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Class 8 – Wrap Up & Funding Mechanisms for Male Reproductive Health 380.720 – Masculinity, Sexual Behavior and Health, 2012 Qtr 2 Funding & Program Types • Funding type depends on… – Health issue to be addressed – Type of service to be offered – Service setting • Multiple funding sources needed since – Different funding sources for clinical & non-clinical services – Funding for reproductive health is primarily categorical 1 Funding Sources • Currently no single federal program has a mandate or mission to serve male adolescents Service Type Clinical Public Private Insurance Funding Grants Programs ++ ++ ++ Education ++ ++ - Counseling ++ ++ - Funding Options Federal Grants • Title V -Social Security Act (Maternal & Child Health Block Grant) • Title X -Public Health Services Act (Federal family planning program) • Title XX -Social Security Act (Social Services Block Grant) • STD/HIV prevention programs-Centers for Disease Control (CDC) • Community health centers • Ryan White program (Titles I, II, IV) • Temporary Assistance for Needy Families (TANF) • Healthy Marriage Initiative • CDC STD, HIV, Reproductive Health & School Health programs Funding Options Insurance programs – Medicaid – SCHIP & other insurance programs State & Region funding – Male involvement programs - CA Other funding – Local public funds – Private foundation funds – e.g., Ford Foundation, California Wellness Foundation 2 Funding: Medicaid • Federally-funded health insurance program • Eligibility varies from state to state – Males <19 years may qualify if child in welfare family, have disability – Eligibility expansion to parents in families (RI, CA, WI, DOC) – Services available to low-income childless men (TN, HI, MN, OR, WA) • Other – Managed care programs assign patients to “primary care provider” – Federal “freedom of choice” provision allows individual to seek family planning services outside managed care network – EPSDT requirements (Early & periodic screening, diagnosis, & treatment) Funding: SCHIP • Health insurance program established in 1997- Title XXI of the Social Security Act • Administered as an expansion of Medicaid coverage for children OR under a new separately administered plan (or a combined approach) • Eligibility varies from state to state • Most teens <19 years with net incomes <200% Federal poverty Available services – Broad medical services, including STI/HIV testing & treatment – Counseling & case management Other – Managed care arrangement may limit range of providers Funding: Title X • Program dedicated to family planning & administered by the Office of Family Planning in DHHS Funding – Can be used for clinical, educational & counseling services for males – Limited funding available – organization needs to be approved to provide services Recipients – Family planning clinics – Male involvement initiatives 3 Funding: Office of Adolescent Health • Coordinates adolescent health programs & initiatives across DHHS related to adolescent health promotion & disease prevention Funding • New discretionary grant program to support evidence-based teen pregnancy prevention approaches. Recipients • Pregnancy Assistance Fund – 17 states ($25 million) – Support for pregnant & parenting student services at institutions of higher education; – Support for pregnant & parenting teens at high schools & community service centers; – Improving services for pregnant women who are victims of domestic violence, sexual violence, sexual assault, & stalking; – Increasing public awareness & education • Teen Pregnancy Prevention - Replication of Evidence-Based Program Models ($75 million) - Research & Demonstration Programs ($25 million) Funding: CDC • Grant programs created to help control & prevent communicable diseases (HIV & other STIs) Funding – Prevention programs for high-risk individuals – HIV in communities of color – HIV prevention services in African American faith-based organizations – Comprehensive STI prevention systems Contact www.cdcnpin.org/db/public/fundmain.htm Funding: Title V • MCH block grants to state health departments to improve maternal & child health • This is a theoretical funding source but it is subject to authorization by each state health department Funding – Can be used for clinical & educational services Recipients – State & local health departments – Non-profit health clinics 4 Funding: Community Health Centers • Administered through Health Resources & Services & under Section 330 of the Public Health Services Act Funding – Broad range of primary care services to people living in underserved areas Recipients – Ideal partners for community-based organizations to provide preventive services to young men Funding: Ryan White • Categorical funding to areas with disproportionately high rates of HIV prevalence • As part of Title IV, one component funds community-based projects for children, youth, women, & their families who are living with or at risk of HIV infection (Pediatric/Family AIDS Demonstration Program) Services – Can provide medical &/or psychosocial services for youth at high risk for HIV infection Funding – Limited (disadvantage) Funding: Title XX • Social Services Block Grant distributed by DHHS’s Administration for Children & Families to state social service agencies Purpose – To encourage individual self-sufficiency & reduce individuals’ dependence on government Funding – Potentially available for reproductive health activities – Relevant for male reproductive health as part of a broader social services program 5 Funding: TANF • State block grant program replacing Aid to Families with Dependent Children (AFDC) Purpose – Provides cash assistance to needy families, job training & related services with potential to fund reproductive health services for men Funding – Legislation provides $100 million annual bonus to be shared with 5 states with greatest reductions in non-marital birth rates: CA, MI, AL, MA & DOC – Youth development focus; Programs with male involvement components; Programs focusing on young women; Abstinence education programs Services – Family planning is the only medical service that is funded Healthy Marriage Initiative • Deficit Reduction Act (2005) provides $150 million each year for healthy marriage promotion & fatherhood • Goals include – Increase percent children raised by 2 parents in healthy marriage – Increase percent married couples in healthy marriage – Increase percent premarital couples equipped with skills & knowledge necessary to form & sustain healthy marriage – Increase percent youth & young adults with skills & knowledge to make informed decisions about healthy relationships – Increase public awareness about value of healthy marriages & skills & knowledge to help them form & sustain healthy marriages – Encourage & support research on healthy marriages & healthy marriage education – Increase percent of women, men & children in homes free of domestic violence Funding: Other Programs Administration for Children & Families (DHHS) • Independent Living Program • Community Services Block Grant • Runaway and Homeless Youth Programs • Healthy Marriage Initiative Health Resources & Services Administration • Healthy Start • Healthy Schools, Healthy Communities Office of Juvenile Justice & Delinquency Prevention • Youth Violence Initiatives Department of Labor • WIA (Workforce Investment Agency) • Job Corps 6 Advocacy & Support Men's Health Network Washington, DC menshealthnetwork.org 202-543-MHN-1 (6461) contact: info@menshealthnetwork.org Top 10 Things to Talk About with Your Partner & Consider Before Having Sex First & foremost. . . 1. Develop relationships & not sex. Be honest, communicate & above all respect each other. 2. The best way to prevent pregnancy & avoid STI/HIVs is to not have sex. If you plan on having sex. . . 3. Both get tested before doing the deed. 4. Know that the standard STI lab tests cover only 4 of the possible 33 STIs that one can contract in the world. 5. Don’t drink and bonk. 6. Keep in mind: once your sperm leave the gates, you may not have final say in what may happen. Talk about pregnancy decision-making & prevention up front with your partner. Top 10 Things to Talk About with Your Partner & Consider Before Having Sex If you plan on having sex continued. . . 7. Condoms come in many shapes & sizes. . .Don’t like one? Find another that works & don't forget to use a condom every time you have sex. 8. Practice makes perfect condom use. Remember: squeeze at the tip, roll to the base, hold while pulling out. Reduced sensation with a condom? Try a drop or 2 of lube inside. 9. Find out if your partner is on birth control & doesn't hurt to learn about hormonal and barrier contraception options as well as how they are used. 10. Don't forget about Plan B contraception in case a condom breaks or slips off. It is available over the counter for adult females & good for use up to 5 days. 11. Sex should be pleasurable. If you're having any issues, find someone to talk to about it. 7 Top 10 Things to Talk About with Your Partner & Consider Before Having Sex Oh yea -• Don't forget to brush your teeth and floss every day. • Use deodorant & shower daily. • Eat your breakfast every day (energy is power). • Call your mom at least once a week to say hi. 8