Making Reproductive Health Services Acceptable, Accessible, Affordable, Confidential - and Convenient

    • May 25, 2015

In 2004, Robert Wood Johnson Foundation named Lon Newman, MS, an RWJF Community Health Leader for his work to make family planning and contraception accessible and affordable for poor, young, and uninsured women in Wausau, Wis.

The problem. Limited access to contraceptive care places women at heightened risk of unintended pregnancy. Lack of health insurance coverage and of access to family planning-related services, such as sexually transmitted disease (STD) screenings, contribute to other negative sexual health outcomes. So how can contraceptives and reproductive health information be delivered conveniently and at low cost, especially in poor, rural areas?

Putting a face and a name to teenage pregnancy. As a high school student in the mid-1960s, Lon Newman was vaguely aware that teen pregnancy was a serious issue in his small rural town of Austin, Minn. “There was no sex education, no birth control pills, nothing other than morality and shame for the girls who got pregnant,” Newman recalls. “There were no options other than go away and have the baby or seek an early abortion. It was really traumatic.”

But it wasn’t until the late 1970s that Newman was able to put a face and a name to a teenage pregnancy that he never forgot.

After getting his bachelor of arts degree in psychology–sociology from Minnesota’s Winona State University and a master’s degree in guidance and counseling from the University of Wisconsin–Stout, Newman landed a job as guidance counselor at a high school in Melrose/Mindoro, Wis.

One of the female students had suddenly stopped attending school and it was Newman’s job to find out what had happened and encourage her to return. “She was a little girl, probably 16 at best,” Newman says. “Tammy was her name.”

In his search for Tammy, Newman recalls walking through a muddy cornfield to get to an abandoned farmhouse, “except they were living in it, so it was not abandoned. Here she is—this is true—seven months pregnant. She had a stick like a broom handle in her hand, and she’s stirring a 55-gallon drum of laundry over a fire in the front yard, while her twin brothers played around her. Her father was there, sitting in the living room watching TV. Her mom was timid and withdrawn.

“I talked to Tammy a little bit—she had no doctor, no help from anyone, no prenatal care, no social services; and she was going to deliver at home. She was not coming back to school,” Newman says. “It was a heart breaker. I kept thinking, ‘What is going to happen to this little girl?’”

With the help of the school superintendent, Newman arranged for prenatal care for Tammy and social services for the family. But Tammy never returned to school, and Newman never found out what happened to her. And the experience remained fresh in his mind.

After his job in Melrose/Mindoro, Newman and his wife, Janet, moved to Stevens Point, Wis., where he took a new job with the local Cooperative Educational Service agency, coordinating sex education programs for students in 24 school districts. After several years in this position, Newman worked briefly for a state senator, and then tried his hand as an entrepreneur with his own small business start-up. Then, in 1988, Newman landed the job he always wanted: executive director of Family Planning Health Services (FPHS), a nonprofit, community-based agency in Wausau, Wisc., that provides family planning and reproductive health services for families at all income levels.

Family planning champion and innovator. In his new position, Newman quickly established himself as the champion of what he called the four dimensions of sexual health care, reproductive health care, and family planning: “It has to be acceptable, accessible, affordable, and confidential.”

“Everybody becomes sexually active, or at least 98 percent do,” says Newman, “so they need that information and access to health care related to their bodies and sexual health.”

Newman added clinics and services at the agency, including an Emergency Contraception Hotline and expanded WIC (Women, Infants, and Children) nutrition and healthy food services. From 1997 to 2003, Newman also worked to pass and implement Wisconsin’s Medicaid Family Planning Waiver that allowed an estimated 150,000 low-income women to receive free contraceptive care.

To help women enroll in the new waiver program, in 2003 Newman set up “contraceptive kiosks” similar to ATM machines at some Wisconsin college campuses and local businesses. He also worked with then-Lieutenant Governor Barbara Lawton to form a women’s health task force in 2003 to develop a long-range strategic plan, including improved access to reproductive health services. This effort, Newman says, resulted in the formation of a Department of Health Services Family Planning Council charged with developing an integrated family planning program in Wisconsin.

Becoming a Community Health Leader. For his work championing improved access to health care and family planning, the Robert Wood Johnson Foundation named Newman a Community Health Leader in 2004. By then, the Family Planning agency led by Newman served about 10,000 women a year in eight clinics in seven central counties in Wisconsin.

Though the agency had already taken significant measures to make family planning and reproductive health acceptable, accessible, affordable, and confidential, Newman also wanted it to be convenient.

With part of his $125,000 award, Newman borrowed a concept from fast-food restaurants, opening the first drive-up window in Wisconsin (and one of only three in the United States) to conveniently dispense contraceptives and prescribed birth control supplies.

The drive-up window, installed at the Family Planning headquarters in Wausau, opened on Valentine’s Day in 2006. Existing Family Planning clients who had already received medical assessments could pick up refills of their prescription birth control supplies, while new customers could get non-prescription birth control. “This is especially convenient for parents with small children and working women,” a news release said of the service. “In a busy world, clients expect fast, friendly, convenient service.”

Pro-life advocates in Wisconsin immediately denounced Newman’s new concept. “Lon Newman’s new birth control window has made love a commodity as cheap as a cheeseburger,” Peggy Hamill, then state director of Pro-Life Wisconsin, said in a press release. “Will girls be asking, ‘Can I get fries with that patch?’”

But Newman disagrees. “Our patients are our wives, our sisters, our business associates, and our friends, and there is nothing cheap about them!” he argues. “That is our response to that criticism. The idea is to be open and acceptable in the community. We are not going to be shaming ourselves. We have a drive-up like every other business.”

To help his agency do a better job advocating for reproductive health, Newman used a portion of his RWJF award to hire a social media expert. One result was a new blog called “Below the Waist,” in which Newman and other contributors have posted videos and columns that discuss recent news and legislation related to family planning and contraceptive issues.

Seeing a higher vision. Being named a Community Health Leader “not only gave me self-confidence that we were headed in the right direction, but it gave others the sense that there is some value to this,” says Newman. The RWJF program provided “a working network of ongoing friendships that raised my sights and enabled me to see a higher vision every day.”

The RWJF program provided “a working network of ongoing friendships that raised my sights and enabled me to see a higher vision every day.”—Lon Newman

Protesters have continued to show up in Wausau, and Newman routinely uses humor to ease the tension. When a group of Catholic abortion protestors gathered several years ago outside the agency (which has never offered abortion or adoption services), they were greeted with two 18-foot-high red inflatable tube figures dancing friskily in the Wisconsin wind. “That brought a festive air to the day,” a reporter for a news website noted. “The clients of FPHS were instantly relieved of their long walk of shame by the happy distraction the balloons created.”

Even as he neared retirement, Newman has continued to champion innovative methods to make family planning options accessible to a wider public that included men and women ages 15 and up. With the agency’s drive-up window still operating, Newman set up virtual clinic services, which today connect clients online with health care providers at different locations.

“Young people have to be able to access practitioners by cell phone, and pick up prescriptions at Walgreens,” he says. “It sounds simple, but it’s not really that simple. It has to be done technologically.”

Newman retired in 2014 to his woodworking shop and pontoon boat in northern Wisconsin, but he’s open to projects that require the kind of innovation and tenacity that RWJF Community Health Leaders are known for. “At the retirement party, my wife said, ‘Lon was able to find a job where he could be himself.’ ... If someone wanted to work on these kinds of initiatives, I’d be delighted.”

RWJF perspective. RWJF recognized the first 10 Community Health Leaders in 1993. They are unsung and inspiring individuals who work in their communities—often among the most disenfranchised populations—to address some of the nation’s most intractable health care problems. The formal recognition of these Robert Wood Johnson Foundation Community Health Leaders and their programs often launches them to greater levels of influence and extends their reach to serve more vulnerable populations. For more information on the program see the Program Results Report.

Under the RWJF Community Health Leaders award, each year from 1992 through 2012 RWJF has provided a $125,000 award to 10 individuals and their organizations ($105,000 supports a project at their organization and $20,000 goes directly to the leader for personal development). RWJF also connects the Community Health Leaders with each other so they can continue their work with the support and experience of their peers and previous award winners.

“Community Health Leaders are characterized by three specific traits—they are courageous, they are creative, and they are committed,” says National Program Director Janice Ford Griffin. "The Foundation recognizes the tremendous resource of experience among the leaders and we look forward to mining that resource as we consider future initiatives."

“Through the Robert Wood Johnson Foundation Community Health Leaders award, we at the Foundation have the opportunity to recognize innovative and courageous local leaders behind ground-breaking efforts in communities across the United States,” says Sallie George, MPH, program officer at RWJF. “These individuals remind us that one person can have a powerful impact on health and health care within their communities.”

The last round of leaders was chosen in the fall of 2012. The program closed at the end of 2014.