Concerns Remain About State WHP Capacity

Earlier this week, HHSC released a study finding that in most areas of the state, other providers can serve Women’s Health Program clients who can no longer go to Planned Parenthood.  The study shows that the 51 Planned Parenthood clinics in Texas served more WHP clients in 2012 than ALL the other 1,948 near-by WHP providers combined. We have continued concerns that WHP will not have enough providers to serve clients.
Two thoughts on this–
1 – Over the last year much attention has been paid to the fate of the 130,000 women in WHP, and especially the 40,000+ who choose Planned Parenthood as their provider.  While this is certainly worthy of attention (and even outrage), comparatively little attention has been paid to the DSHS family planning cuts that took effect in 2011 and have already resulted in 147,000 women losing access and 53 safety net family planning clinics closing.
It seems the media followed WHP more closely, because of the attention-grabbing dispute between Texas and the federal government, and lawsuits between the state and Planned Parenthood.  By comparison the 2011 Legislature’s votes to cut DSHS family planning by two-thirds ($73 million over the biennium) provided less drama, even though they’ve harmed more women and slashed or eliminated funding from more safety net providers.  And the DSHS cuts didn’t just hurt that program.  Clinics that closed in the wake of the DSHS cuts also provided care in WHP and had staff on site that helped women through the WHP enrollment process.  Since the DSHS cuts took effect, client enrollment in WHP has declined.
Moving forward, Texas should ensure that all low-income women who need access to preventive care and contraception (whether they were historically served by DSHS family planning, the Women’s Health Program, or left without help) have access to family planning services that are adequately funded and have sufficient provider capacity.
2 – Though the HHSC study paints a pretty rosy picture of future WHP provider capacity, we have continued concerns.  When you look at the numbers in the study you can see that providers who served a modest number of WHP clients in 2012 now project that they’ll be able to serve many times the number of women they’ve served in the past.
Take the Abilene area, for example.  The one Planned Parenthood clinic in Abilene served 601 WHP clients in 2012.  There are 16 other WHP-certified providers within 30 miles of Abilene, and together they served just 285 WHP clients in 2012.  Nine of those providers didn’t respond to HHSC’s new survey, and together they served 106 clients in 2012.  The 7 providers who responded to HHSC’s survey treated 179 clients in 2012, but now project that they can serve 5,750 WHP clients in 2013—that’s 32 times the number of women they served in the preceding year.  An increase in capacity of that magnitude is astonishing.
The projected capacity appears optimistic, and it certainly has not been demonstrated at this point.  Physicians are unlikely to add much capacity for several reasons including low reimbursement rates.  Federally Qualified Health Centers have already said they cannot meet the needs of all women losing access to Planned Parenthood.  Many safety net family planning clinics funded by DSHS that might normally be in a position to add capacity are still reeling from huge funding cuts,  and some have closed down completely.
(Speaking of closed clinics, the HHSC study just looks the ability of providers to take new clients in areas of the state with a Planned Parenthood.  It does not investigate capacity in the system to serve WHP clients who already lost their non-Planned Parenthood local provider due to DSHS cuts.)
HHSC should carefully monitor how actual capacity plays out in WHP to see if optimistic projections translate into an actual ability of providers to increase capacity dramatically and quickly.

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