- Associated Press - Sunday, February 5, 2017

DES MOINES, Iowa (AP) - As the Iowa Legislature rushes to pass a bill to remove funding for Planned Parenthood and create a state-run program to distribute family planning money, some health clinics that could see an increase in patients say they haven’t heard anything about the system that could take effect within months.

The GOP-backed legislation flew through the Senate on Thursday and now moves to the House. The bill hinges on rejecting millions in federal Medicaid dollars in order to eliminate state funding for Planned Parenthood because Republicans oppose the organization’s practice of offering abortion services at some of its clinics, although no state funding now pays for abortions.

Instead, Iowa intends to start its own program to reimburse qualifying clinics for family planning services. The bill does not explain how it will pay for the program, though Gov. Terry Branstad has recommended tapping into other federal money that currently goes to needy kids.

Republican lawmakers contend the state-run program will allow more rural health clinics to offer family planning services. However, representatives for some of those facilities say they’re not familiar with the state’s plans. While some clinics say they’re capable of helping more patients if needed, they are confused about how the new system would work.

Julie Rupe, clinic director for the Wayne County Hospital’s clinic system in southern Iowa, said she wasn’t aware a new system was in the works.

“If there are changes being made to the program, we definitely need to know because we’re the ones that provide those services,” she said. “It is important that we would have that information.”

Although officials at some clinics would like more information, Iowa Department of Human Services spokeswoman Amy McCoy said the legislation needs to be approved before the agency can release more information.

“Whenever there is legislation that may make changes in operations or programs, there is always interest and concern,” she said. “But we do have to wait for legislators to be able to do their work and finalize legislation that then directs our agency with how we’re going to operate our programs.”

DHS provided a list of hundreds of clinics that could offer family planning services under a new system, but the nonprofit Iowa Primary Care Association noted that some rural centers vary in patient capacity, hours and services.

“Not every rural health clinic has someone who would feel comfortable with their certification and background doing family planning,” said Erica Shannon, the association’s program manager.

Planned Parenthood has 12 Iowa locations that provide reproductive health services such as birth control counseling and preventative screenings. Abortions are performed at eight of the clinics.

While Planned Parenthood has no intention of closing, women who rely on Medicaid for their family planning services may need to find a different clinic that qualifies for reimbursement under the new system.

Rachel Lopez, a representative for Planned Parenthood of the Heartland, said she wasn’t surprised by the confusion.

“Lawmakers have provided zero specifics on how they plan to implement or fund this program,” she said. “There is no evidence that state health care providers are prepared to absorb Planned Parenthood patients.”

Sen. Amy Sinclair, a Republican from Allerton and one of the bill’s sponsors, acknowledged some of the confusion Thursday during floor debate. She noted that she spoke with a representative from some health centers that could be affected.

“They do have some concerns about ramping up to do the women’s health care family planning, but they are willing,” she said.

Messages left Thursday and Friday for Sinclair were not returned.

Another concern is money. Under the current federal system, participating health clinics receive unlimited reimbursement for providing family planning services. With the state-run program, that funding would end at roughly $3.3 million.

The Department of Human Services doesn’t expect to exhaust its budget, according to an internal department document about the program.

However, the funding change still worries Lisa Koppin, health services coordinator for North Iowa Community Action Organization, a Mason City-based private nonprofit that specializes in care for low-income families. Koppin said the bill’s language would place her facility under the lowest priority for funding.

“It’s not very well-planned or thought out,” Koppin said. “The time it will take to figure out the funding formula, the method for payment and getting it all to roll out with the rules in place and the infrastructure built, it will just delay services for our clients even further.”

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