Family Planning Program Under Attack


FEATURING: Jodi Tomlonovic, Executive Director of Family Planning Council of Iowa, Des Moines, Iowa

Connie Cunningham, Executive Director of Missouri Family Health Council, Jefferson City, Missouri

For more than 40 years, the Title X family planning program has supported access for high-quality family planning services and other preventive health care for low-income individuals who may otherwise lack access to care. Title X, a grant program administered by the Department of Health and Human Services’ (HHS) Office of Population Affairs and funded within the Health Resources and Services Administration’s budget, distributes resources to a diverse network of safety-net providers nationwide. In 2012, Title X supported nearly 4,200 service sites through its 93 grantees.i

Between 2010 and 2013, Title X’s budget was slashed by $39.2 million.ii Consequently, 460,000 patients lost access to essential health care services, reducing the number of patients servediii with no indication that patients received care elsewhere. Even before the funding cuts, Title X’s resources were only sufficient to address approximately a quarter of the need for publicly funded family planning services.iv The challenges faced by family planning providers in Iowa and Missouri provide stark examples of the harmful downstream effects of draconian budget cuts to safety-net providers and their patients.

Centers Closed; Services Reduced; Patients Harmed

The Family Planning Council of Iowa (FPCI) and the Iowa Department of Public Health are the two grantees in the rural state of Iowa, serving 66,992 individuals through 74 locations in 2012.v The majority of their patients have yearly incomes of $28,725 or Cuts to Title X caused an 11.15 percent reduction in Title X funding to these sites between 2011 and 2014,vii resulting in more than 15 percent of the health centers scaling back their hours and 20 percent closing down altogether.viii As Jodi Tomlonovic, Executive Director of FPCI explained:

The decreases in sites and available hours have a significant impact on the ability of Iowans to receive timely contraceptive care. Health center closures and reduced hours are especially egregious in rural states such as Iowa where there are no other providers nearby and people must find transportation to travel a number of miles to another clinic.ix

The Missouri Family Health Council (MFHC), the sole Title X grantee for the state, supports a network of 79 health centers providing family planning care to over 60,000 individuals.x Although MFHC minimized the impact of budget cuts for its statewide network of providers by absorbing the majority of the funding cuts internally, the cuts have still had an impact on the grantee. As Connie Cunningham, Executive Director of MFHC explained,

Missouri Family Health Council took much of the cuts internally so the agencies would not feel the impact. This included reducing staff, discontinuing projects, and increasing an already heavy workload on a small staff.xi

Despite MFHC’s efforts to shield its agencies, the reductions are still impacting patients. Staff from one Missouri health center commented that “[since they were forced to close on Fridays] some of our clients cannot remember to think ahead and pick up supplies before the end of the day on Thursday. They often show up on Monday morning, a day late in starting a new pack of pills.”xii

Timing is imperative when it comes to contraceptives – missing dosage can increase the likelihood of an unplanned pregnancy. Moreover, these cuts have stopped many agencies from pursuing endeavors they would normally undertake.

“Because we’re doing our best just to keep afloat, there isn’t anything extra to expand services. We don’t handle male clients but would like to. We’d like to open a clinic in Barton County, the only county in our service area where we don’t have one,” said Tony Wright, Director of Program Planning and Women’s Health at the Economic Security Corporation of the Southwest Area, an agency with three health centers in its four-county, low-income region of southwest Missouri.xiii

Proven Effective While Saving Millions in Taxpayer Funds

As Congress continues to grapple with how best to distribute limited federal resources, it should not lose sight of the imperative to make investments in programs, like Title X, that are proven effective and save taxpayer dollars. Services provided by Title X centers helped women avert more than half of the 2.2 million unintended pregnancies that occurred in 2010.xiv Moreover, Title X-supported centers accounted for $5.3 billion of the $10.5 billion in federal savings attributed to providing publicly funded family planning in a single year.xv Preserving Title X not only strengthens the safety net, it helps ensure that millions of vulnerable patients can access the health care they need and deserve.

National Family Planning & Reproductive Health Association

i Christina Fowler, Julia Gable, Jiantong Wang, and Emily McClure, Title X Family Planning Annual Report: 2012 National Summary, (Research Triangle Park, NC: RTI International, November 2013),

ii National Family Planning & Reproductive Health Association (NFPRHA), “Title X: Budget and Appropriations” (NFPRHA, 2014), accessed April 2014,

iii Christina Fowler, “Title X Family Planning Annual Report: 2012 National Summary,” November 2013.

iv Jennifer J. Frost, Mia R. Zolna and Lori Frohwirth, Contraceptive Needs and Services, 2010, (New York: Guttmacher Institute, July 2013),

v Jodi Tomlonovic (Executive Director, Family Planning Council of Iowa), in discussion with NFPRHA staff, April 2014.

vi Ibid.

vii Ibid.

viii Ibid.

ix Ibid.

x Missouri Family Health Council Staff (MFHC), in discussion with NFPRHA staff, April 2014.

xi Ibid.

xii Ibid.

xiii Ibid.

xiv Jennifer J. Frost, “Contraceptive Needs and Services, 2010,” July 2013.

xv Jennifer J. Frost, “Contraceptive Needs and Services, 2010,” July 2013.