Linkages to Contraception Services
- Conduct an organizational assessment to identify which clinicians can o er the full range of contraception options, including procedure-based methods such as sterilization, IUDs, implants and diaphragm fittings.
- Determine which ones are only comfortable with prescription-based methods.
- Ensure good communication regarding which clinicians offer which services so that patients can be referred internally first.1,2
- For any contraceptive methods not available within the clinic, identify clinicians in the community who are willing to serve as a referral resource. Communicate with them about how to optimize referrals for those services.1,2
- Ensure that counseling documentation reflects the fact that all methods were offered to the patient. If the patient chooses a method not available, document the clinic to which the patient was referred.
- If as a result of this self-assessment your clinic scores as an “expert-level” provider, then draft a letter to the practice managers of local provider offices that: introduces your practice as an expert-level contraception practice; reviews the contraceptive methods your practice offers; and explains your availability as a resource to provide telephone consultation or patient referrals with contraceptive complications or difficult contraceptive management issues (e.g. ultrasound on-site).
- Geiger Gibson /RCHN Community Health Foundation Research Collaborative, Policy Research Brief # 26A; Natural Fit: Collaborations Between Community Health Centers and Family Planning Clinics; George Washington University, October 9, 2011: http://www.rchnfoundation.org/?page_id=1563
- OHA, Effective Contraceptive Use Among Women at Risk of Unintended Pregnancy: A Guidance Document, page 28: http://www.oregon.gov/oha/analytics/CCOData/Effective%20Contraceptive%20Use%20Guidance%20Document.pdf
Linkages to Social and Behavioral Services, Including Domestic Violence/ Mental Health/Substance Abuse
- Consider screening all patients for domestic violence and distribute Safety Cards routinely (available from Futures Without Violence).1
- Consider screening all patients for depression using the Patient Health Questionnaire (PHQ-2).2
- Consider screening all patients for Substance Use Disorders using the SBIRT tool.3
- If patients express difficulty in meeting basic needs such as food, housing, transportation or child care, refer them to 211 Info. Or help patients, if willing, to call 211 Info from the clinic.4
- Identify key mental health, domestic violence and substance use treatment providers in the community.
- Maintain an up-to-date list of their contact information.
- 211 Info can also be used for this purpose—clinicians can call to find out where to send patients in their community.4
- When a social or behavioral health concern arises as part of the patient’s visit, document any referrals made or phone numbers/ contact information given to the patient.
- Mental health, substance use treatment and domestic violence providers are usually restricted from communicating back with referring clinicians, to protect the privacy of the patient. Documenting that the referral was made is usually sufficient, although it is good practice to check back with the patient to make sure they received needed services.
- Futures Without Violence: http://www.futureswithoutviolence.org To order Safety Cards: https://secure3.convio.net/fvpf/site/Ecom- merce/567623699?FOLDER=1133&store_id=1241
- Patient Health Questionnaire for depression screening: http://www.cqaimh.org/pdf/tool_phq2.pdf
- SBIRT tool and support for substance use screening: http://www.sbirtoregon.org
- 211 Info Family Resource line: http://211info.org
Linkages to Primary Care and/or Chronic Disease Care Management Services
- If your clinic is a specialty family planning provider, identify primary care providers in the community who are accepting new patients, including Medicaid and uninsured patients. Communicate with them about the best ways to refer patients in need of primary care and/or chronic disease management.1,2
- Primary care providers and specialty family planning providers should consider developing cross-referral agreements or contractual collaborations when they serve the same community.
- Cross-referral agreements allow for primary care to refer contraceptive patients to family planning for services they do not provide, and for family planning to refer patients to primary care for services they do not provide. In this type of agreement, it is important to understand the parameters for appropriate referrals for each organization to avoid frustrating the patients.
- Sharing space or co-locating with the family planning center, allows primary care to provide family planning services to its patients. More detail on these arrangements can be found at the Guttmacher Institute link below.1
- Guttmacher Institute Policy Review Fall 2011: Strengthening the Safety Net: Pathways for Collaboration Between Community Health Centers and Family Planning Programs: https://www.guttmacher.org/pubs/gpr/14/4/gpr140414.html
- Rosenbaum S, et al: Health Centers and Family Planning Update: Implications of the 2014 Quality Family Planning Services Guidelines Issued by the CDC and the Office of Population A airs July 2014: https://publichealth.gwu.edu/pdf/hp/health-centers-family-planning-update.pdf