42 C.F.R. § 59.2

Definitions

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As used in this subpart:

Act means the Public Health Service Act, as amended.

Adolescent-friendly health services are services that are accessible, acceptable, equitable, appropriate and effective for adolescents.

Clinical services provider includes physicians, physician assistants, nurse practitioners, certified nurse midwives, and registered nurses with an expanded scope of practice who are trained and permitted by state-specific regulations to perform all aspects of the user (male and female) physical assessments recommended for contraceptive, related 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. 9902(2). “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 entity's net earnings benefit, or may lawfully benefit, any private shareholder or individual.

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 trauma-informed 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 re-traumatization.

Notes of Decisions

Cited in 25 cases (1 in the last 5 years), 1983–2024 · leading case: Rust v. Sullivan, 500 U.S. 173 (1991).

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Rust v. Sullivan, 500 U.S. 173 (1991). · cites it 4× “" 42 CFR § 59.2 (1989). [2] The regulations "focus the emphasis of the Title X program on its traditional mission: The provision of preventive family planning services specifically designed to enable individuals to determine the number and spacing of their children, while…”

State of California v. Alex Azar, II, 950 F.3d 1067 (9th Cir. 2020). · cites it 4× “at 7787; 42 C.F.R. § 59.2 (2019). Like the 1988 Rule, the Final Rule states that family planning services “include preconception counseling” but not “postconception care (including obstetric or prenatal care) or abortion as a method of family planning.”

Patterson v. Planned Parenthood of Houston & Se. Texas, Inc., 971 S.W.2d 439 (Tex. 1998). · cites it 2× “" 42 C.F.R. 59.2 (1997). In light of this express suggestion that Texas might lose its federal family planning funds, Planned Parenthood filed this action against the Department and its commissioner seeking a declaration that rider 14 is unconstitutional.”

Little Sisters of the Poor Saints Peter & Paul Home v. Pennsylvania, 140 S. Ct. 2367 (2020). “These definitions now provide that "for the purpose of considering payment for contraceptive services only," a "low income family" "includes members of families whose annual income" would otherwise exceed the threshold "where a woman has health insurance coverage through an…”

Com. of Mass. v. Bowen, 679 F. Supp. 137 (D. Mass. 1988). · cites it 2× “” 42 C.F.R. § 59.2 (1988). A Title X project has always been required to supplement its federal grant with 10% matching funds.”

State of NY v. Bowen, 690 F. Supp. 1261 (S.D.N.Y. 1988). · cites it 2× “2, 1988) (to be codified at 42 C.F.R. §§ 59.2 , 59.8, 59.9, 59.10) control the use of funds for family planning services and set specific standards for compliance with Title X.”

Planned Parenthood Fed'n of Am., Inc. v. Schweiker, 559 F. Supp. 658 (D.D.C. 1983). · cites it 2× “4 Finally, the regulations modify the definition of “low income family” contained in 42 C.F.R. § 59.2 . The modification deletes a prior provision requiring Title X projects to treat unemancipated minors who wish to receive confidential medical services on the basis of their own…”

Commonwealth of Massachusetts v. Sec'y of Health & Human Servs., 899 F.2d 53 (1st Cir. 1990). “” 42 C.F.R. § 59.2 . By virtue of this change, the extensive prohibitions against counseling, referral and abortion-related activities in the regulations apply broadly to recipient generated income as well as to federal funds.”

New York v. Heckler, 719 F.2d 1191 (2d Cir. 1983). · cites it 3× “The other change is the deletion from 42 C.F.R. § 59.2 of a provision added in 1980, 45 Fed.”

State of NY v. Schweiker, 557 F. Supp. 354 (S.D.N.Y. 1983). · cites it 2× “The regulations also delete the provision currently contained in 42 C.F.R. § 59.2 , which states that “unemancipated minors who wish to receive services on a confidential basis must be considered on the basis of their own resources.”

Planned Parenthood of Santa Barbara, Ventura & San Luis Obispo, Inc. v. City of Santa Maria, 93 Cal. Daily Op. Serv. 4447 (Cal. Ct. App. 1993). “( 42 C.F.R. §§ 59.2 , 59.8, 59.9 and 59.10 (1992).”

Planned Parenthood Fed'n of Am. v. Bowen, 680 F. Supp. 1465 (D. Colo. 1988). “8, 1988) (to be codified at 42 C.F.R. §§ 59.2 , 59.8 (including examples)).”

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