When Texas abruptly ended its $600,000 HIV prevention contract with Planned Parenthood’s Houston affiliate in late December, state health officials promised that there would be no interruption in services. The Department of State Health Services parceled the money out to three county health departments in the Houston area and insisted at the time that the counties would have the capacity to pick up where Planned Parenthood left off.
But the Observer has learned that as of early June, Harris County’s health department has yet to perform a single HIV test with the money.
So far, the department has received about $250,000 in state funding but is still in the planning stages for its program. The Fort Bend and Galveston County health departments also received smaller portions of the money — Galveston began providing testing in March; Fort Bend hired its staff and began testing in May.
In the five months since losing its contract, Planned Parenthood Gulf Coast (PPGC) estimates that it would have provided 2,900 HIV tests and distributed around 165,000 condoms. Rochelle Tafolla, PPGC’s spokesperson, said most of its testing was conducted in Harris County, the most populous in Texas and home to nearly 23,000 Texans living with HIV. According to state data, Harris County is home to one in four new Texas HIV cases every year and its diagnosis rate is nearly double the state average. Among the state’s five largest urban counties, only Dallas County has a higher new diagnosis rate.
Martha Marquez, spokesperson for the Harris County Public Health and Environmental Services Department, told the Observer that the department plans to hire three staff members and begin testing “in the coming weeks.” Marquez also said that Harris County offers HIV testing at family planning appointments under a separate funding structure.
From 1988 to 2015, Planned Parenthood tested more than 138,000 people in Harris, Fort Bend, Galveston, Brazoria and Montgomery counties, and identified almost 1,200 individuals with HIV. The organization conducted testing and prevention at bars, colleges and jails. Tafolla also told the Observer that the organization provided about 575 HIV tests every month and distributed about 33,000 condoms.
“Think of all the cases of HIV that would’ve been prevented had the people who did this, and do it well, still been testing,” said state Representative Jessica Farrar, D-Houston. Terminating PPGC’s contract, she said, “was a pure political move and something you don’t do to people’s health, especially when you have state leaders who are charged with overseeing the public health of Texas.”
In late January, Farrar and 13 other Democratic state representatives sent a letter to DSHS Commissioner John Hellerstedt demanding to know why PPGC lost the long-standing contract.
In his response, Hellerstedt wrote that the contract was not terminated, but rather “expired,” and that the agency “acted consistent with the overall position of the State leadership.”
Susan Rokes served as PPGC’s HIV prevention program director for 13 years before she and her team of seven were laid off at the end of 2015. During an interview in March, she told the Observer that she worried that disrupting the relationship between Planned Parenthood and its clients could put people at risk.
“It takes time to get a program in place, to get policies and procedures in place and establish trust with clients,” she said. PPGC’s loss of funding is going to affect “all those education services that we did for the clients,” such as distributing information about safe sex, healthy relationships and risk factors for sexually transmitted infections.
According to the state health department’s HIV Surveillance Report, nearly 1,300 Harris County residents were diagnosed with HIV in 2014, the highest number of new cases that year across all 254 Texas counties.
Testing individuals at risk for HIV as quickly as possible is “key” for reducing new infection rates, said Daniel Williams, policy and regional field coordinator at Equality Texas.
“It’s unfortunate that an organization that had a proven track record in doing exactly what this contract was intended to do was removed from it,” he said. “It’s doubly unfortunate that the contract was then sent to an agency that doesn’t have the resources to pick it right up without the delay.”
Williams pointed to other organizations in the Houston area that provide HIV testing and might have been better prepared than the county health department to pick up where PPGC left off, such as Legacy Community Health or The Montrose Center.
“Harris County has lagged behind the rest of the state in reducing its HIV infection rate, and this six-month gap in performing testing and getting people into treatment is making the situation worse,” he said.
Update, June 11: This story has been updated to include that Harris County provides HIV testing by appointment.