Opinion ID: 421802
Heading Depth: 2
Heading Rank: 1

Heading: The Statute and Regulations

Text: 2 In 1970 Congress enacted Title X of the Public Health Service Act to establish a nationwide program with the express purpose of making comprehensive family planning services readily available to all persons desiring such services. 3 Congress authorized the Department of Health, Education and Welfare (HEW) to make grants and enter into contracts with public or nonprofit entities to assist in the establishment of family planning projects that offer a broad range of family planning methods, including the provision of prescription and nonprescription contraceptive drugs and devices. See 42 U.S.C. § 300(a) (as amended). The Title X program was originally funded for three years, but has since been reauthorized and refunded continuously. 4 3 In light of the breadth of the statutory language and clear congressional intent that all persons receive such services, 5 Title X grantees have served the teenage population from the inception of the program. Following enactment of Title X, however, Congress frequently expressed its increasing concern about the still unmet family planning needs of sexually active teenagers in this country. See, e.g., H.R.Rep. No. 1161, 93d Cong., 2d Sess. 14 (1974) (certain population groups requiring these services are not being reached    includ[ing] teenagers); S.Rep. No. 29, 94th Cong., 1st Sess. 55 (1975). Ultimately, Congress in 1978 amended the statute itself to require that Title X projects offer a broad range of acceptable and effective family planning methods and services (including    services for adolescents ). See 42 U.S.C. § 300(a) (emphasis added). While this amendment simply codified accepted past practice, the added language clearly reflected Congress' intent to place a special emphasis on preventing unwanted pregnancies among sexually active adolescents. S.Rep. No. 822, 95th Cong., 2d Sess. 24 (1978). 6 4 In 1981 Congress again amended Title X, this time to require by statute that grantees encourage family participation in their Title X programs. With this additional language, Section 300(a) of the Act now reads: 5 The Secretary is authorized to make grants to and enter into contracts with public or nonprofit private entities to assist in the establishment and operation of voluntary family planning projects which shall offer a broad range of acceptable and effective family planning methods and services (including natural family planning methods, infertility services, and services for adolescents). To the extent practical, entities which receive grants or contracts under this subsection shall encourage family participation in projects assisted under this subsection. 6 42 U.S.C. § 300(a) (amendment emphasized). 7 On February 22, 1982 the Secretary published for public comment modifications of certain regulations governing Title X grants. Proposed as a means of implementing Congress' 1981 amendment to Title X, 7 the new regulations seek to mandate the encouragement of family participation in three basic ways. First, and most significantly, they require Title X grantees to notify a parent or guardian within 10 working days of initially prescribing contraceptives to an unemancipated minor. 8 Without verification that such notice was received, no further prescriptions may be provided to the minor. 9 8 Second, the regulations require Title X recipients to comply with any state law that mandates notification or consent of parent or guardian upon provision of family planning services to a minor. 10 Finally, the new regulations redefine the statutory phrase low-income family so as to require Title X grantees to consider the economic eligibility of minors on the basis of their parents', rather than their own, financial resources. 11 9 As the Department itself acknowledged, public response to the proposed regulations was overwhelming. 12 Over 120,000 individuals and organizations contributed to the public comment. 13 Among those opposing the proposed regulations were 19 major medical associations, including the American Medical Association and the American Psychiatric Association, 40 states, and the District of Columbia. On January 26, 1983 HHS nevertheless promulgated the final regulations, virtually unchanged. 14 They were accompanied by a 15-page preamble that generally discussed the comments submitted and the reasons for the new rules. 15 The regulations were to take effect on February 25, 1983.