September 6, 2012 — There has been a drastic decrease in the number of people accessing services through the federal Title X family planning program in Tennessee's neediest county since officials awarded the funding to Christ Community Health Services instead of Planned Parenthood Greater Memphis Region, the Memphis Flyer reports (Sayle, Memphis Flyer, 8/30).
Compared with other Tennessee counties, Shelby County by far has the greatest number of women -- 57,270 -- who need publicly supported contraceptive services and supplies, according to a 2006 Guttmacher Institute study (Sayle, Memphis Flyer, 8/23).
PPGMR had received Title X funding -- which covers services such as birth control, annual wellness exams, cancer screenings and testing for sexually transmitted infections -- in the county for more than 30 years (Women's Health Policy Report, 7/6).
In October 2011, state officials awarded the contract to CCHS instead, although the actual agreement was not signed for another five months for reasons that remain unclear, according to the Flyer. Yvonne Madlock, director of the county's health department, said the delay was a natural consequence of the transition, but CCHS practice administrator Shantelle Leatherwood said the organization was ready to go.
Drop in Visits
When the contract was ultimately finalized in March of this year, CCHS was seeing an average of 51 Title X visits monthly, compared with Planned Parenthood's 719 visits in July 2011 and 841 in August 2011. Since this March, the number of CCHS Title X visits has only risen to about 300 monthly (Memphis Flyer, 8/23).
From July 2011 to June 2012, Shelby County did not use $572,000 of its available $1.3 million Title X grant (Memphis Flyer, 8/30). The state health department said the unused funds likely were redistributed to other counties.
In July, PPGMR received $395,000 in Title X funding directly from the federal government and has since resumed offering Title X services.
Concerns About Change
During the bidding process, several concerns, including CCHS' opposition to abortion rights and emergency contraception, were raised about the organization's ability to provide Title X. While Title X funds cannot be used for abortion, Title X providers must provide abortion referrals when requested. Rick Donlon, associate executive director for CCHS, in October said, "We really try to provide women with other options [than abortion] and make sure they have those possibilities," adding, "And if they at the end still want a pregnancy termination, we know they know where to go." CCHS refers patients to other health care providers for emergency contraception.
Steve Mulroy, county commissioner, said the contract to CCHS was awarded "amidst a climate of ... hostility to Planned Parenthood" at the state level. He said the "substantial decline" in Title X visits since CCHS received the contract is "a red flag."
Mulroy added that it is unlikely the need for the services has declined. He questioned whether patients' confusion about where to obtain services or reluctance to visit CCHS might play a role in the drop in visits (Memphis Flyer, 8/23).