Family planning funding through four federal-state programs, FY 1997

Area of Science:

• Public Health
• Health Services Research
• Health Policy

Background:

• Maternal and Child Health (MCH) and social services block grants historically support family planning.
• The integration of family planning into newer state-controlled programs like Temporary Aid to Needy Families (TANF) and the State Children's Health Insurance Program (CHIP) remains under-examined.

Purpose of the Study:

• To identify the extent to which states incorporate family planning services into TANF and CHIP programs.
• To analyze public expenditures and activities related to family planning across various federal and state funding streams.

Main Methods:

• Survey of health and social services agencies in all U.S. states, D.C., and federal jurisdictions for FY 1997 expenditures and activities.
• Analysis of state CHIP plans post-federal approval.
• Methodology differences preclude comparison with prior expenditure studies.

Main Results:

• In FY 1997, $41 million was spent on family planning via the MCH block grant (42 states, D.C., 2 jurisdictions) and $27 million via the social services block grant (15 states).
• Most funding supported direct patient care, primarily contraceptive services and supplies. Indirect services were more common through MCH.
• TANF reported family planning activities in four states. Nearly all CHIP plans included family planning services for adolescents, often exceeding federal requirements.

Conclusions:

• Newer, state-controlled programs (TANF, CHIP) are emerging as crucial funding sources for family planning.
• Advocates should look beyond traditional federal funding (Title X, Medicaid) to state-level decisions for publicly funded family planning services.