July 1, 2025 • 29 mins
In April 2025, some organizations and health centers receiving Title X funding were given sudden notice by the current administration that critical funding would be withheld. This action by the federal government threatens roughly $65.8 million in Title X funds and implicates an estimated 846,000 patients. It has resulted in massive layoffs, stopped contracts, mental strain, and confusion for both employees and patients. As patients are not receiving the care they need due to a stop in funding, possible results could include rising rates of unintended pregnancies, rising rates of STIs, poorer maternal health outcomes, and later diagnoses of breast and cervical cancers.
We sit down with co-founders and executive directors of some of these impacted organizations, including:
Michelle Trupiano, Executive Director for the Missouri Family Health Council, and
Danielle Lampton, and Jamie Bardwell, Co-Founder and Co-Executive Directors at Converge in Jackson, Mississippi.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Jennie (00:03):
Welcome to rePROs Fight Back, a podcast on all things
related to sexual andreproductive health, rights, and
justice.
Hi rePROs, how's everybodydoing?
I'm your host, Jennie Wetter,and my pronouns are she/ her.
So y'all, I hope everybody islooking forward to having a long
holiday weekend.
I hope you have some fun plans.
(00:24):
My fun plans are nothing, andI'm very much excited about it.
This is one of those holidayswhere I stick really close to
home with all the fireworks, andthere are a lot of fireworks in
my immediate neighborhood.
It's really loud, and the poorkitties get really upset, so
Luna tends to hide under my bedand just like in the far corner
(00:47):
against the wall and there'slike she's just real upset and
Cinder sticks really close to meand wants to just be within a
couple feet of me while they'reall going off so I tend to stay
home so I'm here for thembecause they do get pretty upset
with all the fireworks.
It's weird lots of other loudnoises don't bother them but
(01:09):
fireworks they really- they arenot a fan.
So yeah, I'm looking forward tohaving a pretty chill weekend.
Might do some baking.
We'll see.
But mostly, I think it's goingto be pretty quiet, which...
I'm here for it.
I'm excited because there is somuch happening right now.
We're not going to get into allof it because there are so many
things happening, but I amrecording this on Friday, June
(01:30):
27th, and there were six SupremeCourt decisions handed down,
not counting ones earlier inthis week.
So, there has been so muchgoing on and there were so many
bad rulings out of the SupremeCourt.
They're going to have reallynegative implications on
people's lives that there isjust a lot to talk about.
And we'll have a wrap-upepisode where we'll talk about
(01:50):
some of the cases related tosexual and reproductive health.
I'm in the process ofscheduling that.
It'll either be next week orthe following week.
So there's just a lot of piecesmoving.
And like I said, there is somuch to talk about.
We already talked aboutSkrmetti.
One of the other big ones thatcame down today when I'm
recording it is the one aroundschools and LGBTQ books.
(02:13):
And the Supreme Court said thatschools have to allow parents
to opt out of any informationthat conflicts with their
religion.
And the school district waspretty clear that these opt-out
policies were not workable.
So that means that kids are notgoing to be getting those
inclusive books as much becausethe opt-out isn't workable to
(02:36):
have to send those kids out andfind something else for them to
do during that time.
So that just means that kidsaren't going to be able to see
books that represent their fulllived experience.
And that's pretty tragic.
And there's been so much goingon right now around banning
books and it's alwaysdevastating because we should
(02:59):
not be banning books.
I know that seems like itshould be just such a basic,
simple statement, but it hasreally become...
really been taking on steam thelast several years. And you're
seeing more and more of that,but I was definitely brought up
with the, the read all thethings, learn all you can.
And as a big book person, Ialways make a point of reading
(03:22):
banned books and celebratingbanned books week.
I usually read a banned bookduring that week.
So, I don't know.
This one struck close to homebecause, like I said, big
reader.
The other big case that I thinkI'll take a moment to talk
about and it relates to today'sepisode because it's kind of
related is the Supreme Courtdecision that said that people
(03:47):
don't have a right to a specificprovider under Medicaid.
So, this case was aboutbasically trying to kick Planned
Parenthood out of Medicaid inSouth Carolina.
So yeah, so now the SupremeCourt says that you're not
entitled to a specific provider.
And so states are now free tokick Planned Parenthood out,
(04:09):
which is what the big impetus ofthis case was.
But I think it's just reallyimportant to note that it
doesn't stop there.
It's saying that you don't havethe right to any specific
provider.
So this could impact othersexual and reproductive health
providers, not just PlannedParenthood, you know, access to
gender-affirming care.
I think there's going to be anykind of number of ways you can
(04:31):
see this that is going toprevent people from accessing
sexual and reproductive health.
And it's just really importantthat not all providers except
Medicaid and Planned Parenthoodwas a really important role in
ensuring that you were able toget affordable contraception and
(04:51):
breast exams and STI treatmentand any number of other things
, and often people on Medicaid,that was like their one contact
with the healthcare system andit came through Planned
Parenthood.
So I just...
it's going to have really bigimplications, and we'll talk
about it when I do the SupremeCourt wrap-up, but this is also
(05:14):
one that we will do a deeperdive and do an episode just
specifically focused on this andthe implications around it.
So stay tuned.
I'll be working on getting thatout in the near future as well.
But I said that's related totoday's episode because there is
another way that sexual andreproductive health providers
have been attacked, and that isthrough Title X.
(05:37):
I did an episode earlier thisyear talking about the ways the
administration is attacking theTitle X program.
I'll drop a link in our shownotes so that way you can refer
back to what has been going on.
We're not really going to talkabout all of the things that
have been happening in thisepisode.
This episode, we're reallylucky to have two Title X
(05:58):
providers come on and tell theirstories of what have been the
implications of theadministration withholding
funding from them.
So I'm very excited to sharethat with you.
We have three more providersthat we'll be doing another
episode with either next week orthe following week.
So I'm very excited to have youhear their stories and and see
(06:19):
what is happening.
So, the two providers we havetoday, one is from Missouri and
the other one is based inMississippi. [music transition]
Michelle (06:28):
So, my name's Michelle Trippiano.
I am the Executive Director forMissouri Family Health Council.
And since April 1st, when wereceived notice that the funds
were going to be withheld, ithas been very difficult for our
organization and our healthcenters and the patients that we
serve.
Health centers have beennavigating funding issues,
(06:51):
they've been navigating concernfrom their patients about
whether or not they can stayopen.
They've been navigating stressfrom their staff regarding
whether or not staff are goingto have to be laid off.
And ultimately, patients arethe ones who are going to be
lost in all of this.
(07:12):
And so, since April 1st, we'vebeen working really hard to
raise emergency funding to tryto ensure that there's been no
disruption in care.
And since that time, we've beenable to maintain all of our
services, but we know that thattime is not going to last much
longer and that we are facingreally difficult decisions in
(07:34):
the upcoming months.
Our network serves over 35,000patients across the state from
very small rural health centersto larger urban health centers.
And we know everyone's going tobe impacted, but especially
those small rural healthcenters.
That is where we are mostconcerned that those health
(07:56):
centers rely heavily on thoseTitle X funds.
And without those Title Xfunds, it's going to be near
impossible for those healthcenters to stay open.
And for most of those patients,that health center is their
only access point.
And so we know that thedevastation is gonna be both
immediate, but it's gonna havelong-term consequences as a
(08:20):
result of the crumbling of thepublic health infrastructure
that is beginning to take place.
And so, we're really concernedabout maternal health outcomes
in the future, about the rateand rise of STI rates, but just
the fact of that people may nothave access to basic, we're
(08:41):
talking basic family planningand health services is going to
be really detrimental.
And so, right now, our healthcenters are scrappy.
They are committed, they arepassionate, and that they are,
you know, doing everything thatthey can to, again, not have any
disruption in care.
(09:02):
But we know that that cliff is,you know, just a few weeks
away.
And it is beyond disappointingthat the federal government is
using Title X and is usinggrantees as a political pawn.
And that ultimately, again, itis patients that are going to be
suffering.
I mean, we've seen so much harmcome upon the network and our
(09:26):
patients over the last severalyears from abortion bans, from
misinformation, that patientsare already left really kind of
confused and mistrustful of ahealthcare system.
And so the fact that so manypatients have a provider that
they trust, that they know thatthey can go to for accurate
(09:47):
information, that they know thatthey're going to be in a safe
and accommodating space.
And for that just to go away,and to not have anywhere else to
go, is also just really I meandetrimental to the psychological
safety of our patients andagain it's going to have just
long-term impact and increasethat mistrust and distrust of
(10:11):
providers.
We are still hopeful that thefederal government will release
their funds that we along withthe other impacted grantees are
all in compliance and haveresponded accordingly and while
it has been 80-something dayssince the funds have been
withheld, and we know that eachday without funds is a day
(10:34):
closer to health services beingeliminated in our state, that
the federal government will seethat we are in compliance and
that they will release thosefunds so that, again, services
can continue without disruptionand that we can continue to meet
the needs of over 35,000patients throughout the state.
Danielle (10:57):
I'm Danielle Lampton, co-founder and co-executive
director at Converge, based inJackson, Mississippi.
Jamie (11:05):
And I'm Jamie Bardwell, the other co-founder and
co-director of Converge, alsobased in Jackson, Mississippi.
I will never forget being on aplane headed to DC for the
[National Family Planning & Reproductive Health Association]conference and getting a text
that said, I'm hearing Convergeis on the withheld grant list.
(11:29):
And I remember sobbing on thisplane and texting Danielle and
you calling me immediately andhaving this like almost out of
body experience.
And that image is forever stuckin my brain when I think about
(11:50):
this situation that we are in.
Danielle (11:54):
And it's also, in a lot of ways, a good reminder
that this withholding of fundshas massive impacts for our
communities, for policy in ourstates.
It also has real impacts on thepeople who do this work, like
(12:14):
us.
So, I was not traveling to theNFPRHA conference because my
father has a terminal illnessand I needed to be a bit closer.
And so we get this initialnews.
We're separated.
Jamie's on a plane about totake off.
You were on the tarmac.
I am alone in our office.
(12:36):
And I remember thinkingsomething that I still think
almost every day, which is, whatcan we even do?
Because I think the firstemotion is, is utter
powerlessness and fear.
We're terrified.
I'm still terrified.
(12:57):
I guess now we're over threemonths in.
We at Converge had to lay offhalf of our staff.
That was 10 people.
Those are 10 people who gave upa lot to dedicate their time to
quality reproductive care inthe Deep South.
(13:19):
So, we miss them.
We had to stop contracts withour clinical partners, of
course, which means that inshort order, clinics had to
start reducing hours, scalingback services, charging for care
that otherwise was free or lowcost.
Those clinics are alsoexperiencing the kind of mental
(13:43):
strain that we at Converge areexperiencing, and grantees all
over the country, people, in themovement and in other movements
are feeling that terriblepressure, the crushing sense of
powerlessness.
It's terrible and it's having Ithink lasting impacts all over
(14:08):
our movement.
Jamie (14:09):
You know, of course this is the anniversary this month of
the Dobbs decision and thereare so many parallels in
Mississippi, especially aroundpost-Dobbs and post the Title
X freeze, because back whenDobbs happened, so many people
in Mississippi already thoughtabortion was illegal anyway,
(14:30):
because it's so confusing, thisnetwork of laws and, you know,
the average person who needsthis care cannot understand what
is legal, where, when, and how.
I mean, I think I barely hadunderstanding of this and I'd do
this all day long.
And so, when the Title X fundswere frozen, we had almost the
(14:53):
same thing.
It was like, okay, well, wherecould I go for contraception
that's free or low cost?
No one knows.
You know, we're stillconsidered a Title X grantee,
but we have no money.
So, what about these clinicsthat were receiving funding from
us in March of this year, butcome April, we can't give them
(15:13):
any money?
You know, we were all at a lossreally as to how to explain
this because there was noinformation coming from HHS.
And the consequence again wasthis massive confusion.
And when you have so muchconfusion, people just don't get
the care that they need.
And, again, that includes notgetting birth control, which of
(15:35):
course contraception is, basichealth care that people want.
But it also means that patientsare going to have to delay or
even just forego preventive carebecause it won't be able to be
offered at a discount becausethe only place open is too far
away, wait times...
(15:57):
A lot of health outcomes aregoing to suffer.
We think there are going to berising rates of STIs and
increasing rates of STIs thatare perfectly treatable.
that simply go withouttreatment.
Unintended pregnancies, laterstage diagnoses of breast and
cervical cancers.
Of course, later diagnosisoften means a terrible outcome
(16:21):
for women.
So, I think there are going tobe these sort of measurable
health outcome impacts, but toJamie's point, there's also this
terrible impact of chaos in aspace where we're already
working about as hard as we canto get reliable, consistent,
(16:44):
medically accurate informationto our neighbors.
And now having this additionalconfusion means that it's even
harder to help people know wherethey can get what to them is
really simple, basic healthcare.
And, you know, we...
created an entire Title Xnetwork basically from scratch
(17:10):
when we won this grant for thefirst time in 2022.
I mean, prior to Convergewinning the grant in 2022 for
Title X, the Mississippi StateDepartment of Health had been
the sole Title X grantee andthey used Title X funds to prop
up their health departments.
And what we found from actuallyworking at the health
(17:30):
department was that people werenot getting the quality care
that they needed and wanted.
And we felt strongly then, andobviously we do now, that we
need to be part of the solutionof figuring this out.
So, we left the healthdepartment and with very little
money, $150,000, and I was aboutto have a baby, and we thought
(17:54):
to ourselves, like, we canfigure this out.
And we spent, you know, a goodtwo years years talking to
clinics, talking to patients,doing all this groundwork.
And so when we applied theTitle X grant, we were like, we
have a great strategy.
(18:14):
And we won.
It was a huge deal.
And so we started working veryquickly with community health
centers because that's reallythe medical home model that we
would want people to have accessto.
The health departments werereally providing just kind of
bare bones care, kind of yourtraditional public health
services, but not the qualitycare that we wanted people to
(18:37):
have.
And it was a slog to get all ofthese FQHCs to say yes to Title
X, especially with such kind ofbad taste in their mouth from
previous attempts at trying todo Title X with the health
department, where there was nomoney involved.
And we were offering them moneyand technical assistance.
And we actually were eager toreturn their phone calls and
(19:00):
answer all their questions.
And so we created thisbeautiful statewide network.
And it was going so well.
And for it to happen in thisway, I will never get over how
heartbreaking the whole thinghas been.
For us as leaders, for ourorganization, and obviously for
(19:20):
the people that we serve, it hasbeen, I think, the worst
possible outcome I could haveimagined in this administration.
Danielle (19:28):
And there's something especially difficult about the
timing for us.
It felt...
for us, for our team, for ourclinical partners, we're hitting
our stride in Mississippi andTennessee.
We are facing down a crisis ofaccess, a crisis of mis- and
(19:56):
disinformation, a super hostilepolicy environment, but we're
building.
We're doing it.
And I think that we...
anticipated that the incomingTrump administration would mean
we'd have to get super focusedon holding the line as many
(20:19):
places as we could for as longas we could.
I did not anticipate takingsuch a serious hit so early.
We didn't get the chance to doany of the things we wanted to
do.
We didn't even get to do theshouting.
Yeah.
But...
I think that is also true thatfrom this experience of the
(20:48):
funds being withheld, we havebeen reminded of the thing that
also saw us through andcontinues to see us through
post-Dobbs, which is thesolutions for the needs down
here in the South—the solutionscome from the soil, the
solutions come from the place.
(21:10):
So, in community with ourclinics, with our patient
advocates, with each other,we've been able to gather
ourselves and think about thatsame question we had at the
beginning which is (21:27):
what what can we do continue to demand
that we receive some informationfrom HHS about our funds that
are currently withheld?
We have complied with theirrequest for information and
would like for them to thenprovide us an update.
(21:48):
We received nothing.
What we have decided is that wecan continue to increase the
number of places people can getaccess to contraception.
It feels like the politicalwinds are definitely blowing in
(22:10):
the direction of increasedpressure to stop certain kinds
of contraceptive care, torestrict or limit certain kinds
of contraceptive methods.
And so, we're out there withour telehealth operation trying
to make sure that people knowthat they can still get a wide
(22:33):
array of contraceptive methods,but it's devastating that we're
here.
And man, none of it had to bethis way.
Jamie (22:42):
And after the initial shock and sadness and
disappointment, we very quicklyrealized, okay, we have a job to
do here.
There are no Title X designatedclinics in Mississippi.
And we must serve our people.
And so we very quicklycommitted that we would not stop
telehealth.
(23:02):
We had no Title X fundssupporting it.
So, we're relying on privatedonations, which we had never
really done any kind of campaignto raise money for individuals
because we didn't need to,right?
And using foundation andprivate money for our telehealth
operation, we continue to dofree at-home STD test kits and
(23:25):
treatment.
The only organization inMississippi doing that, still
doing that.
And then we thought, well,gosh, like, why not us?
Why can't we also have a clinicpresence?
Like, we've been saying, okay,clinics, we'll give you this
money if you'll agree to thesestandards and quality
(23:45):
improvements.
And we thought, we know allabout that.
So we signed a lease with12-month lease for a clinic
space in the Jackson MedicalMall.
And it's an underserved area ofJackson where the main tenants
had decided this summer to leaveand go out to the nice suburbs.
(24:05):
And so there's this huge voidin here.
And to Danielle's point, we'redoing the opposite of fleeing.
We are committing that we'regoing to be here.
And so September 1st, theConverge Clinic will operate.
And it is so exciting to knowthat we would have not moved
(24:29):
into this space so quickly ofoffering direct clinical care,
brick and mortar, without havinglost our Title X funds.
And that's kind of weird tosay, but Title X is really
complicated and takes so muchtime to administer.
And so we were really likefocused in on that, right?
And we had decided before weeven started Converge that a
(24:51):
brick and mortar clinic was oneof our dreams.
And how beautiful that we havecome back to this, unfortunately
in this way, but because we didhave some time to think, okay,
if we're not doing Title Xadministrative stuff, we do have
the bandwidth then to have abrick and mortar clinic and it's
(25:13):
the clinic of our dreams,right?
It's all the feedback we'veever received from patients and
we're doing it.
And it's, and that's the thingthat's really gotten us through
the last few months is thisforward momentum and excitement
that we all feel that we can dosomething for our people.
Danielle (25:30):
And we can't give up because when you commit to this
work, you commit to to holdingthe line.
And we're aware that we arecertain to take more losses it's
gonna get worse before it getsbetter and it's gonna get better
(25:52):
in an uneven pace it's gonnaget better everywhere before it
gets better in the South so wewant to hold the line for our
people and Ii think we're hopingto remind people that you don't
have to give up, that you canget caught trying
something else.
What we have been hearing isthat many funders are still
(26:16):
waiting to see how bad it'sgoing to get.
And we encourage them to comedown to Mississippi and talk
with us, meet with our patientadvocates, and see how bad it is
becoming. And we don't deserveto have to wait to see how bad
it's going to get.
We deserve a vision ofabundance that tells us however
(26:42):
bad it is, together we can dreamand work toward the best.
And that's really what Convergeis based on is this desire for
folks here in the South who welove, who we are, that we
deserve the best.
(27:02):
We're not waiting to see howbad it's going to get.
It's really bad.
We deserve better.
And we can just act on that.
Jennie (27:12):
Okay, y'all, I hope you enjoyed the stories from these
amazing Title X providers.
I am so grateful to them forsharing their stories and so
that you can hear from them whatthe implications of this
withholding of funds has meantto them and to their programs.
Like I said, we have three moreproviders that are going to be
sharing their stories in thenear future.
So stay tuned.
(27:32):
It'll either be next week orthe following week.
And then we'll have the SupremeCourt break down, you know,
whichever week we don't have theTitle X one.
With that, hope everybody has awonderful holiday weekend and I
will see y'all next week.
[music outro] If you have anyquestions, comments or topics
you would like us to cover,always feel free to shoot me an
email.
You can reach me at Jennie,J-E-N-N-I-E at
(27:55):
reprosfightback.com or you canfind us on social media.
We're at rePROs Fight Back onFacebook and Twitter or @repros
fb on Instagram.
If you love our podcast andwant to make sure more people
find it, take the time to rateand review us on your favorite
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podcast, you can also donate onour website at
(28:17):
reprosfightback.com.
Thanks all.
Welcome to rePROs Fight Back, a podcast on all things
related to sexual andreproductive health, rights, and
justice.
Hi rePROs, how's everybodydoing?
I'm your host, Jennie Wetter,and my pronouns are she/ her.
So y'all, I hope everybody islooking forward to having a long
holiday weekend.
I hope you have some fun plans.
(00:24):
My fun plans are nothing, andI'm very much excited about it.
This is one of those holidayswhere I stick really close to
home with all the fireworks, andthere are a lot of fireworks in
my immediate neighborhood.
It's really loud, and the poorkitties get really upset, so
Luna tends to hide under my bedand just like in the far corner
(00:47):
against the wall and there'slike she's just real upset and
Cinder sticks really close to meand wants to just be within a
couple feet of me while they'reall going off so I tend to stay
home so I'm here for thembecause they do get pretty upset
with all the fireworks.
It's weird lots of other loudnoises don't bother them but
(01:09):
fireworks they really- they arenot a fan.
So yeah, I'm looking forward tohaving a pretty chill weekend.
Might do some baking.
We'll see.
But mostly, I think it's goingto be pretty quiet, which...
I'm here for it.
I'm excited because there is somuch happening right now.
We're not going to get into allof it because there are so many
things happening, but I amrecording this on Friday, June
(01:30):
27th, and there were six SupremeCourt decisions handed down,
not counting ones earlier inthis week.
So, there has been so muchgoing on and there were so many
bad rulings out of the SupremeCourt.
They're going to have reallynegative implications on
people's lives that there isjust a lot to talk about.
And we'll have a wrap-upepisode where we'll talk about
(01:50):
some of the cases related tosexual and reproductive health.
I'm in the process ofscheduling that.
It'll either be next week orthe following week.
So there's just a lot of piecesmoving.
And like I said, there is somuch to talk about.
We already talked aboutSkrmetti.
One of the other big ones thatcame down today when I'm
recording it is the one aroundschools and LGBTQ books.
(02:13):
And the Supreme Court said thatschools have to allow parents
to opt out of any informationthat conflicts with their
religion.
And the school district waspretty clear that these opt-out
policies were not workable.
So that means that kids are notgoing to be getting those
inclusive books as much becausethe opt-out isn't workable to
(02:36):
have to send those kids out andfind something else for them to
do during that time.
So that just means that kidsaren't going to be able to see
books that represent their fulllived experience.
And that's pretty tragic.
And there's been so much goingon right now around banning
books and it's alwaysdevastating because we should
(02:59):
not be banning books.
I know that seems like itshould be just such a basic,
simple statement, but it hasreally become...
really been taking on steam thelast several years. And you're
seeing more and more of that,but I was definitely brought up
with the, the read all thethings, learn all you can.
And as a big book person, Ialways make a point of reading
(03:22):
banned books and celebratingbanned books week.
I usually read a banned bookduring that week.
So, I don't know.
This one struck close to homebecause, like I said, big
reader.
The other big case that I thinkI'll take a moment to talk
about and it relates to today'sepisode because it's kind of
related is the Supreme Courtdecision that said that people
(03:47):
don't have a right to a specificprovider under Medicaid.
So, this case was aboutbasically trying to kick Planned
Parenthood out of Medicaid inSouth Carolina.
So yeah, so now the SupremeCourt says that you're not
entitled to a specific provider.
And so states are now free tokick Planned Parenthood out,
(04:09):
which is what the big impetus ofthis case was.
But I think it's just reallyimportant to note that it
doesn't stop there.
It's saying that you don't havethe right to any specific
provider.
So this could impact othersexual and reproductive health
providers, not just PlannedParenthood, you know, access to
gender-affirming care.
I think there's going to be anykind of number of ways you can
(04:31):
see this that is going toprevent people from accessing
sexual and reproductive health.
And it's just really importantthat not all providers except
Medicaid and Planned Parenthoodwas a really important role in
ensuring that you were able toget affordable contraception and
(04:51):
breast exams and STI treatmentand any number of other things
, and often people on Medicaid,that was like their one contact
with the healthcare system andit came through Planned
Parenthood.
So I just...
it's going to have really bigimplications, and we'll talk
about it when I do the SupremeCourt wrap-up, but this is also
(05:14):
one that we will do a deeperdive and do an episode just
specifically focused on this andthe implications around it.
So stay tuned.
I'll be working on getting thatout in the near future as well.
But I said that's related totoday's episode because there is
another way that sexual andreproductive health providers
have been attacked, and that isthrough Title X.
(05:37):
I did an episode earlier thisyear talking about the ways the
administration is attacking theTitle X program.
I'll drop a link in our shownotes so that way you can refer
back to what has been going on.
We're not really going to talkabout all of the things that
have been happening in thisepisode.
This episode, we're reallylucky to have two Title X
(05:58):
providers come on and tell theirstories of what have been the
implications of theadministration withholding
funding from them.
So I'm very excited to sharethat with you.
We have three more providersthat we'll be doing another
episode with either next week orthe following week.
So I'm very excited to have youhear their stories and and see
(06:19):
what is happening.
So, the two providers we havetoday, one is from Missouri and
the other one is based inMississippi. [music transition]
Michelle (06:28):
So, my name's Michelle Trippiano.
I am the Executive Director forMissouri Family Health Council.
And since April 1st, when wereceived notice that the funds
were going to be withheld, ithas been very difficult for our
organization and our healthcenters and the patients that we
serve.
Health centers have beennavigating funding issues,
(06:51):
they've been navigating concernfrom their patients about
whether or not they can stayopen.
They've been navigating stressfrom their staff regarding
whether or not staff are goingto have to be laid off.
And ultimately, patients arethe ones who are going to be
lost in all of this.
(07:12):
And so, since April 1st, we'vebeen working really hard to
raise emergency funding to tryto ensure that there's been no
disruption in care.
And since that time, we've beenable to maintain all of our
services, but we know that thattime is not going to last much
longer and that we are facingreally difficult decisions in
(07:34):
the upcoming months.
Our network serves over 35,000patients across the state from
very small rural health centersto larger urban health centers.
And we know everyone's going tobe impacted, but especially
those small rural healthcenters.
That is where we are mostconcerned that those health
(07:56):
centers rely heavily on thoseTitle X funds.
And without those Title Xfunds, it's going to be near
impossible for those healthcenters to stay open.
And for most of those patients,that health center is their
only access point.
And so we know that thedevastation is gonna be both
immediate, but it's gonna havelong-term consequences as a
(08:20):
result of the crumbling of thepublic health infrastructure
that is beginning to take place.
And so, we're really concernedabout maternal health outcomes
in the future, about the rateand rise of STI rates, but just
the fact of that people may nothave access to basic, we're
(08:41):
talking basic family planningand health services is going to
be really detrimental.
And so, right now, our healthcenters are scrappy.
They are committed, they arepassionate, and that they are,
you know, doing everything thatthey can to, again, not have any
disruption in care.
(09:02):
But we know that that cliff is,you know, just a few weeks
away.
And it is beyond disappointingthat the federal government is
using Title X and is usinggrantees as a political pawn.
And that ultimately, again, itis patients that are going to be
suffering.
I mean, we've seen so much harmcome upon the network and our
(09:26):
patients over the last severalyears from abortion bans, from
misinformation, that patientsare already left really kind of
confused and mistrustful of ahealthcare system.
And so the fact that so manypatients have a provider that
they trust, that they know thatthey can go to for accurate
(09:47):
information, that they know thatthey're going to be in a safe
and accommodating space.
And for that just to go away,and to not have anywhere else to
go, is also just really I meandetrimental to the psychological
safety of our patients andagain it's going to have just
long-term impact and increasethat mistrust and distrust of
(10:11):
providers.
We are still hopeful that thefederal government will release
their funds that we along withthe other impacted grantees are
all in compliance and haveresponded accordingly and while
it has been 80-something dayssince the funds have been
withheld, and we know that eachday without funds is a day
(10:34):
closer to health services beingeliminated in our state, that
the federal government will seethat we are in compliance and
that they will release thosefunds so that, again, services
can continue without disruptionand that we can continue to meet
the needs of over 35,000patients throughout the state.
Danielle (10:57):
I'm Danielle Lampton, co-founder and co-executive
director at Converge, based inJackson, Mississippi.
Jamie (11:05):
And I'm Jamie Bardwell, the other co-founder and
co-director of Converge, alsobased in Jackson, Mississippi.
I will never forget being on aplane headed to DC for the
[National Family Planning & Reproductive Health Association]conference and getting a text
that said, I'm hearing Convergeis on the withheld grant list.
(11:29):
And I remember sobbing on thisplane and texting Danielle and
you calling me immediately andhaving this like almost out of
body experience.
And that image is forever stuckin my brain when I think about
(11:50):
this situation that we are in.
Danielle (11:54):
And it's also, in a lot of ways, a good reminder
that this withholding of fundshas massive impacts for our
communities, for policy in ourstates.
It also has real impacts on thepeople who do this work, like
(12:14):
us.
So, I was not traveling to theNFPRHA conference because my
father has a terminal illnessand I needed to be a bit closer.
And so we get this initialnews.
We're separated.
Jamie's on a plane about totake off.
You were on the tarmac.
I am alone in our office.
(12:36):
And I remember thinkingsomething that I still think
almost every day, which is, whatcan we even do?
Because I think the firstemotion is, is utter
powerlessness and fear.
We're terrified.
I'm still terrified.
(12:57):
I guess now we're over threemonths in.
We at Converge had to lay offhalf of our staff.
That was 10 people.
Those are 10 people who gave upa lot to dedicate their time to
quality reproductive care inthe Deep South.
(13:19):
So, we miss them.
We had to stop contracts withour clinical partners, of
course, which means that inshort order, clinics had to
start reducing hours, scalingback services, charging for care
that otherwise was free or lowcost.
Those clinics are alsoexperiencing the kind of mental
(13:43):
strain that we at Converge areexperiencing, and grantees all
over the country, people, in themovement and in other movements
are feeling that terriblepressure, the crushing sense of
powerlessness.
It's terrible and it's having Ithink lasting impacts all over
(14:08):
our movement.
Jamie (14:09):
You know, of course this is the anniversary this month of
the Dobbs decision and thereare so many parallels in
Mississippi, especially aroundpost-Dobbs and post the Title
X freeze, because back whenDobbs happened, so many people
in Mississippi already thoughtabortion was illegal anyway,
(14:30):
because it's so confusing, thisnetwork of laws and, you know,
the average person who needsthis care cannot understand what
is legal, where, when, and how.
I mean, I think I barely hadunderstanding of this and I'd do
this all day long.
And so, when the Title X fundswere frozen, we had almost the
(14:53):
same thing.
It was like, okay, well, wherecould I go for contraception
that's free or low cost?
No one knows.
You know, we're stillconsidered a Title X grantee,
but we have no money.
So, what about these clinicsthat were receiving funding from
us in March of this year, butcome April, we can't give them
(15:13):
any money?
You know, we were all at a lossreally as to how to explain
this because there was noinformation coming from HHS.
And the consequence again wasthis massive confusion.
And when you have so muchconfusion, people just don't get
the care that they need.
And, again, that includes notgetting birth control, which of
(15:35):
course contraception is, basichealth care that people want.
But it also means that patientsare going to have to delay or
even just forego preventive carebecause it won't be able to be
offered at a discount becausethe only place open is too far
away, wait times...
(15:57):
A lot of health outcomes aregoing to suffer.
We think there are going to berising rates of STIs and
increasing rates of STIs thatare perfectly treatable.
that simply go withouttreatment.
Unintended pregnancies, laterstage diagnoses of breast and
cervical cancers.
Of course, later diagnosisoften means a terrible outcome
(16:21):
for women.
So, I think there are going tobe these sort of measurable
health outcome impacts, but toJamie's point, there's also this
terrible impact of chaos in aspace where we're already
working about as hard as we canto get reliable, consistent,
(16:44):
medically accurate informationto our neighbors.
And now having this additionalconfusion means that it's even
harder to help people know wherethey can get what to them is
really simple, basic healthcare.
And, you know, we...
created an entire Title Xnetwork basically from scratch
(17:10):
when we won this grant for thefirst time in 2022.
I mean, prior to Convergewinning the grant in 2022 for
Title X, the Mississippi StateDepartment of Health had been
the sole Title X grantee andthey used Title X funds to prop
up their health departments.
And what we found from actuallyworking at the health
(17:30):
department was that people werenot getting the quality care
that they needed and wanted.
And we felt strongly then, andobviously we do now, that we
need to be part of the solutionof figuring this out.
So, we left the healthdepartment and with very little
money, $150,000, and I was aboutto have a baby, and we thought
(17:54):
to ourselves, like, we canfigure this out.
And we spent, you know, a goodtwo years years talking to
clinics, talking to patients,doing all this groundwork.
And so when we applied theTitle X grant, we were like, we
have a great strategy.
(18:14):
And we won.
It was a huge deal.
And so we started working veryquickly with community health
centers because that's reallythe medical home model that we
would want people to have accessto.
The health departments werereally providing just kind of
bare bones care, kind of yourtraditional public health
services, but not the qualitycare that we wanted people to
(18:37):
have.
And it was a slog to get all ofthese FQHCs to say yes to Title
X, especially with such kind ofbad taste in their mouth from
previous attempts at trying todo Title X with the health
department, where there was nomoney involved.
And we were offering them moneyand technical assistance.
And we actually were eager toreturn their phone calls and
(19:00):
answer all their questions.
And so we created thisbeautiful statewide network.
And it was going so well.
And for it to happen in thisway, I will never get over how
heartbreaking the whole thinghas been.
For us as leaders, for ourorganization, and obviously for
(19:20):
the people that we serve, it hasbeen, I think, the worst
possible outcome I could haveimagined in this administration.
Danielle (19:28):
And there's something especially difficult about the
timing for us.
It felt...
for us, for our team, for ourclinical partners, we're hitting
our stride in Mississippi andTennessee.
We are facing down a crisis ofaccess, a crisis of mis- and
(19:56):
disinformation, a super hostilepolicy environment, but we're
building.
We're doing it.
And I think that we...
anticipated that the incomingTrump administration would mean
we'd have to get super focusedon holding the line as many
(20:19):
places as we could for as longas we could.
I did not anticipate takingsuch a serious hit so early.
We didn't get the chance to doany of the things we wanted to
do.
We didn't even get to do theshouting.
Yeah.
But...
I think that is also true thatfrom this experience of the
(20:48):
funds being withheld, we havebeen reminded of the thing that
also saw us through andcontinues to see us through
post-Dobbs, which is thesolutions for the needs down
here in the South—the solutionscome from the soil, the
solutions come from the place.
(21:10):
So, in community with ourclinics, with our patient
advocates, with each other,we've been able to gather
ourselves and think about thatsame question we had at the
beginning which is (21:27):
what what can we do continue to demand
that we receive some informationfrom HHS about our funds that
are currently withheld?
We have complied with theirrequest for information and
would like for them to thenprovide us an update.
(21:48):
We received nothing.
What we have decided is that wecan continue to increase the
number of places people can getaccess to contraception.
It feels like the politicalwinds are definitely blowing in
(22:10):
the direction of increasedpressure to stop certain kinds
of contraceptive care, torestrict or limit certain kinds
of contraceptive methods.
And so, we're out there withour telehealth operation trying
to make sure that people knowthat they can still get a wide
(22:33):
array of contraceptive methods,but it's devastating that we're
here.
And man, none of it had to bethis way.
Jamie (22:42):
And after the initial shock and sadness and
disappointment, we very quicklyrealized, okay, we have a job to
do here.
There are no Title X designatedclinics in Mississippi.
And we must serve our people.
And so we very quicklycommitted that we would not stop
telehealth.
(23:02):
We had no Title X fundssupporting it.
So, we're relying on privatedonations, which we had never
really done any kind of campaignto raise money for individuals
because we didn't need to,right?
And using foundation andprivate money for our telehealth
operation, we continue to dofree at-home STD test kits and
(23:25):
treatment.
The only organization inMississippi doing that, still
doing that.
And then we thought, well,gosh, like, why not us?
Why can't we also have a clinicpresence?
Like, we've been saying, okay,clinics, we'll give you this
money if you'll agree to thesestandards and quality
(23:45):
improvements.
And we thought, we know allabout that.
So we signed a lease with12-month lease for a clinic
space in the Jackson MedicalMall.
And it's an underserved area ofJackson where the main tenants
had decided this summer to leaveand go out to the nice suburbs.
(24:05):
And so there's this huge voidin here.
And to Danielle's point, we'redoing the opposite of fleeing.
We are committing that we'regoing to be here.
And so September 1st, theConverge Clinic will operate.
And it is so exciting to knowthat we would have not moved
(24:29):
into this space so quickly ofoffering direct clinical care,
brick and mortar, without havinglost our Title X funds.
And that's kind of weird tosay, but Title X is really
complicated and takes so muchtime to administer.
And so we were really likefocused in on that, right?
And we had decided before weeven started Converge that a
(24:51):
brick and mortar clinic was oneof our dreams.
And how beautiful that we havecome back to this, unfortunately
in this way, but because we didhave some time to think, okay,
if we're not doing Title Xadministrative stuff, we do have
the bandwidth then to have abrick and mortar clinic and it's
(25:13):
the clinic of our dreams,right?
It's all the feedback we'veever received from patients and
we're doing it.
And it's, and that's the thingthat's really gotten us through
the last few months is thisforward momentum and excitement
that we all feel that we can dosomething for our people.
Danielle (25:30):
And we can't give up because when you commit to this
work, you commit to to holdingthe line.
And we're aware that we arecertain to take more losses it's
gonna get worse before it getsbetter and it's gonna get better
(25:52):
in an uneven pace it's gonnaget better everywhere before it
gets better in the South so wewant to hold the line for our
people and Ii think we're hopingto remind people that you don't
have to give up, that you canget caught trying
something else.
What we have been hearing isthat many funders are still
(26:16):
waiting to see how bad it'sgoing to get.
And we encourage them to comedown to Mississippi and talk
with us, meet with our patientadvocates, and see how bad it is
becoming. And we don't deserveto have to wait to see how bad
it's going to get.
We deserve a vision ofabundance that tells us however
(26:42):
bad it is, together we can dreamand work toward the best.
And that's really what Convergeis based on is this desire for
folks here in the South who welove, who we are, that we
deserve the best.
(27:02):
We're not waiting to see howbad it's going to get.
It's really bad.
We deserve better.
And we can just act on that.
Jennie (27:12):
Okay, y'all, I hope you enjoyed the stories from these
amazing Title X providers.
I am so grateful to them forsharing their stories and so
that you can hear from them whatthe implications of this
withholding of funds has meantto them and to their programs.
Like I said, we have three moreproviders that are going to be
sharing their stories in thenear future.
So stay tuned.
(27:32):
It'll either be next week orthe following week.
And then we'll have the SupremeCourt break down, you know,
whichever week we don't have theTitle X one.
With that, hope everybody has awonderful holiday weekend and I
will see y'all next week.
[music outro] If you have anyquestions, comments or topics
you would like us to cover,always feel free to shoot me an
email.
You can reach me at Jennie,J-E-N-N-I-E at
(27:55):
reprosfightback.com or you canfind us on social media.
We're at rePROs Fight Back onFacebook and Twitter or @repros
fb on Instagram.
If you love our podcast andwant to make sure more people
find it, take the time to rateand review us on your favorite
podcast platform Or if you wantto make sure to support the
podcast, you can also donate onour website at
(28:17):
reprosfightback.com.
Thanks all.
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