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The provision of public-sector services by family planning agencies in 1995.

Frost JJ, et al. Fam Plann Perspect. 1997 Jan-Feb.

Abstract

Results from a 1995 survey of a nationally representative sample of 603 publicly funded family planning agencies reveal that 96% rely on federal funding, 60% on state funding and 40% on local funding to provide family planning and other services. Although only 25% of the contraceptive clients served by these publicly funded agencies--including health departments, hospitals, Planned Parenthood affiliates, independent agencies and community and migrant health centers--are Medicaid recipients, 57% have incomes below the federal poverty level and an additional 33% have incomes of 100-250% of the poverty level. Some 40% of the recipients of family planning services are black, Hispanic or from other minority groups, and 30% are younger than 20. Each agency employs an average of three physicians who together provide approximately seven hours of care per week and seven midlevel clinicians who provide 71 hours of care per week. The pill is the only contraceptive method provided by all agencies, but 96% provide the injectable; at least 90% spermicide, the condom and the diaphragm; 78% periodic abstinence; and 59% the implant. The remaining methods are provided by fewer than 50% of agencies. Almost 70% of agencies have at least one special program of outreach, education or services to meet the needs of teenagers, but far fewer have special programs for such hard-to-reach groups as the homeless, the disabled or substance users.

PIP:

This article provides the findings from a 1995 nationally representative survey of 603 public-supported family planning (FP) service centers in the United States. 96% relied on federal funding, 60% relied on state funding, and 40% relied on local funding. 25% of clients were Medicaid recipients receiving narrowly targeted services. 57% had incomes below the federal poverty level, and an additional 33% had incomes of 100% to 250% of the poverty level. 30% were under 30 years old, and 50% were 20-29 years old. 61% were non-Hispanic Whites. The responses were weighted to reflect the actual distribution of family planning agencies according to type and Title X funding status. Agencies varied in the extent to which contraceptive services were the main focus. 80% of clients at Planned Parenthood affiliates and 65% of clients at independent FP clinics received contraceptive services. Only 45% of clients at hospital outpatient departments and 39% of clients at public health departments received family planning. Agencies receiving Title X funding received more poor contraceptive clients. The average delay between appointment scheduling and actual care was 4 days (Planned Parenthood clinic) or 11 days (hospital or health department clinic), and 9% of agencies provided same-day service. 32% averaged about 2 weeks. 97% offered evening appointments, and 73% offered weekend appointments. 71% followed-up missed appointments. An average of 3.1 physicians were employed to provide an average of 6.8 hours per week of care. An average of 6.7 mid-level nurses and clinicians provided 70.9 hours of patient care per week. This article includes findings on routine services, method mix, condoms, new methods, services for the hard-to-reach, services to teenagers, school-based clinics, noncontraceptive services, sources of funding, public funding, and fees charged. It is concluded that FP agencies will continue to need Title X funding even after Medicaid clients are switched to managed care alternatives.

PMID

9119045 [PubMed - indexed for MEDLINE]

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