Family Planning CentersBy Helen Altonn
clinics change with times
The name has changed. So has the location.
"But everything we do is exactly the same," said Dianne Baker. "We're here, like for our patients, pro-choice."
Baker is the lead nurse practitioner at the Family Planning Centers of Hawaii -- formerly known as Planned Parenthood of Hawaii.
While the philosophy of the reproductive health services program remains the same, Baker has seen a number of changes in her 17 years with the organization.
For one thing, it was renamed in January 1998 after losing affiliation with the Planned Parenthood Federation of America in a management dispute. The island agency refused to be governed by a mainland affiliate that it felt wouldn't be sensitive to Hawaii's culturally diverse population.
After several moves and landlord problems on Oahu, the agency has established a clinic it believes is more accessible to patients at 1350 S. King St. It also has clinics on Maui, and in Kona on the Big Island.
Artist Pegge Hopper has designed a logo -- a hibiscus with a heart-shaped stamen -- to help establish the center's new identity. An unveiling was planned at her gallery from 5:30 to 7:30 p.m. today.
'We're filling a big need'Barry Raff, who formerly ran the Department of Veteran Affairs Medical Center, joined the family planning organization last September as executive director and the only male on the staff.
"I've gone from treating elderly veterans to young teens with reproductive health," he said, adding that "it's a challenge and it's fun."
He said the staff of about 20 is "totally dedicated. They love what they do, and it shows in the care we give."
"We are filling quite a big need," said Baker, noting that the agency had more than 10,000 client visits last year. About half were under age 24, a third were teens, and two-thirds had incomes below poverty levels.
Services include education and low-cost health care to prevent unwanted pregnancies. "We're trying to do a lot more education than we have in the last couple of years," Raff said.
The agency worked for passage of a bill in the last session to mandate health plan coverage of contraceptives. The bill has a religious exclusion clause, Raff said. "There is a lot of compromise."
The Family Planning Centers provide pregnancy tests, counseling and all methods of birth control. They offer emergency contraception, gynecology exams, Pap smears, abortions, sexually transmitted infection treatments, midlife services and vasectomies.
The target population is between 16 and 36 years old, although clients are younger and older, Baker said.
Fees for services are low, and teens are charged half-price on Oahu, she said. Limited state funding is used to provide free teen services on the neighbor islands, she said.
As a sample of the centers' charges, a month's supply of birth control pills costs $16, a Depo-Provera shot good for 12 weeks is $65, an intrauterine device costs $250, and a comprehensive annual exam is $80.
A pregnancy test that costs $20 for teens and adults is the only thing that may not be considered a bargain, but it includes counseling and other services, Raff said.
Baker said a big change over the years is that teens are better informed about sex and sexually transmitted diseases.
"This doesn't necessarily mean they are listening to what we tell them, but they have information," she said. "They're very aware of safe sex and in general do a pretty good job of using condoms."
Chlamydia, a sexually transmitted disease that can cause sterility without treatment, probably has increased, but not necessarily with teens, Baker said. "We see a lot of that with the military population."
Chlamydia is easy to treat, but HIV, also sexually transmitted, "is a different story," she said.
However, she said the Family Planning Centers have never had a positive HIV test. "Our clientele, it's just that they're not a high-risk group."
The average client is looking for birth control and using contraceptive pills, she said, while older people without insurance turn to the agency for affordable Pap smears.
The Kona clinic is struggling because there isn't strong focus on "staying well" in that population, she said. "Going to the doctor is not high priority. It is very acceptable to have an unplanned pregnancy culturally."
Despite free teen services, because of state funding the teen pregnancy rate is very high, she said. "So, what can you do? We're there."
The Maui clinic is doing well because the island has a lot of transient people, Baker said. "There is much more focus on contraceptives and taking care of business."
Making difficulty easierIn her earlier years with the agency, Baker said she was always defensive. That, too, has changed. "I feel we're doing a wonderful job. We're doing a service in the community that nobody else wants to do.
"We have been shaky financially over the years, but our service will always be needed. People mess up. Birth control is not perfect. ... I'm just happy that we're here and can do a good job."
Baker said one of the reasons she's stayed with the program is that she really likes the teen patients. For many it's their first experience with gynecologists, she said. "I feel like I really get through to them.
"We give them a lot of time, and they ask a lot of questions" because they feel comfortable, she said. "It's like everything is OK."
She said patients tell them: "You made a very hard thing for me much easier. I'm very grateful."
The center is open six days a week, from 8 a.m. to 5:30 p.m. It accepts QUEST, Medicaid and most insurance plans.