Opinion ID: 421802
Heading Depth: 2
Heading Rank: 3

Heading: Title XX

Text: 55 Appellants seek support for their strained interpretation of the 1981 amendment to Title X in yet another, separate statute. Title XX of the Act, 42 U.S.C. § 300z et seq. (Supp. V 1981), was enacted as part of the same legislative package as the Title X amendment. It established a new grant program for demonstration projects to provide services and research related to adolescent sexuality and pregnancy. Title XX expressly requires family involvement by mandating parental notification and consent, 42 U.S.C. § 300z-5(a)(22)(A)(i), 50 as well as by determining eligibility for the program on the basis of family income, id. § 300z-3(c). Indeed, Congress' intent in Title XX is to make family involvement the centerpiece of this program designed explicitly to discourage adolescent sexual relations. See id. § 300z(a)(9). 51 56 Appellants contend that Congress' philosophical intent in Title XX can and should be used to inform any interpretation of Title X. More specifically, Title XX's explicit requirement of parental notification demonstrated that [Congress] believed parental notification to be important policy in and of itself. See brief for appellants at 22. On this view, if Congress approved of parental notification in one context, it should be presumed to intend its use in a related context as well. 57 This argument totally ignores the very different nature of the two programs. Title X is the largest of the Federal Government's family planning programs, designed to serve the family planning needs of all persons in need of such services. Title XX, by contrast, is a limited and experimental program; it provides for demonstration projects with a special emphasis on serving the needs of already pregnant adolescents and the prevention of adolescent sexual relations, see 42 U.S.C. § 300z-1(a)(7) & (8). While some traditional family planning services may be provided under limited circumstances, see id. § 300z-3(b)(1), the primary thrust of Title XX clearly lies elsewhere. 58 The distinct differences in the scope and purposes of the two programs necessarily dictate different approaches to striking an appropriate balance between the need for confidentiality and the goal of parental involvement. The Senate report accompanying Title XX clearly delineated these differences and their consequences: 59 It must be stressed, however, that this [Title XX] program is to be a demonstration project in which the Federal Government attempts to promote family-centered approaches to serious social problems. Unlike contraceptive services or venereal disease treatments, adolescent pregnancy cannot be an indefinitely confidential affair. Furthermore, it should be noted that this [Title XX] program is a Federal demonstration project and not a far-ranging Government entitlement program. These requirements [e.g., parental notification and consent] are an attempt to determine the effect that such parental involvement requirements might have on a small scale. 52 60 As an experimental demonstration project, then, Title XX provides a useful, but limited, context in which Congress may experiment and then evaluate the impact on teenagers of mandating family notification and involvement without irrevocably undermining its large-scale family planning program. Congress has, in fact, since indicated its intent to monitor the progress of the projects involved very carefully and to hold hearings to assess the implementation and impact of the parental involvement requirement under this experimental program. 53 61 It would therefore be both illogical and contrary to legislative intent to follow appellants' suggestion and import the strong family involvement component of Title XX into Title X. 54 In point of fact, one senator feared just such an inappropriate amalgamation of the two programs. To clarify the limited nature of Title XX's requirements, Senator Mark Hatfield, chairman of the Appropriations Committee, raised the issue during the debate over HHS's appropriations for 1982: 62 Mr. President, while we are in Labor-HHS matters, may I ask the Senator from New Mexico, the chairman of the Labor, Health and Human Services and Education Subcommittee, about language in the committee report concerning adolescent family life program? There has been some concern expressed that the report language could somehow be interpreted to apply the parental consent and notification provisions of the adloescent [sic ] family life program to other programs under the jurisdiction of the Department of Health and Human Services. Can the Senator tell me whether the language does apply to Health and Human Services programs other than adolescent family life? 63 Whereupon Senator Schmitt, chairman of the Subcommittee on Labor, Health and Human Services, and Education, responded, It does not. See 128 Cong.Rec. S10067 (daily ed. Aug. 10, 1982). 64 Notwithstanding this insurmountable evidence that Title XX's parental notification requirements were not intended to apply to Title X, appellants argue that the Secretary was properly guided by the philosophy of Title XX. They point to a review provision of Title XX as strong evidence of Congress' intent to apply the family-centered philosophy of Title XX outside the narrow confines of its specified programs. Section 300z-6(a)(3) calls on the Secretary to:review all programs administered by the Department of Health and Human Services which provide prevention services or care services to determine if the policies of such programs are consistent with the policies of this subchapter   . 65 42 U.S.C. § 300z-6(a)(3). This language, however, merely calls for review of existing federal family programs to identify any inconsistencies in policy. It does not authorize the Secretary, on her own, to remedy any such inconsistencies by regulation. In fact, the Senate report accompanying Title XX makes clear the limits of the Secretary's authority to act: 66 Remedial legislation or regulations to alter any Federal programs that the Secretary may identify as duplicative or inconsistent with the new Federal policy contained in this legislation should be formulated as quickly as possible. 67 S.Rep. No. 161, 97th Cong., 1st Sess. 16 (1981) (emphasis added). The use of the words remedial legislation clearly concedes that the Secretary may not be able to alter by regulation alone every program deemed inconsistent with Title XX. Given Congress' express intent to limit Title XX's parental notification and consent requirements to the confines of that experimental program, the Secretary has no authority deriving from this provision in Title XX to graft comparable parental notification requirements onto the structure of the completely separate Title X program. 55 68