For better or worse – mostly for worse – North Carolina has a new state budget. Here’s the quick and dirty rundown of what it means for teen pregnancy:
GOOD NEWS: Funding sustained for Teen Pregnancy Prevention Initiatives!
First, a very big thank you to leaders in both parties for sustaining the state’s Teen Pregnancy Prevention Initiatives! This will allow the Division of Public Health to continue their highly successful Adolescent Pregnancy Prevention Program (APPP) and Adolescent Parenting Program (APP). Governor Perdue included funding from federal sources in her version of the budget. Leaders in the House and Senate went a step further by using state dollars to maintain these efforts, thus allowing NC to continue receiving federal matching dollars. So, thanks to all NC General Assembly members – Republicans and Democrats alike – who recognized the historic and ongoing importance of the state’s teen pregnancy prevention efforts!
BAD NEWS: New restrictions on access to care and programs
Teen pregnancy prevention became an unfortunate pawn in the General Assembly’s successful push to ban Planned Parenthood from receiving funds that pass through the NC Department of Health and Human Services. This limits teens’ access to programs and critical medical care.
Programs: Planned Parenthood will no longer receive state funds to administer two successful, highly regarded, long-running programs: the APP for parenting teens in New Hanover County and APPP primary prevention program in Cumberland County. These could be a huge loss for teens in those counties. While the APPP could continue with private funds, APP is essentially a proprietary program of the state and it’s questionable what will happen when it ceases to be a part of the statewide APP initiative. If TPPI can continue to use the funds that were paying for those two programs, dollars will likely go to new grantees in other counties.
Access to Care: The ban on Planned Parenthood funding will significantly reduce access to contraceptive care and STD tests for low-income young people taking positive, responsible steps to protect their health. This will have a direct impact on adolescent pregnancy rates in our urban centers where Planned Parenthood clinics exist – Asheville, Charlotte, the Triangle, the Triad, Fayetteville, and Wilmington. Last year, these centers provided $255,000 in STD tests, cancer screenings, and contraceptive care using federal funds. They also received ~$45,000 to help low-income women access long-acting reversible contraceptives (LARCs) that can be inserted at a low one-time cost but are effective for 3-5 years. We know that without these publicly funded contraception programs in North Carolina, our teen pregnancy rate would be more than 30% higher.
So what happens now? Most likely young people who would have gotten care through Planned Parenthood will not get care at all. Health departments will make teens wait weeks or months for an appointment. Many health departments are no longer offering contraceptive care because of their own budget cuts. Teens have lots to contend with when they decide to seek contraceptives: cost, wait periods, embarrassment, fear of a very personal exam. These young people are not going to stop having sex because of the reduced access to care. But limiting access to Planned Parenthood’s youth-friendly, affordable, well-known clinics will reduce the number of young people who use contraception.
THE UNKNOWN: What happens when…?
There are more than 200 significant risk factors for adolescent pregnancy, meaning teens get pregnant in an environment where lots of factors are at play. Similarly, prevention happens in a network of educational settings, family and community supports, and medical facilities. So, what does the state budget do to these?
What happens when teen parents can’t access child care subsidies – or afford them?
Having a baby is the number one reason girls drop out of high school. With cuts to the state’s child care subsidy system and a new copay requirement for More at Four participants, many girls will be unable to finish school.
What happens when fewer nonprofits can host prevention programs?
In addition to restrictions on Planned Parenthood, the state budget places a new web of restrictions on the state’s early childhood education system. Many Smart Start partnerships host Adolescent Parenting Programs, as well as other services for young parents. These nonprofits may stop offering these services in order to meet new legislative requirements.
What happens when schools make cuts?
We already know that schools can’t buy new textbooks (or curricula) until 2014. So schools that didn’t get sex ed curricula or materials to update their programs in accordance with the 2009 Healthy Youth Act aren’t allowed to buy them now using curriculum budgets. Same goes for professional development dollars.
And what about the teachers? Our state’s sex educators are a truly amazing bunch of people. Many have received training in evidence-based curricula. Will they still have jobs? Are they more likely to be cut than math or science or language arts teachers?
What happens when cuts hit health departments?
As health departments pare down their budgets, critical pregnancy prevention programs are at risk. In the past we’ve seen the following cut: HIV/STD outreach, health education, clinic hours, and even pharmaceutical services.
This is by no means an exhaustive list! If your organization has problems addressing adolescent pregnancy prevention because of the state budget, please let us know today!
THE FINAL TALLY
Again, the NCGA wisely chose to continue direct investments in adolescent pregnancy prevention programs. We’re very thankful for that. But combatting adolescent pregnancy requires a network of policies and services. Only time will tell the overall effect of the new state budget on this issue.