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Department of Human Services oversight council rejects new family planning rules

State-funded waiver program slated to start July 1

Combination estrogen and progestin birth control pills, photographed on Nov. 1, 2016. (Liz Zabel/The Gazette)

DES MOINES — In a rare move, members of the Iowa Department of Human Services’ oversight council voted 4-1 Wednesday to reject proposed agency rules that would guide a new state family planning program.

That program is eligible only for women’s health care clinics that do not offer abortions as part of their service menu, effective July 1.

During the 2017 legislative session, majority Republicans passed legislation to set aside $3 million in state money to fund women’s health care clinics that do not offer abortions. The money would pay for contraceptives, exams and other reproductive health services for Medicaid patients.

Republican lawmakers declined federal dollars to avoid funding services at Planned Parenthood clinics in Iowa.

On Wednesday, DHS officials presented a proposed rule to its oversight council, the Iowa Council on Human Services, that spells out parameters for operating essentially the same program as before, with the exception that it would not be available to Planned Parenthood clinics, the University of Iowa Hospitals and Clinics and UnityPoint Health.

DHS staffer Wendy Rickman said the agency was notifying eligible family planning clinics of the new arrangement for services currently provided to about 12,000 recipients monthly on a fee-for-service basis.

Rickman said the state-run program has adequate funding but told council members “there are many questions whether there are new entities ready to jump into this or not.” She said the agency hopes to make the process “as seamless as possible” for recipients and providers, and report back to lawmakers next January regarding access and other benchmarks as the program progresses.

Board chairman Mark Anderson of Dubuque raised concerns that women seeking birth control who were not legal residents of Iowa or were visiting clinics in border communities would be denied services under the DHS rules. But DHS official Nancy Freudenberg said those provisions were unchanged from current rules governing the federally funded program.

After the board rejected the family planning waiver rules, Freudenberg said she planned to consult with the agency’s lawyers and expected the new program would go forward July 1 as planned.

“I believe since it’s a state law, we move forward, but we’ll have to check with our legal counsel,” she said. “We’ll bring rules back. They’ll come back every month until they approve them. We’ve had this happen before. It will be on the agenda every month.”

Later on Wednesday, DHS spokeswoman Amy McCoy said board chairman Anderson requested the council meet on a teleconference Friday to discuss the same rule that was rejected on Wednesday.

“The council’s role is to approve the rules that help us develop the framework for operating it,” McCoy said. “I think some of the issues that they took with the rules today were really pieces that were parts of the legislation, and to be able to change those would really have to go back to the Legislature for changes to the actual law.”

Earlier at Wednesday’s meeting, council members voted 3-2 to approve rules to implement Medicaid cost-containment changes. After the vote, the council agreed unanimously to send a letter to lawmakers expressing concern that the changes appeared to be a cost shift to providers, hospitals and taxpayers. McCoy said the council may decide to draft a similar letter expressing concerns over the family-planning waiver change when they reconvene Friday.

“When you have the law in place that’s directing us to implement the program, if you don’t have your rules approved, that’s certainly not an ideal position to be in for the department,” McCoy said.

Last month Planned Parenthood of the Heartland announced plans to close one-third of its Iowa clinics at the end of June, affecting more than 14,600 people. The women’s health provider said te clinic closures come after the state’s Republican legislators worked to redirect Medicaid family planning dollars away from abortion providers starting July 1.

Planned Parenthood — which operates 12 clinics in Iowa — will close clinics in Sioux City, Burlington, Keokuk and the Quad Cities-Bettendorf. All services immediately will stop on June 30 at the Sioux City, Burlington and Keokuk health centers, while abortion services will continue at the Quad Cities health center until the building is sold, the organization said.

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