Family planning nurse Melissa McGee is worried about the nearly 900 Tri-City clients who may not seek birth control when her program that serves low-income people is eliminated Jan. 30.
"I've been told (by clients) that they will not be able to get any more care," said the nurse for the Department of Health and Human Services Community Service Office.
That includes clients like 18-year-old Elizet, who lives near the Pasco office where McGee works. She says it will be difficult to take time to go elsewhere with her two young daughters.
"Don't close it down because there would be a lot of unplanned pregnancies going on," said Elizet, who asked that her last name not be used.
Faced with a projected $5.7 billion state revenue shortfall, DSHS' Health Care and Recovery Services Administration was told to cut $200 million from its budget in the first six months of 2009. The more than $1 million family planning nurse program was one of the services that hit the chopping block.
While some family planning organizations like Planned Parenthood of Central Washington say this cut will lead to more unplanned pregnancies, DSHS officials say they don't expect unplanned pregnancy rates to rise because of the cut.
"I just have a hard time believing that (unplanned pregnancies will increase)," said MaryAnne Lindeblad, director of DSHS' division of health care services. "Our commitment to family planning hasn't changed."
Though the 55 family planning nurses who staff the 57 Community Service Offices statewide no longer will be there to provide Medicaid-eligible people with birth control pills or emergency contraception, Lindeblad said the same services still are available at places like community health clinics, primary care doctors' offices and Planned Parenthood locations.
"There are numbers of agencies that we contract with," she said.
Lindeblad added that the role of the family planning nurses is to provide clients with contraception and then assist them in finding a medical service such as a local clinic or doctor's office where they can get birth control in the future. There still will be staff at the Community Service Offices who can refer those seeking birth control to other locations.
But McGee said the ease of the service -- it usually takes no more than 30 minutes to counsel clients and provide birth control -- was attractive to clients, as well as the location at Court Street and Eighth Avenue.
"Most of my clients do not have any transportation," she said, adding that about half of her nearly 330 clients are Pasco High School students who walk to the office.
And access to birth control should have as few barriers as possible, said Brian Griffith, a spokesman for Planned Parenthood. The nonprofit agency contracts with DSHS to employ McGee and four other family planning nurses who work at the Pasco and Kennewick Community Service Offices.
"People are putting their health care in second or third place," Griffith said. "This cut makes one more roadblock."
The cut will affect those who are most vulnerable, such as those without transportation, Griffith added. He said taking public transportation from Pasco to Kennewick's Planned Parenthood can take up to two hours.
"That's a day off from work for some people to seek birth control," Griffith said. "That's a decision between birth control or food sometimes."
Lindeblad, however, said Medicaid clients have access to transportation services to avoid situations like that.
The state spent nearly $333 million on pregnancy care last year, with nearly half of the pregnancies unplanned. McGee and Griffith said that price tag will rise with elimination of the family planning nurse program.
"(Washingtonians') tax dollars are going to pay for these Medicaid increases," Griffith said.
Also, Planned Parenthood officials are balking at eliminating a program that brings in nine federal dollars for every $1 the state contributes to the program. They say that means the state will no longer receive more than $9 million from the federal government for the family planning nurse service.
Though the service is scheduled to be discontinued at the end of this month, Griffith and McGee hope the Legislature decides to include the program in the 2010-2011 budget.
"I think there will need to be a great statewide outcry in this tight year," Griffith said.