Planned Parenthood clinics in Springfield, Peoria, Pekin, Ottawa and elsewhere in Illinois are using private donations to continue family planning services, including referrals for abortions, after a federal court allowed controversial changes in the federal Title X grant program to take effect.

Planned Parenthood of Illinois put a temporary hold on accepting Title X funding for family planning services after a June 20 ruling by a panel of West Coast judges from the 9th Circuit U.S. Court of Appeals. The judges allowed the changes to take effect for the first time in all states except Maryland.

Planned Parenthood chief executive officer Jennifer Welch said her not-for-profit organization doesn’t want to comply with new restrictions that come with Title X dollars. The group is using the donations, instead, because it doesn’t want to discontinue family planning services or the subsidies that many patients are offered to reduce out-of-pocket costs, she said.

Welch wouldn’t say how much money is available in donations. She told GateHouse Media Illinois last week that it’s unknown how long donations to the not-for-profit will hold out amid court appeals challenging the Title X changes.

She said some Planned Parenthood patients have been confused by publicity about the changes, which she and other critics call the “gag rule.”

Some patients believe incorrectly that Planned Parenthood no longer can serve them or no longer offers affordable “sliding-scale” fees based on income, Welch said. Many Title X patients qualify to pay nothing out of pocket.

“I want them to know our doors are open,” Welch said.

Chicago-based Planned Parenthood of Illinois, which receives $3.5 million in Title X funding annually, opposes the restrictions because they bar referrals for abortion, Welch said.

“The gag rule silences medical professionals” and prohibits doctors and nurses funded by Title X from telling patients how they can “safely and legally access abortion,” she said.

If Planned Parenthood complied with restrictions pushed by the administration of Republican President Donald Trump, “Our medical professionals would be violating their own medical ethics and refusing information for patients, even if a patient specifically asked for a referral for an abortion,” Welch said.

Critics of the restrictions said they would lead to less access to family planning services, more taxpayer-funded unplanned pregnancies and more cases of sexually transmitted diseases. They fear the restrictions could be in place for months before there’s definitive court action.

Legal appeals prevented similar restrictions from taking effect during Republican President Ronald Reagan’s term. One of Reagan’s successors, Democrat Bill Clinton, rescinded the proposal in 1993 after outcries from groups that included the American College of Obstetricians and Gynecologists.

ACOG, as well as the American Medical Association, American College of Physicians and more than 100 other public-health associations, oppose the restrictions.

The Illinois Department of Public Health receives between $3.7 million and $3.9 million in Title X funds each year and distributes the money to various organizations, including local health departments and not-for-profits in communities such as Canton, Galesburg, Havana, Kewanee, Jacksonville, Pittsfield and Rockford.

The state, which is among entities challenging the Trump administration on the restrictions, hasn’t decided whether to turn down or continue to accept the money, Illinois Department of Public Health spokeswoman Melaney Arnold said.

The state hasn’t given instructions to recipient agencies because the U.S. Department of Health and Human Services hasn’t provided guidance to states on how to implement the restrictions, Arnold said.

She said the administration of Gov. JB Pritzker, a Democrat, “strongly opposes this rule change, and the state of Illinois remains committed to the multi-state lawsuit to permanently block this damaging proposal.”

Ashley German, executive director of Galesburg’s Family Planning Service of Western Illinois, said losing between $130,000 and $173,000 in Title X funding would threaten the nonprofit’s existence. The agency, which employs six people, operates with total annual revenues of $405,000.

If the state accepted the federal money, with restrictions, Family Planning Service would have to decide whether to accept the funding and give women less-than-complete information about all their options, German said.

The agency serves 1,500 to 1,800 clients a year in the Title X program and doesn’t provide abortions. Some clients drive from rural areas up to 90 minutes away.

“It’s a moral and ethical issue if we can’t say certain things,” German said.

Title X money can’t be used to pay for abortions, but supporters of the restrictions, who reject the gag-rule label, contend that Planned Parenthood uses Title X funding to indirectly subsidize the abortions provided at some of its locations.

“Money is fungible,” said Tim Moore, president of Springfield Right to Life. He said he supports the restrictions to ensure “a judicious use of taxpayer money.”

“Planned Parenthood has gobs and gobs of money,” Moore said. “Why do they need taxpayer money?”

Planned Parenthood, which operates 17 health centers in Illinois, offers both surgical and medication abortions at its clinic at 601 N. Bruns Lane in Springfield. Medication abortions are offered at the Peoria clinic.

Planned Parenthood, which serves about 40 percent of the 4 million patients nationwide in the $286.5 million-a-year Title X program, says the federal money doesn’t support abortions.

Welch said it’s unfair for family planning services to receive so much more scrutiny from federal officials than other medical services.

“The regulations are designed to eliminate funding for Planned Parenthood,” she said. “We know that the administration is targeting us, and right now the court cases are indicating that they’re being successful.”

In Illinois, Planned Parenthood serves 50,000 Title X patients, Welch said.

The “vast majority” of Planned Parenthood’s patients — most of whom are women — receive services other than abortions, she said. Those services include birth control, breast and pelvic exams, and sexually transmitted disease testing and treatment.

Welch wouldn’t say how much of her organization’s $38 million to $40 million in annual revenues come from abortions.

Illinois is among 15 states that allow Medicaid to pay for all or most “medically necessary” abortions, according to the Kaiser Family Foundation.

Throughout the country, Planned Parenthood is using “limited emergency funds” that will allow affiliates to continue care for Title X patients in the short term while court appeals continue, according to a news release from the national Planned Parenthood office in Washington, D.C.

Moore, the Springfield pro-life advocate, said there are “many sources of information” other than Title X-funded clinics for patients interested in getting abortions. Those sources include the Internet and patients’ personal physicians, he said.

However, Planned Parenthood officials say many women who receive Title X-funded services are considered low-income but make too much money to be covered by Medicaid and aren’t covered by private insurance, so their access to private health-care providers can be limited.

Moore said federally funded health centers — primary care clinics such as Central Counties Health Centers and Southern Illinois University’s Center for Family Medicine — can serve people if Planned Parenthood and other agencies lose their Title X money.

But Planned Parenthood officials said those clinics aren’t equipped to serve all the patients that Planned Parenthood might lose if the Title X restrictions remain in place.

Audrey Sandusky, spokeswoman for the National Family Planning and Reproductive Health Association in Washington — a group that opposes the restrictions — said she hasn’t heard of any medical providers abiding by terms of the gag rule, at least not yet.

The association believes that the restrictions haven’t taken formal effect yet because HHS officials haven’t issued any guidance since the June 20 federal court ruling. HHS officials didn’t respond to a request for comment.

The restrictions, Sandusky said, “put the providers in an untenable situation. It’s putting the provider network at perilous risk.”

Contact Dean Olsen: dean.olsen@sj-r.com, 788-1543, twitter.com/DeanOlsenSJR.