NEICAC Family Planning Director discusses successes and challenges of closed clinic at monthly meeting of the Allamakee County Democrats

June 30, Northeast Iowa Community Action Corporation (NEICAC) closed the doors of its Family Planning Program, resulting in Allamakee citizens losing access to reproductive healthcare. The clinic covered the six counties of Allamakee, Chickasaw, Clayton, Fayette, Howard and Winneshiek.

Lori Egan of Waukon, who served for almost 16 years as the manager of the Family Planning Program based in Decorah, talked to local Democrats at the monthly meeting of the Allamakee County Democrats August 10 on her experiences and her concerns of reproductive healthcare going forward.
Family planning services were the result of the federal Title X program which began in 1977. The primary goals of the services have been providing healthcare to allow women to plan pregnancies, to gain economic freedom and provide reproductive healthcare to men and women. Like all public health programs, the underlying philosophy is providing programs for the common good. The staff fought for reproductive justice for women and provided early detection services, such as cancer screenings.

Egan stated that the program has often faced misconceptions about what services were and were not provided at the clinic. After opening satellite clinics in communities such as Postville, Elkader and New Hampton, Egan stated protesters lining the entrances thought abortions were being performed at the clinics. In over 40 years, NEICAC Family Planning Clinic has never provided abortion services, Egan explained.

As a recipient of Title X funding, the clinic was required to provide “all options” counseling when a pregnancy was confirmed. Egan stressed that “all options” counseling must be unbiased, and it is required to cover the options of continuation of a pregnancy, adoption, and termination of a pregnancy.
Egan said decisions at the State level played a substantive role in the financial strain faced by the Family Planning Clinic. Three main factors were cited by Egan that led to the ultimate decision of the board of NEICAC to close the clinic. Privatization and changes to Medicaid, loss of private funding, and the establishment of a State-run family planning program are the main factors that were addressed. Egan stated, “It felt like a direct effort to defund our program.”

When Medicaid was turned over to private, for-profit insurance companies, Egan said these insurance companies denied many claims submitted by the NEICAC Family Planning Clinic. Processing of claims and payment for services were not problems when the State of Iowa administered Medicaid, she noted. Then the State Senate and State House voted to reject $3.1 million dollars in federal Title X funding for family planning services.

Egan explained that, basically, this Title X federal money was tax dollars coming back to Iowa to pay for healthcare. The legislators’ rejection of this federal funding hurt many family planning clinics in the state and prevented experts in reproductive healthcare from providing needed services. Instead of accepting the Title X federal money, legislators set up  State-run clinics.

“This has been a disaster,” said Egan. “Some of the so-called Department of Human Services (DHS)-approved clinics turned out to be dental offices who knew nothing about providing healthcare to women,” she shared.

Egan further explained that the newly created state program does not allow funding to go to clinics that provide abortion services, which eliminates Unity Point Health Systems, Planned Parenthood and the University of Iowa from participating in the program. In the absence of the Family Planning Clinic at NEICAC, the only place to enroll in the new state-funded program is at a DHS office.

July 5, Egan looked into whether DHS was ready to enroll patients by calling the agency. The Decorah DHS office was unaware of the Iowa-run family planning program, even though the enrollment was intended to begin July 1, she explained.

Egan sees the closure of the clinic as a short-sighted decision that will have long-term consequences. She shared that Iowa is currently experiencing its lowest level of teenage pregnancy, and that in 2014, abortion rates were at their lowest point in the history of this nation. "It is a disservice to our community and neighbors to not provide basic healthcare screenings and family planning services that have helped struggling women," Egan concluded. “If one of us benefits, we all benefit."

When asked where the thousands of northeast Iowa residents go to access services once provided by NEICAC Family Planning Clinic, Egan painted a grim picture.  She explained that since the private insurance companies running Medicaid continue to deny claims or are delinquent in payments, healthcare providers are limiting the number of patients they will accept who are on Medicaid. She reasoned that the so-called State-managed programs are non-existent and that women end up going without screenings and without healthcare.  “This is a tragedy and sadly will result in the loss of life,” said Egan.