President’s Teen Pregnancy Initiative

1. President’s Teen Pregnancy Initiative • 75M for Tier 1- replication of evidence-based programs. • 25 M for Tier 2- “research and demonstration projects to develop, replicate, refine and test additional models and innovative strategies for preventing teenage pregnancy” • public and private entities • Age appropriate & medically accurate • Newly created Office of Adolescent Health within the Department of Health and Human Services (DHHS)

2. Public Health ActTitle X: Family Planning • the only federal grant program dedicated solely to providing individuals with comprehensive family planning and related preventive health services. • designed to provide access to contraceptive services, supplies and information to all who want and need them. • priority is given to persons from low-income families • 2008, 88 Title X grantees served five million women and men through more than 4,500 community-based clinics that include State and local health departments, tribal organizations, hospitals, university health centers, independent clinics, community health centers, faith-based organizations, and other public and private nonprofit agencies • $317,491 million FY10 • Funding not to be used for abortion • Facing total elimination from Federal budget

3. Public Health ActTitle XX: Adolescent Family Life • Created in 1981, the Office of Adolescent Pregnancy Programs (OAPP)within OPA (Office of Population Affairs), is responsible for administering AFLprogram • Three main parts: Prevention, Demonstration and Research • Preventive projects to delay sexual activity, programs directed toward age 9-18 • FY 2010, the AFL Program was not appropriated funds to support prevention projects (http://www.hhs.gov/opa/familylife/grantees/afl_grantees_ae/afl_grantees_ae.html) • 2001, the program supported 73 abstinence education projects and 37 care projects (http://www.policyalmanac.org/health/archive/hhs_teenage_pregnancy.shtml) HHS June 2002 • In 2010-2011, the AFL program is supporting 27 care demonstration projects across the country, some in their third, fourth, and fifth years- largely for pregnant and parenting teens. • (http://www.hhs.gov/opa/familylife/index.html) • $16,658,000 in fiscal year 2010, comparetd to 31million in 2003 • Research on the causes and consequences of adolescent premarital sexual relations, adolescent pregnancy and parenting. • Research grant for FY 2008 (ending Aug 31, 2009) was for summarizing & reviewing past AFL research and proposing future topics for AFL research.

4. Social Security ActTitle V: Abstinence Education • ACYF Administration on Children, Youth and Families (part of HHS) • Part of Title V Maternal and Child Health Services Block Grant (which we saw last semester) – State grants • Title V abstinence-only state-grant program totals $250 million over the next five years, 2010–2014 (SEICUS) • Requires states to match with $3 for every $4 received from the federal government (SEICUS) • Part of 1996 Welfare Reform, from 1998-2002, $50 million a year in mandatory funds would be added to the appropriations of the Maternal and Child Health (MCH) Block Grant for abstinence education.

5. A-H Definition of Abstinence Education for Title V, Section 510 Programs A     Have as its exclusive purpose teaching the social, psychological, and health gains to be realized by abstaining from sexual activity B     Teach abstinence from sexual activity outside marriage as the expected standard for all school-age children C     Teach that abstinence from sexual activity is the only certain way to avoid out-of-wedlock pregnancy, sexually transmitted diseases, and other associated health problems D     Teach that a mutually faithful, monogamous relationship in the context of marriage is the expected standard of sexual activity E     Teach that sexual activity outside the context of marriage is likely to have harmful psychological and physical effects F     Teach that bearing children out of wedlock is likely to have harmful consequences for the child, the child's parents, and society G     Teach young people how to reject sexual advances and how alcohol and drug use increases vulnerability to sexual advances H     Teach the importance of attaining self-sufficiency before engaging in sexual activity Source:   Title V, Section 510 (b)(2)(A-H) of the Social Security Act (P.L. 104-193).

6. Personal Responsibility Education Program (PREP) • Section 513 of Title V: Personal Responsibility Education (PREP) • Part of health care reform i(Patient Protection & Affordable Care Act) in 2010, added this section to Title V, for 2010-2014 • 75million/year total for this Section • $55million for state grants (SEICUS), each state awarded at least $250,000/year • 10 million of the 75 million for “entities” implementation of new programs • 5% of remainder to be used for Indian or tribal organization (http://www.ssa.gov/OP_Home/ssact/title05/0513.htm). • PREP notices of grant awards will be made by ACYF and those projects will be managed by ACYF • most high-risk or vulnerable for pregnancies or otherwise have special circumstances, including youth in foster care, homeless youth, youth with HIV/AIDS, pregnant youth who are under 21 years of age, mothers who are under 21 years of age, and youth residing in areas with high birth rates for youth. (http://www.acf.hhs.gov/grants/open/foa/view/HHS-2010-ACF-ACYF-PREP-0125) • Age appropriate, medically accurate & complete.

7. State Policies • 35 states and the District of Columbia require that public schools teach some form of sex or STI/HIV education • 2007 and 2009, policymakers in six states (Colorado, Hawaii, Iowa, North Carolina, Oregon and Washington) adopted new requirements that sex education be both medically accurate and age appropriate • Eight states—Arizona, Colorado, Illinois, Maryland, Massachusetts, Michigan, Oklahoma, and Virginia—foster care

8. State Education Policies • New Mexico • how to engage Hispanic individuals and families • does not mandate sex education or regulate its content if taught (Advocates for Youth) • Applied for PREP in FY10, but had not applied for Title V funds in FY09 nor in FY10 (SEICUS fact sheet) • Nevada • State rules require sex education, but largely has abstinence funding. • Parents must sign consent for children to participate in sex ed during school • MA • evidence-based teen pregnancy prevention services to at-risk youth • Brockton, Chelsea, Chicopee, Everett, Fall River, Fitchburg, Holyoke, Lawrence, Lowell, Lynn, New Bedford, Springfield and Worcester

9. Federally Approved Evidence-based Programs • http://www.thenationalcampaign.org/resources/pdf/Briefly_OAH_Funded_Programs.pdf • AbanAya Youth Project x x African-American youth x starts in 5th grade • Project AIM x xx • All4You! x youth in alternative school x • Assisting in Rehabilitating Kids (ARK) x teens in substance use facilities x • Be Proud! Be Responsible! x xxx • Be Proud! Be Responsible! Be Protective! (Project CHARM) x x pregnant and parenting teens x x • Becoming a Responsible Teen (BART) x xxx • CAS-Carrera x x x x • Comprehensive Abstinence and Safer Sex Intervention x x African-American youth x • ¡Cuídate! x x Latino youth x x • Draw the Line/Respect the Line x x • FOCUS x young women in the military x age 17 -22 • HIV Risk Reduction Among Detained Adolescents x youth in juvenile justice x • Horizons x x African-American youth x up to age 21 • It's Your Game: Keep it Real x xx • Making a Difference! x xx • Making Proud Choices! x xx • Promoting Health Among Teens! x x African-American youth x • Project TALC x Parents living with HIV and their adolescent kids x x • Reducing the Risk x x • Rikers Health Advocacy Program (RHAP) x youth in correctional facilities x • Safer Sex x x x • Seattle Social Development Project x x elementary school • SiHLE x x African-American youth x • Sisters Saving Sisters x x Latino/African-American youth x x • Teen Health Project x xx • Teen Outreach Program x xxxx • What Could You Do? x

10. State Programs • Abstinence: Florida (Project SOS) vs. Massachusetts (Healthy Futures) • Abstinence as a possible choice • Stage presentation, skits, rap, alternative rock, local celebrities • Afterschool clubs • Urban and rural • Classroom based • Terms and phrasing • Jemmott study: 33% vs. 47% engaged in sexual activity • Comprehensive Program: Making Proud Choices! • Middle school and community- based • Goals and dreams adolescent • Knowledge about STD/STI and condom use • Consequences of sex • Negotiation-refusal and condom use skills • Role plays, video clips