Letter to the Editor: Senate File #2 will affect the Decorah Family Planning Clinic

(The following Letter to the Editor has been e-mailed to decorahnews.com by NEICAC Executive Director Mary Ann Humpal in response to an earlier Letter to the Editor by State Senator Michael Breitbach (http://www.decorahnews.com/news-stories/2017/01/15608.html)):

"In reading Mr. Breitbach's article posted to decorahnews.com on January 29th, I felt it important to clarify how Senate File #2 will in fact affect the Decorah Family Planning Clinic.  Mr. Breitbach correctly indicated SF2 includes the development of a state family planning services program with the discontinuation of the Medicaid Family Planning Network Waiver. The following are things Mr. Breitbach may not be aware of relating to our local family planning clinic at NEICAC and how the elimination of the Family Planning Network Waiver will affect our ability to provide services to the women and men in Northeast Iowa.

 How we see this Bill SF2 applying to NEICAC Family Planning Clinic:
•    As it is currently defined in the bill, our clinic looks like it will fit into the third tier of providers, nonpublic entities that provide family planning services but do not provide required primary health services as described in 42 U.S.C. NEICAC is a Private Non-profit 501 (C) (3) organization. We do not meet the established criteria of being a primary care provider.
•    There are not currently any dollars tied to this bill, so we are unsure what the reimbursement schedule will be for the various provider levels. Will Tier 1 providers be reimbursed more than a Tier 3 provider?
•    If passed, this new program/funding state funding stream will begin July 1st, 2017 through DHS. It is our understanding the current state budget is $117.8 million short of being balanced. This leads to questions of how this program is going to be funded in the future when there aren't funds to cover the current budget items. If there isn't enough money this year, how will this program continue into the future?

Current
•    Iowa currently receives a $0.90 cent Federal match and the state puts in $0.10 for every $1.00 spent on Family Planning. The state will be turning away $3M in federal matching funds with the implementation of this state funded program.
•    Currently the Iowa Family Planning Network Waiver provides reimbursement to providers who provide preventative health screenings, cancer screenings, STD screenings & treatment, and a variety of birth control methods.
•    With the privatization of MCO (Managed Care Organization) in April 2016, we have experienced decreased reimbursements for the services we provide. This is primarily due to the lack of understanding the MCOs had of the family planning program prior to the privatization process. Our clinic is still trying to recoup erroneously denied claims for services; this has tripled our administrative time and effort for the billing process in order for us to get paid for fee-for-services.
•    Our clinic has adjusted our staffing with the decreased funding made available and now operates with a bare-bones staff. We constantly work to be good stewards of the public funding we receive to provide family planning services in our six county service area.
•    We are a grant funded program. Our grant funds (Title X Federal funding) have not increased with the rate of inflation in the past 27 years.
•    NEICAC has contributed $85,000 of local funding for each of the past 2 years to keep the family planning clinic open.  The decreased MCD reimbursements and lack of private insurance plans that cover birth control products are a contributing factor.
•    The closest Federally Qualified Health Centers in NE Iowa are in Waterloo, Dubuque, and Cedar Rapids; which means clients from our service area will need to travel up to four hours round-trip to obtain their routine family planning services.
•    This action alone would not cause the clinic to close, but in fact is the straw that probably will break the camel's back."