A woman in a yellow shirt smiling and a teacher at the head of a classroom

Personal Responsibility Education Program (PREP)

About the Personal Responsibility Education Program (PREP)

PREP funds evidence-based programs dedicated to educating adolescents on both abstinence and contraception to prevent pregnancy and STIs. PREP also educates youth on adulthood preparation topics, such as healthy relationships, parent-child communication, and financial literacy. The program targets youth age 10–19 who are homeless, in foster care, live in rural areas or in geographic areas with high teen birth rates, or come from racial or ethnic minority groups, as well as pregnant and parenting youth. PREP includes formula grants to states (or competitive grants to organizations in the states that decline the formula grants), grants to tribes and tribal organizations, and grants for research and demonstration projects to implement and evaluate innovative strategies.

PREP and the Teen Pregnancy Prevention (TPP) Program are complementary federal funding streams for teen pregnancy prevention education. They are high-quality examples of tiered, evidence-based grant making that use evidence to inform awards and continuous program improvement.

FUNDING STATUS

Status: Funded through November 30, 2020—see our handy budget chart.

The latest

- On September 11, Power to Decide and 17 other national organizations sent a letter urging Congressional Leadership to take immediate action in support of a 5-year reauthorization of vital public health programs, including PREP, that are set to expire on November 30, 2020.

- On Friday, March 27, 2020, the President signed H.R. 748, the CARES Act. In addition to providing relief for COVID-19, the bill extends PREP, the Sexual Risk Avoidance (SRA) program, and other health extenders until November 30, 2020.

WHAT'S HAPPENED SO FAR ON PREP Reauthorization

- On Monday, February 10, 2020, the President's FY 2021 budget proposal was released. It proposes a two-year reauthorization of PREP at $75 million annually, along with the state Sexual Risk Avoidance Program at $75 million annually. It is important to note that the President's budget is merely a proposal. It signals the President's priorities, but Congress ultimately controls the purse. You can read our full statement on the President's budget proposal here.

-On December 20, 2019, the President signed into law an appropriations deal that will fund the government for the rest of FY 2020. The agreement also provided an extension of mandatory programs, including PREP, through May 22, 2020. This short-term extension of expiring mandatory programs will give Congress time to work out a longer-term agreement. 

- On November 21, Congress passed and the President signed another continuing resolution (CR) to fund the government through December 20. Like the first CR, it contains a measure to extend certain mandatory programs including PREP grants through December 20. However, longer-term extensions of these and other programs such as the Pregnancy Assistance Fund must still be worked out. 

- Congress passed its first CR for FY 2020 on September 26 that the President signed the following day. The CR funded the government through November 21, and also included short term extensions for certain mandatory programs, including PREP, through the same date. Power to Decide's statement on the CR can be found here.

- On July 17, 2019 the full House Energy and Commerce Committee voted to advance HR 2328. Like the bill passed out of subcommittee on July 11, HR 2328 level-funds PREP ($75 million annually) through FY 2023. The bill also level-funds the sexual risk avoidance education program ($75 million annually) through FY 2023 (see pg. 4 of the bill for both programs). The next step is for the full House to consider the legislation, though it isn’t known yet when that will be.

- On July 11, 2019 the House Energy and Commerce Committee's Health Subcommittee marked up (considered) a package of 10 bills to extend a number of health programs. One of the bills, HR 2328 includes a four-year extension of PREP with level funding ($75 million annually). Similarly, it includes a four-year extension of the sexual risk avoidance education program with level funding ($75 million annually). Rep. Blunt Rochester of Delaware, who introduced a stand alone bill to reauthorize PREP in June, spoke in favor of PREP’s inclusion in the bill. HR 2328 passed with strong bipartisan support. It now advances with the same package of bills to the full Energy and Commerce Committee, which will likely consider the legislation during the week of July 22nd.

- On June 3, 2019, Rep. Blunt Rochester (DE - At Large) introduced the PREP Reauthorization Act (HR 3053) to extend the program for 5 years. You can read Rep. Blunt Rochester's press release on the bill, as well as Power to Decide's press release.

HHS TEEN PREGNANCY PREVENTION EVIDENCE REVIEW

The HHS Teen Pregnancy Prevention Evidence Review is an independent, systematic, and rigorous review of evaluation studies conducted by Mathematica Policy Research and managed by the HHS Assistant Secretary for Planning and Evaluation (HHS' evidence and evaluation experts). The evidence review has identified a growing number of evidence-based teen pregnancy prevention program models that represent a variety of approaches.

The majority of State Personal Responsibility Education Program grantees use models identified by the evidence review. Tier 1 TPP Program grantees (FY 2010 - FY 2014 & FY 2015 - FY 2019) also used these models. 

On April 23, 2018, HHS released updated findings for the Teen Pregnancy Prevention Evidence Review. Four more models have demonstrated positive impacts on at least one teen sexual risk behavior or reproductive health outcome—bringing the list of evidence-based program models to 48. Also, two models already on this list now have evidence of longer-term impacts and/or youth outcomes. Past TPP Program FOAs have referenced the evidence review; the April 2018 FOAs do not, however this list still represents a valuable source of information on evidence-based programs. You can see a handy summary here.

The Teen Pregnancy Prevention Evidence Review is included in the Results First Clearinghouse Database, a project of the Pew-MacArthur Results First Initiative.

ADDITIONAL RESOURCES

PREP Specific Resources 

State-specific resources

Key Messages to Use in Your Outreach

  • 85% of adults (including 75% of Republicans and 89% of Democrats) favor maintaining federal funding for the TPP Program and PREP
  • Due to the 64% decline in the teen birth rate between 1991 and 2015, the U.S. saved $4.4 billion in public spending in 2015 alone. If all teens were able to avoid unplanned pregnancy and childbearing, the U.S. could save an additional $1.9 billion each year. (Find state specific information here)

Pregnancy Assistance Fund

The Pregnancy Assistance Fund (PAF) is administered by the Office of Population Affairs. It provides $25 million annually from FY2010–2019 for competitive grants to states, tribes, and territories to support pregnant and parenting teens and women, and combat violence against pregnant women. Projects help teens in high schools and community service centers and young women in institutions of higher education complete school and gain access to health care, childcare, family housing, and other critical supports. Currently, there are 23 grantees in 22 states. Read more information about PAF here

Power to Decide is working with the Healthy Teen Network to extend PAF. We are pleased that Senators Murkowski (R-AK) and Casey (D-PA) introduced a bipartisan bill in late July 2019 to reauthorize PAF for five years, at $25 million annually (S 2296). This is just the first step in the process.

It should also be noted that on February 10, 2020, the President's FY 2021 budget was released. It proposed ending PAF. You can read our full statement on the President's budget proposal here.  It is important to note that the President's budget is merely a proposal. It signals the President's priorities, but Congress ultimately controls the purse.

If you can advocate, we are asking local, state, tribal, and national organizations to sign on to this PAF support letter.

Resources

FY 2019 to FY 2021 Budget Chart 

Research

A Maternal and Child Health Journal supplement highlighting the Pregnancy Assistance Fund (PAF) program has been published. The supplement includes 19 articles with information about the PAF program, PAF grantees’ promising approaches, implementation experiences, lessons learned, systematic reviews, evaluation data, and related research analyses.