Under Senate Budget Proposal, Women ‘Will Die’

Haven Health Clinic in Amarillo provides gynecological care and cancer screenings to women across 26 counties in the Panhandle, serving a 25,000-square mile swath of the state. Under a Senate budget proposal that redistributes funding for a state breast and cervical cancer program for uninsured women, speciality clinics like Haven Health could lose money for Pap smears and mammograms.

“If we were to lose the money, there are women in our area who will die,” Carolena Cogdill, CEO of Haven Health Clinics, told the Observer. “We do see a lot of women who have a precursor to cervical and breast cancer.”

The Senate proposal is intended to keep Planned Parenthood from participating in the breast and cervical cancer program. According to the draft budget, funding would follow a three-tiered formula: Money would first go to public health entities, such as hospital districts and community health clinics, followed by providers that offer “comprehensive primary and preventative care.” The third and final tier would include specialty clinics like Planned Parenthood and Haven. Cogdill fears her clinic could be in that bottom tier because it’s privately-run and doesn’t clearly offer “comprehensive primary and preventative care.”

“So far I haven’t been able to get in touch with anybody at the Department of State Health Services who knows the answer,” she said.

According to a list of providers compiled by the Department of State Health Services and obtained by the Observer, at least 13 providers—many of which operate multiple clinics or are the only provider in their area—could fall into the second or third funding tier and risk losing money.

The Observer contacted five of the providers on the list, including Haven. Representatives for four of the five said they were concerned about losing funding but hadn’t been able to determine conclusively which tier they would fall into.

The fifth, Jennifer Riley of the YWCA of Lubbock, said that she’s unsure how the budget proposal would affect her organization. The YWCA doesn’t directly provide the cancer services, but instead  gives financial assistance to low-income women and refers them to clinics in the community for services and treatment.

Other representatives of specialty providers testified at a Senate Finance Committee hearing Thursday, many warning of the collateral damage that could come with a tiered system. In 2011, the Texas Legislature slashed $70 million from state family planning programs in part to defund Planned Parenthood and imposed the same tiered funding scheme, which resulted in the closure of more than 50 family planning clinics. Many of the clinics had nothing to do with Planned Parenthood.

The proposal “does exactly the opposite of investing in women’s health,” said Ana Rodriguez Defrates, Texas policy director with the National Latina Institute for Reproductive Health, in testimony before the committee. “It would have the effect of eliminating funding for many of the frontline clinics that provide breast and cervical cancer services in rural communities.”

According to the Kaiser Family Foundation, Hispanic women in Texas are more likely to develop cervical cancer than white or African-American women.

Martha Zuniga, executive director of the South Texas Family Planning and Health Corporation in the Corpus Christi area, said that her organization would likely be in the second tier of funding. Three of her clinics can see women immediately for screenings and diagnostic services, whereas patients may experience long wait times at the “tier one” public and community health centers.

“In my part of Texas, the [proposal] may eliminate organizations like us, which are an important part of the breast and cervical cancer safety net for the Coastal Bend community,” she told senators.

Health care providers and advocates also urged Senate Finance Committee members to protect women’s health services in the budget this session. In 2013, legislators restored the family planning funding lost in 2011. This session, the Texas Senate budget includes $50 million for a consolidated women’s health program. Still, as Dr. Janet Realini of the Texas Women’s Healthcare Coalition reminded the committee Thursday, only three in 10 eligible women are being served.

“We still have a long way to go,” she said.

Alexa Garcia-Ditta is a staff writer (and former intern) covering women's health, reproductive health and health care access.

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Published at 7:52 am CST