GOP lawmakers want more scrutiny of providers using public money for reproductive health care

Reproductive health care centers warned lawmakers Thursday that a bill requiring they do a second audit of how they spend public funds would leave them less money to provide basic health care to low-income patients. 

State law already requires the Department of Health and Human Services to audit state-subsidized family planning centers to ensure they use federal and state money for cancer screenings, STI and pregnancy testing, contraception, and other basic reproductive health care and not abortion services.

Rep. Jess Edwards, an Auburn Republican, told the House Health, Human Services, and Elderly Affairs Committee that Executive Councilor Janet Stevens asked him to sponsor the bill. Stevens was one of the council’s four Republicans who voted four times  to eliminate state funding to three reproductive health centers that cared for more than 12,000 Granite Staters despite assurances from the department and Attorney General John Formella that state audits showed they were using public money as required by state and federal law.

House Bill 615 would require all centers that receive public money for family planning services, including those that do not provide abortions, to provide the state a second “independent” audit by a certified public accountant showing no money is going to abortion care. It would also require centers to provide the council the audits at least a week prior to their vote. The bill does not say who would pay for the audit, but Edwards told the committee he assumed it would be the centers. 

Edwards said he does not see his bill as limiting access to abortion but rather preserving public money for contraception, cancer and STI screenings, breast exams, and other non-abortion reproductive health services.

Stevens declined an interview request but sent a statement through her chief aide, Kevin Chrisom, Thursday evening. She said Health and Human Services cited two issues: She doesn’t believe the department has the staffing to do the audits. And the department did not provide her the audits before the first council vote. She had the audits before the second vote, she wrote, but not the “corrective action” steps the centers would take to provide clarification or missing information.

At that meeting, Meredith Telus, director of program planning and integrity at the Department of Health and Human Services, told councilors the department’s requests for additional information sought more detailed policy and procedure manuals and additional information about staff training, and did not reflect a concern that the centers are misusing public money.

Stevens said she received the corrective action plan the night before the third meeting and did not have time to review it before voting. In her statement, Stevens did not say why she voted against the contracts the fourth time, in July.

Gov. Chris Sununu, who urged the council to pass the contracts, expressed his frustration following that fourth vote in July.

“I keep bringing (the contracts) back … but I think they’ve made it pretty clear that regardless of timing, regardless of what we put in there, regardless of the explanations that we give and the understanding that we’ve kind of pushed upon them, they’re not really willing to move on,” he said.

In her statement Thursday, Stevens wrote: “With critical information lacking, it was not possible to make a proper assessment of the proposed contracts, which is a disservice to everyone, particularly the patients served by these facilities. Moving forward, we should consider simplifying the process through use of an outside auditing firm or more standardized facility requirements. Additionally, the Department of Health and Human Services is critically understaffed and outsourcing this process should be considered.”

Department spokesman Jake Leon could not be reached Thursday evening for comment.

Gregory White, executive director of Lamprey Health Services, which receives state money but does not provide abortions, told the committee his center already spends more than $50,000 on two audits of health care programs subsidized with public funds; federally qualified health centers like Lamprey Health Services are also required to audit other federally funded services. White said he’s been told a third would cost the center another $2,000 to $10,000. 

White has said his center receives about $229,000 annually from the state through the Family Planning Program.

“My concerns here mainly are, this is redundant, it’s not necessary, and would be a crushing administrative burden on some very scant resources,” White told lawmakers.

Edwards said the bill, which has seven Republican cosponsors, is intended to ensure there is a “firewall” between money spent on basic reproductive health care and abortion. It’s a concern raised often by Republicans who have argued that public money used to keep a reproductive health care center open is funding abortions done in that center.

“What we had heard for years, years, and years, probably since I first paid attention to this issue in the ’70s, is that there is no commingling of money between abortion providers and family planning money,” he said. “We heard that, we heard it, we heard it.”

He told the committee, “This (bill) is for abortion providers who have not convinced the Executive Council of the (financial) separation.”

Those providers are the three defunded last year by the council: Planned Parenthood of Northern New England, Lovering Health Center, and Equality Health Center. They had provided 70 to 80 percent of the state’s subsidized family planning care to low-income people, which they estimated to be more than 12,000 people.

Patricia Tilley, director of the Division of Public Health Services at Health and Human Services, told the committee the council’s vote has left four centers in the state’s Family Planning Program: Lamprey Health Care in Nashua, Amoskeag Health in Manchester, the Community Action Program for Belknap and Merrimack counties, and the Coos County Health Center in Berlin.

Tilley said she’s concerned the added cost of another audit will reduce money available for reproductive health care and be a hurdle for providers.

“We are concerned about additional barriers and costly expenses to our very fragile system of reproductive health care in the state,” she said. “This is fundamental primary care for women as well as men to be able to have access to all of those screening services and contraception. We are concerned that by adding additional barriers and additional cost of their work, we will no longer have a safety net of providers for-low income individuals.”

Rep. Lucy Weber, a Walpole Democrat on the committee, raised the same concern Wednesday.

“Isn’t that cost going to come out of the monies that we really would rather have spent on actually providing services to a vulnerable population?” she said. 

Kayla Montgomery, vice president of public affairs for Planned Parenthood of Northern New England and New Hampshire, told the committee that their organization had been in the program for most of the last 50 years, complying with financial audits, until last year. 

Two of their New Hampshire sites, in Exeter and Derry, do not provide abortions. She said the council vote eliminated needed funding for basic health care.

“That is particularly important now as STI rates are really on the rise in this region,” she said. “And we do it all on a sliding scale fee. If you come in and you can’t afford services, we give them to you for free.” 

The bill’s supporters who testified Wednesday included Kurt Wuelper, president of New Hampshire Right to Life. He said he’d prefer the state not give money to health care centers that do abortions, regardless of what an audit showed.

“We consider abortion to be a violation of fundamental human rights, and as such, we believe that to use taxpayer dollars to support that in any way is a violation of the rights of conscience for every taxpayer who believes the way we do.”

In a June poll, the University of New Hampshire Survey Center said 10 percent of respondents opposed abortion in all circumstances. The vast majority said abortion should be legal in all circumstances (55 percent) or in limited circumstances (35 percent).