Family planning clinics may have to return or destroy medication

 
By Rebecca Anzel
Capitol News Illinois
ranzel@capitolnewsillinois.com
Updated 7/30/2019 5:25 PM

SPRINGFIELD -- Health clinics overseen by Illinois organizations that opted not to receive federal family planning dollars may have to return or destroy contraception and other medication purchased at a discount.

All three of the state's family planning groups -- the Illinois Department of Public Health, Planned Parenthood of Illinois and Aunt Martha's Health & Wellness -- are declining millions in federal grants after a court allowed new rules governing the Title X program to take effect.

                                                                                                                                                                                                                       
 

Forgoing the funding removes the organizations, and the clinics they oversee, from the family planning program. The decision might also eliminate the clinics' eligibility for a federal drug pricing program that allows safety net facilities to purchase medications directly from drug manufacturers and wholesalers at discounted prices.

Once clinics are no longer participants, they are not permitted to keep any of the birth control medication, intrauterine devices, treatments and other drugs purchased through the initiative.

The 340B program, overseen by the Health Resources and Services Administration, "enables covered entities to stretch scarce federal resources as far as possible, reaching more eligible patients and providing more comprehensive services," according to the agency's website.

The amount of medication Illinois clinics will need to dispose of depends on the facility, with factors including how many patients it serves and its inventory, a spokesman for HRSA said in an email. He clarified the rules apply to the products purchased through the program at a discounted price from a drug manufacturer or wholesaler.

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There are 1,423 health facilities that participate in the drug pricing program in Illinois. Of those, 68 are Title X grantees, according to HRSA data.

Planned Parenthood's clinics will not be affected by the organization's departure from the Title X program, Brigid Leahy, senior director for public policy, said.

"We've been anticipating these changes for months so we have been monitoring inventory closely," she said. "Because of this, PPIL will not need to discard or return any medications."

It is unclear how the 72 clinics overseen by the Department of Public Health might be impacted.

A spokeswoman did not directly respond to questions about whether the department has a plan to ensure service is not disrupted for patients as it complies with the rules governing the drug pricing program, or whether additional resources will be expended replacing clinics' supply of medication.

"IDPH's priority is ensuring that patients have access to comprehensive reproductive health care in Illinois, including birth control and other drugs," she said in an emailed statement. "We continue to evaluate options to make sure that the delegate agencies in Illinois are able to provide all necessary care."

                                                                                                                                                                                                                       
 

"IDPH continues to evaluate options during these unprecedented times," she added in a separate email.

Democratic Gov. J.B. Pritzker's office did not respond to a question about whether removal from the drug pricing program factored into his administration's decision for Illinois to withdraw from the Title X program.

A representative for Aunt Martha's also did not return a request for comment about how its nine clinics might be affected.

According to the law that governs the drug pricing program, a clinic "shall not resell or otherwise transfer the drug to a person who is not a patient" of that clinic.

"Therefore, if a Tile X clinic loses their eligibility as a 340B covered entity, the statute prohibits the reselling or transferring of 340B drugs to anyone who is not a patient of the entity," an HRSA spokesman said. "Subsequently, the clinic would not have any eligible patients for the remaining 340B drugs in stock since they no longer participate in the 340B Program."

Some options for disposing of the medications, the spokesman said, may include returning them to the drug manufacturer or wholesaler, transferring them to "an associated covered entity site" still eligible under the program, or destroying them according to state law.

There is "no set timeline" for doing so, he added.

One way health facilities could avoid losing eligibility in the drug pricing program is if they have a co-classification as a federally qualified health center, rural referral center or another kind of safety net clinic or hospital. That is how Planned Parenthood of Illinois' clinics are protected -- they are dually categorized as Sexually Transmitted Disease clinics.

The state's three family planning groups announced they would forgo federal Title X grants after new U.S. Department of Health and Human Services rules governing the program were allowed by a court to take effect.

In part, they prevent medical personnel at clinics that accept grant money to "perform, promote, or support" abortion and require there be a "physical and financial separation" between clinics that provide the procedure.

In a statement, a department spokesperson said "Title X grantees have been given specific instructions on how to withdraw from the program."

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