The long-term viability of eight women's health clinics operating under regional affiliate Planned Parenthood Golden Gate (PPGG) was thrown into question Aug. 6 when Planned Parenthood Federation of America (PPFA) announced that the affiliate would lose its accreditation.
The clinics — which serve roughly 55,000 clients, predominantly women living at or below the federal poverty level — will still be allowed to operate but must stop using Planned Parenthood's nationally trusted name beginning Sept. 3.
Some news articles immediately following PPFA's announcement referenced confidential internal conflicts to explain the break, but financial documents and the accounts of several former employees gathered by the Guardian suggest that the organization had reached a precarious financial position that made it difficult to meet accreditation standards.
"To not have a Planned Parenthood in San Francisco is like heresy," a former PPGG employee told the Guardian. Yet this person and other former coworkers attributed this outcome to dysfunction at the senior management level of PPGG and said the national organization had little choice but to take action.
The Bay Citizen reported that 30 members of PPGG's medical services staff sent a letter to Harrison and PPFA executives in October 2008 to raise concerns about "the misappropriation and mismanagement of PPGG's funds." The letter charges that "executive staff's personal expenditures are excessive and are not aligned with the mandatory fiscal restrictions. Flagrant use of PPGG funds to pay for personal belongings, personal services, and exorbitant technology products is seemingly unchallenged and not subject to the same financial scrutiny that clinic supplies and staff salaries are, for example."
A former PPGG staffer noted that employees had tried in the past to sound the alarm, including going to the media. Another noted that they had been made to sign a confidentiality agreement on leaving the organization, a practice that was common within PPGG.
While the current CEO, Therese Wilson, did not return numerous phone calls seeking comment, she was quoted in a fairly sympathetic San Francisco Chronicle article referencing the economic downturn and inability for many of the clients to pay as reasons behind the agency's financial woes. While the recession, cuts to state funding to nonprofits, and other external factors have clearly had an impact, documents suggest that things were going awry before the recession hit full force.
An internal PPGG document provided to the Guardian displays the agency's on-hand cash reserves compared with other affiliates, suggesting that the reserve ratios were at or below the minimum required by Planned Parenthood national for all but one year from 1998 to 2007 — and well below that of other affiliates of similar size. That is a key requirement for meeting accreditation standards.
When we asked Elizabeth Toledo, a Planned Parenthood Federation of America (PPFA) spokesperson, about this apparent pattern, she said she could not comment because she had not seen the documents. She also said the accreditation reviews were confidential. "Understanding the true financial picture for health care providers takes a very in-depth evaluation," Toledo said. "PPFA and PPGG were working together over the last few years to resolve fiscal challenges."
The Packard Foundation, a major donor to Planned Parenthood, awarded PPGG a $30,000 "organizational effectiveness" grant last year to "select a talented, external provider to help them think through some of these challenges." The grant expires in September, according to spokesperson Dan Cohen.