With a new $450,000 grant from the Centers for Disease Control (CDC), long-time Arizona advocate Patti Jo Angelini is ready to take her issue—reducing teen pregnancy—statewide. Since 1995, Angelini has been lobbying for programs to reduce Arizona's teen pregnancy rate, currently among the highest in the nation. Much of that time, it's been a pretty lonely struggle. But now Angelini's Phoenix-based organization, the Arizona Coalition on Pregnancy and Parenting (ACAPP), will be able to bring effective pregnancy prevention programs to new communities.

The three-year grant, which will provide funds to open three staffed satellite offices in Tucson, Yuma and northern Arizona, will help ACAPP work towards its goal of reducing teen pregnancy in the state 25 percent by 2005.

"Instead of reinventing the wheel," says Angelini, "we'll be telling policy makers and community leaders what programs work and what don't. This will help communities make wiser use of their resources."

The CDC grant allows Angelini to build on years of successful lobbying on a smaller scale. In a socially and politically conservative state like Arizona, progress on an issue so tightly linked to policies surrounding contraception and abortion can be hard-won. The state typically does not fund family planning services or birth-control education programs for teens. Angelini's success seems to depend on a combination of tireless hard work, and a pragmatic approach.

Lobbying Victories
Angelini's first lobbying victory came in 1995, when she was serving as community relations director for the Arizona Family Planning Council. She worked with two legislators to craft the final compromise language on a bill for a teen pregnancy package that included a media campaign and several pilot programs. To help push the bill through, Angelini testified and met individually with legislators and the bill sponsor. She explained that in 1994, 75 percent of all births to teen mothers were paid for with federal funds. Welfare monies then took over the cost of caring for these children.

"Why don't we spend public funds on prevention?" Angelini asked legislators. "By investing money in young people, you're lessening the chances of teen mothers going on welfare. It's pay now or pay later."In its final form, the bill appropriated $110,000 for a teen pregnancy media campaign handled by a public relations firm and $140,000 for three to five abstinence-only pilot programs.

In 2001, Angelini won another lobbying victory. This time, she took on school districts throughout Arizona that had a policy of dropping pregnant teens and new moms from school rolls if the teens or their infants needed special medical care that required the moms to miss school over long periods. Angelini contacted different legislators with whom she had built up trust, and wrote a draft bill that would make it easier for teens to return to school after giving birth.

The bill passed, and now pregnant teens in these districts are considered "homebound or hospitalized" if they can't attend school for a minimum of three months at a time due to medical problems. School districts are required to provide at least four hours of in-home instruction per week to students categorized in this way. The new law helps these new mothers keep up with their studies without compromising their own health or that of their child.

A Process of Compromise
One of the ways Angelini gets bills before the legislature is by cultivating relationships with people who have different viewpoints. "She's amiable, professional and respectful," says Rep. Laura Knaperek (R-District 27) who often disagrees with Angelini's viewpoints. "She treats people fairly whether she agrees with them or not."

"I learned you don't let confrontations stop you," Angelini says. "The more people get to know you, the more the stereotypes fade away."

Angelini, a Catholic who supports abortion and contraceptives, has been dubbed a "liberal" when it comes to teen pregnancy. Although she supports abstinence, she doesn't hesitate to suggest contraception to sexually active teens. And she doesn't waste precious time on legislators committed to firm pro-life and pro-abstinence views. "Patty Jo doesn"t approach me often," says Rep. Karen Johnson (R-District 30), a member of the House Human Services Committee, "but when she does, it's not in an adversarial way. She knows I'm a staunch opponent of abortion, but she works to change the views of the more ambivalent legislators."

Angelini has built up a network of sympathetic legislators, among them Sen. Mary Hartley (D-District 20), who take the initiative to introduce, sponsor and support appropriate bills. In 2001, when Angelini wanted more teen dads to be eligible for programs to help them improve their academic and employment skills as well as their parenting, problem-solving and social abilities, she convinced Hartley to sponsor legislation that lowered the minimum age of dads in a statewide mentoring and counseling program from 16 to 14.

The program was to be administered by community and religious organizations, but in this case, Angelini's hard work didn't help. "The bill passed," says Angelini, "but the governor completely gutted the money for that program."

Raising Funds and Raising Awareness
So far Angelini has amassed $550,000 in grants, which pays for much of ACAPP's advocacy work. For grant writing, she draws on prior experience from her work on the Arizona Family Planning Council, college journalism courses and a six-month internship at the state legislature.

Angelini organizes fundraisers to raise money for grant application fees, and to educate and inform the public. For example, she puts together a yearly conference for professionals working with teens, including doctors, nurses, psychologists and social workers. Last October a speaker from the CDC lectured on violence and substance abuse, and workshops offered practical tips on adolescent sexuality, prenatal care and teen parenting. Angelini also meets individually with many clinicians to provide information.

ACAPP also sponsors an annual awards dinner recognizing effective teen pregnancy programs. Media attention generated by these awards not only spotlights the issue of teen pregnancy, but motivates other organizations and institutions to help. For example, Planned Parenthood recently started offering classes for kids and their parents on the changes that take place during puberty.

Angelini uses the ACAPP Web site (www.azteenpregnancy.org) and periodic mailings to attract and retain new and old volunteers. She also speaks on radio and TV talk shows and to the print media. Last year Arizona's teen pregnancy problem got national exposure when Angelini appeared on the cable show, "The O'Reilly Factor." And every month or so she travels through the state, appearing before citizens groups such as the Kiwanis and Toastmasters, local policymakers and parents. Angelini believes that her appearances attract volunteers, some of whom become marvelous spokespeople for ACAPP and teen pregnancy prevention.

Strategy for State Budget Cuts
Arizona's teen pregnancy rate has declined 9 percent this year, but a budget crunch threatens to cut off funds from programs that may be helping. Angelini is keeping a close eye on locally and state-financed teen pregnancy programs in danger of extinction. In May 2002, she spoke in support of the Tempe high school district's teenage pregnancy prevention program and its mentoring component, which matches pregnant high school students with adult volunteers who were formerly pregnant teens. She brought three former program participants, a parent, and Rabbi Andrew Straus (chair of the program's advisory board), to speak to school board members at a public meeting.

Angelini's "team" approach saved the program. Now, she and a group of parent volunteers plan to meet with school board members of Phoenix Union School District, which has an extremely high teen pregnancy rate, to convince them to establish a prevention program.

In addition to trying to protect programs from budget cuts, Angelini will also try to push through bills or regulation changes that don't require any state money to be carried out. For example, Angelini wants to change data collection regarding high-school dropouts. Currently, when Arizona teens leave school, they must check off a reason on a form. But 'pregnancy' is not listed as a reason. This omission affects state teen pregnancy figures, which are important when trying to establish the need for prevention programs. Angelini is currently working on it with Arizona Department of Education staff. "Either they'll change the student form through a departmental rule, or we'll go to the legislature," she says.

Another cost-free legislative change on Angelini's agenda is participation in the CDC Youth Risk Behavior Surveillance Survey, a national survey on health risk behavior, such as smoking, drinking and drug abuse, among young people. The information from this survey is invaluable to legislators and professionals, she says. They can learn the percentage of Arizona teens abstaining from sex and the percentage of teens using contraceptive methods. "The more we know," says Angelini, "the better our prevention efforts can be."

Angelini's acknowledges that the present economic slump and tough job market can discourage progress among teens. "When students feel they don't have any economic hope, this feeds into the pregnancy problem," says Angelini. "So we need to get our economy up and going AND provide teen pregnancy prevention programs. Then we'll see the pregnancy rate diminish."

Resources:

• Visit the Arizona Coalition on Adolescent Pregnancy and Parenting
• Connect for Kids offers resources on teen sex and pregnancy.
  

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Janice Arenofsky is a full-time freelance writer who has written for many national publications.