Results: OFRH has had considerable success with the EBC access efforts thus far. OFRH first focused on pharmacists, who are on the front line of access, as EBC can be sold by the pharmacist over-the-counter without a prescription. We worked with the Oregon Board of Pharmacy to secure one of the premier policies in the country designed to prevent pharmacy refusals.
We also worked with the Oregon Department of Human Services to develop a reimbursement plan for pharmacists dispensing to low-income women and co-sponsored, with the Oregon State Pharmacy Association, an education program that trained over 400 pharmacists through a traveling training module and one-on-one project pharmacist outreach. This training and education has increased the number of pharmacies stocking and dispensing EBC in rural Oregon by almost 40% to date.
Borders Perrin and Norrander developed our public education campaign pro-bono, including volunteer models and photographer. With the benefit of their professional design work, we did an initial printing and have distributed over 2,000 educational pieces to reproductive age women in Lane and Marion Counties, and an equal number of materials on college campuses, and through community organizations. We also do direct outreach and distribution to primary care providers and pharmacists in rural areas encouraging them to display our posters and educational materials in their waiting rooms or service areas.
Target demographics: Rural & Underserved Oregon Women
Geographic areas served: Oregon
Programs: The oregon foundation for reproductive health (ofrh) created and promotes an initiative to dramatically increase women's access to preventative reproductive health care including preconception care and contraception. We researched and analyzed gaps in access between primary care and reproductive health services and developed a mechanism for pregnancy intention screening to increase preventive reproductive health services, thereby increasing the number of pregnancies that are wanted, planned and as healthy as possible. Ofrh developed the one key question (okq)initiative to be integrated in primary care policy within health care reform. This will change primary care service delivery so that all reproductive age women are routinely asked by their primary care clinician: "would you like to become pregnant this year? " if the woman answers "yes", she can be offered screening for pre-existing conditions and medications known to effect the health of a pregnancy, including a folic acid prescription. If she answers "no" she can talk about using contraception, whether she is satisfied with her method, and offered options as needed. This will enable more women to access preventive reproductive health services such as preconception care and contraception within a primary care setting. We successfully completed our first okq feasibility study at oregon health and science university's richmond clinic, and a small pilot study at a rural health center in john day, or. Due to the success of our feasibility study we have identified multiple pilot study sites for okq and have gained local and national attention. Okq has a registered trademark for intellectual property so as health centers across the country and within oregon implement the initiative, we serve as a clearinghouse for the various approaches to implementation, barriers experienced and solutions developed in response to those barriers. Ofrh offers technical assistance, custom tailored consultation, and an implementation toolkit including provider and patient educational materials, to all interested in implementing this new practice of pregnancy intention screening. Ofrh has presented okq at over 50 conferences including the association of reproductive health professionals (arhp). We also published "one key question: preventive reproductive health is part of high quality primary care" in the highly regarded peer review journal contraception. Ofrh is a charter member of the oregon preventative reproductive health advisory panel which will develop a tiered set of standards for the delivery of service within primary care, and of the national arhp metric advisory committee which will recommend a national metric for ensuring these services are routinely provided in primary care. We have studiously monitored and tracked oregon's health care reform process. Health care reform efforts in oregon presented us with a window of opportunity to ensure that preventative reproductive health is integrated into oregon's primary health care policy. To that end, we have consistently provided data-heavy testimony and grassroots advocacy at state-sponsored health care reform meetings, meeting with key policy makers and providing critical data at every point of influence. As a result, we secured a women's health domain for contraception and preconception services as an incentivized metric for coordinated care organizations (cco) such that ccos will be held accountable for "effective contraception use among women who do not desire to be pregnant". We also made sure that the standards for patient centered primary care homes included those for reproductive health. Ofrh is engaged in education and outreach to women on enrolling for insurance through the health insurance exchange or to gain medicaid coverage. We have supplied best-messaging to use in outreach that addresses the motivators and barriers for women to enroll. Our community partners in this effort benefit from our expertise on "women focused" messaging and we will continue to advocate for reproductive health services to be included, comprehensive, and accessible within the exchange. Ofrh is a grantee of the ms. Foundation for women and raising women's voices; both provide research and best messaging to address women's needs in health care reform. We also receive guidance from a 60 active member community advisory council. These members are community leaders in diverse areas and offer expertise from areas outside health care. Ofrh is part of the oregon outreach and enrollment alliance with community partners from across the state. We collaborate as a watchdog to cover oregon's policies and processes and build cross-movement alliances to advocate for inclusion and accessibility of coverage. Ofrh specifically provides women-centric messaging and reproductive health focused information to a broad range of community partners. Ofrh maintains membership in the allies for healthier oregon coalition and oregon health equity alliance; a collection of progressive advocacy organizations that bring policies most affecting communities of color and health disparities to the awareness of key policy and decision makers. This coalition provides the opportunity to coordinate our advocacy efforts with other statewide organizations. Ofrh has the endorsement from 27 oregon professional associations and organizations for the one key question initiative as well as the american public health, the governor's office, and us senators merkley and wyden. A representative from each organization participates in the okq coalition to help navigate barriers to implementation in the health care system. Through extensive use of social media we have provided weekly public education on reproductive health care and supplied information to endorsing organizations, community partners, and more than 5,000 oregonians. We also manage the spring adam fund, the only fund in oregon that provides transportation and lodging for women traveling to portland for abortion care. We continue to work on the emergency contraception access project, which increases women's pharmacy access to emergency contraception. We provide a policy watchdog role to ensure against pharmacy refusal. Other organization documents publicly available-one key question implementation manual-one key question patient brochure (spanish, english)-one key question: preventive reproductive health is part of high quality primary care was published in the highly regarded peer review journal contraception.
