“Small Government” in Kentucky, Alabama

Nel's New Day

bevins hammerWhen GOP Matt Bevin ran for Kentucky’s governor, he promised to save the people by doing away from the dreaded “Obamacare” in the state. Republicans elected him, and he kept his promise. Under the former governor, the state’s health care, KYNECT, was a model for the country in its coverage for over 500,000 people.

Here is what happened with the Tea Party’s new state computer system:

  • Benefind—Bevin’s new system to replace KYNECT for—has shut people out of their online accounts or entirely eliminated their health coverage with no warning and no explanation.
  • Children have been cut off from Medicaid coverage.
  • People who visit overcrowded state offices where they are forced to wait hours—sometimes an entire day—to see anyone. Or they are forced to come back the next day after the computers crash.
  • The helpline is available only from 8:00 am to 3:00 pm, limiting access for people who work those…

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Great Schools, Great Communities Forum

Newport: April 7, 2016 (6:00 p.m. to 8:00 p.m.), Oregon Coast Community College, Community Room, 400 SE College Way.

Reserve your place by calling 541-574-8145 or emailing ruthjkistler@q.com.

great schools

Schools are a bedrock for our communities and our state. Quality schools enable children to fulfill their potential, while opening the doors to opportunity. They create an educated and skilled workforce essential for strengthening our state’s economy.

While magical moments of learning take place every day in our classrooms, the reality is that Oregon public schools are far from where they need to be to provide our children the education they deserve. The main reason is the inadequate funding of Oregon public schools — the legacy of two ballot measures in the 1990s that upended Oregon’s property tax system.

For too long we’ve asked educators to do more with less. That has to change. Our kids cannot wait any longer.

Great Schools, Great Communities is a collaborative effort to engage communities on the need to address the chronic underfunding of our public schools. It will take active, engaged citizens to make the changes necessary so that all children in Oregon have the quality schools they deserve.

RESOURCES

Oregon school performance and funding

Underachieving Oregon: Schools perform in bottom third nationally – The Oregonian, June 3, 2015

When public schools get more money, students do better – The Washington Post, January 20, 2015

Investing in kids and their achievement has long-term economic benefits for communities – National Education Association

 

Current Oregon school funding and education ballot initiatives 

Initiative Petition 28 – Increases corporate minimum tax when sales exceed $25 million; funds education, healthcare, senior services.

Initiative Petition 65 – Requires state funding for dropout-prevention, career/college readiness programs; reduces funds for other services.

Five Top Female Players Accuse U.S. Soccer of Wage Discrimination

Five key members of the United States women’s national soccer team, the reigning World Cup and Olympic champion, have filed a federal complaint charging U.S. Soccer with wage discrimination.

In the filing, the five players contend that the women’s team is the driving economic force for U.S. Soccer, the governing body for the sport in America, even as its players are paid far less than their counterparts on the men’s national team, said their lawyer, Jeffrey Kessler.

The players involved in the complaint are among the most prominent and decorated female athletes in the world: the co-captains Carli Lloyd and Becky Sauerbrunn, forward Alex Morgan, midfielder Megan Rapinoe and goalkeeper Hope Solo.

In their complaint — which was submitted to the Equal Employment Opportunity Commission, the federal agency that enforces civil rights laws against workplace discrimination, on Wednesday — the players requested an investigation of U.S. Soccer. But in taking official action, they also thrust their team into a debate roiling in several sports, notably professional tennis, about equal pay for men and women.

“We have been quite patient over the years with the belief that the federation would do the right thing and compensate us fairly,” Lloyd, the most valuable player of last year’s Women’s World Cup, said in a statement released by the players and Kessler.

Solo was more blunt in the statement, directly comparing the women’s achievements with those of the men’s national team.

“The numbers speak for themselves,” Solo said. “We are the best in the world, have three World Cup championships, four Olympic championships, and the U.S.M.N.T. get paid more to just show up than we get paid to win major championships.”

Citing budget figures released last month by U.S. Soccer, Kessler said the players contend that they earned as little as 40 percent of what players on the United States men’s national team earned even as they marched to the team’s third world championship last year, and that they were shortchanged on everything from bonuses and appearance fees to per diems.

“This is the strongest case of discrimination against women athletes in violation of law that I have ever seen,” Kessler said.

Though only five players signed the complaint, they said they were acting on behalf of the entire women’s team, saying they are all employees of U.S. Soccer through their national team contracts.

The filing of the complaint was the latest move in an increasingly contentious legal fight between U.S. Soccer and the women’s national team players, who are favored to repeat as Olympic champions at the Rio Games in August.

“While we have not seen this complaint and can’t comment on the specifics of it,” U.S. Soccer said in a statement, “we are disappointed about this action. We have been a world leader in women’s soccer and are proud of the commitment we have made to building the women’s game in the United States over the past 30 years.”

Women’s national team players have long grumbled about their pay, working conditions and travel and hotel arrangements, which the players contend are inferior to those given to the men’s national team despite the women’s far superior record. The men’s most notable achievement in the past half-century was a quarterfinal appearance at the 2002 World Cup.

The long-simmering feud between the women’s team and U.S. Soccer’s leadership boiled over after last summer’s Women’s World Cup. A match in Hawaii that was part of the team’s so-called victory tour was canceled when the players refused to play on an artificial-turf field they deemed unsafe. U.S. Soccer’s president, Sunil Gulati, later apologized for the situation.

Two months later, the disagreement veered into federal court when U.S. Soccer took the unusual step of filing a lawsuit against the national team’s players’ union as part of a dispute about the validity of the players’ collective bargaining agreement. The federation contends the agreement, which expired in 2012, lives on in a memorandum of understanding the sides signed in early 2013. The union contends it does not.

Video of Obama honoring U.S. Women’s Soccer Team:

http://graphics8.nytimes.com/video/players/offsite/index.html?videoId=100000004001645

The Equal Employment Opportunity Commission will not deal with the larger issues in that fight, or in the bargaining talks, because it does not have jurisdiction, Kessler said. But by raising the issue of the compensation of the men’s national team, the women’s players may risk dividing the teams’ fan bases even as they put U.S. Soccer in a difficult position. The federation has collective bargaining agreements with both teams, but the financial terms differ widely.

The women’s players are salaried employees — the top players are paid about $72,000 a year by the federation — but they contend that even with that extra income, their bonus structure means they earn far less than their male counterparts, who receive money from U.S. Soccer only if they are called to the national team.

A men’s player, for example, receives $5,000 for a loss in a friendly match but as much as $17,625 for a win against a top opponent. A women’s player receives $1,350 for a similar match, but only if the United States wins; women’s players receive no bonuses for losses or ties.

Yet the women point to the television ratings for their matches and the crowds they draw as evidence that the disparity in federation pay is unfair.

The men and the women “have identical work requirements,” Kessler said. “The same number of minimum friendlies, the same requirements about participating and making the World Cup teams — identical work.

“But the women have without dispute vastly outperformed the men not just on the playing field but economically for the U.S.S.F. The women have generated all the money in comparison with the men.”

U.S. Soccer is expected to argue that the players’ pay is collectively bargained, and that the players agreed to all issues, including compensation and working conditions like whether the team must play on artificial turf or not. (The federation and the women’s players’ union are continuing discussions on compensation in a new collective bargaining agreement amid the current action.)

U.S. Soccer also receives substantially higher payouts from FIFA, world soccer’s governing body, for participation in the men’s World Cup. But the women’s complaint seems to take aim at a bigger share of domestic revenue, like sponsorships and television contracts.

Budget figures provided by U.S. Soccer at its annual general meeting in February showed a $20 million increase in national team revenue in 2015. The women’s players attributed that to their World Cup triumph and the subsequent multicity victory tour. U.S. Soccer is expecting another windfall this year; among its budget projections for 2016 is $2.3 million for another victory tour after the Olympics.

It is unclear how long it will take to resolve the complaint, but the process will almost certainly hover over the women team’s preparations for the Rio Games in August. If the E.E.O.C. rules for the players, it could seek relief on behalf of the entire women’s national team in the form of a negotiated settlement or side with the players in federal court, Kessler said. If the case is successful, it could force U.S. Soccer to surrender millions of dollars in back pay.

Opportunities for women to participate in sports have increased greatly in the more than 40 years since the passage of the gender-equity legislation known as Title IX. But financial parity has often lagged behind.

The N.C.A.A. men’s basketball tournament, which began in 1939, pays about $260,000 to a conference for each game a team plays in the tournament, the sports economist Andrew Zimbalist wrote recently in The New York Times. The winning team rakes in $1.56 million for its conference. By contrast, the N.C.A.A women’s tournament, which began in 1982, awards zero dollars for winning a game.

It could be argued that men’s sports deserve a financial edge because they are more popular, draw bigger crowds, generate far more money in ticket sales and corporate sponsorships. But that is not true for every sport. Women’s figure skating, for instance, has often drawn higher television ratings and bigger crowds than men’s figure skating.

And while women have often been dismissed internationally as soccer players — the men’s World Cup began in 1930 and the women’s not until 1991 — they have become the sport’s standard bearers in the United States.

It is the women’s team that has provided repeated success that has remained elusive for the American men. Not so long ago, perhaps the best known soccer player in the country was not a man but a woman, Mia Hamm. Even today, the United States is perceived by many around the world to be a predominantly female soccer culture.

When Hamm and her teammates won the 1999 World Cup in the United States, they set records for attendance and television viewing. Last summer, when the United States defeated Japan to win another Women’s World Cup, the final was seen by 25.4 million viewers on Fox — a record for a men’s or women’s soccer game on English-language television in this country.

 

April Is Sexual Assault Awareness Month

oregoncoastdailynews

my sister's placeApril is Sexual Assault Awareness Month (SAAM), and this year’s campaign focuses on ways that individuals, communities, and businesses can prevent sexual violence. In the United States, sexual violence is a widespread problem: nearly one in five women and one in 71 men are victims of sexual assault (Black et al., 2011), though all of us are impacted by sexual violence.

In addition to the effects on survivors and their families, the effects of this violent crime can create a cultural climate of fear, anger, and disbelief. Sexual violence also generates criminal justice, medical, and crisis and mental health expenses. The impact of sexual violence effects everybody.

The good news? Sexual violence in preventable, and everyone has a role to play in creating safe, equitable, and respectful communities. “Spring is a great time to remember that so many things—from small flowers to enormous trees—start with just one tiny seed,” says…

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Teens face birth control barriers at school-based health center

By Samantha Swindler | The Oregonian/OregonLive   March 30, 2016

school health care

Enter a caption

A tour of the school-based health center on Beaverton High’s campus. Like the clinic at Century High School, Beaverton’s school-based health center is operated by Virginia Garcia Memorial Health Center. (OS-)

 

 

In Oregon, you can make your own primary care medical decisions at age 15, without parental consent or notification.

Yet in school districts across the state, teens are likely to need a note from Mom just to get an aspirin from the school nurse.

These two very different views of healthcare are now clashing in Hillsboro, where the nonprofit Virginia Garcia Memorial Health Center wants to offer birth control services on the Century High School campus.

The Hillsboro School Board is in the uncomfortable position of figuring out what role it has – if any – in teens’ options around safe sex.

Century’s school-based health center opened in 2013 to provide primary care and mental health services for interested students or nearby residents 20 years old or younger. The school district received a federal grant to construct the building; Virginia Garcia staffs and manages the clinic. No one is denied services if they can’t pay.

Most visits are for mental health counseling; vaccines; well-child checks; ear, nose or throat issues; and sports physicals.

The district benefits because on-campus clinics cut down on absenteeism, and healthy students are better learners.

Students – particularly those who don’t have or have limited insurance coverage – benefit from convenient access to healthcare.

Parents benefit because they don’t have to miss work to take a child to a doctor’s appointment.

Win, win, win, right?

Oregon has 76 school-based health centers in 24 counties across the state. Virginia Garcia operates six, including five in Washington County.

When the Century clinic opened three years ago, the school district had an informal understanding with Virginia Garcia – no offering birth control. But Virginia Garcia spokesperson Olivia MacKenzie said the policy isn’t written anywhere in the clinic agreement between the district and the nonprofit, which puts physicians in a bind when students ask about contraceptives.

Olivia said Virginia Garcia would like to offer those services, but only if “it’s a priority to the district and families, as well.”

The clinic does offer reproductive health services, which includes things like pap smears, screening for sexually transmitted diseases and pregnancy tests, but not “family planning services” – aka, birth control.

So, a patient at the school-based health center can find out after sex if she’s gotten pregnant, but she can’t get contraceptives to prevent it in the first place.

Within Hillsboro’s two zip codes, the Oregon Health Authority reports there were 238 teen pregnancies between 2012 and 2014. Century High even has an on-campus daycare program for students who have had a child; it’s not that far from the clinic where they can’t get preventative reproductive services.

Century’s health center does provide referrals to other clinics that can provide contraceptive prescriptions, but it’s not always easy for teens to travel for help off-campus. Last year, Washington County closed its health department clinics and contracted out for care services. The clinic in Hillsboro is now only open two days a week, and without the teen program that specifically addressed contraceptive questions.

That’s part of why Virginia Garcia is now asking to be able to prescribe birth control.

Earlier this month, the Hillsboro School Board spent an hour listening to public comment about whether birth control prescriptions should be offered at the Century clinic. Eleven residents testified in favor of offering services; six testified against. At least one woman questioned why the district was involved in student healthcare at all.

That’s something school board member Erik Seligman questions, too.

“I feel bad that there’s a problem with community access to health care in Hillsboro, but the schools aren’t chartered to address that,” he said. “The intermingling with school and health care, that’s what really concerns me … but it’s a community concern, not a school concern.”

Whether a school district should help students get access to primary healthcare is an entirely different question than whether a school district should determine what kinds of primary healthcare students have access to.

Let’s start with the first question: Is is appropriate for schools to have clinics at all?

Yes. It definitely is.

No one is in a better position to help students access healthcare than the school district where they spend most of their time. That’s why this model works so well, especially for the most vulnerable populations. About a quarter of the Century clinic’s patients come from families at or below the federal poverty line; 66-percent are covered by either Medicaid or the Oregon Health Plan.

In a state survey last year, nearly half of school-based health center patients said they either wouldn’t have another place to go, or weren’t sure where they could go, for medical services outside the school clinic.

In many ways, the district is already in the healthcare business. It addresses nutrition by choosing school lunches. It address mental health with bullying and suicide outreach programs. If it’s going to provide a daycare for students with children, it shouldn’t stand in the way of services to prevent teen pregnancy in the first place.

Which brings us to the second question, about contraceptives. School boards shouldn’t be a roadblock to teens’ access to preventative care.

The district can best serve the clinic and its patients by simply being a landlord. Birth control – not abortion, mind you – is considered a function of a primary care facility. How, what, and why it is prescribed should not be influenced by a school board.

In an ideal world, you know who would be making decisions about teens’ bodies? Teens. With the guidance of a physician, and the support of a parent.

Sadly, that doesn’t always happen. Not all students have easy access to medical care. Not all students have good relationships with their parents, or have parents who know how to help them.

Those are the students who need full primary care services from the school-based health center most of all. And the last thing they need is a lecture from the school board about what kind of health care services they should be receiving.

— Samantha Swindler

@editorswindler / 503-294-4031

 

F.D.A. Eases Requirements on Abortion Pill Label

The Food and Drug Administration stepped into the politics of abortion on Wednesday, relaxing the requirements for taking a medication that induces abortion, a move that is expected to expand access to the procedure.

The move was a victory for abortion rights advocates who had been fighting laws in states like Texas, North Dakota and Ohio that required providers to follow the requirements on the original F.D.A. labels for the drug when conducting abortions by medication. Many doctors say the original labels, based on clinical evidence from the 1990s, were outdated and that the state laws requiring doctors to adhere to them went against accepted medical practice and made it harder for women to get abortions.

The changes announced on Wednesday reduce the number of trips women have to make to a doctor from three to two in most states, and also increase the number of days that she has to be able to use medication to induce abortion from 49 to 70 days after the beginning of her last menstrual period, experts said. The new label also reduces the dosage of the drug, called mifepristone, from 600 milligrams to 200. Most medical societies had said the previous dosage was too high, and abortion rights advocates said it increased the cost and the side effects of the procedure.

“This is a huge step in increasing access to medication abortion and it comports with the scientific evidence,” said Elizabeth Nash, a senior state issues associate at the Guttmacher Institute, which tracks women’s reproductive health issues. She said that medication abortions accounted for about a quarter of all abortions in 2011, the last year measured by the institute.

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Mifeprex, a medication that induces abortion. The F.D.A. on Wednesday relaxed the requirements on use of the drug.

In most states, doctors had been following the medically-accepted regimen, despite the fact that the label advised otherwise — a practice that is fairly common in medicine and is known as off-label use. But in recent years legislators in a number of states have sought to impose legal requirements that doctors follow the F.D.A. label for abortion medication, saying they were trying to protect womens’ health.

Such restrictions have passed but then been blocked by court order in Arkansas, Oklahoma and Arizona. Arizona legislators have passed yet another measure that tries to maintain the original F.D.A. protocol, but it has not yet been signed into law.

The F.D.A. first approved the drug, formerly known as RU-486, in 2000. It works by blocking receptors of progesterone, an important hormone in pregnancy. When taken with another drug, misoprostol, it induces miscarriage. It is different from the so-called morning after pill, which prevents pregnancy.

But the rules on the label were based on clinical trials completed in the late 1990s, according to advocates, and new evidence had emerged showing that taking lower doses was preferable and that a woman could take the medication safely up to 70 days from the beginning of her last menstrual period.

The American Congress of Obstetricians and Gynecologists said in a statement that it was “pleased that the updated FDA-approved regimen for mifepristone reflects the current available scientific evidence and best practices.”

The group added that “medication abortion has been subject to legislative attacks in various states across the country, including mandated regimens that do not reflect the current scientific evidence. We hope that these states take the FDA label into account.”

Planned Parenthood, which has fought the state laws, said in a statement: “The benefit of this announcement will be most immediately felt by women and providers in Ohio, Texas and North Dakota,” states that have laws requiring medication abortion to be provided according to the original label.

Since the F.D.A. approved the medication, states have passed a number of different laws to restrict its use. Some require medical professionals who administer the drug to be licensed physicians, and not nurses or physician assistants. Other states require the prescribing doctor to be physically present with the patient, a rule that abortion rights advocates say blocks rural women from receiving the medication through telemedicine.

Dr. Raegan McDonald-Mosley, chief medical officer of Planned Parenthood Federation of America, said the change would reduce confusion among patients who had to sign two sets of consent forms, one with the regimen recommended by much of medical science and one that detailed the requirements on the F.D.A. label.

“Now those two things are in sync,” she said.

Dr. McDonald-Mosley said that medication abortion is an increasingly popular method: About half of women in Planned Parenthood clinics who fall within the time limit choose it.

Cracks in LGBT Discrimination, SCOTUS Hearings

Nel's New Day

Two huge events in LGBT rights occurred in the past week—one for and one against. A week ago, North Carolina’s legislators, traumatized by Charlotte’s anti-discrimination ordinance, went into a special session that cost taxpayers $42,000 in order to prevent any city or county from allowing LGBT people rights—especially using the bathrooms that match their gender identities. The justification for this legislation, deemed the “worst anti-LGBT bill in the country,” was that straight men would have the freedom to go into public restrooms and molest women. Shortly after the successful North Carolina legislation, Georgia’s Gov. Nathan Deal vetoed a bill that would allow any government entity or private business to discriminate against LGBT people by declaring “religious belief.” The bill was similar to the one in Indiana last year that caused such an uproar that GOP Gov. Mike Pence most likely lost his hopes for a presidential candidacy after he signed the…

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