D.C. Will Try To Lower Teen Birth Rate Through Social Impact Bonds | DCist

Between 1997 and 2011, the number of teen births dropped by 64 percent in D.C. But in Wards 5, 7, and 8, the numbers were still in the double digits, as of 2012: 113, 192 and 265 births, respectively.

In addition to the traditional local and federal funding for programs to combat the teen pregnancy rate, Mayor Vince Gray announced yesterday that D.C. will pursue a Social Impact Bond to "finance services aimed at reducing teen pregnancy and improving education outcomes."

A social impact bond uses private investment capital to provide the upfront funding needed for evidence-based programs, in this case, one that will reduce teen pregnancy. D.C. will work with the intermediary Social Finance US, which released a Request for Qualifications yesterday. "The mechanism used is a 'Pay-for-Success' (PFS) contract, which allows government payors, in this case the District of Columbia, to re-pay a portion of savings and benefits generated if and only if the intervention achieves predefined outcomes," the RFQ states.

Qualifications to apply for the SIB include "a history of service delivery in the District or demonstrated potential to undertake successful operations in the District; demonstrated capacity for completing program evaluations, tracking program participants, and 
keeping accurate records; and demonstrated capacity for managing services to meet performance targets."

Brenda Miller, executive director of the DC Campaign to End Teen Pregnancy, said the cost of a "mistimed" pregnancy compared to prevention makes the case for the latter. A 2012 report by the Campaign found that for every dollar the government spent on the results of teen pregnancy, only a penny is spent in prevention.

"It's exciting that there will be this money to invest in preventing a totally preventable problem," Miller said. Teen pregnancy, she said, results in neighborhood instability, issues with the law, school dropouts, joblessness, and other preventable issues. She pointed to the D.C. General family shelter, where 40 percent of families are headed by women under the age of 24.

"It's not an indictment of anyone," she said, "but do you remember when you were 15? ... Can you imagine having a baby?"

A release states that "programs that are well-suited for SIB financing have clear and measurable outcomes, a strong and research-tested evidence base, a need for significant up-front capital investment, a well-defined target population, and an ability to generate significant savings to the taxpayers."

Miller said she hopes the SIBs will "reward creativity that's grounded in evidenced research," and programs that aren't one-size-fits-all and limited to education. Part of this is making sure "teens have a sense of belonging, get the healthcare they need, and have good relationships with trustworthy adults." They also need to make a plan for their future, Miller said, and develop goals and examine their talents. Being able to have a place to share that goal is also key.

"An important part of the program side is making your outcome match your input," Miller said. For a program that helps teens make a future plan, the outcomes could include improved grades on a report card or attendance.

There's also not a one-size-fit-all program for every teen in D.C. The DC Campaign, for example, has instituted a program that teaches boys and young men skills like tying a tie and looking a person in the their eyes when they speak to them. "So many boys in D.C. don't have fathers, don't have grandfathers, don't have uncles. They don't have anyone who's a suitable role model," Miller said. "We looked at the situation the boys are in and what it takes for them to be able to succeed." While part of this program is about contraception education, Miller said they also talk about exploitation and relationship planning.

"It's interesting to see how the parents and the teachers around the boys are amazed because they see the transformation," Miller said. "If you start paying attention to your school work as a brown or black boy in the District, what does mean for your future? If you don't use sex as a way to self-medicate, but you really think about what kind of relationship you want to have and don't cause pregnancy before you're ready to be an adult, that's the kind of thing I think is a really promising approach."

That more than 50 percent of the babies born to teens are born east of the Anacostia River is a concern of Miller's that she says deserves more attention. Miller shared a comment from a colleague, who said that if half of the teen births occurred in Ward 2, 3 or 4, CNN would be lined up around the street.

"These are the two Wards with the least resources, highest unemployment, highest poverty," she said. "There's no way this isn't connected."