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Health Department

Dr Paul's Tennessean Guest Column - June 15, 2011

Metro Acts to Preserve Family Services

Last week, I notified state Health Commissioner Susan Cooper that the Metro Public Health Department will accept the $335,000 portion of Nashville's federal funds for family planning services that now go to Planned Parenthood of Middle and East Tennessee. Our main motivation was to reduce the risk that this funding and the services it pays for would be lost for the women of Davidson County.

Debate about this change has been passionate, and there has been a tendency for some on each side to demonize the other, but it is important to keep focused on the health of the women we are serving. The federal Title X program provides important health services for women and prevents unplanned pregnancies, which reduces the number of abortions. The services can help ensure that women are healthy before pregnancy, and we know that good health before conception is one of the most important factors in preventing prematurity and infant mortality. So these Title X services are part of a larger system of public health efforts that support the life-affirming goals of protecting and improving the health and well-being of women, infants and families.

On this score, we have much room for improvement. Earlier this year, the 2011 Tennessee Women's Health Report Card gave us generally poor grades for the health and well-being of women in our state. Our infant mortality rate is among the highest in the nation. In some parts of Nashville, one in 65 infants dies before their first birthday.

As a health department, we will make every effort to ensure good return on investment — to offer high-quality, accessible family planning services within a coherent, community-wide system of public health efforts.

Full cost is not covered

We have noted repeatedly that federal and state funding does not cover the full cost of providing these services, and for years the Metro Health Department has supplemented the federal dollars with local funds. We can't commit additional local taxpayer money now for this increase in service but are optimistic we will be able to meet the need. The basic overhead costs of the program are covered, and there are some economies of scale. Further, some customers will choose to continue their relationship with Planned Parenthood for family planning services despite an increase in out-of-pocket expenses. Nonetheless, we need to monitor our performance, along with Planned Parenthood and other providers, and communicate about any positive or negative impacts of this change.

At Metro Health, we are now coordinating with Planned Parenthood to ensure a smooth transition. We are hiring staff, expanding available appointments, and establishing referral procedures to help customers make the transition to the Health Department. We will monitor the availability of services and report about our progress.

This transition comes at a time when budgets are squeezed and when it is popular to devalue government-provided services. You can help by strongly supporting your community's efforts to improve the health and well-being of women, children and families in Nashville.

Dr. William S. Paul is director of the Public Health Department of Metropolitan Nashville/Davidson County.