Revision 24-2; Effective Oct. 15, 2024

HHSC Family Planning Program Overview

The Texas Health and Human Services Commission (HHSC) Family Planning Program (FPP) is a non-Medicaid program that provides comprehensive family planning and related health services throughout the state to reduce unintended pregnancies, positively affect future pregnancies and improve the health status of low-income women and men.

Funding Sources

All HHSC FPP grantees and subgrantees must be enrolled providers of services to Medicaid-eligible women and men.

FPP services are funded by state general revenue and federal Temporary Assistance for Needy Families (TANF) to Title XX funds.

Rules

State rules governing the FPP are in Texas Administrative Code (TAC) Title 1, Part 15, Chapter 382, Subchapter B.

Federal rules for Medicaid are in Title XIX, Social Security Act, 42 USC Section 1396-1396v et. seq. Grants to States for Medical Assistance Programs. 

Revision 25-3; Effective Oct. 29, 2025

The following words and terms, when used in this manual, have the following meanings.

Abortion – As defined in Texas Health and Safety Code Section 245.002.

Alternate Eligibility Screening Tool (AEST) – An HHSC-approved eligibility screening form substitute, such as in-house form, an electronic form or phone interview, that contains the required information for determining eligibility.

Applicant – A person who applies to receive services under FPP, including a current client who applies to renew.

Barrier to Care – A factor that hinders a person from receiving health care. Distance, lack of transportation, documentation requirements and copayment amount can impact access to services.

Class D (Clinic) Pharmacy License – A license issued to a pharmacy to dispense limited types of drugs or devices under a prescription drug order. Information on how to apply for a Class D Pharmacy License is on the Texas State Board of Pharmacy’s website (PDF).

Client – A person who has been screened and determined to be eligible for the program.

Compass 21 – Texas Medicaid and Healthcare Partnership’s automated system used to process claims for services delivered to HHSC FPP and Medicaid.

Consultation – A type of service given by a health care provider with expertise in a medical or surgical specialty. Helps with the evaluation or management of a client when another appropriate health care provider requests assistance.

Contraception – The means of pregnancy prevention, including permanent and temporary methods.

Contraceptive Methods – A broad range of pregnancy prevention options approved by the U.S. Food and Drug Administration.

Copay or Copayment – Money collected directly from clients for services.

Cost Reimbursement – The basis for reasonable, allowable and allocable Grant Project Direct Costs.

Covered Services – A service that is reimbursable under FPP.

Diagnosis – The recognition of disease status determined by evaluating the client history, the disease process and the signs and symptoms present. Determining the diagnosis may require some or all the following:

• microscopic – culture;
• chemical – blood tests; and
• radiological examinations – X-rays.

Eligibility Date – Date the grantee or program administrator determines a person becomes eligible for the program.

Family Planning Program Provider – A health care provider contracted with HHSC and qualified to perform covered services.

Family Planning Services – Educational or comprehensive medical activities that enable clients to freely decide the number and spacing of their children and select how this may be achieved.

Federal Poverty Level (FPL) – The household income guidelines issued annually and published in the Federal Register by the U.S. Department of Health and Human Services. FPL varies by family size. Public assistance programs, such as Medicaid, define eligibility income limits in terms of a percentage of FPL.

Fee-for-Service – Payment mechanism for services that are reimbursed on a set rate per unit of service. This is also known as unit rate.

Fiscal Year – The state fiscal year is from Sept. 1 through Aug. 31.

Grantee – An entity HHSC has contracted with to provide services. The grantee is the responsible entity, even if a subgrantee provides the service.

Health and Human Services Commission (HHSC) –The Texas administrative agency established under Chapter 531, Texas Government Code, or its designee. HHSC manages programs that help families with food, health care, safety and disaster services.

Health Care Provider – A physician, physician assistant, nurse practitioner, clinical nurse specialist, certified nurse midwife, federally qualified health center, family planning agency, health clinic, ambulatory surgical center, hospital ambulatory surgical center, laboratory or rural health center.

Healthy Texas Women (HTW) – A Medicaid waiver program administered by HHSC. The program provides uninsured women with women’s health and family planning services such as women’s health exams, health screenings and contraception. HTW providers must provide client services on a fee-for-service basis. They may also contract with HHSC to give support services that enhance the HTW fee-for-service client delivery on a cost reimbursement basis. This is not required.

Informed Consent – A health care provider makes sure the benefits and risks of a diagnostic or treatment plan, the benefits and risks of other appropriate options, and the benefits and risks of taking no action are explained to a client in a manner that is understandable to that person and allows the client to participate and make sound decisions about their own medical care.

In-reach Activities – Activities that inform and educate existing clients within an organization about services they may be eligible to receive.

Intimate Partner Violence (IPV) – Physical, sexual or psychological harm by a current or former partner or spouse. IPV may also be referred to as domestic violence or family violence.

Long-Acting Reversible Contraceptives (LARCs) – Methods of contraception that are effective for an extended period without required user action. LARCs include intrauterine devices (IUDs) and subdermal contraceptive implants.

Medicaid – The Texas Medical Assistance Program, a joint federal and state program provided in Texas Human Resources Code Chapter 32 is subject to all the rules in Title XIX of the Social Security Act, 42 USC Section 1396. It reimburses for health care services delivered to low-income clients who meet eligibility guidelines.

Minor – Per the Texas Family Code, a minor is a person younger than 18 years who is not and has not been married, or who has not had the disabilities of minority removed for general purposes such as emancipated.

Monthly Voucher Packet – Required forms, B-13X, 4116 and Data Management, to request reimbursement for the categorical component of the contract.

Outreach – Activities conducted to inform and educate the community about services and increase the number of people served.

Patient Navigator – A person who provides personalized assistance to clients to eliminate barriers to timely care across all segments of the health care continuum, including application assistance for Family Planning Program (FPP).

Program Income – Money collected directly by the grantee, subgrantee or provider for services provided under the contract award such as client copay fees and donations.

Referral – The process of directing or redirecting a medical case or a person to an appropriate specialist or agency for information, help or treatment.

Reproductive Life Plan – A plan that outlines a person’s individual goals about having children, the desired number of children, and the best timing and spacing of children. Counseling should include the importance of developing a reproductive life plan, information about reproductive health, family planning methods and services, and how to get preconception health services as needed.

Subgrantee – A non-state entity that receives a subaward from a pass-through entity to carry out part of a state program. It does not include a person who is a beneficiary of such a program. A subgrantee may also be a grantee of other state awards directly from a state awarding agency. Refer to the Texas Grant Management Standards, Appendix 2, p.57 (PDF).

Telemedicine – A health care service delivered with telecommunications or information technology to a client at a different physical location than a physician or health professional. The physician must be licensed in this state and act within the scope of their license. The health professional must act under the delegation and supervision of a physician licensed in this state and act within the scope of their license.

Texas Medicaid and Healthcare Partnership (TMHP) – The Texas Medicaid Claims and Primary Care Case Management administrator. HHSC contracts with TMHP to process claims for providers.