2013 | A N N U A L R E P O R T | i
2013 a n n u a l
r e p o r t
2013 | A N N U A L R E P O R T | i i
Dear Friend, It is my privilege to share with you our 2013 Annual Report. In 2013 we saw the Texas Legislature pass HB2, a terrible law that disrespects women and their personal decisions about pregnancy. We also saw new levels of support for the women we serve and for the simple but powerful idea that when people can plan their families they are able to plan their futures. People everywhere rallied around the mission and good work at Planned Parenthood. Support to our Annual Fund surpassed $2 million for the first time ever. That is very exciting and very humbling. Your contributions mean everything because it is your support that allows Planned Parenthood to provide essential health care. You and I know what a positive impact we are making in providing this health care; the benefits and empowerment that come from family planning. Our impact is made all the more special knowing that more than one thousand caring donors were behind every patient encounter in our health centers during 2013. Many of us give to Planned Parenthood because we have a personal connection to its mission. Perhaps someone we know has relied on Planned Parenthood at some point in his or her life—for a well-woman exam, for birth control, for lifesaving cancer screenings, for STD testing and treatment, or for abortion care. Perhaps that someone was your sister, your brother, your best friend, your mother … or maybe it was you. For decades Planned Parenthood has been there for millions of Americans—helping women, men and teens with the most intimate aspects of their health care. Supporting Planned Parenthood has never been more important. A small but vocal group of narrow-minded people cannot be allowed to determine the future of women and families in Texas. Their negative efforts cannot be left unchallenged. That is why I have chosen to stand with Planned Parenthood. My association with Planned Parenthood makes me proud because of all the health care we provide and how that helps so many people. I’ll bet you feel the same way. Thousands of people stood with us in 2013; they shared our links on Facebook, re-tweeted our messages, called their legislators, wrote letters, rallied at the State Capitol, and contributed generously to our work. I am so grateful for everything you have done and continue to do to as you proudly stand with us and with our patients. That said, we cannot rest because our work is not over. Your continued support is needed to ensure that Planned Parenthood remains a trusted resource and capable provider for people in San Antonio and the Rio Grande Valley who are trying to build a better life for themselves and their families. We can’t let them down. Thank YOU for everything you have done, are doing and will do to support our mission.
2014 BOARD OF DIREC TORS Lila Aguirre
ch a i r
Dr. James Benedict
Alan Kramer
Elise Boyan
v i ce - ch a i r
Virginia A. Cardin, DrPH
Alison Boone
Cheryl Davis, DMD
t re a su rer
Ceci Goldstone
Barbara Moschner
Lupita Gutierrez
s ec re ta ry
Pat Jasso
Kathy Armstrong
Pat Kalmans
i m m ed i at e pa s t ch a i r
Ellen Lake
Marty Hixon
Janet McNutt Don McRee
&
Stuart Schlossberg
president
Susan Smith
Jeffrey Hons
Gerri Wolfle
sr. vice president
ceo
&
coo
Polin C. Barraza, RN
Planned Parenthood recognizes the importance of art as an integral element of community—a source of inspiration and a reminder of humanity’s potential for greatness. fro n t cov er : Debra Sugerman, Dive, 2009
Jeffrey Hons with Marilyn Harrington at the Annual Luncheon
I have always been straightforward about the challenges we face—our disappointments and our successes. 2013 had them both. The rough spots are, unfortunately, easy, and painful, to recall. The 2013 Legislative Session ended without an expansion of Medicaid—and the Lege passed a rule that future expansion can occur only at the direction of the Legislature. They passed HB2, the terrible new abortion law, despite the objections of every reputable group of physicians including the American Congress of Obstetricians and Gynecologists. 2013 was the first full year without reimbursements from the Women’s Health Program, and the second full year without a state family planning contract. I miss the money and all the people we were able to serve with those resources, but I am so proud of where we are today without that money; and I am even relieved in some ways. Our client volume declined as a result of the loss, and that makes me sad, but those declines are behind us now and service delivery numbers have leveled off. The financial information on page 8 shows our struggle in 2013 and I imagine you might worry a bit when you see those numbers, but 2014 performance is much improved. Our organizational turnaround is working. Step by step we are learning to operate successfully without the politically vulnerable money we relied on previously. And this means we’re ready for growth in the future. You are making this happen; your generosity and your strong spirit are essential to the success at Planned Parenthood South Texas. I cannot thank you enough.
2013 | A N N U A L R E P O R T | 3
There is more good news from 2013. We migrated to electronic health records—no small feat. We moved our Brownsville health center to a much better location and in so doing removed a chunk of debt off the balance sheet that was attached to the old and unattractive building that was the prior location. Our clients deserve to find their family planning and women’s health care at nicer facilities. We’re going to relocate three other facilities over the next few years. For me, the very best memory from 2013 was when Pat Smothers and I met for wine at Nosh and I explained to her the charge from our board of directors—establish a surgery center inside a beautiful building that would be Planned Parenthood’s home base for at least a generation if not more. I asked her to chair the capital campaign. She said yes. And immediately began talking to everyone about why we must do this and how important this project is to Texas. And you all agreed with her. You gathered at fundraising salons and meetings and you jumped in, taking ownership of this shared enterprise. You introduced us to new friends—people with expertise and connections— who were able to do special things that have moved this project forward in ways that would have never happened otherwise. I have received so many compliments about my work on this, and every time that happens I think about all of the people who did things I cannot do. This work has been an honor. Collaboration and partnership make it possible. You jumped in. That’s what I see in the artwork that graces the cover of this report. Dive is a Debra Sugerman photograph and I love it. I love looking at it. Over and over. In it, I find so many of my feelings about our work over the past year or more. The subject, a woman whose face we cannot see, is moving forward in a most dramatic way. She took a moment to remove her shoes before she dove into the water but her dress is still on. That means she was thinking, but she knew she had to move fast—diving in is something that was urgently necessary. Time was of the essence. When I look at the photograph I can tell that she knows what she’s doing. She will emerge from this dive and take in a huge breath of new air. She will be cooler because of the water. She will have accomplished whatever it was that compelled her to jump in. In my most haunting interpretations of this photograph, I imagine she emerges from the water carrying someone else to the surface. Someone she dove in to help. Thank you, Ms. Sugerman, for sharing this dramatic image with Planned Parenthood. Your generosity is a great tribute to your mother, the late Sondra Sugerman, who was an Education Director at Planned Parenthood in the 1970s and a lifelong advocate for health education. We are all in this together. We all dove in. And we’re just about to resurface.
Jeffrey Hons p res i den t
&
ceo
2013 HEALTH SERVICES
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w e l l - w o m a n e x a m s physical examination that includes chest, heart,
lungs, abdomen and genital area; pelvic exams; Pap tests for early detection of cervical cancer; and clinical breast exams that can detect abnormalities, including the early signs of breast cancer. Note: in mid 2013, added human papillomavirus (HPV) testing for the virus strains associated with cervical cancer, giving women more tools to help prevent cervical cancer. m a l e s e x u a l h e a lt h e x a m s physical examination that includes chest,
heart, lungs, abdomen and genital area; screening for testicular cancer and instruction on performing a testicular self-exam to detect for lumps or bumps that may be cancerous. b i rt h c o n t r o l condoms and birth control pills, as well as several long
acting reversible contraceptives: the birth control shot, the ring, the patch, the implant, and intrauterine devices (IUD). Planned Parenthood also offers non-surgical, non-hormonal permanent birth control. p r e g n a n c y t e s t i n g urine and blood-based testing.
e m e r g e n c y c o n t r a c e p t i o n birth control to prevent pregnancy up to
five days (120 hours) after unprotected sex.
“ p e a c e o f m i n d ” s t d t e s t i n g & t r e at m e n t including the latest rapid-based testing for some of the more frequently requested tests that can provide results at the time of visit. s t o p c e rv i c a l c a n c e r vaccine for HPV, clinical evaluation of abnormal Pap
test results and medical treatment to stop the progression of cervical cancer. m e n o pa u s e c a r e clinical evaluation and hormonal replacement therapy
when indicated. a b o rt i o n c a r e Planned Parenthood trusts women with this private,
personal decision and we’re here for her if she needs abortion care. We provide the abortion pill (thru 7 weeks*) and in-clinic procedures (thru 13 weeks). r e f e r r a l f o r p r e n ata l c a r e
&
a d o p t i o n Planned Parenthood respects
all choices by all women. In order to help women effectuate their decision, we provide women who decide to continue their pregnancy with information and referrals for prenatal care and adoption services. *In 2013, the Texas Legislature passed HB2, which, among other things, reduced the number of weeks when the abortion pill could be administered—from nine weeks to seven weeks. There is no medical basis for the rule, nevertheless, the law went into effect the evening of October 31, 2013.
DEMOGRAPHICS
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SEX
Female 94%
Male 6%
R ACE & ETHNICIT Y
Latino 71%
White 20%
Black 5%
Other 4%
AGE
17 yrs. & under 7%
18-19 yrs. 10%
20-24 yrs. 30%
25-29 yrs. 24%
30-34 yrs. 14%
35+ yrs. 15%
HEALTH CARE BY THE NUMBERS
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At our health center on E. Southcross Blvd., we can provide same-day results for the most common STDs— Chlamydia and Gonorrhea. This is possible through our own high-complexity laboratory, created with your generous philanthropy. In 2013, more than 90% of the people who came to Planned Parenthood came to us for preventive health services. We are proud of our prevention work, and are equally proud to be a resource for women who need access to abortion care. Each birth control method provides protection—a condom for one day, pack of pills for one month, the shot for three months, and an IUD for several years. The number that follows measures the weeks of protection for all methods combined. This is an unduplicated number of women who were seen through our Stop Cervical Cancer project, which seeks to prevent cervical cancer via the HPV vaccine; follow-up care for abnormal Pap test results; colposcopy; and loop electrosurgical excision procedure (LEEP). Prevention and early detection are hallmark of our work.
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More than 18,000 people came to us for health care in 2013. Through our health centers in San Antonio, Harlingen and Brownsville, Planned Parenthood helped people across South Texas get the care they need to create a better future for themselves and their families.
t ota l n u m ber h e a lt h c a re
o f p eo p l e w h o recei v ed i n o u r h e a lt h cen t er s 18,309
wo m en s een i n o u r h e a lt h cen t er s
17,215
m en s een i n o u r h e a lt h cen t er s 1,094
std
&
h i v t es t s p er f o r m ed
30,308
p reg n a n c y t es t s p er f o r m ed
8,562
a bo r t i o n c a re 1,267
pa p t es t s p er f o r m ed
co n t r acep t i v e u n i t s p rov i ded
4,462 40,970
em erg en c y co n t r acep t i o n
3,375 w eek s o f p rot ec t i o n 267,541
s to p cerv i c a l c a n cer tota l c l i n i c v i s i t s
594 19,227
“The services and staff at Planned Parenthood were amazing. I appreciate everything they did for me. They were very attentive, understanding and helpful. My experience could not have been any more comfortable or great. They truly make a difference in women’s life and I was lucky to have their services available to me.” —Jessica, patient
2013 FINANCIALS
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re v en u e
&
su p p o r t
Medicaid $243,115 Patient Fees $2,788,838 Commercial Insurance $255,609 Contributions & Grants* $3,097,963 Miscellaneous** $65,389 Revenues before Investment $6,450,914 Gain or (Loss) Net Investment Gain or (Loss) $153,370 Total Revenue $6,604,284 e x p en s es
Salaries/Benefits $ 3,490,646 Travel/Training $61,056 Office/Program $312,992 Medical $1,051,011 Space $415,332 Other*** $819,702 Depreciation $113,950 Total Expenses $6,264,689
Increase/(Decrease) in Net Assets Add: Depreciation Less: Gain in Endowment Less: Capital Expenditures for Equipment & Improvements Net Effect on Cash Flow
$339,594 $113,950 ($153,370) ($104,042) $196,132
re v en u e
Medicaid 4%
Patient Fees 42%
Commercial Insurance
4%
Contributions & Grants* 47% Miscellaneous** 1%
Net Investment Gain/Loss
2%
*Includes: Investment Income, Realized Gain on sales of Assets & Investments **Includes endowment & contracted services revenue ***Accounting, Professional Services, Association fees, Staff Activities, Financial Service Fees, Interest Expense, Misc, Bad Debt
TWO WAYS TO LOOK AT EXPENSES
2013 | A N N U A L R E P O R T | 9
ex p enses
by p ro gra m area
Health Care 69%
Marketing 2%
Fundraising 5%
Administration 24%
ex p enses by acc o u nting
Salaries/Benefits 56%
Travel/Training 1%
Office/Program 5%
Medical 17%
Space 6%
Other*** 13% Depreciation 2%
At first glance it appears we held a positive margin in 2013. But there is a lot to understand within 2013 that actually indicates we had a tough year. First, the year-end performance you are seeing includes $902,838 in contributions (excluding pledges) toward the capital campaign. Additionally, when you remove transactions resulting from our investments and other restricted contributions beyond the capital campaign, our performance in 2013 resulted in a loss of $654,715. But that is not all from operations. There are two non-recurring unusual items that must be understood. We booked a $189,000 expense to record a potential billing correction to Texas HHSC from a prior year. Additionally, we wrote off $98,000 in legacy accounts receivable from 2012. When all of this is understood together, we see a $367,715 operating loss in 2013—put differently, this is how much improvement must be achieved in 2014. I am glad to say the year-to-date June 2014 income statement indicates we are on track to a breakeven operation. Our organizational transformation has been underway for 2+ years and it is working.
PHILANTHROPY - ANNUAL FUND
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For the first time ever, total gifts to our Annual Fund surpassed $2 million dollars. To add a little bit of perspective, ten short years ago, contributions to the Annual Fund totaled $671,364 and made up 13% of budget revenue. In 2013, philanthropic support—$2,058,390.75*—represented 31% of revenue. Your heroic philanthropy helped more than 18,000 women, men and teens get the health care they need to plan their families and their futures. You gave like never before—total support for the 2013 Annual Fund increased by almost 22% over the previous year. Keep in mind that we reached this record-level of fundraising in a year that we concomitantly, but separately, raised $1.7 million for the Capital Campaign. We told you about the challenges we’re facing on behalf of the women we serve and 1,073 of you jumped in to help. More than 300 of you made gifts online. And 175 of you made a gift at the Patron Level of $1,000 or more. Given all that is happening around women’s health, it was certainly refreshing to see 286 people made a gift for the very first time. The Annual Luncheon, which is now a hallmark event for Planned Parenthood South Texas, raised almost $340,000. About 900 supporters, 237 of whom were new to Planned Parenthood, filled the Marriott Rivercenter to hear the intelligent Jeffrey Rosen discuss, and even foreshadow, the potential consequences of decisions made by U.S. Supreme Court.
At a time when a handful of elected officials are taking unprecedented actions to diminish women, Planned Parenthood continues to step up and do the right thing, putting the health of women first and defending the rights of women and their families to make their own decisions about pregnancy and becoming a parent. We couldn’t do this good work if it weren’t for YOU. There will come a time when the tide will turn and public policy will re-align with justice, compassion, intelligence and morality on matters of women’s health. And at that time, history will look back on everyone who supported Planned Parenthood and say,“Thank goodness they stood their ground.” In the meantime, please know how grateful we are to you for your unwavering support, and how grateful our clients are for helping them build better lives for themselves and their families.
2013 Luncheon Committee with Jeffrey Hons (middle) and Jeffrey Rosen (far right).
2013 ANNUAL GIFT SIZE
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2013 $2,058,390.75
2012 $1,692,081.06
gifts
$50,0 0 0 +
7 gifts = $898,154.00 gifts
$10,0 0 0 - $49,999
30 gifts = $540,725.10 gifts
$1,0 0 0 - $9,999
185 gifts = $406,280.82 gif t s up to
$999
2,344 gifts = $213,230.83 t o ta l
$2,058 ,39 0.75
From left Adam Harris, Megan Harris and Dr. Dudley Harris.
* Represents audited figures.
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esta b l ishing a next generati o n faci l ity
In 2013, Planned Parenthood South Texas (PPST) launched an accelerated capital campaign in order to comply with Texas’ terrible new abortion law (HB2). We were already engaged in a comprehensive facilities relocation plan, Beyond the Horizon, to better serve our patients and fulfill our mission. Building an ambulatory surgery center (ASC) was not originally part of the plan1. When the new abortion law passed, we moved quickly to create a plan that ensures that women can continue to count on Planned Parenthood in San Antonio for abortion care. Planned Parenthood does more than any organization Jeffrey Hons and Pat Smothers at the new building site earlier this year.
to prevent abortion, but we believe abortion care should be safe, legal and accessible—and that decisions about pregnancy and abortion must be left to a woman, her family and her faith. Politicians make lousy doctors! So we dove into our work—to identify a location and raise the funds needed to establish a new flagship medical center that includes an ASC. To the best of our knowledge, after September 1, Planned Parenthood in San Antonio will be one of only 5-8 providers of abortion care in the entire state. Not only will the new location safeguard women’s access to abortion care, it will allow us to expand the scope of the health care we provide. With a new surgery center of our own, we will be able to consider providing new treatments and procedures that our clients need. For example, we are exploring the addition of procedures to treat abnormal uterine bleeding, to diagnose and treat polyps and fibroids, and to conduct biopsies. With the appropriate physician, in the future, we will be able to provide hysteroscopic evaluation and treatment, tubal sterilizations for women and vasectomies for men. San Antonio community leader and philanthropist Pat Smothers has been at the helm of this project, serving as Chair for the capital campaign. Many of you have answered the call. By the end of 2013, we had already raised $1.7 million in gifts and pledges. As of July 31, 2014, you have made gifts and pledges totaling $5,048,696 towards our Next Generation Facility, which we estimate will ultimately cost $6.5 million. These gifts are in addition to gifts you have made to support our Annual Fund. Both are equally needed to continue our work and we are so incredibly grateful for your support. For some of you, your gift the Next Generation Facility represents the largest gift you’ve made, to any organization, ever. We are honored to have your confidence and promise to use your investment wisely. The Beyond the Horizon campaign will not end with the Next Generation Facility. After this building is complete, we will continue our work by re-imagining and re-locating three of our other health centers—making certain our facilities match our superior client experience and are located where we will have the most impact.
1
PPST provides abortion care through 13 weeks and prior to HB2, only abortion services beyond the first trimester (beyond 14 weeks) were required to occur in an ASC.
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fi g h t i n g back
In 2013, the resolve of Texans who care about women’s health was tested like never before. While Governor Perry declared that his goal “is to make abortion, at any stage, a thing of the past,” anti-choice legislators were unable to pass any harmful bills during the regular 83rd Legislative session. Yet immediately after the regular session ended, the Governor called a special session wherein the Senate decided to forego a rule that requires a two-thirds vote to consider bills, making it easier for the Governor’s friends to fast-track and push through controversial legislation. But Texans would not go down without a fight. On June 26, the last day of the first special session, Sen. Wendy Davis staged an 11-hour filibuster in an attempt to stop a bill that, in effect, ends access to abortion care for many women in Texas. With the help of fellow senators, including Sen. Leticia Van de Putte from San Antonio, the first special session ended without passage of the bill. However, Governor Perry called a second special session and this time, a new abortion bill (HB2) passed and was signed into law on July 18, 2013. Despite Planned Parenthood’s efforts—including litigation—to protect Texas women from this onerous law, three provisions took effect on October 31, 2013. The last provision, the ASC requirement, goes into effect September 1, 2014—all but a handful of providers throughout the state are expected to stop providing abortion care.
the f o u r m ain p rov isi o ns o f the ne w a b o rti o n l aw
( h b 2):
1.
The admitting privileges requirement: All physicians must have “active admitting privileges” at a hospital providing obstetrical or gynecological care services no further than 30 miles from the location where the abortion is performed.
2.
The medication abortion restriction: Providers may not use the best-practice, evidence-based protocol for medication abortion—that OB/GYNs have found to be safest. Rather they must follow an outdated regimen that was approved more than a decade ago.
3. The 20-week ban: No abortion can be performed after 20 weeks post fertilization (or 22 weeks from last menstrual period). 4. The ASC requirement: Mandates that all abortions be provided in ambulatory surgical centers—no exception for medication abortion (oral medication taken by the patient to end the pregnancy).
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s ta n d i n g w i t h t e x a s wo m en
The new, unnecessary restrictions to abortion care galvanized supporters for women’s health across the state. In the days leading up to the historic filibuster more than 1,000 supporters flooded the capitol to testify against the bill or attend floor votes. The Texas Tribune’s live feed viewership peaked at 183,000 the night of the filibuster. On July 1, the day the second special session began, more than 6,000 supporters attended a rally at the State Capitol. Planned Parenthood hosted a seven-city bus tour with stops including San Antonio and Brownsville, calling attention to legislation that restricts access to abortion. In San Antonio, Mayor Julian Castro spoke to more than 700 attendees at Sunset Station. In the days and months following the signing of HB2, Planned Parenthood South Texas partnered with local organizations to keep our communities informed of the consequences of the new law. In keeping with our history of working with local artists and galleries to create spaces where art and reproductive justice intersects, we worked with Darryl Mixx of Gallery SA and Dr. Dudley Harris, who creates one-of-kind pottery. Both gentlemen were kind enough to create art events to benefit Planned Parenthood South Texas. Additionally, we partnered with the Lilith Fund for a film screening of After Tiller and with the Texas Observer for a panel on women’s health. The Stand with Texas Women coalition continues today, coordinating efforts of health care leaders and advocates to build awareness and support for women’s health in Texas.
2013 LOCATIONS From left: Elayne Sloane, Brownsville Chamber of Commerce Board Member with Planned Parenthood staff Cyndi Contreras and Mara Posada.
SAN ANTONIO 104 Babcock Rd (Texas License #008246) San Antonio, TX 78201-2900 (210) 736-2262 6749 Bandera Rd San Antonio, TX 78238-1438 (210) 681-7800 2346 E Southcross Blvd San Antonio, TX 78223-3226 (210) 333-5454 8725 Marbach Rd, Ste 215 San Antonio, TX 78227-2378 (210) 674-2222 11514 Perrin-Beitel Rd San Antonio, TX 78217-2113 (210) 590-0202 120 W Ashby Pl San Antonio, TX 78212-5838 (210) 736-2475
BROWNSVILLE 870 E Alton Gloor Blvd, Ste B Brownsville, TX 78526-3364 (956) 546-4571
HARLINGEN 712 North 77 Sunshine Strip, Ste 18 Harlingen, TX 78550-8897 (956) 423-8584
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On October 18, 2013 Planned Parenthood celebrated the Grand Opening of its relocation in Brownsville, which is now conveniently located near the Valley Regional Medical Center. This move is part of a major capital campaign and facilities plan, Beyond the Horizon (see more on pages 12-13), which invests in our health centers and ensures that our facilities match our superior client experience.
We provide and protect the health care and information people need to plan their family and their futures. ppsouthtexas.org