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A Review of the HHS Family Planning Program: Mission, Management, and Measurement of Results (2009)

Chapter: Appendix B: Population Research and Voluntary Family Planning Programs

« Previous: Appendix A: Data Sources and Methods
Suggested Citation:"Appendix B: Population Research and Voluntary Family Planning Programs." Institute of Medicine. 2009. A Review of the HHS Family Planning Program: Mission, Management, and Measurement of Results. Washington, DC: The National Academies Press. doi: 10.17226/12585.
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Page 191
Suggested Citation:"Appendix B: Population Research and Voluntary Family Planning Programs." Institute of Medicine. 2009. A Review of the HHS Family Planning Program: Mission, Management, and Measurement of Results. Washington, DC: The National Academies Press. doi: 10.17226/12585.
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Page 192
Suggested Citation:"Appendix B: Population Research and Voluntary Family Planning Programs." Institute of Medicine. 2009. A Review of the HHS Family Planning Program: Mission, Management, and Measurement of Results. Washington, DC: The National Academies Press. doi: 10.17226/12585.
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Page 193
Suggested Citation:"Appendix B: Population Research and Voluntary Family Planning Programs." Institute of Medicine. 2009. A Review of the HHS Family Planning Program: Mission, Management, and Measurement of Results. Washington, DC: The National Academies Press. doi: 10.17226/12585.
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Page 194
Suggested Citation:"Appendix B: Population Research and Voluntary Family Planning Programs." Institute of Medicine. 2009. A Review of the HHS Family Planning Program: Mission, Management, and Measurement of Results. Washington, DC: The National Academies Press. doi: 10.17226/12585.
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Page 195
Suggested Citation:"Appendix B: Population Research and Voluntary Family Planning Programs." Institute of Medicine. 2009. A Review of the HHS Family Planning Program: Mission, Management, and Measurement of Results. Washington, DC: The National Academies Press. doi: 10.17226/12585.
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Page 196

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Appendix B Population Research and Voluntary Family Planning Programs PROJECT GRANTS AND CONTRACTS FOR FAMILY PLANNING SERVICES SEC. 1001 [300] (a)The Secretary is authorized to make grants to and enter into con- tracts with public or nonprofit private entities to assist in the establishment and operation of voluntary family planning projects which shall offer a broad range of acceptable and effective family planning methods and ser- vices (including natural family planning methods, infertility services, and services for adolescents). To the extent practicable, entities which receive grants or contracts under this subsection shall encourage family participa- tion in projects assisted under this subsection. (b)In making grants and contracts under this section the Secretary shall take into account the number of patients to be served, the extent to which family planning services are needed locally, the relative need of the appli- cant, and its capacity to make rapid and effective use of such assistance. Local and regional entities shall be assured the right to apply for direct grants and contracts under this section, and the Secretary shall by regula- tion fully provide for and protect such right. (c)The Secretary, at the request of a recipient of a grant under subsec- tion (a), may reduce the amount of such grant by the fair market value of any supplies or equipment furnished the grant recipient by the Secretary.   o S in law. See section 931(b)(I) of P.L. 97-35 (95 Stat. 570). Probably should be “family.” 191

192 A REVIEW OF THE HHS FAMILY PLANNING PROGRAM The amount by which any such grant is so reduced shall be available for payment by the Secretary of the costs incurred in furnishing the supplies or equipment on which the reduction of such grant is based. Such amount shall be deemed as part of the grant and shall be deemed to have been paid to the grant recipient. (d)For the purpose of making grants and contracts under this section, there are authorized to be appropriated $30,000,000 for the fiscal year end- ing June 30, 1971; $60,000,000 for the fiscal year ending June 30, 1972; $111,500,000 for the fiscal year ending June 30, 1973, $111,500,000 each for the fiscal years ending June 30, 1974, and June 30, 1975; $115,000,000 for fiscal year 1976; $115,000,000 for the fiscal year ending September 30, 1977; $136,400,000 for the fiscal year ending September 30, 1978; $200,000,000 for the fiscal year ending September 30, 1979; $230,000,000 for the fiscal year ending September 30, 1980; $264,500,000 for the fiscal year ending September 30, 1981; $126,510,000 for the fiscal year ending September 30, 1982; $139,200,000 for the fiscal year ending September 30, 1983; $150,030,000 for the fiscal year ending September 30, 1984; and $158,400,000 for the fiscal year ending September 30, 1985. FORMULA GRANTS TO STATES FOR FAMILY PLANNING SERVICES SEC. 1002 [300a] (a)The Secretary is authorized to make grants, from allotments made under subsection (b), to State health authorities to assist in planning, estab- lishing, maintaining, coordinating, and evaluating family planning services. No grant may be made to a State health authority under this section unless such authority has submitted, and had approved by the Secretary, a State plan for a coordinated and comprehensive program of family planning services. (b)The sums appropriated to carry out the provisions of this section shall be allotted to the States by the Secretary on the basis of the population and the financial need of the respective States. (c)For the purposes of this section, the term “State” includes the Com- monwealth of Puerto Rico, the Northern Mariana Islands, Guam, American Samoa, the Virgin Islands, the District of Columbia, and the Trust Territory of the Pacific Islands. (d)For the purpose of making grants under this section, there are authorized to be appropriated $10,000,000 for the fiscal year ending June 30, 1971; $15,000,000 for the fiscal year ending June 30, 1972; and $20,000,000 for the fiscal year ending June 30, 1973.

APPENDIX B 193 TRAINING GRANTS AND CONTRACTS; AUTHORIZATION OF APPROPRIATIONS SEC. 1003 [300a-1] (a) The Secretary is authorized to make grants to public or nonprofit private entities and to enter into contracts with public or private entities and individuals to provide the training for personnel to carry out family planning service programs described in section 1001 or 1002 of this title. (b) For the purpose of making payments pursuant to grants and con- tracts under this section, there are authorized to be appropriated $2,000,000 for the fiscal year ending June 30, 1971; $3,000,000 for the fiscal year end- ing June 30, 1972; $4,000,000 for the fiscal year ending June 30, 1973; $3,000,000 each for the fiscal years ending June 30, 1974 and June 30, 1975; $4,000,000 for fiscal year ending 1976; $5,000,000 for the fiscal year ending September 30, 1977; $3,000,000 for the fiscal year ending Septem- ber 30, 1978; $3,100,000 for the fiscal year ending September 30, 1979; $3,600,000 for the fiscal year ending September 30, 1980; $4,100,000 for the fiscal year ending September 30, 1981; $2,920,000 for the fiscal year ending September 30, 1982; $3,200,000 for the fiscal year ending Septem- ber 30, 1983; $3,500,000 for the fiscal year ending September 30, 1984; and $3,500,000 for the fiscal year ending September 30, 1985. RESEARCH SEC. 1004 [300a-2] The Secretary may - (1) conduct, and (2) make grants to public or nonprofit private entities and enter into contracts with public or private entities and individuals for projects for, research in the biomedical, contraceptive development, behavioral, and program implementation fields related to family planning and population. INFORMATIONAL AND EDUCATIONAL MATERIALS SEC. 1005 [300a-3] (a) The Secretary is authorized to make grants to public or nonprofit private entities and to enter into contracts with public or private entities and individuals to assist in developing and making available family plan- ning and population growth information (including educational materials) to all persons desiring such information (or materials). (b) For the purpose of making payments pursuant to grants and con- tracts under this section, there are authorized to be appropriated $750,000 for the fiscal year ending June 30, 1971; $1,000,000 for the fiscal year

194 A REVIEW OF THE HHS FAMILY PLANNING PROGRAM ending June 30, 1972; $1,250,000 for the fiscal year ending June 30, 1973; $909,000 each for the fiscal years ending June 30, 1974, and June 30, 1975; $2,000,000 for fiscal year 1976; $2,500,000 for the fiscal year ending Sep- tember 30, 1977; $600,000 for the fiscal year ending September 30, 1978; $700,000 for the fiscal year ending September 30, 1979; $805,000 for the fiscal year ending September 30, 1980; $926,000 for the fiscal year ending September 30, 1981; $570,000 for the fiscal year ending September 30, 1982; $600,000 for the fiscal year ending September 30, 1983; $670,000 for the fiscal year ending September 30, 1984; and $700,000 for the fiscal year ending September 30, 1985. REGULATIONS AND PAYMENTS SEC. 1006 [300a-4] (a)Grants and contracts made under this subchapter shall be made in accordance with such regulations as the Secretary may promulgate. The amount of any grant under any section of this title shall be determined by the Secretary; except that no grant under any such section for any program or project for a fiscal year beginning after June 30, 1975, may be made for less than 90 per centum of its costs (as determined under regulations of the Secretary) unless the grant is to be made for a program or project for which a grant was made (under the same section) for the fiscal year ending June 30, 1975, for less than 90 per centum of its costs (as so determined), in which case a grant under such section for that program or project for a fiscal year beginning after that date may be made for a percentage which shall not be less than the percentage of its costs for which the fiscal year 1975 grant was made. (b)Grants under this title shall be payable in such installments and subject to such conditions as the Secretary may determine to be appropri- ate to assure that such grants will be effectively utilized for the purposes for which made. (c)A grant may be made or contract entered into under section 1001 or 1002 for a family planning service project or program only upon assurances satisfactory to the Secretary that— (1) priority will be given in such project or program to the furnishing of such services to persons from low-income families; and (2) no charge will be made in such project or program for services provided to any person from a low-income family except to the extent that payment will be made by a third party (including a government agency) which is authorized or is under legal obligation to pay such charge. For purposes of this subsection, the term ‘’low-income family’’ shall be defined by the Secretary in accordance with such criteria as he may prescribe so as

APPENDIX B 195 to insure that economic status shall not be a deterrent to participation in the programs assisted under this title. (d)(1) A grant may be made or a contract entered into under section 1001 or 1005 only upon assurances satisfactory to the Secretary that infor- mational or educational materials developed or made available under the grant or contract will be suitable for the purposes of this title and for the population or community to which they are to be made available, taking into account the educational and cultural background of the individuals to whom such materials are addressed and the standards of such population or community with respect to such materials. (2) In the case of any grant or contract under section 1001, such assur- ances shall provide for the review and approval of the suitability of such materials, prior to their distribution, by an advisory committee established by the grantee or contractor in accordance with the Secretary’s regula- tions. Such a committee shall include individuals broadly representative of the population or community to which the materials are to be made available. VOLUNTARY PARTICIPATION SEC. 1007 [300a-5] The acceptance by any individual of family planning services or family planning or population growth information (including educational ­materials) provided through financial assistance under this title (whether by grant or contract) shall be voluntary and shall not be a prerequisite to eligibility for or receipt of any other service or assistance from, or to participation in, any other program of the entity or individual that provided such service or information. PROHIBITION OF ABORTION SEC. 1008 [300a-6] None of the funds appropriated under this title shall be used in pro- grams where abortion is a method of family planning.   ection S 1009 was repealed by section 601(a)(1)(G) of P.L. 105-362 (112 Stat. 3285).

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A Review of the HHS Family Planning Program provides a broad evaluation of the Title X family planning program since its establishment in 1970. The program successfully provides family planning services to its target audience of low-income individuals, but there is room for improvement. While the program's core goals are apparent, a secondary set of changing priorities has emerged without a clear, evidence-based strategic process. Also, funding for the program has increased in actual dollars, but has not kept pace with inflation or increased costs. Several aspects of the program's structure could be improved to increase the ability of Title X to meet the needs of its target population. At the same time, the extent to which the program meets those needs cannot be assessed without a greater capacity for long-term data collection.

A Review of the HHS Family Planning Program 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, cervical cancer, and infertility. The book will guide the Office of Family Planning toward improving the effectiveness of the program. Other parties who will find the research and recommendations valuable include programs receiving Title X funding from the Office of Family Planning, policy makers, researchers, and professional organizations.

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