BY MELINDA YOUNG
Worry-Free Sex
Funding extended for Oregon’s
Family Planning Expansion Project.
F
or thousands of UO students, there is
one incomparably good reason to
brave the student Health Center even
on its busiest days — free birth control.
The UO Health Center is one of more than
120 statewide providers that offers free birth
control and family planning resources to
women and men who otherwise couldn’t
afford it, thanks to Oregon’s Family
Planning Expansion Project (FPEP),
which reimburses the providers for
these services.
Despite its importance, funding
for FPEP, a five-year “demonstration
project,” was originally slated to end this
December. But last month, the federal gov-
ernment renewed FPEP through October
2006. Even an administration that’s presently
waging war against family planning pro-
grams cannot dispute FPEP’s benefits: The
savings are substantial, the social impacts far-
reaching.
At sites where FPEP is offered, the UO
Health Center, LCC, Planned Parenthood or the
Public Health Department, clients go through
the same process: After scheduling an appoint-
ment, they merely fill out an eligibility form, go
through a height/weight/blood pressure check,
and have an informative conversation with a
typically pleasant nurse practitioner.
Eligibility requirements include being a
U.S. citizens and for Oregon residents, hav-
ing an income within 185 percent of the fed-
eral poverty level (a single person with an an-
nual income less than $16,613 or a family of
four with less than $34,040).
As long as they meet eligibility require-
ments, clients receive the kind of birth con-
trol they prefer, such as pills, diaphragms and
condoms (including expensive methods like
Depo-Provera) at no cost. In most cases, they
can walk out with a supply of contraceptives
that day.
On-the-spot allocation of contraception is
a cornerstone of FPEP. Jeanne Atkins, FPEP
program manager, emphasizes the impor-
tance of not making clients apply for contra-
ceptives only to make them wait several
weeks to receive them. “Because,” she says,
“people don’t necessarily wait until they can
get birth control to have sex.”
$1.75
In addition to birth control and family
planning resources, eligible women receive
free annual exams and pregnancy tests
through FPEP and eligible men may also re-
ceive family planning counseling and serv-
ices.
‘It is no small
accomplishment
that Oregon
received this
renewal.’
– Marilyn Helton,
Planned Parenthood
Because FPEP is a program specifically
geared toward preventing unintended preg-
nancies, resources are allotted on the premise
that clients want to avoid this particular situa-
tion (safer sex, though, is an added benefit).
THE VISION
The vision for FPEP was born seven years
ago when the Oregon Legislature joined
forces with several public health departments
and family planning programs to reduce the
high rates of teen pregnancies in the state.
The visionaries knew the cost of providing
free birth control would be less than the short-
term and long-term costs of Medicaid-funded
births.
The people involved — then-Gov. John
Kitzhaber, Bill Sheppard, CEO of the re-
gional Planned Parenthood, and Atkins —
began drafting the proposal to the federal
Medicaid office. FPEP was proposed as a
waiver project similar to the Oregon Health
Plan. Like the OHP, it would reach economi-
cally disadvantaged people who may not
qualify for Medicaid. The goals cited in the
proposal were to decrease unintended preg-
nancies among teenagers and women of all
ages, to expand family planning services, and
to save significant dollars.
“It was an exciting opportunity,” says
Atkins. “But meeting all of the requirements
of the federal Medicaid office for this kind of
waiver was a bureaucratic challenge.”
So challenging, in fact, that it took almost
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two years to write. The work put into the
complicated and lengthy waiver application
would ultimately pay off though. In late
1998, the approval from the federal Medicaid
office came through.
“We were celebrating in the clinic hall-
ways the minute approval from the feds was
received in the fall of 1998,” says Marilyn
Helton, patient services co-director of
Planned Parenthood of Southwestern
Oregon.
Since that time, Helton says, “We have
seen nearly 400 percent growth since FPEP
began in early 1999. We have built new clin-
ics in the Bethel/Danebo neighborhood and
on Q Street in Springfield, purchased larger
buildings, expanded hours of operation, and
hired many additional staff.”
Family planning clinics and health centers
across the state cite similar expansion of their
services and programs. Thus the “expansion”
in Family Planning Expansion Project.
In constantly soliciting feedback through
surveys and focus groups, FPEP employees
like Uebel have tailored the program to fulfill
clients’ requests. Some changes seen over the
past five years include shortening waiting
times at clinics; providing educational mate-
rials directed toward male partners, espe-
cially in the Latino communities; and provid-
ing additional cultural competency training
to service providers.
Renewal of FPEP through October 2006
is cause for celebration for employees,
providers and clients alike. “In the face of
such a conservative administration and polit-
ical climate, it is no small accomplishment
that Oregon received this renewal,” says
Helton.
Until now, many providers were waiting
in the wings, unsure if they would be able to
continue offering services beyond December.
The UO Health Center was urging clients to
take care of their birth control needs by the
end of the year. Now they can rest easy — at
least for another three years.
MILLIONS IN SAVINGS
More than 10,000 unintended pregnan-
cies among Medicaid subscribers were
averted during FPEP’s first two years alone.
(This was measured by comparing the num-
ber of actual unplanned pregnancies to the
number of expected unplanned pregnancies.)
With the typical cost of a Medicaid birth esti-
mated at $4,875, that’s an estimated gross of
$64.9 million in savings.
Over the past five years, thousands of
women and men have come to rely on
FPEP’s services to help prevent unplanned
pregnancies. Arwen Ungar, a UO senior, has
used FPEP through Eugene’s Planned
Parenthood since she was 16. Ungar received
free birth control based on her own income,
not that of her parents. Through the inherent
privacy FPEP offers, Ungar was given the
freedom to make decisions on her own.
Understanding the needs of clients is of
utmost importance to FPEP staff. They know
that many people have been misinformed or
have had bad experiences with birth control
in the past and that many welfare recipients
have been treated with judgment and conde-
scension in the past.
“The ultimate goal is to make sure that
every FPEP-qualified person receives the in-
formation and care that they deserve,” says
Leslie Uebel, FPEP social marketing coordi-
nator.
LOOKING FOR
PERMANENCE
FPEP employees and providers intend to
continue their quest to constantly improve the
program. At a statewide level, the primary
focus will be on reaching out to clients who
may not have had access up to this point.
(Though, unfortunately because of citizen-
ship requirements, this does exclude some
populations that could greatly benefit from
FPEP.) At the provider level, programs like
Planned Parenthood and the UO Health
Center are looking for more ways to expand
their services.
The greater hope is that FPEP may some
day obtain permanent status. Clinics through-
out the state are keenly aware of Marilyn
Helton’s observation — that until such a pro-
gram becomes permanent and no longer
deemed a “demonstration project,” it could
disappear.
After all, as long as people continue to be
sexually active, the need for this program will
exist. Says Jeanne Atkins, “We are just begin-
ning to see the impact on unintended preg-
nancies that such an effort [as FPEP] can pro-
duce.”
For more information about FPEP
(including county programs), visit
www.dhs.state.or.us/publichealth/fp/about.cfm ew
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