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Pro-life Catholic medical group’s Title X application included contraceptive promise

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CALIFORNIA, April 18, 2019 (LifeSiteNews) ― Controversy continues to swirl around pro-life medical group Obria as its application for government funding in Texas comes to light.

Obria’s pro-life critics believe that the medical organization has compromised its original Catholic mission to provide pro-life medical services by agreeing to partner with groups that dispense contraceptives.

A reporter for the Houston Chronicle has published a copy of the application Obria made this year to receive Title X funding for its affiliates in Texas. Obria’s proposal, written on Obria letterhead, clearly states that it will “ensure” several forms of contraceptives.

[T]his project ensures that a broad range of family planning methods include: education and support related to abstinence, fertility awareness based methods (FAB) and the lactation amenorrhea method (LAM); condoms, diaphragm fit provision; combined oral contraception pills; 3 month hormonal injection; vaginal ring; and long-acting methods which include intrauterine and implantable devices. (pp 49–50)

Mauricio Leone, executive director at Obria Group, issued a statement to LifeSiteNews saying that the promise was made not by Obria, but by its Texas partner, the Heidi Group.

“The Obria Group agreed to partner with the Heidi Group in Texas in order to write a grant proposal on the condition that they would not use Title X funds for the distribution or referral of contraceptives,” Leone stated. 

“The Heidi Group took the lead in writing the grant proposal, and they used standard language that they had used in previous proposals. Unfortunately, in the final editing process of the 155-page proposal, the language in question was not edited out despite not meeting the conditions of our agreement,” he continued.

“At no time in the grant writing process was anyone at Obria responsible for the language in question, and we would not have accepted the grant under those conditions.”

According to the Title X application, the Heidi Group, the Community Wellness Clinic, and Midland Community Healthcare clinics, all sub-recipients of the Obria Group, are “specially trained and qualified with the capacity to deliver high-quality, culturally competent family planning service” in Texas “providing a broad range of family planning service” (p. 43).

The Obria application does exhibit slight confusion as to what family planning services are being offered. Page 52 states that “this project ensures that a broad range of family planning methods to include: abstinence education.” However, Page 53 abruptly begins with the incomplete sentence “FABM and LAM, condoms, diaphragm fitting and provisions, cervical cap, combined-oral contraceptive pill, progesterone-only contraceptive pills, 3-month hormonal injection, vaginal ring, and long-acting methods which include intrauterine and implantable devices.”

Page 53 then outlines education and advice to be given to clients about all these artificial forms of contraception, including information about their side-effects.  

However, on Page 90, after identifying key Obria personnel and staffing positions, the proposal clearly lists artificial contraceptives as one of the group’s projected expenses:

“Pharmaceuticals include birth control — oral contraceptives, Depo-Provera, LARCS [long-acting reversible contraceptives], diaphragms, implants, condoms, contraceptive patch, contraceptive rings, and prenatal vitamins.”

Contraceptive Requirements for Title X Funding

On April 1, the U.S. government announced that Obria had won a Title X grant of $5.1 million over three years for use in California.

The Houston Chronicle noted in March that the Obria Group’s bid for Title X funding had been rejected in the past because it “does not support the use of  condoms and other kinds of birth control beyond so-called natural family planning methods[.]” The Chronicle added, however, that this year’s Texas application said “all forms of contraception would be offered, as is required, thought it’s not clear whether that would be on-site or through referrals only.”  

Title X is the USA’s one federal grant program offering birth control and sexual health services to low-income and underinsured people. It requires applicants either to provide a broad range of contraceptive services or to partner with groups who do. 

According to the federal HHS guidelines, dated October 2018, the applicant has to keep tabs on its subrecipients: “An applicant may propose a family planning service project that either is comprised of a single provider or a group of partnering providers who deliver coordinated and comprehensive family planning services. For applicants that will not provide all services directly, the applicant must document the process and criteria it will use for selecting subrecipients as well as a plan to monitor their performance.”

The HHS guidelines stipulate a “wide range of family planning methods,” particularly “hormonal methods”: 

“If an applicant plans to only provide a limited range of family planning methods, they must select subrecipients who offer additional family planning methods or act as a subrecipient for another applicant,” the guidelines instruct.

In order to fulfill the requirements in the Title X statute, the project, made up of the applicant, and any subrecipients, must provide a broad range of family planning methods to clients throughout the proposed service area. A broad range of family planning services should include several categories of methods, such as: abstinence counseling, hormonal methods (oral contraceptives, rings and patches, injection, hormonal implants, intrauterine devices or systems), barrier methods (diaphragms, condoms), fertility awareness-based methods and permanent sterilization. A “broad range” would not necessarily need to include all categories, but should include hormonal methods since these are requested most frequently by clients and among the methods shown to be most effective in preventing pregnancy.

Other pro-life medical groups who have recently applied for Title X funding ultimately did not qualify because they would not provide or refer for artificial contraceptives.

One Omaha, Nebraska, pro-life health provider, Sancta Familia Medical, initially considered for the Title X grant, was ultimately rejected because it offered only natural family planning and would not partner with groups who dispense artificial contraceptives.

In a 2018 letter to Dr. Lloyd A. Pierre of Sancta Familia Medical, made available to LifeSiteNews, Tina Goodwin of Nebraska’s Department of Health and Human Services (HHS) explained that according to the Title X requirements, recipients who offer only one form of family planning must partner with a group that dispenses contraceptives:

“If an organization offers only a single method of family planning, it may participate as part of a project as long as the entire project offers a broad range of family planning services,” Goodwin quoted.

Subrecipient agencies must provide all family planning services listed in the ‘Required Services’ sections of the Title X Guidelines, either on-site or by referral. When ‘required services’ are to be provided by referral, the subrecipient agency must establish formal arrangements with a referral agency for the provision of services and reimbursement of costs, as appropriate.

Several pro-life medical organizations, including members of the Pro Women’s Healthcare Centers, have reached out to LifeSiteNews to voice their dismay that Obria, which has received funding from the U.S. Catholic bishops as well as Catholic private donors, has succeeded in receiving the Title X grant. They believe that it is impossible to receive Title X funding without compromising on a natural law stance. It is the doctrine of the Catholic Church that using artificial methods to render the marital act sterile is intrinsically evil because it is a direct violation of God’s purpose in creating sexuality. 

Obria Group insists that it neither prescribes nor refers for artificial birth control. 

Kathleen Eaton-Bravo, founder and CEO of the Obria Group, told LifeSiteNews, “Obria clinics have never distributed or referred for contraceptives and have no plans to do so.”

However, one of Obria’s subrecipients for Title X funding, the Community Wellness Clinic, states on its website that it provides several kinds of contraceptives and devices, including IUDs. Another of Obria’s partners, Midland Community Health Services, states on its website that clients can receive such methods as birth control pills, IUDs, and tubal ligations from its providers.

Modern birth control pills and IUDs are considered abortifacients because when they do not prevent conception, they endanger the normal implantation of a human zygote in the womb.

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