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Federal Register / Vol. 86, No. 192 / Thursday, October 7, 2021 / Rules and Regulations
preventive health, and basic infertility care.
Client-centered care is respectful of, and responsive to, individual client preferences, needs, and values; client values guide all clinical decisions.
Culturally and linguistically appropriate services are respectful of and responsive to the health beliefs, practices and needs of diverse patients.
Family means a social unit composed of one person, or two or more persons living together, as a household.
Family planning services include a broad range of medically approved services, which includes Food and Drug Administration FDA-approved contraceptive products and natural family planning methods, for clients who want to prevent pregnancy and space births, pregnancy testing and counseling, assistance to achieve pregnancy, basic infertility services, sexually transmitted infection STI
services, and other preconception health services.
Health equity is when all persons have the opportunity to attain their full health potential and no one is disadvantaged from achieving this potential because of social position or other socially determined circumstances.
Inclusive is when all people are fully included and can actively participate in and benefit from family planning, including, but not limited to, individuals who belong to underserved communities, such as Black, Latino, and Indigenous and Native American persons, Asian Americans and Pacific Islanders and other persons of color;
members of religious minorities;
lesbian, gay, bisexual, transgender, and queer LGBTQ+ persons; persons with disabilities; persons who live in rural areas; and persons otherwise adversely affected by persistent poverty or inequality.
Low-income family means a family whose total annual income does not exceed 100 percent of the most recent Poverty Guidelines issued pursuant to 42 U.S.C. 99022. Low-income family also includes members of families whose annual family income exceeds this amount, but who, as determined by the project director, are unable, for good reasons, to pay for family planning services. For example, unemancipated minors who wish to receive services on a confidential basis must be considered on the basis of their own resources.
Nonprofit, as applied to any private agency, institution, or organization, means that no part of the entitys net earnings benefit, or may lawfully benefit, any private shareholder or individual.

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Quality healthcare is safe, effective, client-centered, timely, efficient, and equitable.
Secretary means the Secretary of Health and Human Services HHS and any other officer or employee of the Department of Health and Human Services to whom the authority involved has been delegated.
Service site is a clinic or other location where Title X services are provided to clients. Title X recipients and/or their subrecipients may have service sites.
State includes, in addition to the several States, the District of Columbia, Guam, the Commonwealth of Puerto Rico, the Northern Mariana Islands, the U.S. Virgin Islands, American Samoa, the U.S. Outlaying Islands Midway, Wake, et al., the Marshall Islands, the Federated State of Micronesia, and the Republic of Palau.
Trauma-informed means a program, organization, or system that is traumainformed realizes the widespread impact of trauma and understands potential paths for recovery; recognizes the signs and symptoms of trauma in clients, families, staff, and others involved with the system; and responds by fully integrating knowledge about trauma into policies, procedures, and practices, and seeks to actively resist retraumatization.
59.3 Who is eligible to apply for a family planning services grant?

Any public or nonprofit private entity in a State may apply for a grant under this subpart.
59.4 How does one apply for a family planning services grant?

a Application for a grant under this subpart shall be made on an authorized form.
b An individual authorized to act for the applicant and to assume on behalf of the applicant the obligations imposed by the terms and conditions of the grant, including the regulations of this subpart, must sign the application.
c The application shall contain 1 A description, satisfactory to the Secretary, of the project and how it will meet the requirements of this subpart;
2 A budget and justification of the amount of grant funds requested;
3 A description of the standards and qualifications which will be required for all personnel and for all facilities to be used by the project; and 4 Such other pertinent information as the Secretary may require.
59.5 What requirements must be met by a family planning project?

a Each project supported under this part must:

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1 Provide a broad range of acceptable and effective medically approved family planning methods including natural family planning methods and services including pregnancy testing and counseling, assistance to achieve pregnancy, basic infertility services, STI services, preconception health services, and adolescent-friendly health services. 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 acceptable and effective medically approved family planning methods and services. Title X service sites that are unable to provide clients with access to a broad range of acceptable and effective medically approved family planning methods and services, must be able to provide a prescription to the client for their method of choice or referrals to another provider, as requested.
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
3 Provide services in a manner that is client-centered, culturally and linguistically appropriate, inclusive, and trauma-informed; protects the dignity of the individual; and ensures equitable and quality service delivery consistent with nationally recognized standards of care.
4 Provide services in a manner that does not discriminate against any client based on religion, race, color, national origin, disability, age, sex, sexual orientation, gender identity, sex characteristics, number of pregnancies, or marital status.
5 Not provide abortion as a method of family planning.2 A project must:
i Offer pregnant clients the opportunity to be provided information 1 42 U.S.C. 300a8 provides that any officer or employee of the United States, 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 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.
2 Providers may separately be covered by federal statutes protecting conscience and/or civil rights.

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