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“The attacks are relentless — any little angle they can chip away at what we do, they are doing it,” said Lisa Ecsi Davis, the clinic’s director of operations, who has worked at Tri-Rivers for 30 years. “It’s exhausting.”

“There are many at the political extreme who equate birth control with abortion,” said Michelle Trupiano, executive director of the Missouri Family Health Council, a private nonprofit that administers federal funding for family planning services in the state. “The attack on the full range of reproductive health care is going to continue.”

In a Senate committee hearing, the Missouri State Medical Association and Missouri Family Health Council testified for the bill. No residents spoke against it.

In 2021, the two Planned Parenthood health centers that participated in Missouri Family Health Council’s family planning services served 52% of the nearly 44,000 patients seen, said Michelle Trupiano, the nonprofit’s executive director.

“We remain hopeful that the state of Missouri will set ideology aside and work collaboratively with us to expand access to sexual and reproductive health care in Missouri,” Trupiano said. “MFHC will preserve the hallmarks of Title X: comprehensive, client-centered, non-directive health care for all clients, regardless of the ability to pay.”

Missouri Family Health Council Inc., serving 65 clinics statewide, continues to be the sole Missouri grantee to receive grants for the public health program (Title X). The council received $5.3 million.

The Missouri Family Health Council Inc. (MFHC) administers federal family planning dollars to clinics across the state, and in 2021 MFHC-funded sites provided family planning services to over 44,200 patients. More than half of those patients were served by Planned Parenthood, Michelle Trupiano, MFHC’s executive director, previously said.

With attacks on reproductive health services and rights on the rise in Missouri and across the nation, I believe St. Louis County’s efforts are a refreshing and welcome change.

Page’s order also directs the county health department to strengthen an existing partnership with the Missouri Family Health Council and seek other funding opportunities that would enhance the county’s contraceptive services.

Over half a dozen health care organizations, like the Missouri Center of Public Health Excellence, Missouri State Medical Association and Missouri Family Health Council, Inc., voiced their support for the proposal Tuesday, with no one testifying in opposition. The bill now heads to the Senate floor for consideration.

"The safety net is already at capacity and stretched very thin, it can take weeks for patients to get an appointment, and we need all the providers working together to meet the needs," Trupiano observed. "All this ideological attack does is further the disparities that already exist in Missouri."

“Anytime that they are trying to limit providers, that has a very negative impact on the overall safety net,” Trupiano said, “And at the end of the day, the care that patients receive.”

"Missouri Family Health Council runs The Right Time initiative, which executive director Michelle Trupiano says is focused on giving everyone free access to reproductive healthcare.

'One of the goals of the initiative is really to reduce inequalities that people may face and some of those inequalities may be based on location, especially for rural Missourians,' Trupiano says."

"January is Cervical Cancer Awareness Month, a disease that can be greatly reduced, or even eliminated, by screenings, getting vaccinated against the human papillomavirus (HPV) and raising awareness. Cervical cancer is the fourth most common cancer in women."

“Our providers are stretched,” Trupiano said. “We know there is a crisis in our health care field.”

“This tactic to limit providers is in violation of Medicaid to begin with,” said Michelle Trupiano, the executive director of Missouri Family Health Council Inc., which administers federal funds for family planning services.

"But our state’s elected officials are once again playing politics with it through the implementation of new regulations that attack Planned Parenthood, a vital family planning provider. Eliminating such a significant, high-volume provider will have a detrimental effect on all health care providers and those who seek care."

I am among the majority of Missourians who voted in favor of expanding Medicaid in 2020. I am also among the majority of Missourians astounded by the legislative maneuvers and litigation saga that followed, even after the people had spoken on the issue.

Seventy-six percent of Missouri residents, including large majorities across the political spectrum, believe the state legislature should increase access to birth control for Missourians, according to a new public opinion survey.

"Missouri being party to this lawsuit doesn’t change the need for high-quality, patient-centered family planning services or the many barriers Missourians face accessing healthcare," said Michelle Trupiano, executive director of the Missouri Family Health Council.

Sunday was World Contraception Day, an annual celebration to improve awareness of birth control and enable individuals to make informed choices about their sexual and reproductive health. During a standard year, it’s a time to reflect on the transformative impact of birth control. But this year – after the Missouri legislature risked destabilizing the entire state budget to eliminate IUDs and emergency contraception from the state Medicaid program – it’s something else entirely: a cautionary tale.

On Sept. 26, the world will unite for a global event to raise awareness for protecting and improving access to family planning services that are vital for so many. World Contraception Day allows us to reflect on the ways society can continue to enable all people to make informed decisions regarding their health care.

The Missouri Family Health Council, which administers funding for a statewide network of family planning clinics, has said nearly half of its members’ 38,000 mostly low-income patients go to a Planned Parenthood facility.

Although much of the focus over the past six months has been the COVID-19 vaccine — an equally important component of a strong public health safety net — there are additional vaccines for students that merit mentioning.

Today marks a significant milestone for contraceptive equity in America: 22 years ago, the Food and Drug Administration approved emergency contraception brand, Plan B, for prescription use.

Of the 38,000 primarily low-income women who visited the Missouri Family Health Council’s statewide member clinics for family planning services, 48% went to a Planned Parenthood, spokeswoman Leslie Pritchard said.

"Tonight, the State Senate chose to pass an FRA that removed dangerous language equating birth control to abortion and limiting safety-net providers," Trupiano said. "We applaud the Senators who put people over politics tonight and ushered in a bipartisan resolution on this."

"The state Senate chose to pass [legislation] that removed dangerous language equating birth control to abortion and limiting safety-net providers," said Michelle Trupiano, executive director of Missouri Family Health Council, Inc. "This is a win for science."

"This is a win for science, MO HealthNet patients, and all Missourians [...]," said Michelle Trupiano, Executive Director of Missouri Family Health Council, Inc.

"The message is clear: it is not a winning strategy to use birth control – which is essential healthcare – as a bargaining chip," said Michelle Trupiano, executive director of the Missouri Family Health Council, which supports broader access to contraception.

“Conflating birth control methods with abortion-inducing drugs is designed to confuse and create uncertainty," said Michelle Trupiano, the executive director of the Missouri Family Health Council, Inc. "The concern with the language is that it will be left up to interpretation by non-medical professionals and could have a chilling effect on medical professionals and the use of IUDs, because it will create this uncertainty that folks will not be really sure what is and isn’t allowed."

[Trupiano] said the legislation would have a "chilling effect" on providers and "no doubt will limit access to certain methods for those that are on Medicaid."

"There are certain legislators that are conflating abortion and birth control, and what folks need to know is that these legislators are trying to take away access to certain forms of contraception, including emergency contraception," Trupiano said.

"Contraceptive prevents pregnancy, including these methods that the legislature is considering limiting. It doesn’t interrupt a pregnancy," said Dr. Elizabeth Allemann, medical director of the Missouri Family Health Council and a practicing physician. "Statements in the law should be true."

"Missourians deserve better," Executive Director for Missouri Family Health Council Michelle Trupiano said. "Birth control should be accessible for everyone regardless of their income or health insurance."

“This language tries to equate contraception with abortion. And that is highly irresponsible in that the two are not the same," Trupiano said. "So the impact that this would have is that, especially low-income women, would not have access to the full range of contraceptive methods, and they’d be forced to choose a method that is not actually right for them."

IUDs and implants made up 16% of the chosen methods last year for roughly 31,000 mostly low-income women who sought contraceptives from the Missouri Family Health Council’s clinics statewide, said director Michelle Trupiano.

"‘It is purposefully and irresponsibly conflating abortion and birth control,’ Trupiano said.”

This May, we observe Sex Ed for All month, a campaign highlighting the critical need for equitable and accessible sexuality education for all young people.

The COVID-19 pandemic has highlighted the importance of investing in public health for the public good. The backbone of the public health sector always has been, and always will be, nurses.

The Missouri legislature returned from its annual spring break and wasted no time putting the health care of almost 1 million Missourians in jeopardy. The Senate recently added an anti-birth control amendment to a mandatory Medicaid spending bill, which prohibits the program from providing some forms of birth control. This restrictive and dangerous amendment is a direct attack on those seeking family planning services and even threatens our whole Medicaid funding by putting the program out of compliance with federal law. Additionally, the legislature added unlawful language to the budget that prevents patients from seeing the provider of their own choice, further threatening Missouri's Medicaid funding.

We at the National Council of Jewish Women St. Louis were stunned to learn that Missouri state Sen. Paul Wieland, R-Imperial, recently offered an amendment that will do unprecedented harm to our state’s mandatory Medicaid funding bill. Though his intention was to make it even more difficult to obtain an abortion in Missouri, under his amendment, any Food and Drug Administration-approved medication or device that would destroy or prevent a fertilized egg from implanting in the uterus would be prohibited.

While playing politics with healthcare in Missouri is certainly nothing new, holding Missouri Medicaid hostage over basic birth control is a stunning — and consequential — shift.

Public health leaders have been working day and night to respond to the coronavirus. But it is not all they do. Mid-Missouri public health organizations promote well-being in a variety of ways; but a global pandemic still takes precedence.

A month ago, President Joe Biden’s administration issued an executive memorandum on women’s health. Among other things, the memo directed the Department of Health and Human Services to review and consider rescinding Donald Trump-era regulations for the Title X federal family planning program. A month ago, this was an adequate — even celebratory — first step. But too much is on the line to wait any longer. Missouri needs relief now.

"As Executive Director of the Missouri Family Health Council, which helps to provide low- and no-cost reproductive health care across the state, Michelle Trupiano is used to navigating a challenging political environment. 'I’m from Missouri, I work in Missouri, and Missouri’s a conservative state where our providers, in general, are used to an onslaught of attacks on reproductive health,' she said."

“We’re disappointed the Biden administration did not suspend the dangerous Title X ‘gag rule,’” read a statement by Michelle Trupiano, the executive director of Missouri Family Health Council, which is the sole Title X grantee for the state. “But we’re encouraged that the President has placed such an emphasis on access to quality, affordable healthcare so early in his term.”

The state of Missouri is, once again, playing politics with reproductive and sexual health care, trying to restrict access to highly qualified and experienced providers in its Medicaid family planning program.

Does anyone really support the notion that decisions about women’s health should be made by their employers? Unfortunately, the Supreme Court does.

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