I’ve heard a lot of misinformation in the past month about how the public funds pregnancy prevention strategies. Some statements are just poorly informed. Some statements are intentional, but “not intended to be factual.”
We understand this is a tough economic climate – we’ve seen funds reduced and programs disappear in recent years. We also know there are significant differences of opinion on what sorts of services should be funded. But funding and policy decisions should not be made on false statements about how programs actually function.
This is how funding actually works:
Most of the inaccurate statements on pregnancy prevention, including adolescent pregnancy prevention, deal with reimbursements for medical services.
False Claim: The government gives clinics (like Planned Parenthood clinics) large chunks of cash up-front to pay for services.
If you have private insurance, here’s a simplified version of what happens: You go to the doctor. You get a test or treatment. Your doctor’s office files a claim with your insurance provider. If your insurance covers the services that your doctor provided, then your insurance provider pays your doctor’s office.
The federal government’s various medical programs – including family planning programs – work the same way. The federal government’s Title X program reimburses clinics when they provide low-income youth with reproductive health care services like STD/HIV tests, pregnancy tests, contraceptives, and cancer screenings. Funds cannot be used for other health services, including abortion.
Title X funds are distributed to states by the federal government, and then states manage reimbursements to clinics. In North Carolina, these funds flow through the state’s Department of Health and Human Services.
The House’s special provision to bar Planned Parenthood from receiving funds is so damaging because it means Planned Parenthood can’t access a federal reimbursement if they give a low-income patient an STD test.
Without Title X, North Carolina’s adolescent pregnancy rate would be approximately 30% higher. We can’t afford to impose unnecessary barriers to Title X services.
False Claim: Teen pregnancy prevention is funded elsewhere in the budget.
One false claim that is particularly disturbing is that teen pregnancy prevention is funded elsewhere in the budget. Indeed, the NCGA funds grants programs to reduce the state’s adolescent pregnancy rate. These programs are important, but they do not meet adolescents’ clinical needs. I’ve described these programs below.
Adolescent pregnancy prevention programs work hand-in-hand with local clinics to help teens act responsibly on what they’ve learned in programs. A program can successfully teach a teen to delay sex. A program can teach a sexually active teen the importance of using contraception. But if a teen can’t access contraceptives or STD tests or treatment for chlamydia, then those lessons on responsible, healthy decision-making become moot.
Teen Pregnancy Prevention Programs
The North Carolina General Assembly provides funding for the Teen Pregnancy Prevention Initiatives in the Department of Health and Human Services Division of Public Health. Teen Pregnancy Prevention Initiatives (TPPI – pronounced “tippy”) distributes these funds through two separate competitive grants processes: one for the Adolescent Pregnancy Prevention Program (APPP, aka AP3 in the field) and one for the Adolescent Parenting Program (APP, aka AP2).
Adolescent Pregnancy Prevention Program grants help local communities implement primary pregnancy prevention programs – meaning, they’re intended to help prevent a first teen pregnancy. Programs selected by local communities must be evidence-based and proven-to-work. These programs teach youth about healthy decision-making, adhering to one’s values, STD and pregnancy prevention, and relationship skills.
The Adolescent Parenting Program works with teens who have already had at least one child. The program teaches them parenting skills, helps them stay in school, and avoid a subsequent pregnancy. APP is critical for North Carolina: almost 30% of our teen pregnancies happen to a girl who has already had a baby in her teen years; teen pregnancy is the primary reason girls drop out of school; and a girl who has a baby before age 20 has less than a 2% chance of getting a college degree before age 30. APP graduates are more likely than non-APP teen parents to graduate high school and go to college, and less likely to be the subject of a child abuse/neglect reports.
Both APPP and APP have been successful at helping teens avoid pregnancy, stay in school, and adopt healthy habits. The health departments, Planned Parenthood clinics, nonprofits, faith groups, and school systems that implement APPP and APP go through a rigorous application process to ensure programs are implemented in the highest need areas by the organizations best-equipped to implement them. Funded organizations also follow strict accountability procedures. In addition, lending state funds to these programs allows North Carolina to access more than $1.5 million each year in federal funds to help the counties with the 25 highest teen pregnancy rates implement evidence-based programs that otherwise wouldn’t exist.
North Carolina’s teen pregnancy rate has dropped by almost 50% in the past two decades. I’m convinced we couldn’t have been so successful without the state-funded and state-administered structures described above. Unfortunately, we still have the 14th highest teen pregnancy rate in the country. North Carolina can’t afford the backslide that would occur if these medical or programmatic structures disappeared or became less accessible to North Carolina youth.
Things get a little more complicated from there… There are TANF allocations, education funds that help local school systems meet federal requirements to help parenting teens stay in school, child care subsidies for parenting teens in school, funds to promote long-acting reversible contraceptives, and more. The two funding methods described above are simply the two biggest, the two most important, and the two that have been the most incorrectly described. If you still have questions, I’m happy to answer them: firstname.lastname@example.org or 919-226-1880 .