Medicaid Family Planning Program ‘Successful’

California's vanguard Medicaid-funded family planning program has successfully expanded access to care and services for "large numbers" of state residents, according to a report in the October 2000 issue of the Guttmacher Report on Public Policy. A newly released study conducted by the Institute for Health Policy Studies and the University of California-San Francisco's Department of Obstetrics, Gynecology and Reproductive Sciences called California's effort to increase the use of effective contraceptive methods and improve access to reproductive health services among low-income residents "successful." Launched in 1997 with state funds, the Family Planning, Access, Care and Treatment Program is an "open-ended" entitlement that provides state-funded family planning services and supplies for residents with incomes up to 200% of the poverty level. In December 1999, the HCFA granted California a waiver allowing Family PACT to become part of the Medicaid program. As a result, the state now receives federal reimbursement for 90% of the program's costs. While several states have Medicaid-funded family planning services, Family PACT has three "unique" features, including:

• A "one-stop shopping" approach: California determines participants' eligibility at the same site where patients may obtain services, allowing "immediate" eligibility determination and eliminating a trip to a welfare agency -- "widely considered to be a deterrent to enrollment";
  
• An expanded delivery system: In addition to public clinics, California includes private physicians in the program to increase access to services and allow participants to chose a provider who meets "individual needs";
  
• Inclusion of pharmacies: While enrollees can obtain contraceptive supplies from the state's 450 clinics, they also receive a card allowing them to have prescriptions refilled at the pharmacy, and providers may also write prescriptions for over-the counter supplies, such as condoms -- a process that allows pharmacies to claim reimbursements from the state.

According to the study, which examined Family PACT's FY 1997-98 record, the program provided services to 749,572 participants, including 642,000 women and 28,000 men. Six in 10 already had at least one child, and 61% were Hispanic. While one-third of the program's participants receiving contraceptives previously used "ineffective" contraceptive methods, 95% began using "effective" methods after their initial visit. In addition, four in 10 began using "more reliable" contraceptive methods. Researchers also estimated that the program prevented 108,000 unintended pregnancies, including 24,000 teen pregnancies, and helped California women, including 9,000 teens, avoid 41,000 abortions. In FY 1997-98, Family PACT spent $114.4 million in direct client services, but the pregnancies prevented by the program would have cost $511.8 million in medical, social services and education costs, leading researchers to conclude that "every dollar spent through Family PACT saved an estimated $4.48 in public expenditures." Pointing out that the program "represents an important investment in the state's future," Claire Brindis, one of the study's researchers, said that the "importance of the full range of services provided under Family PACT -- including screening for cervical cancer, STDs and HIV -- is indisputable and very real for the women, men and families of California" (Gold, Guttmacher Report on Public Policy, 10/00).