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Exclusive: Family planning clinics closing in Fremont and Norfolk after state yanks grants

By   /   June 29, 2012  /   32 Comments

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, deena@nebraskawatchdog.org.

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Deena Winter

  • Patrcik

    This is our state govenrment looking out for our best interest? The rural counties already have limited resources so this doesn’t solve an issue, it creates one. Get your Aspirin out girls because you’re on your own.

  • http://www.nebraskansadvisorygroup.org Susan Smith

    Grant funding should not be taken for granted. According to the article it doesn’t sound like services will be lost because four facilities will receive grant $ in addition to Planned Parenthood new location(s).

    Bunn could ask the ACLU, churches and local businesses to fund the $164,000 for her two clinics. Is there room in the salaries of staff to cut costs? Fundraising events in the community is another great way that allows the citizens to show their support.

  • Mother Middleton

    I AGREE WITH SUSAN. BAKE SALES WILL HELP PREVENT UNWANTED BUNS IN THE OVEN.

  • http://msn.com Jason3

    amazingly, fisher knows nothing about this…how dumb are suppose to play while she plays the republican game!

  • Believer

    A bake sale? Ask the community? When you live in a community where the schools teach abstinice only yet the pregnancy rate is sky high… no private agency will donate money for a clinic that provides women’s health and birth control.

    When you start taking money away from agencies like family planning and giving it to generalized clinics, there will be a loss in education and services that are very needed… the entire reason Nixon gave title x money was so women of all ages could afford, with dignity and without judgement, to have a pap, std testing, hiv testing, education and birth control at low or no cost.

  • Catherine

    I work for Norfolk Family Planning. Today is my last day. The loss of this agency is a travesty. It would seem that some of the commentators do not know what it means to be a federally funded, non-profit agency. As employees, we already worked for less than average pay…because we believe in what we do. We sacrificed higher paying positions to continue servicing our patients. This wasn’t just a job to us. We know the jeopardy that this puts our patients in. Norfolk Community Health Care Clinic is a general practice FQHC. Not to mention they also operate a dental clinic out of the same facility. How does a 15 year old girl walk in there without risking the chance of running into a cousin, aunt, family friend or someone else who isnt obligated to keep confidential who they see at the clinic?? I would hope that this wouldn’t stop our patients from continuing services with this other clinic. I would hope that there wouldn’t be women of all ages facing an unwanted pregnancy due to greedy politics. Because if the purpose of this was to be more cost effective–the state, and ultimately the taxpayers, are going to end up paying for a lot of babies when these girls go on medicaid. Cost effective would have been to continue funding our agency for less than half of what was handed to NCHCC and Three Rivers. We had a contract. We were two years in. How is what they did in any way legal, let alone cost effective??? You cannot tell me that Deb Fischer’s bill had nothing to do with this. It was a proposed bill that was not passed, but if you read it, you will also see that what was proposed, is exactly what has happened to our agency. I’m sure that we were just the guinea pigs for this movement, and that we may have been the first, but we definitely wont be the last Family Planning Clinic to close because of this.

  • julie johnson

    Our agency has legal binding contract through 2013 with no requirement to re-write for the grant until 2013, when it was to be renewed with a possibility of having to do a non-competitive grant yearly through 2015. How is it the state can void a contract, with the only explnantion of “have to look for the most cost efficient provider”. Well, you still can’t break a contract just because you want to. There shouldn’t have been a grant to compete for until 2015. Where is the transparency in how this decison was made to put it up for bidding? Who did that idea come from, why isn’t HHS willing to discuss it??

    The grants are scored by three “independent” reviewers, and there is no accountability in this process either, since none of those reviewers names are revealed.

    The results of the grant process weren’t made public until the end of May, yet I heard of our losing the grant in April, during a chance meeting with someone who attends some state meetings for another agency. It was remarked to me that the closing was being talked about by several people during that meeting in April.

    This was dirty pool. If you’re going to de-fund us, then be honest enough to admit it up front, and don’t sneak around.

    Also, having four locations (and where is the fourth, one in madison, one in norfolk, one in fremont, where is the fourth??) is no indicator of serving more people. You could have 4 locations, and if you’re serving 25 people a month at each location, and I’m serving 200 ppl a month from one location, I’m still serving more people, and probably cheaper too, with less staffing/administrative costs (savings)and less overhead (one location versus 4)

    Lastly, the transition process, supposedely coordinated by the state, has been chaotic, to say the least. No one from State or the takeover clinic contacted us regarding when they would be picking up charts, what furnishings they wanted, etc, until Wednesday, June 27th…Our patients will not be able to get exams or pick up supplies for several days or weeks, again, no information was provided to us to give to patients regarding continuity of services, finances/fees, or anything else, actually. Poorly done, State.

    I’m probably burning some bridges by writing here, but at this point, I am quite tired of the politics involved in this, and done worrying about getting this place closed down properly. State can come in and help close the rest of this down, as we are officially unemployed as of now.

    And to Susan Smith, our salaries are so low now that it’s not really livable wages. ACLU doesn’t fund anything, there is no communnity support other than those that have used our services. Would you like to try living on a salary based on bake sales?? We all use our own money to buy things as it is, we literally could not get a paper cutter for years, someone finally donated one. Staff that are here are here because they are passionate about women’s health care, especially those who might go without if they can’t pay the $85 charge just to visit a gynocologist, which doesn’t include a pap smear or any other testing. Far from taking grant funding for granted, we are always aware of the need to watch costs. We did take for granted an award letter/contract would be honored. So I guess that means no one should take theri contracted funding for granted. I’d sure like to have seen what state would have said if WE announced we weren’t going to honor the contract terms…

  • Dan

    Yes, a PP on every street corner and free condoms, pills, and abortions for everybody. That’s how our society should be. I’m just wondering if all you lunatic femi-nazis are the LEAST bit ashamed that your sex habits are subsidized by the taxpayers? And by your logic, my not wanting to subsidize your sex lives, I am therefore denying you access to all the birth control you want. How exactly do you square that? Should we also provide private rooms in schools with nothing but a bed, with a box of condoms and a pack of cigarettes on the nightstand? I want to go on a snowboarding vacation, but you fems are confiscating my tax dollars, therefore yoy are denying me access. See how easy that is. The feminist movement has become the worst hinderance of progress for women because at first the movement was all about independence and equal rights, which are noble, but now it’s DE-volved into a movement preaching total DEPENDENCE on government instead of the natural family structure. I hope you’re all proud.

  • Good choice

    I’m so happy to hear this good news! We need more clinics that “offer a broader range of services.” If the government is going to hand out our tax dollars to offer healthcare services, it should be at clinics that serve everyone.

  • Mayra

    Maybe Bucco-White should have dug deeper before handing hundreds of thousands of dollars to Fremont’s health dept. Questions should be asked as to why 11/15 employees have been replaced since the director Brandi Trumbleson took over in Aug. 2011.

    Why are current grant monies awarded to 3 Rivers Health Dept. being used for gifts, food, bonuses etc…instead of used for the real purpose of them?

    Shouldn’t the executive director of a health department at least live in one of the counties she serves, especially since she isn’t engaged in the community?

    Someone needs to do an investigation into why 3 Rivers has taken a nose dive straight into the ground since Tubmleson took over. And now she is going to over see Family Planning services, which she knows nothing about?

    Something about this whole thing smells a little fishy.

    State statue says a health department is to fill a void in counties. Not to take over existing agencies.

    And last, bake sales are not going to fund an entire clinic.

  • Catherine

    @Dan—would your tax dollars be put to better use to fund a lot of unwanted children? Food stamps. Medicaid. AFDC. Because that is what you are ultimately asking for when you deny these young men and women the education–NOT the acceptance–of caring and being responsible for their own sexual health! You think that not talking about sex will prevent them from doing it?? Do they ask you about the effects of alcohol before having their first drink?? Do they ask you about tobacco health complications before having their first smoke?? No. They are kids. Curious and with raging hormones. They do not ask our permission. But we provide them with the education they need to make the right decision! Something that most parents dont do at home for the same reason that you deem appropriate–talking about it equals giving them permission. Well youre wrong. I can count on my left hand the number of virgins who have seeked assistance at our clinics!! They come to us already having MADE the choice to have sex!! They come to us when they miss a period and are afraid they may be pregnant! They come to us when theyre too afraid to talk to their parents because their parents havent opened the doorway to that topic of conversation! Parents should be the first line of education, but for those too afraid to talk about it, thats what we’re here for! Would you rather your teenage daughter come to you and say, “i think i need to be on birth control” or “dad…im pregnant”??

  • Nadine

    Dan, this clinic which just closed had a ton of services that did not include abortions. Health screenings of many kinds on a sliding scale to allow uninsured folks access to health care. Why don’t you find out what you’re talking about?

    And if you don’t like to see condoms and pills available, are YOU taking on the children of unwanted pregnancies, are YOU doing something to help? What are YOU doing to help folks who are underprivileged?

    As for things which are subsidized by tax payers, even by your standards there are far worse things going on with our tax dollars. Like welfare and Social Security fraud. You’re just laughable, sir.

    And Dan, if you had a vagina, you would be easier to listen to. But you don’t and you’re not. Your mother would be ashamed.

    I’ve been going to this clinic for many years and I worked there, too. They had a fine service and I AM proud.

  • Believer

    Dan, for one…. we are NOT talking about Planned Parenthood. We are talking about Family Planning. Family Planning has never performed abortion, nor is it a ‘free’ clinic. They are income based and MOST women DO pay.. they pay on a sliding scale fee. It’s expensive at an OB/GYN to get an annual cancer screening… an upward of $300 to $500. The highest demographic seen at these clinics is women in their 20′s and 30′s… most who have high deductible insurance or no insurance. Family Planning has provided low cost exams and low cost birth control for women for more than 40 years. Cancers have been detected and have saved these women’s lives. If you are married, you obviously are lucky enough to have great paying insurance so you and your wife can space your children accordingly, or you have decided to have dozens of children? Birth Control pills, until recently with the low cost formulary, oral contraceptives were $50 to $100 per month at a pharmacy. Many married couples have utilized FP to space the births of their children… what can be worse for a family who lives in the poverty level, but to bring even more children into the world? Afterall, how many men want to abstain for the rest of their marriage when a couple is done have kids but cannot afford contraceptives?

  • Tom

    Defund Planned Parenthood!

    Abortion is the killing of innocent human life.

  • Bree

    At Dan and whoever else is rudely commenting: I think you need to do some more research because these clinics are not all about young kids having sex and getting abortions..a lot of these clinics do not do abortions..and what you don’t understand is whether these clinics are here or not kids are going to be having sex..do you want them to not be safe? I know people who haven’t gone to family planning and now are young mothers and I know people who have gone and are not pregnant. No they shouldn’t be having sex but they will no matter what. And also if a women decides to have an abortion it is her choice…I wish they wouldn’t do that but that is not for me or you to judge them and it has no affect on your life. I don’t think you would appreciate people judging your life. These clinics help a lot of women and I think it is really sad that they are closing. And the whole femi-nazi and fem movement comments are just plain ridiculous…I bet in some way you or someone you know has used some sort of birth control because you do not want 15 kids running around. I wish you would look into these clinics more and try to be atleast a little bit understanding.

  • Watching From Lincoln

    @ Dan: It’s a crying shame your mother didn’t have the foresight to utilize proper contraceptive techniques.

    @ Tom: You’re a moron. Family Planning is NOT Planned Parenthood, and FP does NOT perform abortions. At all. Period. They only provide women’s health services and contraceptive (prevention) services as well as cancer and STD testing. Pretty simple concepts to understand for anybody with an IQ above 70, unless of course you happen to be a rote-reciting rabid (knee) jerk in which case no amount of intelligence would matter. The same goes for you, Dan.

    What we are witnessing in this de-funding is the first salvo, in reaction to the SCOTUS decision handed down Thursday upholding almost all of the Affordable Care Act, in this state by our petulant, petty and regressive Governor, AG and NEGOP Party Chair over having their asses handed to them yet again. As typical of all cowards, they strike out at those unable to defend themselves yet once again – women, children, minorities and the poor. This reeks of Deb Fischer’s proposed bill, and is just one more reason to prove that anybody who is willing to vote against their own best interests by voting Republican because of a single issue, deserves to get the fascist government that we are quickly seeing come to fruition.

  • Julie Johnson

    Thanks, Nadine, you said it so well….on average, we sold (they’re not free, by the way) between 200-300 pill packs a month, did over 50 pap tests a month, and 30 STD tests a month.

    Mayra, right on!! No one at State is willing to say “This is how this rebidding came about. This is who proposed it at this meeting”. Unfortunately, it may never be truthfully told who first broached the topic to whom.

    Is it a coincidence that the director of the Norfolk clinic (who was awarded the money) was director of Elkhorn Logan Valley Health Department until a year or two ago? The two clinics who got the money are both heavily involved in the Health Department, and the Norfolk clinic receives huge dollars from the Federally Qualified Health Center program ??? Give us a break, there had to be a phone call or other communication when one person brought it up. Standing behind a comment of finding the most cost efficient agency is a cowardly way out.

    This is not about sour grapes, we’ve all moved on. Beware, people, if the state can break contracts at will, everyone is at risk of having their funding taken away….

    Signing off, and going to go apply for unemployment. State doesn’t want to pay me to work, they can pay me for not working!!

  • Dan

    Cry me a bleeding-heart river. It’s not my responsibility to pay for your sex lives and it’s not my responsibility to pay for the consequences of your decisions. You feminists scream about “choice” but when you make the wrong choice you come screaming for your sugar daddy, big daddy government, courtesy of John and Jane Q Taxpayer to bail you out. If you can’t afford birth control then don’t have sex, if you can’t afford a child then don’t have sex. It’s not our fault if you can’t keep your legs together or your men off of you. This is what’s lost in our society as a result of all your liberal ideas, RESPONSIBILITY. But what do I know, i’m just a man, and as your messiah gloria steinam said, a woman needs a man like a fish needs a bicycle. And fwiw, steinam slept with mort zuckerman for a million bucks to save her stupid feminist magazine, what a freaking hypocrite.

  • Dan

    And your clinics may not perform abortions per se, but you can refer any woman where they can get one, and you will happily inform them how to swindle the taxpayers to pay for it. And i’m sure you can perform a chemical abortion via skype and a robotic arm. And the dirty little secret is that fam planning clinics are notorious for intentionally handing out defective birth control so women do get pregnant and panic so you figure they have to come back and get an abortion as they figure it’s their only way out, even if your clinic doesn’t do them, the abortion clinic you refer them to gives you a hefty kickback. Don’t give us this bs that you’re non-profit either, you people are raking in the taxpayer money and funneling it to yourselves and lawyers and lawmakers to protect the money trough you feed heartily out of. You may be raging liberals, but you know how to run your business, and business is good.

  • AtleastIhaveaclue

    I love the “defective birth control” sentence. I would be laughing if it weren’t so sad. And these clinics rolling in the dough. LOL Dan you are a riot. PP yes~FP no. Ladies, thank you for your knowledgeable comments. It is refreshing to read them. I will comment because I have been a patient at the FP clinic for 40 years for pap smears, breast exams and the education that helped me have two healthy pregnancies. I have never been a patient of Planned Parenthood so I will not comment on them. Thank you for your dedication to men and women who seek education and care so they can have a healthy, happy NORMAL reproductive life with a partner they care about. I have so much respect for what you do and am sorry to see you go. I will now go to a private GYN for services, since I am lucky enough to have insurance. I came to you all these years because I liked you and trusted you. Thank you thank you thank you! Whomever hires you will be very lucky to have you!

  • Dan

    Hasn’t this lie been exposed that NOT ONE of these clinics nationwide owns a mammogram machine?

  • Catherine

    @Dan–I cannot speak for any other Family Planning clinics, but as for our two clinics, no we do not own mammography equipment, but we do clinical breast exams and refer out for follow-ups as needed. Perhaps if we had all the funding that you believe us to have had, we would’ve, but unfortunately, we are (once again) a federally funded non-profit agency, and if you were even remotely aware of federal funds, you would know that we get the bare minimum. As for your assumptions regarding “hefty kickbacks” from organizations for referring women for abortions–WRONG!! We get no compensation from any other clinics or agencies for referrals we make! And the only thing we do is give patients the information that they request. It is then the patients CHOICE to follow through with any decision they make…from appointments to follow-ups to everything else that their decision entails. It’s unfortunate that you are so misinformed about what Family Planning does. And another FYI–we are required by FEDERAL LAW to provide all information that a patient requests…no matter what our personal feelings or beliefs are.

  • Dan

    The problem with socialism is eventually you run out of other people’s money. It doesn’t matter how much govt money you get, it never is enough. This sense of entitlement that people have that it is other peoples responsibility to pay for their bad choices or provide for their wellbeing is sickening.

  • Dan

    If you want to do all this stuff, FINE, go get private sponsors, do fundraisers, sales, whatever to raise money, then go do whatever you want with THAT money and leave us taxpayers alone.

  • Believer

    You really should, Dan, be better informed before spouting off and making yourself look ignorant to people who know what they’re speaking about. It’s unfortuenate, but we do have people who need help in our country and that’s what Title X was/is desigened to do. Does PP receive a GREAT deal in donations, they do. Family Planning relies on the grant and income from the sliding scale fee. If not for the title x money, TO HELP THOSE IN NEED, the clinic wouldn’t maintain it’s existence, and that is exactly what happened. It’s surely a shame to know that people outwardly make vial comments based on their own lack of knowledge. I hope you and/or your loved ones are never in the need for help from a government funded source.

  • AtleastIhaveaclue

    I love when people yell “Socialism” and then send their little kids to public schools and libraries and use medicaid and social security and on and on and on. Another red neck hypocrite without a clue. LOL

  • http://todayonthelege.wordpress.com Franklyn

    I looked up “misogynist” in the dictionary. The definition was accompanied by a photo of Dan.

  • http://todayonthelege.wordpress.com Franklyn

    To connect the dots between State Senator Fischer’s legislative bill to “tier” Title X grants, with the resulting defunding of family planning clinics, one needs only to look at what has happened in Texas:

    http://blogs.dallasobserver.com/unfairpark/2012/03/as_the_womens_health_program_w.php

    There is indeed a war on women, and it’s name is Republican.

  • Dan

    Believer, your statement proved my point, you just admitted that your goal is to get people hooked on public assistance aka government with the side effect to completely remove the family from the picture. And well franklyn, good for you, you know how to use a dictionary. A mysoginists picture would probably be Bill Maher or Ted Kennedy or John Edwards or your peoples heroes George Tiller and Leroy Carhart, how many women have they killed by botched abortions, how many baby GIRLS have they killed franklyn, and they’re all DEMOCRATS! FWIW, I’m not a repub.

  • Dan

    Giving women handout after handout and freebie after freebie doesn’t empower them, it denegrates them, it takes them to level of livestock, whose existence is to keep coming back to the trough for more. I do know the deal, clinics don’t want to know names, they assign numbers, like cattle with eartags. And yes clue, we’re all seeing how wonderful govt run schools and ss and medicare are working, they’re driving this country off the cliff.

  • Ellen

    Stop electing creepy republican misogynists.

  • j

    Just an update….very interesting that the head of the State Reproductive Health program, which made the decision to give the money to another agency, has a daughter that was just hired by the agency the money went to, to be their title x coordinator. Nepotism? Hmmm…