Family planning agencies: services, policies and funding.

Approximately 2,614 agencies are providing family planning services in at least 5,460 clinics throughout the nation, a slight increase over the 2,462 agencies and 5,174 clinics that were estimated to be providing such services in 1983. Health departments operate an estimated 52% of clinic sites; Planned Parenthood affiliates, 15%; hospital, 6%; and other agencies, 27%. Although many agencies also offer noncontraceptive services, the large majority provide family planning services in separate clinic sessions devoted to that purpose. According to a 1992-1993 survey of a random sample of family planning agencies, Planned Parenthood affiliates provide contraceptive services for an average of 2,041 clients per clinic site, compared with 761 per health department clinic. The agencies report offering an average of 7.2 contraceptive methods at their clinics, with Planned Parenthood affiliates and hospitals offering the highest mean number, 9.2. The clinics provide an average of 8.3 tests and examinations for their medical contraceptive clients, with at least 98% providing a pelvic examination, blood pressure measurement, breast examination and Pap smear; 90% screen for anemia, and 70% screen for gonorrhea. While almost all of the agencies get some income from Medicaid (83%), only 15% receive more than 20% of their budget for contraceptive services from that source. The federal Title X program provides more than 20% of the budgets of 53% of agencies; state and local governments fund 40% of family planning agencies at that level; and client fees do the same for 32% of agencies. Some 92% of clinics with Title X funding provide the initial visit and a three-month supply of the pill without charge to clients with an income below the federal poverty level, compared with about 50% of clinics without Title X funding.