HeinOnline is a subscription-based resource containing thousands of academic and legal journals from inception; complete coverage of government documents such as U.S. Statutes at Large, U.S. Code, Federal Register, Code of Federal Regulations, U.S. Reports, and much more. Documents are image-based, fully searchable PDFs with the authority of print combined with the accessibility of a user-friendly and powerful database. For more information, request a quote or trial for your organization below.
![handle is hein.crs/govcanp0001 and id is 1 raw text is:
FF. ' ,iE ,E .$r, i ,
mppm qq\
p\w -- , gn'a', go
I
as
11LULANJILiN,
Updated March 9, 2020
Title X Family Planning Program: 2019 Final Rule
The Title X Family Planning Program (Title X) is the only
domestic federal program devoted solely to family planning
and related preventive health services. The program
provides grants to public and nonprofit agencies to establish
and maintain family planning projects (Title X projects).
On March 4, 2019, the Department of Health and Human
Services (HHS) published a final rule on the program in the
Federal Register, at https://go.usa.gov/xEdTp. The final
rule changes, among other things, how Title X projects
provide family planning methods and services to clients. In
2018, the program served 3.9 million clients through 3,954
Title X clinics.
As of July 15, 2019, HHS has required compliance with the
final rule, except for the physical separation requirements,
for which compliance was required by March 4, 2020,
https://go.usa.gov/xVX4t. However, on February 14, 2020,
the United States District Court for the District of Maryland
enjoined the rule's implementation in Maryland. Future
court rulings could affect the rule's implementation in that
state and in others.
Some Title X providers who oppose the 2019 rule,
including Planned Parenthood-affiliated clinics, have
announced that they are no longer using Title X funds or
have withdrawn from the program because of the new
regulatory requirements. (The Kaiser Family Foundation is
tracking program participation at https://www.kff.org/
interactive/the-status-of-participation-in-the-title-x-federal-
family-planning-program.) Previously, Planned Parenthood
had served an estimated 40% of Title X clients. HHS
redistributed some of the relinquished funds among
remaining grantees, https://go.usa.gov/xVMPF.
0 v er vi - o at h e 2 0 0 F Fna I R, Ie
This section summarizes selected regulatory changes made
by the final rule.
Prior regulation. Prior regulations did not define family
planning.
2019 rule. The rule introduces a new definition of family
planning, referring to it as the voluntary process of
identifying goals and developing a plan for the number and
spacing of children and the means by which those goals
may be achieved. Family planning can include, among
other things, a range of acceptable and effective choices,
which may range from choosing not to have sex to the use
of other family planning methods and services to limit or
enhance the likelihood of conception (including
contraceptive methods and natural family planning or other
fertility awareness-based methods) and the management of
infertility (including adoption).
A Title X grantee can undertake a Title X project that has
several participating entities, organizations, or clinics. A
grantee that is a state agency, for example, can have a Title
X project that supports local entities, organizations, and
clinics throughout the state.
Prior regulation. Prior regulations required Title X
projects to[p]rovide a broad range of acceptable and
effective medically approved family planning methods
(including natural family planning methods) and services
(including infertility services and services for adolescents).
If a health care entity offers only a single method of family
planning, it may participate as part of a project as long as
the entire project offers a broad range of family planning
services.
2019 rule. The rule requires Title X projects to [p]rovide a
broad range of acceptable and effective family planning
methods (including contraceptives, natural family planning
or other fertility awareness-based methods) and services
(including infertility services, information about or referrals
for adoption, and services for adolescents). The rule does
not require family planning methods and services to be
medically approved. The rule does not require Title X
projects to provide every acceptable and effective family
planning method or service. The rule states that [a]
participating entity may offer only a single method or a
limited number of methods of family planning as long as
the entire project offers a broad range of such family
planning methods and services.According to the rule's
preamble, the rule allows participation by clinics that, for
reasons of conscience, limit the services they offer.
Mhy~ica an, d :n. iSepakrak:i'--,n
Prior guidance. By law, Title X funds may not be used in
projects where abortion is a method of family planning.
Prior program guidance interpreted the law as requiring that
a grantee's abortion activities be separate and distinct
from its Title X project activities. Under prior guidance, a
grantee's abortion activities and its Title X project activities
could share a common facility, a common waiting room,
common staff, and a common records system, so long as it
is possible to distinguish between the Title X supported
activities and non-Title X abortion-related activities, for
example, through allocating and prorating costs,
https://go.usa.gov/xEdtA.
2019 rule. The rule requires Title X projects to be
physically and financially separate from prohibited
K~:>](ViewImageLocal?handle=hein.crs/govcanp0001&div=1&collection=&method=preview&ext=.png&size=3)