Family PACT (Planning, Access, Care and Treatment) Program Evaluation

INTRODUCTION

Since 1997, the Bixby Center has provided program support and evaluation for the Family PACT (Planning, Access, Care and Treatment) Program, California’s publicly funded family planning program. The overall goal of Family PACT is to promote optimal reproductive health and reduce unintended pregnancy by increasing access to comprehensive family planning services for low-income Californians. Annually, Family PACT serves more than 1.8 million low-income women, men, and adolescents. The program, which is administered by the California Department of Health Care Services’ Office of Family Planning (DHCS-OFP), was established by the California legislature in 1996, and implemented in 1997. Between December 1999 and July 2010, the State received additional funding for the program from the federal government through a Centers for Medicare and Medicaid Services (CMS) Section 1115 Demonstration Waiver. Evaluation analyses provided by the Bixby Center assisted the State in demonstrating Family PACT’s positive impact on cost-saving and health outcomes over the waiver period. In March 2011, the federal government approved California’s application for a State Plan Amendment, formally integrating Family PACT into the Medi-Cal State Plan.

The Bixby Center conducts an annual analysis of key program metrics of the Family PACT Program. The data analyzed are derived from enrollment and claims data and describe provider and client populations, the types of services utilized, fiscal issues, and county profiles. For the FY 2009-2010 Annual Report, click here. Using a multi-method evaluation approach, the Bixby Center conducts evaluation of the program using additional data sources to assess, among other things, the quality of clinical care, adherence to program standards, provider referral practices, the cost-benefit of the services, and the level to which women who need publicly-funded family planning services access the program. Findings from these evaluations are reported in study-specific reports, policy briefs, and research summaries.

These findings inform Family PACT’s quality improvement, utilization management, and provider education activities, all of which help to ensure that clients receive high quality clinical services. The Bixby Center evaluation team also partners with the California Department of Public Health’s STD Control Branch to monitor sexually transmitted infection services and to develop clinical practice guidelines and provider education programs.

HIGHLIGHTS FROM FAMILY PACT EVALUATION STUDIES

The 2007 Medical Record Review report presents findings on clinical quality and client outcomes derived from a retrospective review of medical charts obtained across a representative sample of 201 Family PACT providers and 4,136 Family PACT clients. The report presents findings on a wide scope of topics related to the quality of clinical patient care within Family PACT, provider adherence to Family PACT Program Standards, descriptive details on provider types, and changes over time. Highlights of the report include analyses on contraceptive utilization by clients with a special focus on intrauterine contraception, pregnancy testing and follow-up, risk assessment for sexually transmitted infections with a special focus on Chlamydia screening and treatment, and service provision to clients with limited English proficiency. Findings from the study indicate that in general, Family PACT providers are delivering services consistent with the program standards and most, but not all, quality indicators improved over time. Differences are noted by provider sector and specialty. The report identifies opportunities for improvement such as improving the quality of documentation, facilitating the provision of high efficacy contraception, improving the quality of medical records and documentation, and facilitating better follow-through on referrals.
The Access to Publicly Funded Family Planning Services in California, Fiscal Year 2006-2007 report presents estimates on the number of California women in need of publicly funded family planning services and the proportion who have accessed these services through Family PACT and Medi-Cal. The proportion of women in need who have accessed services is presented for adult and adolescent women, by race/ethnicity, and by geographic area. Included in the report are maps displaying overall access among women in need by county, for adult and adolescent women. Additionally, because of the large size of Los Angeles County, data are presented by Los Angeles Service Planning Area.
The 2007 Family PACT Client Exit Interview report presents findings on interviews with adolescent and adult Family PACT clients immediately following their clinical visit. Findings from these interviews indicate that the Family PACT Program continues to offer a wide range of quality services, with high satisfaction ratings among its recipients, and with marked improvements in several areas from the previous survey conducted in 2003.
The 2007 Cost-Benefit Analysis - A Brief found that the Family PACT Program averted an estimated 296,200 unintended pregnancies in California. By reducing public health and welfare expenditures resulting from unintended pregnancies, every dollar spent on Family PACT saved the public sector $4.30 from conception to age two and $9.25 from conception to age five (Read the full report)
Latina Voices: Findings from a Study of Latina Teen Childbearing in the Fresno and Los Angeles Areas presents data from 65 interviews with teen and adult Latinas who were about to become mothers for the first time. The goal of this study was to inform efforts to reduce the high rate of adolescent childbearing among foreign- and U.S.-born Latinas in California. Findings from this study highlight the many challenges faced by primarily low-income, pregnant Latina teens, and also highlight important assets experienced by many adult study participants when they were teenagers that appear to have helped protect them from teen childbearing.

OPA COOPERATIVE AGREEMENT GRANT

As part of a Family Planning Research Cooperative agreement with the Office of Population Affairs, the Bixby Center analyzes Family PACT claims data and provider survey data from Title X and non-Title X Family PACT providers. Three briefs, Providing Access to Family Planning through Title X and Medicaid Family Planning, Family Planning Provider Education and Training in California, and Chlamydia Screening in the Family PACT Program have been written. The first two compare Title X and non-Title X Family PACT providers with the first describing provider/client characteristics and client access to services and the second describing training opportunities available to providers. The third describes chlamydia screening rates in the Family PACT program.

For more information about Family PACT, see the Family PACT website

For selected publications, see Family PACT Publications