1. 2009 Office of Population Affairs Natural Family Planning Research Grantee Meeting January 14-15, 2009 Washington, DC Susan Moskosky, MS, RNC Director, Office of Family Planning Office of Population Affairs/DHHS December 2008 Title X – An Overview of the National Program

2. What we hope you (and we!) learn at this meeting  A little about Title X and the Office of Population Affairs  A little about the history of NFP globally as well as NFP role in Title X  A lot about each other’s projects  A lot about what is expected of you as grantees  A lot about what you can expect from OPA/your project officer

3. Department of Health & Human Services * Office of Minority Health* Office of HIV/AIDS Policy * Office of Population Affairs* Office of Research Integrity * Office of Women’s Health* National Vaccine Program * Office of Regional Health Administrators * President’s Council on Physical Fitness * Office of the Surgeon General * Office of Military Liaison and Veterans Affairs * Office of Disease Prevention and Health Promotion Secretary – Mike Leavitt Assistant Secretary for Health - Dr. Joxel Garcia, MD, MBA Office of Public Health and Science (OPHS) Programs

5. Organizational Structure Office of Population Affairs (OPA) Deputy Asst. Secretary for Population Affairs Vacant Evelyn Kappeler, Acting Director, OPA Office of Family Planning Susan Moskosky, MS, RNC Director 10 Regional Program Offices Office of Research & Eval. Office of Adolescent Pregnancy Programs Alicia Richmond-Scott Acting Director

6. Office of Population Affairs Vacant Deputy Assistant Secretary for Population Affairs Evelyn Kappeler Acting Director, OPA Vacant Deputy Assistant Secretary for Population Affairs Evelyn Kappeler Acting Director, OPA Office of Family Planning Susan Moskosky, M.S., R.N.C. Director Office of Family Planning Susan Moskosky, M.S., R.N.C. Director Immediate Office Evelyn Kappeler, Acting Director, OPA Senior Policy Analyst Susan Dunnell Vacant Management Analyst Medical Officer Vacant Shanaè OakmanVacant Policy Analyst Staff Assistant Public Affairs Specialist Immediate Office Evelyn Kappeler, Acting Director, OPA Senior Policy Analyst Susan Dunnell Vacant Management Analyst Medical Officer Vacant Shanaè OakmanVacant Policy Analyst Staff Assistant Public Affairs Specialist Charon Flowers Vacant Health Education Staff Assistant Specialist Jule HallerdinDavid Johnson Nurse ConsultantPublic Health Advisor VacantElizabeth Phillips Public Health AdvisorProgram Analyst VacantBetty Churn-Hughes Public Health AnalystClinical Nurse Consultant Charon Flowers Vacant Health Education Staff Assistant Specialist Jule HallerdinDavid Johnson Nurse ConsultantPublic Health Advisor VacantElizabeth Phillips Public Health AdvisorProgram Analyst VacantBetty Churn-Hughes Public Health AnalystClinical Nurse Consultant VacantJacqueline Crump- McCain Staff Assistant Program Analyst JoAnne Jensen Allison Roper Medical EducationProgram Analyst Specialist Alicia Richmond-Scott Stephanie Alexander Acting Director, Program Analyst Program Analyst Lizzette Del Canto Program Analyst VacantJacqueline Crump- McCain Staff Assistant Program Analyst JoAnne Jensen Allison Roper Medical EducationProgram Analyst Specialist Alicia Richmond-Scott Stephanie Alexander Acting Director, Program Analyst Program Analyst Lizzette Del Canto Program Analyst Office of Adolescent Pregnancy Programs Alicia Richmond-Scott Acting Director Office of Adolescent Pregnancy Programs Alicia Richmond-Scott Acting Director Office of Research & Evaluation Amy Bianchi Public Health Analyst Eugenia Eckard Statistician Melanie Brown Public Health Analyst Amy Bianchi Public Health Analyst Eugenia Eckard Statistician Melanie Brown Public Health Analyst

7. Public Health Service Regions

8. Title X of the Public Health Service Act  Created in 1970  Amended the Public Health Service Act to provide for special project grants for the provision of family planning services, and related research, training, and technical assistance - cited as “Family Planning Amendments of 1970”  Mission is to provide individuals with the educational, comprehensive medical, and social services necessary to exercise personal choice in determining the number and spacing of their children

9. Structure of Title X Five Major Provisions of the Law  1001 – Title X Services - Heart of Title X -88 Grantees, more than 4,500 clinics in the system  1003 – Title X Training 10 Regional Training Centers - One in each Region 3 National Training Centers – Male, Clinical, National  1004 – Title X Research -Evaluation Activities, Service Delivery Improvement Grants, Research Cooperative Agreements, Male Research Cooperative Agreements, NFP Research  1005 – Title X Information and Education -Title X Clearinghouse, publications, directory  1008 – Prohibition of Abortion

10. Title X  Section 1001 of Title X of the Public Health Service Act -Authorizes grants “to assist in the establishment and operation of voluntary family planning projects which shall offer a broad range of acceptable and effective methods and services (including natural family planning methods, infertility services, and services for adolescents).”

11. Title X  Section 1004 -Authorizes support for “research in the biomedical, contraceptive development, behavioral and program implementation fields related to family planning and population.”

12. Title X Program Priorities 2009  Assuring the delivery of quality family planning and related preventive health services, where evidence exists that those services should lead to improvement in the overall health of individuals, with priority for services to individuals from low-income families  Assuring access to a broad range of acceptable and effective family planning methods and related preventive health services that include natural family planning methods, infertility services, and services for adolescents, including adolescent abstinence counseling

13. Title X Program Priorities 2009  Providing preventive health care services in accordance with nationally recognized standards of care  Assuring compliance with State laws requiring notification or the reporting of child abuse, child molestation, sexual abuse, rape, or incest

14. Title X Program Priorities 2009  Encouraging participation of families, parents, and/or legal guardians in the decision of minors to seek family planning services; and providing counseling to minors on how to resist attempts to coerce minors into engaging in sexual activities

15. Title X Program Priorities 2009  Addressing the comprehensive family planning and other health needs of individuals, families, and communities through outreach to hard-to-reach and/or vulnerable populations, and partnering with other community-based health and social service providers

16. Funding  FY2009 - $299,981,000 -Currently on a Continuation Resolution for FY 09 (Mar-09)  90% supports clinical family planning service projects  10% supports: -Training grants and other activities -Research grants and other activities -Information and Education contract and other activities -Administrative responsibilities (rent, salaries, etc.)

17. Title X Service Grants Grantee Profile Title X Service Grantee Network:  88 Service Grantees, including State, territorial, tribal, county or local health agencies, universities, faith-based and community-based nor for profit agencies  4,542 Family Planning Clinics, at least one in 75% of all US counties  4,987,238 Clients Served 2007 with family planning and related preventive health care services

18. Client Characteristics 2007*  4,987,238 total clients  56% 24 yrs. or younger  25% 19 yrs. or younger  50% Racial and/or Ethnic minority  26% Hispanic/Latino  69% < 100% FPL  91% <200% FPL * 2007 Family Planning Annual Report

19. Title X Service Grants Requirements Title X funded Family Planning Services must be :  Voluntary  Confidential  Provided to any person, male and female, desiring services, with priority for persons from low-income families  Provided regardless of the inability to pay  Provided under the direction of a physician with training or experience in family planning

20. Section 1001 – Family Planning Services Scope of Required Services :  Broad range of acceptable and effective FP methods, including natural family planning  Education and counseling related to FP  Physical exam and related preventive health services  Pregnancy diagnosis and counseling  Adolescent services  Clinical procedures as indicated for method  Laboratory tests as indicated for method  Level I infertility services  STD and HIV prevention education; counseling and testing either on-site or by referral

21. Related Preventive Health Services May be offered  Gynecologic Services  STD Screening and Treatment  HIV Testing, Counseling and Referral  Special counseling  Other services as specified in “Program Guidelines”  Key Point- scope of Title X project as indicated/defined in the approved grant application

22. Why Are We Here?????  As reflected on FPAR, the utilization of NFP methods remains low among Title X family planning users (8,784 users in 2007)  Need for more complete understanding of factors that impact decisions of individuals and couples to use NFP successfully  Need for more information regarding strategies that might lead to increased utilization of NFP methods

23. Purpose of Grant  “To expand the body of knowledge on users of NFP through a greater understanding of the determinants of the use of NFP or Fertility Awareness Methods (FAM) and the predictors of success among users of NFP and FAM, as well as to identify and/or evaluate strategies and approaches that will lead to increased or improved utilization of these methods”

24. Natural Family Planning Research Grants 3-Year Project Period Non-competing continuation grant applications required each year of the project period 7 Grantees – diverse locations, backgrounds, and approaches Washington, DC Philadelphia, PA Salt Lake City, UT Milwaukee, WI Seattle, WA Kansas City, MO

25. What You Can Expect from OPA  Timely response to your questions  Technical assistance as needed  Feedback on your project  Ongoing support

26.  We value the contribution that your projects will make to advancing our understanding of NFP, including: -Determinants of NFP usage as well as predictors of success using NFP -Identifying and/or evaluating strategies and approaches that are effective at increasing or enhancing the use of NFP among family planning clients

27. Thank You!! Questions???