title: Scope of family planning services available in Federally Qualified Health Centers.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Health Policy, The George Washington University School of Public Health and Health Service, Washington, DC 2006, USA. Electronic address: sfwood@gwu.edu.
authors.forename: Susan
authors.initials: S
authors.lastname: Wood
authors.affiliation: Department of Health Policy, The George Washington University School of Public Health and Health Service, Washington, DC 2006, USA.
authors.forename: Tishra
authors.initials: T
authors.lastname: Beeson
authors.affiliation: Department of Health Policy, The George Washington University School of Public Health and Health Service, Washington, DC 2006, USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Bruen
authors.affiliation: Department of Health Policy, The George Washington University School of Public Health and Health Service, Washington, DC 2006, USA.
authors.forename: Debora Goetz
authors.initials: DG
authors.lastname: Goldberg
authors.affiliation: Department of Health Policy, The George Washington University School of Public Health and Health Service, Washington, DC 2006, USA.
authors.forename: Holly
authors.initials: H
authors.lastname: Mead
authors.affiliation: Department of Health Policy, The George Washington University School of Public Health and Health Service, Washington, DC 2006, USA.
authors.forename: Peter
authors.initials: P
authors.lastname: Shin
authors.affiliation: Department of Health Policy, The George Washington University School of Public Health and Health Service, Washington, DC 2006, USA.
authors.forename: Sara
authors.initials: S
authors.lastname: Rosenbaum
mesh_terms: D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data; D003267:Contraception / Q000379:methods* / Q000706:statistics & numerical data; D003270:Contraceptive Agents; D005193:Family Planning Services / Q000706:statistics & numerical data; D006801:Humans; D011320:Primary Health Care / Q000706:statistics & numerical data; D012749:Sexually Transmitted Diseases / Q000175:diagnosis* / Q000453:epidemiology; D014481:United States / Q000453:epidemiology
chemical_list: D003270:Contraceptive Agents
keywords: Community health centers; Contraceptive methods; Family planning; Reproductive health services