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Brent Ewig

Improving Adolescent Health and Coordinating Funding for Teen Pregnancy Prevention

By Brent Ewig, MHS
Director of Public Policy & Government Affairs, AMCHP     

Adolescence is an important time to promote optimal health and to prevent many of the behaviors that can place youth at-risk for health problems. While many adolescents have health insurance, a significant proportion (13 percent) still lack health care coverage and the proportion of adolescents with private insurance is declining. Among young adults, nearly one-third are uninsured, representing more than one in five of all uninsured individuals.   

The Affordable Care Act (ACA) therefore presents a significant opportunity for state MCH programs and their partners to improve the health care delivery system overall, promote adolescent health specifically, and assure that adolescents have access to quality health care and prevention services.  

This issue’s theme on Adolescent Health also offers a good opportunity to remind readers of our previously published issue brief entitled “Health Reform – What’s in it for Adolescents?” available here. This publication highlights the numerous provisions that impact health programs and services for all children and youth, including adolescents. It also provides details on ACA investments in teen pregnancy prevention. 

Chief among these is inclusion of a new section of the Title V statute (513) creating the Personal Responsibility Education Program (PREP). PREP provides $75 million per year in mandatory funds for FY 2010 through FY 2014 and is administered by the Administration for Children and Families. The program makes grants to states for programs to educate adolescents on both abstinence and contraception to prevent teenage pregnancy and sexually transmitted infections, including HIV/AIDS.  

In September 2010, HHS awarded $55 million total in PREP funds to states, territories and communities. Of this total amount, $45 million was awarded as formula grants to 46 states (including the District of Columbia) and U.S. territories for programs that replicate evidence-based teen pregnancy prevention strategies and incorporate other adult responsibility subjects such as maintaining healthy relationships, developing healthy attitudes and values about growth and development, increasing healthy parent-child communication and enhancing financial literacy. An additional $10 million was awarded competitively through a joint application process with the TPP Tier 2: Innovative Approaches funding to support programs that test innovative strategies to reducing teen pregnancy and repeat pregnancy among high risk, vulnerable and culturally under-represented youth populations.  

As we welcome this new investment in a critical MCH priority, we are also faced with the (welcome) challenge of assuring this program is coordinated with existing efforts. We’ve advocated that state Title V programs continue their role in assuring a balance between investing in areas of greatest need while assuring that critical services are offered state-wide. We’ve also asked all our federal partners vested in leading teen pregnancy prevention efforts – from Title V in HRSA, to CDC, ACF, the Office of Population Affairs, and the new Office of Adolescent Health - to help by considering the following suggestions: 

·         Harmonizing HHS program guidance to work from one state-wide MCH needs assessment (submitted by all states as required under Title V last July 15, 2010)

·         Using common performance measures

·         Coordinating all-grantee meetings

·         Promoting dialogue among all federal project officers and regional staff working with state MCH programs

·         Spacing grant application deadlines 

What have we missed? As always, we value your feedback and appreciate all you do to assure the health of all our nations’ adolescents.