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History of Title X

The Title X Family Planning program was enacted in 1970 as Title X of the Public Health Service Act (Public Law 91-572 Population Research and Voluntary Family Planning Programs). Title X is the only federal grant program dedicated solely to providing individuals with comprehensive family planning and related preventive health services.

Title X: The National Family Planning Program

Title X Clinical Services 2011

  • Clients served. Title X-funded centers served approximately five million clients. 92% were women and 8% were menii.
  • Contraceptive care. Title X family planning centers help to avert an estimated one million unintended pregnancies
  • Screening for sexually transmitted infections. More than 2.5 million clients (2,287,270 women and 245,326 men) were tested for chlamydia; 2.7 million for gonorrhea (2,470,645 women and 258,933 men). Nearly 750,000 clients were tested for syphilis (608,224 women and 135,557 men)ii.
  • HIV testing. Approximately 1.3 million HIV tests were provided to female and male clientsii.
  • Cervical cancer screening. More than 1.5 million screenings were performed in Title X service sites. About 15% of these tests had a result indicating a precancerous or cancerous condition needing further evaluation or possible treatment, including 1% that indicated the presence of a more serious conditionii.
  • Underserved communities. 91% of clients had incomes at or below 250% of the federal poverty leveliii.
  • People of all races and ethnicities. 57% of clients self-identified as white, 20% as black, 3% as Asian, 1% each as Native Hawaiian/Pacific Islander or American Indian/Alaska Native and 5% as multiracial. 29% of all races self-identified as Hispanicii.
  • Age. The majority of clients were in their 20s (51%). 28% were age 30 or over and 21% were 19 and underii.

For more than 40 years, Title X family planning centers have provided high quality and cost-effective family planning and related preventive health services for low-income women and men. Family planning centers play a critical role in ensuring access to voluntary family planning information and services for their clients based on their ability to pay.

Family planning centers offer a broad range of FDA-approved contraceptive methods and related counseling; as well as breast and cervical cancer screening; pregnancy testing and counseling; screening and treatment for sexually transmitted infections (STIs); HIV testing; and other patient education and referralsi.

Title X Providers

The U.S. Department of Health and Human Services’ Office of Population Affairs (OPA) oversees the Title X program. OPA funds a network of 4,400 family planning centers which serve about five million clients a yearii. Services are provided through state, county, and local health departments; community health centers; Planned Parenthood centers; and hospital-based, school-based, faith-based, other private nonprofits.

Title X staff are specially trained to meet the contraceptive needs of individuals with limited English proficiency, teenagers, and those confronting complex medical and personal issues such as substance abuse, disability, homelessness or interpersonal and domestic violence.

Title X Mission

Title X assists individuals and couples in planning and spacing births, contributing to positive birth outcomes and improved health for women and infants.

In addition to clinical services, Title X also funds the following program supports aimed at improving the quality of family planning services:

  • Training for family planning clinic personnel through five national training programs that focus on clinical training; service delivery; management and systems improvement; coordination and strategic initiatives; and quality assurance/improvement and evaluation
  • Family planning research and evaluation to improve Title X service delivery and inform the broader reproductive health care field
  • Information dissemination and community-based education and outreach

Cost Effectiveness of Family Planning

Title X provides significant cost savings to taxpayers. In 2008, every every public dollar spent on contraceptive services yielded an estimated $3.74 in savings that would have been spent on Medicaid costs related to pregnancy care and delivery and to infants in their first year of lifeiv.

Significantly, this figure does not include savings realized from the prevention and treatment of STIs and avoiding and detecting reproductive cancers. These calculations also do not measure the broader health, social or economic benefits of enabling women to time or prepare for their pregnanciesiv.

Program Policy

OPA sets the standards for publicly funded family planning services in the U.S. The Title X statute, regulations and guidance offer patient protections by requiring that programs are voluntary, confidential and include a broad range of contraceptive methods. Program guidelines establish standards for the delivery of services based on the most current evidence.

Sources

i By statute, Title X funds are not used to pay for abortions.

ii Fowler, CI, Lloyd, S, Gale, J, Wang, J and McClure, E. (November 2012). Family Planning Annual Report: 2011 National Summary. Research Triangle Park, NC: RTI International.

iii In 2011, the Federal Poverty Level was $18,350 for a family of three. 250% of the Federal Poverty level would be 2 ½ times that amount or $45,875 for a family of three.

iv Frost, J, Henshaw, SK, Sonfield, A, “Contraceptive Needs and Services: National and State Data, 2008 Update,” Guttmacher Institute, May 2010. A 2012 study by Adam Thomas of the Brookings Institute, “Policy Solutions for Preventing Unplanned Pregnancy,” found that every dollar spent on Medicaid family planning services saved $5.60 in publicly subsidized medical care for pregnant women and a variety of means-tested benefits.



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