money.jpgThe Women’s Community Clinic in San Francisco is like many other reproductive health and family planning providers for low-income women.

It offers gynecological exams and menopausal care at little to no cost to the patients. Its paid and volunteer staff prescribe birth control and give abortion referrals, although the clinic itself does not offer the procedure.

And like many women’s health clinics, the modest operation at 1833 Fillmore St. has unwittingly become embroiled in the federal government’s budget impasse–in more ways than one.

Not only are reproductive health issues allegedly at the heart of the budget stalemate, the clinics would be among the first groups to feel the sting of a government shutdown if an appropriations agreement is not reached by midnight today.

Democratic legislators have accused the Republican leadership of digging in its heels over the federal Title Ten Family Planning program for reproductive health, about a quarter of whose funding goes to Planned Parenthood.

The GOP has been vocal in its opposition to Planned Parenthood because the organization provides abortions, albeit not with federal dollars and in programs not connected to its general services.

The Republicans, however, claim these ideological differences are not at the crux of the budget issue, which they say is predicated on disagreements about how many billions of dollars in spending should be cut.

Regardless of the reasons, elimination of Title Ten funding–which serves 5 million men and women nationwide through more than 4,500 clinics–is on the Republicans’ list of budgetary demands. House Speaker John Boehner has said he’s prepared to let the government shut down if the cuts aren’t made.

Proponents of the clinics say either scenario could be devastating to them.

The Women’s Community Clinic receives about 5,000 visits per year from about 2,700 women, and is one of many clinics in San Francisco that receive reimbursements from government programs such as Medi-Cal and Family PACT, Executive Director Carlina Hansen said.

Those reimbursements would be frozen during a government shutdown.

“We would get IOUs,” Hansen said. “(A shutdown) can have a pretty dramatic impact on cash flow at clinics all around the country.”

She said the situation is “very nerve-wracking right now,” because of the possibility of a government shutdown and the threat to Title Ten funding, of which the clinic receives about $140,000 per year.

Although the organization’s total budget is $2.3 million per year, a significant amount of that goes to special projects, Hansen said.

“In the context of funding for actual health services, ($140,000) is pretty significant,” she said, especially when measured against health care visits, which cost about $100 each.

“Losing it would almost certainly reduce our capacity to provide services,” she added.

Funding cuts therefore do not take long to translate to lack of access to care, which takes both human and financial tolls, Hansen said.

Women suffer untreated infections and experience unwanted pregnancies, leading to human suffering as well as more emergency room visits and financial burdens on the system.

“There are pretty huge budget implications pretty quickly,” when women start to lose access to gynecological services, Hansen said.

The loss of Title Ten funding also would come at a time when reproductive health clinics in San Francisco are already struggling to meet demand due to closures across the city.

“We’re looking at city cuts, state cuts, now federal cuts,” Hansen said. “So we are definitely keeping a close eye on all of those things and trying to do what we can. Budget advocacy has become a nearly year-round thing because of the instability of the budget climate.”

Janna Brancolini, Bay City News

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