The Iowa Department of Human Services is working to form a more “complete picture” of how Iowans use family planning services, given a decline in patients since the state switched its program in 2017.
DHS Director Kelly Garcia said the report released earlier this week on the state’s Family Planning Program is a piece of the picture but does not include everything there is to know on “the entirety of where women can access services.”
The next step is to map family planning service providers, she told the Council on Human Services during its monthly meeting in Des Moines on Wednesday.
“If we have a comprehensive map, that will show us where we need to focus our efforts to increase our provider access, which would increase client access,” Garcia said during the meeting. “Right now, I don’t have the data around where that might be.”
PROGRAM LITTLE USED
The Iowa Legislature created the $3 million Family Planning Program in 2017, funneling state dollars into women’s health care clinics that do not perform abortions — a move that cut funding to Planned Parenthood — in an effort to expand access to other parts of the state.
The Family Planning Program is meant to provide reproductive health care services — including birth control, testing for sexually transmitted infections and preventive exams, among others — to low-income Iowans.
This week’s report, which was obtained by The Gazette, is the first comprehensive analysis from DHS of the program, which covers calendar year 2018.
To offer services under the Family Planning Program, providers must accept Medicaid patients. In 2018, 5,545 providers offered family planning services under the program and Medicaid.
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However, the new DHS analysis found only 746 “attested” health care providers in the Family Planning Program.
“We have to understand why they’re not providing services on the family-planning side,” Garcia said.
ACCESS TO BE MAPPED
In its report, DHS said it intends to collaborate with the Iowa Department of Public Health and provider associations to “create maps of access points across the state for family planning services.” It did not specify when that study would happen.
Once that map is complete, Garcia said, DHS can find areas where family-planning services are lacking and target resources to those areas.
Gov. Kim Reynolds echoed Garcia’s statements during her weekly news conference Wednesday, stating officials need to take a closer look at the program to understand the shift.
“We need to take a look as how it’s currently being distributed,” Reynolds said. “We need to take a look at what the gaps are and what we need to do differently.”
MEDICAID NUMBERS UP
The DHS report showed an 86 percent drop in Iowans’ use of the Family Planning Program. In 2016, 10,817 Iowans used the program’s services. By 2018, it had dropped to 1,502.
But the number of patients accessing family planning services through Medicaid has increased — from 352,000 in 2016 to about 359,000 in 2018 — which DHS officials on Wednesday could be a factor.
The report also alludes to this.
Qualifications for the two programs vary, but fewer people would qualify for Medicaid services than for the state’s Family Planning Program, based on income requirements.
$59M ON FAMILY PLANNING
Reynolds said the increase in family planning services through Medicaid could indicate services provided to Iowans is on the rise but stated again that officials need to study the program further.
“Medicaid probably provides more comprehensive services when it comes to the family planning services, so it’s probably even more,” Reynolds said. “But we need to take a look at that and see what’s happening and better understand it. We need to find out why and where the gaps are at and what we need to do differently to address that.”
Overall, about 1.7 million Iowans used family planning services through the state in 2018.
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The cost of family planning services provided to Medicaid patients remained steady between 2017 and 2018, at about $59 million, DHS reported.
Providers were reimbursed for about $212,000 worth from the Family Planning Program in 2018, a small percentage of the $3 million allocated to the program. That’s about a fourth of the funding in the previous year, when providers were reimbursed $808,000 for family planning services.
In creating the Family Planning Program in 2017, Iowa officials passed on federal funding that allowed participation by providers that include abortion among their services.
Under the previous family planning program, no tax dollars were used to perform abortions.
A Gazette investigation last year found the state’s database of Family Planning Program providers was plagued with errors and redundancies, listing dermatologists, surgeons and other physicians who didn’t offer family planning services. Of the 1,400 listings, 135 were independent laboratories that don’t see patients.
PLANNED PARENTHOOD REACTION
As a result of the shift, Planned Parenthood clinics in Iowa lost nearly $2 million in funding, causing the organization to close four clinics across the state.
“It is alarming that the state waited more than two years to publicly report out on the performance of this essential program, which has been decimated by a narrow political agenda,” Erin Davison-Rippey, Iowa executive director of Planned Parenthood North Central States, said in a statement following the council meeting.
“It’s even more unacceptable to provide incomplete and misleading information — Iowans deserve better.”
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