Two family planning clinics that serve 17 counties in northeast Nebraska are closing today after they were forced by the state to re-apply for their federal grants and then lost the money to more generalized clinics.
Norfolk Family Planning and Fremont Family Planning have provided reproductive health care services for more than 40 years, but the clinics will close their doors today after the state yanked their grants and gave them to a clinic and a public health department.
Deborah Bunn, executive director of the agency that oversees the family planning clinics, said the clinics were two years into a five-year family planning grant when the state required them to re-apply for the grants this year.
Bunn said as long as the clinics followed the rules and turned in reports on time, the grants had always been renewed in the past. She said state officials just told her it was their duty to look for the best, most efficient way to allocate the grants, which amounted to about $164,000 for her two clinics. The loss of the grant was too big of a hit to keep the doors open.
“That pretty much leaves us out in the cold,” Bunn said.
However, the two new clinics will get $476,000 in grants, which includes $150,000 in startup costs, according to a spokeswoman for the state Department of Health and Human Services, Leah Bucco-White. Bucco-White provided some information about how the grants were dispersed, but declined to provide anyone from HHS for an interview.
Bunn noted that during the legislative session, Sen. Deb Fischer introduced a bill, LB925, that would have required the state health department to give preference to public health departments, federally qualified health centers or public or private health care facilities when awarding the family planning grants, which are called Title X grants. Those kinds of clinics offer a broader range of services than the family planning clinics, which focus on reproductive health, providing pap smears, contraceptives, breast exams, STD tests, pregnancy tests and HIV tests.
Fischer told Nebraska Watchdog on Thursday the closure of the family planning clinics had nothing to do with her bill, which she introduced in response to concerns from public health clinics – particularly rural ones.
She said she did not ask the health department to change the way it awards the grants.
“I had nothing to do with it,” she said. “I have had no conversations with HHS.”
Bunn said she’s nervous about the Norfolk clinic taking over family planning services because Norfolk is “very conservative” and she is worried that adolescents won’t get the same service her clinics have provided. Her clinics provided “all options,” including the morning-after pill, emergency contraceptives and birth control for adolescents.
She suspects a change in providers was sought so the funds could be more closely regulated by lawmakers and the state, whereas her small, independent clinic closely followed Title X regulations and fought any attempts to curb services.
“But we’re not Planned Parenthood and that seems to be something that most of the state doesn’t understand,” she said.
Last year, Planned Parenthood of the Heartland announced plans to open six new clinics in Nebraska, including Norfolk and Fremont.
“We’re wondering if this is a way to make sure there’s no Title X money available for Planned Parenthood,” Bunn said. “They want to keep Planned Parenthood out of state because they know they will provide abortions.”
She wasn’t given a reason for the termination of the grant. Bucco-White said it was a competitive grant process with a scoring system.
“We’re required to look at all applications objectively,” she said via email. “Based on scoring, other service providers won the bid. It’s unfortunate that the locations are closing but no services are being lost in the community. People will continue to be served by a different provider.”
Bucco-White said services will be provided at four locations instead of two, making the services available to more people.
Bunn said it doesn’t make sense to her that the state is now doling out more money to the new providers. She said her nonprofit agency has struggled with cash flow for years, and now the state is tripling the size of the grants.
“I could have done so many wonderful things with an extra one or two or three hundred thousand dollars,” she said.
She acknowledged the state has been critical of the fact that her sister-in-law was her clinical manager – but Bunn said she was hired before she became director 12 years ago.
Her agency and the state also tussled over its annual audits, which routinely dinged the agency for not have adequate segregation of duties. But Bunn said most small nonprofits have that problem.
“We don’t have enough staff to segregate all those duties as the federal government would like you to,” she said.
Last July when the federal grant was awarded to her agency for six months, the grant was contingent upon completion of a second audit because “they didn’t like the first firm we hired.”
“We fought them on that,” she said, and in December the state removed the requirement as a condition of the grant, Bunn said. She doesn’t know if that had anything to do with the loss of the grants.
She has worked for the agency for 34 of its 40-plus years, but she and her 15 employees are now looking for jobs.
Lori Meyer, who has worked at Norfolk Family Planning for 14 years, is one of those employees looking for work. The office manager had a child when she was 19 years old, and knows what it’s like to have an unplanned pregnancy, as well as planned pregnancies.
“It would be a travesty if family planning clinics are closing left and right,” she said. “I guess I just believe in what we do here.”
Reported by Deena Winter, email@example.com.
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