Title X

For nearly 50 years, the Title X (ten) family planning program has served as the nation’s only dedicated source of federal funding for family planning. The Title X program supports high-quality, culturally sensitive family planning services and other preventive health care for low-income, under-insured and uninsured individuals who may otherwise lack access to health care. These gains are at risk under the Trump administration new rules for Title X, which were finalized in March 2019.

As the lead national advocacy organization for the Title X family planning program, NFPRHA spearheads efforts to promote resources and support for the program on Capitol Hill, with federal agencies, and in national coalitions. NFPRHA works to bolster support for expanded funding opportunities for Title X and develops strategies to reinforce the importance of the publicly funded family planning network and its integral role as a part of the public health safety net. NFPRHA further works to preserve the integrity of the program as a supporter of a diverse network of high quality family planning providers. Click here for details of the Title X network in each state and click here for the latest information about the Title X program.

Resources

2021 Notice of Proposed Rulemaking (NPRM) Resources

- 2021 NPRM – “Ensuring Access to Equitable, Affordable, Client-Centered, Quality Family Planning Services” (PDF) (Federal Register, April 15, 2021)
- Title X Regulations – Comparison of 2021 Notice of Proposed Rulemaking and 2000 Title X Regulations (PDF) (April 2021).

2019 Title X Final Rule Resources
For details on NFPRHA's litigation to stop the Title X rule, please visit our legal action page.

Analysis of 2019 Final Rule on Title X Family Planning Program (March 2019).
Comparison of Current Title X Regulations and 2019 Final Rule – With Implementation Dates (PDF) (March 2019).
Advocacy Resources (February 2019).
Summary of the 2019 Draft Title X Family Planning Program Final Rule (PDF) (February 2019).

2018 Notice of Proposed Rulemaking (NPRM) Resources

A Comparison of Current Title X Regulations and 2018 NPRM (PDF) (May 2018).
Top Line Summary of 2018 NPRM (PDF) (July 2018).
Expanded Summary of 2018 NPRM (PDF) (July 2018).
Analysis of the 2018 NPRM (PDF) (July 2018).
NFPRHA's Comments on the NPRM (PDF) (July 2018).
Title X NPRM (PDF) (May 2018).
Fact sheet on the 1988 Domestic Gag Rule (PDF) (May 2018).

NFPRHA Fact Sheets

Title X 101 (PDF) Introduction to the Title X family planning program (October 2020).
FPAR 2019 Infographic (PDF) (October 2020).
Title X Overview Infographic (PDF) (February 2018).
Title X Funding Announcement Comparison Document (PDF) - A NFPRHA memo highlighting how the 2018 Title X funding opportunity announcement (FOA) diverges from the 2017 FOA, which was the last issued under the Obama administration (February 2018).
Title X Policy Brief - Helping Ensure Access to High Quality Care (PDF) Background on the health disparities facing the Title X network's most vulnerable patient populations (March 2015).
Title X in Context: Understanding the Diverse Revenue Sources that Support the Publicly Funded Family Planning Newtork - Background on the funding sources that Title X-supported health centers use to provide reproductive services to poor and low-income women and men (July 2016).

Happening Now

On September 18, the Office of Population Affairs (OPA) released the 2019 Family Planning Annual Report (PDF), the first to include any of the impact of the 2019 program rule. The report showed that the total number of patients seen in Title X-funded health centers shrank from 3.9 million patients in 2018 to 3.1 million in 2019, a 21% decrease overall. That same day, OPA also announced five new Title X grants and additional supplemental awards.

	NFPRHA's Position
	The National Family Planning & Reproductive Health Association (NFPRHA) believes that the Title X family planning program is a critical underpinning of the public health safety-net infrastructure that serves millions of low-income people. This federal program should be preserved and strengthened to ensure that the millions of women and men who rely on the varied network of providers participating in the Title X program can continue to access high-quality, culturally responsive family planning and sexual health services.

NFPRHA's Position

Title X

The National Family Planning & Reproductive Health Association (NFPRHA) believes that the Title X family planning program is a critical underpinning of the public health safety-net infrastructure that serves millions of low-income people. This federal program should be preserved and strengthened to ensure that the millions of women and men who rely on the varied network of providers participating in the Title X program can continue to access high-quality, culturally responsive family planning and sexual health services.

Primary Health Care Integration

Frequently Asked Questions (FAQ): Federal Reporting Guidance for FQHCs Providing Title X Family Planning Services (PDF) This resource supports complete and accurate reporting through FPAR and the Uniform Data System (UDS) by addressing frequent questions and concerns raised by FQHCs that provide Title X services. (March 2019).
Family Planning Annual Report (FPAR) - UDS Data Crosswalk (PDF) For every data element reported to FPAR (469 fields in total), this resource outlines reporting guidance, indicates where the specific data element aligns with data reported in the UDS (where applicable), and provides commentary on FPAR and UDS alignment. The current crosswalk is in draft form as NFPRHA seeks user feedback, most notably on how data elements in Table 14 (Revenue Report) align with UDS data elements in Tables 9D (Patient Related Revenue) and 9E (Other Revenues).

Disclaimer: These documents are intended for general guidance and informational purposes only. NFPRHA recommends that FQHCs that provide Title X services should communicate directly with their Title X grantee or the Office of Population Affairs (OPA), as appropriate, about specific questions related to FPAR reporting.

Other Resources

Family Planning Annual Report (PDF)- Annual data about Title X patients, providers, and services from the Office of Population Affairs (September 2020).
Use of Health Insurance Among Clients Seeking Contraceptive Services at Title X-Funded Facilities in 2016 (Guttmacher Institute) (September 2018).
Moving Forward: Family Planning in the Era of Health Reform (PDF) - Guttmacher Institute report examining the importance of the publicly funded family planning network in the new health care environment. (April 2014).
Trends in Uninsured Clients Visiting Health Centers Funded by the Title X Family Planning Program — Massachusetts, 2005–2012 (PDF) - CDC report indicating that after Massachusetts enacted health reform, Title X health centers continued to have high volumes of patients and remained providers of choice for many (January 2014).
The Title X Factor: Why the Health of America’s Women Depends on More Funding for Family Planning (PDF) – Roosevelt Institute report on Title X’s post-ACA importance to maintaining family planning infrastructure and meeting new patient demands (October 2013).
Contraceptive Needs and Services, 2014 Update (PDF) - Guttmacher Institute report providing state and national data on current status of contraceptive needs and services in the US and the impact these services have had on reducing unintended pregnancy and the cost savings to the public (September 2016).
Publicly Funded Contraceptive Services at U.S. Clinics, 2015 update (PDF) - Guttmacher Institute report providing state and national data on publicly funded health centers (April 2017).

For additional resources & information, access NFPRHA and federal comments by issue or read NFPRHA's publications and recent press statements.

Title X

Resources

Happening Now

Issues

National Family Planning & Reproductive Health Association