Federal and State Policies and Programs

President’s Teen Pregnancy Initiative Signed December 2009, Funding in March M 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 )

Public Health Act Title 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

Public Health Act Title 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 , 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

Social Security Act Title V: Abstinence Education Part of 1996 Welfare Reform, from , $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

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.

Personal Responsibility Education Program (PREP) Part of health care reform (Patient Protection & Affordable Care Act) in 2010, added this section to Title V, for , 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.

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

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

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

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,

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

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