Proposed Changes to Title X: Implications for Women and Family Planning Providers

Appendix 1: Federal Rules for Title X Projects on Abortion Services and Activities
(only in effect for one month due to litigation and subsequent change of Administration)
1993-Present 2018 Proposed Regulations
Counseling Prohibited. Nondirective counseling required for pregnant women addressing:

prenatal care & delivery,

infant care, foster care, adoption,

pregnancy termination.

The language of the proposed regulation: “A Title X project may not provide, promote, refer for, support, or present abortion as a method of family planning.”

The non-binding preamble to the proposed regulation states: “A doctor, though not required to do so, would be permitted to provide nondirective counseling on abortion.”

Referral Prohibited. Must offer referral for abortion if asked but cannot:

  • promote abortion;
  • schedule an appointment;
  • negotiate a rate; or
  • arrange transportation.
Prohibited, unless a woman has already decided to have an abortion, and requests a referral. A medical doctor may provide a list of comprehensive health service providers, some but not all of which also provide abortion.
Requirements For How Abortion Activities Supported By Non-Title X Funds Must Be Handled
Financial Separate accounting records. Separate accounting records. Separate accounting records, electronic and paper health records.
Facility Separate treatment, consultation, waiting rooms. Shared waiting room permissible as long as costs are properly pro-rated. Separate treatment, consultation, examination, and waiting rooms, office entrances and exits, workstations, signs, phone numbers, email addresses, educational services, and websites.
Staff Separate staff. Shared staff permissible as long as all abortion related activities are financed separately from the Title X project. Separate staff.
Prohibition on activities that encourage, promote, or advocate for abortion Lobbying, providing speakers or educators who promote abortion, paying dues to an abortion advocacy group, legal action to make abortion available, developing or disseminating materials advocating for abortion. No prohibition on these activities. Lobbying, providing speakers or educators, attending events or conferences during which the grantee or subrecipient engages in lobbying, paying dues to an abortion advocacy group, legal action, developing or disseminating materials.
SOURCE: Kaiser Family Foundation analysis of federal regulations.
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