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October 2012

Staten Island Gets Reproductive Health:The Long Process of Establishing a Health Center

The 60,000 girls and young women who live on Staten Island are breathing a little easier about getting safe, affordable, and confidential reproductive health care. Until last October, none of the City’s major reproductive health providers offered services on the Island. Young women who needed contraception, sex education, and screening and treatment for sexually transmitted diseases, but didn’t want to go to their families’ doctors, had very limited options.

All of that changed when Community Health Action of Staten Island (CHASI) and Planned Parenthood of New York City (PPNYC) joined forces to open the Staten Island Health Center. CHASI is a multi-service health and social service agency, and PPNYC established the nation’s first reproductive health clinic in New York City back in 1916. The advent of the Staten Island clinic expands Planned Parenthood’s presence in the boroughs: the organization now serves more than 49,000 people a year through full-service reproductive health clinics in Manhattan, the Bronx, and Brooklyn, and a mobile medical van.

Plans for bringing a reproductive health clinic to Staten Island began gaining momentum back in 2008 when The Trust made a $75,000 grant to establish a center, but actually getting things up and running was many more years in the making. “Just because you want to deliver a service doesn’t mean you can set up shop and jump in right away,” says program officer Irfan Hasan. “Even a good idea has to go through a long process to have staying power.” For PPNYC and CHASI this meant navigating the complex process of applying for a license, and obtaining funding, facilities, and patients. The task required a great deal of patience and persistence, not the least because Staten Island is home to some of the most vocal and active opponents of reproductive choice and young people’s rights to reproductive health services.

Nonetheless, the partnership was up to the challenge, combining the technical expertise and trusted reputation of Planned Parenthood with the community expertise and sensitivity of CHASI. The two groups decided to locate in Community Health Action’s store-front office, which serves Stapleton, St. George, and Port Richmond, neighborhoods with the borough’s highest rates of sexually transmitted diseases. While Planned Parenthood took the lead in applying for a Certificate of Need (CON), the license to operate in New York State, and tackled setting up Medicaid and other billing systems, CHASI used its local reputation to publicize the clinic’s client-friendly focus on girls and young women. CHASI and PPNYC both made presentations at local youth agencies; placed posters on bus kiosks, trains, and in the ferry terminal; and distributed catchy brochures and wallet cards.

Setting up any kind of clinic is challenging, but setting up a reproductive health clinic is even more complex, since it adds concerns about confidentiality to the mix. Questions race through patients’ heads when they consider visiting a reproductive health clinic: “What if this shows up on my insurance? Will it be scary? Will it be safe?” Planned Parenthood and CHASI calmed these concerns by educating the community about their expertise and their deep care and concern for patients’ safety and confidentiality. Though interest in the center was growing, logistics and legalities were complex. As is often the case with licenses, the CON took some time to get approved, requiring resubmissions regarding construction code compliance.

In the meantime, however, there were young women eager to get services, so while planning was underway between September  2010 and 2011, Planned Parenthood stationed its mobile medical unit van in front of the storefront one day a week. The 397 clients served by the van foreshadowed the enthusiastic patient response to newly available services on the Island. Establishing a reproductive health care facility on Staten Island was a marathon, but as with the story of the tortoise and the hare, slow and steady progress eventually paid off; the Staten Island clinic opened its doors in October 2011. Already, the center has served 1,600 patients. PPNYC’s Vice President of Clinical Services, Anne Robinson, refers to the collaboration with the Community Health Action of Staten Island (CHASI) as “instrumental in helping us to connect with community partners.” Robinson says the most gratifying aspect of the long process has been the response from the people on Staten Island for whom the center has quickly become a go-to resource: “It’s been particularly wonderful to see that 24 percent of all clients we are seeing are teens.”

With the opening of the center, The Trust granted another $60,000 to CHASI to develop a plan for sustaining the center. There are still administrative kinks to work out—for example, figuring out how to enroll the large volume of walk-in patients in public insurance when many don’t come to the clinic with sufficient documentation. It will take some time for the clinic to sort out these growing pains, but from a dearth of options only a few years ago to a medical van parked out front to a freshly-renovated clinic awaiting patients with open arms, reproductive healthcare on Staten Island has already come a long way.

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