HACKENSACK, N.J. (WOMENSENEWS)–It seemed like business as usual last week at the local affiliate of Planned Parenthood of Greater Northern New Jersey.

Two young women sat together in the dusty rose color waiting room watching news about the impending Hurricane Irene on the TV monitor.

Behind the glass, women clad in pastel-colored scrubs swiveled around in chairs, quickly navigating between shelves lined with color-coded medical folders.

But life for Cindy Raske, the registered nurse who started off as health director of the nearby Englewood Center, is a lot different from a year ago.

In January, in the wake of state budget cuts, Raske’s counterpart in this Hackensack clinic–a 15-minute bus ride from the Englewood Center–was laid off and Raske was put in charge of supervising both locations.

Like many patients and employees, Raske now floats back and forth between the two health centers.

When asked about how things are going since the loss of state funding, Raske wearily shook her head of dark curly hair. "I can’t tell you exactly how many patients we’ve lost but we have lost some," she said.

In March 2010, New Jersey Gov. Chris Christie eliminated the federal budget line of $1.2 million for family planning, which was seen as a direct attack on Planned Parenthood, one of the biggest family planning providers in the state.

The governor’s action struck 10 percent from Planned Parenthood Affiliates of Greater Northern New Jersey’s overall budget and 25 percent from the medical budget at the Englewood and Hackensack clinics, Raske said.

Each week the combined operations of the two clinics have been cut by about 27 hours. In the wake of some layoffs, people who remain employed must work longer and harder, added Raske.

Six Centers Closed

After Christie’s cuts, six health centers were forced to close statewide.

One of them, the Dover location, was operated by Planned Parenthood of Greater Northern New Jersey. It served over 3,900 patients in 2009, according to a fact sheet on the Web site of Planned Parenthood of Greater Northern New Jersey.

Raske said she had heard, on more than one occasion, of patients who became sick or pregnant as a direct result of not accessing their regular appointment at the Dover center.

Patients have other choices, such as North Hudson Community Action Corp., a group of full-service medical clinics with locations throughout New Jersey that still receives federal funding.

But Raske says a one-stop service provider such as North Hudson does not specialize in family planning and reproductive health. Patients seeking help for those needs often find more personal attention at a Planned Parenthood clinic.

In Bergen County, which includes the Hackensack and Englewood locations, the income of 82 percent of Planned Parenthood patients is below 150 percent of the poverty line and

93 percent are uninsured. One-third of Bergen County patients are of Latino or

Hispanic heritage, 19 percent are African American, 5 percent are Asian and 24 percent are under the age of 24.

Planned Parenthood affiliates in New Jersey have other sources of funding such as Title X, the federal program that designates funds specifically for family planning services to some states, and Medicaid, the public health program for low-income Americans.

Private donations are also welcome. A sign posted on the glass at the front desk of the Hackensack office reads, "I Stand With Planned Parenthood," and the one next to it implores patients to donate some of their own money to support the clinic in light of last year’s budget cuts.

Endowment Not Shared

Although the Planned Parenthood Federation of America has a significant endowment–over $100 million as of 2010–those funds are not shared by affiliates around the U.S., like the Hackensack and Englewood clinics.

Hackensack and Englewood heavily relied on state funding and now, more than ever, on private donations.

The two clinics provide family planning and reproductive health services, such as HIV/AIDS testing, emergency contraception and STD testing, to patients based on a sliding scale of price, according to the patient’s household income. Patients will never be turned away because they cannot afford services.

Lots of patients do not have their own transportation and have had to learn to take the bus from a clinic that is closed or now offers fewer hours.

Raske said the higher level of inconvenience means patients wait until they have an issue to come in, often arriving when they are sicker. She said that’s disturbing in a state where 1-in-4 young women under 25 are infected with chlamydia, a sexually transmitted disease.

Raske, in her 12th year at Planned Parenthood of Central New Jersey, said the Hackensack and Englewood staff have streamlined procedures. First-time visitors have less paperwork to fill out and can work ahead of time by printing the forms off the Web site. Returning clients have little or anything to fill out and give clinicians updates orally. Raske said the efficiency measures were made to conserve and emphasize customer service.

But the cutbacks have inevitably affected the quality of service. Raske said clinicians are expected to fit more patients into one hour of the day, with potentially less one-on-one time with the patient, and spend less time speaking with them on the phone if they have questions.

"We used to talk with them and provide counseling; we can’t do that to some extent anymore," she said.

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Marley Gibbons is an editorial intern at Women’s eNews.

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