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For counties in Florida that offer vasectomies funded through federal Title X family planning monies, there is access to male sterilization for low-income men. But what happens for those men who live in counties that have not established such services and cannot afford to pay for private care?
Enter the Clearwater-based Vasectomy Support Foundation Inc. (VSF), a not-for-profit organization that promotes and helps pay for vasectomy services for qualified-income level men who desire such services, are content with the number of children that they have, and possess no medical coverage through Title X, Medicaid, or private insurance funds.
The foundation is the brainchild of Tampa urologist Douglas Stein, MD, who has been active in providing vasectomies through contracts with area county health departments and Planned Parenthood clinics since 1996, as well as through his own private practice.
Stein is an advocate of the no-scalpel vasectomy (NSV) technique, which was pioneered in the United States in 1988 by New York City-based AVSC International (now EngenderHealth). Developed by Chinese surgeon Li Shunqiang, the NSV technique is less invasive, less painful, heals more quickly, and has fewer complications than the traditional vasectomy procedure. (To learn more about NSV, check out Contraceptive Technology Update, May 2000, p. 56.) Stein underwent AVSC’s NSV training in 1990 and quickly incorporated the procedure into his practice.
Raising public awareness
Stein sees the foundation as a way to move vasectomy out of its current "Catch-22" situation. He explains it in this manner:
In Florida, each county may or may not have a contract with a provider for vasectomy services. These services can be provided in the provider’s office or in the county health department facility. The vasectomies are paid for by federal Title X funds, which are administered through the state to individual counties, which then make payment to the provider. (Some counties might have in-house providers trained through AVSC’s program. See CTU, March 1998, p. 29.)
Public assistance isn’t well known
What happens when there are no publicly funded vasectomy programs? Because men are unaware that there might be public assistance for vasectomy services, they don’t ask for them, says Stein. Since there appears to be no public demand, health departments do not establish vasectomy services with Title X funding. Men then have to resort to contacting private providers, and many stumble at the barrier of private-pay charges.
"I’ve heard a hundred times, Doc, I’ve called around, and one guy wanted $600, one guy wanted $800, and I can’t afford that kind of money,’" Stein observes. "When I say, Do you know you could get it through the county?’ they say, "That would be a great idea.’"
Stein began to brainstorm. What if vasectomy services could be offered to all men, regardless of whether they live in a county that provides publicly funded procedures, with a nonprofit organization paying the costs? The nonprofit organization would not only underwrite the vasectomy services, but would demonstrate the need for establishing local publicly funded vasectomy services.
The VSF was founded in 2000 with the following goals:
• Educate the public about the ease and advantages of vasectomy as long-term contraception for those couples whose families are complete.
• Educate referral sources, such as health departments, Planned Parenthood clinics, and private health care offices, about government-funded and VSF supplemental programs through personal visits, direct mailings, and brochures.
• Educate vasectomy services providers (primarily urologists) as to how they may become registered VSF providers.
The VSF has established a web site, www. vasectomysupport.com, to serve as an information clearinghouse for information about low-income vasectomy funding throughout the Florida region.
Advertisements are run in local large-circulation weekly newspapers. While their format might differ, the message remains the same: no scalpel, nothing removed, 15 minutes, and $0-$290, depending on income. The ads and the $290 price do much to pull in clients, says Cynthia Street, RN, MS, senior community health nursing supervisor at the Pasco County Health Department, New Port Richey clinic. The health department contracts with Stein to deliver its Title X vasectomy services.
The department previously contracted with another urologist who performed hospital-based vasectomies, says Street. With the NSV technique, men can come directly to the clinic in the morning and be out by noon. A mail-in process verifies the sperm count, which eliminates the need for a return visit. Street reports the clinic is seeing a broad cross-section of the population, who cite the convenience and price as motivation for making the family planning decision.
Vasectomy seems to be not only dependable, but a simple, long-term arrangement for many men, says Stein.
"We’re not trying to tell people how many kids they should have. We’re only trying to say that vasectomy is a good option, if you feel comfortable with the number of children you already have," states Stein. "Finances should be no barrier."
For more information on the Vasectomy Support Foundation, contact:
• Douglas Stein, MD, Vasectomy Support Foundation Inc., P.O. Box 3851, Clearwater, FL 33767-8851. Telephone: (727) 827-4636. E-mail: firstname.lastname@example.org.