnancy centers and sexual risk avoidance programs get a fair and legal chance to compete for federal funding.
The Beacon Christian Community Health Center, directed by CMDA members Drs. David and Janet Kim, is one of 11 new grantees recently funded through the federal Title X family planning program. Beacon won a three-year, two-million-dollar Title X grant to address high rates of teen pregnancies and sexually transmitted disease in north shore communities in Staten Island.
Beacon’s grant application fit well into the newly reformed federal Title X program, which now offers a broad range of voluntary family planning methods and services, that includes information and education related to family planning, preconception care, contraception, natural family planning, infertility services, sexual risk avoidance education and more.
The grant provides Beacon with $675,000 in funding the first year and $2,035,000 over three years. Beacon will partner with Young Lives, Bethany Services and Gianna Center to focus on adolescents and young adults.
Beacon’s Chief Medical Officer Dr. Janet Kim wrote to me about their motivation for seeking the grant:
“Since 2006, Beacon Christian Community Health Center’s mission is to honor God by caring for the physical, mental, emotional and spiritual health of our community. This has particularly played out by taking care of the neediest of our community members. We hope that this new grant award will allow us to expand our comprehensive Ob/Gyn services that includes providing education to our patients in meaningful family planning.”
The clinic plans to add a second nurse practitioner, a second nurse and a social worker.
New policies open the Title X door to life-affirming healthcare
The Beacon grant offers a tangible illustration of the federal government’s recent revival of conscience protections in healthcare and the administration’s reform of federal programs. The U.S. Department of Health and Human Services (HHS) appears determined to transform the long-abused Title X family planning program from an exclusive feeding trough for abortion businesses into a more life-honoring, holistic healthcare program designed to yield better health outcomes for patients.
- Example A: A non-profit health organization provides a broad range of contraceptive services (as required by Title X law) among other healthcare services but does not participate in abortion in any way or provide potential abortifacients. That organization now can serve as a Title X “prime grantee,” i.e., the organization that receives and is responsible for the grant.
- Example B: A faith-based health clinic does not provide any contraceptives but does provide natural family planning education. That clinic now might participate as a Title X “sub-grantee,” serving as a partner under a state health department or other prime grantee.
- Example C: A federally qualified health center (FQHC) does not participate in abortions in a state where Planned Parenthood historically has won state-wide Title X grants. The FQHC could apply for a Title X grant by offering to serve as a prime grantee for a limited area of the state or population that is not already well covered by existing Title X clinics.
New Title X policies will benefit patients, taxpayers and health professionals
A new rule proposed by HHS will complete the Title X program transformation, by preventing the comingling of abortion and Title X activities, by emphasizing new and scientifically proven approaches to family planning, and by broadening health services and eligible organizations to provide a more comprehensive and holistic approach to patient care.
Even before the proposed rule is finalized and fully implemented (likely in early 2019), HHS meanwhile has reversed previous policy and restored federal conscience protections to health professionals who will not participate in abortion, including through referrals.
Once implemented, the new Title X rule on federal family planning funding promises to benefit:
- Patients seeking family planning services from health professionals and organizations with life-affirming values.
- Taxpayers who do not want their tax dollars to fund the abortion industry.
- Health professionals and organizations who could use federal funding to help provide services for family planning.
Highlights of the new rule include:
- Conscience protections enforced.
- No required abortion referral or counseling.
- New funding partners sought.
- Parents involved in decisions about children.
- “Family planning” more broadly defined.
The Christian Medical Association and Freedom2Care submitted an official comment on the new rule; a few excerpts follow:
The new, law-conforming policy of no longer requiring referrals is a key provision essential to breaking the abortion industry monopoly and to opening the door to new and more effective and holistic health partners. Without this change in policy, pro-life health professionals and programs would remain on the sidelines, prevented by ethical commitments from participating in abortion-promoting Title X programs.
One in twelve patients in the United States—including one in three who live in poverty—currently rely on a federally funded health center. HHS’s HRSA notes that “Today there are nearly 1,400 health centers, which operate approximately 10,400 delivery sites, across the country serving nearly 26 million people.”
Federally qualified health centers (FQHCs) offer years of experience as well as establishment and recognition within communities. They already have successfully navigated the federal grants system and they have systems in place to comply with federal requirements. Many FQHCs could quickly partner with HHS on Title X programs.
Implementing the valuable and strong reforms in the proposed rule related to Title X requirements is an important step in closing the door to past abuses and opening the door to new and more effective Title X partnerships. Turning this vision into reality also will require reevaluation and reformation of the grants process, building bridges to communities previously discriminated against, and providing technical training and encouragement to help new partners engage with HHS to serve Americans in need.