Scope of family planning services available in Federally Qualified Health Centers

• Published in: Contraception (Stoneham) Vol. 89; no. 2; pp. 85 - 90
• Main Authors: Wood, Susan, Beeson, Tishra, Bruen, Brian, Goldberg, Debora Goetz, Mead, Holly, Shin, Peter, Rosenbaum, Sara
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.02.2014; Elsevier
• Subjects: Ambulatory Care Facilities - statistics & numerical data; Biological and medical sciences; Community health centers; Contraception - methods; Contraception - statistics & numerical data; Contraceptive Agents; Contraceptive methods; Family planning; Family Planning Services - statistics & numerical data; Genital system. Reproduction; Gynecology. Andrology. Obstetrics; Humans; Medical sciences; Obstetrics and Gynecology; Pharmacology. Drug treatments; Primary Health Care - statistics & numerical data; Reproductive health services; Sexually Transmitted Diseases - diagnosis; Sexually Transmitted Diseases - epidemiology; United States - epidemiology; United States; Family planning; Reproductive health services; Community health centers; Contraceptive methods; Contraceptive; Public health
• ISSN: 0010-7824; 1879-0518
• DOI: 10.1016/j.contraception.2013.09.015

Abstract Objectives Federally Qualified Health Centers (FQHCs) are a major and growing source of primary care for low-income women of reproductive age; however, only limited knowledge exists on the scope of family planning care they provide and the mechanisms for delivery of these essential reproductive health services, including family planning. In this paper, we report on the scope of services provided at FQHCs including on-site provision, prescription only and referral options for the range of contraceptive methods. Study Design An original survey of 423 FQHC organizations was fielded in 2011. Results Virtually all FQHCs reported that they provide at least one contraceptive method (99.8%) at one or more clinical sites. A large majority (87%) of FQHCs report that their largest primary care site prescribes oral contraceptives plus one additional method category of contraception, with oral contraception and injectables being the most commonly available methods. Substantial variation is seen among other methods such as intrauterine devices (IUDs), contraceptive implants, the patch, vaginal ring and barrier methods. For all method categories, Title-X-funded sites are more likely to provide the method, though, even in these sites, IUDs and implants are much less likely to be provided than other methods. Conclusion There is clearly wide variability in the delivery of family planning services at FQHCs in terms of methods available, level of counseling, and provision of services on-site or through prescription or referral. Barriers to provision likely include cost to patients and/or additional training to providers for some methods, such as IUDs and implants, but these barriers should not limit on-site availability of inexpensive methods such as oral contraceptives. Implications With the expansion of contraceptive coverage under private insurance as part of preventive health services for women, along with expanded coverage for the currently uninsured, and the growth of FQHCs as the source of care for women of reproductive age, it is critical that women seeking family planning services at FQHCs have access to a wide range of contraceptive options. Our study both highlights the essential role of FQHCs in providing family planning services and also identifies remaining gaps in the provision of contraception in FQHC settings.