SENATE BILL REPORT

SHB 2601

BYHouse Committee on Health Care (originally sponsored by Representatives Belcher, Brooks, Hine, Dellwo, Brough, Sprenkle, Winsley, Scott, McLean, Morris, Jacobsen, Miller, Prentice, Wang, Leonard, Spanel, Nutley, R. Fisher, Todd, Haugen, Nelson, Grant, Brekke, H. Sommers, Beck, S. Wilson, Schmidt, Hankins, Pruitt, Bowman, Ferguson, May, Fraser, G. Fisher, Cole, Vekich, Dorn, Locke, Anderson, P. King, Basich, Valle, Crane, Wineberry, Jesernig, Rector, Holland, Forner, Wood, R. Meyers, R. King, Jones, Ebersole and Cooper)

Creating a comprehensive program for pregnancy prevention and support for women and their partners.

House Committe on Health Care

Rereferred House Committee on Appropriations

Senate Committee on Children & Family Services

Senate Hearing Date(s):February 22, 1990

Senate Staff:Lidia Mori (786-7755)

AS OF FEBRUARY 20, 1990

BACKGROUND:

Teen pregnancy has been identified as a serious public policy program. Nationally, by age 19, eight in 10 males and six in 10 females will have had intercourse.  Only one- third of teens who have sex use birth control regularly; one-third use it inconsistently; and another third never use it.  High levels of sexual activity and low levels of effective use of contraception among U.S. teens inevitably result in high teen pregnancy rates.  One of every 10 women aged 15 to 19 in the U.S. becomes pregnant each year, a proportion that has changed little during the past 15 years.  Three-quarters of unplanned teen pregnancies occur among women not practicing contraception.  Moreover, teen pregnancy disproportionately affects those who are poor.

In Washington State, one in 12 female teens gets pregnant each year.  Overall, four in 10 teens will be pregnant at least once by the time they reach age 20.  In 1988, there were 14,583 teen pregnancies reported in Washington.  Approximately half of these pregnancies resulted in live births, although less than 5 percent of these pregnant teens relinquished their babies for adoption.  Nationally, virtually all teens (93 percent) who have live births choose to parent their babies, with fewer than 8 percent relinquishing their babies for adoption.  Approximately 40 percent of teen pregnancies, in Washington and nationwide, end in abortion.

The inability of teen parents to gain the skills needed to meet the requirements of today's labor force is only one of the costs associated with teen parenting.  There are other, more direct costs.  The public cost of teen childbearing nationally is substantial:  in 1985, nearly $17 billion was paid through Aid to Families with Dependent Children, food stamps and Medicaid to women who first gave birth as teens.  In Washington, income assistance payments equalling $36 million per year are made to mothers under 21 not living with their parents.  In addition, teen prenatal care has been publicly funded in Washington at a cost of approximately $10 million per year.  Because pregnant teens seek prenatal care later than older women, the maternal mortality rate for teen mothers is more than double that for mothers age 20 to 24.  The younger the mother, the more likely she is to suffer complications from pregnancy, and have a low birthweight baby.

Nationally, the social and financial consequences of teen pregnancy are substantial.  Only half of all teen mothers ever finish high school.  Teen mothers who marry are more likely to be separated or divorced within 15 years than women who postpone childbearing until their 20s.  Children of teenage parents are more likely to exhibit lower academic achievement and to show a tendency to repeat their mother's pattern of early marriage, early childbearing and high fertility.  Two-thirds of families headed by women who first gave birth before age 20 live below the poverty level.

Poverty has been identified as a major risk factor for teen pregnancy.  Other risk factors include low educational attainment of parents, low religious involvement, low basic skills and achievement, low parental involvement and supervision, low resistance to peers and unconventional attitudes and behavior. In addition, there may be a link between teen pregnancy and physical, emotional and sexual victimization.

SUMMARY:

The problems of teen pregnancy are addressed through the establishment of comprehensive reproductive health projects in six pilot sites, geographically distributed throughout the state.  The program will be administered by the Department of Social and Health Services until January 1, 1991, when it will be transferred to the Department of Health, along with the parent and child health program, pursuant to RCW 43.70.080.

The projects shall embrace the following principles:  1) a comprehensive approach is necessary to solve the problem; 2) each community's needs are unique, therefore, each should have the primary responsible of designing its own program; and 3) many communities presently have reproductive health services available, thus coordination and collaboration is also a crucial element to addressing the problem.

Projects are required to provide services necessary to accomplish a set of program outcomes, including reduction in teen pregnancies and an increase in the number of teen parents completing high school, vocational training, and becoming employed.  Service priority shall be given to low-income persons.  Project services may include education, family planning, counselling, case management, housing support, transportation, and other needs services.  Project funds shall not be used to provide medical services.

An application process is set forth.  It requires the definition of the community to be served and the designation of a lead agency or organization for the project.  Projects must have broad community support as reflected in a project advisory board.  Projects are required to provide 25 percent local matching funds, which may be in-kind services.

The secretary shall award grants on a competitive basis.  To assist in the award process, a peer review committee shall be appointed.  Initially, the project period will be for two years, but it may be continued if progress is made based on identified outcomes.  The secretary shall contract for an independent evaluation of the project and report to the Legislature by December 1, 1992.

For the current biennium, $2.5 million is appropriated; of that sum, $300,000 is to be used for a statewide media campaign and $20,000 for the evaluation.  Annual project awards shall not exceed $500,000, including match.

Appropriation:    $2,500,000 to the Division of Parent and Child Health within the Department of Social and Health Services.

Appropriation:    none

Revenue:    none

Fiscal Note:      available

Effective Date:The bill contains an emergency clause and takes effect immediately.