The aim of this study was to examine perceptions of Health Department and Federally Qualified Health Care clinic- and system-level staff regarding the impact of Choose Well-provided trainings on clinic organizational resources and clinic scope of services.

The purpose of this Policy Brief is to provide comprehensive contextual evidence for Title X services given the historical context and current policy landscape surrounding contraceptive care and access to services, particularly in the United States South.

Youth-friendly, person-centered contraceptive care (YFPCCC) improves the quality of care that youth receive. Research shows that clinic characteristics that support youth-friendly, person-centered care,like confidentiality and consent policies and trained providers, contribute to high quality contraceptive care for youth. As such, establishing or strengthening clinic policies requiring training and confidentiality will support a clinic’s capacity to provide YFPCCC. Understanding Southern safety-net clinics’ characteristics supporting YFPCCC and Southern youths’ perceptions of their care can highlight areas where policies may need to be established or strengthened.

Choose Well (CW), an ongoing statewide contraceptive access initiative in South Carolina, was launched in 2017 and aimed to implement contraceptive care best practices via training and funding for contraceptive methods. As part of the initiative, clinics within the South Carolina Health Department (DHEC clinics), which is the state’s Title X agency, received trainings in the areas of administrative support, contraceptive counseling, and device placement and removal, in addition to funding for contraceptive devices. Title X Family Planning program is a federal program that provides reproductive health services for low-income patients through a network of safety–net clinics. While Title X has standards and requirements for training, there are still some gaps in the trainings for contraceptive provision.

With the U.S. Supreme Court anticipated to overturn the 1973 Roe v. Wade decision (and the modifications to that decision by Planned Parenthood of Southeastern Pennsylvania v. Casey from 1992), the protection, regulation, or prohibition of abortion would likely default to state laws and state constitutions. Therefore, to understand how this upcoming Supreme Court decision could impact access to abortion in Tennessee, it is useful to examine both key current state laws in effect related to abortion access, as well as the current state of access to abortion in Tennessee. This brief intends only to summarize current Tennessee state laws and does not speculate on what additional legislative action may be taken after a final Supreme Court decision is rendered.

Over 300,000 low-income women in Alabama live in a contraceptive desert (counties where a full range of contraceptive methods is not readily accessible to patients). In 2019, Alabama introduced funding of a full range of contraceptive methods (long-acting, short-acting, and barrier methods) via Title X funding to family planning health department (HD) clinics. The goal is for this implementation to be statewide, though clinics may have different resources for facilitation. This policy change required no additional funding, just new permissions for nurse practitioners (NPs) and reallocation of Title X funds.

During the COVID-19 pandemic, one in three women delayed contraceptive care or had difficulty obtaining contraception. To improve access, reimbursement and HIPAA policies were relaxed to facilitate implementation of telehealth services across the health care system nationally. Federally Qualified Health Centers (FQHCs) are part of the nation's health care safety-net and provide contraceptive care services to underserved patient populations. As such, it is important to study access to services at these clinics, particularly at the onset of the COVID-19 pandemic. This study aimed to examine telehealth service provision for contraceptive services at rural and urban FQHC clinics in South Carolina (SC) and Alabama (AL) before and during the initial months of the COVID-19 pandemic. Both SC and AL have large rural and low-income populations, which experience disproportionate barriers to contraceptive care, making telehealth particularly important for meeting their reproductive health needs.

In January-August 2021, staff at Choose Well participating clinical partners were asked about their experiences with Choose Well in 2020, including perceptions about access to contraceptive counseling and facilitators and barriers to contraceptive counseling. Interviews were conducted over the phone, audio recorded with permission, and transcribed. The aim of this issue brief is to examine access to contraceptive counseling across three sectors, hospitals, health departments, and Federally Qualified Health Centers (FQHCs), that provided contraceptive counseling and partnered with Choose Well during the COVID-19 pandemic (2020). Findings from each sectors’ perceptions of contraceptive counseling are presented.

The COVID-19 pandemic has significantly affected access to and the delivery of health care services, including contraceptive service2s. Despite the need for adequate and timely pandemic response, maintaining the safe and effective delivery of contraceptive services remains essential. This issue brief highlights findings from interviews conducted with 45 staff and providers at Federally Qualified Health Centers (FQHCs) and Health Department clinics, in South Carolina and Alabama, to assess the impact of the COVID-19 pandemic on contraceptive services in their clinics. The brief focuses on the following indicators: Overall Patient Volume, Contraceptive Care Patient Volume, Contraceptive Service Provision, Staffing Capacity, Medical Supplies, and Perceptions of Long-Term Impact.

The Choose Well initiative aims to improve contraceptive access at partnered Federally Qualified Health Centers (FQHCs) in South Carolina. We conducted key informant interviews with FQHC clinical and administrative staff (N= 45) to assess progress in achieving this aim during the first two years of program implementation (2017 and 2018). The interviews were recorded, transcribed and analyzed for emerging themes. Respondents highlighted facilitators of contraceptive access during Choose Well including: enhanced contraceptive counseling, funding for implants and IUDs, the availability of same-day implant and IUD placement procedures, and increased patients enrolling in Medicaid.