All NIH research fellowships are being phased-out.

Therefore,

no new applications (with the exception of applications for Research Career Development Awards) are being accepted.

A new Training Program authorized under Title I of the National Research Service Award Act of 1974 will provide for future NIH training activities. Regulations for this program are currently being prepared.

The coordination of Federal population research programs and the communication of population research information is accomplished through the following activities:

Interagency Committee on Population Research

The Interagency Committee on Population Research (ICPR) coordinates the population research activities supported by Federal agencies and fosters the exchange of information among Federal population research programs. The Committee was established by the Secretary of HEW on October 5, 1970, and has been extended through June 30, 1976. The ICPR is chaired by the Director of NICHD's Center for Population Research and reports to the HEW Deputy Assistant Secretary for Population Affairs.

Inventory of Federal Population Research

An important product of the ICPR is the Inventory of Federal Population Research which has been updated annually since fiscal year 1969. It represents a cooperative effort on the part of the Federal agencies that fund population research projects. The Fiscal Year 1973 Inventory reports that Federal agencies supported about $54 million in population research during fiscal year 1973, approximately 11 percent less than the $61 million obligated in fiscal year 1972. An additional $23 million was invested in generating statistical data directly relevant to population research, a decrease of about $5 million from fiscal year 1972. This decrease was due to completion of much of the work on the 1970 Census. There was a slight decline in the total number of projects sponsored by Federal agencies, from 767 in fiscal year 1972 to 730 in fiscal year 1973. DHEW continued as the major Federal funding agency for population research, providing $44.1 million or 81 percent of the fiscal year 1973 total.

Analysis of Federal Population Research

The ICPR also prepared its Analysis of Federal Population Research Fiscal Year 1973. This annual report analyzes current Federally

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supported population research and recommends research to meet information gaps in the population sciences.

Population Sciences: Index of Biomedical Research

Population Sciences: Index of Biomedical Research, a bibliographic journal published on a monthly basis, provides information concerning current biomedical research literature in the population sciences. Beginning with the September 1974 issue, the journal will be available only through a subscription placed with the Superintendent of Documents.

Population Research Monographs

The NICHD also disseminates population research information through publication of monographs. The monographs review and evaluate specialized areas of population research in the biomedical or social sciences and indicate the research required to obtain needed knowledge. Research monographs currently in press or final preparation include: The Walnut Creek Contraceptive Drug Study; Rural-Urban Migration Research in the United States; Handbook of Steroid Contraceptives; Fertility of the Yugoslav Population; and Population Psychology: Research and Educational Issues.

Publications of Workshops and Conferences

The publications resulting from NICHD conferences and workshops constitute a valuable addition to population research literature. Books added during fiscal year 1974 include: Biorhythms and Human Reproduction; Proceedings of a Research Conference on National Family Planning; and Oral Contraceptives and High Blood Pressure.

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IV

SOCIAL AND REHABILITATION SERVICE

Community Services Administration

Family planning services are included in the Social Services Program authorized under Titles I, IV, VI, X, XI, XIV, and XVI, of the Social Security Act (SSA).= Administration of these programs is in the Community Services Administration.

Current recipients of public assistance under Aid to Families with Dependent Children (AFDC), Aid to the Aged, Blind, and Disabled and Supplemental Security Income (SSI) are eligible to receive family planning services. States may also choose to provide family planning services to potential recipients of cash assistance under these three programs.

Family planning services include the provision of information, personal counseling, medical services, payment for medical services, referral for medical care, follow-up of medical referrals, provision for transportation and child care arrangements so that parents may obtain medical care, and the development of medical resources when none exist.

The Social Security Amendments of 1967 (P.L. 90-248) required that under SSA Title IV-A, family planning services were to be offered in all appropriate cases. Acceptance of such services was to be voluntary and was not to be a prerequisite. for or impediment to eligibility for the receipt of any other service or financial aid.

The Social Security Amendments of 1972 (P.L. 92-603) provided significant new incentives for the provision of family planning services. This Act makes the informing of the availability and the prompt provision of family planning services mandatory to all present recipients of AFDC who are of childbearing age and imposes a penalty of one percent per annum on the Federal share of AFDC funds on States which failed to provide these services in the previous year to eligible persons desiring them. In addition, the Act increases the Federal share of matching for family planning services under Social Services from 75 percent to 90 percent.

The requirement that States offer and provide promptly upon request family planning services to eligible individuals has resulted in an increase in State family planning program activities. Staffs of public agencies are available to provide referral to a medical resource and other assistance needed to enable individuals to obtain services. Federal instructions to States as to when the offer of family planning services is to be made (within 31 days of the first assistance payment and once a year thereafter) and the placement of a 30-day time limitation within which a request for services must be met have assisted the States in complying with the requirements of P.L. 92-603.

Although there is a favorable Federal matching rate of 90 percent for family planning services, it should be noted that such services are included under the overall annual $2.5 billion ceiling on social services expenditures under SSA Title IV-A.

1/ Effective January 1, 1974, SSA Titles I, XIV, XVI, and X services were provided under new SSA Title VI, except for Guam, Virgin Islands, and Puerto Rico.

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Medical Services Administration

The Social Security Act of 1965 (P.L. 89-97--approved July 5, 1965) added Title XIX, "Grants to States for Medical Assistance" to the Social Security Act. Under the Federal-State medical assistance program which it established, known as Medicaid, States participating in the program were required to provide medical assistance to all recipients of cash assistance. At State option, they could also finance medical care for the medically needy, i.e., those persons who would otherwise be eligible for cash assistance except that the level of their income is sufficient to sustain themselves, but too low to provide necessary medical care. In addition, States could opt to provide coverage to children under 21 from low-income families.

Under the original legislation, inclusion of family planning services was a State option. However, P.L. 92-603, passed in October 1972, made coverage of family planning services for cash assistance recipients under Title XIX mandatory on the States. In addition, the rate of Federal financial participation for family planning services for both the categorically and medically needy was increased to 90 percent on the date of enactment of the Bill.

Medical assistance for family planning includes payments for appropriate medical examinations, diagnosis, medical counseling and treatment, laboratory services, surgical procedures, drugs, supplies and devices. These services may be provided in doctors' offices, clinics, hospitals (on both an inpatient and outpatient basis), family planning centers, or any other suitable settings.

Because of the increased responsibilities placed on the State agencies to assure that family planning services are offered and available to all eligible persons who wish to utilize them and the increased Federal matching, a sizeable increase is expected in Title XIX expenditures for family planning from FY 72 through FY 75.

V

EDUCATION DIVISION

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Office of Education

The Office of Education (OE), through its various grant programs, enables educational institutions at all levels to include family life, sex education and population education in their programs. In addition, OE provides limited Federal support for innovative family-related projects. All decisions concerning curriculum, teaching methods, qualification of teachers, and classroom materials are made by state and local authorities acting within the framework of state law.

Elementary and Secondary Education

The Elementary and Secondary Education Act of 1965 (P.L. 89-10) and its amendments provide several titles under which family life and sex education activities are eligible for support.

Title I, Grants for the Disadvantaged, assists in expanding and improving educational programs aimed at meeting the special needs of educationally deprived children. Through payments to state education agencies, grants are made for children from low-income families, handicapped children, delinquent or neglected children, and migrant children. Further, payments are made to the Secretary of the Interior for grants to benefit Indian children in federal schools administered by the Bureau of Indian Affairs as well as out-of-state Indian children in elementary and secondary schools. Recipients of Title I grants may use the funds for projects relating to dropouts, pre-schoolers, teen-age unwed mothers, and other approaches for remedying education deprivation. However, the components of these projects which are concerned with family life and sex education are not identifiable per se.

is:

The purpose of ESEA Title III, Supplementary Educational Centers and Services, to enable schools to provide programs currently unavailable to children; to improve educational services already offered; and to stimulate the development and evaluation of experimental elementary and secondary educational programs which can serve as models. Fifteen percent of program funds is mandated for projects serving handicapped children. Other funds are mandated for projects in guidance, counseling and testing. Although not dealing directly with family life and sex education, Title III projects in environmental education provide information on population environmental affairs.

Originally, the Commissioner of Education made grants directly to local education agencies. Beginning in fiscal year 1971, 85 percent of Title III funds were to be administered by State education agencies, with fifteen percent to be used at the Commissioner's discretion within the State.

The Dropout Prevention program, Title VIII, Section 807 of the Elementary and Secondary Education Act, has no family planning projects as such. However, several projects for pregnant women in fiscal year 1974 included components related to family planning such as pre- and post-natal care, personal counseling, and child care. Under this program, funds are used to support demonstration projects designed to reduce the number of dropouts in low-income areas and in areas where a high percentage of children do not complete their elementary or secondary school education. Since pregnancy and/or early marriage constitute the largest cause of dropout by teen-age girls, the need for inclusion of family life and sex education in a comprehensive school program is apparent.