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/govechd0001 and id is 1 raw text is:
Cogesoa Reeac Service
S
Updated February 18, 2021
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). A
Title X grantee can undertake a Title X project that has
several participating entities. For example, a state-agency
grantee can have a Title X project that supports the state's
local organizations and clinics.
In the March 4, 2019, Federal Register, the Department of
Health and Human Services (HHS) published a final rule
for the program, https://go.usa.gov/xEdTp. Among other
things, it prohibits Title X projects from referring clients for
abortion as a method of family planning. It also requires
physical and financial separation between Title X projects
and certain abortion-related activities. For a redline
document showing how the rule changed prior regulations,
see https://go.usa.gov/xAFQA.
Status of the Final Rule
HHS required compliance with the final rule starting July
15, 2019, except for the physical separation requirements,
for which compliance was required by March 4, 2020. The
rule was challenged in several lawsuits across the country,
but took effect in all states except Maryland, where it was
enjoined. Future court rulings could affect the rule's further
implementation, see https://go.usa.gov/xVX4t.
On January 28, 2021, President Biden released a
memorandum stating that The Secretary of Health and
Human Services shall review the Title X Rule and any other
regulations governing the Title X program that impose
undue restrictions on the use of Federal funds or women's
access to complete medical information and shall consider,
as soon as practicable, whether to suspend, revise, or
rescind, or publish for notice and comment proposed rules
suspending, revising, or rescinding, those regulations,
consistent with applicable law, including the Administrative
Procedure Act, see https://go.usa.gov/xAJKC.
Overview of the 2019 Final Rule
This section summarizes selected regulatory changes made
by the final rule.
Family Planning Definition
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, an array 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).
Scope of Family Planning Services
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 preamble,
the rule allows participation by clinics that, for reasons of
conscience, limit the services they offer.
Physical and Financial Separation
By law, Title X funds may not be used in projects where
abortion is a method of family planning (42 U.S.C. 300a-6).
Prior guidance. 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, see https://go.usa.gov/xEdtA.
2019 rule. The rule requires Title X projects to be
physically and financially separate from prohibited
activities, including providing, referring, encouraging,
igross.gov](ViewImageLocal?handle=hein.crs/govechd0001&div=1&collection=&method=preview&ext=.png&size=3)