The Family Planning Program and Cuts in Federal Spending: 1. Impact on State Management of Family Planning Funds

Abstract

A preliminary study of levels of funding funding processes and patient eligibility in 20 states in Fiscal Year (FY) 1982 shows that a few states drastically curtailed their use of Title V and XX funds for family planning services while some other states used their own funds to offset the loss of Title X support. Nevertheless most states that had depended on Titles V and XX for medical family planning services continued to use the block grants for this purpose and most retained the same patient eligibility standards although definitions of these standards were deleted from the block grants. In addition there were few changes in the ways states funded family planning programs even though the federal government lifted restrictions on the allocation and use of Title V and XX funds and gave states greater flexibility in the ways they could spend Medicaid funds. There are several reasons why so many of the federal changes in the administration of these 4 programs did not immediately have an identifiable impact at the state level: this study was conducted close to the end of the states 1982 FY when only early changes could be detected; at the time of the federal budget cuts most of the states were already in the 2nd quarter of their own FY and program obligations had already been made; because of the new block grant process many state legislatures became responsible for appropriating these federal funds which limited how quickly the states could act; and finally once state agencies have made plans for distributing federal funds and delivering specific services these plans cannot always be revised quickly. Many of the 1st steps taken in reaction to the budget reductions were small cost saving measures that tended to maintain general service delivery. Title V and Title XX are given most attention because they had been changed the most. In many ways the FY 1982 budget has not directly affected the latitude that state agencies already had in managing the Title V or Title XX (now block grant) funds or in operating their Medicaid programs. What has changed is that states are no longer required to provide family planning services through the Maternal and Child Health (MCH) and Social Services block grants. The real impact of the changes that have taken place in the federal governments support of organized family planning services thus will require a longer period of time to be adequately measured.