The Trump administration has abruptly cut short grant programs aimed at ending teen pregnancy, leaving the institutions that receive the funds scrambling for answers.
An office within the Department of Health and Human Services (HHS) notified 81 institutions across the U.S. that the five-year grants they were awarded would end two years sooner than planned.
The Teen Pregnancy Prevention Program (TPPP), a national program created in 2010 under former President Barack Obama, funds organizations working to reduce and prevent teen pregnancy, with a focus on reaching populations with the greatest need.
But HHS informed the recipients in their annual grant award letters that programs would end next year rather than in 2020, a cut of about $200 million over two years.
The TPPP has funded initiatives in 39 states, including one run by the Baltimore City Health Department.
“There was no communication about the reason. The notice of the award just stated that instead of a five-year grant, it is now a three-year grant,” said Baltimore City Health Commissioner Dr. Leana Wen. Baltimore’s program aims to decrease the overall teen birth rate there, which is three times higher than the national average. But the program will now lose $3.5 million in grant funding over two years, meaning 20,000 fewer students will have access to reproductive health education and other services. “We don’t have another way to fill this deficit. This will leave a huge hole in our ability to deliver health education,” she said.
Bill Albert, chief program officer at the National Campaign to Prevent Teen and Unplanned Pregnancy in Washington, D.C., said HHS had “offered up very little explanation” for the change. Grantees were told that the administration was looking for something that was a “better fit for its priorities, but those were not specified,” Albert said.
Mark Vafiades, a spokesman for HHS’s office of the assistant secretary for health, said the program was cut short because there is little evidence they have had a positive impact. He also noted that the program is not funded in Trump’s budget proposal. “Given the very weak evidence of positive impact of these programs, the Trump administration, in its FY 2018 budget proposal did not recommend continued funding for the [TPPP],” he said in a statement to The Hill.
“Current [TPPP] grantees were given a project end date of June 30, 2018.”
The decision could signal a shift in how the federal government addresses teen pregnancy.
Under Obama, HHS approved 44 pregnancy prevention programs to coincide with their grants. Only three were abstinence education programs. But the Trump administration includes influential social conservatives who have supported abstinence-only education, including HHS Secretary Tom Price and Vice President Pence.
Valerie Huber, a prominent national abstinence education advocate, was recently named chief of staff to the assistant secretary for health, which oversees the office that manages the Teen Pregnancy Prevention program.
It’s not clear how much of a role Huber played in the decision to cut funding. But she has questioned its effectiveness in the past. “The healthiest message for youth is one that gives youth the skills and information to avoid the risks of teen sex, not merely reduce them. Policymakers finally have an opportunity to give American youth the reinforcement they need to continue to make healthy choices — and to normalize sexual delay for all teens and especially for those teens who currently feel pressured to have sex by social media, their favorite music — or their sex education classes.”
Democrats on the Senate Health Committee called the decision to cut the grant period short “highly unusual” and “short-sighted,” especially since Congress has yet to pass a 2018 appropriations bill. If Congress does appropriate the funding for the TPPP in its budget, the administration could make changes to gear the grants toward different types of programs.
Vafiades, the spokesman for the office of the assistant secretary of health, did not specify how that funding would be used if appropriated, only that HHS would “continue to review the evidence and determine how to better structure this program, should the U.S. Congress decide to continue its funding.”
Now congressional Democrats and state officials are rallying together to protect the program. Both Senate and House Democrats have sent letters to Price asking him to keep the program.
The Big Cities Health Coalition, which is made up of health officials from 28 major cities, called on Price on Wednesday to reconsider the decision to cut the funds and shorten the project period. “Ending what was intended to be five year TPPP grants two years early is highly disruptive to ongoing work in localities across the country. These cuts will negatively affect the lives of young people currently participating in these programs, and will mean fewer project jobs, fewer trained professionals, and reduced community partnerships,” the officials wrote in a letter to Price. “Cutting TPPP funding and shortening the project period will not only reverse historic gains made in the U.S. in reducing teen pregnancy rates, but also make it difficult to truly understand what practices are most effective in our communities across the nation.”
Child & Family EBP Consortium note: It can take up to five years to implement program innovations effectively with fidelity.