|Back to July Ed Reporter|
|NUMBER 150||THE NEWSPAPER OF EDUCATION RIGHTS||JULY 1998|
Goals 2000, Health Care, and Family Planning
|by: Marie Smith|
In Missouri, schools create partnerships with healthcare providers in their communities, including the county health departments that distribute contraceptives to minors without parental consent, for which they receive Medicaid money and Title X federal family-planning dollars. The health departments have access to private and parochial school nurses as well as to public school nurses.
At the federal level is Goals 2000, which is the education component, and Healthy People 2000, which is the health component. All the health objectives for our nation are listed in Healthy People 2000, a 692-page document produced by the U.S. Dept. of Health and Human Services. At the state level in Missouri is the School Improvement Plan, which is the education component.
The health component in our state is called Healthy Missourians 2000, and it's based on Healthy People 2000. Implementation of this top-down process is accomplished locally through schools, churches, private businesses, and community organizations. If you hear of a Healthy Communities program or something similar, it is all part of this initiative.
There are three primary topics in Goals 2000. The first is standards and assessments. The second is state and local reform. The third is workforce standards - the School-to-Work aspect - which rounds out government control of education, health and labor, and adds up to socialism.
We're told it's all voluntary. States "voluntarily" want the federal money so they "voluntarily" implement Goals 2000. The school districts are told it's all voluntary, but the states must ensure that the system is implemented.
In Missouri, the school improvement plan is implemented by the State Dept. of Education and local school district administrators. Accreditation is withheld if a district doesn't comply because, in Missouri, the private enterprise, non-governmental accreditation agency has been phased out and replaced by the Missouri Dept. of Education's School Improvement Program. A team of educators visits a school district and assesses it. The district either receives accreditation, is provisionally accredited, or is denied accreditation. If the district is provisionally accredited, it has two years to earn accreditation or its accreditation lapses. That means the school district may be dissolved and merged with another school district, not necessarily an adjacent school district. So the bottom line is, districts must either "voluntarily" comply or "voluntarily" lose their accreditation and also their funding. Without funding, they "voluntarily" disappear. The bottom line is: a school district either "voluntarily" complies or "voluntarily" dies.
In Goals 2000, Section 102, objective #1 is entitled "School Readiness." It states that children will receive the health care they need to arrive at school with healthy minds and bodies, and that the number of low-birth-weight babies will be significantly reduced through enhanced prenatal healthcare programs. When Dr. Joycelyn Elders was still U.S. Surgeon General, she visited St. Louis and explained that this is a very strong component of Goals 2000 because "you can't teach children who are not healthy."
The School Improvement Plans must describe how each local district will implement Goals 2000, and specifically include identifying the most pressing needs facing students and their families. The whole family is included. Schools must also show how they will enter into partnerships with public and private nonprofit agencies, such as county health departments, to increase students' and families' access to coordinated, non-sectarian services in a school setting or at a nearby site.
The Safe Schools Act of 1994, another component of Goals 2000, states that grantees' school improvement plans shall contain a description of how school crime and violence prevention efforts will be coordinated not only with education and law enforcement agencies, but also with health and social services. The health and social services strand runs throughout the law, and family planning is always part of social services.
Part G of Goals 2000 creates an office of Comprehensive School Health Education. This office is to function as a hands-on coordinator of activity between the U.S. Dept. of Education and the U.S. Dept. of Health and Human Services. Its job is to integrate and coordinate the objectives of Goals 2000 and Healthy People 2000.
Title X of Goals 2000, entitled "Miscellaneous," lists contraceptive devices under Section 1018, which states that the Dept. of Health and Human Services and the Dept. of Education shall ensure that "all federally-funded programs that provide for the distribution of contraceptive devices to unemancipated minors will develop procedures to encourage, to the extent practical, family participation in such programs." An "unemancipated minor" is a child who is neither married nor independent.
What does "to the extent practical" mean when the brochures from the health departments inform our young people that, for teens aged 12 to 18, parental consent is required for general medical visits but not for services such as family planning, sexually transmitted diseases, or prenatal care? Most school district employees who collaborate with health departments in providing referrals probably don't know that this is the case, because schools generally don't even give children an aspirin or other over-the-counter drugs without a note from a physician. But that lack of knowledge is being exploited, and local people are being used as puppets. The state is saying, Here's Medicaid money that your district can use to hire more nurses for your schools. Those nurses are providing referrals for children and families and, when the children receive services they are asked about their sexual activity. "Are you sexually active?" "Are you using condoms or contraceptives?" "Are you talking to your parents?" The state wants children to know that they can obtain contraception without parental consent.
In Healthy Missourians 2000, unintended pregnancy is defined as all abortions plus live births and fetal deaths to females younger than 18, plus live births and fetal deaths with spacing less than 12 months for females ages 18 - 34, plus out-of-wedlock births to females with less than a college education. Healthy People 2000 encourages states to increase to at least 50% the proportion of sexually active unmarried people who used a condom during their last sexual intercourse.
The Medicaid-funded, early periodic screening and diagnostic testing (EPSDT) for children ages 13 to 18 includes more than just hearing tests, vision tests, and scoliosis screenings; they can also include a history of sexual practices. The laboratory and diagnostic procedures include pap smears. "Counseling" can cover sexual practices, sexual development behavior, sexually transmitted diseases, partner selection, condoms, unintended pregnancy, and contraceptive options. Healthy People 2000 says that clinicians may choose to add other preventatives such as for family dysfunction, and instructs them to remain alert for signs of child abuse and neglect. Healthy Missourians 2000 states that "establishing a school-based health clinic could help achieve objectives, including objectives connected to unintended pregnancy."
All these services are funded or subsidized through Medicaid. Every state must offer ten basic required services under the Medicaid plan. Number 8 is family planning services and supplies. Number 7 is early and periodic screening, diagnosis and treatment (EPSDT). Missouri's Medicaid manual states that EPSDT includes linking at-risk adolescents to family planning and pre-pregnancy risk education (which could mean abstinence education, but is actually "safe sex" programs).
Medicaid's Case Management Billing Instructions explain that EPSDT covers unclothed physical exams including external genitals. You may have heard what happened in East Stroudsburg, PA in 1995 when the 5th and 6th graders were given genital exams against their will and without parental consent. The children begged to call their parents and tried unsuccessfully to escape. Our school district denies doing such things, but according to the Medicaid billing instructions, schools can be reimbursed for performing those services. I foresee a day when school nurses will be told that providing these types of exams are to be part of the school's accreditation, and that the state will be checking to make sure they are performed in order to keep students "safe and free of disease."
In a letter from the Missouri Dept. of Social Services dated May 2, 1995, I was told, "Schools may not necessarily provide services but will make arrangements for linking a student to an appropriate Medicaid provider for the needed service." So the school is being used as a vehicle to access all children in order to achieve the federal goals in Healthy People 2000. The letter says that the interagency agreement between the Department of Social Services and each school district does not vary from school to school. Yet our school districts are told they can write these agreements any way they want to reflect the values of their communities. The letter, however, attests to the fact that a school does not write its own agreement. These agreements are the same for private and parochial schools as they are for public schools.
If Medicaid is for the poor, then why are the schools collecting it? I'm not opposed to having school nurses in every building, but let's pay their salaries out of general revenue. We've been paying school nurses a salary for performing hearing tests, vision tests, and scoliosis screenings for years. Now, schools are being reimbursed for providing these services, even though we reimburse the nurse for those same services every time she receives her paycheck.
In 1996-97, one school district receiv-ed $80,000 in Medicaid money for performing services they had already been paying school nurses to do. Of that $80,000, $30,000 was spent on computers, copiers, and printers for counselors' offices, i.e., data collection. In 1997-98, they expected to receive $80,855, all of it to be spent on salaries and benefits.
What about the broader implications of all this - the "world view"? School administrators, school board members, Congressmen and state officials have a responsibility not to undermine the faith, values, and the cultural diversity of the families in our school districts and in our states. A large segment of our community believes that contraception is immoral. Even those who don't consider it immoral don't want contraceptive chemicals and gadgets given to their children, because they don't want to encourage their children to be sexually active. Protestants Against Birth Control opposes contraception. The Catholic Church's Humanae Vitae takes the position that every marriage act must remain open to the transmission of life.
We need to stand up for our values. We pay taxes. We send our children to school to learn academics, not to have our values undermined. Goals 2000 is undermining the philosophies of even our religious health organizations. A letter dated December 22, 1997 from the Missouri Dept. of Social Services states: "Health plans with religious affiliations which prevent the direct administration of family planning services have engaged a third party administrator to fulfill their contractual obligation." I call this the "Pontius Pilate Syndrome." Some religious healthcare organizations are collecting Medicaid money for family planning services that their church teaches are morally wrong.
What can we do? As a start, we should repeal Goals 2000. The best way to help a child is not to tax his parents into poverty. Just think of what we could do for education more economically, efficiently and effectively if we could do it ourselves. We must limit the percentage of federal grants to be used for salaries and benefits, define the use of these grants more narrowly, and limit Medicaid funds to the truly poor. Let's mandate that school districts publicly report to the taxpayers on what grants they are receiving and how the money is being used. Let's make our health expenses tax deductible.
Last but not least, to avoid the pill, we mustn't eat the applesauce. A mother with a sick child puts the medicine in the applesauce, and the child eats the applesauce and doesn't know he took the medicine. That is exactly how we are being poisoned by the family-planning/population-control agenda. States are hungry for the professional development funds and the grant money. The pill is hidden in the money.
Marie Smith is the founder of Life's Silver Linings. She is an education researcher, an elected school board member, and the author of "Health & Education Reform: Freedom's Voluntary Demise."