National Title X Grantee Meeting

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WELCOME

• National Title X Grantee Meeting
• Phoenix, AZ
• September 19, 2006
• Evelyn Kappeler, Acting Director
• Office of Population Affairs

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Title X of the Public Health Service Act The
Nations Principal Family Planning Program.

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Family Planning A Great Public Health
Achievement

• CDC characterized family planning as one of the
  Ten Great Public Health Achievements of the
  20th century because of its
• opportunity for prevention
• and
• impact on morbidity and mortality.

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Achievements in Public Health, 1900-1999 Family
Planning

• During the 20th century, the hallmark of family
  planning in the United States has been the
  ability to achieve desired birth spacing and
  family size.
• Fertility decreased as couples chose to have
  fewer children concurrently, child mortality
  declined, people moved from farms to cities, and
  the age at marriage increased.
• Smaller families and longer birth intervals have
  contributed to the better health of infants,
  children, and women, and have improved the social
  and economic role of women.
• Modern contraception and reproductive health-care
  systems that became available later in the
  century further improved couples' ability to plan
  their families.

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Title X Groundbreaking Legislation

• Became the cornerstone of a modern system of
  publicly funded family planning services in the
  U.S.
• Spurred a nation-wide network of clinics as a
  source of quality family planning services and
  education
• So that now, in 85 percent of U.S. counties, at
  least one provider of contraceptive services is
  funded by the Title X family planning program

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Title X Groundbreaking Legislation

• Marked the first time that family planning
  services and research were the primary purpose of
  any Federal law
• Provides authority for service delivery and
  activities that support clinics with client
  needs
• Information and Education on family planning
  (outreach)
• Training to carry out program purposes
• Research to assist in service delivery
  improvements (data collection)

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Title X Assisting Family Planning Providers
Training
Information and Education

• SERVICE PROVISION

Research
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Title X Unique Features and High Standards

• Title X program clinical guidelines set a high
  standard for uniformity and quality of care in
  family planning service delivery
• Diverse provider agencies create a nationwide
  network of accessible service sites that are
  responsive to local needs
• Buttressed by a unique training program for
  family planning clinic personnel
• Support for research focused on program
  development and improvement
• An emphasis on education and counseling
• Outreach and services for special populations
  (homeless, disabled, LEP, males)
• Strategies for serving diverse populations and
  community needs
• Annual program data collection and reporting

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Title X Since 1970

• In 1970, federal funding for family planning
  services was established under the Family
  Planning Services and Population Research Act,
  which created Title X of the Public Health
  Service Act
• Medicaid funding for family planning was
  authorized in 1972 (guaranteeing family planning
  coverage in State Medicaid plans)
• Services provided under Title X grew rapidly in
  the 1970s and 1980s
• After 1980, public funding for family planning
  continued to shift to the Medicaid program

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Title X and Medicaid

• Title X
• Clinic infrastructure
• Clinic personnel
• Training for clinic personnel
• Client education and counseling
• Direct service provision
• Medicaid
• Finances health care services for low-income
• Reimburses public and private providers

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• Title X Experience Remarkable Resiliency and
  Continued Commitment

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Title X A Public Health Program

• Major goals of public health
• Promotion of health
• Prevention of disease

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Title X A Public Health Program

• Title X shares some of the same dilemmas and
  challenges faced by the entire public health
  system
• Title X also faces unique challenges

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Title X Remarkable Resiliency and Continued
Commitment

• Achieving the Title X mission
• Addressing geographic and socio-economic
  inequities in health service delivery and access.
  
• Ensuring safe and effective family planning
  services are available to all individuals, with
  priority for low-income.

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Title X Remarkable Resiliency and Continued
Commitment

• And, responding to challenges and creating
  opportunities
• New technologies contraceptive methods
• STDs (HIV and Chlamydia)
• Related preventive health needs
• Increasing costs
• Misperceptions about the program
• Translating research into practice
• Health care financing
• Needs of different populations (males)

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Research

• Integral to the Title X program efforts
• Future Directions for Family Planning Research
  A Framework for Title X Service Delivery
  Improvement Research
• Translating research into practice

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Medicaid Waivers

• State Demonstration Waivers
• 23 states now have broadened eligibility for
  Medicaid covered family planning services
• Two general approaches
• Extending post partum coverage for women leaving
  Medicaid
• Extending coverage for women with incomes up to
  185 or 200 of the FPL

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Male Involvement

• General agreement on the need for improved
  strategies for reaching and serving men, as well
  improved data on men.
• For the first time, the cycle six of the NSFG
  (2002) included a national sample of men data
  now available
• OFP male research projects

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Title X

• Remarkable Resiliency
• Continued Commitment