Life’s Silver Linings, Inc.

(THERE WAS NO BOARD APPROVAL FOR THE DISTRICT TO BE A MEDICAID PROVIDER UNTIL EIGHT MONTHS LATER).

Four months later, a parent asked a board member if the board was planning to attend the district Medicaid meeting for PTGs and principals.Â? The parent was shocked to learn that not only did the board member NOT KNOW that such a panel or committee had been formed, but that the board was unaware that the district was actively moving forward to become a Medicaid provider.

The board member shared the telephone call with fellow board members.Â? Since no board member acknowledged that they were aware of the Medicaid meeting or panel, the consensusÂ? was that the board president should ask administration about it.Â? The board president reported back to board members that the district had formed a committee and was prepared to make a recommendation to the board at the next board meeting for approval to enter into the Medicaid Agreement!

This was the first time the board was formally aware of district activities taking place to become a Medicaid provider.� (Interestingly, the chairperson of the district’s Medicaid panel was a six year school board incumbent who had been unseated in the previous election by a candidate who was opposed to Medicaid-funded school-based clinics, and school/community-linked services).

The board requested a study session on the Medicaid issue prior to receiving a formal recommendation from administration.� In preparation for the study session, a board member who was concerned about the Medicaid Agreement, provided packets documenting Medicaid’s family planning� component to each board member and three administrators for examination prior to the study session.

April 19 Study Session

During the board’s study session, administration distributed a sample copy of the Medicaid Agreement.� Concern was voiced that schools were being used to implement socialized medicine, and government documents were quoted which verified the family planning� component of Medicaid.

A principal stated that parents on the panel voted in favor of the Medicaid Agreement.Â? In response, a board member explained that while advisory councils and panels are beneficial, there are some issues for which EACH PARENT should be able to speak for his/her own family.Â? Some issues should allow the wishes of EACH PARENT to be followed, and such panels represent parents who are not aware that they are being represented, or that important decisions are being made on their behalf.

In anguish the board member sent the following letter to the Archbishop.Â? It must be understood that this Archbishop is in no way responsible for the existence of HB564, and inherited the consequences of HB564 that became law prior to his appointment to this country and the community.Â? However, Archbishops may decide what their diocesan institutions do or do not continue to participate in.

“Dear Archbishop (N,)

“I am a member of the (N) school board.� I am also Catholic.� The evening of April 19th, our school board met with administrators in a study session regarding school/community-linked services� grants� and becoming a Medicaid provider.

“Being a Medicaid� provider is of grave concern to me.� I have obtained documentation that Medicaid pays for contraception� and case management� which allows for referrals� to community health providers who provide contraceptives, which may be distributed to minors� without parental consent.

“In defense of becoming a Medicaid provider, our district’s community specialist stated that five Catholic� schools are already Medicaid providers and in the near future, all Catholic schools will be.� I kindly requested she not use Catholic schools as an example, since a Post Dispatch� article which quoted the general counsel of Missouri Catholic Conference� as explaining that parents who choose contraceptive referral for their children could do so, was NOT consistent with the teachings of the Catholic faith.

“Health care providers MAY provide contraceptives� to minors� WITHOUT parental consent.� Even though Catholic� schools, and our public school district may not provide contraceptives and abortion� referrals, we are providing those who do, ACCESS to our children and their families.� The foundress of Missouri’s largest abortion clinic, Judith Widdicombe is the author of the legislation which allows schools to become Medicaid providers.� She emphatically stated that collaborative practice was the ‘benchmark’ of HB564, which provides ACCESS to ‘services.’

“I will continue to oppose schools as Medicaid providers in an effort to avoid sacrificing the fertility of our children to the god of Medicaid on the altar of universal health care.� I doubt that I will be successful, there are too many good, well intentioned people who don’t see the population control� component of the ‘big picture’.� However, I will continue to educate families wherever possible, and promote natural family planning, so families may protect themselves and their children from the population controllers, and those who would hand them over.

“We thank Almighty God and Pope John Paul II for your presence here.
“Working for LIFE,
(Name)
“Enclosures:

St. Louis County’s Teen Clinic

Schools’ Health Services May Grow-St. Louis Post Dispatch� 5-28-93

Planned Births, The Future Of The FamilyÂ? And The Quality of American Life

State Medicaid Manual-EPSDT

March 2, 1995 letter from Missouri Division of Social Services”

Soon afterwards a letter was received from the Vicar General stating that the Archbishop had requested that the letter and enclosures be sent to the Missouri Catholic Conference’s� General Counsel for analysis.� Missouri Catholic Conference was a major supporter of HB564, whose lobbying efforts were a key factor in the passage of the Missouri law that allowed schools to become Medicaid providers in the first place.

May 24 Study Session

“The district supports and promotes abstinence, recognizing it as the only method to be 100% effective in preventing all sexually-transmitted diseases and unintended pregnancies.

“Consistent with the district’s ‘no use’ drug policy, the district will not distribute and/or refer minors� for contraceptives.� Students requesting such services will be referred to their parent/legal guardian.

“The district supports the individual rights and preferences of families to teach as they wish in this regard within their homes.� While recognizing this, it is the responsibility of the district to promote abstinence� in an effort to uphold that which is in the best interest of the physical and social health of minor students.”

ALL board members and administrators supported abstinence, but one board member stood alone in support of such a policy !!!� An administrator stated that it was not the board’s place to pass policy regarding curriculum.� Another expressed the benefits of having compliance� come from the bottom up, rather than being imposed as a mandate from the top down.� The school board made known its desire to promote abstinence and family values, but to date had neglected to see the necessity and benefits of putting it in writing.� The board president then asked if any board member was interested in further discussion of the topic and promptly pronounced the issue closed.

On June 19, 1995, a copy of Missouri Catholic Conference’s� (MCC’s) analysis was requested, which arrived in a letter dated July 11.� The analysis simply consisted of a copy of a letter dated November 23, 1993, which had been sent to the President of American Life League that explained MCC’s interpretation of HB564.� A documented point-by-point counter analysis of MCC’s November ‘93 letter was sent to the Vicar General, MCC and the Archbishop.

July 12 Board Meeting

During the July 12, 1995, board meeting, school district administrators invited Medicaid representatives from another school district, the Archdiocese, and selected members of the district’s Medicaid committee (panel) to encourage the board to vote in favor of becoming a Medicaid provider.� In an effort to influence the board favorably, it was repeatedly stated that the Archdiocese was present to explain its participation in the Medicaid program.� The board had an opportunity to ask questions of the presenters.

The representative from the other school district was asked if their school district had an abstinence� policy.� She said she didn’t know.� She was also unaware of the ten basic Medicaid services to be available to those eligible for Medicaid, including family planning� services and supplies, and that Medicaid providers who choose not to provide those required Medicaid services are obligated to provide referrals� for those services.� She stated that she was aware that Medicaid services were to be provided to ALL students, not just those who are Medicaid� eligible since there was to be no discrimination regarding who received care.

When the Medicaid representative from the Archdiocese� was asked how their pregnant teens were handled, she replied that it was not an issue for them since Medicaid services are provided only to grades K-8.� She stated that families which have no physician are given a list of 25 doctors which she had put together.� She did not say whether or not these were Medicaid doctors, nor whether these doctors were “screened” regarding the distribution of contraception� for purposes of family planning.� (Artificial contraception for reasons of family planning is not consistent with the Catholic� faith). Initially the Archdiocese may not have been “privy” to district concerns regarding family planning, but it became clearly evident the evening of the July board meeting.

A board member quoted from page 6272 of the June 1992 Commerce Clearing House Medicare and Medicaid Guide� regarding “Family Planning Services: [which stated] State Medicaid programs must offer family planning� services and supplies directly or under arrangements with others to categorically needy individuals� of childbearing age (including minors� who can be considered to be sexually active) who desire such services and supplies and may offer them to comparable medically needy individuals� (See ‘Mandatory and Optional Services’ at 14,511).� [Soc. Sec. Act 1905(a)(4)(C); Reg. 440.40(c) and 440.250(c)]” emphasis added.

An administrator adamantly stated that the district has not, does not, nor will ever provide or refer students for contraception, and asked that the board trust them in this regard.

However, the issue was not one of trust, but of good business practice.Â? Providing written direction to school district staff on this issue would protect them from the possible consequences of not understanding the board’s (which reflects the community’s) philosophy on such an important and controversial matter, as had happened in the past.

Since school districts form partnershipsÂ? with community heath organizations and others who work with district students in an effort to reduce teen pregnancy, a tangible district procedure on the issue is necessary with which to provide direction and enforcement.Â? Parents worry about the safe passage of their children while at school, and are at the mercy of teachers, counselors and social workers who may or may not know whether the district allows staff to provide contraceptive referrals.Â? A written procedure allows parents to understand that their children are intended to have “safe passage” from those who might otherwise (perhaps unintentionally) undermine their family’s valuesÂ? while at school. Without a written policy or procedure parents have no avenue for recourse should someone refer their child for contraceptive drugs.

The July 12 board meeting ended in a 5-2 vote in favor of tabling the Medicaid issue until the board had an opportunity to discuss the Medicaid Agreement document at another study session.Â? The board study session was scheduled for August 3, in time to add the Medicaid Agreement to the August 9 board meeting agenda.Â? This would ensure its approval in time for the district to be a Medicaid provider prior to the start of the new school year.

August 3 Study Session

The August 3, 1995, study session consisted of a presentation from the Medicaid panel.Â? The board president informed a fellow board member, who wished to also provide information during the study session, that each person would be allowed only five minutes and then be promptly cut off when told the time was up.Â? The board president informed the fellow board member that in order to be fair, there would be NO exceptions.

During the presentations, the Medicaid panel’s co-chairman quoted from Missouri’s School Health Initiative� section 167.611 (HB564) which states,� “Contraceptive devices or contraceptive drugs shall not be provided by school personnel or their agents.”� The next sentence in the legislation that was not quoted states, “When a child seeks contraceptive devices or contraceptive drugs, the child shall be referred to the previously designated family practitioner.”� The law does NOT state that the child is to be referred to the parents.� The Interagency Medicaid Agreement� which school/districts sign states that the school/district will follow the law as defined in HB564!

Eight panel members including the representative of the Archdiocese, spoke in support of the district being a Medicaid provider.� This resulted in an unbalanced amount of time spent on arguments favoring Medicaid, since only one “presenter” represented the alternative point of view, who was also limited to five minutes.� Neither the board president nor administration invited an alternate “panel” to present the alternative viewpoint.

Reasons cited for favoring Medicaid included more money for the district with which to hire additional nurses, social workers, psychologist, counselors, etc. ALL children would receive health services, not just those who are Medicaid eligible, (although the formula for “reimbursement” is based on the number enrolled in Medicaid within the district,) NO additional services would be provided outside of what was already being offered, and accepting state and federal Medicaid dollars would prevent a need to raise personal property taxes.� People are wise enough to realize that ALL taxes, whether federal, state or local, come from the same paycheck, THEIRS!� The Archdiocesan representative explained that they use Medicaid dollars to hire school nurses, provide health education and referrals.

In the five minutes allowed to present the dissenting viewpoint, copies of the following documents were presented which verified the family planningÂ? component of Medicaid:

1. A copy of the U.S. Department of Health and Human Services’� chart listing “family planning� services and supplies” as one of ten “basic required Medicaid services” (emphasis added).

2. A July 25, 1995, letter from the U.S. Department of Health and Human Services� Region VII� Chief of Medicaid� Operations Branch stating that “you are essentially correct in your understanding of the services and provisions” (emphasis added).� This letter was in response to a July 19 letter asking if the state is required to reimburse for those health services to be provided to Medicaid eligible patients, and that those choosing not to provide certain services may choose not to provide them, but MUST provide referrals� for those services they choose not to provide.

3. A May 2, 1995, letter from the Medicaid Unit Supervisor of the Missouri Department of Social Services� which stated that “The interagency agreement� between the Department of Social Services and each school district does not vary from school to school.� A school does not write their own agreement.� Schools may not necessarily provide services, but will make arrangements for linking the student to an appropriate Medicaid provider for the service” (emphasis added).

5. Page 5124 from the State Medicaid ManualÂ? Part 5 regarding the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) program (which is the basis of the district’s Medicaid agreement), which states, “Prenatal Care Services–Just as it can provide enhanced services for at-riskÂ? infants, EPSDT can link at-risk adolescents to pre-pregnancy risk education, family planning, pregnancy testing and prenatal care” (emphasis added).

6. A letter from the U.S. Department of Health and Human Services’Â? Region VII’s Medicaid Operations Specialist which states “EPSDTÂ? is a comprehensive healthÂ? care program for children which includes–pregnancy testing–I believe Missouri Medicaid covers Norplant–. “

7. Page 6273 from the Medicare and Medicaid Guide’s� section 14,553 titled “Family Planning Services” which states “Utah’s prohibition of Medicaid payment for family planning� services and supplies provided to minors, unless parental consent� was obtained, violated the Supremacy Clause and was enjoined.� By choosing to participate in Medicaid, Utah� became bound by federal Medicaid requirements, one of which is unrestricted coverage of family planning services for eligible individuals of childbearing age, including minors.� The parental consent requirement was also barred as a violation of a minor’s right to privacy under the Fourteenth Amendment because it was unsupported by compelling state interest. T.H. v. Jones, USDC (CD Utah), 425 F. Supp. 873 (1975).� Affirmed U.S. Sup. Ct. (1976).� This decision was originally reported at NEW DEVELOPMENTS 27,568.);� Planned Parenthood� Association of Utah v. Dandoy, CA-10, 810 F 2d 984 (1987) (originally reported at NEW DEVELOPMENTS [36,040], affirming USDC CD Utah,� � � 635 F. Supp. 184 (1986) [originally reported at NEW � � � DEVELOPMENTS [35,827]” (emphasis added).� A number of people from the community attended the open meeting.� The board president announced that they would not be afforded an opportunity to speak.

August 9 Board Meeting

The August 9, 1995, board meeting was the climax of the district’s Medicaid debate.� Prior to the vote a board member read the following prepared statement addressed to the community:

“In May of 1993, legislation passed which allows schools to become Medicaid providers.� It concerns me that this law funds� government universal health care through schools which provide administrative case management� for the state.� It is my belief that schools should be centers for academics, not one-stop centers for state health and social services.� The community reflected these same concerns when it elected me to the school board in April of 1994.� Parents were not informed that for two years a fellow parent from their school was representing them on a committee that was preparing for the district to become a Medicaid provider.

“Administration has stated no new services will be provided.� Through salaries, the district already reimburses for health services.� To collect additional Medicaid funds� for what is already being provided, is an undue tax burden on our already financially overburdened families.

“While the law states that ‘contraceptive devices or–drugs may not be provided by school personnel,’ the next sentence states, ‘When a child seeks contraceptive devices–or drugs, the child shall be referred to the previously designated family practitioner.’Â? It does NOT say the child is to be referred to the parents.

“The Agreement diminishes local autonomy, since the district agrees to ‘conduct all activities recognizing the authority of the state–on issues, policies, rules and regulations on program matters.’Â? The (N) school district is in need of a written policy stating it will refer only to parents those children seeking such referralsÂ? and/or services, and will not indirectly make such referrals.

“The Medicaid AgreementÂ? our district is to sign with the Missouri Department of Social ServicesÂ? states that the district is to provide:Â? ‘REFERRAL to any needed services,’ as well as ‘prenatal care services:Â? [which] includes the provision of outreach coordination and preventionÂ? services.’Â? According to the State MedicaidÂ? Manual, prenatal care includes ‘link[ing]–adolescents to–FAMILY PLANNING.’Â? An April 7, 1994, letter from the Director of Missouri’s Department of Social Services states, ‘In this instance, prevention refers to coordinating pre-pregnancy risk prevention activities.’Â? Outreach activities include ‘provid[ing] scheduling assistance and develop[ing] transportationÂ? resources.’

“While the district can cancel this contract� at any time with a 30 day notice, rare indeed is the institution who is willing to return public funds� to the people, once it has become accustomed to receiving them.� Contact your elected officials to let them know how you feel about this.

(Closing and signature.”)

During this board meeting a Protestant board member publicly stated, “I find it a little odd that as a school district, we are being asked to be more conservative than the Archdiocese� of the City of St. Louis.” (The August 17, 1995, issue of The Independent News printed the quote as “I find it hard to believe that we are being asked to take a more conservative approach than the archdiocese of St. Louis.”)� In response the Catholic� board member stated that the Archdiocese had a Christian Witness Statement, whereas the district had no such statement or abstinence� policy.

It was obvious that board members had received the message that the concerns of their CatholicÂ? board member were not credible since the diocese was a Medicaid

provider and came to say so.� In the long run, the documentation didn’t seem to matter.� The final vote at the August 9 school board meeting of 5-2 allowed the school district to become a Medicaid

provider in spite of the documentation regarding its bias favoring contraceptionÂ? for minors.

A PTG officer confided that following the board’s approval for the Medicaid

Interagency Agreement, a district employee attended school PTG meetings to explain the Medicaid

agreement, and pointed out that the ArchdioceseÂ? was also a Medicaid provider.

Where is the “silver lining” in this cloud?� Well, God can do anything with nothing.� We are simply asked to be faithful whether or not we are successful.

The good news is that on the evening of November 29, 1995, another board study session was scheduled to discuss the issue of family planning� as it related to district staff as well as the Medicaid Agreement.� The consensus� was to add wording to the Methodology� (which describes how the district will implement the Medicaid Agreement) stating, “It in no way obligates the District (sic) to promote any services related to reproduction, abortion� counseling� or birth control.� Any student requesting information or a referral� for family planning or abortion or assistance in accessing these services will be referred to the parent or guardian.”� YEA !!!

However, as good as this news is, the population controllers STILL win.� As long as a school district is involved in referring children and their families to community health providers for any reason, those visits will be used to encourage children to use contraception� in an effort to meet the government’s “health” goal of increasing to at least 90 percent the proportion of people aged 19 and younger who use contraception.

Sometime later, a letter dated December 12, 1995, from the Missouri Department of Social Services, Division of Medical Services,� to the (then) school district superintendent appeared in the weekly packet to school board members. Among other things, the letter stated “All changes in methodology must be prior approved by the Division of Medical Services in order for change to occur (emphasis added).� If any policy clarifications are made in regard to the ACM [Administrative Case Management] program, the methodology� must be updated to reflect current procedures.” What NERVE! Administrators have not mentioned, referred to, or discussed this letter with the school board!

During administrative presentations to the Board, the board member who did not support the district entering into a Medicaid Interagency Agreement, explained to administrators the contraceptive connection and loopholes. District administrators clearly assured the board that “we don’t have to provide any services we don’t want to.” What happened? And what happened to local control?

Christian Witness Statement

The ArchdioceseÂ? utilizes a Christian Witness Statement to be signed by social workers and counselors stating they will be consistent with the teachings of the CatholicÂ? faith.Â? While such social workers and counselors MAY understand that Catholic institutions are not to provide or refer for contraceptivesÂ? for purposes of family planning, there is no guarantee about what takes place behind closed doors.Â? Even the Christian Witness Statement is so broad that it makes no mention of specifics such as contraception.Â? How many Catholics practice Natural Family PlanningÂ? as opposed to taking the PillÂ? or some other form of artificial birth control?Â? It is believed to be minimal.Â? What are the chances that social workers and counselors working in Catholic schools and paid for with Medicaid fundsÂ? will refer Catholic children and families only to clinicsÂ? and doctors which will not provide contraception?Â? The chances are slim to none since there are only a handful of doctors in all of St. Louis (Catholic or otherwise) who do not distribute contraceptives.Â? Who is going to check to make sure that the faith is not being undermined?

It’s been said that contraception� isn’t an issue for the diocese since its use isn’t consistent with the Catholic� faith.� Reality dictates otherwise.� Such a “head-in-the-sand” attitude� is exactly what the government and its non-governmental population controllers are counting on in order to use Catholic institutions to pump Catholic children and families into the government’s contraceptive-providing health-care system.

Two separate spiritual directors urgently advised that this information be directly provided to the Archbishop.� A telephone call was placed to the Chancellor (the Archbishop’s secretary,) to request an audience with the Archbishop.� The Chancellor explained that the Archbishop was out of the country and suggested speaking with the Vicar General.� Even though he was active in supporting HB564, the Vicar General kindly and patiently listened to and understood the concerns.� He stated that the best that could be done was to have the decision regarding contraception� put into the hands of parents. � It was explained to him how HB564 circumvents parents.� He asked that the concerns be explained to the director of Catholic� education, and said the director could send a copy of the Christian Witness Statement.� The education director requested that the concerns also be explained to his Director of Personnel, who had the Director of Health Related Issues call to discuss the concerns.� Each referral� was a welcomed opportunity to educate another administrator.

After following the Chancellor’s advice, an August 10 letter was sent to him explaining the past events relative to the public school district, the consequences of HB564, and a formal request for a meeting with the Archbishop.� The Chancellor was kind enough to respond on August 22.� He wrote that information in the letter would be discussed in a meeting with the Archbishop and Vicar General, and asked that his office be contacted after September 10th for an update.� The return call resulted in an explanation of the Bishop’s busy calendar.� It is true that the Archbishop is a very busy man and leadership necessitates delegating responsibility.

Very early one October morning an opportunity presented itself for a brief and impromptu visit with the Archbishop about the Medicaid issue.� It was explained to the Archbishop that the government is very wise.� The government will not ask the Catholic� schools to provide family planning� services, but the Catholic schools are being used by the government as a vehicle to gain access to Catholic children and families.� This is done when Catholic schools which become Medicaid providers refer their children and families to Medicaid health providers who DO provide family planning services and supplies.� It was explained to the Archbishop that the Archdiocese’s participation, however sincere and innocent, was being used to lend credibility to the state’s school Medicaid program, and its use among public schools.

The Archbishop is a good and holy man who seemed greatly concerned at the enormity of the situation which includes CatholicÂ? hospitals.Â? He is trusting that through prayer, example, and the perseverance of good people, that the situation will be corrected.Â? He explained that people must come to do what is right on their own and cannot be forced.Â? He explained that people can’t be taken from where they are and simply put “up here” where they need to be.Â? We live in the world and must work with the world.Â? A comparison was made to parenting.Â? Parents teach and train their children about what is right and expected of them, but have a God-given free will to do just what they want to do.Â? They can’t be MADE to do what is right and good for them.Â?

This is so true.Â? However, parents can and should insist that certain activities may or may NOT take place under their roof regardless of how their children may choose to exercise their free will elsewhere.Â? Consequences for breaching these expectations should be swiftly, fairly and mercifully dispensed with love.Â?

Likewise, adults need and expect spiritual leadership which says “this is right, this is wrong and this is why.”Â? Strong leadership which explains and enforces what may or may not take place within the church’s institutions, under its roof, within its walls, with dollars donated to the church, or in collaboration with the church, is needed and appreciated.

How will Missouri Catholic Conference (MCC) address the situation it has helped to create regarding the unsafe passage of our school children?� Population controllers may now access our children in exchange for Medicaid funds.� The result of Missouri Catholic Conference’s� support of HB564� was a key element which defeated a Catholic board member’s efforts to protect school district children and families from Medicaid-funded school-based clinics� and government population control� goals.

These goals include increasing to at least 90 percent the proportion of unmarried people aged 19 and younger who use contraception, and reducing to no more than 30 percent all unintended pregnanciesÂ? as broadly defined by the government.

The Protestant board member’s statement of “it seems a little odd that the district is being asked (by the school board’s Catholic� member) to take a more conservative approach than the Archdiocese� of the city of St. Louis” says it all.