After years of having the highest teen pregnancy rate in Kansas, Wyandotte County -- home of Kansas City -- got some relief. In 2010, the Obama administration started offering grants to help schools back away from abstinence-only and integrate evidence-based lessons into their sex education.

That year, many schools in Kansas stopped teaching abstinence-only, and the state's teen pregnancy rate declined 9 percentage points. That's because the federal Personal Responsibility Education Program (PREP) is proven to delay sexual activity, increase use of birth control and reduce teen pregnancy. It was created as an alternative to Title V, which funds strictly abstinence-only teaching.

But more and more states are refusing PREP grants, while continuing to accept Title V funding. It's a trend that worries health officials.

“If a 16-year-old gets pregnant, she is more likely to not finish school, and that sets off a bad domino effect for the rest of her life," said Greg Stephenson, personal health services manager at the Wyandotte County Public Health Department. "The impact of these programs goes way beyond sexual health."

Less than 50 percent of the nation's high schools meet the CDC’s standards for comprehensive sex education, and this recent trend may worsen the problem. In 2015, Florida, Indiana, North Dakota, Texas and Virginia all opted out of PREP grants. They're joined this year by Kansas and South Dakota.

With the exception of South Dakota, the other states that declined PREP funds also accepted Title V funds this year and last year. Most states are awarded a mix of both, with 35 receiving Title V funds and 44, plus the District of Columbia, receiving PREP grants.

“Not all of these PREP-funded programs were even comprehensive, sometimes they just covered the bare basics -- but that is still essential,” said Chitra Panjabi, president of the Sexuality Information and Education Council of the United States.

States accept the money and then award it to the local health departments and school districts of their choosing. When Stephenson got an email that the state wouldn't be taking the grants this year, he was shocked because PREP seemed to satisfy everyone.

“The local government was pushing it, the school board wanted it, parents liked it, we got a green light from everyone. It was amazing."

The reason Kansas, and many of the other states, don't want the funds anymore isn't totally clear.

Cassie Sparks, public information officer at the Kansas Department of Health and Environment, said the state decided to forgo the funds so localities can apply for them on their own. But the state didn't apply that some logic when they accepted $600,000 in abstinence-only Title V grants this year. In addition, Stephenson is unsure whether local agencies and districts can even apply for the funds.

The state's Republican governor, Sam Brownback, falls at the extreme end of conservativism when it comes to reproductive issues. He signed a bill in 2012 that allows pharmacists to refuse filling a prescription if they think it will be used to induce an abortion. He followed that up in 2013 with a set a bills that include blocking tax breaks for abortion providers and defining life as beginning "at fertilization."

When states don't take PREP funding, Panjabi said it’s not uncommon for private groups to fund a sex ed program that pushes their own political agenda. She points to an example in Teton County, Wyo., which wasn't granted any PREP funding this year.

An anti-abortion group foot the bill to get abstinence-only speaker Shelly Donahue to talk to students at a public school. Donahue is known for her unorthodox speeches on sex, like referring to people who have sex outside of marriage as “chewed pieces of gum.” If Teton County had been awarded PREP grants, there's no way hiring Donahue would have been an option, said Panjabi. (Donahue, by the way, never spoke because of pushback from parents.)

As for what’s next for Stephenson and Wyandotte County’s sex education curriculum, it’s all up in the air. Once the PREP funding dries up at the end of this coming school year, there's no money -- or seemingly enthusiasm -- to keep evidence-based sex ed going there.

"We are going to try to energize teachers to take it up on their own," said Stephenson, "but they don’t seem to want to."