Unlike other states that draw from several sources, Iowa has only one federal funding stream for abstinence education. Barring an act of Congress, that stream — Title V, Section 510 — is poised to dry up at the end of September. "The program officially expired June 30," said Lindsay Miller, abstinence-education program coordinator for the Iowa Department of Public Health. "Congress came back about a week and a half later and approved a three-month extension. As of now, the program is set to expire once again on September 30." Congress returns from its August recess on Tuesday, Sept. 4, and is expected to re-visit the funding issue for possible re-authorization. "We receive our funding from the U.S. Department of Health and Human Services — specifically the Administration for Children and Families," she said. "We've received direction from them about three possible scenarios." According to HHS, the program could be denied re-authorization, it could be re-authorized as-is, or could be revamped and then re-authorized under new, less-restrictive guidelines that could incorporate more comprehensive-based education without such a strict focus on abstinence until marriage.

"Everything is very unknown right now," Miller said. "Things can change very quickly, and we just don't know what might come once the discussion takes place."

Under Section 510, Iowa received $318,198 this fiscal year. The state Health Department keeps a small portion for statewide implementation and grants the remainder to eight local programs and to the University of Iowa for program evaluation. The local programs primarily conduct school-based programming. This curriculum instruction varies between one-time, large assembly events and programs that stretch over several weeks. Local programs also conduct media campaigns and parent outreach.

Legislation signed by the governor in spring calls for all human growth and development education taught in schools to be research-based. This new mandate, Miller says, will not affect local groups teaching abstinence-only education in Iowa as a part of Section 510.

"One of the last lines of House File 611 states that the bill shall in no way prohibit schools from teaching abstinence only education," she said. "So, it does not affect them. All of the curriculum that we use in our program, we assure that it is medically accurate and research-based. All of our contractors have to sign an assurance form stating that all the information they present is medically accurate and research-based. We also approve all of the curriculum that our contractors use."

When a local program wants to switch curriculum, Miller says the contractor has submit an "A through H Adherence Curriculum Summary Table." (See insert below for the A through H federal guidelines.)

Abstinence only education is defined in Section 510 as an educational or motivational program which:

1. Has as its exclusive purpose, teaching the social, psychological, and health gains to be realized by abstaining from sexual activity;
2. Teaches abstinence from sexual activity outside marriage as the expected standard for all school age children;
3. Teaches that abstinence from sexual activity is the only certain way to avoid out-of-wedlock pregnancy, sexually transmitted diseases, and other associated health problems;
4. Teaches that a mutually faithful monogamous relationship in context of marriage is the expected standard of human sexual activity;
5. Teaches that sexual activity outside of the context of marriage is likely to have harmful psychological and physical effects;
6. Teaches that bearing children out-of-wedlock is likely to have harmful consequences for the child, the child's parents, and society;
7. Teaches young people how to reject sexual advances and how alcohol and drug use increases vulnerability to sexual advances; and
8. Teaches the importance of attaining self-sufficiency before engaging in sexual activity.

"They have to list out very specifically how each component of the curriculum adheres to the guidelines," she said. "That must be submitted, reviewed and approved before any new curriculum can be implemented. So, we assure that all the curriculum our grantees are using is medically accurate and research-based."

Rhonda Chittenden, executive director of FutureNet, an Iowa-based group working to ensure all service providers in Iowa use science-based practices in teen pregnancy, parenting and sexual health education programs, said adherence to the guidelines may not be enough.

"We do believe it would be really difficult to adhere to that eight-point definition and the new state legislation at the same time," she said. "There are some conflicts in the really value-based points that are set out in that abstinence only legislation. It would be a real challenge for programs to be able to fulfill both of those mandates at the same time.

"We believe that young people deserve to have medically accurate information that is verified by the weight of peer-reviewed research. That hasn't been the case in many abstinence-only programs. If the standards were changed to adhere to that, it would make us real happy."

The Sexuality Information and Education Council of the United States reviewed several pieces of curricula used by the Iowa contractors and found reliance on messages of fear and/or shame.

A portion of their report reads, "SIECUS reviewed two of the curricula produced by Choosing the Best, Inc.—Choosing the Best LIFE (for high school students) and Choosing the Best Path (for middle school students). These reviews found that the curricula name numerous negative consequences of premarital sexuality activity and suggest that teens should feel guilty, embarrassed, and ashamed of sexual behavior. For example, Choosing the Best LIFE states that 'relationships often lower the self-respect of both partners—one feeling used, the other feeling like the user. Emotional pain can cause a downward spiral leading to intense feelings of lack of worthlessness (sic).' Choosing the Best PATH says, 'Sexual activity also can lead to the trashing of a person’s reputation, resulting in the loss of friends.'"

While Iowa is currently one of the few states grappling with meshing federal and state mandates, it is not alone in the waiting game for Section 510 funding. The federal dollars are distributed using a formula that contrasts the number of low-income children in the state to the total number in the nation. Iowa ranks low on that scale but states like Illinois that have higher low-income populations stand to lose nearly $2 million for their abstinence-education programs. Kansas and Nebraska have awards similar to Iowa's, but Missouri stands to lose nearly $1 million.