The Impact of Program Design Changes on Access to Publicly Funded Family Planning Services in California

M. Catherine Maternowska, University of California, San Francisco
Claire Brindis, University of California, San Francisco
Antonia Biggs
Denis Hulett, UCSF Center for Reproductive Health Research & Policy
Philip Darney, University of California, San Francisco
Felicia Stewart, University of California, San Francisco
Diana G. Foster, University of California, San Francisco
J. Joseph Speidel, UCSF Center for Reproductive Health Research & Policy
Sara Laufer, University of California, San Francisco
Deborah Weiss, University of California, San Francisco

In 1997, California greatly expanded publicly funded family planning services for low-income residents through Family PACT. Five data sources — client eligibility certification forms, provider enrollment data, paid claims for Family PACT and for its predecessor, and California Department of Finance population and birth projections — were examined to determine the impact of program implementation on the number and types of providers and clients between 1995 and 2003. Providers expanded from approximately 450 clinic sites to 2,121, and clients served increased almost 300%: from 525,000 to 1.57 million. Increases in adolescent and male clients were greater than overall increases in clients served. In FY 02/03, Family PACT cost $414 million and averted 205,000 pregnancies, which would have cost $2.2 billion in public expenditures over five years following birth. The program provides a cost-saving model for other states to consider in improving access to reproductive health services for low-income populations.