Squeezed Out
How anti-abortion-rights activists and the OC Board of Supervisors teamed up to cut off funds to Planned Parenthood
*This article was altered on July 6.
When Orange County Republican strategist Mark Bucher met Lila Rose last summer, he was incredulous and ecstatic. The 20-year-old pro-life activist and UCLA history major with a cascading brown mane had impressed Bucher with the details of what she planned to do with her summer vacation: With a hidden camera in tow and disguised as a 13-year-old, Rose would infiltrate Planned Parenthood clinics around the country to hopefully catch them breaking statutory-rape-reporting laws.
“She said she thought this is what Planned Parenthood does, and sheNd like to try to prove it,” says Bucher, a well-connected lawyer from Tustin. “And then youNre like, sure, yeah, what are the chances of that?”
Bucher had heard of her activism—Rose founded a pro-life organization in her teens and had turned her attention toward Planned Parenthood in college. A large map of the U.S. with dots for Planned Parenthood clinics below the words “Exposing Planned Parenthood” adorns her homepage. Because thereNs nothing illegal or covert about any of the medical and educational services Planned Parenthood and other hospitals and clinics in the country provide, including abortion, Rose focused on the reporting laws, which, if broken, can result in criminal prosecution—and bad press. Her goal of targeting Planned Parenthood fits in with a national pro-life strategy to pressure state and local governments into pulling federal dollars from Planned ParenthoodNs network of community clinics because they perform abortions.
Although Rose didnNt videotape any violations at any Orange County (or California) clinics, what she filmed in Tennessee and Indiana would later serve as ammunition for Bucher, who says the videos were the catalyst for his own efforts to get the county to cut all funding to the organization. His success has generated a new, homegrown county fight over Planned Parenthood.
Bucher is chatty and affable, qualities that belie his political feats: He founded the influential, anti-union Education Alliance, helped qualify the stateNs first gay-marriage-ban initiative in 2000, co-founded the conservative-candidate-funding Family Action PAC, and is treasurer of both the OC Republican Party and the powerful Republican Lincoln Club. “When you get conservatives together, great things happen,” Bucher said at a recent Family Action luncheon.
He was impressed by the bravado Rose displayed in front of a group of Family Action members last year and decided to support her summer project. Although she wouldnNt reveal how much Bucher donated to her project, Rose says she definitely received financial support from Bucher and considers him one of her most avid and active supporters. “HeNs been following our work—and my work—for quite a while, along with others in Orange County,” she says.
The video she came back with, as well as the edited short clips she put up on YouTube, would pay off, especially for Bucher, who used the videos to alert county Supervisor John Moorlach (who received campaign money from Family Action PAC) that Planned Parenthood was receiving county funds—a fact that, according to Moorlach, came as a “shock” to him and the rest of the Board of Supervisors.
Although no county funds have ever gone to abortion services (Planned Parenthood is audited every year), in early March, the five-member, all-Republican board, citing their moral opposition to abortion, voted unanimously to cut off the $291,788 grant in tobacco-settlement funds the organization has received for the past nine years. In 1998, the attorneys general of 46 states settled their multiple Medicaid lawsuits against the four largest U.S. tobacco companies for $206 billion. The companies agreed to pay various annual amounts to the states, which would then distribute the funds to counties as tobacco-settlement-revenue (TSR) grants to pay for indigent medical primary and specialty care and smoking-related prevention and education. Counties decided how to spend their settlement funds; in Orange County, it was decided through 2000Ns Measure H. Planned Parenthood was using its share of the grant to pay for comprehensive reproductive-health education for teens, health-education training (often attended by county employees) and family-communication workshops.
Bucher, Moorlach and others viewed Planned Parenthood as having somehow surreptitiously wormed its way into the county budget, despite the organizationNs long track record in the county: Seed money to open its first OC clinic in 1965 was approved by the Board of Supervisors, and the county Health Care Agency (HCA) has long tapped Planned Parenthood to act as the primary health-care provider for thousands of women whom the countyNs dismal public health system no longer serves.
“One in three women have used Planned Parenthood at one time in their lives in Orange County,” says Stephanie Kight, senior vice president for Planned Parenthood of Orange and San Bernardino Counties. “WeNre a mainstream health-care provider, a primary provider. Women are turning to us in droves during these tough economic times. Lila Rose speaks to that small segment of the population who disagrees with one small part of our services.”
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On April 28, the board reinstated the organizationNs money through June because of potential illegalities, but it also directed the HCA to adopt a new policy that makes it tougher for local nonprofit clinics that provide abortions or abortion counseling to secure future county funding. Planned Parenthood believes it is being unduly targeted, and so far, the new policy seems to support that theory: The organizationNs most recent request for TSR funds for an in-patient clinic that would treat hundreds of young breast-cancer patients has been rebuffed by the HCA for more than a month, while all the other community clinics that applied for funds under the new policy have been approved for their blocks of money.
“The countyNs [two public] clinics refer patients in need of an abortion to us,” says Kight. “So by their own rules, they would not be eligible for tobacco-settlement revenue.”
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Jason Warner is talking about talking about sex.
“A lot of adults, we think that a teachable moment is, ‘Hey, sit down here; I need to talk to you.N And we kind of make this lecture out of it,” Warner says to a group of professional counselors, therapists, mentors and educators on the sunny afternoon of June 25 at Planned ParenthoodNs offices in Orange. “ThatNs one of the most uncomfortable situations, from what I hear from young people, to deal with. And it shuts them out.
“One of my favorite approaches is to use TV,” he continues. “After seeing Flavor of Love, or Flava Flav, whatever itNs called, where you have 10 women all flaunting for this one guy, ask, ‘Is that realistic? What did you think about that?N”
A laugh ripples through the class. Warner, a handsome health-education specialist in his thirties whose Trinidadian parents also work in the medical field, is giving his “Train the Trainer” workshop to professionals from the county HCA, UCI WomenNs Center, the UCI Health Education Center, Irvine Unified School District, the Child Abuse Prevention Center, Juvenile Hall, Cal State Fullerton, the Nurse Family Partnership program and others. The group is curious and attentive, scribbling notes as Warner talks, laughing with him and throwing out their responses to questions he jabs them with about kids who meet online, sex education for handicapped teens, abstinence, lubricants, STDs and everything else that falls under the umbrella of the day-long workshop that Planned Parenthood has been giving for the past nine years throughout the county—thanks to TSR funds.
Though the session will have plenty of laughs—including during a spirited, educational game of Sex Bingo—it is a bittersweet afternoon for Warner: This is the last Planned Parenthood health-education workshop to be paid for by a TSR grant. The HCANs new policy prohibits all community clinics applying for TSR funds from using the money for group educational workshops. The new policy restricts the grants for use solely for direct medical care between a medical professional and a patient. Planned Parenthood is now looking for ways to fund future workshops—including possibly charging for them.
A county employee asks what exactly is happening with the TSR funding to Planned Parenthood. “Unfortunately,” Warner explains, “they decided to cut funding for community clinics for health education.” A small slip of paper tucked into the groupNs packets explains further: “Our annual grant of almost $300,000 helped to sponsor events like this one as well as comprehensive sex-education classroom instruction across Orange County, including at-risk and underserved youth.” The group is perplexed. County employees want to know how itNs possible for the county to ask that they participate in these kinds of training sessions while cutting off the money to pay for them.
“This is exactly what we do in a high-school classroom, or for nurses, or for the Health Care Agency,” says Kight of such health-education workshops, which also include sessions with people who work at federally funded Women Infants and Children (WIC) program centers around the county. “This kind of education that extends far beyond our doors and into the community is so much of what we do—and is now no longer funded by the county.”
Planned Parenthood hasnNt accepted the countyNs sudden rejection of its services without a fight. After all, the organization has been intertwined with the county for decades; in 1965, it received $30,000 from the Board of Supervisors and opened the first outpatient, family-planning clinic at the Orange County Medical Center. Clinics sprang up throughout the county, with the support of supervisors and HCA in the following decades.
In the mid-1990s, following the countyNs massive bankruptcy, several public health clinics were shuttered. Planned Parenthood was asked on several occasions by HCA to absorb those clinicsN family-planning patients, who included men and women seeking contraception, OB/GYN exams and prenatal care.
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Planned Parenthood saw 75,000 patients in Orange County through the most recent fiscal year, which ended June 30—up 20 percent from the previous year. The majority of those visits—57 percent—were for contraception and well-woman OB/GYN exams. Only 7.1 percent were for abortion services.
Planned ParenthoodNs management expresses frustration that its services in the county, as well as its long relationship with HCA, have been ignored throughout the current controversy. “Our grant through the Coalition of Clinics for the tobacco funds was done exactly the same way all the other clinics applied for funding. There was no effort, I think, on anyoneNs part, to hide who these clinics were,” says Jon Dunn, CEO of Planned Parenthood of Orange and San Bernardino Counties. “We always provided reproductive-health education with the funds, and we did so, in part, because I anticipated that, at some point, someone might decide that they werenNt happy with Planned Parenthood getting the funds, and I wanted to be able to take the position that everything weNre doing with these funds is preventative in nature and is unrelated specifically to abortion except that it prevents unintended pregnancies.”
A recent call about a possible pregnancy to the number listed on the HCA website elicited an immediate referral to Planned Parenthood. “They can talk to you about all of your options,” the woman said on the phone. When asked if the countyNs two remaining public health clinics do prenatal care, the answer was a simple no and another referral to Planned Parenthood, which offers full prenatal-care services. The only “family planning” services the countyNs two clinics provide is “birth control,” she said.
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When Rose returned with her videos at the end of the summer of 2008, Bucher says, he was alarmed by what sheNd recorded, and he began looking into whether the local Planned Parenthood received county funding. “I have never before gotten involved in the [abortion] issue,” Bucher says. “It was her video that motivated me to do what I did.”
RoseNs footage—and the way she edited it—created a brief, national sensation. She caught two staffers in Indiana and one in Tennessee on tape suggesting to Rose, whose hair was bleached blond and who was posing as a pregnant 13-year-old with a much-older boyfriend, that she lie about her boyfriendNs age. Planned Parenthood, like any other health provider, is required by law to report any incidents of statutory rape to the police or Child Protective Services, so the women in the video, in essence, broke the law. Although the incidents caught on tape were isolated cases (Planned Parenthood has thousands of employees), they were enough to re-ignite the pro-life movement around its new media-savvy darling. Rose will not say how many clinics she actually visited, but, she says, she plans to release more videos.
“These are isolated incidents, and appropriate disciplinary action has been taken,” says Kight. “How many other clinics did she go to where nothing went wrong? Why wonNt she disclose those numbers? We are mandated by state law to report these incidents, and we take this very, very seriously. We always report. We must, by law. If someone at one of our clinics is not complying with the law, then we deal with it immediately. You have to understand that young girls between 13 and 15 years old are less than 1 percent of the patients we see. Four out of five times, they come with their mother or an adult female relative. Remember, they canNt drive. We always pay attention for possible signs of abuse in these situations because theyNre so rare.”
Rose sent out press releases, appeared on FOX News, and chatted with Rush Limbaugh and a string of other conservative radio talk-show hosts. Her sound bites, repeated again and again in slight variations, were down pat: Planned Parenthood receives $300 million in federal funding and, according to Rose, the organization is endangering young girls.
Within Planned Parenthood, the videos created enough upheaval to launch internal investigations and bring about firings and resignations. They prompted the Tennessee state legislature to pass laws dedicated to stripping Planned Parenthood of its state funds.
Bucher began bugging Moorlach about the countyNs ties to Planned Parenthood after he saw that the organization was listed on HCANs website. “I had no recollection that anything was going to sex education, or that kind of component, in this whole deal,” says Moorlach of the TSR funds. (Moorlach once said he didnNt believe teens should be given contraception.) “Mark approached me and said, ‘Hey, you guys are funding Planned Parenthood.N I said, ‘No way. I have never seen their name on any agenda item.N”
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After some digging, Moorlach discovered that the organization had, in fact, been receiving a TSR grant for the past eight years. He was beside himself. A straight-talking, amiable supervisor who laughs easily and is known for his razor-sharp analyses of perceived government waste and excessive spending, Moorlach rose to stardom during his 12-year tenure as the countyNs treasurer-tax collector and was easily elected to the Board of Supervisors in 1996. Despite his deep involvement in county politics and conservative issues, he seemed unaware of Planned ParenthoodNs long history in the county.
“For me, it was one of those shock moments,” he says. “I wanted to know, ‘How did this happen?N” He felt deceived by the HCA, he says, and at a February board meeting, he asked HCA to report back with information on all the community nonprofit clinics in the county receiving funds from the TSR.
The agency says it never had any obligation to disclose subcontractors to the board, only the contractor, which was the Coalition of Community Clinics, an organization that oversees the distribution of state funds to 19 clinics in the county. “Nothing was deliberately obfuscated,” says Bob Gates, deputy director of indigent medical services for HCA. At any time, he says, the board could have asked and been told which clinics were receiving funds. The agencyNs county website, as well as the CoalitionNs website, openly lists Planned Parenthood as an affiliate nonprofit clinic.
Once the information was submitted, Moorlach was unequivocal: He didnNt believe funding should go to Planned Parenthood because he was morally opposed to abortion. The board agreed with him. “I think abortion is a moral issue,” Supervisor Chris Norby said at the March 10 meeting. “I donNt believe the county should be funding abortion.”
At that meeting, the board voted unanimously to suspend Planned ParenthoodNs $291,000 grant for the rest of the fiscal year.
The fact that the TSR funds Planned Parenthood was receiving had not been used for abortions didnNt seem to matter. And the board did not discuss whether the county should continue giving TSR money to local private hospitals that also perform abortions, or to HCA itself, since the two remaining public county clinics refer pregnant patients to Planned Parenthood to discuss all of their options, including abortion.
That morning, Moorlach sent an e-mail to constituents: “Not to generalize, but when you contact a law firm that specializes in bankruptcies, they most likely will advise you to file for bankruptcy,” Moorlach wrote. “If you go to Planned Parenthood, they are most likely to recommend their specialized surgical solution, which they provide and are compensated for, which appears to be a conflict of interest.”
Planned Parenthood fought back, threatening to sue and gathering petition signatures from local supporters. In April, the board voted 3-2 to reinstate Planned ParenthoodNs funding through June (Moorlach and Bill Campbell dissented) and to adopt a new set of policy rules for the next round of grant applications.
The new policy requires that HCA list all the clinics the agency approves for TSR funds and that the clinics specifically outline how the money will be used for direct medical services. Funds can no longer be used for any type of group-education purpose, which includes not only sex education, but also diabetes, cancer, dental and other types of group workshops given at other clinics. The new policy also includes specific caveats for clinics that perform abortions or give abortion counseling.
“The ability to use the money for what the clinics determine the needs are in the community has been hampered,” says Isabel Becerra, director of the Coalition of Orange County Community Clinics, a separate nonprofit that works with HCA and oversees the distribution of the TSR funds. “As a funder, the Health Care Agency is acting within their right to determine what the funding is being used for.”
Some clinics rely on the TSR funds for up to 30 percent of their budgets. Becerra says they can no longer use the funds for overhead costs, education services or case managers. “For the past eight years, it wasnNt restricted to this level,” she adds. “Clinics were allowed to design programs that they felt were necessary for their communities.”
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In the past month or so, Moorlach has shifted his rhetoric away from abortion, saying now that this is really about money and how itNs being spent in the county. “I came here to fight deficits, not abortions,” he says.
In a way, Moorlach has returned to his old fight over Measure H. Back in 2000, Moorlach, who was serving as county treasurer, had countered the initiative with Measure G, which restructured Measure H so that a significant amount of the health-care money for the poor would be used instead to reduce the countyNs bankruptcy debt. The fight, which pitted Moorlach against Measure H proponent Todd Spitzer, a county supervisor at the time, was messy (see R. Scott MoxleyNs “Behind the Smoke,” Nov. 9, 2000) and resulted in an overwhelming vote in favor of Measure H.
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“There are programs where federal and state funding allow for providing abortions. ItNs something we have to administer and canNt change. I serve on the Cal Optima board and have never made an issue of that funding,” he says. “Measure H is unique, and we do have control over where that money goes.”
But should that control be predicated on his and other supervisorsN personal moral beliefs? “Abortion funding is very divisive among constituents. If youNre going to have half of your constituents upset with it, then why are we there when weNre already providing sex education at the schools and have other critical needs?” he asks. “How do you justify it? I think thatNs probably where most of us are coming from.”
Simply put, Moorlach doesnNt think Measure H money should go to Planned Parenthood for health and sex education—even if county employees and health-care organizations rely on such education. “WeNre in a recession; the money goes to community clinics for family and specialty care for families. Is education for STDs and sex education a real high priority? Is that really where the money should be going?” He said no, and the board agreed with him.
He says this doesnNt mean he will block Planned Parenthood from receiving funds in the future if they meet the new criteria, which require clinics that perform abortions and are seeking Measure H funds to spend the money in a location where abortions are not performed and to financially separate the funds from money used for abortion services.
Being seen as tough on Planned Parenthood certainly plays well with MoorlachNs constituents. At a luncheon two weeks ago at the Pacific Club—an opulent, wood-paneled private establishment in Newport BeacH N Mdash;for the Family Action PAC, guest speaker Moorlach brought up Planned Parenthood. “ItNs been like dealing with the demon from the pit,” Moorlach told the group of about 22, who politely chuckled and sent a soft wave of applause through the room when Moorlach told the story of how the HCA would now be more transparent in disclosing clinics that receive public funding, thanks to the work of the board and an unnamed “constituent” who had pestered him to look into the issue. Bucher, seated next to Moorlach, smiled wide.
When asked later about the demon comment, Moorlach laughs. “There are some organizational names that just invoke some kind of reaction,” he says. The demon comment was a reference to some of the e-mails he received from supporters of Planned Parenthood during the March debates—some of which were very polite, some of which “were just attacks,” he says. “How is that supposed to help me change my mind?” He notes that his chief of staff met with a Planned Parenthood board member, and heNs not averse to having the county fund them in the future.
While all the other clinics had their new proposals approved within the past month, Planned ParenthoodNs proposal has not been. Their most recent effort to secure funding for a much-needed comprehensive breast-cancer clinic for women younger than 40, who donNt qualify for any publicly subsidized treatments, has been rejected several times by HCA. “We were fully confident that our proposal met all their new rules and restrictions,” says CEO Jon Dunn. The agency rejected the first application in late April, not because it violated any of the new policy rules, but because it included the hiring of a nurse case manager, which the agency said did not qualify as direct medical-care personnel.
Planned Parenthood has since revised the proposal several times, eliminating the nurse case manager. Gates says they are still openly negotiating the proposal and that the grant is still set aside for Planned Parenthood, pending the HCANs approval. If the agency signs off on the proposal, it wonNt have to go before the supervisors again, Gates says.
Even so, Dunn remains wary. “One of the things thatNs been very troubling about this whole process, and I think it leaves little doubt that thereNs a larger agenda here,” he says, “is that every time we attempt to comply with a new rule, thereNs another new rule.”
