[Code of Federal Regulations]
[Title 42, Volume 1]
[Revised as of October 1, 2002]
From the U.S. Government Printing Office via GPO Access
[CITE: 42CFR59.5]

[Page 300-302]
 
                         TITLE 42--PUBLIC HEALTH
 
    CHAPTER I--PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN 
                                SERVICES
 
PART 59--GRANTS FOR FAMILY PLANNING SERVICES--Table of Contents
 
         Subpart A--Project Grants for Family Planning Services
 
Sec. 59.5  What requirements must be met by a family planning project?

    (a) Each project supported under this part must:
    (1) Provide a broad range of acceptable and effective medically 
approved family planning methods (including natural family planning 
methods) and services (including infertility services and services for 
adolescents). If an organization offers only a single method of family 
planning, it may participate as part of a project as long as the entire 
project offers a broad range of family planning services.
    (2) Provide services without subjecting individuals to any coercion 
to accept services or to employ or not to employ any particular methods 
of family planning. Acceptance of services must be solely on a voluntary 
basis and may not be made a prerequisite to eligibility for, or receipt 
of, any other services, assistance from or participation in any other 
program of the applicant.\1\
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    \1\ Section 205 of Pub. L. 94-63 states: ``Any (1) officer or 
employee of the United States, (2) officer or employee of any State, 
political subdivision of a State, or any other entity, which administers 
or supervises the administration of any program receiving Federal 
financial assistance, or (3) person who receives, under any program 
receiving Federal assistance, compensation for services, who coerces or 
endeavors to coerce any person to undergo an abortion or sterilization 
procedure by threatening such person with the loss of, or 
disqualification for the receipt of, any benefit or service under a 
program receiving Federal financial assistance shall be fined not more 
than $1,000 or imprisoned for not more than one year, or both.''
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    (3) Provide services in a manner which protects the dignity of the 
individual.
    (4) Provide services without regard to religion, race, color, 
national origin, handicapping condition, age, sex, number of 
pregnancies, or marital status.
    (5) Not provide abortion as a method of family planning. A project 
must:
    (i) Offer pregnant women the opportunity to be provided information 
and counseling regarding each of the following options:
    (A) Prenatal care and delivery;
    (B) Infant care, foster care, or adoption; and
    (C) Pregnancy termination.
    (ii) If requested to provide such information and counseling, 
provide neutral, factual information and nondirective counseling on each 
of the options, and referral upon request, except with respect to any 
option(s) about which the pregnant woman indicates she does not wish to 
receive such information and counseling.
    (6) Provide that priority in the provision of services will be given 
to persons from low-income families.
    (7) Provide that no charge will be made for services provided to any 
persons from a low-income family except

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to the extent that payment will be made by a third party (including a 
government agency) which is authorized to or is under legal obligation 
to pay this charge.
    (8) Provide that charges will be made for services to persons other 
than those from low-income families in accordance with a schedule of 
discounts based on ability to pay, except that charges to persons from 
families whose annual income exceeds 250 percent of the levels set forth 
in the most recent Poverty Guidelines issued pursuant to 42 U.S.C. 
9902(2) will be made in accordance with a schedule of fees designed to 
recover the reasonable cost of providing services.
    (9) If a third party (including a Government agency) is authorized 
or legally obligated to pay for services, all reasonable efforts must be 
made to obtain the third-party payment without application of any 
discounts. Where the cost of services is to be reimbursed under title 
XIX, XX, or XXI of the Social Security Act, a written agreement with the 
title XIX, XX or XXI agency is required.
    (10)(i) Provide that if an application relates to consolidation of 
service areas or health resources or would otherwise affect the 
operations of local or regional entities, the applicant must document 
that these entities have been given, to the maximum feasible extent, an 
opportunity to participate in the development of the application. Local 
and regional entities include existing or potential subgrantees which 
have previously provided or propose to provide family planning services 
to the area proposed to be served by the applicant.
    (ii) Provide an opportunity for maximum participation by existing or 
potential subgrantees in the ongoing policy decisionmaking of the 
project.
    (11) Provide for an Advisory Committee as required by Sec. 59.6.
    (b) In addition to the requirements of paragraph (a) of this 
section, each project must meet each of the following requirements 
unless the Secretary determines that the project has established good 
cause for its omission. Each project must:
    (1) Provide for medical services related to family planning 
(including physician's consultation, examination prescription, and 
continuing supervision, laboratory examination, contraceptive supplies) 
and necessary referral to other medical facilities when medically 
indicated, and provide for the effective usage of contraceptive devices 
and practices.
    (2) Provide for social services related to family planning, 
including counseling, referral to and from other social and medical 
services agencies, and any ancillary services which may be necessary to 
facilitate clinic attendance.
    (3) Provide for informational and educational programs designed to--
    (i) Achieve community understanding of the objectives of the 
program;
    (ii) Inform the community of the availability of services; and
    (iii) Promote continued participation in the project by persons to 
whom family planning services may be beneficial.
    (4) Provide for orientation and in-service training for all project 
personnel.
    (5) Provide services without the imposition of any durational 
residency requirement or requirement that the patient be referred by a 
physician.
    (6) Provide that family planning medical services will be performed 
under the direction of a physician with special training or experience 
in family planning.
    (7) Provide that all services purchased for project participants 
will be authorized by the project director or his designee on the 
project staff.
    (8) Provide for coordination and use of referral arrangements with 
other providers of health care services, local health and welfare 
departments, hospitals, voluntary agencies, and health services projects 
supported by other federal programs.
    (9) Provide that if family planning services are provided by 
contract or other similar arrangements with actual providers of 
services, services will be provided in accordance with a plan which 
establishes rates and method of payment for medical care. These payments 
must be made under agreements with a schedule of rates and payment 
procedures maintained by the grantee.

[[Page 302]]

The grantee must be prepared to substantiate, that these rates are 
reasonable and necessary.
    (10) Provide, to the maximum feasible extent, an opportunity for 
participation in the development, implementation, and evaluation of the 
project by persons broadly representative of all significant elements of 
the population to be served, and by others in the community 
knowledgeable about the community's needs for family planning services.

[65 FR 41278, July 3, 2000; 65 FR 49057, Aug. 10, 2000]