New Hampshire Family Planning Program Contracts Back Before Executive Council

CONCORD - On Wednesday, November 29, the Executive Council will consider new, 18-month New Hampshire Family Planning Program contracts, including for three reproductive health providers whose contracts have been rejected four times since July 1, 2021: Planned Parenthood of Northern New England (PPNNE); Equality Health Center; and Lovering Health Center. The agenda items for all Family Planning Program contracts are #16-22.

The four rejections resulted in a loss of $544,914 for PPNNE, and a total loss of $1,499,833 for the three reproductive health care providers.

The current contract award for PPNNE’s four New Hampshire health centers is $773,474.

Statement from Kayla Montgomery, Vice President for Public Affairs at Planned Parenthood of Northern New England:
“The New Hampshire Executive Council has the opportunity to do the right thing and put public health before their personal politics. The reproductive health care landscape in this country right now is chaotic, and Granite Staters deserve to know that their local, quality, affordable, compassionate health care providers have the proper funding to continue to offer their necessary care. This funding ensures access to critical preventative health care services -- including birth control, cancer screenings, and STI testing and treatment -- for our most vulnerable populations. The Executive Council plays a role in creating a strong public health network to keep our communities healthy. It’s been over two years since New Hampshire helped cover these services, and there has never been a more critical time for the Executive Council to approve contracts with all New Hampshire family planning providers.”

BACKGROUND:
The Executive Council voted 4-1 against contracts for the reproductive health care providers in September 2021, December 2021, January 2022, and July 2022, resulting in the loss of state funding for over two years toward their family planning services. This critical funding is essential for allowing these health care facilities to continue to provide preventive care like STI testing and treatment, cancer screenings, and birth control to New Hampshire’s most vulnerable populations.

FACT: Granite Staters Rely on Care from Planned Parenthood of Northern New England 

• In Fiscal Year 2022, over 11,000 Granite Staters relied on PPNNE’s New Hampshire health centers for high-quality, affordable health care.
• PPNNE was named a 2021 and 2022 Guardian of Excellence Award^® winner by Press Ganey, the national leader in health care consumer and workforce engagement. Press Ganey recognizes PPNNE as a top-performing healthcare organization, achieving the 95^th percentile or above for performance in patient experience. 

FACT: What the Executive Council’s Continued Rejecting Funding Would Mean for New Hampshire Patients and Health Care Access

• In 2020-2021, PPNNE, Equality Health Center, and Lovering Health Center provided care to approximately 80 percent of patients in the New Hampshire Family Planning Program. There are no other providers in New Hampshire who specialize in sexual and reproductive health.  
• During this period, PPNNE made every effort to absorb and offset this significant loss of funds without having a direct impact on patient care, but this ongoing defunding has contributed to the closing of a health center in Claremont.
• Additionally, patients at certain locations have experienced appointment delays of 3 to 5 weeks due to fewer appointments being available.
• The services that have been impacted by these delays include access to family planning/birth control, cancer screenings, annual exams, STI testing and treatment, and other reproductive care such as care for urinary tract and vaginal infections.

This contract is necessary in order to ensure that lower-income Granite Staters have access to timely and quality health care. New Hampshire offers limited alternatives for patients seeking access to affordable and trusted care – there are currently only four health centers in the NH Family Planning Program. By changing course and approving this contract, patients in the Granite State will have certainty around the care that they have come to expect at Planned Parenthood health centers and PPNNE can return to being a partner with the state of New Hampshire. Rejecting this contract again and going another nearly two years without this crucial funding would increase the financial strains on PPNNE and cause disruptions in the continuity of care.

FACT: The NH Family Planning Program Has a Major Impact on Health Outcomes in New Hampshire

• New Hampshire has the lowest unintended pregnancies and teen pregnancy rates in the country and some of the best maternal health outcomes. The New Hampshire Family Planning Program is part of the network of care that drives these positive outcomes.
  • However, sexually transmitted infections (STIs) are skyrocketing in NH. New Hampshire is currently in “outbreak” status as reported by NH DHHS for gonorrhea and syphilis, both of which had the highest number of cases reported in NH in a single year in 2021. Additionally, a drug resistant strain of gonorrhea appeared in New England this year. 
• During an October 2021 Executive Council discussion over family planning funding, Councilor Cinde Warmington and DHHS Commissioner Shibinette highlighted the fragility of New Hampshire’s positive maternal/fetal health outcomes and the impact the defund votes could have. Shibinette said that these defunding efforts could make it harder to attract maternal fetal health care providers. “I think that it makes sense that specialty and subspeciality providers would typically settle in states that are more supportive and less restrictive around family planning and abortion. The more restrictive we become, the less attractive New Hampshire becomes for those specialties.”
• Since the last family planning vote, the U.S. Supreme Court overturned Roe v. Wade, ushering rapid chaos and confusion for family planning patients and clinics in this country, and there has been an increased demand for contraception. However, even with this increased demand, 66 clinics across 15 states have been forced to close in the 100 days post-Dobbs decision.
• PPNNE is a critical component of the state’s health care safety net. For most Title X patients (60%) surveyed in 2016, the Title X–funded site where they sought family planning care was their only source of broader health care over the past year.
•  Family Planning Programs save money. The NH Family Planning Program saves the state millions in taxpayer dollars by providing patients with services to prevent or delay pregnancies and to protect against reproductive cancers and STIs. Overall, research has shown that publicly funded family planning services resulted in an estimated savings of $4.83 for every public dollar invested.

FACT: The Executive Council has Voted Multiple Times on Similar Contracts for New Hampshire Health Centers, and Has Approved Funding Many Times

• The contracts being voted on are for the second half of SFY 2024 and the full SFY 2025 (18 months total).
• Contracts for New Hampshire health centers were consistently approved between June 2016 and September 2021, with bipartisan support.
• Six votes in recent years (2011, 2015, 2021, and 2022), have jeopardized the care provided at local Planned Parenthood health centers when contracts were blocked by the Executive Council and state funding was interrupted.
• Most recently, the Executive Council voted in July 2022 to reject a total of $1,070,385 for the state’s three reproductive health providers:
  • Equality Health Center (Concord) - $463,164
  • Lovering Health Center (Greenland) - $300,771
  • Planned Parenthood of Northern New England (Claremont, Manchester, Keene, Derry, and Exeter) - $306,450 

FACT: The Federal Title X Program Outlines What These Funds May and May Not Be Used For and Under What Circumstances – And Those Guidelines Have Always Been Met and Were Reconfirmed by the Recent New Hampshire Budget

• The Federal Title X program has always provided guidelines specifying the appropriate utilization of family planning funds and the circumstances under which they can be allocated. These funds are designated for purposes such as STI screenings and treatment, cancer screenings, and contraception. Notably, they are explicitly excluded for use in abortion-related services. The allocated funds have always been used in accordance with these guidelines and for the intended purposes outlined in the budget. PPNNE is a  health care non-profit who follows all state and federal laws.
• In September 2021, following a series of financial reviews, the New Hampshire Department of Health and Human Services confirmed that no New Hampshire family planning dollars go toward abortion care. DHHS stated unequivocally, multiple times, that the financial reviews, which took place over the course of that summer, clearly showed that no Family Planning funds have been used for abortion. This fact has been echoed time and time again, most recently on July 22 by DHHS officials at a Fiscal Committee meeting. 

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Planned Parenthood New Hampshire Action Fund (PPNHAF) is an independent, nonpartisan, not-for-profit organization formed as the advocacy and political arm of Planned Parenthood of Northern New England in New Hampshire. The Action Fund engages in educational and electoral activity, including voter education, grassroots organizing, and legislative advocacy. 

Planned Parenthood of Northern New England (PPNNE) is the largest provider of reproductive and sexual health care across the State of New Hampshire. We serve New Hampshire residents through 5 health centers in Derry, Exeter, Keene, Manchester and White River Junction, VT. Last fiscal year we saw more than 11,000 patients at these sites. PPNNE was named a 2021 Guardian of Excellence Award^® winner by Press Ganey, the national leader in health care consumer and workforce engagement. Press Ganey recognizes PPNNE as a top-performing health care organization, achieving the 95^th percentile or above for performance in patient experience.