'Fear and Shame'

Cuts to teen pregnancy prevention programs will mean less education for thousands of Eastern Washington teens

About half of the dozens of teenage girls who go through Daybreak Youth Services' inpatient and outpatient services each year report having been sexually assaulted. Some of them have been coerced into sex while under the influence of drugs or alcohol, many have been victims of sexual violence, and more than a handful were victims of sex trafficking, the Spokane nonprofit says.

For the past year, each teen going through the treatment center's program has spent about five hours over two days learning about sexual health, consent, and how to properly use condoms and avoid sexually transmitted infections and diseases. The comprehensive course is called Sexual Health and Adolescent Risk Prevention or SHARP, and it's specially designed for youth in juvenile detention centers or treatment programs.

"The SHARP program has really enabled them, in a really safe environment, to talk about their sexual health in an environment that is non-triggering for them," says Daybreak CEO Annette Klinefelter. "Being able to process what [consent] means is absolutely important for them to be sexually safe and healthy moving forward."

But this summer, the center learned that their facilitator won't be able to offer the program anymore.

And they weren't the only ones: Schools, youth organizations and centers that help at-risk youths are all among the places where thousands of Eastern Washington teens were set to take one of several pregnancy prevention courses through the Healthy Youth Collaborative, which is run by Planned Parenthood of Greater Washington and North Idaho.

The local Planned Parenthood had secured federal Teen Pregnancy Prevention Program grant funding for five years, through June 30, 2020, but learned that the final two years had been cut when reading their grant-award letter this summer, says Rachel Todd, education manager for the local Planned Parenthood affiliate.

They immediately reached out to the Office of Adolescent Health, the arm of the federal Health and Human Services department managing the teen pregnancy prevention grants. They wanted to see if their program wasn't measuring up, or whether this was about the fact that they're a Planned Parenthood helping teach the courses, Todd says.

It was neither. All 84 grantees across the nation, which include public health offices, universities and community groups, had their funding cut. Some are in the middle of researching and creating new courses, while others, like the affiliate in Eastern Washington, are teaching evidence-based programs to prevent teen pregnancies in low-income and minority communities.

The Trump administration decided to cut the Teen Pregnancy Prevention Program entirely due to what it says was "very weak evidence of positive impact of these programs," calling them "a poor use of more than $800 million in taxpayer dollars," according to a statement that Health and Human Services sent to CNN.

But grant recipients say the program was designed to create and test courses in the first round from 2010 to 2015, then have the programs that proved most effective implemented during the second round.

"These changes create uncertainty that impacts the effectiveness and viability of sex education and reproductive health care programs that people depend on," says Karl Eastlund, CEO of the local Planned Parenthood, in an emailed statement. "What this means is that essential programs like the Healthy Youth Collaborative could be replaced by outdated, ineffective programs. This administration is moving forward to push fear- and shame-based, abstinence-only education programs despite all evidence that shows they don't work and aren't based in reality."


While the teen birth rate has dropped steadily since 1991 — from 61.8 births per 1,000 teen girls ages 15 to 19, to 22.3 per 1,000 in 2015 — the rates in the U.S. are still higher than other developed countries such as Canada and the United Kingdom, according to Health and Human Services.

In addition to improving outcomes for teens who might be more likely to drop out of school and rely on public assistance if they have a baby, reducing the birth rate saves taxpayers money, according to the Healthy Youth Collaborative. In Washington state, teenaged childbearing cost taxpayers $124 million in 2010, and it cost $9.4 billion nationally, according to the National Campaign to Prevent Teen and Unplanned Pregnancy.

"Central and Eastern Washington have double the state average for teen pregnancy, so there's definitely a very high need for some sort of intervention and education for the teens in our area," Todd says.

In Spokane, 21.7 of every 1,000 teens aged 15 to 17 got pregnant in 2015. The rate statewide that year was 11.9 per 1,000. The same year, the Spokane birth rate for teens was 13 per 1,000, and abortion rate for teens was 8.7 per 1,000.

Since the federal Teen Pregnancy Prevention Program started in 2010, the teen birth rate declined by 29 percent nationally.

Losing the grant, which would have provided nearly $2 million over the next two years for the Eastern Washington program, means that much of the education effort will go away, Todd says.

"There are basically not other community foundations or national grants that have the same amount that they can give, and have similar objectives that this grant has," Todd says. "We also know it's not sustainable to ask our supporters and our donors to try and cover the gap."


Washington's Democratic senators, Patty Murray and Maria Cantwell, joined a letter calling out Health and Human Services Secretary Tom Price for the shift in funding, and demanding to know how the decision was made.

"These notices of shortened project periods are highly unusual, especially given that Congress has yet to act on [fiscal year] 2018 appropriations," the July 21 letter states. "This action is short-sighted and puts at risk the health and well-being of women and our most vulnerable youth who depend on the evidence-based work that TPP Program grantees are doing across the nation."

Each year, the local programs in Yakima, Franklin, Benton, Okanogan and Spokane counties were projected to reach about 2,000 youths, and could reach more where schools take on one of the curricula.

In addition to Daybreak, other Spokane youth organizations that have taught teens through the program include the Excelsior Youth Center, Odyssey Youth Movement, Richard Allen Court Apartments, Crosswalk, and the West Central Community Center, among others.

"One of the biggest barriers in Spokane is that we have not been able to partner with any of the schools," Todd says.

After two years of evaluation, Spokane Public Schools were close to adopting a new human growth and development curriculum called "Get Real" this summer, but put off their vote after backlash from local conservatives, who did not like that the course was designed by a Planned Parenthood affiliate in Boston. The program, geared to middle schoolers, is one of the curricula offered through the grant. It emphasizes abstinence as the safest choice for youth, teaches emotional and social skills for healthy relationships, and encourages dialogue with parents and trusted adults.

"It's not just us saying this is a good curriculum. There is some really hard evidence behind it that really supports it," Todd says. "It reduces young people's risk behavior for unintended pregnancy and STDs. It also helps bring about that communication between young people and a trusted adult."

The school board sent the decision back to a committee of local parents, religious leaders, members of the medical community and youth educators (including Todd) that could vote on whether they still support the curriculum at their Sept. 27 meeting, Todd says.

In preparation for funding to run out, Healthy Youth Collaborative educators will be helping to get programs and teachers around the region set up to teach the courses on their own. That includes the staff at Daybreak.

"We will, as an organization, have to determine how we'll have to backfill this critical educational resource," says Klinefelter, the Daybreak CEO. "We've always done work around healthy sexual identity formation, but we haven't had a really, really solid curriculum to follow, and that's really what SHARP did." ♦


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About The Author

Samantha Wohlfeil

Samantha Wohlfeil covers the environment, rural communities and cultural issues for the Inlander. Since joining the paper in 2017, she's reported how the weeks after getting out of prison can be deadly, how some terminally ill Eastern Washington patients have struggled to access lethal medication, and other sensitive...