176-181 Gold

been a lightning rod for opponents. Title X funds are distributed directly by the federal government to a range of grantees, which include state agencies as well as nonprofit organizations such as Planned Parenthood affiliates and regional family planning councils. Title X funds are distributed in all states. Two major federal block grants, the maternal and child health (MCH) and the social services block grants (Titles V and XX of the Social Security Act, respectively), stand in sharp contrast to either Medicaid or Title X. By federal law, both Medicaid and Title X must fund family planning. Under the block grants, inclusion of family planning is left entirely to the discretion of each state. Under these two programs, federal funds go directly to a single state agency, which in turn has broad discretion over their use. States determine the specific activities that will be funded and the Rachel Benson Gold is assistant director for policy analysis and Adam Sonfield is senior public policy assistant with The Alan Guttmacher Institute, Washington, DC. The research on which this article is based was supported in part by the U.S. Department of Health and Human Services (DHHS) under grant no. FPR000057. The conclusions and opinions expressed in this article do not necessarily represent the views of DHHS. The authors express their gratitude for the important contributions of several AGI colleagues, including Rebekah Saul and Anjali Dalal. Family Planning Funding Through Four Federal-State Programs, FY 1997