A Review of the HHS Family Planning Program Mission, Management, and Measurement of Results (2009) / Chapter Skim
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Appendix F: Committee Site Visits
Appendix F: Committee Site Visits
Pages 267-284
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The sites visited were selected to reflect various geographic regions, clinic types (including health departments, community health centers, hospital and academic centers, and Planned Parenthood health centers) , and patient demographics (including race and ethnicity)
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A summary of the strengths and weaknesses of the Title X program cited by interviewees is presented below, followed by a summary of the interviewees' perceptions of the Family Planning Annual Report (FPAR) and additional findings.
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12. Does the site work in conjunction with other clinics or other organizations that provide family planning services?
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___ Education ___ Counseling ___ History, physical assessment, labs ___ Fertility regulation (contraception) ___ Infertility services ___ Pregnancy diagnosis and counseling ___ Adolescent services ___ GYN services ___ STD and HIV/AIDS ___ pecial counseling (future pregnancies, substance use, sexual S abuse, domestic violence)
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33. Does your program coordinate with other clinics or organizations that provide family planning services?
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12. Does the site work in conjunction with other clinics or organizations that provide family planning services?
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___ Education ___ Counseling ___ History, physical assessment, labs ___ Fertility regulation (contraception) ___ Infertility services ___ Pregnancy diagnosis and counseling ___ Adolescent services ___ GYN services ___ STD and HIV/AIDS ___ pecial counseling (future pregnancies, substance use, sexual S abuse, domestic violence)
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that provide family planning services?
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12. Does the site work in conjunction with other health departments or organi zations that provide family planning services?
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___ Education ___ Counseling ___ History, physical assessment, labs ___ Fertility regulation (contraception) ___ Infertility services ___ Pregnancy diagnosis and counseling ___ Adolescent services ___ GYN services ___ STD and HIV/AIDS ___ pecial counseling (future pregnancies, substance use, sexual S abuse, domestic violence)
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Does the site work in conjunction with other health departments or organizations that provide family planning services?
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12. Does the site work in conjunction with other planned parenthood clinics or other organizations that provide family planning services?
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From page 279... ...
___ Education ___ Counseling ___ History, physical assessment, labs ___ Fertility regulation (contraception) ___ Infertility services ___ Pregnancy diagnosis and counseling ___ Adolescent services ___ GYN services ___ STD and HIV/AIDS ___ pecial counseling (future pregnancies, substance use, sexual S abuse, domestic violence)
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Do you work in conjunction with other organizations that provide family planning services?
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From page 281... ...
Moreover, interviewees reported having difficulty meeting Title X's "unfunded mandates," which they described as multiplying each year in the form of annual program priorities that require additional service components with no additional funding. Interviewees also expressed frustration with requirements to follow Title X program guidelines that are outdated and do not reflect current best practices as outlined by professional organizations, such as the American College of Obstetricians and Gynecologists.
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Additional Findings Difficult-to-Reach Groups While the client population varies depending on the location of the Title X site, several interviewees reported that difficult-to-reach groups include women aged 20–40 who have no health problems, as well as older women who may think they are less fertile than they used to be and thus no longer need to worry about contraception. Another interviewee noted that the "undocumented, homeless, poor, and children in foster care are the most hard-to-reach in the neighborhood." The gay, lesbian, bisexual, and transgender population was also cited as being difficult to reach.
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Many respondents had one or two bi- or multilingual staff members and a phone service that provided access to an interpreter for a wider range of languages. Best Practices Best practices identified during the site visits included holding a Friday Clinic during which there are no scheduled appointments, and women without health insurance are welcomed; providing a warm and inviting clinic environment; offering a "Quick Start" program through which the clinic is able to provide birth control pills immediately and then arrange appointments within 3 months; engaging the local community to build trust and maintaining those relationships; cross-training personnel, which allows for growth through acquisition of advanced skills; and holding events such as a fish fry and health fair in the parking lot to reach out to the community.
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284 A REVIEW OF THE HHS FAMILY PLANNING PROGRAM refills can get an appointment for an "expedited visit" more quickly. Few interviewees provided information regarding client wait times at the clinic; however, those who did so said that patients were generally seen within about a half-hour of arriving at the clinic.
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