Even if someone owns a car, they have to put gas in it. They could be deciding between gas and rent, and putting food on the table. Everything feeds into systematic pain.”

Marty Colavito, SALT (Sullivan Allies Leading Together)

By the numbers

0—The number of Planned Parenthood health clinics in Sullivan County.

4—The number of years that Sullivan County has not had a Planned Parenthood health clinic.

5.6—The percentage of Sullivan County residents without health insurance.

30—The percentage of Sullivan County residents on Medicaid.

63.1—The percentage of births in Sullivan County with first-trimester prenatal care.

75.9—The percentage of births in New York state with first-trimester prenatal care.

12.7—The incidence of cervical cancer per 100,000 women in Sullivan County.

7—The incidence of cervical cancer per 100,000 women in New York state.

4.8—Teen pregnancies per 1,000 girls under 18 in Sullivan County.

3.7—Teen pregnancies per 1,000 girls under 18 in New York state.

After the Goshen clinic closes:

50—The number of miles from Monticello to the nearest Planned Parenthood health clinic (Kingston).

52—The number of miles from Monticello to the nearest New Jersey clinic (Newton).

99—The number of miles to the nearest Pennsylvania clinic from Monticello (Wilkes-Barre).

MONTICELLO, NY — Back in 2020, Planned Parenthood of Greater New York (PPGNY) promised that the closure of its Monticello clinic—the only one in Sullivan County—would be temporary, and would result in improved access to reproductive care.

In the four years since, it’s only gotten worse.

The Monticello clinic never reopened. The nearest Planned Parenthood health center is now in Goshen, more than 30 miles from Monticello. But that clinic, too, is among four to shut down this fall “amid compounding financial and political challenges,” PPGNY announced in an August 7 press release. 

PPGNY also said it would put a “temporary pause” on deep sedation services in Manhattan; the services are needed for abortions performed after 20 weeks of pregnancy. 

The other clinics targeted for closure are in Cobleskill, Amsterdam and Staten Island.

After Goshen closes, the nearest Planned Parenthood health center in New York will be Newburgh, more than 50 miles from Monticello. The nearest Pennsylvania clinic is in Wilkes-Barre, 99 miles from Monticello. The nearest New Jersey clinic is in Newton, 52 miles away.

“Even if someone owns a car, they have to put gas in it,” said Marty Colavito, who chairs the SALT (Sullivan Allies Leading Together) Steering Committee and has been working to get reproductive health care services back. “They could be deciding between gas and rent, and putting food on the table. Everything feeds into systematic pain.”

NYS Assemblywoman Aileen Gunther (D, 100) told the River Reporter she is “devastated, disappointed and frightened” by news of the Goshen closure.

“It’s a travesty,” she said. “How dare they?”

Senti Sojwal, communications director for PPGNY, told the River Reporter in an email that PPGNY is “consolidating services in Orange County into our Newburgh health center, which is a full-service site.” 

The long driving time to urgent and critical care was among the metrics that landed several Sullivan County towns on the state’s Disadvantaged Communities (DAC) list. Sojwal said PPGNY discussed options with Gunther’s office and SALT, such as reserving telehealth appointments for Sullivan County residents, or getting volunteers to drive clients to Newburgh. “We are deeply aware that transportation in this region is very difficult,” she said.

She recommended Sun River Health as an affordable alternate medical provider in Sullivan County.

A nurse manager at Sun River Health said that, after the Monticello clinic closed in 2020, their practice saw an increase in patients referred by PPGNY.

Sun River Health did not comment about its current capacity or the services it offers, although a spokesperson confirmed to the River Reporter that it offers gender-affirming care, specifically, hormone therapy and surgery referrals.

In 2021, Crystal Run Healthcare moved its obstetrics and gynecology office from Liberty to Rock Hill.

The Goshen clinic also provides gender-affirming care services and lists “hormone therapy, surgery referral, initial appointment, follow-up appointment, transition support (legal,social), education, and other resources” among its offerings.

Low-cost care is vanishing

Denise Frangipane, CEO of Sullivan 180, a nonprofit that works to improve the health of county residents, said the Goshen closure will compound problems accessing reproductive health care, especially for those who are uninsured or covered by Medicaid.

Planned Parenthood’s host of medical services includes prenatal care and cancer screenings, which Sullivan County residents desperately need. A significantly lower percentage of pregnancies in the county receive early (first-trimester) prenatal care than statewide, and Sullivan’s rate of cervical cancer is nearly double the statewide rate (see sidebar).

A Sullivan County resident who used Planned Parenthood of Monticello for around two decades says, “Those gynecological exams were really important because I had no health insurance for a whole bunch of years.”

In Sullivan County, 5.6 percent of the population is uninsured, compared to 5.2 percent statewide, according to NYS Department of Health data from 2018 through 2021. And 24,590 Sullivan County residents are on Medicaid, which represents more than 30 percent of its population.

Sullivan County has some of the worst health outcomes in the state, consistently ranking near the bottom since 2010. In 2015 and 2016 Sullivan County was second-to-last in health rankings, ahead only of the Bronx, according to data from the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute.

‘I felt betrayed’

Gunther said her office has had multiple conversations with Wendy Stark, the PPGNY president, as well as with community activists about returning Planned Parenthood to Monticello. 

Barb Schmidt, a community activist and Planned Parenthood volunteer patient escort, participated in these calls. She said Gunther’s office suggested finding funding outside of Planned Parenthood. She said she’s been on four or five conference calls with Stark but that the organization shows “no willingness to work towards a solution.”

Colavito, of SALT, was also on those calls. SALT, which helps local residents struggling with addiction, hunger, and homelessness, asked PPGNY for a number: How much to bring services back?

But they did not provide a number. They said there are no plans to revive the Monticello clinic.

“There was just no consideration for community support or input,” he said—and it felt personal. “I felt betrayed.”

Sojwal, of PPGNY, said in an email to the River Reporter, “We have spoken to the Assembly member and SALT on numerous occasions to brainstorm options for care and our doors are always open to collaborate with community members and elected officials.”

Why is this happening?

Why is PPGNY closing so many clinics?

In a statement, PPGNY attributed the closures to “compounding financial and political challenges”:

“Systemic failures in the U.S. healthcare system have yielded unprecedented challenges that are forcing many healthcare providers, including PPGNY, to take serious and immediate cost-saving measures and pursue long-term structural shifts. These challenges include growing operating expenses, unreliable insurer reimbursements, ongoing pandemic recovery, a hostile political landscape, and an FY25 state budget that fell short of responding to the needs of sexual and reproductive health care providers.” 

Colavito expressed skepticism.

“It’s hard for me to feel bad for Planned Parenthood’s financial loss when my family, and families, are experiencing these losses too,” he said.

In May 2022, NY Gov. Kathy Hochul allocated $35 million to expand access for patients seeking abortion care in New York. The New York State Catholic Conference this month lauded the closure of the clinics while asking what happened to the money.

Stark, the PPGNY CEO, told Capital Tonight host Susan Arbetter that, even with the $35 million, the gaps between insurance reimbursements and the cost of care “are persistent and growing.” 

Colavito said it “never felt right is that [the clinic closures] happened overnight without a fight or any transparency. In Sullivan and Goshen, one day it was there, and then it wasn’t.”

U.S. Rep. Marc Molinaro (R-NY-19), a Republican who opposes a nationwide abortion ban and has also backed legislation to protect contraceptive rights, compared the Planned Parenthood closures to the sudden closure of another vital local service back in February.

“This is just like what we experienced with the abrupt closure of Sullivan County Head Start,” told the River Reporter. “There needs to be stronger state and federal oversight so that when financial mismanagement occurs, there’s an opportunity to course-correct before women or children in our community are left with less service. Sullivan County especially is in need of access to all aspects of care.”

The Alabama Reflector zooms out for a bigger picture, pointing to the nationwide shakeup caused by the Supreme Court’s Dobbs decision in 2022 to end federal protection for abortions: “Many individuals must now travel hundreds or thousands of miles to seek abortion care, and the consolidation of demand at a smaller number of clinics is increasing wait times, which means pregnancies progress to a more advanced stage and the costs balloon further. According to leaders of Planned Parenthood affiliates and abortion funds, there simply aren’t enough dollars right now to support the need at any level.”

Crisis centers instead of health centers

In this bluest of blue states, two years after the Supreme Court ended federal protection for abortion rights, services that provide free and low-cost abortions and contraception are disappearing, while services that offer anti-abortion counseling remain available nearby.

Sullivan County has two crisis pregnancy centers (CPCs), nonprofit organizations that provide prenatal services and counsel against abortion and, in many cases, contraception. Licensed centers can provide some medical services, such as ultrasounds and testing for sexually transmitted diseases. CPCs can be also be found in Milford, PA, and New Windsor.

“Most of these facilities are not health care providers and are not subject to the same privacy laws as medical facilities,” warns NYS Attorney General Letitia James. “Many are connected with organizations that oppose abortion, contraception and education about reproductive health.”

Barb Schmidt, the Planned Parenthood volunteer patient escort, said young adults in Sullivan County have lost access to the contraception and science-based sex education previously provided by Planned Parenthood staff.

In Pennsylvania, Gov. Josh Shapiro last year declined to renew a contract with a nonprofit that partners with crisis pregnancy centers in 83 locations across the commonwealth, and is instead soliciting applications for women’s health centers. Shapiro’s first budget allocated $6 million to crisis pregnancy centers, almost $1 million of it from the state line item providing cash assistance to low-income families, according to Spotlight PA.

Meanwhile, the New York State Catholic Conference lauded Planned Parenthood of Greater New York’s decision to close the four clinics—while asking the whereabouts of $35 million allocated by Gov. Kathy Hochul for reproductive care.