Health department fills role by providing contraceptives
By Nick Tabor, New Era Staff Writer
On
Monday, the U.S. Supreme Court will begin hearing challenges to the Obama
administration’s healthcare law, including the requirement for most employers
to pay for contraceptive services.
This
means the funding of contraceptives remains up in the air for working women in
this region and elsewhere. But in a county where the unemployment rate tops 10
percent, many women won’t get contraceptives from insurance regardless of what
the Supreme Court decides.
Though
Planned Parenthood agencies are widely known as abortion clinics, they also
offer contraceptive services to women who can’t pay out of pocket and don’t
have insurance. They’re the obvious sources for many women in big cities.
But
the nearest Planned Parenthood agency to Hopkinsville
is in Nashville, Tenn., about 75 miles away.
Instead,
the Christian County Health Department provides contraceptives to all women who
come through its doors seeking them, regardless of their ability to pay, said
Amy Maternowski, the department’s nursing supervisor.
A
spokeswoman from Kentucky’s
Cabinet for Health and Family Services said all the state’s local health
departments follow this practice.
In
the fiscal year that ended in June, the Christian County Health Department
spent $50,441 of its funds from local taxes to buy contraceptives and fund
counseling related to family planning, according to data the department
provided.
This
expenditure supplemented funds from the federal and state governments,
Medicaid, private insurance and out-of-pocket payments. Altogether, the public
funds amounted to $289,063.
These
numbers suggest the community depends heavily on the health department’s
services. The department only collected $7,000 from out-of-pocket payments and
$22,000 from private insurance.Kentucky’s challenges
Planned
Parenthood Kentucky only has offices in Louisville and Lexington.
Spokeswoman Taylor Ewing Johnstone attributes this to the state’s average
income levels: Wealthier states tend to support nonprofits better.
Lack
of funding prevents Planned Parenthood Kentucky
from serving rural areas.
“It’s
really just as simple as that,” Johnstone said. “We’re just very small. It’s
not just from thinking it’s not important, because it definitely is.”
As
a result, all county health departments in Kentucky provide contraceptives to anyone
who needs them, regardless of income, said Beth Fisher, spokeswoman for the
Cabinet for Health and Family Services. Health departments determine what to
charge each person based on income.
Sometimes
local clients can’t pay at all, but no one gets turned away, Maternowski said.
Methods of coping
In
the 2010-11 fiscal year, the Christian County Health Department provided 18,163
contraceptive services.
Clients
only paid with private insurance 5.23 percent of the time. In 19.43 percent of
transactions, they used Medicaid.
The
vast majority, 82.95 percent, paid on the sliding scale with their own money.
This category totaled 15,066 transactions.
From
out-of-pocket payments and “other” revenue, the department took in only $7,000.
A
small share of the clientele have regular visits with private doctors, but they
feel more comfortable obtaining contraceptives from the health department,
Maternowski said.
Some
clients only come in for a physical and want to discuss birth control or timing
a pregnancy. Though the department offers services to both men and women, men
seldom come in seeking help.
Nurses
begin by recording clients’ height, weight and blood pressure and performing
risk assessments, including the risks a woman would face if she became
pregnant.
The
health department provides 16 varieties of contraceptive services, ranging from
birth control pills and condoms to implantable contraceptives and patches.
Because
federal funding has fallen off in recent years, health department nurses go to
lengths to keep their costs down. They order all these products directly from
manufacturers, as they get lower prices via the state. Because prices fluctuate
from month to month, they look at every manufacturer’s price on every product
and buy the cheapest brands.
“Trying
to save our taxpayers a little bit of money,” Maternowski said.
The
nurses also provide counseling about infertility, abstinence and safe sex.
In
the last fiscal year, health department personnel had 2,990 client meetings
regarding contraceptives.
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