Coretta Jamison rejoiced when Barack Obama was elected president and pledged to support teen-pregnancy-prevention programs like the one she runs in a poor rural community in South Carolina. Now, she is worried her program won't last until the money arrives.
Cuts in state funding, growing competition for grants and shrinking sources of other dollars are depleting the coffers of one of the nation's longest-running programs to prevent unplanned teen pregnancy. Ms. Jamison said the Denmark-Olar Teen Life Center might close its doors in June, after nearly three decades of bombarding a population of mostly African-American teens with sex-education classes, "life skills" sessions and guidance on the use of contraceptives.
"I'm really afraid of what might happen in this community if we close," she said.
The nonprofit organization is one of hundreds of similar teen-pregnancy-prevention and sex-education programs across the country under recessionary pressure at the very moment their prospects of government funding appear to be the best in years.
Valerie Huber, executive director of the National Abstinence Education Association, questioned whether the reduction of comprehensive sex-education programs around the country would be such a bad thing. "There is very, very little research that's compelling that shows that it is effective," she said. Ms. Huber said teaching abstinence is a more effective way of ensuring that teenagers don't get pregnant.
Supporters of comprehensive sex-education programs maintain that research backs their efforts.
Mr. Obama has signaled he is likely to make a sharp break with the policies of former President George W. Bush, under whom more than $1.3 billion in federal funds were appropriated for education programs that promote abstinence only until marriage to reduce teen pregnancy and sexually transmitted infections. A blueprint for Mr. Obama's proposed 2010 budget suggests teen-pregnancy-prevention funding will go toward efforts that "stress the importance of abstinence while providing medically accurate and age-appropriate information to youth who have already become sexually active."
Congress also is expected to consider a bill introduced in March by Sen. Frank Lautenberg (D., N.J.) and Rep. Barbara Lee (D., Calif.) to provide federal money for comprehensive sex education in schools.
Such programs, which support both abstinence and the use of contraceptives, don't currently have a dedicated federal funding stream, though they receive federal funds through family planning, Medicaid and other medical-service programs, according to the Guttmacher Institute, a reproductive-health think tank that favors comprehensive sex education.
A White House spokesman declined to comment on the administration's specific budget proposals in advance of their release. The proposed budget is expected within the coming weeks. "President Obama is committed to reducing the number of unintended pregnancies in this country, and we are reviewing this issue as part of the budget process," said the White House spokesman, Reid Cherlin.
But new money, if approved, would take until late fall or next year to start reaching programs at a time when teen births are rising again and HIV-infection rates remain high. After a 14-year decline, births to girls and women between the ages of 15 and 19 rose 3% in 2006 and 1% in 2007, according to the Centers for Disease Control and Prevention.
Some teen-pregnancy prevention advocates blame the reversal on a lack of funding for comprehensive sex-education and family-planning services, sexual content in the media and complacency as birth rates declined. "This is no time for an interruption in services," said Forrest Alton, executive director of the South Carolina Campaign to Prevent Teen Pregnancy, which is helping struggling programs find new grants and figure out how to stretch their dollars.
Many sex-education programs are facing cutbacks from public and private sources all at once. The Teen Health Center for York County in Rock Hill, S.C., plans in July to close a clinic offering medical and counseling services due to changes in Medicaid that reduced its revenue. Private donations are also down.
"I've never seen such a juxtaposition of opportunity and pain," said Marcia Egbert, a senior program officer with the nonprofit George Gund Foundation and chair of a collaborative of public and private organizations that operates a sex-education program in Cleveland's public schools.
The Cleveland program's budget was slashed by more than half this school year, to about $494,000, when a state welfare block grant was reduced. The foundation had to trim its donation to $50,000 this school year from $60,000 after a market-driven decline in its assets. The collaborative arranged for district teachers to lead classes, rather than community-based providers, in order to keep classes going.
The Denmark-Olar center, which was profiled in a page-one article in The Wall Street Journal in 2006, lost a large chunk of its main source of funding when state budget cuts last year prompted South Carolina's Department of Health and Human Services to narrow criteria for Medicaid reimbursement. The center now may bill Medicaid only for services provided to youth who are teen parents, sexually active or fit other medical criteria.
The changes reduced its number of billings to the point that the center can't sustain itself, even with its other grants, said Ms. Jamison, who participated in classes as a student in the 1980s and has worked at the center for 17 years. The local school board is providing some funds to help the center get through the school year, but sources of funding beyond that are unclear, Ms. Jamison said.
