Funding for Teen Pregnancy Prevention Approved in Appropriations Bill
Latest Developments from the Obama Administration and Capitol Hill
Funding for Teen Pregnancy Prevention Approved in Appropriations Bill
The Office of Adolescent Health within the U.S. Department of Health and Human Services (HHS) will soon announce the availability of competitive grants for effective and promising teen pregnancy prevention programs. This funding was provided through the annual federal appropriations process. In December 2009, Congress passed the Consolidated Appropriations Act for FY 2010, which included the Labor, Health and Human Services, Education, and Related Agencies Appropriations bill. The President signed it into law on December 16, 2009 (P.L. 111-117).
Read the legislative and report language for the new teen pregnancy prevention initiative.
Congress provided a total of $110 million for a new Teen Pregnancy Prevention Initiative, which includes $100 million for competitive grants to a range of public and private entities for evidence-based programs that reduce teen pregnancy. All programs must be medically accurate and age appropriate. The $100 million is divided into two separate pots: (1) $75 million to replicate programs that have been rigorously evaluated and have the strongest evidence of success and (2) $25 million for innovative strategies and programs that may not yet have a strong evaluation. The initiative also includes $10 million for technical assistance, training, evaluation, outreach and additional program support to assist the newly-established Office of Adolescent Health in effectively running the program. In addition, Congress provided $4.5 million for program evaluation (which is similar to amounts provided in past years).
This initiative, which is very similar to what the President proposed in his FY 2010 budget (see pages 490 and 491), replaces the Community Based Abstinence Education program.
Tier 1: $75 million for replicating proven programs
According to language in the bill that was passed, the majority of the funding for this initiative will be reserved for organizations who are replicating programs that have been rigorously evaluated and shown to actually change teens’ behavior related to teen pregnancy. While the Congressional language does not define what qualifies as a rigorous evaluation, it is generally accepted that the strongest studies are those that use an experimental design – that is, participants are assigned to treatment and control groups – and focus on changes in behavior among program participants rather than changes in knowledge or attitudes. The Congressional language also does not specify exactly which behavior a program evaluation must measure, but this might include such measures as delaying sex, increasing condom/contraceptive use, and/or reducing teen pregnancy among program participants. [Note: This does not mean that individual applicants need to perform/fund a rigorous evaluation of the program they are applying to use; rather, applicants must choose a program already shown through a careful evaluation to meet the criteria to be specified by HHS]
Tier 2: $25 million for research and innovation
The new program also provides funding for research and demonstration grants to develop, replicate, refine and test innovative strategies and other programs that may not yet have rigorous evidence of success. The Office of Adolescent Health will likely provide further guidance and criteria on what types of programs will be eligible for this funding.
Eligible entities can probably apply for either pot, according to which criteria the program it’s proposing to use best fits.
There is no indication that a match will be required for either tier of funding.
The Office of Adolescent Health, a newly established office within HHS, will administer the initiative. Congress has required the office to submit a report on the progress of the new office within 60 days of enactment of the law (around mid-February). The National Campaign will provide more detailed information as it becomes available.
Note: The information presented here is based on the limited information that is available from Congress – the Administration has not yet provided any official guidance or information.
Funding for Teen Pregnancy Prevention in Health Reform – Pending Congressional Action
Mandatory funding* for states, tribes, and territories for evidence-based programs
The Senate health reform bill—although not yet passed— currently includes a program that would provide a total of $75 million in mandatory funds for FY 2010 through FY 2014 to help young people avoid teen pregnancy and sexually transmitted infections. The Personal Responsibility Education program would provide approximately $50 million to states and territories for evidence-based programs. These formula grants would be based on the proportion of youth in a given state and funds would be given directly to the state agency that would administer the program. These programs would also be required to address several other issues to help prepare youth for adulthood including healthy relationships, financial literacy, parent-child communication, and educational and career success.
The Personal Responsibility Education program would also provide $10 million annually to support innovative strategies and services for high risk and vulnerable youth, approximately $3 million specifically for Indian tribes and tribal organizations, and approximately $6 million for research, training and technical assistance.
There is no indication that a match will be required for this funding.
Mandatory funding for states and territories for abstinence-only programs
The Senate health reform bill—again, not currently passed—includes a provision that would restore the Section 510 Abstinence Education grants that expired on June 30, 2009. These grants would also go directly to state agencies, and grantees would be required to adhere to an eight-point definition of abstinence currently in statute.
Guidance issued under the Bush Administration required grantees to give equal weight to each of the eight points in the definition. It may be the case that the Obama Administration would return to the original interpretation of the law, which was less restrictive.
This provision would provide $50 million in formula grants annually for FY 2010 through FY 2014, and a state match of $3 for every $4 in federal funds would be required.
Discretionary funding** for states and territories for evidence-based programs
The House health reform bill includes the Healthy Teen Initiative a program that would provide $50 million annually in formula grants to states and territories for medically accurate, age-appropriate programs to reduce teen pregnancy or sexually transmitted infections. Unlike the two mandatory streams above, this funding would be subject to the annual appropriations process.
The Centers for Disease Control and Prevention would create a registry of evidence-based programs eligible for the funding from which applicants could choose. Programs that have been found through “methodologically sound” research to delay initiation of sex, to decrease number of partners, to reduce teen pregnancy, to reduce sexually transmitted infection rates or to improve rates of contraceptive use would be included.
Like the abstinence grants, the formula is based on the proportion of low-income youth in a state. A match of $1 (cash or in-kind) for every $4 in federal funding would be required for states.
Next steps in health reform
The Senate is expected to pass its health reform bill on December 24th. The House and Senate will then reconcile their respective health reform bills in January 2010. If the Senate bill passes with both the Personal Responsibility Education program and the Abstinence Education provisions intact, the House and Senate will negotiate during conference to decide which of the three programs will end up in the final health reform bill.
*Mandatory funding is funding that is authorized and directly appropriated from the federal budget for the specified amount of time, rather than being subject to the annual federal appropriations process.
**Discretionary funding is subject to annual Congressional approval through the federal appropriations process.