2009 Office of Population Affairs Natural Family Planning Research Grantee Meeting January 14-15, 2009 Washington, DC Susan Moskosky, MS, RNC Director,

2009 Office of Population Affairs Natural Family Planning Research Grantee MeetingJanuary 14-15, 2009 Washington, DC

Susan Moskosky, MS, RNCDirector, Office of Family PlanningOffice of Population Affairs/DHHSDecember 2008

Title X – An Overview of the National Program

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

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

Organizational StructureOffice of Population Affairs

(OPA)Deputy Asst. Secretary for Population Affairs

VacantEvelyn Kappeler, Acting Director, OPA

Office of Family PlanningSusan Moskosky, MS, RNC

DirectorOffice of Research & Eval.

Office of Adolescent Pregnancy Programs

Alicia Richmond-ScottActing Director

10 Regional Program Offices

Office of Population AffairsOffice of Population Affairs

VacantDeputy Assistant Secretary for Population Affairs

Evelyn KappelerActing Director, OPA

VacantDeputy Assistant Secretary for Population Affairs

Evelyn KappelerActing Director, OPA

Office of Family PlanningSusan Moskosky, M.S., R.N.C.

Director

Office of Family PlanningSusan Moskosky, M.S., R.N.C.

Director

Immediate OfficeEvelyn Kappeler, Acting Director, OPA

Senior Policy Analyst

Susan Dunnell VacantManagement Analyst Medical Officer

Vacant Shanaè Oakman VacantPolicy Analyst Staff Assistant Public Affairs Specialist

Immediate OfficeEvelyn Kappeler, Acting Director, OPA

Senior Policy Analyst

Susan Dunnell VacantManagement Analyst Medical Officer

Vacant Shanaè Oakman VacantPolicy Analyst Staff Assistant Public Affairs Specialist

Charon FlowersVacant Health EducationStaff Assistant Specialist

Jule Hallerdin David JohnsonNurse Consultant Public Health Advisor

Vacant Elizabeth PhillipsPublic Health Advisor Program Analyst

Vacant Betty Churn-HughesPublic Health Analyst Clinical Nurse Consultant

Charon FlowersVacant Health EducationStaff Assistant Specialist

Jule Hallerdin David JohnsonNurse Consultant Public Health Advisor

Vacant Elizabeth PhillipsPublic Health Advisor Program Analyst

Vacant Betty Churn-HughesPublic Health Analyst Clinical Nurse Consultant

Vacant Jacqueline Crump- McCainStaff Assistant Program Analyst

JoAnne Jensen Allison Roper Medical Education Program Analyst Specialist

Alicia Richmond-Scott Stephanie Alexander Acting Director, Program AnalystProgram Analyst

Lizzette Del CantoProgram Analyst

Vacant Jacqueline Crump- McCainStaff Assistant Program Analyst

JoAnne Jensen Allison Roper Medical Education Program Analyst Specialist

Alicia Richmond-Scott Stephanie Alexander Acting Director, Program AnalystProgram Analyst

Lizzette Del CantoProgram Analyst

Office of Adolescent Pregnancy Programs

Alicia Richmond-ScottActing Director

Office of Adolescent Pregnancy Programs

Alicia Richmond-ScottActing Director

Office of Research & Evaluation

Office of Research & Evaluation

Amy BianchiPublic Health Analyst

Eugenia EckardStatistician

Melanie BrownPublic Health Analyst

Amy BianchiPublic Health Analyst

Eugenia EckardStatistician

Melanie BrownPublic Health Analyst

Public Health Service Regions

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

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

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).”

Title X

Section 1004

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

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

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

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

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

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.)

Title X Service GrantsGrantee 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

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

Title X Service GrantsRequirements

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

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

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

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

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”

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

What You Can Expect from OPA

Timely response to your questions

Technical assistance as needed

Feedback on your project

Ongoing support

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

Thank You!!Questions???