71: Title X Grants Explained

Clare Coleman, President and CEO of the National Family Planning and Reproductive Health Association, explains how to apply for a new round of Title X grants now available from HHS; Dr. Steven Stack, Commissioner of the Kentucky Department for Public...

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Clare Coleman, President and CEO of the National Family Planning and Reproductive Health Association, explains how to apply for a new round of Title X grants now available from HHS; Dr. Steven Stack, Commissioner of the Kentucky Department for Public Health, says states and territories could not have done their work without emergency COVID-19 funds, but he hopes for a different funding approach going froward; and Mylynn Tufte, former state health officer from North Dakota, delivers today’s “thankful” note.

Website: National Family Planning and Reproductive Health Association

The Hill webpage: The US has reached a critical moment for birth control access

ASTHO webpage: Public Health Review podcast

APHA webpage: Public Health Thank You Day

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This is Public Health Review Morning Edition for Friday, November 19th, 2021. I'm Robert Johnson.

Here's today's news from the Association of State and Territorial Health Officials.


The next few weeks will be hectic for public health agencies looking to apply for a new round of Title X grants now available from the federal government. About $265 million is up for grabs. The money will help pay for family planning, screening, and preconception services.

Clare Coleman, president and CEO of the National Family Planning and Reproductive Health Association, explains the process in today's morning conversation.

HHS is accepting applications for Title X grants. What services do these grants cover and how does the process work?


Title X family planning grants cover contraceptive services for clients who want to achieve pregnancy or space their births.

It covers pregnancy testing and counseling, assistance to help achieve pregnancy, basic infertility screening. It also covers STD screening and services, including testing for HIV, and other what we call preconception health services—so, for example, screening for obesity, smoking, and mental health.

These are considered family planning services because they improve health and can influence a person's ability to conceive or to have a healthy outcome with a pregnancy.


By joining us on this newscast, you have the attention of ASTHO members across the states and territories. What do you want them to know about this upcoming 2022 round of grants?


This round of grants is a nationwide competition—which, until relatively recently, was very unusual for Title X grants. So, the entire country will be competing for about $265 million in Title X service grant funding.

There is no state or territorial allocation chart— which, again, is a difference from in the past—so any state, tribal authority, municipal government, city government can apply, as well as any private not-for-profit. And they can apply for any amount they can justify between $200,000 a year and $22 million—that's the top award.

It's a very robust application process, and we encourage all applicants to read that funding opportunity very, very closely and answer it to the letter. So, this application is due January 11th. Awards are scheduled to go into effect on April 1st and the practice of the federal government has been to make awards very, very close to what we call start dates. So, the start date is April 1st, 2022.

So, the next couple of months are going to be very intense periods. Whether a state health organization or a private non-for-profit are long-time Title X participants, or they are brand new to the program, when you're applying for a competitive grant the federal government treats you as new. So, they look at those applications just on their face, they don't look at your history in working in Title X.

And so, it's going to be a very intense period the next several weeks.


It sounds like a very complicated process. If ASTHO members need help with these applications, can you provide that assistance?


Yeah. Title X grants are complicated things and the applications are, as I mentioned, quite dense, they're quite technical, and they're very detailed, and each year they move just a little bit.

So, one of the things that our association does for our members—again, in state governments, city governments, private not-for-profits—is offer technical assistance. We will take pieces from the competition. One notable one this year is the competition has a real emphasis on how Title X family planning is going to advance health equity. And there's a new requirement in the application we've never seen before—it's been in other federal programs, but never Title X family planning before—to do what they call a diversity impact statement.

So, we're going to be doing some webinars for our membership to help them walk through, from the perspective of other federal agencies: what are those statements consist of, how are they put together, and how do the federal government evaluate statements that are submitted to them in the course of overseeing federal programs. So, we provide some technical assistance, some information. We often provide people with resources for things like needs assessment.

And then the last thing that I think is really important about this process is there's a lot of learning that happens peer-to-peer.



We know that the influx of federal investment in public health has been critical to the local COVID-19 response.

Dr. Steven Stack, commissioner of the Kentucky Department for Public Health, says states and territories could not have done their work without the money; but, he hopes for a different funding approach going forward.


The federal support also has the potential to help and it's the intention of our federal partners that it will help when we look at trying to invest in public health and improve some of these challenges.

But it is a boom-bust cycle all too often: there's a apparently a rich tradition of chronic underfunding, punctuated by episodic crises that result in a relatively large influx of resources after a disaster; and then it's very difficult because you don't have sustainable funding.

You have these peaks and troughs that make it very difficult to build sustainable, high-performing, reliable systems.


Dr. Stack discusses public health funding in a new episode of the Public Health Review podcast, coming soon everywhere you stream audio.


Also today, ASTHO members are thinking about how to remind millions of holiday travelers to be safe even as COVID-19 case numbers are rising in many parts of the country. Among the messages, a White House Instagram post telling parents they could have their kids fully vaccinated by Christmas if they start the process now. AAA projects more than 53 million people will travel over the next week—the highest single-year increase in travel since 2005.


Finally this morning, as we've been reporting all month, Public Health Thank You Day is Monday. We continue our month-long celebration with this thankful note from Mylynn Tufte, the former state health officer from North Dakota.


I've been doing a lot of work in the health equity space, and I've been reflecting on education and the gift of education and especially around social determinants of health. So, I'm especially thankful for our teachers—the formal ones and the informal ones—and the gift of education in schools, and all the things that we're learning and we're teaching our kids.



Remember, every story in this newscast has a link to follow for more information—those can be found in the show notes.


That'll do it for today's report.


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Be sure to join us again Monday morning for more ASTHO news and information.

I'm Robert Johnson. You're listening to Public Health Review Morning Edition. Have a great weekend.

Steven Stack MD

Kentucky Commissioner for Public Health

Mylynn Tufte

Senior Director, Population Health Practice Lead, Optum

Clare Coleman

President and CEO, National Family Planning & Reproductive Health Association