Increase Access to Contraception - Revision history

BasilSavitsky: /* Impactful Federal, State, and Local Policies */

2025-01-28T22:14:46Z

Impactful Federal, State, and Local Policies

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	= Impactful Federal, State, and Local Policies =		= Impactful Federal, State, and Local Policies =

			*SAMHSA maintains that contraceptive counseling and access to contraceptive services should be a routine part of substance use disorder treatment among women of reproductive age to mitigate the risk of unplanned pregnancy. <ref>https://www.regulations.gov/document?D=SAMHSA-2016-0002-0001</ref>

	*The Medicaid program has always required that family planning services be fully covered for patients without cost sharing. <ref>National Women's Law Center. (2015). Fact sheet: Contraceptive coverage in the health care law: Frequently asked questions.</ref>		*The Medicaid program has always required that family planning services be fully covered for patients without cost sharing. <ref>National Women's Law Center. (2015). Fact sheet: Contraceptive coverage in the health care law: Frequently asked questions.</ref>
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	*The Patient Protection and Affordable Care Act (ACA) similarly required new private health plans to provide no-cost coverage for all FDA-approved contraceptives. <ref>https://www.patientassistance.bayer.us/</ref>		*The Patient Protection and Affordable Care Act (ACA) similarly required new private health plans to provide no-cost coverage for all FDA-approved contraceptives. <ref>https://www.patientassistance.bayer.us/</ref>

	*~~SAMHSA maintains that contraceptive counseling and access to contraceptive services should be~~ a ~~routine part~~ of ~~substance use disorder treatment among women~~ of ~~reproductive age~~ to ~~mitigate the risk of unplanned pregnancy~~. <ref>https://~~www~~.~~regulations.gov~~/~~document?D=SAMHSA~~-~~2016~~-~~0002~~-~~0001~~</ref>		*The National Academy for State Health Policy provides a review of states have expanded scope of practice laws to allow pharmacists to prescribe hormonal contraceptives to increase access to contraceptives. <ref>https://nashp.org/state-approaches-to-pharmacist-prescribing-of-hormonal-contraceptives/</ref>

	*Virginia law allows women a full year of birth control covered by insurance vs. the previous 3-month supply. <ref>https://lis.virginia.gov/cgi-bin/legp604.exe?212+sum+SB1227</ref>		*Virginia law allows women a full year of birth control covered by insurance vs. the previous 3-month supply. <ref>https://lis.virginia.gov/cgi-bin/legp604.exe?212+sum+SB1227</ref>

BasilSavitsky: /* Promising Practices */

2024-11-30T19:24:40Z

Promising Practices

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	*'''emPOWERhealth USA''' has a program that provides tele-health with a focus on women who are using opioids. They provide coaching on birth control to help more ~~women~~ get LARCs or make other informed decisions on birth control. <ref>https://www.venturenashville.com/empower-health-sets-12m-raise-for-push-into-self-pay-nad-infusion-space-cms-1917</ref>		*'''emPOWERhealth USA''' has a program that provides tele-health with a focus on women who are using opioids. They provide coaching on birth control to help more people get LARCs or make other informed decisions on birth control. <ref>https://www.venturenashville.com/empower-health-sets-12m-raise-for-push-into-self-pay-nad-infusion-space-cms-1917</ref>

	*'''The Tennessee Department of Health''' has a NAS Primary Prevention Initiative that is working with over 40 local jails and Methadone clinics to make make family planning and free IUDs available. The project is paid for by federal funds for incarcerated women who don't have private insurance or have lost TennCare, which automatically ends during incarceration. 94% of ~~the women~~ received a contraceptive method, and 84% chose a voluntary LARC. Officials stress that the choice to obtain LARCs is up to each incarcerated ~~woman~~. <ref>https://www.tennessean.com/story/news/2017/02/04/iuds-inmates-seen-tool-combat-opioid-crisis/97056396/</ref> <ref>https://www.tn.gov/content/dam/tn/health/documents/Bright_Spot_East_Region_NAS_Reduction_Effort_10-6-14_mbb_10-10-14.docx</ref>		*'''The Tennessee Department of Health''' has a NAS Primary Prevention Initiative that is working with over 40 local jails and Methadone clinics to make make family planning and free IUDs available. The project is paid for by federal funds for incarcerated women who don't have private insurance or have lost TennCare, which automatically ends during incarceration. 94% of them received a contraceptive method, and 84% chose a voluntary LARC. Officials stress that the choice to obtain LARCs is up to each incarcerated person. <ref>https://www.tennessean.com/story/news/2017/02/04/iuds-inmates-seen-tool-combat-opioid-crisis/97056396/</ref> <ref>https://www.tn.gov/content/dam/tn/health/documents/Bright_Spot_East_Region_NAS_Reduction_Effort_10-6-14_mbb_10-10-14.docx</ref>

	*'''Access and Resources in Contraceptive Health (ARCH).''' This patient assistance program provides Bayer IUDs (the 3-year Skyla IUD and the 5-year Kyleena and Mirena IUDs), at no cost. ~~Eligible women include~~ those who do not have either private health insurance or Medicaid coverage ~~and who meet all other program eligibility requirements~~. Although the IUDs are free, patients may incur other costs such as insertion and removal costs. <ref>https://www.patientassistance.bayer.us/</ref>		*'''Access and Resources in Contraceptive Health (ARCH).''' This patient assistance program provides Bayer IUDs (the 3-year Skyla IUD and the 5-year Kyleena and Mirena IUDs), at no cost. Eligibility includes those who do not have either private health insurance or Medicaid coverage. Although the IUDs are free, patients may incur other costs such as insertion and removal costs. <ref>https://www.patientassistance.bayer.us/</ref>

	= Sources =		= Sources =

BasilSavitsky: /* Available Tools and Resources */

2024-11-30T19:21:56Z

Available Tools and Resources

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	*This brief news article provides information on the relative effectiveness of different types of contraceptives and the complexity of choices involved. <ref>http://www.latimes.com/health/la-he-0528-birth-control-20160515-snap-story.html</ref>		*This brief news article provides information on the relative effectiveness of different types of contraceptives and the complexity of choices involved. <ref>http://www.latimes.com/health/la-he-0528-birth-control-20160515-snap-story.html</ref>

	*"A Step Ahead" in East Tennessee provides transportation ~~for women~~ to an appointment for a free LARC and a free wellness visit that includes a pregnancy test and an STI test. ~~Women~~ over 21 with a medical provider referral may also receive a free PAP test. <ref>http://www.astepaheadeasttn.org/faq.html</ref>		*"A Step Ahead" in East Tennessee provides transportation to an appointment for a free LARC and a free wellness visit that includes a pregnancy test and an STI test. Those over 21 with a medical provider referral may also receive a free PAP test. <ref>http://www.astepaheadeasttn.org/faq.html</ref>

	*NEXPLANON is a hormone-releasing birth control implant ~~for use by women to prevent~~ pregnancy for up to 3 years. <ref>https://www.nexplanon.com</ref>		*NEXPLANON is a hormone-releasing birth control implant which prevents pregnancy for up to 3 years. <ref>https://www.nexplanon.com</ref>

	*Paragard is an IUD that can prevent pregnancy for up to 10 years. Paragard is a hormone-free IUD and may be 100% covered by insurance. <ref>http://www.paragard.com</ref>		*Paragard is an IUD that can prevent pregnancy for up to 10 years. Paragard is a hormone-free IUD and may be 100% covered by insurance. <ref>http://www.paragard.com</ref>
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	*Healthcare providers or clinics can join a Group Purchasing Organization (GPO) to get lower costs on birth control. Afaxys is a pharmaceutical company that produces birth control pills. It has a GPO that provides discount pricing on Bayer IUDs.		*Healthcare providers or clinics can join a Group Purchasing Organization (GPO) to get lower costs on birth control. Afaxys is a pharmaceutical company that produces birth control pills. It has a GPO that provides discount pricing on Bayer IUDs.

	*Project Prevention uses donation funding to ~~pay women~~ $300 to ~~get~~ on long-term birth control. <ref>https://projectprevention.org/</ref>		*Project Prevention uses donation funding to provide a $300 payment to support getting on long-term birth control. <ref>https://projectprevention.org/</ref>

	= Promising Practices =		= Promising Practices =

BasilSavitsky: /* Relevant Research */

2024-11-30T19:17:10Z

Relevant Research

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	= Relevant Research =		= Relevant Research =

	*The Family Planning Initiative was a four-year project that delivered contraceptive services ~~to women within~~ a pediatric clinic within a drug treatment facility. They found that staff education levels and discomfort discussing the issue were barriers and recommend education and availability of appropriate staff. <ref>https://doi.org/10.1080/15332985.2011.575723</ref>		*The Family Planning Initiative was a four-year project that delivered contraceptive services in a pediatric clinic within a drug treatment facility. They found that staff education levels and discomfort discussing the issue were barriers and recommend education and availability of appropriate staff. <ref>https://doi.org/10.1080/15332985.2011.575723</ref>

	*This study completed in Western North Carolina documents the feasibility of delivery of family planning services at addiction treatment clinics. <ref>https://sys.mahec.net/media/onlinejournal/Contraceptive%20Choices.pdf</ref>		*This study completed in Western North Carolina documents the feasibility of delivery of family planning services at addiction treatment clinics. <ref>https://sys.mahec.net/media/onlinejournal/Contraceptive%20Choices.pdf</ref>

BasilSavitsky: /* Key Information */

2024-11-30T19:15:35Z

Key Information

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	In the general population, 31–47% of pregnancies in the US are unintended. <ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3052960/</ref> Approximately half of these end in termination of pregnancy. <ref>Finer L, Henshaw S. Disparities in rates of unintended pregnancy in the United States 1994–2001. Perspect Sex Reprod Health. 2006;38:90.</ref> One study of 946 ~~women~~ who were using opioids who gave birth revealed that 86% reported that the pregnancy was unintended.<ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3052960/</ref> In another study in Eastern Tennessee on ~~women~~ who were using opioids ~~who gave birth~~, it was found that their general knowledge of birth control was very low and that only 3% of them used a reliable birth control method. <ref>https://www.venturenashville.com/empower-health-sets-12m-raise-for-push-into-self-pay-nad-infusion-space-cms-1917</ref> While there is often disagreement on what type of sex education is appropriate, communities should make it a priority to improve understanding of birth control as a way to avoid unintended pregnancies. Unintended pregnancies result from contraceptive failure, incorrect or inconsistent use of a method, or lack of use of any form of contraception. <ref>Jones RK, Darroch JE, Henshaw SK. Contraceptive use among U.S. women having abortions in 2000–2001. Perspect Sex Reprod Health. 2002;34:294–303.</ref> <ref>Moreau C, Trussell J, Rodrigues G, Bajoo N, Bouyer J. Contraceptive failure rate in France: results from a population based survey. Hum Reprod Update. 2007;22:2422–7.</ref> Interventions to increase adherence to pills and condoms, such as enhanced counseling, have not consistently improved contraceptive use patterns, continuation rates (ongoing use of the method after 12 months), or unintended pregnancies. <ref>Cleland J, Bernstein S, Ezeh A, Faundes A, Glasier A, Innis J. Family planning: the unfinished agenda. Lancet. 2006;368:1810–27.</ref> One study found that ~~women~~ using user-depended methods (pills, patches, and rings) were 20 times more likely to have an unplanned pregnancy than ~~women~~ using an intrauterine device (IUD) or implant. <ref>Winner B, Peipert JF, Zhao Q, et al. Effectiveness of long-acting reversible contraception. N Engl J Med. 2012;366(21):1998–2007.</ref>		In the general population, 31–47% of pregnancies in the US are unintended. <ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3052960/</ref> Approximately half of these end in termination of pregnancy. <ref>Finer L, Henshaw S. Disparities in rates of unintended pregnancy in the United States 1994–2001. Perspect Sex Reprod Health. 2006;38:90.</ref> One study of 946 pregnant people who were using opioids who gave birth revealed that 86% reported that the pregnancy was unintended. <ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3052960/</ref> In another study in Eastern Tennessee on pregnant people who were using opioids, it was found that their general knowledge of birth control was very low and that only 3% of them used a reliable birth control method. <ref>https://www.venturenashville.com/empower-health-sets-12m-raise-for-push-into-self-pay-nad-infusion-space-cms-1917</ref> While there is often disagreement on what type of sex education is appropriate, communities should make it a priority to improve understanding of birth control as a way to avoid unintended pregnancies. Unintended pregnancies result from contraceptive failure, incorrect or inconsistent use of a method, or lack of use of any form of contraception. <ref>Jones RK, Darroch JE, Henshaw SK. Contraceptive use among U.S. women having abortions in 2000–2001. Perspect Sex Reprod Health. 2002;34:294–303.</ref> <ref>Moreau C, Trussell J, Rodrigues G, Bajoo N, Bouyer J. Contraceptive failure rate in France: results from a population based survey. Hum Reprod Update. 2007;22:2422–7.</ref> Interventions to increase adherence to pills and condoms, such as enhanced counseling, have not consistently improved contraceptive use patterns, continuation rates (ongoing use of the method after 12 months), or unintended pregnancies. <ref>Cleland J, Bernstein S, Ezeh A, Faundes A, Glasier A, Innis J. Family planning: the unfinished agenda. Lancet. 2006;368:1810–27.</ref> One study found that people using user-depended methods (pills, patches, and rings) were 20 times more likely to have an unplanned pregnancy than those using an intrauterine device (IUD) or implant. <ref>Winner B, Peipert JF, Zhao Q, et al. Effectiveness of long-acting reversible contraception. N Engl J Med. 2012;366(21):1998–2007.</ref>

	IUDs and the implants are collectively known as long-acting reversible contraception (LARC) methods. These are the most effective and cost-effective reversible methods available. They have an inherent ability to prevent pregnancy, but their effectiveness also arises from the fact that they are set and forget methods that do not require daily compliance, unlike condoms or the oral contraceptive pill. These are attributes that ~~women themselves rate~~ highly when considering ~~their~~ contraceptive options. <ref>Madden T, Secura GM, Nease RF, Politi MC, Peipert JF. The role of contraceptive attributes in women’s contraceptive decision making. Am J Obstet Gynecol. 2015;213(1):e41–6.</ref> Therefore, increased use of LARCs should be promoted. One way may be via the integration of contraceptive services into drug health clinics. In this way, ~~women~~ may be enabled to more easily address their various needs in an environment that is both more familiar and less threatening. Similarly, integrated services may be more successful if they can provide low-threshold service access, i.e., services with few or no barriers to access. <ref>Islam MM, Topp L, Conigrave KM, Day CA. Defining a service for people who use drugs as ‘low-threshold’: what should be the criteria? Int J Drug Policy. 2013;24(3):220–2.</ref> <ref>Islam MM, Topp L, Conigrave KM, Day CA. Opioid substitution therapy clients’ preferences for targeted versus general primary health-care outlets. Drug Alcohol Rev. 2013;32:211–3. </ref> These forms of birth control last for years once inserted and prevent pregnancy for more than 99 percent of users. Since 2007, there has been a sharp rise in LARCs, which helps explain why they are a big part of the story behind America's decreasing rate of unintended pregnancies. <ref>https://www.vox.com/2016/3/2/11148108/unplanned-pregnancy-larc-iud</ref>		IUDs and the implants are collectively known as long-acting reversible contraception (LARC) methods. These are the most effective and cost-effective reversible methods available. They have an inherent ability to prevent pregnancy, but their effectiveness also arises from the fact that they are set and forget methods that do not require daily compliance, unlike condoms or the oral contraceptive pill. These are attributes that are rated highly when considering contraceptive options. <ref>Madden T, Secura GM, Nease RF, Politi MC, Peipert JF. The role of contraceptive attributes in women’s contraceptive decision making. Am J Obstet Gynecol. 2015;213(1):e41–6.</ref> Therefore, increased use of LARCs should be promoted. One way may be via the integration of contraceptive services into drug health clinics. In this way, people may be enabled to more easily address their various needs in an environment that is both more familiar and less threatening. Similarly, integrated services may be more successful if they can provide low-threshold service access, i.e., services with few or no barriers to access. <ref>Islam MM, Topp L, Conigrave KM, Day CA. Defining a service for people who use drugs as ‘low-threshold’: what should be the criteria? Int J Drug Policy. 2013;24(3):220–2.</ref> <ref>Islam MM, Topp L, Conigrave KM, Day CA. Opioid substitution therapy clients’ preferences for targeted versus general primary health-care outlets. Drug Alcohol Rev. 2013;32:211–3. </ref> These forms of birth control last for years once inserted and prevent pregnancy for more than 99 percent of users. Since 2007, there has been a sharp rise in LARCs, which helps explain why they are a big part of the story behind America's decreasing rate of unintended pregnancies. <ref>https://www.vox.com/2016/3/2/11148108/unplanned-pregnancy-larc-iud</ref>

	'''Barriers.'''		'''Barriers.'''
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	*Cost. One of the biggest obstacles to LARC use, historically, has been price. Planned Parenthood has estimated that IUDs can cost between $500 and $900 out of pocket. Insurance plans tend to charge patients more for IUDs than for birth control pills, because the devices have such high upfront costs. <ref>https://www.vox.com/2016/3/2/11148108/unplanned-pregnancy-larc-iud</ref>		*Cost. One of the biggest obstacles to LARC use, historically, has been price. Planned Parenthood has estimated that IUDs can cost between $500 and $900 out of pocket. Insurance plans tend to charge patients more for IUDs than for birth control pills, because the devices have such high upfront costs. <ref>https://www.vox.com/2016/3/2/11148108/unplanned-pregnancy-larc-iud</ref>
	*Copayments. Patient contraceptive selection is sensitive to copayment. One analysis confirmed that employer-based plans display significant variation in copayments by contraceptive method, with LARC methods being the most expensive in terms of upfront costs to patients. <ref>Dusetzina, S.B., Dalton, V.K., Chernew, M.E., Pace, L.E., Bowden, G., and Fendrick, A.M. Cost of contraceptive methods to privately insured women in the United States. Women's Health Issues. 2013; 23: e69–71</ref>		*Copayments. Patient contraceptive selection is sensitive to copayment. One analysis confirmed that employer-based plans display significant variation in copayments by contraceptive method, with LARC methods being the most expensive in terms of upfront costs to patients. <ref>Dusetzina, S.B., Dalton, V.K., Chernew, M.E., Pace, L.E., Bowden, G., and Fendrick, A.M. Cost of contraceptive methods to privately insured women in the United States. Women's Health Issues. 2013; 23: e69–71</ref>
	*Insurance complexities. The American College of Obstetricians and Gynecologists (ACOG) supports placement of LARC devices during the immediate postpartum period to improve the use of LARC ~~among~~ postpartum ~~women~~. However, bundled payments for delivery create a relative financial disincentive to place LARC devices at the time of delivery. <ref>https://pediatrics.aappublications.org/content/139/3/e20164070</ref>		*Insurance complexities. The American College of Obstetricians and Gynecologists (ACOG) supports placement of LARC devices during the immediate postpartum period to improve the use of LARC during postpartum. However, bundled payments for delivery create a relative financial disincentive to place LARC devices at the time of delivery. <ref>https://pediatrics.aappublications.org/content/139/3/e20164070</ref>
	*State variability. State Medicaid programs play a critical role in ensuring access to highly effective contraception at the time when it is desired, including the time of delivery. However, recent research suggests that states are variable in aligning financial incentives to ensure access to LARC methods if elected at the time of delivery. <ref>Pace, L.E., Dusetzina, S.B., Fendrick, A.M., Keating, N.L., and Dalton, V.K. The impact of out-of-pocket costs on the use of intrauterine contraception among women with employer-sponsored insurance. Medical Care. 2013; 51: 959–963</ref>		*State variability. State Medicaid programs play a critical role in ensuring access to highly effective contraception at the time when it is desired, including the time of delivery. However, recent research suggests that states are variable in aligning financial incentives to ensure access to LARC methods if elected at the time of delivery. <ref>Pace, L.E., Dusetzina, S.B., Fendrick, A.M., Keating, N.L., and Dalton, V.K. The impact of out-of-pocket costs on the use of intrauterine contraception among women with employer-sponsored insurance. Medical Care. 2013; 51: 959–963</ref>

BasilSavitsky: /* Introductory Paragraph */

2024-11-30T19:10:10Z

Introductory Paragraph

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	An important strategy to reduce the incidence of fetal alcohol syndrome (FAS) and neonatal abstinence syndrome (NAS) is to increase family planning and preconception care for people who use substances . <ref>https://www.cdc.gov/mmwr/volumes/66/wr/mm6609a2.htm</ref> The CDC and the Office of Population Affairs of the U.S. Department of Health and Human Services recommend that health care providers support family planning services. This includes preconception services, pregnancy intention screening, and contraceptive counseling to prevent unintended pregnancy. It is recommended that access is increased to the full range of contraceptive methods, including long-acting reversible contraception, such as intrauterine devices and implants. <ref>Gavin L, Moskosky S, Carter M, et al. Providing quality family planning services: recommendations of CDC and the U.S. Office of Population Affairs. MMWR Recomm Rep 2014;63(No. RR-4)</ref>		An important strategy to reduce the incidence of fetal alcohol syndrome (FAS) and neonatal abstinence syndrome (NAS) is to increase family planning and preconception care for people who use substances. <ref>https://www.cdc.gov/mmwr/volumes/66/wr/mm6609a2.htm</ref> The CDC and the Office of Population Affairs of the U.S. Department of Health and Human Services recommend that health care providers support family planning services. This includes preconception services, pregnancy intention screening, and contraceptive counseling to prevent unintended pregnancy. It is recommended that access is increased to the full range of contraceptive methods, including long-acting reversible contraception, such as intrauterine devices and implants. <ref>Gavin L, Moskosky S, Carter M, et al. Providing quality family planning services: recommendations of CDC and the U.S. Office of Population Affairs. MMWR Recomm Rep 2014;63(No. RR-4)</ref>

	= Key Information =		= Key Information =

BasilSavitsky: /* Introductory Paragraph */

2024-11-30T19:09:56Z

Introductory Paragraph

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	~~Family planning and preconception care for women who use substances are~~ important ~~strategies~~ to reduce the incidence of fetal alcohol syndrome (FAS) and neonatal abstinence syndrome (NAS). <ref>https://www.cdc.gov/mmwr/volumes/66/wr/mm6609a2.htm</ref> The CDC and the Office of Population Affairs of the U.S. Department of Health and Human Services recommend that health care providers support family planning services. This includes preconception services, pregnancy intention screening, and contraceptive counseling to prevent unintended pregnancy. It is recommended that access is increased to the full range of contraceptive methods, including long-acting reversible contraception, such as intrauterine devices and implants. <ref>Gavin L, Moskosky S, Carter M, et al. Providing quality family planning services: recommendations of CDC and the U.S. Office of Population Affairs. MMWR Recomm Rep 2014;63(No. RR-4)</ref>		An important strategy to reduce the incidence of fetal alcohol syndrome (FAS) and neonatal abstinence syndrome (NAS) is to increase family planning and preconception care for people who use substances . <ref>https://www.cdc.gov/mmwr/volumes/66/wr/mm6609a2.htm</ref> The CDC and the Office of Population Affairs of the U.S. Department of Health and Human Services recommend that health care providers support family planning services. This includes preconception services, pregnancy intention screening, and contraceptive counseling to prevent unintended pregnancy. It is recommended that access is increased to the full range of contraceptive methods, including long-acting reversible contraception, such as intrauterine devices and implants. <ref>Gavin L, Moskosky S, Carter M, et al. Providing quality family planning services: recommendations of CDC and the U.S. Office of Population Affairs. MMWR Recomm Rep 2014;63(No. RR-4)</ref>

	= Key Information =		= Key Information =

BasilSavitsky: /* Introductory Paragraph */

2024-07-08T17:57:51Z

Introductory Paragraph

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	Family planning and preconception care for women who use substances are important strategies to reduce the incidence of fetal alcohol syndrome (FAS) neonatal abstinence syndrome (NAS). <ref>https://www.cdc.gov/mmwr/volumes/66/wr/mm6609a2.htm</ref> The CDC and the Office of Population Affairs of the U.S. Department of Health and Human Services recommend that health care providers support family planning services. This includes preconception services, pregnancy intention screening, and contraceptive counseling to prevent unintended pregnancy. It is recommended that access is increased to the full range of contraceptive methods, including long-acting reversible contraception, such as intrauterine devices and implants. <ref>Gavin L, Moskosky S, Carter M, et al. Providing quality family planning services: recommendations of CDC and the U.S. Office of Population Affairs. MMWR Recomm Rep 2014;63(No. RR-4)</ref>		Family planning and preconception care for women who use substances are important strategies to reduce the incidence of fetal alcohol syndrome (FAS) and neonatal abstinence syndrome (NAS). <ref>https://www.cdc.gov/mmwr/volumes/66/wr/mm6609a2.htm</ref> The CDC and the Office of Population Affairs of the U.S. Department of Health and Human Services recommend that health care providers support family planning services. This includes preconception services, pregnancy intention screening, and contraceptive counseling to prevent unintended pregnancy. It is recommended that access is increased to the full range of contraceptive methods, including long-acting reversible contraception, such as intrauterine devices and implants. <ref>Gavin L, Moskosky S, Carter M, et al. Providing quality family planning services: recommendations of CDC and the U.S. Office of Population Affairs. MMWR Recomm Rep 2014;63(No. RR-4)</ref>

	= Key Information =		= Key Information =

BasilSavitsky: /* Promising Practices */

2024-07-05T17:52:36Z

Promising Practices

← Older revision		Revision as of 10:52, 5 July 2024
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	*'''emPOWERhealth USA''' has a program that provides tele-health with a focus on women who are using opioids. They provide coaching on birth control to help more women get LARCs or make other informed decisions on birth control. <ref>https://www.venturenashville.com/empower-health-sets-12m-raise-for-push-into-self-pay-nad-infusion-space-cms-1917</ref>		*'''emPOWERhealth USA''' has a program that provides tele-health with a focus on women who are using opioids. They provide coaching on birth control to help more women get LARCs or make other informed decisions on birth control. <ref>https://www.venturenashville.com/empower-health-sets-12m-raise-for-push-into-self-pay-nad-infusion-space-cms-1917</ref>

	*'''The Tennessee Department of Health''' has a NAS Primary Prevention Initiative that is working with over 40 local jails and ~~methadone~~ clinics to make make family planning and free IUDs available. The project is paid for by federal funds for incarcerated women who don't have private insurance or have lost TennCare, which automatically ends during incarceration. 94% of the women received a contraceptive method, and 84% chose a voluntary LARC. Officials stress that the choice to obtain LARCs is up to each incarcerated woman. <ref>https://www.tennessean.com/story/news/2017/02/04/iuds-inmates-seen-tool-combat-opioid-crisis/97056396/</ref> <ref>https://www.tn.gov/content/dam/tn/health/documents/Bright_Spot_East_Region_NAS_Reduction_Effort_10-6-14_mbb_10-10-14.docx</ref>		*'''The Tennessee Department of Health''' has a NAS Primary Prevention Initiative that is working with over 40 local jails and Methadone clinics to make make family planning and free IUDs available. The project is paid for by federal funds for incarcerated women who don't have private insurance or have lost TennCare, which automatically ends during incarceration. 94% of the women received a contraceptive method, and 84% chose a voluntary LARC. Officials stress that the choice to obtain LARCs is up to each incarcerated woman. <ref>https://www.tennessean.com/story/news/2017/02/04/iuds-inmates-seen-tool-combat-opioid-crisis/97056396/</ref> <ref>https://www.tn.gov/content/dam/tn/health/documents/Bright_Spot_East_Region_NAS_Reduction_Effort_10-6-14_mbb_10-10-14.docx</ref>

	*'''Access and Resources in Contraceptive Health (ARCH).''' This patient assistance program provides Bayer IUDs (the 3-year Skyla IUD and the 5-year Kyleena and Mirena IUDs), at no cost. Eligible women include those who do not have either private health insurance or Medicaid coverage and who meet all other program eligibility requirements. Although the IUDs are free, patients may incur other costs such as insertion and removal costs. <ref>https://www.patientassistance.bayer.us/</ref>		*'''Access and Resources in Contraceptive Health (ARCH).''' This patient assistance program provides Bayer IUDs (the 3-year Skyla IUD and the 5-year Kyleena and Mirena IUDs), at no cost. Eligible women include those who do not have either private health insurance or Medicaid coverage and who meet all other program eligibility requirements. Although the IUDs are free, patients may incur other costs such as insertion and removal costs. <ref>https://www.patientassistance.bayer.us/</ref>

BasilSavitsky: /* Impactful Federal, State, and Local Policies */

2024-07-05T17:44:50Z

Impactful Federal, State, and Local Policies

← Older revision		Revision as of 10:44, 5 July 2024
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	= Impactful Federal, State, and Local Policies =		= Impactful Federal, State, and Local Policies =

	*The Medicaid program has always required that family planning services be fully covered for patients without cost sharing.<ref>National Women's Law Center. (2015). Fact sheet: Contraceptive coverage in the health care law: Frequently asked questions.</ref>		*The Medicaid program has always required that family planning services be fully covered for patients without cost sharing. <ref>National Women's Law Center. (2015). Fact sheet: Contraceptive coverage in the health care law: Frequently asked questions.</ref>

	*The Patient Protection and Affordable Care Act (ACA) similarly required new private health plans to provide no-cost coverage for all FDA-approved contraceptives. <ref>https://www.patientassistance.bayer.us/</ref>		*The Patient Protection and Affordable Care Act (ACA) similarly required new private health plans to provide no-cost coverage for all FDA-approved contraceptives. <ref>https://www.patientassistance.bayer.us/</ref>

	*SAMHSA maintains that contraceptive counseling and access to contraceptive services should be a routine part of substance use disorder treatment among women of reproductive age to mitigate the risk of unplanned pregnancy.<ref>https://www.regulations.gov/document?D=SAMHSA-2016-0002-0001</ref>		*SAMHSA maintains that contraceptive counseling and access to contraceptive services should be a routine part of substance use disorder treatment among women of reproductive age to mitigate the risk of unplanned pregnancy. <ref>https://www.regulations.gov/document?D=SAMHSA-2016-0002-0001</ref>

	*Virginia law allows women a full year of birth control covered by insurance vs. the previous 3-month supply. <ref>https://lis.virginia.gov/cgi-bin/legp604.exe?212+sum+SB1227</ref>		*Virginia law allows women a full year of birth control covered by insurance vs. the previous 3-month supply. <ref>https://lis.virginia.gov/cgi-bin/legp604.exe?212+sum+SB1227</ref>