Multnomah County sues Trump Administration over politicized changes to teen pregnancy prevention funding

June 8, 2018

Multnomah County Chair Deborah Kafoury announced a lawsuit challenging the terms of federal teen pregnancy prevention grants.

Multnomah County today filed a lawsuit against the federal government alleging it has flouted congressional mandates and politicized teen pregnancy prevention grants.

The suit was filed in U.S. District Court in Portland after the U.S. Department of Health and Human Services violated congressional requirements that they only fund programs that have been proven effective. Instead, the new criteria privilege an abstinence-only approach that is contrary to Oregon law.

“The Trump administration calls evidence-based teen pregnancy prevention a ‘sham.’ But we know teaching comprehensive sex ed works,” said Multnomah County Chair Deborah Kafoury. Teen pregnancy rates in Multnomah County dropped 57 percent between 2005 and 2015, and the federal grant has helped support that trend.

“The administration wants programs based on wishful-thinking. That doesn’t work, Mr. President,” Kafoury said. “Teens, parents and teachers need accurate information so young people can make healthy choices.’’

When Congress created the Teen Pregnancy Prevention Program in 2010, it specifically adopted an evidence-based approach, rooted in science, directing the grants only support programs proven effective in preventing teen pregnancy, sexually transmitted infections, and other sexual risk behaviors.

Multnomah County was awarded a five-year grant in 2015 and used $1.25 million per year to educate 15,000 teens, train 107 teachers, and engaged 329 parents and caregivers in 32 middle and high schools across the county. Last year, with no explanation, Health and Human Services terminated Multnomah County’s grant and the grants of all other 80 grantees after three years of the five-year grants. Federal judges in five cases have since held those terminations unlawful, including, most recently, a ruling in a class action lawsuit filed on behalf of grantees who, like Multnomah County, had not previously sued. Because of those losses, Health and Human Services must process applications for continued funding for all terminated grantees. The federal government has not said whether it will appeal any of the rulings.

Multnomah County’s 2015 grant was administered by the Health Department’s Adolescent Sexual Health Equity program in partnership with Planned Parenthood Columbia Willamette, Latino Network, Self Enhancement Inc, the Native Youth and Family Center, and the Boys & Girls Clubs of Portland. They came together to address sexual health among Black, Latinx and Native American teens, whose birth rates are higher than their non-Hispanic White peers.

"The racial equity focus is at the heart of this work, it's what has made our work better in the past three years than ever before,” said Kim Toevs, director of Youth Sexual Health Equity at Multnomah County. “It's made up focus resources with youth who need it more. It's made us work really hard on developing authentic community partnerships with folks who historically — and rightly — didn't have a lot of trust in government."

Community partners work with students and their parents in five school districts to teach about healthy relationships and safe sex.

“Some youth choose abstinence. Some don’t. But they all need access to the information to help them have healthy lives. Regardless of what our values are, they get to choose when and how they have sex,” said Veronica Leonard, Health and Wellness Manager at Latino Network. “We provide them skills to seek out health services, to learn how to talk about this with a trusted adult.”

While students learn about healthy relationships, so do their parents, who attend group meetings led by nonprofit partners including Latino Network.

“The majority of our parents comment on never having received this information from their parents or in their schools,” Leonard said. “If they did it was very shame-based, secret, hush-hush. It’s really flipping the narrative for them to see sexuality as a healthy part of life.”

But for Multnomah County to be competitive for the next round of grants, staff at the county’s Adolescent Sexual Health Equity program must meet the new criteria to prioritize abstinence-only education. That would also push Multnomah County outside the bounds of Oregon law, which requires students be taught abstinence education, “but not to the exclusion of other material and instruction on contraceptive and disease reduction measures,” and requires programs to “enhance students’ understanding of sexuality as a normal human development.”

Veronica Leonard, Health and Wellness Manager at Latino Network, says families, not government, should decide what's right or them.

In the Trump administration’s new plan, any program that normalizes sexual activity outside of marriage will be at a significant disadvantage in competing for grant money.

“The Trump-Pence administration is trying to change an effective program to impose their ideology on everyone — and it’s putting young people at risk,” said Camelia Hison, vice president of Education for Planned Parenthood Columbia Willamette. “All young people deserve to have the information they need to make safe and healthy choices.”

The lawsuit claims that U.S. Health and Human Services violated its own regulations, which prohibit political interference in the grantmaking process. It points to the role of Valerie Huber, a senior policy advisor for the Office of the Assistant Secretary of Health, who lobbied for abstinence-only education and decried the comprehensive criteria in the original grant terms, before joining the department’s leadership last June.

As executive director of Ascend — formerly known as the National Abstinence Education Association — she lobbied against funding the Teen Pregnancy Prevention Program, arguing that it lacked earmarks for abstinence education and promoted risky behavior. And she sought its dissolution.

Then in June 2017 she was appointed as the Department’s Chief of Staff in the Office of the Assistant Secretary of Health. Within a month of her appointment, and together with other administrators also opposed to comprehensive sexual education, the lawsuit contends, Health and Human Services summarily terminated funding for 81 grantees, including Multnomah County.

The suit is being filed on Multnomah County’s behalf by Pacifica Law Group, based in Seattle, and Democracy Forward, a Washington D.C.-based nonprofit legal organization that won challenges against the administration for stripping Teen Pregnancy Prevention Program funding from King County, Washington,the City of Baltimore and Healthy Teen Network.

"In five cases and counting, courts have blocked the Trump Administration’s attempts to cut these vital, evidence-based programs," said Anne Harkavy, Executive Director of Democracy Forward. "Now the Administration is thumbing its nose at Congress by ignoring its requirement to fund proven programs and instead imposing an illegal ideological litmus test. We will continue fighting to prevent this harmful, unlawful action."

Community partners in Multnomah County said this lawsuit is vital to the protect proven and inclusive practices that are helping to change the lives of teens who need it most.

“It’s important to be inclusive of all people,” said Daniel Guilfoyle, Youth Advocacy Manager at the Native American Youth and Family Center. “Trans youth who really struggled coming to school, it has helped them feel safe. Now we’re seeing attendance rates raise for these youth.”

Parents of two-spirited and transgender youth who get this curriculum say their children come out of their bedrooms more frequently, and go to school more often.

“These youth are feeling more and more safe,” he said. “They started coming out more and being able to advocate for what they think sexual education should be. To me it seems very obvious. The more you talk about it, the easier it is to talk about.”

Marlo Williams-Baker, lead educator for the ACT grant at Self Enhancement Inc., said that’s why a curriculum of comprehensive and inclusive sexual education is important, especially in Black communities. “The conversations are just not happening,” she said. “You don’t talk about sex, because if you're talking about sex, you’re probably having it.”

Instead of judging youth for thinking about, talking about, or having sex, the coaches at Self Enhancement Inc encourage teachers, parents and other trusted adults to listen.

“Whatever your personal beliefs are, whatever your personal values are, whether they are having sex or not, you need to have these conversations,” said William-Baker. “Some youth do choose to be abstinent, and if they’re going to be abstinent, we’re going to give them all the tools so when they decide to be active, that can make good decisions.”