Tag Archives: family planning

Follow the money: family planning in the state budget proposal

A reader has kindly alerted me to the “family planning” line item in the proposed New Hampshire budget, due for a vote in the House tomorrow, April 5.

A bit of background: some of the family planning contractors in our state are abortion providers, who come to the Executive Council threatening denial of services to patients if the Council doesn’t hand over the money. Those providers keep saying that family planning money – specifically Title X money, awarded to states by the federal government – can’t be used for abortions. The same providers then press members of Congress to repeal the Hyde Amendment, which is all that stands between Title X and abortion.

As New Hampshire HHS Commissioner Meyers told the Executive Council in 2016,  family planning grants help pay for abortion providers’ “infrastructure,” also known as overhead costs.

But anyway, back to family planning, now that we know where abortion providers fit in.

Into the Weeds: Page 1191

Here’s a picture of page 1191 from the report prepared by the Office of Legislative Budget Assistant, comparing New Hampshire budget family planning allocations from fiscal years 2016 through 2019. This looks at past spending, plus projections for the next biennium. The “Governor” column reflects the budget request made by Governor Sununu. “H Finance” means House Finance Committee, and it’s the Finance Committee’s proposal that’s getting a House vote this week.

Numbers Get Larger

Look at the “contracts for program services” line. The numbers grow from about a million bucks in FY 2016 to a projected $1.5 million in FY 2019, or to $1.8 million if the House Finance Committee’s request goes through. That’s quite an increase.

The general fund line near the bottom indicates how much money comes directly from state coffers. Again, there’s a projected increase.

Right above that is the gold mine: federal funds. These are grants, including but not limited to Title X, that flow from Washington to Concord for use in specific programs. (And they are tax dollars, just like the money from the state general fund.) In FY 2016, federal family planning money for New Hampshire came to around $700,000.  For FY 2019, the governor expects $1.1 million while House Finance expects $1.4 million.

How many other New Hampshire health and human services needs are getting that kind of boost in this budget?

Looking ahead

I’ve emailed the federal HHS department in the hope that someone there can show me data to support those projected federal numbers for FYs 2018 and 2019. The reader who suggested I take a look at the family planning budget tried that already and got an unsatisfactory answer. I’m not going to bet on getting an answer before the state budget is passed and signed.

At any rate, we’re getting a preview of Executive Council meetings yet to come. Whatever amount is approved for family planning in the next biennium, the “contracts for program services” will go through the Council. The usual contractors, including abortion providers, will be there for a piece of the ever-growing pie.

 



A good vote in D.C. (opposed by both N.H. Senators)

Vice-President Pence broke a tie in the U.S. Senate yesterday. What passed, thanks to him and 50 Senators, was effectively a repeal of an Obama policy penalizing states that refuse to do business with abortion providers. H.J. Res. 43 is the name of the repeal resolution.

Senators Shaheen and Hassan of New Hampshire were perfectly happy with the Obama policy and they voted against the repeal.


The former president signed his policy on his way out the door, almost literally: it went into effect two days before he left office. Marjorie Dannenfelser of the Susan B. Anthony list has called it his parting gift to Planned Parenthood. Last month the House, led by Rep. Diane Black, voted to repeal Obama’s policy. The Senate effort was led by Sen. Joni Ernst.

I hope that by the time you read this, President Trump’s approval will have made repeal a done deal.

What repeal does NOT do: change the amount of any appropriation for family planning under Title X. Repeat: zero effect on the amount of money the federal government allocates to states for family planning programs (which, to hear some folks talk, is all there is to women’s health).

What repeal WILL do: allow states to decide for themselves, without any federal penalty, whether to grant Title X family planning contracts to agencies that perform abortions.

That’s it.

Planned Parenthood hates the repeal resolution. Their respect for women apparently ends when a woman decides to resist the abortion providers reaching into her wallet.

I’m one such woman. I know that abortion isn’t health care. And I’m not alone.

 

PP funding in NH: another end run?

An astute reader left a comment on my last post.

“…are we sure the Executive Council is going to be the decision making body about who gets the NH contract? Didn’t Planned Parenthood orchestrate a by-pass on the NH Executive Council vote against their NH contract during the construction of the previous NH budget?”

State House, Concord NH
From here …
visitthecapitol.gov photo
…to here? (visitthecapitol.gov photo)

 

 

No, we’re not sure. And yes, PPNNE did an end run around a state family planning contract rejection in 2011 by somehow procuring funds directly from the federal government. Regarding that nimble move, the New Hampshire Commissioner of Health and Human Services remarked in 2013, “It’s not appropriate for me to know what they did.”

All we know about the current situation is that the New Hampshire Executive Council has no PP item on its agenda for next Wednesday’s meeting, and that the last PP contract approved by the Council was set to expire eighteen days ago. (What’s more, PPNNE isn’t complaining that “women are being denied health care.”) Late items may be added to the agenda, as the Council’s agenda page indicates. Anything about a future contract or grant is speculative at this point. But if we can’t see into the future, we can certainly look at the past.

Planned Parenthood affiliates nationwide are feeling the heat from the video of a PP medical director chatting about procurement of intact fetal organs. PP’s public funding is under a spotlight, for now. Public dollars are not used for abortion, we’re told. Instead, tax money for “family planning” frees up other PP resources to use for abortions, and the harvesting of fetal organs, and salaries of medical personnel willing to consider changing an abortion method not for the health of the woman but for the better extraction of a child’s organs.

But a state contract or federal grant to PP doesn’t mean I’m paying for abortion itself – just so we’re clear on that. Whew.


As long as we’re seeking clarity, note this: New Hampshire Right to Life has been fighting for years to get information about how a federal grant materialized for PPNNE after three out of five Executive Councilors said “no” to PP’s Title X contract in 2011. (The Council the same day approved contracts with ten other providers, putting a crimp in attempts to cast Councilors as anti-woman.) In April of this year, NHRTL filed a petition with the U.S. Supreme Court seeking review of a lower court decision that turned away in part an NHRTL Freedom of Information Act request about the federal grant. Bits and pieces of information have emerged, but the whole clear story of how the dollars got from the feds to PP is still not on the public record.

This doesn’t mean that history will repeat itself this month. It only means the precedent has been set.

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This is as good a time as any to recall the time four years ago just after the Executive Council vote, when Planned Parenthood put enormous public pressure on the three Councilors who had denied them a contract. At that time, I was with New Hampshire’s Cornerstone Policy Research. We teamed up with the Susan B. Anthony List for a press conference to defend the Councilors. That was the day I met Catherine Adair, who spoke to the crowd about her experience as a PP employee. Here’s a reminder that the need to let taxpayers divest their funds from PP didn’t just spring up this week.

 

 

 

NHRTL petitions US Supreme Court for documents re PPNNE grant

New Hampshire Right to Life today petitioned the U.S. Supreme Court for a hearing to order the U.S. Department of Health and Human Services (HHS) to provide documents regarding a 2011 grant to Planned Parenthood of Northern New England. NHRTL originally filed a Freedom of Information Act (FOIA) request in October 2011 for documents about the sole-source non-competitive grant.

Attorneys for NHRTL say in today’s filing,

“The purpose of NHRTL’s requests was to expose what it considered an improper and potentially unlawful funding decision by HHS….[whose] decision to award Planned Parenthood a direct non-competitive grant was made hastily, in secret, and contrary to the usual protocols for awarding grants. Documents released by HHS showed that HHS was paying Planned Parenthood for birth control pills at nearly four times what Wal-Mart charged customers for the same pills. In addition, NHRTL suspected, as had the New Hampshire Executive Council, that Planned Parenthood was unlawfully using federal funds to subsidize abortion services, and that HHS knew that these federal funds were being used to subsidize abortions.”

The HHS grant in question was made shortly after the New Hampshire Executive Council rejected a Title X (ten) family planning contract with PPNNE in June 2011. Title X funds, while federal in origin, are administered by the states. Three months after the Executive Council vote, HHS in a surprise move made federal funds available to PPNNE, independent of any Executive Council oversight. NHRTL filed its FOIA request in October 2011 an effort to make public the process by which these funds were granted. A federal lawsuit followed after HHS did not produce documents in a timely fashion.

Some but not all of the requested documents relating to the grant have since been produced, some in redacted form. HHS has claimed the redactions and omissions are allowed under two exemptions within the FOIA law. That claim has been upheld in lower courts. NHRTL’s petition to the Supreme Court asserts in part that the U.S. First Circuit Court of Appeals ruling in this case creates a conflict with rulings on FOIA cases in three other Circuits.

One point of contention between the parties is the demand for public production of the PPNNE Medical Manual, outlining policies and procedures for operating a Title X federally-funded planning facility. According to today’s filing, such information is normally required by HHS as a condition for family planning grant funding. The First Circuit ruled that production of the manual and certain other documents would give an unfair advantage to a “potential future competitor” to PPNNE in future grant competitions. NHRTL notes in its petition that three other Circuits have ruled that FOIA exemptions refer to actual rather than potential competition.

NHRTL is also challenging an HHS decision to withhold some documents on the grounds that they refer to a deliberative pre-decision process, another FOIA exemption.

NHRTL is represented in New Hampshire Right to Life v. United States Department of Health and Human Services by Manchester attorney Michael Tierney and attorneys with Alliance Defending Freedom.

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Leaven for the Loaf will continue to cover this case as it develops.

Related posts (2013): PPNNE to get “retroactive” $$ from state? and Retroactivity and how not to de-fund an abortion provider

 

 

 

 

 

 

 

NH Executive Council awards $900k to 3 NH abortion providers

wpid-Screenshot_2014-01-31-18-58-46.pngMea culpa. That’s Latin for I goofed, and this one’s a doozy.

It’s never good when I get an email that says “who should we be calling about this?” when I don’t know what “this” is. That happened to me Wednesday. While I was paying attention to the House session, the Executive Council was meeting. It was no secret. It was a regularly scheduled meeting, the agenda had been posted online for the world to see, and everything was perfectly aboveboard. I hadn’t taken the time to read the agenda. If I had, I would have seen item #35A:

“Authorize to enter into agreements with: (1) Concord Feminist Health Center, in the amount of $73,218, (2) Feminist Health Center of Portsmouth d/b/a Joan G Lovering Health Care, in the amount of $89,214, and (3) Planned Parenthood of Northern New England, in the amount of $737,568, to provide family planning services, for an amount not to exceed $900,000.  Effective upon G&C approval through June 30, 2015.  100% General Funds.” 

These aren’t Title X contracts. This is above and beyond Title X.

My email correspondent caught an item about the contract (which passed 4-0, by the way) in the Concord Monitor online. Someone else contacted me about the contract at the same time. By that time, it was a done deal – just as it would have been even if I had paid attention and sounded the alarm

The vote

None of the four councilors who supported the contracts can be considered a “surprise” vote. Chris Sununu, Republican from District 3 on the Seacoast, bucked his GOP colleagues in 2011 when PP was briefly denied participation in Title X (because once upon a time there were councilors who believed the state shouldn’t do business with abortion providers). The other three councilors are Democrats who self-identify as pro-choice: Colin Van Ostern (District 2, including an astounding gerrymander that brings together Durham, Concord, and Keene), Chris Pappas (District 4 including Manchester), and Debora Pignatelli (District 5 including Nashua).

The Council seat for District One, covering the northern two-thirds of the state, is vacant since the death of Ray Burton. Republican Joe Kenney will face Democrat Michael Cryans in a special election on March 11. The Monitor asked Cryans and Kenney for remarks on this week’s contract. From the article by Annmarie Timmons:

“Democrat Mike Cryans of Hanover said he views the $900,000 contract, which would cover birth control, health exams and cancer screenings for low-income women and families, as a “health care bill.” Cryans said he’d support the contract. Wakefield Republican Joe Kenney’s position was less clear. In a brief interview yesterday, Kenney said he had not read the contract but would look at it and call a Monitor reporter back with his thoughts. Kenney instead had his campaign manager, Casey Crane, return the call, and she said Kenney wants to investigate whether any of the contract’s money would pay for abortions, even indirectly. The contract, which would also provide money to the Concord Feminist Health Center in Concord and a health center in Portsmouth, does not cover abortions. But Crane, like the three Republican councilors who opposed the contract in 2011, said the contract still sends federal money to a facility that provides abortions.”

What could a New Hampshire resident have done to prevent this contract from passing? Really, the decision to pass the contract was sealed as soon as the results of the 2012 election came in.

The contracts themselves are interesting, and so is the supporting documentation. Go to the online agenda here and click on “35A.”  It’s fascinating to see how much detail goes into government-funded fertility suppression. A paragraph-by-paragraph breakdown would require book-length attention.

I am supposed to be reassured by this provision: “Since these funds support a statewide network of family planning services that is also supported by Title X funding, the federal restrictions under section 1008 of Title X of the Public Health Service Act, as amended, stipulating that ‘None of the funds appropriated under this title shall be used for programs where abortion is a method of family planning’ will be applied to these contracts.” Further provisions prohibit the use of these contracts’ funds for capital improvements or “any costs not approved by the State.” Also, “[Department of Health and Human Services] funding may not be used to replace funding for a program already funded from another source.”

What do I have to take on faith here?

  • I would have to believe that money isn’t fungible – meaning that money allocated for a specific purpose will actually be spent only on that purpose. I would have to believe that this contract money does not in any way free up other funds by the abortion providers for use in providing abortions and lobbying against abortion regulation.
  • I would have to believe that self-reporting would be sufficient for determining contract compliance.
  • I would have to believe, against scientific evidence, that chemical abortions (called medical abortions by abortion providers, because somehow the word “chemical” might put some people off) are not really abortions. Some methods that pass for “contraception” are in fact abortive. Science and medicine have moved beyond politics.

All set until 2015

The contract is done. The money will flow. If you have any concerns about what this says about the state’s financial priorities, if you don’t want your money going to abortion providers, if you don’t want your money going for abortion-inducing drugs and devices, too bad.

I didn’t see it coming, and I should have. I’m not feeling (too) discouraged, but certainly humbled.

Will there be a next time? Probably. Ponder this: how many potential Executive Council candidates would know how to handle the false accusation of wanting to deny people “health care”? And how many potential candidates do you know who would challenge any incumbent councilor’s disrespect for prolife taxpayers?

 

 

 

 

PPNNE to get “retroactive” $$ from state?

New Hampshire State HousePart 1 of 2

Planned Parenthood of Northern New England may be in line for “retroactive” contract money via the state of New Hampshire, according to a public exchange among Executive Councilors Chris Pappas (D-Manchester) and Colin Van Ostern (D-Concord) and Department of Health and Human Services Commissioner Nick Toumpas during the June 19 meeting of the New Hampshire Executive Council.

The “retroactive” money, if paid, would apply to Title X  family planning funds for 2014-2015 for the parts of the state covered by PPNNE, retroactive to July 1, 2013, according to the discussion at the meeting. If I understand the exchange between Pappas and Toumpas from the official recording of the meeting, this odd situation arises from the 2011 rejection of a PPNNE contract by the last Executive Council. (The Title X discussion begins about one hour into the recording and lasts 15 minutes. Note that the X is a Roman numeral, not a letter.)

Further, Commissioner Toumpas said in his public remarks that the state has been working with PPNNE “on a different benefit that’s going to go into place on July 1, a limited Medicaid benefit that is outside of anything that is called Medicaid expansion.” He offered no further information about that particular “benefit.”

The Council’s proceedings on June 19 illustrate the challenges facing New Hampshire residents who do not want their tax dollars going to abortion providers. Any legislative attempt to privatize Planned Parenthood, or any other abortion provider, will eventually have to be enforced by the executive branch of government.

I know Title X funds can’t be used directly for abortion. I also know that every Title X family planning dollar that goes to an abortion provider frees up other funds in the provider’s budget to keep abortions going. Therein lies the concern over Title X contracts.

Title X contracts approved by Council last week

At last week’s meeting, councilors unanimously approved a total of ten contracts with various family-planning providers for 2014-2015, mostly community clinics around the state. Under the Title X program, federal dollars are granted to states, which then administer the funds. PPNNE was conspicious by its absence from the list of contractors. During last week’s Council meeting, this missing contractor was discussed at length.The exchange between the Councilors and the Commissioner sounded to me like a planned effort to put things into the public record that were missing from the written material made public before the Council meeting. Why be mysterious at all? Let’s go back two years.

Flashback to 2011

In June 2011, eleven Title X contracts came up for Executive Council approval. Each proposed contractor was to be responsible for a specific part of the state. This was supposed to be a routine matter. One of the proposed contractors was PPNNE, which had handled Title X family planning contracts for years. By itself, it covered 57% of the state; the other ten contractors combined covered the other 43%. PPNNE was the sole surgical-abortion provider among the contractors, though, and that caught the eye of Councilor Dave Wheeler. Wheeler was (and still is) a firm believer in keeping public money away from abortion providers. Wheeler’s vote against the PPNNE contract was no surprise, and neither was the Nay from Councilor Ray Wieczorek. What was stunning was the Nay vote from Councilor Dan St. Hilaire, who didn’t have a high profile – or indeed, any profile – on the funding issue. Result: PPNNE lost the contract, garnering support from only two councilors that day (Republicans Ray Burton & Chris Sununu).

The stuff hit the fan. PPNNE, unaccustomed to being turned away, sidestepped state approval. The agency sought and received a direct grant for family planning from the federal government. Meanwhile, its PP Action arm went to work. Knowing that attacks on Wheeler and Wieczorek were pointless, PP’s allies went after St. Hilaire. Signs like “Dan St. Hilaire wants to take away your birth control” started popping up.

(I continue to be amazed at how determined some people are to keep women dependent on government handouts for birth control. How is that policy not creepy?)

St. Hilaire and Wieczorek chose not to run for re-election in 2012, and Wheeler was defeated by Debra Pignatelli (whom he had defeated in 2010). Result: all five current Councilors are PP supporters. Now, Councilor Pappas refers to the 2011 contract rejection as “a little bit of a hiccup.”

PPNNE & family planning in NH:, post-2011

So what happened to PPNNE’s clients whose services would have been paid for by Title X after July 1, 2011? In a word, nothing. Dollars given to PPNNE directly by the federal government replaced dollars administered by the state of New Hampshire under Title X. Commissioner Toumpas last week didn’t explain to Councilors the details of that particular arrangement, saying it would be “inappropriate” for him to know what those details were.  

I obtained a copy of the Title X contract letter submitted by DHHS to the Council for approval last week.  The ten entities approved for contracts cover the state, excluding “the geographic areas of Cheshire and Rockingham Counties, and the towns of Lebanon and Claremont.” That tells me that those “geographic areas” are PP territory, and I assume that PP is currently providing family planning to clients using the money it received directly from the federal government in lieu of a conventional Title X contract in 2011.

Toumpas: “It’s not appropriate for me to know what they did.”

Councilor Pappas and Commissioner Toumpas put some information about PPNNE’s 2011 “sidestep,” and its implication for future state funding, on the public record. I transcribed this conversation from the recording of last week’s meeting. I have used bold-face text to highlight certain statements. Remarks within brackets are my own.

Pappas: I’ve asked you offline about this as well. These are family planning funds, and obviously there was an issue a couple of years ago – a little bit of a hiccup – with funding and contracts for family planning. And I’m curious, these funds that are contained in these contracts [note: the ten Title X contracts for 2014-2015] don’t appear to represent or cover the whole state. I’m wondering how future contracts will be dealt with with the remainder of the money that’s available for family planning.

Toumpas: What happened a couple of years ago, we had brought forth eleven contracts that in total covered the entire state. We serve around 26,000 people through the family planning/Title X dollars. Planned Parenthood of Northern New England had roughly 57% of those numbers in some of the more populated areas of the state. And the other 43% of the people were served by the other ten agencies. When we [NH Department of Health and Human Services] brought forward a contract, … the Planned Parenthood contract was rejected. What we ended up doing was … going to the federal government; we relinquished the dollars and therefore the responsibility that the state had, and that responsibility is now borne by the federal government, Office of Population Health, working directly with an entity that they would contract with. It turns out that they contracted with, and appropriately I believe, Planned Parenthood of Northern New England. So essentially we created a bifurcated model for the state so that there isn’t any one entity in the state that has oversight over the entire [family planning] program. …  Last year- the grant awards come up every two years – last year we approached Planned Parenthood and said we wanted to go with a statewide proposal again. We did that, we had that discussion, a good discussion with them, and it was determined that they were going to pursue the grant independently of us. We went after it statewide. It’s not appropriate for me to know what they did. But in the end, the federal government granted money to the state [for the approved contracts] and granted money to Planned Parenthood [in lieu of its rejected 2011 contract with the state].

Dollars and cents, “equitable and proportional”

How much state-level money for family planning is in the upcoming budget?

Governor Hassan asked for $894,000 per year in 2014 and 2015 – a more than half-million-dollars-per-year increase over fiscal year 2013. See page 1045 of the Governor’s budget proposal. The House and Senate had no argument, preoccupied as they were with other matters within the state budget. Compare this to the budget request from DHHS, which asked for $344,000 per year for 2014-2015; this was close to level-funded compared to 2013.

Why is there a half-million dollar discrepancy? Commissioner Toumpas told the Council, “…we knew that the Governor had put money in, an additional half a million … but not wanting to issue a contract based on an unknown, we went with a more conservative [budget request].” In other words, DHHS couldn’t be sure the legislature would approve a budget that more than doubled last year’s state expenditures for family planning programs.

By the time of the June 19 Council meeting, all parties were confident that the extra half-million dollars would indeed be appropriated.

Toumpas: …as it’s progressed through the budget language right now, the roughly $850,000, it is our understanding the intent of the legislature and the governor’s office that those dollars would get distributed, I believe the words are ‘equitably and proportionately.’ So the contracts you have here right now [from the ten area agencies] don’t reflect that at a statewide level. What we will do, assuming the budget that is being discussed across the street survives for at least this appropriation, what we will do is then we will, going within the next couple of months, we will then make an adjustment and be able to direct the dollars, the appropriate dollars, into that region that is covered by Planned Parenthood of Northern New England. I believe we have adequate dollars within the contracts we have before you today so we won’t need to do any adjustments there. …I know the issue has been raised that dollars aren’t being directed to Planned Parenthood right now but again my commitment is that I would make that adjustment in a subsequent contract and that we will be going forward.

Pappas: So you haven’t actually determined the formula for distributing those dollars yet.

Toumpas: We have not. …It’s a formula that goes into it, and I don’t profess to know that off the top of my head.

Pappas: But you’ve taken into consideration, or you will, the footnote that will likely … [Toumpas interrupts]

Toumpas: Absolutely. The footnote will be the law that will guide what it is that we are doing. My understanding of what is the intent of the Governor’s office and the intent of the legislature are very clear.…The other question I believe that a couple of the Councilors have asked me is when we will have an opportunity to basically have a unified statewide program again. Because the grants are done every two years, our next opportunity will be calendar year [20]16. And so in calendar 2015, we will then go and submit our request for the funding that will cover a statewide level and that will be our next opportunity to basically bring it under one unified program.

Pappas: And so future dollars that will be contracted out will be retroactive to July 1, …in terms of dollars that will come as part of the budget once it’s approved in the next fiscal year.

Toumpas: Ah, for [20]14, that would be retroactive for the Planned Parenthood part of the state.

 

Coming in part 2: Councilor Van Ostern joins the discussion; “I think the Council botched this two years ago.”

(An earlier version of this post contained an erroneous date for House and Senate action on the state budget.)