Federal and State Policies and Programs

1. Federal and State Policies and Programs

2. President’s Teen Pregnancy Initiative • Signed December 2009, Funding in March 2010 • 75M for Tier 1 for replication of comprehensive evidence-based programs • 25 M for Tier 2 for research and demonstration projects toward promising programs • Public and private entities • Age appropriate & medically accurate • Newly created Office of Adolescent Health within the Department of Health and Human Services (DHHS )

3. Public Health ActTitle X: Family Planning • Since 1970, only federal grant program for providing individuals with comprehensive family planning and related preventive services • provide access to contraceptive services, supplies and information • priority to low-income persons • Funding not to be used for abortion • 2008, 88 grantees served five million through network of 4,500 community-based clinics, including 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 facing total elimination from federal budget

4. Public Health ActTitle XX: Adolescent Family Life • Created in 1981, run by the Office of Adolescent Pregnancy Programs (OAPP) within Office of Population Affairs (OPA) • Three main parts: Prevention, Demonstration and Research • $16,658,000 in fiscal year 2010, compared to 31million in 2003 • Preventive programs directed toward age 9-18 • FY 2010, was not appropriated funds for prevention projects • 2001, the program supported 73 abstinence education projects and 37 care projects • 2010-2011, supported 27 care demonstration largely for pregnant and parenting teens. • Research on the causes and consequences of adolescent premarital sexual relations, adolescent pregnancy and parenting. • Research grant for FY 2008 for summarizing & reviewing past AFL research and proposing future topics

5. Social Security ActTitle V: Abstinence Education • Part of 1996 Welfare Reform, from 1998-2002, $50 million a year in mandatory funds added to the Maternal and Child Health (MCH) Block Grant • ACYF Administration on Children, Youth and Families (part of HHS) • Requires states to match with $3 for every $4 received from the federal government • 8-point (A-H) definition of Abstinence education

6. Special Projects of Regional and National Significance (SPRANS)Community-Based Abstinence Education Program (CBAE) • Started FY 2001 • Public and private, community agencies or schools, local demand • Funds does not go through the state • Currently $113 million to 80 CBAE grantees • 2003, 28 new grants totaling more than $15 • Target young people ages 12 to 18.

7. Personal Responsibility Education Program (PREP) • Part of health care reform (Patient Protection & Affordable Care Act) in 2010, added this section to Title V, for 2010-2014, Section 513: Personal Responsibility Education • 75million/year total for this Section, 55million for state grants • 10 million of the 75 million for new programs • 5% of that remainder for Indian or tribal organization • Target those at 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. • Age appropriate, medically accurate & complete.

8. State Policies • 43 states, the District of Columbia, the Federated States of Micronesia, and Puerto Rico applied for PREP • 30 states and Puerto Rico applied for the Title V abstinence-only program • 35 states and the District of Columbia require that public schools teach some form of sex or STI/HIV education • Between 2007 and 2009, 6 states new requirements that sex education be both medically accurate and age appropriate (Colorado, Hawaii, Iowa, North Carolina, Oregon and Washington) • Foster care round table with support of the National Campaign 8 states: Arizona, Colorado, Illinois, Maryland, Massachusetts, Michigan, Oklahoma, and Virginia

9. State Education Policies New Mexico • How to engage Hispanic individuals and families • Does not mandate sex education or regulate its content if taught • More CBAE than 42 other states, no Title V in FY09 nor in FY10 • Applied for PREP in FY10, Nevada • State requires sex education, but largely has abstinence funding. • Parents must sign consent for children to participate in sex education during school MA • Evidence-based teen pregnancy prevention services to at-risk youth • Targets Brockton, Chelsea, Chicopee, Everett, Fall River, Fitchburg, Holyoke, Lawrence, Lowell, Lynn, New Bedford, Springfield and Worcester

10. Federally Approved Evidence-based Programs • List of 28 Federally approved abstinence-plus programs • Largely middle school and high school, 1 target at elementary school aged • Example: Making Proud Choices! Middle school and community- based Goals and dreams of adolescent Consequences of sex : Knowledge about STDs/STIs and condom use Negotiation-refusal and condom use skills Role plays, video clips

11. State Abstinence-only Programs • Florida (Project SOS) vs. Massachusetts (Healthy Futures) • Urban and rural • Abstinence as a possible choice • Stage presentation: skits, music, local celebrities • Afterschool clubs or classroom based • Virginity phrasing • Jemmott study: 33% of abstinence, 42% of comprehensive, 47% of healthy lifestyle, 57% of safe sex, • Sex until “ready”, not disparage condoms,

12. State Comprehensive Programs • Replicate Federally approved programs • ReCappand ETR Associates • PACHA (Program Archive on Sexuality, Health & Adolescence)-SociometricCorporation's collection of promising teen pregnancy and HIV/STI prevention programs.

13. Recommendation • Advocates for Youth, European Tour since 1998 • Right of adolescent to have knowledge about their bodies • Respectin relationships to partners, friends, family • Responsibility to avoid HIV infection and other STI • Mass media public education campaigns Love without Fear (RenataZolcinska, CRIPS, Paris)