Service Area Strategic Plan
11/23/2009   4:46 am
Department of Health (601)
Biennium: 2008-10
Service Area 1 of 1
Local Family Planning Services (601 440 05)
Description

Local family planning services provide primary and secondary prevention, as well as health promotion, diagnosis and treatment. Family planning counseling is an example of primary prevention. The counseling involves specific intervention to protect against an unintended condition (pregnancy), or to plan for a future pregnancy. This is a voluntary program that offers all men and women in the Commonwealth, regardless of financial status, a means to exercise personal choice in determining the number and spacing of their children. Secondary prevention such as Papanicolaou smear or Chlamydia screening promotes early case finding for cervical cancer and infertility. Health promotion activities such as nutrition counseling, smoking cessation, and behavioral risk reduction counseling all focus on activities that increase a person’s overall level of health and health awareness. Family planning services assist individuals in preventing sexually transmitted infections and play a major role in the early detection of breast and cervical cancer. Local family planning services also include:

Promotion of abstinence education and family involvement messages to minors seeking services,
Provision of acceptable and effective methods of contraception, and
Pre-conceptional counseling.
Background Information
Mission Alignment and Authority
  • Describe how this service supports the agency mission
    This service area is directly aligned with the mission of the Virginia Department of Health to promote and protect the health of Virginians by providing primary and secondary prevention, health promotion, diagnosis and treatment. Family planning allows sexually active persons the option of postponing children until they are financially, emotionally and physically able to bear the responsibilities of parenthood. Promoting abstinence as the only sure way of preventing unwanted pregnancies and sexually transmitted infections among those not married. Prevention of teen pregnancy helps teens to meet education and career goals prior to childbearing, increasing their potential to become independent contributing citizens of Virginia. The development of sexual responsibility encourages healthy attitudes toward marriage and family.
  • Describe the Statutory Authority of this Service
    Code of Virginia § 32.1-2 requires the Virginia Department of Health to administer a comprehensive program of preventive, curative, restorative and environmental health services, including prevention and education activities focused on women’s health.

    Code of Virginia Section 32.1-11 authorizes the Board of Health to formulate a program of environmental health services, laboratory services and preventive, curative and restorative medical care service, including home and clinic health services.

    Title X of the Public Health Service Act, 42 U.S.C. 300, et, seq
    Public Law 91-572, Section 1001.
    Title X (42 CFR Part 59, Subpart A) – Regulations governing Title X set out the requirements of the Secretary of Health and Human Services, for the provision of family planning services funded under Title X and implement the statute as authorized under Section 1001 of the Public Health service Act.

    Federal Title X funding for family planning agencies originates from the Family Planning Services and Population Research Act of 1970, P.L. 91-572. This law was amended in 1975 and 1978 to require Title X projects to provide access to natural family planning, infertility, and adolescent services. These amendments require that economic status not be a deterrent to receiving family planning services.

    Code of Virginia §54.1-2969 - States that a minor shall be deemed an adult for the purposes of consenting to services related to birth control, pregnancy or family planning and the diagnosis or treatment of venereal disease.

    Virginia Department Health Policy, “Limits on Confidentiality for Minors Choosing 'Do Not Contact' Status” - Minor patients must be informed of the advantages of involving their parents or guardians in their medical care. The advantages of parental involvement include: provision of important medical history, assistance to the minor with making wise decisions, and potential for improving family relationships.
Customers
Agency Customer Group Customer Customers served annually Potential annual customers
Low income <250% of Federal Poverty Level individuals served 65,686 371,640
Minority patients served 34,445 167,238
Total Individuals served 74,738 371,640

Anticipated Changes To Agency Customer Base
External (economical, political, technological) pressures will influence changes in the customer base particularly in terms of the number of low-income women.
Partners
Partner Description
[None entered]
Products and Services
  • Factors Impacting the Products and/or Services:
    Service capacity is affected by available funding

    Access to care

    Immigration of foreign-born persons has caused and is likely to continue to require adaptations to language and cultural barriers.
  • Anticipated Changes to the Products and/or Services
    Pap Smear technology advances will improve capability to diagnose and treat

    Immunization against Human Papilloma Virus likely to be available in the near future. This sexually
    transmitted virus is the most common cause for cervical cancer.

    Birth control technology will improve which is likely to attract more clients

    Higher health care costs, fewer employers offering affordable health care insurance, and the Medicaid Family Planning Waiver limiting service coverage to two years post pregnancy will increase the numbers of women seeking publicly funded family planning services.
  • Listing of Products and/or Services
    • Service Evaluation Determine customer satisfaction through annual survey. Maintain contact with area professionals to communicate and receive feedback of effectiveness of services being provided Monitor changes in demographics so the proper number of trained staff are available to serve customers. Also need to recognize shifts in customers who do not speak English so bilingual staff or volunteers are available
    • Three kinds of prevention services are provided: primary, secondary, and health promotion. Prevention products and services are provided primarily through education and screening. 1. Primary Prevention Family Planning – this includes counseling involving specific intervention to protect against an unintended pregnancy, or to plan for a future pregnancy and sexual risk reduction. Abstinence promoted to teens and unmarried Current standard and acceptable contraception methods: Barrier methods, male & female condoms, vaginal foam Hormonal, birth control pills, transdermal patches or injections Intrauterine device Diaphragm, Vaginal Ring Female or male sterilization [on limited basis according to funding] Risk reduction including limiting number of sexual partners and safer sex practices. Pregnancy testing and management of early prenatal care Establish there is a pregnancy Refer to Social Services for Medicaid eligibility Refer for maternity care with delivery health care professional Preconception counseling and testing Infertility counseling and referrals 2. Secondary Prevention These screenings promote early case finding of blood pressure, breast & cervical cancer and infertility. This would include but not be limited to: Breast diseases including cancer Cervical pap smear Chlamydia and other sexual transmitted diseases Blood pressure checks and referrals 3. Health Promotion Nutrition Counseling Folic Acid supplements Fluoride supplements if appropriate BMI [Body Mass Index] assesses body fat Smoking cessation Referrals for Drug / Alcohol / Addiction Mental Health Referrals Dental Health Immunizations Hepatitis B for those at risk Flu immunization annually
    • Community Involvement Information dissemination on populations being served. Outreach efforts to at risk populations and the community at large Recruitment of medical providers/facilities (voluntary sterilization program) Partnerships, collaborations, and coalition building with community agencies/providers/programs both internal and external.
Finance
  • Financial Overview
    Local health department family planning services are funded by a variety of sources. The major source of funding is through the Cooperative Budget including both state and local matching funds. The service area receives state funds for the purchase of contraceptives and cervical cancer screening services. The service area also receives federal Title X funds to supplement family planning services in the local health departments.
  • Financial Breakdown
    FY 2009    FY 2010
      General Fund     Nongeneral Fund        General Fund     Nongeneral Fund  
    Base Budget $8,501,256 $11,313,913    $8,501,256 $11,313,913
    Change To Base $-374,565 $-369,447    $-495,382 $-387,538
               
    Service Area Total   $8,126,691  $10,944,466     $8,005,874  $10,926,375 
Human Resources
  • Human Resources Overview
    [Nothing entered]
  • Human Resource Levels
    Effective Date      
    Total Authorized Position level Ø    
    Vacant Positions Ø    
    Current Employment Level 0.0    
    Non-Classified (Filled)    
    Full-Time Classified (Filled)    breakout of Current Employment Level
    Part-Time Classified (Filled)    
    Faculty (Filled)    
    Wage    
    Contract Employees    
    Total Human Resource Level 0.0   = Current Employment Level + Wage and Contract Employees
  • Factors Impacting HR
    [Nothing entered]
  • Anticipated HR Changes
    [Nothing entered]
Service Area Objectives
 
  • Increase the number of individuals served who are in need of publicly funded family planning services.
    Objective Description
    Local family planning services provide primary and secondary prevention, as well as health promotion, diagnosis and treatment. Family planning counseling is an example of primary prevention. The counseling involves specific intervention to protect against an unintended condition (pregnancy), or to plan for a future pregnancy. This is a voluntary program that offers all men and women in the Commonwealth, regardless of financial status, a means to exercise personal choice in determining the number and spacing of their children. Secondary prevention such as Papanicolaou smear or Chlamydia screening promotes early case finding for cervical cancer and infertility. Health promotion activities such as nutrition counseling, smoking cessation, and behavioral risk reduction counseling all focus on activities that increase a person’s overall level of health and health awareness. Family planning services assist individuals in preventing sexually transmitted infections and play a major role in the early detection of breast and cervical cancer. Local family planning services also include: Promotion of abstinence education and family involvement messages to minors seeking services, Provision of acceptable and effective methods of contraception, and Pre-conceptional counseling.
    Objective Strategies
    • Assure provision of family planning services which comply with state and federal Title X Family Planning Program requirements. Increase public awareness of local health department family planning services within the general community with a focus on hard to reach and high risk populations. Collaborate with community partners to provide access to health department family planning services for women in need. Provide a range of appropriate, affordable and safe contraceptive methods for women in need. Identify and address barriers to access such as language, transportation and appointment availability. Assess customer satisfaction with quality of health department services and modify as indicated.
    Objective Measures
    • Number of individuals served
      Measure Class:
      Other
      Measure Type:
      Output
      Measure Frequency:
      Annual
      Preferred Trend:
      Maintain
      Measure Baseline Value:
      74738
      Date:
      12/31/2004

      Measure Baseline Description: Number of individuals

      Measure Target Value:
      66801
      Date:
      6/30/2010

      Measure Target Description: Number of individuals

      Data Source and Calculation: Virginia Department of Health Web VISION

  • Reduce the teenage pregnancy rate.
    Objective Description
    The United States has highest pregnancy and birth rates of any industrialized country. The negative consequences of teen motherhood include: less likely to complete high school [only 32% of those with one child complete high school], dependent on welfare, more likely to have more children sooner on a limited income, and more likely to abuse or neglect the child. The negative impacts on the child include: Low birth weight and prematurity more likely, Higher percent of school failure, Insufficient health care, and Increased chance of being abused or neglected In the United States the teen birth rate declined steadily from 1960 through the mid-1970s, stayed fairly constant for the next decade, then increased 24 percent between 1986 and 1991. Between 1991 and 1999, the teen birth rate decreased 20% to a record low. This decline has continued into this century. [National Campaign to Prevent Teen Pregnancy analysis of Henshaw, S.K., U.S. Teenage Pregnancy Statistics, New York: Alan Guttmacher Institute, May 1996] Virginia has also seen a continual steady decline of teen pregnancy rates. In 1987 the rate was 45.6/1000 compared with 27.4/1000 in 2003. [Virginia Center for Health Statistics]
    Objective Strategies
    • Promote abstinence as best choice for teens Provide intensive education about sexual health, making healthy choices and avoiding risky behaviors. Encourage family involvement in making decisions about sexual health. For teen choosing to be sexually active, provide information about contraceptive methods and help select the method best suited for them. Assess teen’s satisfaction with local health department services and modify as indicated. Identify and remove barriers to teens receiving local health department services such as transportation and appointment availability. Increase public awareness of health department services for teens Health fairs in private and public schools and colleges News articles Media coverage Develop community partnerships with public and private agencies, governing bodies, parents and youth to address teen pregnancy prevention.
    Objective Measures
    • Teen pregnancy rate
      Measure Class:
      Other
      Measure Type:
      Outcome
      Measure Frequency:
      Annual
      Preferred Trend:
      Down
      Measure Baseline Value:
      26.5
      Date:
      12/31/2004

      Measure Baseline Description: Number per 1,000 for 10-19 year olds

      Measure Target Value:
      26.2
      Date:
      6/30/2010

      Measure Target Description: Number per 1,000 for 10-19 year olds

      Data Source and Calculation: Virginia Department of Health Center for Health Statistics


Back to the Strategic Planning Page
http://www.vaperforms.virgina.gov