They Didn't Just Cut TPP. They Replaced It.

Yesterday I wrote about what it felt like when PATCH lost $130,000 in federal funding overnight. If you haven't read that post yet, I'd encourage you to start there: "It Happened. What We Warned About Is Here."

When most people hear that a federal program lost its funding, they picture an empty line item. A gap. Something that used to exist and now doesn't.

That is not quite what happened to the Teen Pregnancy Prevention program. I spent the past several days digging through the federal government's own documentation, and what I found is more troubling than a simple funding cut. The program wasn't eliminated. It was replaced, with a new version that looks similar on the surface but is fundamentally different underneath.

I think Wisconsin's donors, advocates, and elected officials deserve to see exactly what changed.

What TPP used to be

For more than a decade, the federal Teen Pregnancy Prevention program operated with an annual budget of approximately $101 million. It funded 73 organizations across the country under a five-year grant structure, organized around a deliberate continuum: incubate new ideas, accelerate the most promising ones, evaluate them rigorously, and only then implement proven approaches at scale.

This was not a haphazard program. It had eight straight years of published performance data, tracking reach, dosage, fidelity, quality, partnerships, and dissemination. It reached deeply into communities with the greatest need, including 11,515 youth in juvenile justice settings, 8,203 youth in foster care and out-of-home care, and 1,561 youth experiencing homelessness, just within three specialized settings tracked between 2015 and 2023.

This is the program that funded PATCH here in Wisconsin. It is the program that funded similar work in Milwaukee, in Oneida County, in Bayfield County, and in a dozen other Wisconsin communities. It is the program responsible for a 72 percent decline in teen birth rates since 2007.

What replaced it

On June 26, 2026, the federal government terminated the bulk of this program nationwide, including Wisconsin's award. A few days later, I found the replacement sitting quietly on the same federal website.

It is called "Replicating Effective Teen Pregnancy Prevention Programs." It offers up to $63.4 million, a one-time solicitation, not a stated annual budget, for an estimated 52 awards. Grants last up to two years, with an optional third year, down from the five-year horizon organizations like PATCH had built their work around.

The language has changed too. The old program talked about reducing teen pregnancy and STIs through rigorously evaluated, evidence-based approaches. The new solicitation talks about "body literacy," "informed consent," and helping teens "clarify reproductive life goals." These are not phrases from the public health literature I have spent my career working in. They are phrases drawn from a different ideological tradition, one focused on abstinence and natural fertility awareness rather than comprehensive, evidence-based education.

There is no published commitment to reaching homeless youth, foster youth, or justice-involved youth in this new solicitation. There is no evidence base yet, because the model is new. There is no eight-year track record, because it does not have one.

Why PATCH won't be applying

I want to be direct about something: PATCH will not be competing for this new $63.4 million pool, and it is worth explaining why.

The new funding is explicitly governed by the priorities of the Office of the Assistant Secretary for Health, the same office overseeing this transition. Those priorities state plainly that the administration considers health equity an "ideologically-laden concept" and commits to "ending diversity, equity, and inclusion (DEI) policies and practices" across all OASH-funded programs. They go further, warning against funding anything that could be characterized as "discriminatory equity ideology."

PATCH's entire model is built on equity. We exist because health care systems have historically failed to listen to young people, particularly young people from communities that face the greatest barriers to quality care. Our work centers youth voice specifically because some voices have been left out of decisions about their own health for too long. That is not an ideological add-on to our program. It is the program.

Applying for funding that requires us to disavow that framework, or to redesign our work around "informed consent" and "body literacy" language rather than equity and youth leadership, would mean becoming a different organization. We are not willing to do that, and we do not believe we should have to.

This is, I think, the clearest illustration of what I mean when I say TPP was not simply cut. It was rebuilt around a value system that organizations like ours cannot, in good conscience, compete within. The price of admission to the new program is abandoning the principles that made the old one work.

Why this distinction matters

I want to be precise about what I am and am not saying. I am not simply saying funding was cut, although it was, and PATCH lost $130,000 of it overnight. I am saying something more specific: the federal government dismantled a mature, evidence-based public health infrastructure and replaced it with an unproven, ideologically driven model, under the same program name, in the same week.

That distinction matters because it tells you this was not a budget decision. A budget decision reduces funding. This was a substitution. Roughly $63 million in, roughly $68 million out. The dollar figures are even similar. What changed was not the amount of money. What changed was who gets it and what they're required to say, and believe, to get it.

What I'm asking of you

If you have read this far, you understand something most people do not yet know about what happened to programs like PATCH. I am asking you to do three things with that knowledge.

Share this post. Most people, including many people who care deeply about teen health, do not know that TPP wasn't simply defunded. They think it disappeared. The fact that it was replaced with something built on a different premise entirely, one that organizations like ours cannot in good conscience apply for, is a story that needs to travel further than our blog.

Support PATCH directly. We are still here, still committed to this work, and still need community support to bridge the funding gap created by this transition. You can donate at patchprogram.org/donate.

Talk to your elected officials. Whether you reach out to your member of Congress, your state legislators, or write a letter to the editor, decision-makers need to hear that their constituents understand the difference between cutting a program and quietly rebuilding it around a different set of values.

We did not choose this fight. But understanding exactly what we are up against is the first step in winning it.

It Happened. What We Warned About Is Here. Federal Funding Cuts Hit PATCH.

Donate to Support PATCH Today!

Here's what you need to know from Sara Finger, Executive Director, Embolden WI

Last June, I wrote about the uniquely cruel new threats facing nonprofits like ours. I described the anxiety, the instability, and the uncertainty that the Trump administration had already unleashed on the sector. I wrote about how Embolden WI was not immune, that almost all of our funding for the Providers and Teens Communicating for Health (PATCH) Program comes from federal sources, and that we had already been warned that critical grants were at risk.

I wish I had been wrong. 

On June 26, 2026, the Trump administration terminated 53 of 67 Teen Pregnancy Prevention grants nationwide, effective immediately. Wisconsin's Department of Health Services, which held the federal TPP award and passed funding to community organizations across the state, received its termination notice the same day. So did PATCH.

For us, that means $130,000 in funding is gone. And we are not okay with that. But we are not going anywhere either.

What PATCH is and why it matters more than ever

In 15 years, nearly 300 Wisconsin teens have come through our program. We hire them. We train them. We pay them. And then we watch them walk into rooms full of health care professionals and change how those adults think about the young people they serve.

But don't take my word for it. Listen to the young people who lived it.

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"The whole PATCH team changed my life when I was 16. I will always be so grateful for the chance they took on me and I will take the values I built and fueled from PATCH with me for the rest of my career, the rest of my life."

"PATCH made me realize how passionate and interested in adolescent health I am and now I work with it every single day as a nurse. Absolutely PATCH led to this career for me."

"Leading workshops for health care professionals was an amazing experience. I never would have thought professionals would or could learn from youth in that way. It was an empowering experience to know the impact I could have advocating for myself and fellow youth."

"By FAR the best job. I joined over a decade ago, and yet PATCH is still the best boss, mentorship structure, and culture I have ever experienced in a job. I grew so much without the painful growing pains, but instead a community of support."

These are not cherry-picked outliers. An independent 2024 evaluation of 104 Wisconsin PATCH alumni found statistically significant gains across every area studied, including healthcare confidence, advocacy skills, self-worth, health and wellbeing knowledge, job readiness, and understanding of public health systems. We received over 100 pages of responses from alumni sharing what this program meant to their lives. The numbers tell one story. The words tell another. Together, they make an undeniable case.

Alumni have become nurses, physicians, and physician assistants because of PATCH. Others have gone on to become advocates, community leaders, and public health professionals. They carry what they learned here into everything they do, and the ripple effects reach far beyond any one program or any one grant. 

This work is not just valuable. Right now, with federal priorities shifting toward ideological agendas and away from evidence, this work is more necessary than ever. Young people in Wisconsin deserve health care providers who know how to talk to them. They deserve a seat at the table. PATCH makes that possible, and we are committed to making sure it continues.

What happened and why it's wrong

The stated justification for these TPP terminations is that programs "normalize or promote sexual activity for minors." That framing is deliberately vague, designed to sweep in anything the administration wants to eliminate regardless of what programs actually do. PATCH's work is about youth voice, health communication, and leadership. It is evidence-based, rigorously evaluated, and proven to work. Our alumni prove it every single day.

Teen birth rates have fallen 72 percent since 2007. That is one of the most significant public health achievements of the past two decades, built program by program, community by community, through sustained federal investment in what works. The administration just pulled the plug on that investment, not because the programs failed, but because they succeeded on behalf of young people this administration has decided don't deserve that support.

What makes this particularly frustrating is the method and the message. Our TPP contract was approaching its natural expiration, and PATCH was anticipating a continuation contract that would allow this work to go forward. That expectation was not naive. It was based on years of demonstrated results and a federal program designed to sustain evidence-based work over time. Instead, we received a termination notice with no path forward, no transition support, and no opportunity to responsibly plan for what comes next.

PATCH is not the only Wisconsin organization affected. More than a dozen community organizations, public health departments, and statewide partners across Wisconsin received the same notice on the same day. This is a statewide public health crisis.

Where we go from here

Wisconsin's Department of Health Services has signaled it is assessing all available options to push back on the federal government's actions. Legal challenges to TPP terminations have succeeded before. During Trump's first term, courts ruled five times that the administration acted unlawfully, and the government dropped its appeals every time. We are watching that space closely and staying in close contact with our state partners.

We are also watching the broader federal landscape carefully. There are other funding streams that support PATCH's work in Wisconsin, and the uncertainty is real. We will continue to be honest with you about what we know as we know it.

What I want you to hear most clearly is this: Embolden WI is fully committed to sustaining and strengthening PATCH. This program is not going away. Wisconsin's young people need it too much. The teens who have come through this program, and the ones who are coming next, deserve our full commitment. And they have it.

What we need now is our community to stand with us as we navigate this moment and build toward what comes next.

Here's how you can help

When I read those alumni quotes, I think about the young person who might have written them next year, or five years from now, if we keep this program going. That is what is at stake. That is why your support matters so much right now.

Donate to PATCH today at patchprogram.org/donate. Every gift, at any level, goes directly toward sustaining this work for Wisconsin teens.

If you've been thinking about becoming a monthly supporter of Embolden WI, now is the time. Our Foster the Future Fund, just $10 a month, provides the unrestricted, reliable support that lets us respond to moments exactly like this one. Sign up at emboldenwi.org/about/supportemboldenwi.

Share this post. Talk about PATCH. Tell people what it does and what it means for Wisconsin teens. Public awareness is its own form of power.

And call your legislators. Let them know that cutting evidence-based programs for young people has real consequences for real communities across Wisconsin. They need to hear from you. You can easily speak out by linking here.

The work continues. We need you with us.

Find our press release here

Learn more about this devastating cut to the TPP program:

• Government Overhauls Teen Pregnancy Program to Focus on Marriage and Starting Families

• Trump administration ends $1.2M in federal grants for Wisconsin teen health programs

• Teen pregnancy prevention cuts hit Wisconsin program connecting heatlh providers and teens

• State health dept. confirms US cuts for pregnancy prevention, seeks other funding

• Feds have a new teen pregnancy prevention plan: Fertility and 'reproductive goals'

• Democrats demand HHS reinstate canceled teen pregnancy prevention grants

• Feds cancel 1.2 million grant to Wisconsin to prevent teen pregnancy

• Trump administration cancels millions of dollors in teen pregnancy prevention grants

• Federal health agency cancels most of its teen pregnancy prevention grants

• Trump administration disturbingly cuts funding for teen pregnancy prevention programs

• RFK Jr.'s HHS to Divert Funds From Teen Pregnancy Grant Program

Sara's Reflection: What Two and a Half Years Has Taught Us

When I wrote the story of Embolden WI at the start of 2024, I was equal parts resolved and terrified. I knew the "why" in my bones. What I didn't fully know was the "what comes next.

Two and a half years later, I have some answers. Some are encouraging. Some are humbling. All of them have confirmed that the pivot was right.

What We Said We'd Do

In that first post, I wrote about moving from reaction to upstream action. About building a home for community-driven health equity and civic health work in Wisconsin. About fiscal sponsorship as a vehicle for getting bold ideas off the ground without forcing them through the punishing gauntlet of becoming a 501(c)(3).

That wasn't just a vision statement. It became the work.

Today, Embolden WI serves as a fiscal sponsorship platform and infrastructure organization supporting eleven partner initiatives. From the Building Families Alliance of WI, which has grown to more than 1,000 members statewide advocating for statewide legislation to make effective fertility treatments affordable and accessible through required insurance coverage, to the Parkinson's Disease Alliance of WI, pursuing a statewide Parkinson's disease registry, to Roots4Change Cooperative, improving maternal and child health outcomes for families in Dane County, these initiatives exist and are growing in part because we removed the structural barriers standing in their way. That is not a small thing.

PATCH and ECCHO, our two homegrown programs I mentioned in that first post, are still going strong. PATCH continues to center young people as leaders in shaping adolescent health. ECCHO continues to equip BIPOC women and non-binary leaders in Milwaukee and Rock counties to drive systems change. I remain in awe of what both programs have made possible.

Who We're Reaching

The real measure of this work is the people it touches. Across our two homegrown programs and eleven fiscally sponsored partner initiatives, Embolden WI reaches communities throughout Wisconsin, with a particular focus on those most impacted by health inequities.

Through our own programs, PATCH reaches youth ages 14 to 19, connecting teens with healthcare providers trained to communicate effectively about adolescent health. ECCHO engages women of color and community leaders in Milwaukee and Rock counties through a two-year civic leadership development program.

Our fiscally sponsored partners are leading work across the state on behalf of the communities they serve. AMIWI is building health and well-being in Greater Milwaukee's Kinyarwanda-speaking community. Roots4Change Cooperative is supporting immigrant Latina and Indigenous families navigating maternal and perinatal health in Dane County. Comité Sin Fronteras is advancing immigration reform and direct services with young adult immigrant leaders in Southeast Wisconsin. Healthy School Meals for All Wisconsin (HSM4A) is driving a statewide movement to provide free school meals to every K-12 student. The Dementia Care Alliance of WI is providing education, guidance, and resources to older adults and caregivers navigating dementia-related diagnoses. The Building Families Alliance of WI and its 1,000+ member network are advocating for individuals and families facing fertility challenges. And the Parkinson's Disease Alliance of WI is advancing registry legislation and advocacy for people living with Parkinson's disease and their care partners.

Our fiscally sponsored partners also include KindPath, offering technology-driven mental health support to underserved and rural populations; Cade's Light, will soon be building confidence and mental wellness in underserved middle school youth through the Shine Your Light Youth Experience; Zero Waste Madison, engaging Greater Madison residents in zero-waste and circular economy education; and Altera Circular Solutions, supporting emerging innovators in health equity and workforce sustainability through textile recycling and workforce education.

This is what a network built on shared infrastructure looks like. Not one organization trying to do everything, but eleven community-rooted initiatives, each doing their own vital work, supported by a backbone that lets them move faster and reach further than they could alone.

Growing With Intention

The growth of our fiscal sponsorship platform has been both exciting and clarifying. We welcomed five new partners earlier this year alone, and we currently have seven applications under consideration. That kind of momentum is a testament to the demand for this model and the trust communities are placing in Embolden WI as a home for their work.

It has also made one thing very clear: our most important near-term priority is hiring a Fiscal Sponsorship Director. We want someone who can give our existing eleven partners the holistic, attentive support they deserve, while helping us grow with integrity and quality as that demand continues to increase. The right person in this role will ensure that growth never comes at the expense of the care and partnership our partners count on.

What I Didn't Anticipate

Here's the honest part.

I did not fully anticipate how hard this moment in history would be for organizations like ours. Securing nonprofit grant funding is highly competitive right now, and getting harder. With federal funding in flux, a vast majority of nonprofits that previously relied on government dollars are now pivoting to private foundations, flooding already crowded application pools and driving approval rates down across the sector. Funders are more discerning than ever, requiring detailed proof of sustainability, financial health, and long-term impact, and they continue to heavily prioritize established organizations with proven track records. Over the past year we have submitted more than two dozen grant applications, some of the strongest we have ever written, and secured just two of them. That is not a reflection of the quality of our work. It is a reflection of how difficult this landscape has become for organizations like ours, doing equity-focused work in a political moment that is actively hostile to the communities we serve. We are not immune to that pressure, and we will not pretend otherwise.

I also did not fully anticipate how much the transformation to a fiscal sponsorship platform would ask of us, and how much our team would rise to meet it. Serving eleven partner initiatives takes real infrastructure, expertise, and attention, and I am genuinely proud of what our small but mighty team has built. What I know now is that this model works, and that investing further in our capacity will only multiply what's already possible.

What has held us together is the same thing I wrote about two and a half years ago: the belief that communities already possess the power to create lasting change. Our job is to remove the barriers that stand between that power and its full expression. That belief has not wavered. If anything, this moment has sharpened it.

Where We Are Headed

We are actively building toward what comes next. That means growing our fiscal sponsorship platform thoughtfully and sustainably, investing in the infrastructure that allows our partner initiatives to do their best work, and continuing to develop PATCH and ECCHO as models for what community-driven change can look like.

We are also thinking beyond our own platform. As interest in fiscal sponsorship grows across the nonprofit sector, we feel a responsibility to help raise the bar for how this work gets done. Fiscal sponsorship done well is a powerful vehicle for community-driven change. Fiscal sponsorship done carelessly can cause real harm to the partners who depend on it.

We have spent the last two and half years building and refining this model, and we want to be a resource for others who are stepping into this space. If you are exploring fiscal sponsorship, or deepening your own practice, we hope you will take a few minutes to read our latest thinking: Fiscal Sponsorship Is Growing. Let's Make Sure We Grow It Right.

It also means being clear-eyed about the climate we're operating in. Small nonprofits doing equity-focused work are being asked to do more with less, in a moment that is actively hostile to the communities we serve. We are navigating that reality and doing so from a position of strength. But strength has to be sustained, and that is where your support comes in.

How You Can Help

If you believe, as I do, that communities across Wisconsin deserve a fair and just opportunity to be healthy, to participate civilly, and to shape the systems that affect their lives, then I hope you'll consider investing in the infrastructure that makes that possible.

A donation to Embolden WI is a donation to every initiative in our network. It is a donation to the mothers, young people, advocates, and community leaders who are doing the hard, necessary work of building a more equitable Wisconsin. It is an investment in the home we are building together.

We are still here. We are still building. And we are grateful, every day, for the people who believe this work matters.

Donate to invest in Embolden WI today

Founder & Executive Director of Embolden WI