Health centers are legally required to feature voluntary family planning among their services, and have the option to apply for Title X grants to improve the quality of their care. The Title X program is a federal grant focused on family planning, and allows participating clinics to access greater resources and contraception services. Many women in underserved communities look to local community health centers for reproductive health care.
The Kaiser Family Foundation recently conducted a survey of community health centers and the breadth of their family planning services. Administered from May to July 2017, the survey captures information on 546 health centers in the 50 states and the District of Columbia.
Compared to non-Title X centers, more Title X-participating centers consistently offer more effective and high-quality family planning services, as the above Figure depicts. Health centers are considered to exhibit the highest level of performance if they provide all of the seven most effective family planning methods onsite or by prescription, adhere to all three best practice methods related to contraceptives, and allow new patients to set up family planning appointments on a same-day or walk-in basis. The three contraceptive best practices are: not requiring a pelvic exam to prescribe oral contraceptives, using the “quick start” method, and dispensing one-year supplies of contraceptives so return visits are unnecessary. Only 2% of non-Title X sites are considered optimal by these criteria, compared to 17% of Title X sites.
Although very few health centers perform at the highest level, the superiority of Title X centers compared to non-Title X centers remains clear across all measures of quality. Recent proposed changes by the current Health and Human Services leadership regarding requirements for Title X funding to community health centers threaten the quality and effectiveness of family planning services provided in the United States.
Graphic: Figure 6 from the report Community Health Centers and Family Planning in an Era of Policy Uncertainty, Susan F. Wood, Julia Strasser, Jessica Sharac, Janelle Wylie, Thao-Chi Tran, Sara Rosenbaum, Caroline Rosenzweig, Laurie Sobel, and Alina Salganicoff.