Gov. Bill Lee is looking to use state dollars to continue family planning services for low-income Tennesseans after the federal government denied the state's application for a longstanding grant that typically funds those services.
In a letter dated March 20, officials from the U.S. Department of Health and Human Services said they would not renew Tennessee's funding through Title X — which has covered contraceptive products, pregnancy testing and counseling, infertility services, and sexually transmitted infection testing and treatment, among other services, through the Tennessee Department of Health for more than 50 years.
In fiscal year 2022, Tennessee received $7.1 million in Title X funds.
Historically, those funds are distributed to health departments across the state, including two clinics in Hamilton County and numerous others across Southeast Tennessee.
The letter states the reason for not renewing the grant is because the Tennessee Department of Health's policy concerning pregnancy counseling is not compliant with a Title X rule that counseling must include information about abortion.
"Tennessee's policy must clearly state that the project will offer pregnant clients information and non-directive counseling on each of the following options: prenatal care and delivery; infant care, foster care or adoption; and pregnancy termination (unless clients indicate they do not want such information or counseling).
"Additionally, projects are required to provide referrals upon client request, including referrals for abortion," the letter states. "We understand that in some circumstances, those referrals will need to be made out of state."
In August, any action to terminate a pregnancy in Tennessee became illegal unless it's to remove a dead fetus or in cases in which a baby is delivered prematurely to increase the child's chance of survival.
In a response letter, Tennessee Department of Health officials expressed confusion over the grant ending, noting that an October report from the Department of Health and Human Services' Office of Population Affairs reviewing Title X programs found no issue with the state's policy.
"The department's counseling on infant care, foster care and adoption has not changed since they were last reviewed by OPA," the letter from state officials said. "The only thing that has changed is Tennessee law on abortion."
An earlier letter from Tennessee health officials argued the state's pregnancy counseling policy for Title X clients was compliant in that it covers the cases in which pregnancy termination is legal in the state.
"We do not construe the phrase 'pregnancy termination' to include every possible method of 'pregnancy termination,' such as abortion," the letter states. "Under the regulation's broad and undefined language, Tennessee's non-directive policy appears to be in compliance with Title X given the standard of care in Tennessee."
A budget amendment from the Republican governor includes a request for $7.5 million in recurring funding to replace the loss in federal dollars as well as a non-recurring $1.9 million to prevent a lapse in care for Tennesseans.
"The federal government is denying Tennessee funding that has supported critical maternal and family care for thousands of Tennesseans for decades," Lee spokesperson Jade Byers said via email. "As we discuss next steps with the Attorney General's office, Gov. Lee will fulfill his commitment to serving families by proposing to amend the state budget to include state dollars to fill the void caused by the federal government's decision."
Neither the Hamilton County Health Department nor the Department of Health and Human Services responded to a request for comment.