Wednesday, October 24, 2012

How Loss of Title X Funding nearly resulted in 49 Abortions.

In March the Board of County Commissioners (BOCC) rejected Title X funding. The Republic reported "[T]he reasoning behind their decision is that taxpayer money shouldn’t be spent to hand out contraceptives."  Then the BOCC accepted, from Miami County women, an amount equal to the grant.  The County matched those funds by half, just as they would have matched the grant money.

Arithmetic and numbers is important to understanding what the BOCC did.  There has been confusion about the amount of the grant.  The grant request was for $30,000.  The grant award was $9,000.  The county has always matched half, or $4,500.  If the grant awarded was $20,000 the match would be $10,000.  That's the way it works.

Title X serves the County's Family Planning Clinic.  A volunteer for the Health Department prepared a report which the BOCC had prior to rejecting Title X funds.  That reports says that 54% the women using this program are below the poverty line and 20% are below 150% of that standard.  77% of these women, 116, have no insurance. 

What could go wrong?  Our County does not have a safety net clinic and private physicians cannot afford to absorb the costs of health care on a pro bono basis.  Women with limited means tend to buy food, pay rent, or take care of necessities instead of spending on their health care.  Missed infections can lead to costly emergency room visits, increasing hospital costs for everyone.

The report made a statistical analysis about the impact of denying Title X funds.  According to the report 85% of women with regular sexual activity will become pregnant within one year.  That means these 116 women will have 98 pregnancies. 

What happens to those 98 pregnancies?  Following national trends 49 of them will result in live births and 49 of them will be terminated.  I asked if those 49 terminations included miscarriages or spontaneous abortions.  The answer was no.  Denying Title X created the circumstance for 49 abortions.  Clearly the BOCC didn't think this through.

Of the remaining 49 pregnancies 30 result in normal vaginal deliveries and 19 require caesarian section.  Hospital costs for uncomplicated deliveries are less than $9,000.  That is $270,000 for 30 women.  Hospital costs for c-sections are more than $15,000, or at least $285,000 for 19 women.  That is over a half a million dollars.  We have to ask ourselves what is more cost efficient, matching $4,500 for the Title X grant or covering $555,000 in hospital costs?

Uninsured women tend to receive no prenatal care, putting both mom and baby at risk for additional health issues.  The baby will likely be taken to a special care nursery. Women lacking prenatal care do not get the counseling Title X provides.  They aren't alerted to the importance of stopping smoking, drinking, taking prescription drugs, or other drugs.  There is no opportunity to tell them to avoid exposure to certain environmental or chemical toxins.

In 2010 the health department Title X grant was $8,398.00 The County matched half of that or $4,199 for salaries.  The clinic earned $6,455.58 in fees.  Expenses that year were $10,883.90.  The Family Planning Clinic was in the black by nearly $4,000.

We did not see 49 abortions this year, or escalating rates of sexually transmitted diseases, or a disruption of adult vaccinations because Miami County women stepped up.  The October mammogram clinic is funded by Saint Luke's Hospital, thanks Episcopalians.

What will we do next year?  Rely on the generosity of women or see the BOCC make better choices? 




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