If Lubbockites need Title X-funded family planning services, the closest option is the South Plains Public Health District in Brownfield, a community — with a population of about 9,700 — approximately 40 miles southeast of here.
Despite Lubbock’s notoriously high sexually-transmitted disease and teenage pregnancy rate and population size of about 240,000, citizens do not see a single cent of Title X funding, and the answers from those behind the scenes are vague.
Fran Hagerty, the CEO of Women’s Health and Family Planning Association of Texas, said a falling out occurred with Generation Healthcare after its CEO, Merinda Condra, assumed the former Planned Parenthood of Lubbock. Condra said a dispute over Title X funds, which are solely distributed by WHFPT, have led her to repeatedly threaten legal action against Hagerty.
Condra sat at a long table with her mother and dog by her side for support. Tears filled her eyes as she recounted the timeline of the creation of Generation Healthcare and the beginning stages of its closure.
“The left torpedoed Title X funding because we disaffiliated from Planned Parenthood,” Condra said. “The right is going to because the entity used to be Planned Parenthood. In between are the women of this area who will be denied services.”
Title X funds are federal funds granted to clinics to make it possible to provide affordable sexual health care and family planning services to people who meet the requirements.
In Spring 2013, Women’s Health and Family Planning Association of Texas won the $13 million grant — originally $14.5 million — taking Title X away from the Texas Department of Health and procuring funds for Planned Parenthood and other clinics.
In Lubbock, though, preventive care for low-income women and men has been another casualty in this battle. Generation Healthcare, a family planning clinic that dissociated itself from Planned Parenthood after taking over what was formerly the only abortion provider in Lubbock, is going up for sale.
The clinic has struggled financially ever since it renamed itself and severed ties with Planned Parenthood programs across the state. Form 990s obtained from the organization show net assets plunged from 2012 to 2013 — from more than $800,000 to less than $500,000. The documents also reflect revenue has plummeted from over a million dollars to about $200,000 between those two years. In 2013, however, revenue has dropped to $131,000 with a deficit of about $104,000 after its operational costs.
The remodeled brown clinic in South Central Lubbock stood empty with a large blue and white “For Sale” sign on the street side of the property. The parking lot was empty, but that didn’t deter women from stopping by and asking if the clinic was open.
Condra pulled up in her personal vehicle and stepped out when a woman waiting in a small, black car asked about being seen; she said it was urgent. Condra held a brief conversation with her, and the woman got back into her car and drove away.
Fran Hagerty, the CEO of Women’s Health and Family Planning Association of Texas, said she has had a dispute with what used to be Planned Parenthood of Lubbock, which was renamed Generation Healthcare and is currently run by a new CEO, Merinda Condra. Since the takeover in October of 2013, a dispute over Title X funds solely distributed by WHFPT have even led Condra to repeatedly threaten legal action against Hagerty, she said.
The Emails
A month before the disaffiliation and the United States Court of Appeals for the Fifth Circuit’s decision to uphold tightened abortion clinic standards, Planned Parenthood of Lubbock began to solicit Hagerty for Title X funds. Two weeks after contacting them, an email transcript obtained by Hub@TTU reporters showed the clinic looked like it was going to become a provider in the state’s Title X network.
“Once you have looked them [policies and procedures] over and made the final determination to join us, we might want to hold a conference call with your staff and mine to answer questions and gather the information we will need to submit a ‘Change of Scope’ application to the Office of Population Affairs (OPA) to get approval to include you in our network”, said Hagerty to Tara Haskell, the then President-CEO of Planned Parenthood of Lubbock. “Together, I know we can make this happen!”
Hagerty got word from her chief financial officer that things were starting to change around the Lubbock clinic after the board of directors met. She said in the email she didn’t want to waste any time in submitting the change of scope approval and including them if OPA approved.
“We are so excited to have you, Tara,” Hagerty said in the email, “and want nothing more than to support you in the vital work you do for the community,”
“We are thinking of changing our name but still want to be involved with Title X, especially as there are no Title X providers in this neck of the woods,” Haskell replied.
[youtube http://www.youtube.com/watch?v=M1TKKV3KEiQ&w=420&h=315]
Haskell added that the tax ID number would remain the same, and Hagerty said that decision would have no affect on the clinic’s Title X status. When October came, the clinic’s name and ownership changed and so did WHFPT’s decisions.
Severed Ties
A little over a week later, the name change was implemented, and Generation Healthcare severed all connections with Planned Parenthood of Lubbock. Some of the original board members remained, including Haskell, and when the application was making precarious progress, Condra called Fran to ask her about its status.
“When I asked if every organization that changed its name was required to reapply as a new entity, you asked if I thought that was our situation,” Condra said in a follow-up letter to Hagerty, “When I stated that it was, you responded, ‘So, you are still a Planned Parenthood affiliate?’ To which I responded ‘no.’ You stated, our organization ‘agreed to work with a Planned Parenthood affiliate.’ When I asked if every organization that disaffiliated with Planned Parenthood was going to be denied funding and forced to reapply as a new organization, you stated ‘yes.’”
A clinic representative in Hidalgo County, in Texas’ Rio Grande Valley, had a different story to tell.
“As far as the Title X funds, we didn’t have to reapply whatsoever,” said Kathryn Hern, the community services director of Access Esperanza’s Hidalgo County clinics, formerly known as a Planned Parenthood affiliate. “We just had to let them know of the name change.”
The only difference between Hern’s situation and Condra’s, is that Access Esperanza’s Hidalgo County clinics were already Title X clinics when the organization operated as a Planned Parenthood affiliate, unlike Planned Parenthood of Lubbock.
The letter showed Hagerty told Condra she did not know Generation Healthcare, even though Condra maintained it is the same legal entity: same services, same Medicaid number, same charter number and same tax ID number. Hub@TTU reporters obtained records verifying Condra’s statement.
For Condra, she said she felt the deal breaker was the decision to not associate itself with Planned Parenthood, the most widely known recipient of WHFPT’s Title X funds.
The letter also shows Condra pressed for specifications of recipient qualifications for clinics after Hagerty had stated WHFPT doesn’t have to give funds to anyone short of their standards.
According to her letter, Hagerty admitted there were none.
Condra had said that was odd for an organization with an instrumental role in Texans’ sexual health.
“We are simply trying to provide desperately needed services to the women of this area,” she said. “We have no interest in playing politics with women’s lives. Any attempts by your organization to withhold Title X funds to dissuade entities from disaffiliating or to punish organizations which have disaffiliated from Planned Parenthood is wholly improper and a violation of both state and federal law.”
On top of the setback that occurred after the takeover, Condra said she had also been denied funds because she was not referring patients to abortion clinics but providing counseling and adoption information as an alternative. She said this compelled Planned Parenthood to cancel them by delaying her clinic’s application process.
Truth Be Told
Carolena Cogdill, Title X recipient and CEO of Haven Health Clinic, said her clinic provides patients with several options, including adoption, but abortion referrals are barred from Title X funded clinics.
“We don’t refer anybody anywhere,” she said, “and neither does any other Title X clinic.”
Bell County Public Health District in Temple, Texas, second Cogdill’s statements. However, South Plains Public Health District does things differently.
Soronya Shafer, director of nurses at the South Plains Public Health District, said she does give abortion referrals to clinics with patients in need. Under federal law, a clinic may issue a referral if the patient’s life is in danger either due to a form of violence or illness.
A contract with WHFPT does reflect an unbiased approach to counseling pregnant patients, which would include abortion information, but the contract was signed by Tara Haskell, former CEO of Planned Parenthood of Lubbock. Whether or not Generation Healthcare assumes this responsibility, which Condra said she doesn’t, was not explicitly stated in the contract.
The contract was presented to Condra, and she said she had never seen it before.
Hagerty said it was inaccurate to say the setback happened because there was a disagreement over Generation Healthcare as a new entity. The reason the entity was denied funding, she said, was because she didn’t see an increase in Title X funding. Furthermore, she said, the paucity of Title X funds in the first place doesn’t give her the flexibility to divide the money even more.
Condra said $150,000 was already reserved for Planned Parenthood of Lubbock prior to the name change, when Hagerty knew the board of directors.
She said this has led her to believe funding was denied because of her dissenting views.
When asked to elaborate on the fight with Condra, Hagerty said she could not disregard her lawyer’s advice by talking about it. Condra said she does not plan on bringing any legal action against Hagerty and plans to focus on her latest project — turning the abortion clinic into an educational center for children dealing with learning differences.
The Generation Healthcare Facebook page shows its profile picture as a white square with bold red letters displaying the words, “CLOSING DOWN.”
Condra sat at a rustic-style wooden table as her mother sat looking on while petting their small dog. At times, a pause would give her a chance to compose herself as tears continued to fill her eyes.
After the dust has settled over this, Condra said she remains optimistic of the future but laments her cause being subverted by political polarization. She said while everyone involved should be more concerned with taking care of women, that is not what she has experienced.
She said this has been a trying year as they have spent the better part of it fighting to keep their doors open to help serve women in the Lubbock area.
“There are women hurting and their children hurting,” she said, her mother staring at her as her words slowed and softened, “and we have people playing politics back and forth.
The clinic was approved for funds under the Texas Women’s Health program which provides the clinic with about $5,000 a month. She said they were awaiting to hear about their request for expanded primary health care, which is more broadly based by providing services for women who are not necessarily of reproductive age. She said funds are crucial because most of the women who go to her clinic do not qualify for Medicaid.
She called the actions of the OPA and WHFPT impermissible, abusive, and possibly actionable under Texas law.
“Do we want to spend our time fight or do we want to spend our time helping?” A visibly upset Condra asked. “We all have a limited number of years on this Earth, and we have limited hours in each day. And, for me and my organization, a successful life is one that makes this world better. We have to measure how we’re going to spend those hours, how we’re gonna spend those years to make the world a better place.”
Previous: All-in-All: My Own Words Next: An About-Face with Title X Funds
