Member Spotlights

Montana Department of Public Health and Human Services

Helena, Mont.

The Montana Department of Public Health and Human Services (DPHHS) has been the state’s only Title X grantee since 1972. Federal funding through Title X, the Maternal Child Health (MCH) block grant and the Preventive Health Block Grant, supports Montana DPHHS’ Women’s and Men’s Health Section (WMHS) in providing high-quality family planning services in 28 locations through 14 delegate agencies.

In 2010, Montana Title X health centers served 27,731 patients from all 56 of the state’s counties. Eighty-five percent of all Title X patients in the state are low income and qualify for care at reduced or no cost.

Since its inception, the Montana Family Planning Program has evolved from focusing primarily on women’s reproductive health needs to providing a broad range of women’s and men’s health services. Montana Title X health centers now incorporate male services, infertility prevention and HIV screening as a routine part of its ser­vices. Nurse practitioners provide the majority of clinical services, with registered nurses providing emergency contraception, “quick start” contraceptive services, and Chlamydia and rapid HIV screening.

The Montana Title X program has expanded to include both the Office of Population Affairs’ HIV Integration Project and Male Services Project. The statewide HIV Integration Project supports HIV testing as a routine screen­ing during the family planning visit. In the 2011 project year, more than 3,000 HIV tests were performed, nearly three times as many than were provided in 2006, the first year of the project. In addition, three local service sites are currently piloting a “social networks strategy” to more effectively target HIV testing to those most at risk for infection.

Due to the Male Services Project, Montana Title X health centers have experienced a 45% increase in the number of males served in the past three years. Activities of this project include improving clinical skills through train­ing on male exam techniques, waiting room renovations that create a more welcoming environment for male patients, and conducting focus groups with men to identify needed services.

In many ways, it would seem that the scope of reproductive health services for Montana’s women and men has never been greater. However, like Title X programs nationwide, Montana’s network of Title X health centers faces serious challenges. The high cost of contraceptive supplies has made it difficult for centers to provide a broad range of contraceptive methods. Funding cuts at the state and federal level have led to a 24% decrease in total contract funds for local health centers. In response, Title X agencies have had to reduce both staff and health center hours.

Montana’s Title X program has also faced significant political challenges. Mirroring the federal Fiscal Year 2011 battle over Title X funding, the Montana legislature voted to cut all family planning funding in the state, includ­ing rejecting federal Title X funding. Fortunately, the state’s Title X funding was eventually restored to Montana’s budget; however, the state ultimately received fewer Title X dollars due to the id="mce_marker"8.1 million cut to Title X at the federal level. In addition, all state funds were eliminated from the family planning budget. The WMHS has assisted health center directors in developing financial sustainability and center efficiency plans. In addition, the WMHS has provided training on increasing health center revenue, particularly through increased and more effective insurance billing. As a result, an increase in public and private insurance payments has partially offset the recent decline in funds

While the economic outlook remains uncertain, and other challenges lie ahead, DPHHS and the WMHS remain committed to reproductive health care for women and men in Montana.

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National Family Planning & Reproductive Health Association

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