Comparison of 2000 and 2019 Title X Regulations

2019 Title X Regulation1 2000 Title X Regulation
Referral for abortion as a method of family planning is prohibited; however referral for abortion is permitted for medical emergencies, or in the case of rape or incest. Referral for abortion required upon request from client.
Non-directive counseling on abortion is permitted, but not required. Non-directive counseling about abortion required upon request from client.
Requires non-directive counseling to be provided by physician or advanced practice provider. Not addressed.
Requires referral for medically necessary prenatal care to promote optimal health. Not addressed.
Grantees and subrecipients are required to provide annual training, documentation of that training, and written protocols for their project staff about state requirements for notification and reporting of child abuse, child molestation, sexual abuse, rape, incest, intimate partner violence and human trafficking. Requires education/counseling for minors on how to resist sexual coercion with documentation that it was provided. Not addressed.
Requires encouragement of family participation in family planning decisions, especially of minors, as well as documentation that it was done or reasons why it was not done. Not addressed.
“Family planning” definition includes requirement that contraception must be part of the broad range of acceptable and effective family planning methods and services available within a Title X project. “Family planning” not defined; contraception not mentioned as part of the broad range of family planning methods and services.
Increased grantee responsibility to report on sub-recipient activities and to ensure their compliance with Title X requirements. Not addressed.
Definition of “low income family” entitled to free or low cost services includes unemancipated minors desiring confidential services, so long as grantees document how they encourage minors to involve their parents (absent abuse). “Low income family” may also include women whose employer-sponsored health insurance does not provide contraceptive coverage because of the employer’s religious or moral objection. Maintained existing definition of “low income family” as including unemancipated minors desiring confidential services; no regulatory requirements to encourage family participation.
Removed limitations regarding grantee selection of subrecipients. Restricted freedom of grantees to select subrecipients of their choosing (adopted in December 2016).
Physical and financial separation of Title X and non-Title X activities. Some financial separation from abortion related services.
No physical separation.

1 This document is merely a summary, and grantees should consult the rule itself (Compliance with Statutory Program Integrity Requirements, 84 Fed. Reg. 7714 (Mar. 4, 2019)) for a full and accurate description of its contents and requirements. In the event of a conflict between this document and the rule, the requirements of the rule of course control.