Member Spotlights
Oregon Health Authority's Women's and Reproductive Health Section
Portland, OR
Editor’s Note: In honor of NFPRHA’s 40th anniversary, the 2011 Member Spotlights have highlighted current NFPRHA members who have been involved in the organization throughout its history, and specifically members who were included in NFPRHA’s former publications in the 1980s and 1990s. We hope that you enjoyed our yearlong commemoration of NFPRHA’s 40 years of service and advocacy.
Startling Impact in Oregon (reprinted from “NFPRHA News” publication, December 1981) – Family planning clinics throughout Oregon reported a startling 38% drop in under-18 patients between [June 30, 1981, and] December 1981…most likely as the result of confusion over the proposed parental notification regulations, according to Guerry Dean of the Family Planning Advocates of Oregon. In some counties of the state, family planning providers registered drops of up to 60% in under-18 patients and clinic officials expressed fears of a massive upsurge in unplanned teenage pregnancies in the coming months.
Peter McLean, Multnomah County Health Educator, noted, “the worst part is we can’t even notify our regular patients that it’s okay to come in. How can we call or write someone without possibly destroying the confidentially we try so hard to maintain?” And Janet Engle, Clinic Director of Planned Parenthood of Portland stated, “if you’re not involved, you might overlook the human tragedy in these statistics. These young women are driven away by a false fear… they can’t talk to their parents, and now, they’re afraid to talk to us. So they start taking chances again – until they really end up pregnant. Then what?”
The Oregon Health Authority’s Women’s and Reproductive Health Section has a long-standing history of providing comprehensive sexual and reproductive health care to the citizens of Oregon. For more than 51 years, Oregon’s Women’s and Reproductive Health Section has served many roles in the state including, but not limited to, grant administrator, provider, and educator. As one of two Title X grantees in Oregon, the program manages 36 delegate agencies, and has 155 health centers within its network. The program is funded solely through state funds, Title X, and Medicaid family planning dollars.
Oregon developed a model of integration between its Title X and Medicaid family planning waiver (Oregon Contraceptive Care, also known as C-Care) to reach and provide services to more Oregonians. According to the program’s 2010 Program Report, “[t]his integration has allowed Oregon to administer programs through one office, align policies and streamline communications.”1 Because of the program integration and other common initiatives, family planning services in Oregon have more than doubled in 10 years – from providing services to 50,000 clients in 90 health centers to more than 112,500 clients in 155 health centers in 2010.2 Oregon continues to operate the only integrated Title X and Medicaid family planning health system in the nation. In 2010 alone, more than 16,900 unintended pregnancies were averted.3
Oregon’s Women’s and Reproductive Health Section works to expand access to care while facilitating delivery of a wide range of services, such as: contraceptive methods, including vasectomy; counseling and education; breast, cervical, and testicular cancer screenings; diagnosis and treatments of STDs; STD/HIV prevention counseling; infertility prevention and other services; pregnancy tests; information and referrals to other preventive health and social services; specialized care services for intimate partner/domestic violence; and community outreach and education. Seventy-five percent of the patients served by providers of the program are between the ages of 18-29, although the program serves all women as long as they are of reproductive age (between age 10 and 64), and significant outreach has been made to ensure access for minority communities.
Oregon is also a leader among the states in several ways. After the DRA was implemented, new proof of citizenship requirements presented an additional obstacle for patients trying to access care. The Women’s and Reproductive Health Section offers assistance to clients in proving citizenship by electronically matching birth records for clients born in the state and ordering out-of-state birth certificates on behalf of clients born outside of Oregon. In addition, it will soon be implementing a process to verify all enrolling clients’ citizenship through
the Social Security Administration. The program also has a provider work group that serves as an advisory committee to review new ideas and policies. Composed of providers from rural and urban areas - including Planned Parenthoods, local county health departments, university health centers, and federally qualified health centers - the advisory committee offers an on-the-ground perspective that is invaluable.
Despite these advances, a combination of factors - including the DRA citizenship requirement and a requirement that teens provide a Social Security Number to enroll in CCare - has driven down the number of people enrolled in C-Care. Oregon has responded with several initiatives to bolster those numbers, devoting a social marketing staffer to online and new media outreach. The state recently achieved some enrollment success through a traditional media campaign featuring cinema, bus, billboard, and electric rail advertisements. Despite the fact
that funding for such promotional campaigns is always in short supply, the program is committed to continue pushing for innovative and diverse community outreach.
The Oregon Health Authority’s Women’s and Reproductive Health Section stands as a model for other states through its integration of Title X and Medicaid, and the pioneering ways in which it has developed community outreach services and integrated with service provider networks.
1Oregon Health Authority, Public Health Division, Reproductive Health Program, Celebrating the Past, Embracing the Future: 2010 Oregon Reproductive Health Program Report, accessed December 20, 2011, http://public.health.oregon.gov/HealthyPeopleFamilies/ReproductiveSexualHealth/Resources
/Documents/9857_Family_Planning_Report_2010_Color-Single-Pages-WEB.pdf.
2 Ibid.
3 Ibid.
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Visit the Oregon Health Authority's Women's and Reproductive Health Section on the web at:
http://public.health.oregon.gov/PHD/Directory/Pages/program.aspx?pid=24