Tuesday, May 15, 2007

"A Woman's Concern is persuaded that the crass commercialization and distribution of birth control is demeaning to women, degrading of..."

As a follow up to what I posted earlier today about the U.S. Department of Health and Human Services, here’s a question: Anyone have any idea what the Deputy Assistant Secretary of Population Affairs is for? You are probably thinkIng, "I could care less because it’s not particularly interesting and exciting to think about government health policy," despite the fact that the policies that the government sets in this area can potentially affect very intimate aspects of your life.

You probably take for granted that the policies that your government sets and funds with your tax dollars to educate, gather and provide information about, as well as to set standards related to, Americans’ sexual and reproductive health are based on science and making sure that reproductive health medicine is safe and effective. You probably take it for granted that such policies would leave the moral choices about your sex life to you.

You might not want to be so complacent.

If the idea of the government promoting health policies that focus on the morality of your sexual choices rather than on science and basic health frightens and creeps you out, keep reading.

To answer the question at the beginning of this post, the responsibilities of the Deputy Assistant Secretary of Population Affairs include:

... the implementation of the mandated provisions of two categorical grant programs:

  • The Family Planning program authorized under Title X of the Public Health Service Act (PHSA), and
  • The Adolescent Family Life (AFL) Demonstration and Research program authorized under Title XX of the PHSA.

Here are some of the services that the Title X program provides:

The Title X program is the only Federal program devoted solely to the provision of family planning and reproductive health care. The program is designed to provide access to contraceptive supplies and information to all who want and need them with priority given to low-income persons. A broad range of effective and acceptable family planning methods and related preventive health services are available on a voluntary and confidential basis. In addition to contraceptive services and related counseling, Title X supported clinics also provide a number of preventive health services such as: patient education and counseling; breast and pelvic examinations; cervical cancer, STD and HIV screenings; and pregnancy diagnosis and counseling. For many clients, Title X clinics provide the only continuing source of health care and health education.

The program supports a nationwide network of approximately 4,600 clinics and provides reproductive health services to approximately 5 million persons each year. Title X service funds are allocated to the ten DHHS Regional Offices. The Regional Offices manage the competitive review process, make grant awards and monitor program performance. In fiscal year 2003, Title X provided Federal funds for service delivery grants to 86 public and private organizations to support the provision of comprehensive family planning services and information. Services are delivered through a network of community-based clinics that include State and local health departments, hospitals, university health centers, Planned Parenthood affiliates, independent clinics, and public and non-profit agencies. In nearly 75 percent of U.S. counties, at least one provider of contraceptive services is funded by the Title X family planning program.

Title X funds are critical to maintaining and operating clinics which ensure the availability of family planning services to low-income and uninsured individuals in the United States. Over the last thirty years, the network of Title X family planning clinics has played a critical role in ensuring access to confidential family planning services for millions of low-income or uninsured women at no cost or at a reduced cost. Title X also provides access for many under-insured women who do not have coverage for contraceptive services, devices or drugs. For many women, Title X serves as an entry point into the health care system, as well as a source of primary health care services. Title X-funded services, available regardless of ability to pay, help ensure access to reproductive health care for low-income and uninsured persons, a population which is disproportionately composed of racial and ethnic minorities. Nearly two-thirds of Title X clients have incomes below 100 percent of the poverty level and 89 percent have incomes below 200 percent of the poverty level.

The contraceptive counseling and services available in Title X-funded clinic settings help couples space births and plan intended pregnancies, an important element in ensuring positive birth outcomes and a healthy start for infants. Each year, publicly subsidized family planning services help women avoid an estimated 1.3 million unintended pregnancies. Estimates also show that every public dollar spent for contraceptive services saves an average of $3 in Medicaid costs for pregnancy-related health care and for medical care of newborns. Title X services assist individuals in preventing sexually transmitted infections including HIV and concomitant complications and also play a major role in the early detection of breast and cervical cancer.

(Emphasis mine).

And here are some of the services provided by Title XX of the PHSA:

The Adolescent Family Life (AFL) Demonstration and Research program, created in 1981 as Title XX of the Public Health Service Act, supports both demonstration and research grants. Within OPA, the Office of Adolescent Pregnancy Programs (OAPP) is responsible for administering the program. The AFL program is funded at $30.7 million in fiscal year 2006. Johanna Nestor is the Director, OAPP.

The AFL program supports demonstration projects to develop, implement and evaluate program interventions to promote abstinence from sexual activity among adolescents and to provide comprehensive health care, education and social services to pregnant and parenting adolescents. The program supports two basic types of demonstration projects: (1) prevention demonstration projects to develop, test, and use curricula that provide education and activities designed to encourage adolescents to postpone sexual activity until marriage, and (2) care demonstration projects to develop interventions with pregnant and parenting teens, their infants, male partners, and family members in an effort to ameliorate the effects of too-early-childbearing for teen parents, their babies and their families. The AFL program also funds grants to support research on the causes and consequences of adolescent premarital sexual relations, adolescent pregnancy and parenting.

The Title XX funds not only help the teens and families they serve directly, but also provide valuable information and evaluation findings that can serve as a basis for future strategies. Every program that receives AFL grant funds is required to include an independent evaluation component. This ensures that the lessons learned by each community will benefit others in the future.

In addition, to ensure that all AFL project staff at the local level have the necessary skills and training to implement these programs, the OAPP has conducted numerous technical assistance workshops annually since1998 to train front line care and prevention project staff to provide more comprehensive services to their clients.

In fiscal year 2006-2007, the AFL program is supporting 89 demonstration projects across the country. These projects consist of 57abstinence education programs and 32 care programs.

(Emphasis mine).

You might be interested to know that the person who was nominated by the Bush Administration and who occupied this post before being replaced by someone who is possibly even crazier than she is was Alma L. Golden, M.D. About Ms. Golden:

With support from a federal grant, Dr. Golden served as medical director for S.A.G.E. Advice, a program that trains physicians in techniques encouraging health risk avoidance and delay of sexual activity until marriage for preadolescents through young adults. Typical of the training is this directive: “I’m glad you haven’t started having sex. Waiting until marriage allows you to avoid STD’s, pregnancy, and a broken heart.” An additional sexual-risk avoidance tip Dr. Golden suggests is one that worked for her: Her father gave her flying lessons so she could expend her thrill-seeking enthusiasm in the air.

(Emphasis mine).

After Ms. Golden resigned, the Bush Administration nominated her replacement, Eric Keroack, M.D. About Mr. Keroack:

To the surprise of many that anticipated a more balanced approach to governing following the 2006 elections, the White House named Erik Keroack, MD to head government Title X programs that provide contraceptives, family planning, and other reproductive health services to lower income individuals in every state. Keroack, an ardent anti-choice OB-Gyn, opposes much of the mission of Title X and his career has been dedicated to promoting flawed abstinence-only programs, which have enjoyed federal support of more than $1 billion. He serves on the Medical Advisory Council for the Abstinence Clearinghouse and is a member of the Federal Expert Panel commissioned to define the guidelines for most governmental funding of abstinence education in our public schools-programs that have grown over recent years and have yet to be proven effective. In fact, a recent government report concludes that federally-funded programs do not always contain medically-accurate information. Keroack was the Medical Director of A Woman's Concern crisis pregnancy centes, an organization that opposes contraception and does not distribute information promoting birth control at any of its six centers. Its website states, "A Woman's Concern is persuaded that the crass commercialization and distribution of birth control is demeaning to women, degrading of human sexuality and adverse to human health and happiness." Unfortunatley, Dr. Keroack's clinics seem to be unaware that Title X programs have--among other things benefiting women--enabled them to avoid one million unintended pregnancies every year, which leads to fewer abortions as well. This position does ot require confirmation from the Senate, and Keroack began work in December 2006. The Massachusetts Office of Medicaid filed an action against Keroack in March and as a result, Keroack resigned from this position on March 28, 2007.

(Emphasis mine).

Anyone notice any contradiciton between the personal and moral beliefs of these two nominees (and the way that they have relied on those beliefs in their capacity as health professionals) and the responsibilities of the Deputy Assistant Secretary of Population Affairs, a position funded by tax dollars to oversee programs that affect the sexual and reproductive health of millions of Americans, (potentially you) many of whom may not share such beliefs or want others' morals inappropriately and unjustly influencing policies that affect their own persoanl sexual choices?

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