Publicly Funded Family Planning Organizations' Response to the COVID-19 Pandemic in Texas

Abstract

Introduction: After the onset of the COVID-19 pandemic, the use of family planning services decreased, but there are limited data on how safety net providers were affected.

Methods: Between November 2020 and March 2021, we conducted in-depth interviews with administrators at health departments, federally qualified health centers, and specialized family planning organizations across Texas about pandemic-related changes in family planning services. We analyzed interview transcripts using an inductive thematic approach.

Results: Administrators at the 19 participating organizations described pervasive service disruptions. Some organizations closed for 6-8 weeks at the pandemic's onset owing to safety uncertainties and difficulty interpreting Texas' March 2020 executive order prohibiting "nonessential" medical services; others later suspended services after staff exposures. Health departments and federally qualified health centers commonly decreased family planning services to focus on COVID-19 response, leaving specialized family planning organizations to absorb displaced reproductive health care clients. Some of the advantages of service delivery modifications-including telehealth, curbside and drive-through prescription pickup, and medication by mail-were difficult to realize; barriers included low reimbursement, necessary patient examinations, and clients' confidentiality concerns and lack of technological resources.

Conclusions: Texas' diverse network of family planning organizations illustrated a range of responses to the pandemic, and organizations often focused on their core missions-public health, primary care, or family planning.