• FLAGSTAFF, Ariz. (AP) -- Months after the federal Indian Health Service said it was finalizing a policy that would make emergency contraception more accessible to American Indian women, advocates say they're still waiting. And in the meantime, Native women face a patchwork of policies at hospitals and clinics that don't always ensure timely access to the medication.
• Across the country, any woman 17 or older can buy emergency contraception from behind the counter at retail pharmacies. But the Indian Health Service has no retail pharmacies. Instead, Native women typically must visit a clinic, urgent care facility or emergency room and have a consultation before being prescribed the medicine that is dispensed on-site.
• Critics say that system is time-consuming and burdensome, and they've been pushing for change. In May, they scored a victory when the Indian Health Service's chief medical officer, Susan Karol, said the agency was working on a new policy aimed at allowing pharmacies to give Plan B directly to patients.
• But that policy hasn't been released yet, and until it is, Native women face an unreliable assortment of rules that can vary from clinic to clinic, said Charon Asetoyer, director of the South Dakota-based Native American Women's Health Education Resource Center.
• "There's not consistency and continuity that women should be able to expect through the system in terms of being able to access Plan B or its generic counterpart," Asetoyer said.
• A recent informal survey by the resource center found that some facilities don't carry the medication at all, some hand it out only at the direction of a physician, and others have expanded the list of people who can provide it to patients.
• Karol wrote to Asetoyer in May saying many IHS facilities and tribal sites already have authorized clinicians to provide the medication to patients, and "this is the direction we want all our facilities to go."
• IHS spokeswoman Dianne Dawson declined to discuss when the policy would be released, saying only that "IHS is in the process of standardizing our procedures to ensure patients have access to the medicines they need."
• More than half of the IHS budget is administered by tribes through self-determination contracts or self-governance contracts, which means policies at clinics operated by tribes can be different from those at IHS-run sites. The agency

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