Why was Planned Parenthood’s Houston affiliate suddenly kicked out of a state HIV prevention program?
State legislators posed that question and several more to the Texas Department of State Health Services (DSHS) more than a month ago, and this week, they finally got their answer:
“The contract expired at the end of the year, and it was in the Department’s discretion not to extend the contract. The Department acted consistent with the overall position of the State leadership,” DSHS Commissioner John Hellerstedt wrote Wednesday in response to a January letter penned by 14 Democratic representatives.
That’s politics as usual, said state Representative Celia Israel, an Austin Democrat who initiated the January letter. Israel called the letter’s tone “dismissive” and “defensive,” and said she had never experienced “politics playing as big a role in public health” as it has with this latest Planned Parenthood ouster.
“I would have more respect for [the agency] if they would just come out and say it — Planned Parenthood is controversial, we got the word from high not to do business with them, and we have the legal authority to do it,” she told the Observer. “Just be honest with me.”
The letter repeats four times that the contract with Houston’s Planned Parenthood Gulf Coast was not “terminated,” but rather “expired.” Why, lawmakers wondered, was the organization’s contract suddenly not renewed after years of participation in the program? State Representative Donna Howard called the agency’s justification “insulting, at best,” and “disingenuous.”
“To continually say over and over that they did not terminate the contract, but rather it just happened to expire, is parsing what really happened here,” Howard told the Observer. “Whatever terminology they want to use — it expired, yes, but they didn’t renew a contract that they had been renewing for decades? In my book, that’s termination.”
Lawmakers were also concerned about filling the service gap left without Planned Parenthood. Planned Parenthood Gulf Coast received approximately $600,000 each year from the state to provide HIV screenings in in Harris, Galveston, Brazoria, Fort Bend and Montgomery counties. Since first receiving state money in 1987, Planned Parenthood Gulf Coast has tested more than 145,000 people and helped identify nearly 1,200 positive HIV cases, according to organization officials. Last year, Planned Parenthood distributed 300,000 condoms.
In Planned Parenthood’s absence, the health departments of Harris, Fort Bend and Galveston counties will take over, DSHS wrote to lawmakers. The agency insists in its letter that health education, testing and prevention services “will remain unchanged.”
“In fact, we expect healthcare to benefit from these changes,” Hellerstedt wrote. “These local health departments also perform contact investigations that identify partners at risk of exposure, which is a critical follow up activity after a person has tested positive for HIV.”
According to the state health department’s HIV Surveillance Report, 1,289 Harris County residents were diagnosed with HIV in 2014, the highest number of new cases that year across all 254 Texas counties. Hellerstedt wrote that the agency did confirm that the county health departments would be able to provide the same level of services as Planned Parenthood.
Howard, though, is skeptical.
“They also indicate that the total number of providers is going to remain the same, but there’s no information about the capacity of those providers,” she said. “We know from our experience with [the women’s health programs], that even with the claim of additional providers, that fewer women are getting seen. That does not give me confidence.”