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1 1 (October 5, 2018)

handle is hein.crs/govebib0001 and id is 1 raw text is: Congressional Research Service Informig the legislative debate since 1914 Title X Family Planning Program Updated October 5, 2018 Overview The Title X Family Planning Program (Title X) was enacted in 1970 as Title X of the Public Health Service Act. It provides grants to public and nonprofit agencies for family planning services, research, and training. Administered by the U.S. Department of Health and Human Services (HHS), it is the only domestic federal program devoted solely to family planning and related preventive health services. What Is the Federal Funding Level? FY2019 funding is $286.5 million, the same as the FY2018 level. FY2019 Appropriations: Clients Served (2017): Number of Title X Clinics (2017): $286.5 million 4.0 million 3,858 What Clinical Services Are Provided? Clinical services provided through Title X include contraceptive services and supplies; natural family planning methods; cervical and breast cancer screening; preconception health services; pregnancy testing and counseling; sterilization services, basic infertility services; testing and treatment for sexually transmitted diseases, including HIV testing and prevention; and other patient education and referrals. All services are confidential. Does Title X Fund Abortions? By law, Title X funds may not be used for abortions. Current guidance states that a grantee's abortion activities must be separate and distinct from its Title X project activities. What Do Clients Pay? Priority for services is given to persons with family income at or below 100% of the federal poverty guidelines, who may not be charged for care. Clients from families with income between 100% and 250% of the federal poverty guidelines are charged on a sliding scale based on their ability to pay. Clients from families with income higher than 250% of the federal poverty guidelines are charged fees designed to recover the reasonable cost of providing services. For unemancipated minors who request confidential services, eligibility for discounts is based on the minor's own income. Who Are Title X Clients? In 2017, Title X-funded clinics served 4 million clients, primarily low-income women and adolescents. Of those clients, 88% were female, 12% were male, 87% had incomes at or below 200% of the federal poverty guidelines, and 67% had incomes at or below the federal poverty guidelines. For 61% of clients, Title X clinics were their usual or only regular source of health care. In 2017, 42% of Title X clients were uninsured (compared with 63% in 2013). Figure 1 provides demographic data. Figure I. Title X Clients by Age and by Race 2017 Age 19 or younger 17% 20 through 29 47% 30 or older % Race white 54% Black/African 22% American Race not reported 16% Multiracial 4% Asian 4% American Indian/ Alaska Native 1 Native Hawaiian/ 1% Pacific Islander Source: Figure created by CRS; data from HHS, Title X Family Planning Annual Report: 2017 National Summary, pp. 9 and 13, https://www.hhs.gov/opa/sites/default/files/title-x-fpar-20 17-national- summary.pdf. Notes: 33% of clients (all races) identified as Latino/Hispanic. Due to rounding, percentages may not sum to 100%. The number of Title X clients served in 2017 was 12% lower than in 2013 and 23% lower than in 2010. According to the Title X Family Planning Annual Report, the decrease in demand could be explained in part by newly insured clients' ability to seek care from other providers, by increased use of long-acting reversible contraception, and by recent clinical guideline changes (e.g., Pap tests are now recommended every three years instead of annually). Other Family Planning Programs Do Other Federal Programs Fund Family Planning? Although Title X is the only federal domestic program primarily focused on family planning, other programs also finance family planning, among their other services. These programs include Medicaid, the Health Center Program under Section 330 of the Public Health Service Act, Maternal and Child Health Block Grants, Social Services Block Grants, and Temporary Assistance for Needy Families. In FY2015, Medicaid accounted for 75% of U.S. public family planning expenditures (including federal, https://crsreports.congress.gov

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