Helping pharmacy & health communities improve access to Emergency Contraception (EC)

STATES Re-granting Program

Pharmacy Access Partnership has made a committed investment in promoting expanded access to EC at the state and national levels. Through generous funding support from the Hewlett Foundation, Pharmacy Access Partnership created the States Take Action Toward EC Services (STATES) Re-granting Program to provide direct financial support to stimulate emergent efforts at the individual state level.

Through a competitive application process, Pharmacy Access Partnership selected seven outstanding proposals (from a total of 24 applications) to receive funds ($5,000 to $20,000) for focused short-term efforts: March – October 2006. Organizational grantees selected for funding clearly identified their potential to: (1) effectively leverage momentum achieved by current or past state level activity or (2) initiate new engagement among a cross-section of stakeholders in states where little activity has occurred. Selected grantees effectively proposed efforts to include and increase the commitment of pharmacy stakeholders to address EC, thereby increasing the number of pharmacies and pharmacists that provide EC.

Planned Parenthood of Delaware	Complete assessment of current EC pharmacy access and disseminate results to coalition partners and pharmacy groups Plan educational outreach efforts to reach pharmacists
Healthy Mothers Healthy Babies Coalition of Hawaii	Provide EC trainings to pharmacists including education on new EC access administrative rules and resources Educate and inform teens/young adults about EC pharmacy access/information Integrate EC education and information through statewide systemic improvements
ACLU of Illinois	Coordinate strategic policy advocacy with affiliated organizations to formalize pharmacists’ physician-delegated authority to dispense EC through collaborative agreements, via rulemaking Develop standards, protocols and training (in collaboration with pharmacists, physicians, public officials) Initiate targeted public education campaign to increase EC awareness and dispel misconceptions Establish clear benchmarks and measure outcomes to serve as an example for other states
Pro-Choice Massachusetts Foundation	Educate and train pharmacists about provisions of new pharmacy access law and how to participate Facilitate pharmacist provision of EC through community activism and visibility at pharmacy events Facilitate pharmacists’ process for receiving standing orders from physicians Provide tools to pharmacists to provide and publicize EC pharmacy access
ACLU of Mississippi	Sponsor statewide EC conference for students and healthcare providers Provide education on EC access options and current federal and state policies and practices in other states Host series of workshops and community meetings as well as participate in student health fairs to create EC awareness
Planned Parenthood of Northern New England- New Hampshire	Build necessary infrastructure to implement and sustain EC Collaborative Practice Program Implement training, registration, monitoring plan for establishing/maintaining collaborative practice agreements Conduct outreach/awareness campaign to educate women about EC availability
Planned Parenthood of Northern New England- Vermont	Build collaborative partnerships in anticipation of the Vermont pharmacy access bill be signed into law Research and collect data to determine critical target areas to outreach to pharmacists Identify, engage, and train potential collaborating practitioners Develop an outreach and marketing plan to increase about pharmacy access to EC

Outcomes

STATES Re-Granting grantees reported that 100,000 pharmacists, medical providers, legislators, students, and activists participated in trainings, media outreach, and presentations about EC in pharmacies nationwide during the grant cycle. Cumulatively, hundreds of pharmacists implemented EC pharmacy access services in their pharmacies as well. Five grantees conducted state-level research, including surveys with pharmacists in rural and urban parts of their states, in chain and community-pharmacy settings, to understand and ascertain EC availability in their community and to determine pharmacists’ interest in EC provision and emerging healthcare issues.

Many of the projects required the support of a diverse coalition to be successful. Making connections with community pharmacies was highlighted as a successful method to engage community pharmacy stakeholders and gain new allies. Participants also created a network of colleagues throughout the country with whom they can collectively brainstorm and provide feedback about strategies to advance their work. Final reports from all grantee organizations indicated that a broader and stronger network of professionals interested in increasing access to EC was fostered. Each grantee indicated that — consistent with their stated objectives — new coalitions were established, various organizational links, collaborative activities, and legislative support with medical boards, pharmacy associations, schools of pharmacy, and legislative members resulted from program funding, helping to increase access to reproductive health services (including EC) and supplies.

During the Re-Granting funding cycle the FDA announced that Plan B EC would be sold as an OTC product to consumers 18 years of age and older, and as a prescription product for women 17 and younger, and those without proof of age. This decision created some concern by grantees’ that access to Plan B — for particular populations — would potentially be limited. Grantees were concerned that, with Plan B now available OTC, some providers (including pharmacists) may not be as interested in participating in direct pharmacy access programs or may not want to promote EC access to adolescents. Also, some grantees reported that while some pharmacists are not familiar with EC pharmacy access, there is a high level of awareness about the “pharmacist refusal” topic. The other issue raised by grantees was whether Medicaid would provide coverage for Plan B sold as an OTC product. As a result of these concerns, a coalition has formed – The Low Income EC Access Coalition — and many of the grantees are part of this national coalition working to address these issues.

Through the STATES Re-Granting Program, Pharmacy Access Partnership effectively accomplished its goals to build a broader and stronger network for professionals nationally interested in increasing access to EC.

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