NASHVILLE, Tenn. — The Tennessee Department of Finance and Administration proposed using around $19 million in state funds on programs that would have been covered by federal funds, according to a budget presentation on Wednesday.
Commissioner Jim Bryson said during the presentation that the state would no longer receive federal Title X funding to support family-planning services, and proposed the state spend $9.3 million to continue those programs. He also said that the state would no longer receive federal funds for the state's HIV surveillance and prevention programs, and said the state should spend around $9.75 million to fund those programs too.
Bryson also said he believed by giving organizations that provide the programs the funding upfront, they would be more efficient. Previously, he said the organizations received "back-end payments using an expense reimbursement model."
He said during the presentation that the payments would go to community partners and metro health departments.
"Healthcare is one of the most important industries in our state," said Bryson during the presentation. "Coming out of the pandemic, there have been a lot of challenges to this healthcare system."
Representative Larry Miller (D - Memphis) asked during the presentation why the state was forgoing federal funds.
"The HIV surveillance and prevention program, with that, we're going to be able to put more money into this program and actually have a better program, and actually have a better program in the sense that we're going to be able to grant money instead of getting reimbursements. And the Title X grant, that's actually a program that the federal government is taking away, but we believe it's important and so we want to fund it with state dollars," Bryson said.
Title X is a federally-funded family-planning program. Through the program, the federal government effectively funds health programs across different states. These programs must follow certain standards such as being "client-centered, culturally and linguistically appropriate, inclusive, and trauma-informed," according to the program's website.
The website also says that Title X programs "protect the dignity of the individual; and ensures equitable and quality service delivery consistent with nationally recognized standards of care."
The care can include contraceptive products and family planning methods. Some of the services these programs provide are listed below.
- Pregnancy prevention and birth spacing,
- Pregnancy testing and counseling,
- Assistance to achieve pregnancy,
- Basic infertility services,
- Sexually transmitted infection (STI) services
A spokesperson with the U.S. Department of Health and Human Services said that the department notified the Tennessee Department of Health that it was out of compliance with Title X regulatory requirements.
The spokesperson said that TDH was given a chance to get into compliance, but did not. They said that Title X requires programs to offer pregnant clients information and counseling about different options regarding their pregnancy. The topics that must be covered are listed below.
- prenatal care and delivery
- infant care
- foster care
- adoption
- pregnancy termination (unless clients indicate they do not want such information or counseling)
Title X also requires grantees to provide referrals for abortion treatments if they ask for them.
However, HHS said TDH's policy for providing counseling and information was not compliant with Title X's requirements. Specifically, Title X recipients must provide referrals for abortion treatments if a client asks for them.
Soon after Roe v. Wade was overturned, Tennessee lawmakers activated a "trigger law," which effectively banned providers from giving abortion treatments. Because TDH's policies on abortion do not comply with Title X's requirements, the HHS spokesperson said the department would no longer give Title X awards to the state.
The spokesperson said they are also working to ensure services are continued in the state by working with other possible grantees.
They also said it was possible for Tennessee to be compliant with Title X's requirement, "even if abortions are restricted under state law." The spokesperson also said that all other Title X grantees were complying with the requirement for clients to be given information about pregnancy termination.