PROGRAMS AND COLLECTION PROCEDURES	 Series 1 

Number ’12 

Development of the 

National Inventory of 

Family Planning Services 

United States 

A description of the development of the National Inventory of 

Family Planning Services, which is the first comprehensive listing 

of all family planning service sites in the United States. Describes 

the phases of development and the procedures and results of the 

first national survey. 

DHEW Publication No. (HRA) 76-1312 

U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE 

Public Health Service 

Health Resources Administration 

National Center for Health Statistics 

Rockville, Md. January 1976 
-1 

Library of Congress Cataloging in Publication Data 

Kapantais, Gloria 

Development of the National inventory of’ Family planning services. 

(Vital and health statistics: Series 1, Programs and collection procedures; no. 12) 

(DHEW publication no. (HRA) 76-1 312)


In,cludes bibliographical references.


Supt. of Dots. no.: HE 20.6209:1/12


1. Birth control cIinics–United States. I. Morrow, Donna L., joint author. II. United 

States. National Center for Health Statistics. III. Title. IV. Series: United States. National 

Center for Health Statistics. Vital and health statistics. Series 1: Programs and collection 

procedures, no. 12. V. Series: United States. Dept. of Health, Education, and Welfare. 

DHEW publication no. (HRA) 76-1312. [DNLM: 1. Family planning–History–United 

States. 2. Health surveys-Methods-United States. 3. Health services–United States– 

Statistics. W2 A N148va no. 12] 

RA409.U44 no. 12 [HQ 766.5.U5] 362.8’2 ISBN 0-8406 -0061-5 75-619407 
NATIONAL CENTER FOR HEALTH STATISTICS 

DOROTHY P. RICE, Director 

ROBERT A. ISIL4EL, Acting Deputy Director 

JACOB J. FELD MAN, Ph.D., Associate Director for Arza~ysis 

GAIL F. FISHER, Associate Director for the Cooperative Heahh Statistics System


ELIJAH L. WHITE, Associate Director for Data Systems


EDWARD E. MINTY, Associate Director for Mmagernent


PETER L. HURLEY, Acting Associate Director for Operations


JAMES M. ROBEY, Ph.D., Associate Director for Program Development . ALICE HAYWOOD, Information Officer 

DIVISION OF HEALTH MANPOWER AND FACILITIES STATISTICS 

GLORIA KAPANTAIS, Director


SHELDON STARR, Deputy Director


EVELYN MATHIS, Chiej Health Facilities Statistics Branch


JOSEPH BARBANO, Chief Health Manpower Statistics Branch


SHELDON STARR, Acting Chiej Technical Services Branch


Vital and Health Statistics-Series I-No. 12 

DHEW Publication No. (HRA) 76-1312 

Library of Congress Catalog Card Number 75-619407 
ACKNOWLEDGMENT 

The opening paragraphs of this report were excerpted, with 

permission of the author, from an unpublished manuscript by 

Karen Lashman, “Development of a National Inventory of Family 

Planning Clinics.” Ms. Lashman is a former staff member of the 

Division of Health Manpower and Facilities Statistics of the 

National Center for Health Statistics. 

... 

Ill 
CONTENTS 

Page 

Acknowledgment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


Development ofthe National Inventory of Family Planning Services . . . . . . . . . . . . .


Coverage ofthe National Inventory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


Establishingthe Universe . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


Questionnaire Development........,.. . . . . . . . . . . . . . . . . . . . . . . . . .


The First Annual Survey of the NationaI Inventory of Family Planning Services . . . . .


Procedures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


Bailouts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


Manual Editing and Coding Procedures . . . . . . . . . . . . . . . . . . . . . . . . . .


Keypunching . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


Machine Editing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


Table Generation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


Response tothe First Annual Survey . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


Results of the First Annual Survey . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


Appendix I. Persons Contacted for Comments onthe Pretest Questionniares . . . . . . . .


Appendix II. Attendees of October 1973 Meeting of Technical Advisors . . . . . . . . . .


Appendix III. Geographic Region Classification . . . . . . . . . . . . . . . . . . . . . . . . . . .


Appendix IV. Forms and Questionnaires . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


Request for Clinic Listings . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


MFIFacility Survey Letter . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


College Health Service Survey Letter . . . . . . . . . . . . . . . . . . . . . . . .


Pretest–Project Record . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


Pretest–Clinic Record . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


Universe Verification Letter... . . . . . . . . . . . . . . . . . . . . . . . . .


National Suwey . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


... Ill 

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SYMBOLS 

Data not available---------------------------------------

I Category not applicable ------------------------------ . . . I 

Quantity zero --------------------------------------------- -

Quantity more than Obut less than 0.05---- 0.0 

. 
DEVELOPMENT OF THE NATIONAL INVENTORY 

OF FAMILY PLANNING SERVICES 

Gloria Hollis Kapantais and Donna Morrow, Division of Health Manpo wer and Facilities Statistics 

INTRODUCTION 

Population control is not an idea new to the 

twentieth century. Much of human history has been 

concerned with man’s struggle for food, clothing and 

shelter which would secure for him a position on earth 

which will enable him to live above the level of animals. 

Although such natural calamities as famine, disease, and 

flood, however undesirable, have acted as checks on the 

world’s population, people have, nevertheless, sought 

artificial ways to limit their reproduction since primitive 

times. In fact, birth control in some form has been 

attempted for at least several thousand years. 

Yet in spite of its historical background, the subject 

of contraception has invoked struggles, crusades, moral 

dilemmas, and social problems for generations of people. 

When in 1798 the English economist Thomas R. Malthus 

wrote the now famous “An Essay on the Principle of 

Population,” he set in motion a controversy that has 

raged ever since. To Malthus, population when unchecked increases in a geometric ratio; that is, an 

exponential increase in population occurs amidst resources and production which are inherently limited and 

expand only arithmetically. Therefore, war, famine, and 

disease are necessary balances to a system which 

unchecked could only lead to disaster. Later when 

Malthus himself accepted a fourth deterrent to the 

potential disaster of uncontrolled population growth– 

moral restraint-the seeds for the birth of the population 

control movement were firmly planted. 

While Malthusian predictions did not occur, his 

theory served as a catalyst. Thus, it is not surprising that 

the founder of the modern birth control movement was 

an Englishman. The father of 15 children, Francis Place 

began distributing handbills advising the use of contraceptives in the 1820’s. 

The American birth control movement, begun between 1828 and 1832 by Robert Dale Owen and Dr. 

Charles Knowlton, followed on the heels of the English 

movement and used its momentum. Their work in that 

period of American history caused such an uproar that 

the U.S. Congress in 1873 passed the Comstock Law 

which prohibited the mail distribution of contraceptive 

information on the grounds that it was obscene literature. But this legislation only temporarily halted the 

birth control movement, for in the early 1900’s Margaret 

Sanger, a nurse working with poverty-stricken mothers 

on the lower East Side of New York, made this 

movement her personal crusade. Her daily encounters 

with the problems of the ghettos led her to believe that 

the: 

sexual drive (was) the centralforce inhumanity (and) tie 

moral, psychological, economic and social health of the 

nation depended on the adequate control of its procreative dimension. Its control . . . (was) the key to the 

maintenanceof civilization.a 

In 1914 Mrs. Sanger led a group of feminists in 

founding the Voluntary Parenthood League, the forerunner of Planned Parenthood-World Population, the 

national voluntary family planning organization. In 1916 

Mrs. Sanger was responsible for the opening of a birth 

control clinic in a Brooklyn slum, the first such clinic in 

operation in the United States. Undaunted by numerous 

imprisonments an-d the closing of the clinic as a “public 

nuisance,” her continued work in repealing anticontraception laws, organizing family planning conferences, 

and opening new clinics assured family planning a 

prominent place in the national consciousness. 

The firm conviction of Margaret Sanger’s in the 

necessity of such programs culminated in her work with 

Rama Rau of India, which led to the founding in 1952 

of the International Planned Parenthood Federation. 

But the expansion of family planning services in the 

United States was slow to gain momentum. In its 1959 

policy statement, the American Public Health 

Association urged that “federal, State, and local 

governments in the United States include family 

planning as an integral part of their health programs, 

provide funds and personnel for that purpose, and insure 

al’ates, Wilson: Family Planning on a Crowded Planet. 

Minneapolis. Augsburg Publishing House, 1971. p. 51. 
such freedom of choice of methods that persons of all 

faiths have equal opportunities to exercise their choice 

without offense to their consciences.” Despite this 

encouragement as well as the work started by Margaret 

Sanger and her followers, there was little government 

interest in the field of family planning until the 

mid-1960’s. Both Federal and State governments were 

inhibited from acting in this important area because of 

the fear of antagonizing religious and political groups. 

Thus, family planning as a concern of the Federal 

government has a remarkably short history. WMle the 

government during the Kennedy administration was 

engaged in research on human reproduction and 

contraception, it was not until the Johnson 

administration that there was full support for family 

planning, including the allotment of Federal funds for 

the first national-scope birth control programs. 

President Johnson first brought to the forefront his 

support for family planning in his “Message on 

International Education and Health” of February 2, 

1966, in which he stated that: 

The growing gap–between food to eat and mouths to 

feed–poses one of mankind’s greatest challenges. It 

threatensthe dignity of the individualand the sanctity of 

the family.b 

The following month, in a “Special Message to Congress 

on Health and Education,” he said that: 

We have a growing concern to foster the integrity of the 

family and the opportunity for each child. It is essential 

that all families have access to information and services 

that wilf allow freedom to choose the number and spacing 

of their children within the dictates of indlviduaJ 

conscience,c 

These efforts outlined in his speech of March 1, 1966, 

included substantial budget allocations to fund study, 

training, and services in family planning and research on 

reproduction, and served as an impetus for a growing 

national interest in the family planning area. 

During the last decade, public opinion in the United 

States has grown to recognize that family planning is 

vital to the individual and national health and well-being. 

From a time just twenty years ago when it was common 

to provoke acrimonious debate over the socioeconomic 

as well as the moral issues involved in family planning, 

the concept today is almost universally accepted, tacitly 

or officially, as a sensible approach to the population 

problem. 

bCohen, ~~lb~r J.: iamjly planning: One aspect of freedom 

to choose. Health Educatr”on, and Welfare Indicators, June 

1966. Washington. U. S. Department of Health, Education, and 

Welfare, Office of the Secretary, p. 3. 

cCohen, Wilbur J.: Family planning: One aspect of freedom 

to choose. Health, Education, and Welfare Indicators, June 

1966. Washington. U. S. Department of Health, Education and 

Welfare, Office of the Secretary, p. 4. 

What then is the focus of the family planning 

movement today? The principal challenge of family 

planners has been: 

to assist in devising acceptable ways for men and women 

to control their procreative abilhies and to order their 

lives in more meaningful pattern s.... It is not just a 

wlinicaf and biological problem; it is also social, politicaf, 

economic and moral. The deepest vein of the population 

issue is man and his relation to himself, hk control of 

Klmself and his wilf to determine the qualitative and 

quarrtitative lives of those he creates.d 

In fulfilling this challenge, the primary concern of the 

family planning movement as it has evolved has been to 

stress the welfare of the family and the advantages of 

well-spaced and limited numbers of children. The movement is above all familistic, stressing the rights of parents 

to have the number of children they want, as exemplified by “Children by choice, not by chance,” the slogan 

of the Planned Parenthood Organization. 

While the emphasis on voluntary family planning as a 

health measure of considerable significance for both the 

individual family and the community is readily accepted, 

the interest of public welfare departments has also 

focused attention on the added dimension of family 

planning as a social measure, since the availability of 

family planning services is a crucial part of community 

efforts to reduce poverty and dependency. 

The support of the U.S. Federal and State 

governments for family planning and contraception served as a powerful impetus to the 

proliferation of important new programs in the 

mid-1 960’s. This rapid expansion of family 

planning programs brought to the forefront the 

need for, and lack of, accurate and current 

information on the nature and extent of family 

planning services provided by public and private 

programs and the extent to which the total need 

for subsidized services was being met. It was in 

such an atmosphere that the National Family 

Planning Services Data Collection System was 

conceived as an answer to the legislative requirements and responsibilities imposed by the newly 

created Federal programs in this area. 

On December 24, 1970, the “Family Planning 

Services and Population Research Act of 1970” 

(Public Law 91-572) was signed into being. This 

law put into effect programs for providing 

family planning services to many who desired 

them but would not otherwise have been able to 

afford them. The passage of this act and the 

‘Cooper, John A. D., M.D., Ph. D., Forewerd, The Journal of 

Medical Education. Vol. 44, No. 11 (November, 1969). p. vi. 

2 
influx of Federal funds led to the rapid increase 

in the number of new family planning programs. 

As new programs were begun, it became apparent that there was no method ‘of aggregating 

information from these programs to gain an 

overview of the extent to which they were 

meeting the public’s needs. Several attempts 

were made by individual States and progTams to 

collect such data, but without standardization of 

definitions, services, and so forth; it was impossible to evaluate this information. In addition, 

many facilities that offered family planning 

services were not participants in prpgrams 

organized specifically to provide family planning 

services. These facilities provided comprehensive 

care or some type of specialty care of which 

family planning services were only a segment. 

Information on these facilities and their services 

was sorely lacking. 

Primary responsibility for the methodological 

development and actual implementation of a 

national data collection system was assigned to 

the National Center for Health Statistics 

(NCHS), part of the U.S. Department of Health, 

Education, and Welfare. The system when fully 

developed would consist of three key data 

DEVELOPMENT OF THE 

collection mechanisms: the National Reporting 

System for Family Planning Services, the 

National Inventory of Family Planning Services, 

and Special Studies, as required. 

The National Reporting Systeme began 

operation in January 1972, and collects data on 

the patients receiving services at most publicly 

funded clinics, most Planned Parenthood-World 

Population affiliates, and those other public and 

private organizations which choose to participate in the system. The National Reporting 

System, however, does not maintain a comprehensive listing of all family planning facilities 

nationwide. 

This report concerns the development of 

the National Inventory of Family Planning 

Services. The National Inventory is a comprehensive listing of all facilities in the United 

States, both public and private, that provide 

some type of family planning services-whether 

medical or nonmedical. (These terms are defined 

on page 4.) The National Inventory is the first 

comprehensive nationzd listing of family planning’ service sites and the first expansion of the 

Master Facility Inventory (MFI)f into the outpatient area. 

NATIONAL INVENTORY 

OF FAMILY PLANNING SERVICES


Three basic steps or phases were performed in 

the development of the National Inventory. 

First, it was necessary to determine which 

facilities would fall within the scope of the 

coverage of (i.e., would be included in) the 

National Inventory. Second, an extensive effort 

was required to establish the universe, which is 

the complete list of facilities included in the 

Nat ional Inventory, This step involved 

identifying all the agencies and organizations 

that would have listings of family planning 

facilities, obtaining these listings, and using both 

manual and computer matching procedures to 

process out duplications to acquire the initial 

universe of family planning facilities. Third, the 

questionnaire to be used in surveying the universe facilities had to be developed. After 

completion of these basic steps, the National 

Inventory universe was surveyed in the first of 

the annual surveys to be performed. 

COVERAGE OF THE NATIONAL 

INVENTORY 

The National Inventory includes all facilities 

(except private physicians’ offices) that either 

‘Haupt, Barbara J.: The national reporting system for family 

plsoming services. Health Services Reports 88(7):637-639, 

Aug.-Sept. 1973. 

-fNation~ Center for He~th statistics: Development and 

maintenance of a national inventory of hospitals and institutions. Vitaland Health Statistics. PHS Pub. No. 10()().series 

I –No. 3. Public Health Service. Washington. U.S. Government 

Printing Office, Feb. 1965. 

3 
directly provide medical family planning services 

or serve as referral or contributor agencies, thus 

providing nonmedical family planning services. 

In order to classify facilities, the following 

definitions were used for the National Inventory: 

1. Family planning services are those medical, 

social, and educational services that provide 

the means which enable individuals to meet 

their family planning objectives. 

2.	 Medical family planning services refer to 

the following services provided by a physician, nurse-midwife, registered nurse, or 

other authorized personnel: medical history; physical examinations; laboratory 

testing; testing, consultation, and treatment, including continuing medical supervision; issuance of drugs and contraceptive 

supplies; and appropriate medical referral 

when indicated. 

3. Nonmedical family ~lannin.g services are 

those social &- educa~ional s&-vices such as 

outreach or the provision of transportation 

or babysitting, that are provided to enable 

a person to attend a family planning clinic 

or to otherwise obtain medical family 

planning services. Nonmedical services also 

include referral of patients to other sites 

for medical family planning services; furnishing space, equipment, and/or staff to 

others who provide medical family planning services; or contracting with or paying 

others for the provision of medical family 

planning services. 

4.	 A clinic or service site is a place or facility 

at which any family planning services are 

provided on a regularly scheduled basis. It 

may be a hospital, health center, mobile 

unit, free-standing site, church, or storefront. For mobile units, each stop is considered a clinic location. Physicians’ offices 

are considered clinic locations only when 

there is a formal relationship with some 

project or agency which is responsible for 

providing family planning services. Physicians, nurses, volunteers, etc., who make 

home visits for the purpose of delivering a 

family planning service should count their 

home ba~e of operations as the clinic 

location. 

5.	 A family planning project is the organization or agency responsible for supervising 

or conducting the day-to-day operation of 

the service site. It may be a hospital, 

county or local health department, Planned 

Parenthood organization, or one of numerous other organizations. 

6,	 A family planning patient is a client who 

meets one of the following conditions 

during her/his visit: 

a.	 The client is provided a method of 

contraception by the clinic; 

b.	 The client receives contraceptive, infertility, or sterilization counseling in conjunction with a medical service which is 

not VD or pregnancy testing. 

ESTABLISHING THE UNIVERSE 

The search for sources to be used in developing the universe was initiated in early 1972. 

Because this was the first time a national listing 

was being compiled, it was decided to utilize a 

very broad base for determination of inclusion 

in the National Inventory. For example, the 

universe was to include institutions that offer 

services exclusively to their patients, residents, 

or students, as well as those that provide services 

to the general public. While the former facilities 

serve only a narrow segment of the overall 

population, they were included because it was 

felt that having a broad coverage which could be 

narrowed if desired at a later date would be a 

better initial approach. In addition, facilities 

providing only minimal family planning services 

were retained for the universe. Again, it was felt 

that it was preferable to narrow the criteria for 

inclusion in the universe in the future, if desired, 

rather than create the necessity of redeveloping 

the entire universe in order to broaden its scope. 

Development of the universe continued 

throughout 1972 and 1973, and involved contacting all possible sources that might have 
listings, directories, etc., of family planning 

service sites. These included Federal, State, and 

local government agencies, national organizations, and private agencies. Among the numerous sources contacted during this period were: 

1. The National Reporting System for 

Family Planning Services (NRSFPS) 

2. Community Health Service, DHEW 

3. Regional Medical Programs, DHEW 

4. Indian Health Service, DHEW 

5.	 Maternal and Child Health Service, 

DHEW 

The Master Facility Inventory (MFI) 

;: Planned Parenthood-World Population 

8. Health Maintenance Organizations 

9. HUD Model Cities Program 

10. Office of Economic Opportunity 

11.	 O’Champus (Department of Defense 

Civilian Health and Medical Programs for 

the Uniformed Services) 

12. Office of Education 

13.	 All county health and welfare departments 

14. All State health departments 

15. American Association of Medical Clinics 

16. American Fertility Society 

17. Association for Voluntary Sterilization 

18.	 Twenty-five religious bodies: 

African Methodist Episcopal Church 

African Methodist Episcopal Zion 

Church 

American Baptist Association 

American Baptist Convention 

The American Catholic Church 

American Lutheran Church 

Assemblies of God 

Christian Church (Disciples of G’od) 

Church of God 

Church of Nazarene 

Churches of Christ 

The Episcopal Church 

Jehovah’s Witnesses 

Jewish Congregations–Synagogue 

Council of America 

Lutheran Church in America


The Lutheran Church–Missouri Synod


National Baptist Convention of


America 

National Baptist Convention, USA, 

Inc. 

Presbyterian Church in the United States 

The Roman Catholic Church–National 

Conference of Catholic Bishops 

Seventh-day Adventists


Southern Baptist Convention


United Church of Christ


The United Methodist Church


The United Presbyterian Church in the


United States 

Contacts were made with sources through personal visits if possible and by mail if personal 

visits could not be performed. For the Federal 

Government sources and sources whose offices 

are in the metropolitan Washington, D. C., area, 

contacts were primarily made through personal 

visits. The remaining sources were contacted by 

direct mail correspondence. 

In addition to these methods of contact, two 

specialized inquiries were made. In January 

1973, the administrators of 4,573 custodial and 

remedial care facilities identified from the 

Master Facility Inventory were sent a one-page 

letter inquiring as to whether they provided 

family planning services to their residents. Facilities which did not respond after 3 weeks 

received a followup letter. A total of 4,027 

facilities (88.1 percent) responded, of which 792 

(17.3 percent) provided family planning services 

and 3,235 (70.7 percent) did not. A total of 546 

facilities (11.9 percent) did not respond. Those 

facilities providing services were retained for the 

universe, while those not providing services were 

deleted from the universe, but retained on 

another nonprovider file for recontact in the 

future. 

Also early in 1973, 2,984 colleges and universities, selected from the Office of Education’s 

1972-73 Education Directory,g were contacted 

with a similar letter. Again, nonresponding 

institutions received a followup letter after 3 

weeks. A total of 2,753 institutions (92.3 

percent) responded, of which 578 (19.4 percent) 

provided family planning services and 2,175 

(72.9 percent) did not. A total of 231 institutions (7.7 percent) did not respond. As with the 

gOffice of Education, National Center for Educational 

Statistics: Education Directory, 1972-73, Higher Education. 

DHEW Pub. No. (OE) 73-11404. Washington. U.S. Government 

Printing Office, Dec. 1972. 

5 
MFI facilities, possitive replies were retained for 

the universe and nonproviders were placed on 

the nonprovider file previously created. 

The listings, directories, forms, etc., received 

from the sources and the separate Master Facility Inventory imd college mailings were all 

keypunched and put onto computer tape. Printouts were then generated, which were clerically 

matched to remove duplicates, to yield a total 

initial universe of 14,524 service sites by the 

spring of 1973. At the end of the summer of 

1973, the universe had been further revised to 

include 10,577 facilities. 

In reducing the universe by nearly 4,000 

facilities, both manual and machine or computer 

matching were performed to identify duplicate 

listings. Cases of obvious duplication, where the 

name and address of two facilities were exactly 

the same, were handled by deleting one of the 

facilities. In instances where two facilities with 

similar names were listed at the same street 

address, or where two facilities with the same 

name had different street addresses, telephone 

calls were made or letters sent to verify the 

existence of one or both facilities. Any indication that two facilities listed might be the same 

site was followed-up by a letter or telephone 

call. 

As a final effort at cleaning the universe 

before the first annual survey entered the field, a 

letter mailing to each of these’ potential providers on the universe was conducted in October 

1973. This letter mailing served three purposes: 

1) confirmation of the fact that family planning 

services were provided, 2) confirmation of the 

facility’s address to reduce the problem of 

postmaster returns during the full survey, and 

3) obtaining and/or verifying the name and 

actual location of all service sites operated by a 

project. In conducting this letter survey, an 

initial mailing and two followup mailings were 

sent, with a third followup to nonrespondents 

by telephone. A 95-percent response was obtained from these facilities. As a result of this 

letter mailing the universe was further revised to 

now include 10,321 facilities–5 ,857 presumed 

providers of medical family planning services 

and 4,464 presumed providers of nonmedical 

family planning services. Any nonproviders 

identified through this mailing were placed on 

the file with those previously identified. This 

universe of 10,321 was finalized early in 1974 

and was the basis of the first annual survey 

conducted later in the year. 

QUESTIONNAIRE DEVELOPMENT 

While the universe was being compiled, work 

was simultaneously being performed on developing the questionnaires to be used in the future 

surveys of the National Inventory. In developing 

the questionnaires for the pretest survey, a main 

concern was the need, availability, and usefulness of the information to be collected. Two 

questionnaires were designed to collect information on both the service site level (the clinic 

record) and the project level (the project record). The development of these questionnaires 

was performed with the cooperation and consultation of numerous family planning experts both 

in and out of the government. 

In August of 1971, draft questionnaires were 

sent to these experts for their comments (see 

appendix I for a list of these persons). The 

comments received were reviewed and incorporated into revised questionnaires, which were 

again sent for comments in the summer of 1972. 

While these revised versions were being reviewed, 

staff members at NCHS conducted personal 

visits to directors of family planning clinics 

within the metropolitan Washington area. The 

purpose of these visits was to obtain opinions 

and comments on the feasibility and appropriateness of the questions and the accessibility of 

the information being requested. Based on these 

interviews, the written comments received, and 

meetings with Planned Parenthood Federation 

staff members, final revisions were made to the 

questionnaires in preparation for the pretest. 

Throughout the development of the questionnaires, there was extensive cooperation between 

NCHS and the Planned Parenthood Federation. 

Numerous meetings were held to discuss the 

National Inventory and its goals. Planned Parenthood had previously performed surveys of the 

family planning clinics known to them, and 

these questionnaires were reviewed for possible 

input into the design of the questionnaires for 

the National Inventory. Because of their longstanding and deep involvement in the family 

6 
planning field, Planned Parenthood personnel 

were able to identify questions which could 

potentially pose problems to the clarity and 

validity of the questionnaire. With this insight 

and the comments of the other family planning 

experts, several questions were revised prior to 

the pretest. 

The pretest survey was conducted in the 

spring and summer of 1973, with the cooperation of the Planned Parenthood Federation. 

Selection of the sample of 505 clinics was 

performed by Planned Parenthood. No attempt 

was made to select a true representative sample 

from the universe. The prime criterion for 

sample selection was nonparticipation in an 

automated reporting system. (An automated 

reporting system involves a central agency which 

collects raw data from participating service sites 

and then reports this information to other 

agencies requiring it.) Since the purpose of the 

pretest was to determine whether responses to 

the questions could be easily obtained, it was 

necessary to select facilities that maintained 

their own records. Although this was not a 

representative sample, it was selected to assure a 

cross section of all types of public and private 

facilities to identify any problems in responding 

which may be inherent tp them. An initial 

mailing, two followup mailings, and a telephone 

followup were made. A total of 476 facilities, or 

94.3 percent, responded to the pretest survey.. 

Table A shows the number and percent of 

facilities responding by each contact step. 

A contract was awarded in July 1973 to 

Applied Management Sciences to prepare tabulations of the pretest data, to provide assistance in 

the revision of the questionnaire, to finalize the 

universe, and to conduct the 1974 annual 

survey. This contract ended with the completion 

of tabulations of the 1974 survey data in 

December 1974. The National Center for Health 

Statistics used the results of the pretest solely 

for revision of the questionndre; NCHS published no data reports. Copies of each questionnaire were sent to Planned Parenthood, however, 

for utilization in segments of the analyses being 

performed by them for the annual update of the 

department’s Five-Year Plan for Family Planning 

Services for the National Center for Family 

Planning Services. Planned Parenthood also 

assisted NCHS by performing telephone verifications to responding facilities which did not 

provide complete information. 

During the pretest several problems were 

identified which concerned use of the project— 

as opposed to the service site—as the basis for 

the National Inventory surveys. Among these 

problems were the following: 

1. The fact that the project, as the administrative headquarters, is often in a separate 

location than the clinic poses the potential 

problem of double reporting. It is diffictdt 

to unduplicate listings and identify clinics 

which are reported by more than one 

project because of muhioperational or 

funding arrangements. 

2. A project may simply be a level of aggregation of data. For example, it was discovered on the pretest that among facilities 

being counted as family planning projects 

Table A. Number and percent of facilities respon~ing during each step of the pretest surVey: National Inventory of Family Planning 

Services, 1973 

Request stage 

Initial mailout . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

First followup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Second followup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Telephone followup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Final total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Total number 

of facilities 

surveyed w 

n . . . I 476 

riding 

Cumulative percent 

of total surveyed 

. . . 

33.7 

70.5 

81.4 

94.3 

7 
were places which in fact were mere “subtotals” of various county health departments which report to a larger administrative unit; one example of such an 

arrangement is the Central Shenandoah 

Health Planning District. In the pretest it 

was discovered that even “clinic” reports 

on the NRSFPS could actually represent 

several different county health departments. 

3.	 On the other hand,’ several projects being 

identified as separate entities- are in actuality operationally aggregated. Therefore, 

when pretest survey questionnaires were 

mailed to each project, one project record 

form was selected arbitrarily to represent 

the entire interrelated group, and each 

individual project was rep~rted as a clinic 

on a separate clinic record form. Needless 

to say, this caused havoc with the survey 

receipt control system, since those which 

appeared to be nonrespondent projects (the 

outstanding project record forms) were in 

actuality respondents who had submitted 

clinic record forms. 

4.	 Data on staff which are gathered at the 

project level do not provide an adequate 

picture of clinic operations. In a large 

project, clinic staffing could vary a great 

deal. Staff should be collected at the clinic 

level so that patient load/personnel-type 

ratios can be calculated for each clinic. 

5.	 The problem of identifying new family 

planning facilities is greater when projects 

are the basis of the survey rather than 

clinics. With a project listing rather than 

the actual service sites as the basis of the 

survey, it is conceivable that a project 

could be deleted from the universe tape at 

one stage (e.g., identified as a clinic), and 

added at a later stage when checking the 

universe against newly identified facilities. 

6. Matching published family planning facilities listings such as those put out by the 

District of Columbia and the Greater Los 

Angeles Regional Family Planning Council 

against the NCHS universe file is currently virtually impossible. This is due to 

the fact that such listings identify service 

sites, i.e., clinics, and are user oriented, 

while the Center’s family planning program 

as currently organized is based on the 

project and is administratively oriented. 

7. Many so-called “projects” are in actuality 

clinics; that is, they are not the principal 

administrative bodies of the organized family planning programs for which inf ormation is being sought. In such cases, the 

pretest questionnaire was forwarded to the 

administrative headquarters where the required forms were completed for both the 

original addressee (which was in the sample) and all other “clinics” for which the 

headquarters unit was administratively or 

operationally responsible. Since both this 

headquarters agency and the additional 

clinics it reports can be on the universe 

listing, the danger of duplication of patients abounds. 

Most of these problems encountered were resolved by the time the full survey was conducted, through redesign of the survey to obtain 

data from the clinic level. After reviewing the 

results of the pretest it was felt that to obtain 

useful information, the emphasis must be placed 

on the facility actually providing services to 

patients. This decision resulted in the merging of 

the two pretest questionnaires into one survey 

questionnaire directed at the clinic level. 

A national meeting was then held in October 

1973, attended by technical advisers from Federal, State, and local agencies. (See appendix II 

for list of participants.) The purpose of this 

meeting was to discuss the revised questionnaire 

as well as several methodological aspects of the 

National Inventory coverage. Included among 

the items for discussion were: 

1.	 Should the Inventory include just those 

facilities that provide medical family planning services? 

2.	 Should the Inventory include inpatient 

facilities that provide family planning serv8 
ices only to their residents (e.g., homes for 

the mentally retarded)? 

3.	 Shou~d the Inventory include those facilities that only participate in the provision of 

family planning services, such as: 

a. referral agencies or “umbrella” agencies? 

b.	 facilities such as hospitals that only 

donate space to another family planning 

agency? 

c.	 agencies that contract with private physicians to provide family planning services 

for their clients? 

d.	 locations that subsidize family planning 

services elsewhere? 

4.	 Should a classification scheme be established for clinics, outlining some key services which must be provided before a 

service site can be considered a true family 

planning clinic? 

Based upon the comments of the attendees, the 

survey questionnaire, definitions, and procedures to be used in the first national survey were 

reviewed and revised, when necessary, into their 

find format. 

THE FIRST ANNUAL SURVEY OF THE NATIONAL INVENTORY 

OF FAMILY PLANNING SERVICES 

PROCEDURES 

Mailouts 

In April 1974, the first survey of the universe 

of the National Inventory was initiated to 

collect data on calendar year 1973. The questionnaire, which now centered only on the 

actual service site for its data, was mailed to the 

5,857 providers of medical family planning 

services and the 4,464 providers of nonmedical 

family planning services. To facilitate the mailing and receipt control processes, the projects 

which operated these service sites were used as 

intermediaries in the distribution of the questionnaires, but no information was requested on 

the projects themselves. The questionnaires for 

all service sites of one project were labeled, 

packaged, and mailed to the project for distribution to the service sites or for completion by the 

project’s office if desired. It was requested that 

the questionnaires be returned to the project for 

collection and subsequent mailing to NCHS. In 

some instances, the office of a State family 

planning program requested NCHS to send all 

questionnaires for that State through that office, 

and every effort was made to comply with such 

requests. 

Data collection and processing for this first 

survey, or census, of the-National-Inventory was 

performed by an independent contractor, as 

mentioned previously. The data collection process extended from April through August and 

consisted of an initial mailing, two followup 

mailings, and a final telephone followup to 

nonrespondents. Table B illustrates the timing of 

the mailings and the number of questionnaires 

sent in each mailing. 

As the universe included both medical and 

nonmedical providers, each type of provider was 

handled separately in the mailing process, as 

follows: 

Medical providers.–It was decided that the 

mailing of questionnaires for these medic~ 

providers would follow the project/clinic concept set up during the universe development. 

The questionnaires for medical clinics operated 

by an organization or agency (i.e., “project”) 

would be grouped together and mailed to the 

project. Each questionnaire would have an identifying label. The project would then be responsible for completing the forms at its headquarters or distributing the forms to the 

individual clinic sites for completion. It was also 

requested that all questionnaires sent in this 

manner be returned by the clinics to the project 

9 
Table B. Number and percent of facilities responding during each step of the first annual survey: National Inventory of Family 

Plannina Services, 1974 

Facilities responding 

Totel number 

Date of facilities Cumulative num- Cumulative parcontacted barresponding cent of total 

to date contacted 

Initial mail: May 8, 1974 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10,321 . . . . . . 

First followup: Juna5,1974 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6,790 3,531 34.2 

second followup: June 20, 1974 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,708 5,612 !54.4 

Telephone followup: July 20,1974. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . x 568 7,726 74.9 

Total receivad . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8,980 87.0 

Total unusable (out-of-business, out-of-scope, PMR, etc.) . . . . . . . . . . . . 910 8.8 

Additional facilities identified: 

Respondents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100 . . . 

Nonrespondents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 270 . . . 

‘Telephone followup to nonrespondents was conducted with theprojacts, not the individual medical clinics. This wes necessitated 

by the fact that the projects functioned as intermediaries in the mailing 

for subsequent return to the contractor. In this 

way, receipt control of the individual forms 

could be facilitated. Nine States—Arkansas, 

Colorado, Louisiana, Michigan, Oklahoma: 

Rhode Island, Tennessee, Washington, and West 

Virginia–requested that all medical provider 

questionnaires be sent to a central office at the 

State level since, in these cases, the State 

maintained statistics on medical family planning 

in that office. For each of these States, the 

questionnaires were grouped by project and 

inserted into mailing envelopes in the standard 

manner, but these mailing envelopes were then 

boxed together for mailing in bulk to the 

designated office. By using the project mailing 

envelopes, the State office could forward the 

questionnaires to the projects, if necessary, for 

completion of items not available through the 

State office. 

Nonmedical providers. -In developing the universe for the National Inventory, it became 

apparent that the nonmedical providers were 

single units, and could not be aggregated under 

projects in the way the medical providers were. 

In these cases, the actual service location was 

also the headquarters; that is, for each nonmedical provider the project headquarters and 

the service site were the same place. The process 

of mailing questionnaires to nonmedical providers simply involved mailing each questionnaire to the name and address indicated on the 

form’s identification label. Since the States are 

concerned primarily with statistics on medical 

procass. 

family planning services, none of the questionnaires for the nonmedical providers were mailed 

through State government offices. Some of the 

presumed providers of nonmedical services returned the forms indicating that they did not 

provide family planning services of any nature. 

In some cases this response appeared questionable, and these forms were remailed with a special 

note defining the scope of nonmedical family 

planning services in the hope of clarifying any 

misunderstanding of definitions that may have 

occurred. The first followup mailing also utilized 

this note. As a further effort, a special cover 

letter was included in the second followup 

mailing to emphasize the importance of the 

information requested of the nonmedical providers. 

Information collected on the medical providers included physical location; operating 

responsibility; primary purpose; funding sources; 

patient load; total visits; medical, ancillary, and 

contraceptive services offered; and staffing. For 

the nonmedical providers, information was obtained on physical location; operating responsibility; whether referrals are provided; whether 

space, supplies, etc., are provided to others; and 

whether they contract or pay others for the 

provision of medical family planning services. 

Manual Editing and Coding Procedures 

As the questionnaires were received, they 

were clerically sorted according to type of 

10 
provider. Forms returned by the post office and 

~hose returned by responde~ts in~icating out-ofbusiness, duplicate form, and so forth, were 

coded for deletion from the universe and 

received no further editing. Good returns, that 

is, returns from facilities in operation within the 

scope of the National Inventory, were carefully 

edited by trained clerks following specific written editing and coding instructions based on 

NCHS specifications. The editing and coding 

procedures were designed to: 

� Identify forms with incomplete or missing 

data items which would require further 

contact with the facility to complete. 

� Verify that the facility for which the 

questionnaire was completed was within 

the scope of the National Inventory. 

� Detect any inconsistencies or unreasonable 

entries. 

� Assure that the form contained information for only one facility. 

� Provide uniformity of the data in preparation for keypunching and computerization. 

� Develop codes for the “open end” responses. 

Each questionnaire which failed to pass one 

or more of the manual edits was separated from 

the other forms as a “fail edit.” In most 

instances, the service site which completed the 

form that failed during editing was contacted by 

telephone for verification and/or correction of 

the data reported; in the few instances where a 

major portion of the questionnaire was involved, 

the contact was made by mail. For those 

facilities not responding to the fail-edit inquiry, 

data were imputed during the machine editing 

stage. Once a questionnaire had passed through 

the manual edit, the data were keypunched and 

subsequently placed on computer tape for 

further processing. The effective cutoff date for 

survey returns was August 1, 1974. All editing, 

coding, and keypunching, however, was not 

completed until October 1, 1974, and questionnaires received during this period were processed 

if possible. 

Georgia and Tennessee presented special problems in editing due to their incomplete data on 

nearly every facility. Telephone contact was 

made with the State health department office 

responsible for family planning programs in each 

State. Through these teIephone contacts, general 

information applying to all service sites in each 

State was obtained along with some additional 

information on specific service sites. The types 

of data obtained on the nonrespondents from 

these States can be described as follows: 

Georgia: 

General data: funding, type of and patient 

percentage of receipt of services offered, 

ancillary services, type of and percentage of 

use of contraceptive methods. 

Specific data: total patients, new patients, 

and total visits. 

Tennessee: 

General data: funding, primary purpose, location, ancillary services, patient/new patient 

ratio, patient/visit ratio. 

Specific data: total patients, total IUD users, 

total users of oral contraceptives 

A questionnaire was completed for each nonresponding facility based on these data provided. 

No additional fail-edit procedures were employed during editing. Because of the large 

volume of data still missing on each questionnaire, no imputation during machine editing as 

described later was performed on these forms. 

Applying such a process in these cases would 

have created statewide data which would have 

been primarily imputed and statistically questionable. 

Keypunching 

Specifications for keypunching were designed 

on the basis of the manual editing and coding 

procedures. Nonmedical providers were requested to complete a substantially smaller 

portion of the questionnaire than medical providers, therefore requiring fewer cards to be 

punched. To provide for more effective use of 

keypunching time and more efficient sightscanning for format and structure, the questionnaires were batched for punching according to 

provider classification. Keypunching was 100-

percent key-verified for 99.5-percent accuracy. 

After punching, the data were put on computer 

tape for implementation of the machine-edit 

program. 

11

Machine Editing 

Machine editing included range and ratio 

checks, cross-checks between question responses, and imputation for item nonresponse, 

if desired. Any questionnaire from the first 

annual survey of the National Inventory which 

was only partially completed was subject to 

followup verification and/or imputation of a 

response for the missing item(s). If major portions of the form were not completed when they 

should have been, telephone or mail followup to 

the responding clinic was performed to solicit 

answers. In instances where only one or two 

items required a response, or when there was no 

response to the fail-edit inquiry, the response 

was imputed based on NCHS specifications. 

For all questions except items 15, 17, and 18, 

a “hot deck” process was used for imputation of 

responses. In using “hot decking,” two or three 

key criteria questions are identified for each 

item to be imputed. These key criteria are used 

to sort the records in the data file and group 

together all facilities whose responses are similar 

in nature. Once the file is sorted by the key 

criteria for a particular question, the entry for 

that item is taken from the record immediately 

preceding the one to be imputed. 

For questions 15 and 17, the percentages 

which were missing were obtained by using a 

modification of the “hot deck.” The data file is 

sorted by the key criteria questions; however, 

instead of using the particular response of the 

preceding record, the average percentage across 

all records in the sort for that item is obtained 

and entered as the imputed response. 

The imputation of question 18 responses was 

also performed in a different manner. Thirteen 

ratio tables of staff type to staff hours were 

formulated and utilized for completion of 

missing items. 

The criteria questions upon which the imputation process was based are itemized in table C. 

As indicated previously, two States–Georgia 

and Tennessee—presented special problems due 

to their substantial amount of nonreporting. In 

order not to lose the minimal information 

obtained, but at the same time not inflate the 

figures, no imputation of missing items was 

Table C. Criteria questions used to impute for nonresponse in 

the first annual survey: National Inventory of Family 

Planning 8ervices, 1974 

Question to be imputed Criteria questions 

4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

5,7 

4,7,8 

4,5,8 

4,5,7 

5,7,8 

4,5,7 

7,12 

4,5,7 

4,5,7 

12, 14a 

performed on questions 12-18 of questionnaires 

from these States. 

Once the data file passed all required edits, it 

was considered clean, and tabulations based on 

these data could be generated. 

Table Generation 

The 1974 annual survey was the first survey 

to be conducted on the universe of the National 

Inventory. Because of the lack of previous 

information on the facilities in the listing, no 

attempt was made to “weight up” the reported 

data to axrive at an estimate for the total 

universe. It is not statistically valid at this point 

in time to assume that the characteristics obtained from the reporting facilities would occur 

in the same proportion in the nonreporting 

facilities. Until further data are received on the 

nonresponding facilities and the universe coverage is validated, all data presented will be solely 

that of the reporting facilities and will be 

identified as such. 

RESPONSE TO THE FIRST 

ANNUAL SURVEY 

Completion of the processing of the survey 

data yielded further changes in the universe of 

the National Inventory. Those facilities identified as nonproviders, out-of-business, duplicates, 

etc., were deleted from the universe; and newly 

identified sites were added. There were also 

12 
changes in service-provider status. Some facilities 

originally classified as nonmedical providers 

were actually medical providers, and were transferred to this listing. In other instances, the 

opposite was true , and supposed medical providers were changed to nonmedical providers. 

The result of these deletions and additions was a 

revised universe of 9,781 service sites—5,719 

medical and 4,062 nonmedical. 

A total of 8,170 service sites responded to 

this first survey, for an overall response rate of 

83.5 percent based on the revised universe of 

9,781 sites. These 8,170 responding sites 

included 4,607 medical providers and 3,563 

nonmedical providers. -

The 4,607 medical providers included 113 

service sites for which minimal data were available due to the following reasons. Eighty-nine of 

these sites began operation in 1974 and were 

therefore unable to supply answers to most of 

the questionnaire items which applied to the 

1973 calendar year. Another 24 sites may have 

been operational prior to 1974 but their 

responses did not permit clear-cut categorization 

either as medical or nonmedical providers. 

Responses given, however, indicate that their 

provision of medical services was at best a 

minimal effort. These 113 sites were excluded 

from the main data base used for computing all 

tabulations generated from this survey, thus 

reducing the data base of responding medical 

clinics to 4,494. 

As mentioned previously, no attempt has 

been made to “weight up” the data of the 

reporting facilities to the total universe figure of 

9,781. Two reasons for this are: (1) As a new 

program, no previous information is readily 

available on the nonresponding facilities. Thus, 

applying the same proportion of responses to 

the nonrespondents as occurred with the 

respondents is totally unacceptable. Therefore, 

it was decided to use only the data obtained 

from the reporting sites in any tabulations 

generated. (2) There is no way of knowing that 

the total of 9,781 facilities is accurate. As of 

now, there has been no statistical measurement 

of its validity or the’ scope of its coverage. It is 

anticipated that iti the near’ future a complement survey will be completed which will 

measure the validlty of the National Inventory 

universe. 

RESULTS OF THE FIRST ANNUAL 

SURVEY 

Tables D and E show the breakdown of 

responding facilities by census region and also 

by State (see appendix 111 for a breakdown of 

the geographical classification). The South contains nearly half of the 4,494 medical providers 

who responded, with Georgia and Texas being 

the southern States with the largest number of 

such facilities. For the nonmedical providers, the 

North Central contained the most responding 

sites, with Indiana, Iowa, and Minnesota being 

the States with the largest number. 

Only about 10 percent of the nonmedical 

providers were operated by nongovernment 

agencies or organizations, as illustrated in table 

F. Taking the actual responses, 1,690 of the 

3,121 State/locally operated sites (47.4 percent 

Table D. Number of responding family planning sewice sites in 

the first annual survey, by census region and division and 

type of service provided: National Inventory of Family 

Planning Services, 1974 survey 

Region and division 

All locations . . . . . . . . . 

United States . . . . . . . . . . . 

Regions: 

Northeast . . . . . . . . . . . . . . . . . 

North Central . . . . . . . . . . . . . 

South . . . . . . . . . . . . . . . . . . . . 

West . . . . . . . . . . . . . . . . . . . . . 

Northeast 

New England . . . . . . . . . . . . . . 

Middle Atlantic . . . . . . . . . . . . 

North Central: 

East North Central . . . . . . . . . . 

West North Central . . . . . . . . . 

South : 

South Atlantic . . . . . . . . . . . . . 

East South Central . . . . . . . . . . 

West South Central . . . . . . . . . 

West: 

Mountain . . . . . . . . . . . . . . . . . 

Pacific . . . . . . . . . . . . . . . . . . . 

Puerto Rico . . . . . . . . . . . . . . . . . . 

Outlying areas . . . . . . . . . . . . . . . . 

Medical Nonmedical 

providers providers 

4,494 3,563 

4,410 3,563 

646 381 

700 1,641 

2,210 1,066 

854 474 

193 134 

453 247 

430 735 

270 906 

1,065 524 

544 273 

601 269 

288 294 

566 180 

81 

3 

13 
Table E. Number of responding family planning service sitas in the first annual survey, by Stata or geographic Iocetion and type of 

servica provided: National Inventory of Family Planning Services, 1974 survey 

Location Medical Nonmedical Location Medical 

Allocations . . . . . . . . . . . 4,494 3,563 Missouri . . . . . . . . . . . . . . . . . . . . . . . 111 158 - Montana . . . . . . . . . . . . . . . . . . . . . . . 20 77 

United States . . . . . . . . . . . . . . 4,410 3,563 Nebraska . . . . . . . . . . . . . . . . . . . . . . 23 81 

Nevada . . . . . . . . . . . . . . . . . . . . . . . . 15 13 

Alabama . . . . . . . . . . . . . . . . . . . . . . . 131 38 NawHampshire . . . . . . . . . . . . . . . . . 13 18 

Alaska . . . . . . . . . . . . . . . . . . . . . . . . 19 2 New Jersey . . . . . . . . . . . . . . . . . . . . . 85 46 

Arizona . . . . . . . . . . . . . . . . . . . . . . . 87 16 New Mexico . . . . . . . . . . . . . . . . . . . . 72 34 

Arkansas . . . . . . . . . . . . . . . . . . . . . . 98 50 New York . . . . . . . . . . . . . . . . . . . . . 222 95 

California . . . . . . . . . . . . . . . . . . . . . . 392 90 North Carolina . . . . . . . . . . . . . . . . . . 95 104 

Colorado . . . . . . . . . . . . . . . . . . . . . . 52 91 North Dekota . . . . . . . . . . . . . . . . . . . 8 88 

Connecticut . . . . . . . . . . . . . . . . . . . . 38 8 Ohio . . . . . . . . . . . . . . . . . . . . -. . . . . 165 162 

Delaware . . . . . . . . . . . . . . . . . . . . . . 16 5 Oklahome . . . . . . . . . . . . . . . . . . . . . 135 34 

Districtof Columbia . . . . . . . . . . . . . 28 1 Oregon . . . . . . . . . . . . . . . . . . . . . . . . 63 39 

Florida . . . . . . . . . . . . . . . . . . . . . . . . 221 71 Pennsylvania . . . . . . . . . . . . . . . . . . . 146 Im 

Georgia . . . . . . . . . . . . . . . . . . . . . . . 248 149 Rhode Island . . . . . . . . . . . . . . . . . . . 22 

Hawaii . . . . . , . . . . . . . . . . . . . . . . .. . 27 5 South Carolina . . . . . . . . . . . . . . . . . . 108 41 

Idaho . . . . . . . . . . . . . . . . . . . . . . . . . 23 17 South Dakota . . . . . . . . . . . . . . . . . . . 6 82 

Illinois . . . . . . . . . . . . . . . . . . . . . . . . 57 146 Tennessee . . . . . . . . . . . . . . . . . . . . . . 193 6a 

Indiana . . . . . . . . . . . . . . . . . . . . . . . . 54 179 Texas . . . . . . . . . . . . . . . . . . . . . . . . . 247 76 

Iowa . . , . . . . . . . . . . . . . . . . . . . . . . . 32 177 Utah . . . . . . . . . . . . . . . . . . . . . . . . . . 13 14 

Kansas . . . . . . . . . . . . . . . . . . . . . . . . 54 147 Vermont . . . . . . . . . . . . . . . . . . . . . . 13 10 

Kentucky . . . . . . . . . . . . . . . . . . . . . . 118 72 Virginia . . . . . . . . . . . . . . . . . . . . . . . 170 96 

Louisiana . . . . . . . . . . . . . . . . . . . . . . 121 109 Washington . . . . . . . . . . . . . . . . . . . . 65 44 

Maine . . . . . . . . . . . . . . . . . . . . . . . . . 31 West Virginia . . . . . . . . . . . . . . . . . . . 60 28 

Maryland . . . . . . . . . . . . . . . . . . . . . . 119 : Wisconsin . . . . . . . . . . . . . . . . . . . . . . 23 122 

Massachusetts . . . . . . . . . . . . . . . . . . . 76 87 Wyoming . . . . . . . . . . . . . . . . . . . . . . 6 32 

Michigan . . . . . . . . . . . . . . . . . . . . . . 131 126


Minnesota . . . . . . . . . . . . . . . . . . . , . 36 173 Puerto Rico . . . . . . . . . . . . . . . . . . . . 81


Mississippi . . . . . . . . . . . . . . . . . . . . . 102 75 Outlying areas . . . . . . . . . . . . . . . . . . 3


Table F. Number andparcent distribution ofservice sites responding tothefirst annual survey, byoperating responsitiliW endtypeof 

service provided: National inventory of Family Planning Services, 1974 survey 

Oparating responsibility 

Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Government: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Federal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

State-local . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Proprietary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Nonprofit: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Church . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

University . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Hospital . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Corporation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Medical 

Number Percent 

4,484 100.0 

2,966 66.0 

386 8.6 

2,580 57.4 

28 0.6 

1,500 33.4 

6 0.1 

171 3.8 

245 5.5 

1,051 23.4 

27 0.6 

Nonmedical 

Number Percent 

3,563 100.0 

3,204 89.9 

93 2.3 

3,121 87.6 

79 0.5 

340 9.5 

4 0.1 

33 0.9 

63 1.8 

210 5.9 

30 0.8 

14 
of the total) were county operated and in all 

probability were social service or welfare departments. For the medical providers, 66 percent 

were government operated, again with the 

county government operating the largest portion 

(1,308). 

Inquiry into the services provided by the 

nonmedical sites consisted of three questions: 

1. Do you refer patients to any other site for 

medical family planning services? 

2. Do you provide space, equipment, contraceptive supplies, and/or staff to others who 

provide medical family planning services? 

3.	 Do you contract or pay others for the 

provision of medical family planning services? 

The question on patient referral received the 

largest number of affirmative responses–3,474, 

or about 98 percent. In a substantial number of 

instances— 1,031, or 29 percent—the nonmedical 

providers also contracted or paid others for the 

provision of medical family planning services. 

The smallest number–372, or 10 percent– 

provided space or equipment to others who 

provided the medical family planning services. 

Data collected on the medical providers but 

not on the nonmedical providers included primary purpose, number of patients and patient 

visits, medical services provided, and staffing. 

Responses of the 4,494 reporting medical providers indicated that nearly three-fourths of the 

respondents provided medical family planning as 

their primary purpose, as illustrated in the 

following table: - “ 

Primary purpose Number Percent 

Medical family planning . . . . . . . . . . . . 3,237 72.0 

Sterilization . . . . . . . . . . . . . . . . . . . . . 8 0.2 

Venereal disease testing . . . . . . . . . . . . . 14 0.3 

Postpartum and/or prenatal care ... ,.. 64 1.4 

Comprehensive health care . . . . . . . . . . 1,028 22.9 

Other (mainly general gynecological 

services) . . . . . . . . . . . . . . . . . . . . . . t 143 3.2 

The categories contained in the question on 

medical services provided revealed a wide range 

of provision—from 98.8 percent for the taking 

of blood pressure down to 14.4 percent for male 

sterilization. A clear division in the type of 

services provided can be seen in table G. Medical 

services that are usually considered as standard 

or normal had 80 percent or more of the service 

sites providing each service. The split occurred 

when the more unusual or specialized types of 

services were provided. 

The 4,494 responding medical providers 

served a total of nearly 4.4 million patients in 

1973 with over 7 million visits. Table H shows 

the breakdown of patients served and visits by 

State. 

The auestion on staffing was difficult for . 

many service sites due to the fact that their 

sessions may not have been set up on a formal 

basis with only paid workers. Also, comprehenTable G. Number and percent distribution of medical facilities 

responding to the first annual survey, by medical service 

provided: Nationel Inventory of Family Planning Services, 

1974 survay 

Medical service 

Total sites . . . . . . . . . . . . . . . . . . 

Record of pertinent medical history . . . 

Record of reproductive history . . . . . . . 

Record of pertinent social history . . . . . 

Pap smear . . . . . . . . . . . . . . . . . . . . . . . 

Pelvic examination . . . . . . . . . . . . . . . . 

Breast examination . . . . . . . . . . . . . . . . 

Taking of blood pressure . . . . . . . . . . . . 

Contraceptive prescription . . . . . . . . . . 

lnsertionofl UD . . . . . . . . . . . . . . . . . . 

Testing for syphilis . . . . . . . . . . . . . . . . 

Testing for gonorrhea . . . . . . . . . . . . . . 

Pregnancy testing . . . . . . . . . . . . . . . . . 

Routine lab test . . . . . . . . . . . . . . . . . . 

Infertility diagnosis . . . . . . . . . . . . . . . . 

Infertility counseling . . . . . . . . . . . . . . . 

Female sterilization . . . . . . . . . . . . . . . . 

Male sterilization . . . . . . . . . . . . . . . . . . 

Sickle cell screening . . . . . . . . . . . . . . . 

Other medical services . . . . . . . . . . . . . . 

Number 

of Percent 

sites 

4,494 100.0 

4,408 98.1 

4,351 96.8 

3,856 85.8 

4,420 98.4 

4,377 97.4 

4,336 96.5 

4,439 98.8 

4,284 95.3 

3,936 87.6 

3,889 82.1 

4,262 94.8 

3,630 80.8 

4,092 91.1 

1,008 22.4 

1,729 38.5 

849 18.9 

648 14.4 

1,866 41.5 

1,112 24.7 

15 
Table H. Total patiants served and number of visits raported by servica sites responding to the first annual survey, by State or 

geographic location: National Inventory of Family Planning Services, 1974 survey 

Location 

Allocations . . . . . . . . . . . . 

United States . . . . . . . . . . . . . . 

Alabama . . . . . . . . . . . . . . . . . . . . . . . 

Alaska . . . . . . . . . . . . . . . . . . . . . . . . . 

Arizona . . . . . . . . . . . . . . . . . . . . . . . . 

Arkansas . . . . . . . . . . . . . . . . . . . . . . . 

California . . . . . . . . . . . . . . . . . . . . . . 

Colorado . . . . . . . . . . . . . . . . . . . . . . . 

Connecticut . . . . . . . . . . . . . . . . . . . . 

Delaware . . . . . . . . . . . . . . . . . . . . . . . 

DistrictofColumbia . . . . . . . . . . . . . . 

Florida . . . . . . . . . . . . . . . . . . . . . . . . 

Georgia . . . . . . . . . . . . . . . . . . . . . . . . 

Hawaii . . . . . . . . . . . . . . . . . . . . . . . . . 

Idaho . . . . . . . . . . . . . . . . . . . . . . . . . 

Illinois . . . . . . . . . . . . . . . . . . . . . . . . . 

Indiana . . . . . . . . . . . . . . . . . . . . . . . . 

Iowa . . . . . . . . . . . . . . . . . . . . . . . . . . 

Kansas . . . . . . . . . . . . . . . . . . . . . . . . . 

Kentucky . . , , . . . . . . . . . . . . . . . . . . 

Louisiana . . . . . . . . . . . . . . . . . . . . . . 

Maine . . . . . . . . . . . . . . . . . . . . . . . . . 

Maryland . . . . . . . . . . . . . . . . . . . . . . . 

Massachusetts . . . . . . . . . . . . . . . . . . . 

Michigan . . . . . . . . . . . . . . . . . . . . . . . 

Minnesota . . . . . . . . . . . . . . . . . . . . . . 

Mississippi . . . . . . . . . . . . . . . . . . . . . . 

Patient 

Patients 

visits 

4,391,589 7,158,015 

$,304,065 7,008,785 

80,656 176,828 

20,202 33,908 

63,1$)4 110,201 

82,687 122fi42 

630,609 967,396 

49,082 78,960 

34,112 42,719 

12,349 21,647 

64,291 107,908 

199,991 317,768 

169,285 289,644 

61,663 76,261 

14,241 34,092 

121,028 187,242 

51,613 71,028 

28,149 51,245 

49,856 65,948 

47,804 91,804 

118,271 308,977 

17,879 29,773 

107,598 205,260 

92,314 146,310 

142,711 332,981 

37,473 62,243 

78,092 131,718 

Location 

Missouri . . . . . . . . . . . . . . . . . . . . . . . 

Montana . . . . . . . . . . . . . . . . . . . . . . . 

Nebraska . . . . . . . . . . . . . . . . . . . . . . . 

Nevada . . . . . . . . . . . . . . . . . . . . . . . . 

New Hampshire . . . . . . . . . . . . . . . . . . 

New Jersey . . . . . . . . . . . . . . . . . . . . . 

New Mexico . . . . . . . . . . . . . . . . . . . . 

New York . . . . . . . . . . . . . . . . . . . . . . 

North Carolina . . . . . . . . . . . . . . . . . . 

North Dakota . . . . . . . . . . . . . . . . . . . 

Ohio . . . . . . . . . . . . . . . . . . . . . . . . . . 

Oklahoma . . . . . . . . . . . . . . . . . . . . . . 

Oregon . . . . . . . . . . . . . . . . . . . . . . . . 

Pennsylvania . . . . . . . . . . . . . . . . . . . . 

Rhode Island . . . . . . . . . . . . . . . . . . . . 

South Carolina . . . . . . . . . . . . . . . . . . 

South Dakota . . . . . . . . . . . . . . . . . . . 

Tennessea . . . . . . . . . . . . . . . . . . . . . . 

Texas . . . . . . . . . . . . . . . . . . . . . . . . . 

Utah . . . . . . . . . . . . . . . . . . . . . . . . . . 

Vermont . . . . . . . . . . . . . . . . . . . . . . . 

Virginia . . . . . . . . . . . . . . . . . . . . . . . . 

Washington . . . . . . . . . . . . . . . . . . . . . 

West Virginia . . . . . . . . . . . . . . . . . . . . 

Wisconsin . . . . . . . . . . . . . . . . . . . . . . 

Wyoming . . . . . . . . . . . . . . . . . . . . . . . 

Puerto Rim . . . . . . . . . . . . . . . . . . . . . 

Outlying areas . . . . . . . . . . . . . . . . . . . 

Patient 

Patients 

visits 

106,838 129,944 

24,173 28,2?3 

15,923 22,256 

16,927 23,778 

5,584 11,686 

96,059 167,831 

34,290 54,045 

333,748 541,588 

76,382 124,697 

3,739 4,626 

150,852 249,567 

110,894 172,148 

46,850 66,135 

147,193 235,359 

14,365 31,163 

116,730 157,462 

6,095 7,427 

113,551 154,975 

257,318 387,827 

21,373 23,878 

7,621 11,080 

105,048 160,157 

76,813 120,558 

21,220 31,401 

16,532 22,237 

2,797 3,984 

86,488 145,161 

1,036 4,069 

sive care facilities or facilities not exclusively 

offering family planning services found it difficult to determine the number of staff and 

amount of time spent in providing family 

planning services when these services areincorporated into other services. 

As stated previously, special editing instructions had to be devised for two States (Georgia 

and Tennessee) due to the fact that the staffing 

question was not completed for the majorityof 

their service sites. Therefore, the staff figuresin 

tableJ are based only on data received from the 

other States. 

This first annual survey of the National 

Inventory of Family Planning Services yieldeda 

substantial amount of information on sites 

providing family planning services in the United 

States and selected territories. More detailed 

reports on the characteristics of these sites can 

be found in Series 14 of Vital and Health 

Statistics. 

Table J. Staff division breakdowns for medical service sites 

responding to the first annual survey: National Inventory of 

Family Planning Services, 1974 survey 

1 

Total 

Category of personnel I employees 

Total professional and technical . . . . . . . ‘ 39,061 

Madical personnel: 

Physician . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6,957 

Physician’s assistant, nurse midwife/nurse 

practitioner . . . . . . . . . . . . . . . . . . . . . . . 2,071 

F 

Nursing personnel: 

Registered nurse . . . . . . . . . . . . . . . . . . . . . . 7,586 

Licensed practical nurse . . . . . . . . . . . . . . . . 1,930 

Therapeutic personnel: 

Health educator . . . . . . . . . . . . . . . . . . . . . . 1,064 

Nutritionist . . . . . . . . . . . . . . . . . . . . . . . . . . 514 

Outreach worker . . . . . . . . . . . . . . . . . . . . . . 2,798 

Social worker . . . . . . . . . . . . . . . . . . . . . . . . 1,418 

All other professional and tachnical . . . . . . . . . . I 14,723 

‘Based on 4,053 sites open in 1973 and responding to the 

personnel portion of the questionnaire. 

16 
APPENDIX I 

PER$ONS CONTACTED FOR COMMENTS 

ON THE PRETEST QUESTIONNAIRES 

*Mr, Theodore Woolse y, National Center for Health Statistics 

Dr. Philip Lawrence, National Center for Health Statistics


*Mr. E. Earl Bryant, National Center for Health Statistics


*Mrs. Gail Fisher, National Center for Health Statistics


Mr. Noah Sherman, National Center for Health Statistics


Dr. Robert Mugge, National Center for Health Statistics


*MiSs JudY Capenter, National center for Family Planning services


Dr. Frank Beckles, National Center for Family Planning Services


*Mr. Don Trauger, Maternal and Child Health Service


Mr. Otis Turner, Maternal and Child Health Service


*Dr. Louis $$Pekter, Mate~a~ and Child Health Service


Dr. Alice Chenoweth, Maternal and Child Health Service


*Mr. Mozart Spector, Indian Health Service


*Mr. Royal Crystal, Community Health Service


*Dr. Gooloo Wunderlich, Department
 of Health, Education, and Welfare 

*Mr. Arthur Campbell, Department ofHealth,
 Education, and Welfare


*Dr, Carl Tyler, Center for Disease Control 

Mr. Gerald Sparer, Office of Economic Opportunity


Dr. George Contis, Office of Economic Opportunity


*Mr. Fred S. Jaffee, Planned Parenthood-World Population


Dr. Eleanor Snyder, Planned Parenthood-World Population


Mr. Alan Stone, American Hospital Association


*Dr. Jack Reynolds, Columbia University


Dr. Samuel Wishick, Columbia University


Lt. Col. Russel, O ‘CHAMPUS (Department of Defense)


*Dr. Ronald Freedman, University of Michigan


Dr. Myron Wegman, University of Michigan


Dr. Leslie Corsa, Jr., University of Michigan


Dr. Oscar Harkavy, Ford Foundation


Dr. Charles Schultze, Brooh.ings Institution


Dr. Andre Hellegers, Georgetown University


*Dr. Mary c. Calderone, Sex Information and Education Council ofthe United States


Dr. Ansley J. Coale, Princeton University .


Dr. Philip Hauser, University of Chicago


Mr. Nathan Hershey, University of Pittsburgh


*Dr. Edward R. Schlesinger, University of Pittsburgh


Dr. J. Richard Udry, University of North Carolina


Dr. Elbridge Sibley, Social Science Research Council


17

Dr. Frank Nolestein, Population Council 

*Dr. Christopher Tietze, Population Council 

Mr. Harold Putnam, Regional Director, Department of Health, Education, and Welfare 

*Mrs. Bernice Bernstein, Regional Director, Department of Health, Education, and Welfare 

Mr. Bernard V. McCusty, Regional Director, Department of Health, Education, and Welfare 

Mr. Frank J. Grosshelle, Regional Director, Department of Health, Education, and Welfare 

Mr. Richard E. Friedman, Regional Director, Department of Health, Education, and Welfare 

*Mr. FJ.D. M~&m, Regional Director, Department of Health, Education, and welfare 

$kMr.Max Milo Mills, Regional Director, Department of Health, Education, and welfare 

Mr. William T. Van Orman, Regional Director, Department of Health, Education, and Welfare 

*Mr. Fernmdo E. C. DeBaca, Re@”onal Director, Department of Health, Education, and welfare 

Mr. Bernard E. Kelly, Regional Director, Department of Health, Education, and Welfare 

*Responded 

000


18 
APPENDIX II 

ATTENDEES OF OCTOBER 1973 MEETING 

OF TECHNICAL ADVISORS 

Mr. Martin Bloom, Applied Management Sciences


Mr. Grover Chamberlain, District of Columbti Department of Human Resources


Dr. Cyril Crocker, Director, Howard University Center for Family Planning Services


Ms. Jean Frink, Los Angeles Regional Family Planning Council


Mr. Fred Jaffee, Planned Parenthood-World Population


Mrs. Doris Malin, Bureau of Community Health Services, Department of Health, Education, and


Welfare 

Ms. Helen Chiaruttini, Bureau of Community Health Services, Department of Health, Education, and 

Welfare 

Dr. Vestal Parrish, Tulane University 

Ms. IS. Ryon, District of Columbia Department of Human Resources 

Mr. Ernest Raymond, Office of Population Affairs, Department of Health, Education, and Welfare 

Dr. Carl Schultz, Director, Office of Population Affairs, Department of Health, Education, and 

Welfare 

Mrs. Edna Smith, Director, Boston Family Planning Project 

Ms. Suzanne OUivier, Boston Family Planning Project 

Dr. Eleanor Snyder, Director of Research, Planned Parenthood-World Population 

Mr. Mozart Spector, Indian Health Service, Department of Health, Education, and Welfare 

Ms. Louise Okada, Office of Program Planning and Evaluation 

Dr. William Tash, Director, Office of Evaluation, Health Services Administration 

Mr. Donald T’rauger, Bureau of Community Health Services, Department of Health, Education, and 

Welfare 

Dr. Carl Tyler, Center for Disease Control 

Dr. Louise Tyrer, American College of Obstetrics and Gynecology 

Dr. Richard Udry, University of North Carolina 

Dr. Daniel Weintraub, Planned Parenthood-World Population 

Mr. John Wells, Director, Illinois Family Planning Council 

Ms. Barbara Wood, Geomet, Inc. 

Ms. Joann Langston, Geomet, Inc. 

Dr. Gooloo Wunderlich, Office of Policy Development and Planning, Department of Health, Education, and Welfare 

Dr. William Pratt, Division of Vital Statistics, National Center for Health Statistics 

Ms. Carolyn Warren, Bureau of Health Services Research and Development, Department of Health, 

Education, and Welfare 

Ms. Nancy Wiley, Applied Management Sciences 

Mrs. Gloria Hollis, Division of Health Resources Statistics, National Center for Health Statistics 

Mr. Siegfried Hoermann, Division of Health Resources Statistics, National Center for Health Statistics 

Mr. Peter Hurley, Division of Health Resources Statistics, National Center for Health Statistics 

Ms. Jessie T.abb, Division of Health Resources Statistics, National Center for Health Statistics 

000


19

APPENDIX Ill 

GEOGRAPHIC REGION CLASSIFICATION 

Gensus Region and Division States Included (excludes territories) 

Northeast 

New England . . . . . . . . . . . . . . . . . . . . Maine, New Hampshire, Vermont, 

Massachusetts, Rhode Island, Connecticut 

Middle Atlantic . . . . . . . . . . . . . . . . . . New York, New Jersey, Pennsylvania 

North Central 

East North Central . . . . . . . . . . . . . . . . . Ohio, Indiana, Illinois, Michigan, Wisconsin 

West North Central . . . . . . . . . . . . . . . . . Minnesota, Iowa, Missouri, North Dakota, 

South Dakota, Nebraska, Kansas 

South 

South Atlantic . . . . . . . . . . . . . . . . . . .	 Delaware, Maryland, District of Columbia, 

Virginia, West Virginia, North Carolina, 

South Carolina, Georgia, Florida 

East South Central . . . . . . . . . . . . . . . . . Kentucky, Tennessee, Alabama, Mississippi 

West South Central . . . .. . . . . . . . . . . . . . Arkansas, Louisiana, Oklahoma, Texas 

West 

Mountain . . . . . . . . . . . . . . . . . . . . . .	 Montana, Idaho, Wyoming, Colorado, New 

Mexico, Arizona, Utah, Nevada 

Pacific . . . . . . . . . . . . . . . . . . . . . . .	 Washington, Oregon, California, Alaska, 

Hawaii 

Territories Areas Included 

Puerto Rico Puerto Rico 

Outlying areas	 American Samoa, Canal Zone, Guam, Virgin 

Islands 

000


20 
APPENDIX IV 

FORMS AND QUESTIONNAIRES 

REQUEST FOR CLINIC LISTINGS 

# @“%% a P 

~ ~ 

%4@ 

g< DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE . 

@+“0 ,+$ PUBLIC HEALTH SERVICE 

us. HEALTH SERVICES AND MENTAL HEALTH ADMINISTRATION 

ROCKVILLE, MAR?’LAND 202S2 

NATIONALCENTERFOR 

HEALTH STATISTICS 

Dear 

The National Center for Health Statistics (NCHS) of the U. S. Department 

of Health, Education, and Welfare is creating a Family Planning Facilities 

Inventory, which will include all locations in the country where family 

planning services are provided. We would appreciate your sending us any 

directories or listings that contain family planning facilities or any 

lists of projects or agencies that operate or fund family planning 

facilities. 

Please send your current listings or directories to: 

Chief, Health Facilities Statistics Branch


Division of Health Resources Statistics


National Center for Health Statistics - HSMHA


5600 Fishers Lane


Rockville, Maryland 208.52


If you have any questions, please let me know. Our telephone number 

is (3ol) 443-1524. 

Your help and time in fulfilling this request is greatly appreciated. 

Sincerely yours, 

‘-(Mrs.) Gloria Hollis 

Chief, Health Facilities Statistics 

Branch 

Division of Health Resources Statistics 

21 

6 
�

at 

MFI FACILITY SURVEY LETTER 

*. .. . . !400,> 

,% 

‘+ : : 

~? DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE 

k., @ +--’ PUBLIC HEALTH SERVICE 

e u.. HEALTH SERVICES AND MENTAL HE,A.LTH AEJMINISTRATION 

ROCKVILU. MARYLAND s0252 

January, 1973 NATIONAL CEtiTER FOR 

HSALTHflATISTICS 

Dear Administrator:


The National Center for Health Statistics of the U. S. Public Health


Service is comDilinz .- a list of all facilities in the United States


that provide family planning services. (Family planning services are


those medical, social, and educational services which are primarily


concerned with the regulation of conception.)


It has been brought to our attention that increased emphasis has been


placed on providing these services to residents of facilities such as


yours. In.order to help us in compiling our list of facilities, will


you please complete the bottom portion of this letter and return the


letter in the enclosed postage-paid envelope within 10 days to:


Chief, Health Facilities Statistics Branch


Division of Health Resources Statistics


National Center for Health Statistics, HSMHA


5600 Fishers Lane, Room 12-33


Rockville, Maryland 20852


Thank you for your cooperation.


Yours truly,


/. 

(Mrs.) Gloria Hollis


Chief, Health Facilities Statistics


Branch


Please check one:


~~No family planning services provided


~~Some type of family planning service provided .— this —site


~~No family planning service provided .——
 at this site--patients


referred to other source for family planning service


~~Other (Specify)


22

COLLEGE HEALTH SERVICE SURVEY LETTER


\ 

J

‘: DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE 

t PUBLIC HEALTH SERVICE 

HEALTH SERVICES AND MENTAL HEALTH ADMINISTRATION 

ROCKVILLS, MARYLAND 2W52 

NATIONAL CENTER FOR

January, 1973 HEALTH STAT12T1CE 

Dear Director:


The National Center for Health Statistics of the U. S. Public Health


Service is compiling a list of all facilities in the United States


that provide family planning services. (Family planning services are


those medical, social, and educational services which are primarily


concerned with the regulation of conception.)


It has been brought to our attention that increased emphasis has been


placed on providing these services to college students through facilities


such as student health centers or infirmaries. In order to help us in


compiling our list of facilities, will you please complete the bottom


portion of this letter and return the letter in the enclosed postage-


paid envelope within 10 days to:


Chief, Health Facilities Statistics Branch


Division of Health Resources Statistics


National Center for Health Statistics, HSMHA


5600 Fishers Lane, Room 12-33


Rockville, Maryland 20852


Thank you for your cooperation.


Yours truly,


“(Mrs.)Gloria Hollis


Chief, Health Facilities Statistics


Branch


Please check one:


/TNo family planning services provided


/== Some type of family planning service provided at this —

site
 ——


/==No family planning service provided .——
 at this site--patients


referred to other source for family planning service


L~Other (Specify)


23

PRETEST–PROJECT RECORD 

DEPARTMENT OF 

HEALTH, EDUCATION AND WELFARE 

Pblic Heallh Sefvica 

Health Swwceswd Mental Health Admlntstmi.an 

fiatimd Center for Health Statist{= 

NATIONAL INVENTORY OF FAMILY PROJECT NO. 

PLANNING CLINICS 

PROJECT RECORD 

Dew Project Oirectoc 

The rapid expansion of family planning servicesin ihe United States since the ntid.sixties has bmughtto the fore. 

front ths need for accurate and current information on the extent to which tkesservices are available nationally. 

On January 1, 1972, the Nations! Center for Health Statistics implemented the National Reporting System for 

Family Plannlng &rvi@$to mllectdata on family planning patients $ee"inpubtic facilities mdtiw$ewice$ they 

receive. However, there is no comprehensive inventory of all family planning clinict in the United States and the 

ssrvicesavailablethrough them. 

The National Center for Health Statistics is therefore conducting this survey to obtain current information about 

each family planning clinic such as name, location, meload, serviws offered and staff size. This National Imentory 

of Family Planning Cli”ict expands upon and replaces previous surveys of this injure ccmducted by Planned 

Parenthood.World Population. 

Ttw information from this survey will M used by the National Center for Health Statistics for statistical reports 

cm the characteristics.of family planning clinics. 1“ addition, the data will bs made available to other agencies 

to compile directories of available clinics, to plan for “w&4 additional cli”ics,”and to plan for future manpower 

needs. 

We are thersfore asking your cooperation i“ mntpleti”g sections B and Cof this Project Record. Pleas? be sure 

to fill out a wparate block in Section B of this form for every Iocatio” at wti.hyo.r projeti, agency orprog,am 

provides medical family Planning services.For- location listed in Section B, o“eqf the enclosedClinic Records 

also should bs completsd. If additional Clinic Record forms are needed, please indicate on the enclosed post. 

card ths “umber of addititmal forms “ceded and return the card to us m scon as possible. (Note: this fmstcard 

isalsoto bereturnadto us if yo"provide no family pla"ning sewicesorhavereceived a duplicate request frOM us 

for thcw data.) 

None of the data will be considered confidential except in the following situatiom if you feel that mrne of these 

questions should be kept confidential, please write the numb.sr of each question you wish to be so cksig”ated 

in ths “Confidential” box which follows. Your rssponss$to these “confidential” questions will be ussd only 

In aggregated statistics and will not bs released in any manner in which your project. agency or program can 

be identified. 

Chestionsto be ConsideredTo”fidemial<, 

I 

Page& Question Numbsr Page& Question Number 

t 1 

_,— —l_ I 

I 

I 

—:— —:— I 

I —:— —:— I 

Pleaw complete all questions whether or not they are to be consideredconfidential. Before completing thess forms, 

Itowwer, You should familiarize yoursslf with the definitions on the next psge. If youwish toiwvethe individual 

clinics complete the Clinic Record Forms, please have them return the completed forms to you w that the forms 

fcf all clhti~ under your ditecticm cm b+ retumsd together in the enclosed po$tags.paid envelope. All forms 

dwuld bs returned within three weekstm 

Chief, Health FacilitiesStatistics Branch 

Oividon of Health ResourcesStatistics 

National Center for Health .%stistics 

5600 FishersLane, Room 12-S2 

Rockville, Matyla”d 20852 

Thank you fw your cwperation. 

-T&t&_+. L&&.( 

Theodore O. Woolsey & 

Oirector, National C.snterfor Hsfdth statistics 

HSM.7t1.t (Paw 1} O.M.B. NO =-S721S5 

S-73 APPROVAL EXPIRES: 4.20.74 

24 
SECTION A - DEFINITIONS 

FAMILY PLANNING SERVICES 

Family planning services may be medical, social, and/or educational. 

.!ddM k!!!W W.o!dtN.wL@ .o.sis*Of a medical hisow, phwical examination, Iaboratow 

testing, consultation, treatment including continuing medical supervision, issuance of drugs 

and contraceptive supplies, and appropriate medical referral when indicated. 

.%&l and educgio.wl f~mily Lwing S-S includeservicesuch as outreach,sex education


and the provision of tr.msportatio”, or babysitting when these Sewices are provided to enable 

a person to attend a family planning clinic or to otherwise obtain family plaming services. 

CLINIC LOCATION 

A clinic location is a plain or facility at which any family planning services are provided O“ a r@wIy Schedulti 

basis. It may be a hospital, health center, mobile “nit, free-standing site, church, or store front. For ~C,tiIe “nils, 

each stop is considered a clinic location; therefore, a separate Clinic Record Form should be filled for each stop 

or location. Physicians’ offices should be considered as clinic locations only when there is a formal relationship 

with some project or agency which is responsible for providing family planning services. Physicians, nurses, vol. 

unteers, etc. who make home visits for the purpose of deli.wing a family planning service should count their 

home base of operations as the clinic location. 

PROJECT OR AGENCY OR PROGRAM 

A family planning project is a specifically designed set of activities and services i“te”ded to advance ,mhievmn.mt 

of the program’s family planning objectives. It may be funded through general revenue or specific grants from 

either pubtic or private sources. 

A family planning agency is an administrative mechanism to carry out family planning programs through family 

planning projects which deliver family planning services. 

Family planning programs are activities that provide the services which enable individuals effectively to practice 

family planning. These activities are provided by commercial, governm.mtal, m ncm.pmfh imtituticms a“d indi. 

vidual practitioners. 

SECTION B - CLINIC IDENTIFICATION 

1.	 Oid your project, agency or program participate in :he provision of medical family planning services during 

any part of calendar year 1972? 

� Yes � No (Skip to Section C. question 6) 

NOTE: [f the only family planning services provided were social andlor educational as defined under ,, Family 

Planni~Services” in Section A of this form, check box marked “No”. 

2.	 For e~h location at which your project, agency or program provides medical family planning services, please 

complete one of the following block% 

(a) Name of clinic: 

Number Street Room Number P.O. Box, Route, ate. 

1 I

I Location: city or tow” County State zip 

Administrator 

Number or percentage of all your project, agency or pmgratn,s patients served at this location in 1972: 

Number or Percentage % 

Agency or organization responsible for operation of this clinic. 

tL3M-7tl-l (Pw2) 

2-73 

25 
SECTION B-CLINIC IDENTIFICATION (Cont.) 

I 

Number Street Room Number P.O. Box, Route, etc. 

Location: \ 

City or town I County I State I Zi~ 

] Administrate I 

Numbsr or percentageof all your project, agencyor program’spatients servedat this location in 1972: 

Number or Percentage % I I Age.cyc.rorgan Izat Ion responsiblefor operation of this cli”ic. 

I 

(d ~ N,~, Of c,,.ic 1 

Number Street Room Number P.O. 80X, Route, etc. 

Location: City or tow County State zip 

1 I 1 I 

Administrator: I 

Number or percentageof all your project, agencyor prcqram’spatients servedat this location in 1972: 

Number or Percentage % I 

Agency or organization responsiblefor operation of this clinic. 

I 

(d) Name of .1[.(= 

Number Street Room Number P.O. Box, Route, etc. 

Location: City or tow” County State zip 

Administrator: 

Numb?r or percentageof all your pro~ct, agency”orPrograh patients iir;ed at this iocation in 1972 

I Number or Percentage % I 

Agency or organization responsiblefor operation of this clinic. 

{e) Name of clinic 

Number Street Room Number P.O. Box, Route, etc. 

Location: City or town County State zip 

Administrator: 

I

Number or percentageof all your project, agencyor program%patients servedat this location in 1972: 

I 

Number or Percentage % 

Agency or organization responsiblefor operation of this clinic. 

(f) Name of clinic 

Number Street Room Number P.O. Box, Route, etc. 

Location: City or town County State zip 

Administrator 

b 

. 

Numb?r or percentageof all your project, agencyor program’spatients servedat this location in 1972: 

Number or Percentage % I 

A%ncy or organization responsiblefor operation of this clinic. 

HSM-71 1-1 (Page 3) 

3-73 

26 “ 
sEoTION B - CLINIC IOENTIFICATION (Cont.) 

(9 I N~~~ Of ~li”l~ 

Number Street Room Numb+r P,O. Box. Route, etc. 

I Location: I 

City or town County State Zip 

I 1 1 I 

I Administrator 

Number or percentageof all your project, agencyor program’spatients servedat this location in 1972 

Number or Percentage % I 

Agency or organization responsiblefor operation of this .di”ic. 

I 

(h) Name of ,fi”i,$ 

Number Street Room Number P.O. Box, Route, etc. 

Location: City or tow” County State Zip 

I 1 1 1 I

Administrator: 

I

Number or percentageof all your project, agencyor program’spatients servedat this location in 1972: 

I 

Agency or organization responsiblefor operation of this clinic. 

I I 

If more spaceis needed, pleaseuseadditional sheetsof paper and attach them to this form. Thank You. 

SECTION C - PROJECT, AGENCY OR PROGRAM INFORMATION – CALENOAR YEAR 1972 

1. The following operational data are requestedfor Calendar Year 1972. If the period for which You are rewrting 

h NOT the 12.month wriod from January 1,1972 through Oecembw 31,1972, pleaseimlicafe below the 

period used. 

Number of days Beginningdate Ending date 

monthldayfyr nwnthldaylyr 

Were you in operation 12 “onths at the ending date noted above? 

� Yes � No - How I.”g? 

months 

(a]	 Howmnywtients remivti mdimlbmily planning wrvicesfrom youragenw intheperiodforwKch 

you are reporting? 

New patients Continuing patientt Total patients 

A ~wfamily pkmning ~tient is one who rt?giitered and received medical fami~ phnning semices through 

your agency for the jirst time durikg the penbd for wldch you report. 

A continuing family pkmning patient is one who registered for and received medim[famiSy pkmntig services 

prii~pwiod for which you rqmrt and who made at least one return visit to yourpfogmm dwiig the 

period for which you report. 

(b)	 Howmnymdiml family planni~visits we,er~ordd byyouragen~ inthe~ridfor wMchyouare 

ropotticq? (Do not inskxfe vi!its or mailingswhereby a previouslyregifiered patient recaived SIppliesonly.) 

initial visits return visits total Vidhs 

(should equal new patiants in la. .Imve) 

An_tfor m&imlfam"&pbnning seri,icesisdefin& asavisitdwhgthepw@d forn,hich>+oure~rl 

at which a patient is registered for and receives these w-pica?!for the&&g thro~h your agency. 

Aremrn viti$isdelined usavisit byaprevkxoIyre giitered@ient whoisseen byophysician ornurse orother 

authorized personnel for medical mnsultation, c.vamimtion nndlor hb tests dwing the perwd for which you 

re~rt. Itmybea mutineunnwlret-isit orapob[em visit by bothLNati mntinuinEptients. Exchnfe 

hitiai visits ad visits for supples on(v. 

HSM-711.1 [P69e4) 

2-73 

27 
sECTION C – PROJECT, AGENCY OR PROGRAM INFORMATION – CALENOAR YEAR 1972 (Cont.} 

2.	 How many days were one or more of the clinics operated by this project, agency or program in opwation during 

1972? (Include only those days that the clinics were actually open for and receivin9 Patientt for Medkd familY 

planning services.) 

_ Number of days 

3. Are there any special groups of people that this pioject, agency or program cannot or does not serve based on: 

(a) Sex? � Yes+ � ls.rv.%fan.!., 0.1, 

{ � SW,* mm, .“1” 

� No [Sk fPtO.”.Stim3bl 

(b) Age? II Yes - � C...ot or . ..s not s.rv. p.m.. .nd.r 16 wars of .s. 

12 Cmnot ., does “0, s.rv. P.,aam 16.20 “..,s of �g, 

� C.nn.t or doe% ..: saw. Pm..% 21 wars of .g. or cid.r 

� CannOt or doe% not S. IV. rnlnor. wlthwr !mr..tal co.mt 

� a..ot or does not ww Persons of other .L7. wow [SD9CMY1 

(d Inmm? � Yes* iw.aa SI.CifY t.mm rm., .f P.rso.srhkf.cmtv cannot or . ..snotww*._ 

� No(SkiP to question 3d) 

(d) Anyother physical orsocial characteristic? 

� Yes (Specify) 

� No 

4. IS this project, agency, or program especially trying to reach certain population groups (target populations) based on: 

(a) Sex? � Yes+ � Fenwles..lY-+	 � Aiff.m.fe$ 

� Po,,.parwm m recently Prsxlnan, <mates 

� Ev.r.or.mant fenw.1., 

[ I� Other (Swci f”] 

� Males .“,, 

� NO [S,1. m . ..s.1.. 4b) 

(b) Age? � Ye,+ � Permn, ”nder16year, of.gn 

O ,.....= 162. v...= .f .9. 

n m,,.., 2, “.,,, of .s. and 010’., 

lJ Ml”.,, vJth m,mtal .0”,.”, 

I II Other age wow, ISrmcify) 

� No ISkl. m we,tlo. 4.) 

(.) Income? CIYes - PI.aSSPe.Ify Inc.m. I...r 

� No (Skip to question 4dl 

(d) Ethnic origin? � iYes+ � Iwhrtes 

•l New.., or Black, 

� Anwrrmn Indians 

� MBxlc.n.Amedca”, 

� Puerto RI<.”, 

[ � Other [Smcl f”) 

� No [Ski. w ..,,,1..4,1 

(e) Geographkarea? � Y.s+	 � . . ..lare. 

� TOW. m .nr.c..morare. .Iv 

� Small city loot ind.d.d 1. a larg.r nwtr.a$mlit.. arm) 

� Me,m!mllta. ar.a— 

� E.tlm rnetro.olkan am 

n !“”,, .1,” .,., 

� Model .111.s area 

[ � Oth.r . . . . within rn.:r..olitm am. {Swcl f.] 

� Co.nt” 

[ O other wowc.hlc area ISD.. MY. I.e. SW., region. .:..) 

� NO ISkl, to ,UES1O. 40 

(f) Anyother physical orsocial characteristic? 

� Yes (Specify) 

� No 

HSM.711.1 IPw5) 

3-73 

28 
SECTION C - PROJECT, AGENCY OR PROGRAM INFORMATION - CALENOAR YEAR 1972 [Cont.) 

5.	 (al Wlwt wwt flw tad mIndIU of bnurt ~ dirla opmtad bV your qmwv wm W. for mtiicd fmiily 

P191ninf Wvicm durinp: 

(1I A ~ wok I.?t month (2 I ~ -k 

Hou_ Hews_ 

(b) For tho B@@ + 1- month _ i. Outttion 5 {.) (1) abow Pi.. complete fhc followi~ # 

mblo. {lndurh only that Nsff innnbors who two mmgtd in nwdial family planning mrvkts durin4 fhii 

typial wtok. If data am .nmwihbl. Plemt a$finmfQ the numbtr of, and hours for tach staff typs.) 

{11 (2) 

Nuti of Numbs of 

staff staff 

Staff type workhg wdgnod 

duriw this to work 

Wpial tk!afull 

whUhllo* 

Phyti.im ladminittmtive only) 

Pf@dsn (dhtial sorvkta onky) 

R@stw.d nurw (dminbtratiwa only) 

Rogistwodnurst (dinial SWVICMonly) 

Rogisfomdn.rto both adminiatntiw �nd diniall I I 

Liannd pmctfal numt (or vocttiaul nurse] I I 

&dd worker (nimlnktmtiw only) I I 

30dd work-r (coumditqOlllV} I I 

3odd I 

Adlninbtntol (not kwhld4d 8b.Dw) I 

Pu~fwgiond community w maratch work- I I 

Clsrk, teutfuy, roa@onitf I I 

Htdth edu6t01 I I 

Nwm midwife, or physidds �iamw I I 

Oflw (3POCHVI I 1 

TOTAL I I 

wmkar (bath dministmtivo d countdhw) 

(31 (4I 

Numk+r of Toml tmff 

waft hotwa 

awigntd worbd 

to work duriq this 

WV of tlw w 

Icbedule”” Wnk 

� For wmmph, if dirties wc opm for family pkmnina nwias for 30 hours, tbnt P lb Wafcaf tkt 1 II 30 hours. 

� * par .-mph, if dinim wtm opgmfor fmnily planning mrv~ for 30 hours, tkt ptOpl* WWktd W3 tbn 30 hO~ 

6. f4arm of pcmoncomphting this form (pleaseprint) Jab titlm I T+kans nunbar: 

COMMENT3, 1 

H3M-711-1(Fmw@ 

%73 

29 
PRETEST–CLINIC RECORD 

DEPARTMENT OF 

HEALTH, EDuCATION AND WELFARE 

P.blic Health Service 

Health Servieesmc Mental Health Administration 

Na,, ond Center for Health St,tlsks 

NATIONAL INVENTORY OF FAMILY PROJECT NO. 

PLANNING CLINICS 

CLINIC RECORD I	 I I . 

Dear Director: 

Therapidexpa.sion of family planni~~wics in tie IJnited StitassinG themti.sixti~ has broqhtto tie forefront 

the need for accurate and current information on the extent to which these wrvices are available nationally. On 

January 1, 1972, the National Center for Health Statistics implemented the National Reporting Symem for Family 

Planning Swvices m collect data on family planning patienti wen i“ public facilities and tlw swvicesf hey -iw.. 

HGwever, there is no comprehensive inventory of all family planning clinics in the Unimd States and the swvims 

available through them. 

The Naticmd Center for Health Statistics istherebre ducti~tiis suweyto obtiincument infomtiiontit~& 

family plarming clinic such as name, Iocatio”, caselrxd, ssrvimsdfwed, and staff size. This National Inwrtmryof 

Family Plan”iW Clinics expamjs upen and replaces previous surveys of this nature conducted by Planned Parenthood. 

Worbd Population. 

The information from this survey will be used by the National Cgnter for Health Statist@ for ~tistical repom O“ b 

characteristics of family plarming clinics, In ajditicmr the data will be made avail~le to other agencies to wmnpile 

directories of available clinics, to plan for neejd additiomt clinics, aml to plm for future manpower “4s. 

None of the data will be cnnsiderwl co” fdemid except in the following situation: if you feel that some of th%equestions 

shou!d be kept confidential, pleaw write the number of each qu%ticm W“ wish to be so designated in the “Confidential” 

box only in aggr~t~ ~timj~ ati will 

not be released in any manner in which your individual facility can be identified, 

Questions to be Considered “Confdentied” 

Page & Question Number Page & Question Number 

I I 

which follows. Your respomes to ?JWSS“confide”tialS- auestions will be LISSTJ

—/ — — /— — — l— l— — — l— l—

Please complete all questions whether m cat they are to be cvmidered ccmfdemial, Before completing this form, 

however, you should familiarize yourself with the definitions in Section A, If you are an itiividud clinic completing 

this Clinic Recmrd Form, please remm the completed form m your projti ~ that the fo~~ for ~11~fi”i= “n&r the 

Project’s direction cm be returned together, All forms should be returned within three weeks. 

Thank you for yow ccmpwation, 

sincerely yours, 

c Thecdore O. Woolsey 

Oirector, Natiorml Cmter for Health St@igfim 

O,M.0, NO 0~721BS 

APPROVAL EXP, ”ES, +so.7~ 
SECTION A. DEFINITION 

For this survey, the following defi”itiom apply: 

FAMILY PLANNING SERVICES 

Family planning sarvices provide the means which enable individuals to meet their family planning objectives. These 

sawicesara medical, social, and educational. 

Medical family planning se!vice+ consist of a medical history, physical ex~mination, laboratory testing, 

testing, consultation, treatment including continuing medical supervision, issuanceof drugs and contraceptive 

supplies and appropriate medical referral when indicated. Other servicessuch as outreach, the provision of 

transportation, or babysitting are included associal and educational family planning serviceswhen them services 

are providad to enable a person to attend a family planning clinic or to otherwise obtain family planning services. 

CLINIC LOCATION 

A clinic location is a place or facility at which any family planning servicm are provided o“ a regularly scheduled basis 

It may be a hospital, health center. mobile unit, freestanding site, church, or store front For mobile units each stop is 

considered a clinic location; therefore, a separate Clinic Record Form should be filled for each stop or location. 

Physicians’offices should be considered as clinic locations only when there is a formal relatiotip with some project 

or agency which is responsible for providing family planning services.Physicians,nurses, volunteers, etc. who make 

home visits for the purpom of delivering a family plarming service should .xmnt their,hwne base of oparaticms asthe 

clinic location. 

PROJECT OR AGENCY OR PROGRAM 

A family planning project is a specifically designedsat of activities acd servicesi“tendisdto acivmm achievejne”t of me 

prcgram’s family planning objectives It may be funded through general revenue or specific grants tiom either public 

or private sources. 

A family planning agency is an &dministrative mechanism to carry out family planning programs through family 

planning projects which deliver family planning services. 

Family planning programs are activities that provide the serviceswhich ewAle individuals effectively to practice family 

planning. These activities are providad by commercial, governmental, or nonprofit institutions and individual 

practitioners. 

31

SECTION B. IDENTIFICATION 

la. Enter below the name ard actual location of the Clinic [P[eaS type or print.] 

NAME OF cLINIC 

Numb+r str..t Room No. P. 0. BOX, Route, MC. 

ADDRESS city or town county stat. ZIP 

mu Cod. Nwnb.r 

TELEPHoNE 

lb. Enter below the area(s) s?rved by this clinic: 

Clw m cttm 

county m 02””11.s 

stat. or stat..

01 h., (Sslrcif,) 

Ic 

2. 

3, 

4. 

MONTH I OAY I YEAR Enter the date this clinic first bsgan 

its family planning wvices: 

How many different individuals visited this clinic to obtain family planning services dining 1972? 

Number of Irdividuds 

How many days was this clinic in op+ration during 1972? IIncksle only those days that the cfinic was actually open for family planning services and recsiving patients.) 

Number of day% 

For every day in Column (1) that this clinic is open for fa”ily plan”inq smvicss, enter in tldumn (2) the actual hours it is open asd 

Drovidi”a these sewicss. If fhe clinic is not own for a Particular dav. enter “O” in GOIumn (2). (Example: If this cfinic is oDen from 

10:LM a,;. until 2:OO p.m., enter “1O:OO -2:00” under Column (21.) For each day the clinic is open”ati Column (2) is filled, mark 

“X” in the appropriate box under Column (3) that describfs the frequency of the= -ions. (Complete Sdwdule for s3sEions you 

are now Operating.) 

c.mmn (11 c.alum” (2) G31”mn (3) 

Hours own �mdProvidm@Fumly Frwumcf of S.Sions IMuk %’,] 

DAY Plmni”g Sen’,cn We#kly Ewcy Other Other 

IEmer “w’ sf not open this day.] Wmk Monthly (Spmifyl 

Monday 

Tuetiay 

Wadneld,” 

Thurtday 

Fr,day 

*t”rdsy 

Sunday 

5.	 Is this clinic Iocatd in z 

(CRtck [X) one&x only) 

6.	 Pleass red ALL of the following categories, 

then check all applicable box(m) for the type(s) 

of organization(s) which operate(s) this clinic. 

[Include only th.s+e organizatims actually 

responsible for this cfinic’s operations and not 

three organizations involved only with the fuml. 

ing of the cfinic.] 

y.!~y -711.2 [P,*, 3] 

— 

— 

� Hoipitd � Off ,ca b“lkfiW or store


� S1.1. or Iml health depnrmwnt building � Physlct,”,, .fflc,


� Ch”,ch El Other (Specify)


D Community ho.ss, xhml, etc.


� Mcbl!e ““it


a, Pri.ciwl location of “nit 

Addrew. 

11) PUBLIC


� Federal � city


D .%1* � .Wh.wl Lfbtricf 

n I“t,,xtme � Special Uniz 

� Met,o@it8” D Other (SWciYy] 

•1 count” 

(21 PUBLIC SPONSORED (31 PROFIT 

� Coomw”iry Action � HoI@tal 

0 Sponmrcd Organimti.a” � private clinic 

� Other (Spc.ify) � Priv,t. phy,kim 

•l Other (Specify) 

(4) NONPROFIT (5) oTHER OWNERSHIP 

a Hos@t,l Cl University IZ (Specfly) 

� Church � other (specify) 

� Volumwy agency 

32 

I 

I 
70. Whlti of rhe following eetvicm or functions does this clinic 7b. Pleaseenter below the approximate percentage of your patients 

potide for familyplanningpatients?(~eckallthatwpb.) who fedtd thw servism in 1~72 on initial’ visit. (In&fe 

onp those servicespmvtiedat this S&Z] 

?ermntasd 

•l RuO!d of mrtlnmt m-!icnl, rorm%luctim .rd social history


I-J P,. SmMr .md pelvic examination


� s-t .x.mi..tton


� Taklra of bhcd v-UN


� Rout!”. I* tests (hemam.rk, .rln. for .LIO.r and .Hwmln)


� lnf.rtillt” dlqvmtls or COU”,dhW


� Si.kl. con Scmanlng


O Male swrlltzmlon


� Fend, swrilimtlon 

D V-D twtlw 

� Pr9gn.ncvt8stTw 

� C4mramptlve pmscriptkm 

Cl Oth.r rnodlcsl “rv[ca (Spedfy) 

‘An ln!tl.l v!sitfor hlulf.mi!y pl.""iw wimsisd.f#"ti as. vlslta%wh!chawie"t isr~iaerti f.ratirem.wes mti~ltim$lypl.nnl% 

8mvkes for the ,’flrtt time,, through your clinic. 

Whl&otthefollwiq other ancillawmmim or fun@ionsdoestis clinic provide? 

�	 O.tN.h PrWmm(Outm& atiiviqesam thamwMch infomprqim~tienk .ffamilyplanni~ SwlmsatisSiti timi"~iH~timMlws 

of the sewlcas.) 

� Followup PrWram(Follw.up activibeslncltia wntaml"gpenon%who hammitiapwlntment% a4tias&&.fiW ofrmwointmentz.) 

U CIWmmargrOup Wsrn”s&Outfam!ly pl.n”iW 

El Claawoom or Qroup sessimu on sex educdtlon (in edition to family pla””irq m-i contrweptibm educdtio”) 

� ltilvMu.l wu”s.lins about family p!.n”ing 

U R. femlt. prhmwyslci.ns for family plan" iwormtiial Sw[~"ot prwM&atthls.Nnic. 

� R, f.,r.lto oth.rcllnic for family Pl,nnTw ormtiml SwlWnot Prm~datttiscfinlc. 

7.3 

8a. 

9, 

10. 

� Bebyslttlrw [whilepatlmti satdlnicj


n Tmmportatio. to the di”l. (prov&xI or wbsldized]


� Oth,r (SfXCi~)


� None


Which of the following typse of contraceptive methcds am 

offered by thisclinic? 

� oral (Plnl 

� IUD 

o l“J,ctlo” 

� ni8p41r8#mlj*l!y 

� Foam 

� ~ndom 

� Rhythm method 

� Otfwr(Spccff.) 

� Non. 

Is the primary purpose of this clinic to provide family planning services? 

Cl Yes (Skip to question10,) � No-W71at is the primary 

F’ 

Nmm of -n co@minQ th 1, form , 

Telephonw Arm Cad-, I NUW.	 PIesseenter belc+vthe approximate percwW& of your patienta 

who remived thie method in 1972 visits. (Inc&kle only those 

methods provided at thi$site.) 

Percentage 

pur~ of this clinic? 

W titl.: 

33 

I 
--

UNIVERSE VERIFICATION LETTER€

*$.O”, ‘%*, 

J ,.* 

$.”


1

%. :,a.,! 

.$ DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE€

@% “,, ,+”’ PUBLIC HEALTH SERVICE 

HEALTH RESOURCES ADMINISTRATION 

Rockville, Maryland 20852 

National Canter For 

Health SW”stica 

October 1973 

Dear Administrator: 

The rapid increak.e of family planning programs across the nation over the last decade 

has highlighted the need for current and accurate information on the extent and nature of 

these services. 

Therefore, the National Center for Health Statistics has planned an extensive Nationrd 

Family Planning Services Data Collection System. This system when fully operational will 

provide herdth planners at all levels of government with timely statistics not only on the 

number and characteristics of patients but also facility and staff characteristics and extent 

of services available at the many varied facilities - both public and pfivately funded 

which provide family planning services nationrdly. 

The Center is now in the process of verifying its listing of all facilities in the U.S. 

and its outlying territories which provide some type of Family Planning services. We are 

therefore asking your cooperation in completing the back page of this letter and returning it 

to us in the enclosed self-addressed postage-paid envelope within five (5) days. The information requested will assist us in insuring that all projects, agencies, or programs which 

participate in the provisions of family planning services are included in our listing. 

We sincerely appreciate your support in this developmental period which is so important 

to the success of the full-scale National Family Planning Services Data Collection System. 

Sin~rely yours, 

‘	 (Mrs.) Gloria HolIis 

Chief 

Health Facilities Statistics Branch 

Division of Health Resources Statistics 

In case we need to contact you, pleaee enter your phone number 

/ 

Area Code Phone Number 

34 
For the purpose of this data collection system, Family planning services are those medical, 

social and/or education services which are pn”marily concerned with the regulation of conception. 

CHECK ONE BOX ONLY 

•1 Addressee does not participate in the provision of family planning services, 

•1 Addressee maintains a clinic on site which provides family planning services. Our 

program is part of a more extensive system for delivering family planning which is 

coordinated/operated/ funded by 

agency name 

whose address is 

�	 Addressee is an administrative unit which does participate in the provision of family 

planning services at the following locations: 

Name of serviea site 

Number Street Room Number P,O. Box, Route, etc. 

(a) Location City or Town County Stete zip 

Name of service site 

Number Street Room Number P.O. Box, Route, etc. 

(b) Location 

City or Town County State zip 

4 , I I I 

Name of service site 

Number Street Room Number P.O. Box, Route, etc. 

(c) Location City or Town County State Zip 

Name of service sita 

Number Street Room Number P.O. Box, Route, etc. 

(d) Location 

CitV or Town County State Zip 

If more space is needed, plaesa complete this information on a 

separate piece of paper and attach to this letter. 

Thank you. 

COMMENTS 

35 
NATIONAL SURVEY 

OMB c1earance No.


068R-1393


DEPARTMENT OF


HEALTH, EDUCATION, AND WELFARE


PUBLIC HEALTH SERVICE


Health Resources Administration


National Center for Health Statistics


,JATIONALINVENTORY OF FAMILY PROJECT NO.


PLANNING SERVICES
 (NOTE: Clinic name and


1974 address label goes here


ANNUAL SURVEY


Dear Director:


The rapid expansion of family planning services in the United States


since the mid-sixties has brought to the forefront the need for


accurate and current information on the extent to which these ser­


vices are available nationally. On Jqnuary 1, 1972, the National


Center for Health Statistics implemented the National Reporting


System for Family Planning Services to collect monthly data on
 family planning patients seen in public facilities and the services


they receive. However, there is currently no comprehensive inven­


tory available of all facilities providing family planning services


in the United States and the services available through them.


The National Center for Health Statistics is therefore conducting


this annual survey to obtain current information about each family


planning clinic or service site such as name, location, caseload,


services offered, and staff size. This National Inventory of


Family Pla~ning Services expands upon previous surveys of this


nature conducted by Planned Parenthood-World Population.


The information from this survey will be used by the National Center


for Health Statistics for statistical reports-on the characteristics


of facilities providing family planning services. In addition, the


data will be made available to other agencies to compile directories


of available clinics or service sites, to plan for needed additi­


tional facilities, and to plan for future manpower needs.


One of these questionnaires IS to be completed for each clinic or
 service site at which your project, agency, or program provides


family planning services.


Before completing this questionnaire, you should familiarize yourself 

with the definitions at the top of page 2. If this is one of a group 

of clinics or service sites administered or directed by a central 

agency, project, or program, please return the completed


questionnaire to your Project so that the questionnaires for all


clinics under the Project’s direction can be returned together.


All questionnaires should be returned within three weeks.


Thank you for your cooperation.


Sincerely,


J__j/H%——’— /-

Edward B. Perrin, Ph.D.


Director


National Center for Health Statistics


36 
For this survey, the following definitions apply:


FAMILY PLANNING SERVICES


Family planning services provide the means which enable indivi­


duals to meet their family planning objectives. These services


are medical, social, and educational.


Medical family planning services refer to the following


services provided by a physician, nurse-midwife, registered 

nurse, or other authorized personnel: medical history;


physical examination; laboratory testing; testing,


consultation, and treatment including continuing medical


supervision; issuance of drugs and contraceptive supplies;


and appropriate medical referral when indicated.


Social and educational family planning services are such


services as outreach, the provision of transportation, or
 babysitting, which are provided to enable a person to


attend a family planning clinic or to otherwise obtain


medical family planning services.


CLINIC SITE


A clinic site is a place or facility at which any famil~tp~l.n~~g


services are provided on a regularly scheduled basis.
 a hospital, health center, mobile unit, free-standing site, church,


or store front. For mobile units each stop is considered a clinic


location; therefore, a separate questionnaire should be completed


for each stop or location. Physicians’ offices should be con­
 sidered as clinic locations only when there is a formal relation-


ship with some project or agency which is responsible for pro­


viding family planning services. Physicians, nurses, volunteers,


etc., who make home visits for the purpose of delivering a family


planning service should count their home base of operations as the


clinic location.


‘FAMILY PLANNING PATIENT


A family planning patient is a client who meets one of the follow­


ing conditions during her/his visit:


(1)	 The client is provided a method of contraception by


the clinic;


(2)	 The client receives contraceptive, infertility, or
 sterilization counseling in conjunction with a
 medical service which is not V.D. or pregnancy


testing.


37 
Card 1 

9-1 

1. WHAT IS YOUR AREA CODE AND TELEPHONE NUMBER? Area Code Number


ccl0-1.2 1.7-79


2a. IS THE CORRECT
 (name on label]
 NAME FOR YOUR CLINIC OR SERVICE SITE?


i-g Ye. 

~ No ~b . WHAT IS THE CORRECT NAME?-

3a. IS THE CORRECT 

( ddress on label) LOCATI;N FOR YOUR CLINIC OR SERVICE Number Street P.O.Box,Route 

SITE? 

n Yes Lty or town County 

= No~b. WHAT IS THE ENTIRE tate 21p Code 

CORRECT LOCATIONA“ 

4. IS THIS CLINIC OR SERVICE SITE LOCATED IN A: (Mark (X) one box only)


State or local heaZth
 20-1 n’ department building -40 Store -7 m Mobi2e un$t


Ph38io{an ‘S a. WHAT IS THE
 -2 D Ho8pitaZ -Sn off~ce MAILING ADDRESS?


School or oommun<t~
 ‘: D b~ildi.g -em Church


21- m oti+er (spec;fyj 

s.	 PLEASE CHECK THE BOX WHICH BEST INDICATES THE TYPE OF oRGANIZATION WHICH HAS OPERATING RESPONSIBI- LITY (e.g., THAT PROVIDES MOST, IF NOT ALL, OF THE STAFF, SUPPLIES, AND SPACE) FOR THIS CLINIC OR SERVICE SITE. (DO ~ INCLUDE ORGANIZATIOllSINVOLVED ONLY WITH FUNDING.): 

Governmental Non-governmental:


State 2$- I n Planned Parenthood-WorLd Population 

Clinic AffiZ<ation No. Lw:o-,z? 

county 34-lrJ UnCuer8ity 

City or Metropolitan area 35-Z 0 Church 

Health Di8tFict ‘c- m Ho8pital_ D Profit 

Indian Health Service riz Nonprofit

[ -6“ 

Other Federal Government 

(spec7-fy) “- c1 Corporation _ ~ Profit 

r -1 

La Nonpvofit


-2
 Othe~ nonfede~al


government (Specify) Individual, profit


Partnership, profit


Other non-government (Specify)


6. DOES ANY OTHER AGENCY OR ORGANIZATIONALSO PROVIDE FAMILY PLANNING SERVICES AT THIS SITE?


41-1 a No -20 Yes


I


6a. WHA? IS THEIR NAME?


38 
‘7.	 AI/SMEDICAL FAMILY PLANNING SERVICES (A: OR SERVICE SITE FOR WHICH YOU ARS RRPOR7 AGENCY OR ORGANIZATION NAMED IN QOSSTIO} 

4’2-2


T ‘e”
 a.	 WHAT IS YOUR PRIMARY SERVICE
 OR PURPOSE?


MedieaZ.fami Zy


ptanning


Steri.lizat<on


V-D .Te8ting


Postpartum and/ov


Prenata Z Care


Comprehensive


EeaZth Care


Other (Specify)


WAS MARK D I 7AD 7 ANSW R 6
 (3) ANSW;REDV SKI! TOaQUEST:Ofi8c0


iFINEDAT THE TOP OF PAGE 2) PROVIDED AT THIS CLINIC
 ;? IMPORTANT - THIS QuESTION DOES NOT PER’I’AIN
 TO THE
 J BUT TO YOUR OWN AGENCY OR ORGANIZm.


“ Y ‘“ b. DOES THIS CLINIC OR SERVICE SITE: 

(1) REFER PATIENTS TO AHY O.TEi?R
SI!?EFOR


44-1


(2)


45-I


(3)


<6-1


NEDICA’LFAMILY PLA17171JVG
 SERVICES?


‘R” -’P’ae
 (a) ;~HA;: THEIR NAWS AND


(Name)


(Street)


(city) (zipJ_


PROVIDE SPACE, EQUIPMENT, CONTRACEPTIVE


SUPPLIES, AND/OR S1’AFFTO O!iVIERS
WEO PROVIDE
 MEDICAL FAMILY PLANNIRG SERVICES?


~ No


-29 ‘e=
 (.) ~D:E:: THEIR NAMB AND


(Name)


(StreetJ


(C<ty) (zip)


CON!l’RACT OR PAX OTHERS FOR !lWEPROVISION OF 

MEDICAL FAMILY PLANNING SERVICES? 

~ No -2~ Ye*


(~)	 WHAT IS THEIR NAME AND
 ADDRESS?


(Name)


(Street)


(city) (zip)_


NUE BELOW WITH QuESTION 8. IF “NO” WAS MARKED IN 7 AND
 HE LAST PAGE. I


8. DO YOU REPORT TO THE NATIONAL REPORTING SYSTEM FOR FAMILY PLANNING SERVICES?


47-1 ~ No


‘2 Y ‘e”
 8a. WHAT IS YOUR CLINIC NUMBER?
 CC 48-51


9.	 WHEN DID THIS CLINIC OR SERVICE SITE FIRST BEGIN OFFERING’MEDICAL FAMILY PLANNING SERVICES? 

~ 

cc 52,53 54,5s.


10. PLEASE ENTER BELOW THE NAME OF EACH COUNTY SERVED BY THIS CLINIC OR SERVICE SITE AND THE PERCENTAGE - OF YOUR TOTAL PATIENTS FROM EACH COUNTY. ~-j 

h’ameof County % of patiente Name of County %Ofp atiente 

Cclo 0C13 ce28 0031


CC16 ~ CC34 CC37


CC22 C025 CC40 CC43


39 
11. WHAT PERCENTAGE OF YOUR BUDGET FOR FAMILY PLANNING SERVICES WAS RSCEIVED IN 1973 FROM THE 

FOLLOWING SOURCES? [THE PERCENTAGES SHOULD ADD TO 100 PERCENT. ) 

a. Department of Health. Education, and Welfare 

b. Othe~ Federal agenciee (Speoify)


a. State government 46-


d. County government


e. City government


f. planned parenthoo+h’orld Population


9.	 Special Reeea~oh Grant (S~ecify) 47- h. Other eoum?e(a) than above (Specify)


48-
 2’otaZof a - h


,- .. ,, ,Q 12. WE WOULD LIKE SOME INFORK4TION ON YOUR FAMILY PLANNING CLINIC SESSIONS. THESE ARE 

p- ,? REGULARLY SCHEDULED PERIODS OF TIME DURING WHICH MEDICAL FAMILY PLANNING SERVICES ARE 

PROVIDED AT THIS SITE. 

In oolumn (l). check the box to indicate the day8 of the ueek during


whiah medical family planning 8ervice8 are provided.


In coZumn (2), enter the time period during uhich medical family


pZann{ng service? are provided (e.g., 9-11 a.m.; 3-5 p.m. ). If


a epZzt 8e88ion 1.8ope>ated on any day, enter both time periods


in the name box for that day. If thi8 in a oomp?ehensive health


center OF HMO where faredZy ptanning is provided onZy on an “an 

needed” baei8, check the “a6 needed” boizin coZumn (2). 

In column (s), aheck the bOz ~h~oh beat deecp$bes the tYPe Of 

cZinie seeeion being heZd. For the purpo8e8 of this study, a alinio 

ee.s8ionmay be 8peciaZiaed (S) (where only aervicee reZated to 

medica Z famiZy pZanning are provided) or combined (C) (uhere famiZy 

pZann6ng servicee are offered in conjunction with other heaZth 

aervice6 8uch ae maternity, po8t-partum, matema Z and chiZd health, 

obatet?ic8 and gyneaoZogy, comprehene<ve or other heaZth care).


In ooihmn (4), uheck the boz which de8cribe8 the frequenay of


thee.
e aeseione - w for ueek Zy, B for bimonthZy (e.g., every other 

wek), M for monthly, or O fop other. 

, 1 \


(1) (2) (3) (4) 

Typa of FraauancY’ of 

Days of Week Tima Period Clinic Session Sessions 

Medical 

planning Provided From To As Needad Specialized Combined Weekl Y Bimonthl Y Honthly Other 

Monda Y n a m o 0 != = ~ 

Tuesday u u n El m n a = 

WadnasdaY D n n a u O = = 

Thursday n n c1 m 0 n = n 

Friday n n n n a n a m 

Saturday m a n o 0 ‘m a D 

Sunday n n u u 0 a a n 

Family 

13a . WAS THIS CLINIC OR SERVICE SITE CLOSED AT LEAST ONS MONTH (FOUR CONSECUTIVE WSEKS) DURING ANY 

PART OF 1973? 

~~ 

3-4 

1o-1 n No -2 Yes


7


b.	 C1.oaedfrom / to / month daY month daY cell


/ to /


month dait month day
 CC19


/ to / 

month da# month dag ce27 

/
 ~c,~~onth [ dan ‘0 month day


40 
14a.	HOW MANY PATIENTS RECEIVED MEDICAL FAMILY PLANNING SERVICES AT THIS SITE FROM JANUARY 1,
 1973 THROUGH DECEMBER 31, 1973?


.TOtal Patient8 ~o~~ 

b. SW TL4NY OF THESE TOTAL PATIENTS WERE ENTITLED TO SUBSIDIZED FAMILY PLANNING SERVICES IN 

1973 UNDER: 

(1) Title IV-A (APDC) ? 

ec48 

(2) !7itZe” XIX (Medicaid)? ,.x?5x 

c. HOW MANY OF THESE TOTAL PATIENTS WERE NEW PATIENTS (e.g., THOSE WHO REGISTERED AND
 RECEIVSD.MEDICAL FAMILY PLANNING SERVICES AT THIS SITE FOR THE FIRST TIME) FROM JANUARY 1,
 1973 THROUGH DECEMBER 31, 1973?


New Patients CC68 

d. HOW MANY MEDICAL FAMILY PLANNING VISITS WERE RECORDED AT THIS SITE FROM JANUARY 1, 1973
 THROUGH DECEMBER S1, 1973? (DO N~LUDE VISITS OR MAILINGS WHEREBY A PREVIOUSLY
 REGISTERED PATIENT RECEIVED SUPP~S ONLY.)


Total Vieit8 CC63 

5 15t3.WHICH OF THE FOLLOWING SERVICES OR 15b. WHAT PERCENTAGE OF YOUR PATIENTS


T FuNCTIONS ARE PROVIDED AT THIS SITE RECEIVED THESE SERVICES IN 1973 ON
 FoR FAMILY PLANNING PATIENTS? THEIR INITIAL* VISIT FOR MEDICAL


(Check all that apply.) FAM1LY PLANNING SERVICES?


Percentage


(1) Ig Reaord of. pe~tinent medical hi8tory 

C?clo 

(2) Q Record of reproductive h<e tory 

Cela 

(3) n Reco~d of pertinent social history 

(4) n Pap smear 

CC19 

(5) n Pe Zvia examination 

CC22 

(6) n Brea8t examination 

(7) � Taking of bZood pre88ure 

(8) � Contraceptive p>esc?iption 

(9) n Inaert<on of IUD 

CC34 

(lo) n V-D teetz%g for qjphi Zie 

CL?37 

(11) � v-D teet<ng for gonorrhea 

(12) o Pregnancy teeting 

Routine lab te8t8 (hematoarit, (23) m urine for eugar and aZbumin) 

(14) n In fert{ lit y diagnoa in 

(15) n Infertility counseling 

(16) � Female 8teril{xation 

(17) o NaZe eteri~iaation 

(18) � Siukle ceZZ ecreening 

(19) � Othev medioaZ service (S~ecify) 

*AIIinitial visit for medical family planning services is defined as a visit at which
 a patient is registered for and receives medical family planning services for the
 ,,
fir~t time,,at this site.


CC64 DO NOT FILL IE— 

C068 

FOE A GEi’iCl’ USE OA’.tY CC72 4 

41

W ~~. NHICH OF THE FOLLOWING OTHER ANCILLARY SERVICES OR FUNCTIONS ARE PROVIDED AT THIS SITE 9-6 (Check all that apPIY) 

10-2~ Individual coun8eZing about fam<l.yplanning 

POzZow-up Program (Fo_LZow-upactivities k? Zude contacting persone uho
 11-1El ~aoe ~i8aed ~ppointment8 and the scheduling of reapp0in*men*8.)


ReferPaZ to other alinia for famiZy planning or medical 8ewice8 not
 ]~-1~ ~Povided at thi8 8ite


13-i~ ReferzkzZ to approp~iate agenoy for Eociaz 8ePViOee


Outreach Program (Out~eaoh activities ape thcwe whioh inform prospective
 14-1n patient8 of famiZy planning eervioes and ae8iet them in aveiZ+ng them-


eeZve8 of the eemiae.s. ) 

1.5-1 n
 C2a@8Poom or group 8e88ion8 about famiZy “pZanninff


Classroom or g~oup aeaeiona on uex education (in addition to fam$ly 16-ID pZanning and aontraoeptive eduoation) 

17-1~ Ih.aneportationto the oZinia or aerviae cite (provided OF aubeidiaed)


16-1~ Babysitting (tihilepatient i8 at olinia or service Site)


19- a Other (Speoify)


20-1m None


17.	 NHAT PERCENTAGE OF ALL YOUR PATIENTS USED OR RECEIVED THE FOLLOWING TYPES OF CONTRACJJPTIVS
 METHODS IN 1973? (Includeonly those methods provided at this site.)


(a) ~


(b) ~


(c) m


(d) ~


(e) ~


(f) ~


(g) ~


(h) ~


(i) ~


(i) ~


(k) ~


(’l)
~

(m)D


42 

OraZ (PiZl)


IUD


Foam


Condom


Diaphnagm/~eZZy


Ba8aZ Temperature Rhythm


Ce~vieal-Muaue Rhythm


SteFiliaatiOn (femaZe)


SteFiZizatiOn (male)


Injection


Morning after pill


O*he~ (Speaify)


NOna offered (Infertility couns.Zing onZYJ


Do flOT FILL


Percentage


0C21


aa24


CC.27


0030


CC.33


CC38


0039


ao42


C045


CC48


au51


C054


CC5?


60-


IN—


FOR AGH?CY USE 0NL% M 
Card 

T ? ~8. PLEASE INDICATE BELOW THE NuWBER OF STAFF USUALLY INVOLVED IN THE DELIVBRY OP MEDICAL 

FAMILY PLANNING SERVICES AT THIS CLINIC OR SERVICE SITP, DURING A TYPICAL NSEK. INCLUDE 

VOLUNTEERS , CONTRACT, AND PAID EMPLOYEES1 COONT, EACH PERSON ONLY ONCE, IN THE OCCUPATION 

AT WHICH HE/SHE SPENDS MOST TIME. 

Total Staff Total staff hours 

Staff Type delivering family usual IY worked 

Pl annine servicas Per week 

Administrator/Director Ce.lo CC12 

Clerk lSecrctary CC15 CC17 

Clinic Aide C?020 ce~~ 

Health Educator CC2S CC27 

Licensed Practical Nurse CC30 ac32 

Nurse Midwife/Nurse Practitioner CC35 CC37 

Nutritionist


Outreach Worker


Physician


PhYsicianl s Assistant


RecCistered Nurse


Social Worker


Other (Specify)


19. 

0040 CC42 

CC45 CC47 

CC50 easz 

CC5.5 CC57 

Ccco ce62 

CC65 CC67 

ce70 efl 72 

cc 75-

c LETING THIS FORM ; (Please print) JOB TITLE : 

!m ‘F “RsON ‘w 

TELEPHONE NuMBER :

I 

COMWENTS: 

Cclo DO HOT FILL Ifi 

@e16 

FOR ItU’ERHAL USE ONLY CC22 i 

000


* U.S. GOVERNMENT PRINTING OFFICE: 197d-210.591:32 

43 
VITAL AND HEALTH STATISTICS PUBLICATIONS SERIES 

Formerly Public Health Service Publication No. 1000 

Series 1.	 Programs and Collection Procedures. –Reports which describe the general programs of the National 

Center for Health Statistics and its offices and divisions, data collection methods used, definitions, and 

other material necessary for understanding the data. 

Series 2.	 Data Evaluation and Methods Research. –Studies of new statistical methodology including experimental 

tests of new survey methods, studies of vital statistics collection methods, new analytical techniques, 

objective evaluations of reliability of collected data, contributions to statistical theory. 

Series 3.	 Analytical Studies. –Reports presenting analytical or interpretive studies based on vital and health 

statistics, carrying the analysis further than the expository types of reports in the other series. 

Series 4.	 Documents and Committee Reports. –Final reports of major committees concerned with vital and 

health statistics, and documents such as recommended model vital registration laws and revised birth 

and death certificates. 

Series 10.	 Data from the Health Interview Survey .–Statistics on illness; accidental injuries; disability; use of 

hospital, medical, dental, and other services; and other health-related topics, based on data collected in 

a continuing national household interview survey. 

Series 11.	 Data from the Health Examination Survey. –Data from direct examination, testing, and measurement 

of national samples of the civilian, noninstitutionalized population provide the basis for two types of 

reports: (1) estimates of the medically defined prevalence of specific diseases in the United States and 

the distributions of the population with respect to physical, physiological, and psychological characteristics; and (2) analysis of relationships among the various measurements without reference to an 

explicit finite universe of persons. 

Series 12.	 Data from the Institutionalized Population Surveys. –Discontinued effective 1975. Future reports from 

these surveys will be in Series 13. 

Series 13. Data on Health Resources Utilization.–Statistics on the utilization of health manpower and facilities 

providing long-term care, ambulatory care, hospital care, and family planning services. 

Series 14.	 Data on Health Resources: Manpower and Facilities. –Statistics on the numbers, geographic distribution, and characteristics of health resources including physicians, dentists, nurses, other health occupations, hospitals, nursing homes, and outpatient facilities. 

Sen”es20.	 Data on Mortality. –Various statistics on mortality other than as included in regular annual or monthly 

reports. Special analyses by cause of death, age, and other demographic variables; geographic and time 

series analyses; and statistics on characteristics of deaths not available from the vital records, based on 

sample surveys of those records. 

Sen”es 21.	 Data on Natality, Marriage, and Divorce. –Vanous statistics on natality, marriage, and divorce other 

than as included in regular annual or monthly reports. Special analyses by demographic variables; 

geographic and time series analyses; studies of fertility; and statistics on characteristics of births not 

available from the vital records, based on sample surveys of those records. 

Series 22.	 Data from the National Mortality and Natality Surveys. –Discontinued effective 1975. Future reports 

from these sample surveys based on vital records will be included in Series 20 and 21, respectively. 

Series 23.	 Data from the National Survey of Family Growth. –Statistics on fertility, family formation and dissolution, family planning, and related maternal and infant health topics derived from a biennial survey of 

a nationwide probability sample of ever-married women 1544 years of age. 

For a list of titles of reports published in these series, write to:	 Scientific and Technical Information Branch 

National Center for Health Statistics 

Public Health Service, HRA 

Rockville, Md. 20852