Bozeman News

Gallatin Valley Non-Profit Series

Bridger Clinic: Providing Quality, Affordable Reproductive Health Care

By Alison Grey, 12-06-07

The Gallatin Valley is home to over 200 non-profits. These organizations do not hinge on metropolitan amenities, and are often created to stimulate local communities of the West. As part of our New West economy, NewWest.Net/Bozeman is highlighting Gallatin Valley organizations in a weekly series.

With increasing teenage birth rates in Gallatin County over the past several years, the spread of sexually transmitted infections, as well as the high cost of contraceptives and its financial burden on Montana women, access to quality, affordable reproductive health care and education is a vitally important aspect to our community.

Bridger Clinic, with 24 staff members and four volunteers, was founded in 1972, and is a non-profit clinic with a mission to provide reproductive and related health care in a setting which respects the dignity, well-being and privacy of each individual. They are also committed to the provision of educational programs that enhance information and understanding about sexuality and reproductive health.

The Clinic estimates that of the young and low-income women in need, only 39 percent receive family planning services. This is due, in large part, to federal flat-funding for family planning services, leaving smaller clinics vulnerable and reducing funds for marketing and education in larger clinics. According to the Clinic, funding cuts affect the health of all Montana women. Many of the low-income women served in federal family planning programs would otherwise go without potentially lifesaving exams – including clinical breast exams, pelvic exams and Pap tests.

Stephanie McDowell, associate director, expands further upon Bridger Clinic and its efforts.

NewWest.Net: Why and how did your organization come into being?

BC: Bridger Clinic was established in 1972, just two years after the enactment of Title X of the Public Health Service Act established by President Nixon on Dec. 26, 1970. This was the first, and remains the only, federal program dedicated to providing family planning services nationwide.

President Nixon stated,” It is my view that no American woman should be denied access to family planning assistance because of her economic condition.”

Each year, Bridger Clinic applies for grant funds from Title X, which now comprises 26 percent of our budget. 

NewWest.Net: Why is this organization in Bozeman? What are the advantages and challenges of operating in this area? Are there other non-profits in this area that you partner with or would like to?

BC: Bridger Clinic is one of several Title X-funded clinics throughout the state, however, Bridger Clinic is a grassroots non-profit founded in and for Bozeman. This gives us an advantage in that we can focus on both local and statewide issues. We work closely with the other Title X Family Planning clinics across the state to address issues facing reproductive healthcare. In addition, we work closely with local agencies to address issues specifically facing the Bozeman community. This range of perspective has allowed us to more effectively serve our clients and the community.

We work with other non-profits on a statewide level as members of Montana Shares, which is a partnership of Montana-based nonprofit groups devoted to improving the quality of life in communities throughout the state. Statewide members work on issues concerning women, families and seniors, health and hunger, the environment, arts and culture, domestic and wild animals, social justice and human rights.

In addition, we work with several Bozeman non-profits and agencies on issues ranging from sexual assault to teen pregnancy. Some of the agencies and non-profits with which we work are: the MSU VOICE Center, the MSU Women’s Center, THRIVE, the Adolescent Resource Center, Child Care Connections, the Health Department, the Bozeman School District, Big Sky youth Empowerment and the Parenting Place.

NewWest.Net: Where are you directing your resources?

BC: Bridger Clinic’s goal has always been to offer reproductive health care and education to men and women of all ages. These services include testing and treatment of sexually transmitted infections (STI’s), anonymous HIV testing, reversible birth control methods, annual exams for women which include a pap test for cervical cancer screening and a breast exam, as well as, male exams which include testicular cancer screening and STI diagnosis and treatment. Last fiscal year, Bridger Clinic served over 6,400 patients totaling over 10,000 patient visits. Furthermore, community education remains a priority among our services. Our health educators offered 75 presentations reaching over 4,382 community members on topics ranging from puberty to menopause and including such presentations as parent/child workshops and teen peer theatre.

Special Projects:

Efforts to Prevent Teen Pregnancy:

The rate of births to teens in Gallatin Valley rose 30 percent in one year, 2004 to 2005. It rose again by 20 percent in 2006. These rates coincide with reports of increased rates of sexual harassment in the middle and high schools. Bridger Clinic offers classes on sexual harassment, self esteem and reproductive health in an effort to educate teens and reduce teen pregnancy in an effort to education teens and combat these trends.

In light of the recent trends, Bridger Clinic has initiated two projects to decrease teen pregnancy and sexual harassment in our community. 

First, we have been awarded federal funding to collaborate with the Gallatin City and County Health Department and the Young Parent Program to expand efforts to reduce pregnancy among teens. All outreach and education is free of charge to the schools, parents, teachers and students.

Second, this fall, Bridger Clinic joined forces with the Women’s Foundation of Montana to create the Decreasing Teen Pregnancy Project. This project will consist of an ad campaign to target teens and young women at risk for unintended pregnancy. The goals of the project are to educate teens about the affordable, confidential reproductive health options and education available at Bridger Clinic in order to decrease teen pregnancy.  Our project uses radio, television and print marketing in Bozeman, Gallatin Gateway, Livingston, Big Sky, Dillon, Deer Lodge and smaller communities in these areas to increase awareness of affordable reproductive healthcare at Bridger Clinic.

Increasing Access to Services Projects:

We have been granted four years of funding to offer a clinic in Big Sky to increase access to services for under-insured seasonal and permanent residents of Big Sky and surrounding communities. Services will be offered every third Tuesday during the months of January to May 2008 at Big Sky Health and Fitness. All appointments and supply orders will be managed through our Bozeman location at 587-0681.

HIV Services: 

We provide anonymous or confidential rapid HIV testing (20 minute results) and counseling and referral services for HIV and risk reduction five-and-a-half days per week. Last year we provided 600 tests in the clinic. All of our HIV testing and counseling is on a sliding fee scale and no one is denied services for inability to pay. Our referrals for clients living with HIV are to Ryan White Program through Gallatin Community Health Department.

HIV Prevention Activities:

Our health educators co-facilitate a gay and bi-sexual men’s discussion group that focuses on enhancing self-esteem and self-protective behaviors in an effort to reduce the frequency of unprotected anal intercourse and increase the use of condoms.

We provide ongoing education with high risk youth through the Adolescent Resource Center. The youth participants are involved in community service to meet their obligation to the court system. Part of this time is spent with Bridger Clinic health educators gaining information, skills and communication tools to help them make good decisions, identify and reduce risky and unhealthy sexual behaviors, discuss healthy relationships and support sexual negotiation skills.

Lastly, Bridger Clinic distributes condoms with education materials about prevention and risk reduction for HIV and other STI’s to 12 area organizations. These organizations are locations identified as venues accessed by individuals at high risk.

NewWest.Net: What is your annual operating budget, and can you please break that down between administrative and fund-raising versus program expenses?

BC: Bridger Clinic’s budget for the 2008 fiscal year is $1,522,478. Last year, only 26 percent of our budget came from federal and state funds. Additional funding was gathered from patient fees (charged according to patient income) at 35 percent of our budget, and insurance and Medicaid at 9 percent.

During the past four years, the government has made the unfortunate decision to “flat fund” our grant. Consequently, though prices for things such as contraceptives, lab work, and malpractice insurance have risen, our funding has not.  In the past year alone, the clinic’s cost for contraceptive supplies has leapt by 20 percent and our insurance coverage has more than doubled. It is this decrease in funding and increase in costs that have made grant funding and fundraising even more important to our organization’s sustainability.

NewWest.Net: How are you fulfilling your mission statement?

BC: We fulfill our mission statement by providing care and education to all regardless of ability to pay. We also address the following issues with professionalism and confidentiality both one-on-one and within our community: 

At least 40 percent of all women will get pregnant before the age of 20 years. Approximately 70 percent of these pregnancies are accidental and 50 percent of these mothers will become welfare recipients within five years of the birth of their first child; Without contraception, the average woman would bear between 12 to 15 children in her lifetime; In Montana, family planning clinics avert an estimated 7,500 unintended pregnancies each year through the use of contraceptives.

We address these issues through direct care and education that is offered to all regardless of ability to pay. 

Sixty percent of Bridger Clinic patients do not have health insurance, and 53 percent of patients fall at or below the federal poverty level; Bridger Clinic offers a services to both men and women and 9 percent of our current patient population is comprised of males; Bridger Clinic has expanded efforts to make pap smears, breast exams and mammograms available to all women by increasing our patient enrollment for the Montana Breast and Cervical Health Program by 44 percent so far in 2007. Bridger Clinic also offers care for menopause and perimenopause.

NewWest.Net: What is your most recent success story?

BC: The typical US woman wants to have two children, and therefore will spend three decades trying to avoid becoming pregnant. Contraception is the key to helping women and their partners realize their family size goals. Unfortunately, the cost of contraception and healthcare has become less affordable for more Montana women.

It is estimated that of the young and low-income women in need, only 39 percent receive family planning services. This is due in large part to federal flat-funding for family planning services, leaving smaller clinics vulnerable and reducing funds for marketing and education in larger clinics. 

These funding cuts affect the health of Montana women. Many of the low-income women served in federal family planning programs would otherwise go without potentially lifesaving exams – including clinical breast exams, pelvic exams and Pap tests. In our recent patient satisfaction survey, 88 percent of patients cited affordable fees as the reason they chose Bridger Clinic and 37 percent said they would have no alternative resource for reproductive health care. 

As one of our patients stated in this year’s survey, “The service you all provide is amazing. When I first moved here, I came to you on recommendation as somewhere affordable. Now I continue to come because I respect and want to help support your mission.”

Every woman, man and family we are able to help is a success for the future of Montana families.

NewWest.Net: Thank you!

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