Whereas, The California Legislature through Senate Concurrent Resolution No. 19 in 1965 memorialized the President and the Congress to consider instructing the National Institutes of Health to mount a crash program to perfect a variety of simple means of fertility control widely useful in all cultures and fully acceptable to all religious faiths.

Whereas, The California Legislature through Senate Concurrent Resolution No. 47 in 1965 clearly expressed the intent that all Californians who so desire should have access to family planning information and services;

Whereas, The 1966 California State Population Study Commission and in 1967 the California Interagency Council on Family Planning have proposed the prompt extension of family planning information and services;

Whereas, The California State Board of Health in 1966 adopted regulations requiring all local health departments to take action to meet the needs for family planning services, now, therefore, be it

Resolved by the Senate of the State of California, the Assembly thereof concurring, That the Legislature of the State of California memorialize the President and the Congress of the United States to give due consideration to instructing the Department of Health, Education, and Welfare to provide all possible technical and financial support to private and public agencies in the State which have responsibility in implementing a California Family Planning Program with the objective of within four years developing services to the end that all Californians shall have continuing access to information and services that will make it possible for them to exercise freedom of choice in the number and spacing of their children within the dictates of their own consciences; so that every child in California may be a wanted child, thus improving the health and strengthening the integrity of California families.

ACTION RECOMMENDATIONS OF THE CALIFORNIA INTERAGENCY COUNCIL ON FAMILY PLANNING

The Council recommends:

1. Public information

That a fully staffed Family Planning Information Office should be established in the Planned Parenthood Regional Office and/or the California State Department of Public Health to develop and make available family planning information to California's men and women. Such information should include the broad concept of freedom of choice in family planning, the most recent scientific advances in the field, and sources of service. Newspapers, magazines, periodicals, radio, television and other media should be explored. This should be a positive public information service to strengthen the family and the quality of family life. It should not be limited simply to conception control. It should provide information to families with involuntary sterility problems; it should stress family planning in the context of comprehensive health services, particularly maternal and child health information; it should disseminate information on the strictly voluntary quality of family planning, specifying that no coercion, direct or implied is attached to the seeking of family planning services. Public information should be directed to all individuals who are interested and should not be regarded or conducted as a means of influencing the birth rate among any particular group or class.

2. Education and training

A. That the State Board of Education and the State Department of Education foster and encourage inclusion of family life education courses in California's public schools at the elementary and secondary school levels. This material should be incorporated in existing courses where possible, and in new courses. The State Department of Education should assist interested school districts in development of appropriate curricula and teaching materials; in strengthening existing family life teaching programs; and in mobilizing assistive resources from the U.S. Department of Health, Education, and Welfare's Office of Education. The State Department of Education Office should, when requested, provide technical and fiscal assistance for teacher training programs and workshops in family life education.

The State Department of Education should provide close liaison with junior college, college and university family life education programs, particularly with schools of education.

B. The deans and obstetric department chairmen of schools of medicine, and deans of schools of public health, schools of nursing, social work, theology and law should be petitioned and assisted in developing courses which stress the importance of responsible parenthood, the importance of children being wanted and planned for, and the consideration of individual conscience in family planning programs.

C. Private and Public Agency Staff Education:

1. The State Department of Social Welfare should develop and distribute a policy statement to all local welfare departments on the right of all families to have access to appropriate family planning information and services.

2. The staffs of the California State Departments of Education, Mental Hygiene, Corrections, Public Health, and Social Welfare, and the staffs of local health departments and welfare departments should be provided with training programs in family planning information. These departments may wish to utilize existing in-service training programs for this purpose where possible. 3. Family planning services

A. Program Development:

1. The Western Region Planned Parenthood World Population Office should be assisted in developing additional staff to implement the California Family Planning Program.

2. The California State Department of Public Health should employ an appropriate full-time staff to meet Department responsibility in California's privatepublic family planning program.

3. Family planning services should be available to all low income Californians desiring assistance. Medical programs should be broadened to include family planning services for all low income Californians who desire such services. The categorical requirements of the program should be eased to make this possible. 4. Each major obstetrical hospital service in the State should develop a fulltime family planning nurse, and social worker to make daily family planning rounds a part of nursing programs for all post-partum patients so desiring, in both inpatient and outpatient services, and to provide liaison with community family planning service programs.

5. Family planning aides should be trained to assist in provision of paraprofessional health personnel in staffing the California Family Planning Program through a partnership effort of the junior college, college, and university programs, California Medical Association, California Nurses' Association, the State Department of Public Health, and selected Planned Parenthood affiliates. B. Manpower Mobilization and Professional Training:

1. The California Medical Association, through the mechanism of its existing Committee on Maternal and Child Care, should explore with the California Hospital Association, California Nurses' Association, and the State Department of Public Health, opportunities for extending family planning services particularly through public and private hospital obstetric services. These organizations should look to the extension of family planning services by expanding or developing new services through Planned Parenthood organizations, local health departments, and private physicians' offices. Educational courses for practicing physicians, nurses, and other professional and nonprofessional personnel should be developed and carried out on a continuing basis through the California Medical Association Scientific Board and appropriate committees.

4. Funding from private sources and from local, State, and Federal tax-supported agencies

A. All concerned California groups should petition the United States Congress, and the Department of Health, Education, and Welfare to assist in promptly obtaining necessary federal funds to implement the California Family Planning Program. May 1967 discussions with family planning program directors in over forty California counties yielded information indicating that some $2,000,000 of federal funds is urgently needed and could be effectively invested in California Family Planning Programs during the next fiscal year.

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B. Through a private-public partnership, efforts should be made to obtain private funds to extend family planning services to anyone desiring them in California.

5. Evaluation and research

A. Support should be sought for scientific research in new methods of fertility control and in the correction of infertility. Appropriate social science research efforts should be undertaken to assist in program development to make it possible for everyone to have freedom of choice.

B. Appropriate evaluation procedures should be incorporated in all elements of the California Family Planning Program.

6. Permanent California Population Commission

A. Legislation should be adopted to establish and fund a California Population Study Commission. This Commission would be advisory to the Governor and the Legislature.

REPORT AND RECOMMENDATIONS OF THE CALIFORNIA INTERAGENCY ON FAMILY PLANNING

INTRODUCTION

California's history in family planning over the past decade is one of concern and leadership. Progress has been made toward achievement of complete freedom of choice in the number and spacing of their children for every family in the State. The ultimate goal is to make every California child a wanted child, and to thus improve the health, and strengthen the integrity of California families. The newly formed California Interagency Council on Family Planning, the first statewide private-public partnership of its kind in the United States, has been charged with reviewing the nature and extent of family planning services in the State, evaluating the problem areas, and assisting in the development of appropriate programs of action.

Policy decisions strongly favoring extension of family planning information and services have been made in California by representative public and private groups. Among the important steps have been: Senate Concurrent Resolutions #19 and #47 (1965), statements by representatives of the executive branch of state government, the California Medical Association, various county Boards of Supervisors, the California State Board of Public Health, and the California Congress of Parents and Teachers. In 1966, the California Population Study Commission, the first such state body, developed its report and recommendations.

Forty California counties now have some publicly supported family planning services, as well as those services provided by private groups and private physicians in their own offices. There are sixteen privately supported Planned Parenthood World Population programs in the state.

In California, there is now a concensus among all groups that adequate medical programs should include family planning information and services. Through a private-public partnership effort, it should be possible, with appropriate federal fiscal support, to extend information and services-so that within four years every newborn child in California may be a "wanted" child.

Today, despite the remarkable recent progress that private and public agencies have made toward this objective, there are wide gaps in the availability of both information and services. One conspicuous gap lies in the paucity of information available to young people, despite the truth of the statement that "we cannot ask or expect children to exercise responsibility over procreative powers without information". Professional training programs which include adequate family planning information are lacking especially for persons seeking careers in the helping professions such as medicine, nursing, health education, law, social work,

1 Beaseley, Dr. Joseph, Prof. of Pediatrics, Tulane University, Personal Communication, May 12, 1967.

teaching. Information and programs are limited for both men and women in the general public, particularly for the young, leading to gaps in the availability and acceptability of family planning services, commensurate with present knowledge. These deficiencies are felt particularly by those segments of the population dependent on tax-supported health services. It is currently estimated that, in California, only one woman in seven of child-bearing age and of lower income has information and services in the family planning field really available to her. It is well known that California, with a population larger than 100 individual nations, an area larger than 68 separate countries, has by far the highest population growth rate of any great society in the world. California's population growth rate over the last decade has varied between 4 and 5% per year. India now averages 2.8% per year, Pakistan 3.0%, Colombia 3.2%. Over 60% of California's population growth rate is from in-migration of about 1500 persons a day-a total of over one-half million new citizens moving across the borders into the state each year. California's projected population in 1980 is 28 million. "The density of population in the state (119 per square mile at present) is already nearly double that in the cotermonius United States. As yet, the California population is not so densely settled as that of Japan, but at the rate of growth of the population between 1950 and 1965, it will reach that density (675 per square miles) in 35 years."

2

That the proposed extension of freedom of choice in family planning will have but a secondary effect on California's population growth is well recognized. The primary effect and essential purpose of the family planning program is to extend to all persons the option of planning their families, sharing benefits of the latest scientific advances in this field. The advantage of such information and services is clearly not available to all Californians today.

From materials assembled and distributed to the members of the California Interagency Council on Family Planning, discussions at the first Council meeting on May 12, 1967 in San Francisco, and subsequent discussions with Council members, the following recommendations for a California Family Planning Program have been developed.

Proposed goal

CALIFORNIA FAMILY PLANNING PROGRAM

Through mobilization of local, state and federal resources, guided by a privatepublic partnership:

Development of California family planning services on a continuing basis, so that by 1971

(1) all Californians may have true freedom of choice in the number and spacing of their children within the dictates of their own consciences (2) every child will be a wanted child

thereby improving the health and strengthening the integrity of California families.

Program elements

1. Public information.

2. Education and training.-(a) Public elementary and secondary schools, colleges, and universities; (b) Professional schools; (c) Private and public agencies.

3. Family planning services.-(a) Program development; (b) Manpower mobilization and effective utilization; (c) Funding from private sources, and from local, state and federal tax-supported agencies.

4. Evaluation and research.

5. Permanent California Population Commission.

2 Davis, Dr. Kingsley, in the "Population Study Commission. Report to the Governor." December, 1966, p. 47.

Summary of estimated family planning needs for California counties, fiscal year 1968

Source: State of California Department of Finance, Financial and Population Research Section, California Population-1964, State of California Department of Public Health, Bureau of Maternal and Child Health Records. Planned Parenthood World Population, "Estimating the Minimum Number of Medically Indigent Women Requiring Family Planning Services During the Year," September 1965.