program meets those needs cannot be assessed without a greater capacity for long-term data collection. The committee recommends several specific steps to enhance the management and improve the quality of the program, as well as to demonstrate its direct contribution to important end results, such as reducing rates of unintended pregnancy and infertility.

The Title X Family Planning Program is the nation’s only federal program devoted exclusively to providing family planning services. Through grants to public and nonprofit private entities, Title X funds support the provision of comprehensive family planning and related health services. These services help women and men maintain reproductive health; avoid unintended pregnancies; and determine the number, timing, and spacing of their children—all of which contribute to the health and the social and economic well-being of women, men, children, and families. By law, priority is given to low-income individuals.

The program was created in 1970 and is authorized under the Public Health Service Act, which provides for family planning services, training, research, and information and education. At least 90 percent of the program’s funds must be used for family planning services. The budget for fiscal year 2008 was $300 million.

The program is administered by the Office of Family Planning (OFP) within the Office of Population Affairs (OPA) in the Department of Health and Human Services’ (HHS) Office of Public Health and Science. OFP develops Title X priorities, policies, and performance measures and oversees all family planning grants. It allocates funds to 10 Regional Offices, which make awards to grantees in states and territories through a competitive process. The Regional Offices monitor program operations through site visits, Comprehensive Program Reviews, and extensive data collection, and facilitate communication between OFP and grantees.


In 2005, the Title X program participated in the Program Assessment Rating Tool (PART) process, which was developed and is carried out by the Office of Management and Budget (OMB). One of OMB’s findings was that while several evaluations of the Title X program had been conducted, none of them had been broadly based, independent, and of sufficient quality and scope. To fill this gap and assess the overall impact of the program, OFP asked the Institute of Medicine to provide an independent evaluation of the Title X program. The specific charge to the committee is shown in Box S-1.

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