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Number 132 January 1997
January 1997 Education Reporter inside this issue . . .

Medicaid Moneyline Flows to Schools
Medicaid Funds Make Public Schools Providers of Socialized Health Care

SPRINGFIELD, IL - The Illinois State Board of Education has sent detailed instructions to district superintendents on how to exploit Medicaid to increase taxpayer funding available to public schools. The Illinois Department of Public Aid (IDPA) and the Illinois State Board of Education (ISBE) are encouraging all public schools to participate actively in Medicaid programs in order to "augment and enhance services for children with and/or at risk of disabilities."

A letter sent from Medicaid Consultant Jean Rowe at the ISBE dated Oct. 8, 1996 alerts school officials of "renewed interest in accessing Medicaid federal matching dollars" for Special Education. Schools, Ms. Rowe reports, "have found Medicaid to be a viable funding source."

Medicaid funds are supposed to be spent exclusively for poverty-level (welfare) people. In 1991, Medicaid dollars became available to schools for school-based health services through the IDPA. Since then, two initiatives have made over $100 million in federal matching Medicaid funds available to Illinois public schools.

The first initiative provides Medicaid funding through school-based health services. Schools may bill Medicaid not just for therapies, but also for "social work and psychological services, nursing and audiological services, hearing/vision screenings, and transportation." In fiscal year 1996, $31,700,000 in federal funds were paid to Illinois schools for such school-based health services.

The second initiative allows all Illinois schools to claim Medicaid dollars for Early and Periodic Screening, Diagnosis, and Treatment (EPSDT). Such services include "public awareness, identification and referral, initial health review and evaluation, family notification, health provider networking, care planning and coordination, immunization program management, family planning referral." In fiscal year 1996, Illinois schools received $40,800,000 in federal funds for EPSDT claims.

Ms. Rowe describes how Medicaid dollars have also been used to pay for audiometers, mini-buses, closed-caption TV, computer systems, substitute teachers, special education staff, special education program expansion, and new program implementation. "The potential for the dollars," she boasts, "is limitless."

Ms. Rowe encourages local public schools to use the experienced ISBE and IDPA staff in order to "maximize federal reimbursement" of Medicaid dollars. IDPA allows schools to bill school-based health services for up to two years from the date of service, which means that schools can submit documentation of services from the 1994-95 and 1995-96 school years for Medicaid reimbursement. In fiscal year 1996 alone, 61,000 students received billable services.

Foundations Promote
Medicalization of Public Schools

Meanwhile, several billionaire foundations are pursuing a large-scale plan to turn the public schools into delivery centers for all kinds of health services, including physical examinations, treatment and medication of children, with or without their parents' knowledge or consent. This plan also includes compiling all sorts of private information on schoolchildren and their families.

Leading the movement to use the public schools to propel Americans into a government-controlled health care system is the $5.5 billion Robert Wood Johnson Foundation. Following close behind are the Henry J. Kaiser Family Foundation, the Annie E. Casey Foundation, the Rockefeller Foundation, and the Pew Charitable Trust.

The principal expertise of these foundations is developing creative ways to locate and lock in taxpayer funding for foundation projects. The foundations have successfully captured federal grants from the Medicaid benefit called Early and Periodic Screening Diagnosis and Treatment Services (EPSDT), Medicaid waivers, the Maternal and Child Health Bureau, Goals 2000, and the Individuals with Disabilities Education Act (IDEA).

Goals 2000, whose number-one proclaimed goal is "every child should start school ready to learn," provides the fig leaf of legal authority for this array of federal intervention in public schools. The foundations are making the states and school districts believe that federal mandates in Goals 2000 and IDEA require the schools to test children for emotional, social, mental, and physical disorders.

The foundations are persuading schools that "readiness" requires the schools to provide health services clinics, which then must be staffed by nurse practitioners emboldened with new authority to prescribe medications. The foundations then demand a perpetual, exclusive license to use, and to allow others to use, all data generated by the services.

The Robert Wood Johnson Foundation started funding school-based health clinics 20 years ago and now boasts that there are more than 600. Foundation documents state that the expectation that "every grant dollar is expected to leverage five dollars in public monies." Foundations dole out about $100 million each year to state and local governments and school districts.

Clinton's Plan to Teach 3rd Graders

WASHINGTON, DC - In his Dec. 21 radio address, President Clinton plugged his $2.75 billion national literacy campaign called "America Reads," calling for one million volunteers to "help every 8-year-old learn how to read." The program, announced by Clinton in Michigan on Aug. 27, and frequently reiterated in pre-election stump speeches, is based on his discovery of the shocking fact that "40% of 3rd graders can't read."

Clinton proposes using 30,000 reading specialists and volunteer coordinators to mobilize one million volunteer reading tutors across America.

In his radio address, the President stated that children's "first teachers must be their parents." He added, "All the rest of us must work with them to make sure every child and every adult can read."

Clinton's plan will do nothing for 1st and 2nd graders, who are apparently to be left illiterate. Clinton's plan makes no mention of the reason why 40% of 3rd graders are illiterate, i.e., schools taught them to guess at words instead of to sound them out by phonics.

The heart of the President's program consists of America's Reading Corps, which he expects to fund with $2.5 billion. An estimated $1.5 billion of new money will be used to mobilize 30,000 reading specialists and coordinators to recruit and train one million volunteer tutors nationwide. In some government literature, this is described as "a citizen army of 30,000 volunteers and reading specialists." The one-million tutors will work with reading teachers and school principals to provide individualized tutoring for more than 3 million children a year in grades K-3 in after-school, weekend, and summer reading support.

An additional $1 billion from the National Service budget will fund 11,000 AmeriCorps "volunteers" as tutor coordinators. This part of the project will not require a new appropriation because it will be funded by re-directing funds going to college Work-Study participants.

The Department of Education announced in November that colleges will not have to pay the required 25% of Work-Study wages for those students who become reading tutors. It is hoped that this financial incentive will serve as a "down payment toward our goal of enlisting 100,000 Work-Study students."

Carol Rasco, Clinton's Domestic Policy Advisor, will move to the Education Department to work with Education Secretary Richard Riley to oversee the program. In his radio address, Clinton announced that 20 college presidents have already joined his new "America Reads College Presidents Steering Committee" and promised that half of their campus Work-Study slots will be dedicated to reading tutors.

A second prong of the "America Reads" program is the Parents as First Teachers Challenge Grants. National, regional, and local groups will receive $300 million in grants to assist parents to help their children to read by the end of the 3rd grade.

The third prong calls for expanding Head Start. Funds have already been earmarked to reach an additional one million 3- and 4-year-olds.

The fourth major part of the new federal program is called "Challenge to Private Sector to Work with Schools and Libraries." Parents, along with private and non-profit groups, will be actively encouraged to take part in the President's "America Reads" Challenge.

American Students Miss the
Mark in Math and Science

WASHINGTON, DC - A new U.S. Department of Education international study on math and science performance shows that American students are "far from the mark" of receiving superior math and science education. The study included over a half-million 8th-grade students from 41 countries.

The "Third International Mathematics and Science Study," the largest such survey conducted to date, shows that while American students spend more time in class on the two subjects and are assigned more homework, they trail behind their foreign peers. The Department of Education blames poor teacher training and inadequate course content rather than too much television or lack of money.

"We continue to shortchange America's teachers by not giving them the preparation and help they need to do the best possible job in the classroom," said Education Secretary Richard Riley.

The study says that U.S. math curricula are "less advanced" and "less focused" than those of higher achieving countries. The content of 8th-grade math courses in the U.S. resembles the 7th-grade curricula of most other nations that participated in the study.

American students scored higher than foreign students on environmental issues and life sciences, but foreign students outperformed Americans in physics and chemistry.

Researchers drew their conclusions from exams, teacher surveys, analyses of curricula, and classroom videotapes. Students from Singapore, Korea, Japan, the Czech Republic, and Hungary outperformed the U.S. in math and science. American students performed comparably with those from other major industrial nations like England, Germany, and Canada. Of the 41 nations, U.S. students placed 28th in math and 17th in science.

The news comes at a time when business leaders worry about America's ability to compete globally. Governors promised in 1990 to make American students "first in the world" in math and science by the year 2000.

Education Briefs

Childhood use of Ritalin dashes hopes of young men and women to serve in the armed forces. All branches of the military are rejecting hundreds of potential enlistees who have used Ritalin or similar behavior-modifying medications. The services consider the medication a very serious, mind-altering drug. The military is exempt from the Americans with Disabilities Act and can lawfully discriminate against people with a history of such drug use.

Six-year-old Stephanie Martin had no idea that giving a "love pat" to her teacher might qualify as "offensive touching," punishable by law. Appoquinimink School District Superintendent Tony Marchio felt that the law, which requires school administrators to report offensive touching, assault, extortion, and crimes involving weapons and drugs, compelled him to report the incident to the Delaware attorney general. Now Marchio, who admits he should have "used common sense," has since cleared Stephanie.

Students are given political propaganda instead of fair coverage. The election edition of Weekly Reader for grades 7 through 9 reported that Bill Clinton's accomplishments include handling the economy well, defending Medicare against Republican attacks, working to balance the national budget, and helping restore peace in the Middle East and Bosnia. Dole, on the other hand, "has attacked Clinton and the Democrats for not making more spending cuts and for continuing to support social services." The students also were asked to answer how Clinton has made "the country a better place."

The Edison Project, a for-profit educational venture, recently raised $35 million from new investors, bringing the total to $100 million since its inception in 1992. Edison, which currently operates 12 individual schools under contracts with school districts, will use the new funds to finance expansion.

The Illinois Supreme Court dismissed a case brought by 70 Illinois school districts to level per-pupil spending differences. This ends 6 years of challenging the constitutionality of the current school funding process by the school districts and puts school-funding issues back into the hands of the state legislature.

Idaho Education Department Adopts 'Abstinence-Only' Rule

BOISE, ID - The Idaho State Department of Education has adopted a position statement on HIV/STD education stating that "'abstinence only' should be the total program emphasis."

The purpose of the Idaho HIV/STD programs is to prevent HIV/STD infection. The most effective means of doing so, according to the Department, is for school districts to "make programs available to encourage young people to abstain from sexual intercourse, learn self-restraint, and self-discipline."

The Department announced two criteria that school districts must meet in order to receive funding for HIV/STD programs. Education programs must (1) teach "abstinence-only," and (2) provide accurate information on HIV/STDs. Districts' applications must specifically describe the nature and intent of their programs. The amount of funding, which is provided by the Centers for Disease Control and Prevention, is contingent on the total available amount of funds and the number of districts applying for grants. Participation is voluntary; districts not wanting to be limited by the criteria can obtain funds elsewhere.

The Department established its position on HIV/STD education in full support of Idaho State law, which designates the home and church as responsible for teaching family life and sex education. "Schools," it continues, "can only complement and supplement these standards which are established by the family. The decision as to whether or not any program in family life and sex education is to be introduced in the school is a matter for determination at the local district level by the local school board." The role of Idaho's Department of Education is to "provide guidance and technical assistance to school districts relating to accurate information about HIV/STDs."

The Department encourages school districts to involve their communities so that HIV/STD programs are "locally determined" and "consistent with community values."


The Whole Language/OBE Fraud by Samuel L. Blumenfeld, 1996, Paradigm, 329 pp., $19.95 paper.

Early in the 20th century, educational leaders decided to change the purpose of education from its traditional academic function to a radical social one. Why? Because a highly literate population posed an obstacle to their progressive agenda. To this end, a new method of teaching reading was introduced to produce a more socially desirable result. This is the thesis of Sam Blumenfeld's new book, The Whole Language/OBE Fraud.

Sixty years later, the social engineers' plan has proven successful. A 1993 U.S. Department of Education study showed that 90 million American adults-almost half the adult population-possess only the most rudimentary reading skills.

One of the world's leading authorities on the teaching of reading, Blumenfeld shows how and why Whole Language was intentionally designed to create an illiterate nation.

Whole Language, the new name given to the look-say method of the 1930s, is the dominant philosophy of reading instruction in American education. "To be politically correct in education," Blumenfeld writes, teachers "have to be an enthusiastic proponent of whole language, or else. The pressure to conform has become irresistible."

Whole Language trains children to read English as if it were an ideographic writing system, like Chinese. As Dr. Rudolf Flesch explained in his 1955 book Why Johnny Can't Read, children get reading disabilities when an ideographic teaching method is imposed on an alphabetic writing system.

Despite clear warnings from respected professionals about the dangers and deception of sight reading, modern educators have clung zealously to this method. Educators redefined reading as merely a "psycholinguistic guessing game." Professor Kenneth Goodman, who formulated this definition, told the New York Times that it is perfectly acceptable for a child to substitute the word "pony" for "horse" because the child had gotten the meaning.

The strength of Blumenfeld's book lies in his using the "progressive" educators' own words on the origins, intentions, and effects of Whole Language and OBE. His thorough documentation will dispel any doubts as to whether or not Whole Language is just a well-intentioned teaching method gone astray or part of a long-range plan.

The Medicalization of Public Schools

by Genevieve Young

Albert Einstein, was, from all accounts, a poor student in school, suffering what would now likely be called dyslexia and attention deficit disorder. What would our world be like today if his public school teacher had sent him down to the school clinic for testing for social, emotional, mental, and physical disorders? Imagine! Ritalin would have been prescribed. Data would have been compiled. He wouldn't have performed well at all in the School-to-Work program. And he likely would have been dependent on the government upon reaching adulthood.

I won't claim to know the answers for what is plaguing the education system in America. But I do know that the answer is not to turn our schools into social and health service delivery centers that compile all kinds of private information on families and children, and medicate or physically examine or otherwise treat children, with or without their parents' knowledge or consent.

A power elite in this country controls a great deal of wealth and governmental power without any public accountability. This power elite resides in the realm of philanthropy, the world of tax-exempt wealth where money flows freely for lofty-sounding purposes. "Philanthropy" has been a sacred cow in this country, nearly untouchable, and, up until recently, a rarely-questioned force for what was thought to be good. One turning point occurred in 1994 when the national media, including The Wall Street Journal, The Washington Times, and Investors' Business Daily recognized that several major tax-exempt foundations were involved in the operations and staffing of the Clinton White House Health Care Task Force and Interdepartmental Working Group. A chapter called "The Charge of the Light Brigade" in David Brock's book The Seduction of Hillary Rodham is the best investigative effort relating to this thus far. Philanthropy is actively involved in providing grant monies-with specific strings attached-to our federal and state governments.

What does all this tell us about the push for school clinics? Examining the Health Care Task Force, we perceive a pattern of influence on the federal government that goes far beyond the typical story of special interests lobbying for special treatment from our elected representatives, and paying big dollars-which are ultimately publicly reported-for the privilege. The Health Care Task Force showed us that the foundations are teaming up with executive officials, at the federal and state levels, to perform an end-run around Congressional appropriations authority and lobbying laws in order to get programs implemented in the executive agencies without the knowledge and consent of our elected representatives, but that we, the taxpayers, end up paying for. These organizations are actively undermining the American form of republican government. If IBM or Toyota were doing what these foundations are doing, the FBI would be investigating mass-scale bribery schemes. In Kentucky, when a Humana lobbyist handed a lawmaker $300 in a paper bag, jailtime was ordered for both. Yet when the Robert Wood Johnson Foundation paid the Office of the Governor $300,000 for a certain health reform law, nothing was done even though the FBI was provided with relevant documents.

The scheme to impose a government-controlled health care system on the American public is not yet dead. Advocates of Hillary-style health care are sneaking their statist health agenda past the statehouse and in through the schoolhouse door. Health care reform has been reincarnated as welfare and education reform. With financial support from major private philanthropies such as the Robert Wood Johnson Foundation, the Henry J. Kaiser Family Foundation, the Annie E. Casey, the Rockefeller, and the Pew Charitable Trusts, a new framework of public-private partnerships in education and welfare are being proposed.

State officials are now relying on a patchwork of private foundation grant programs, federal grants from the Maternal and Child Health Bureau, the Individuals With Disabilities Education Act, Goals 2000 for Education, a Medicaid benefit known as the Early and Periodic Screening Diagnosis and Treatment Services (EPSDT), and the availability of Medicaid waivers to create a crazy quilt of legal authority for school-based clinics.

Testing child health at school is justified by the Goals 2000 program, where Goal 1, "Readiness for school," means measuring that readiness by testing children for emotional, social, mental and physical disorders through school health services clinics established within public schools. States are currently expanding Medicaid rolls to include every child in public schools-not just the financially needy, but any child identified as "disabled"- because foundations and their consultants, along with federal officials, make the states believe that there are federal "mandates" under Goals 2000 and the Individuals with Disabilities Education Act (IDEA) that require schools to provide and pay for health services, even though federal grant programs are said to be voluntary for the states. The school clinics are staffed by nurse practitioners, with new authority to prescribe medications under state laws that have liberalized restrictions on who can prescribe medications.

Moreover, we have discovered that the Robert Wood Johnson Foundation (RWJF), as a matter of course, requires state government agencies to provide to the Foundation all data, in whatever form, that is generated pursuant to the grant program. In other words, in return for grant money, the state gives the Foundation a perpetual, exclusive license to use, and to allow others to use, all data created under the program. These provisions, which are part of every contract between the Foundation and its grantees, create the possibility that state laws regarding confidentiality of medical and educational records have been violated by state officials in making disclosures to foundations.

School Health Clinics

I will list five primary objections to establishing school clinics. One major problem is the bilking of the public treasury. In Pennsylvania, one memorandum describes a list of 20 possible services that could be provided to each child for up to 20 sessions during the school year, billed to Medicaid at $20 per session. This amounts to $8,000 per child per year that schools are told they could receive in "additional revenues."

In the health business, everyone knows that Medicaid payments do not even cover the cost of providing services in most cases. Yet our schools, strapped by the unfunded mandates of Goals 2000 and IDEA, have been fooled into believing Medicaid is the answer.

A second serious problem with school clinics is the issue of informed consent for medical services. Recently, there was a tragic occurrence at J.T. Lambert Middle Schools in East Stroudsburg, Pennsylvania. Fifty-nine 6th-grade girls were given pelvic exams without their own or their parents' prior informed consent. Many of the parents have sued the school district and the doctor, who has resigned her position.

Third, who is sending the child for health services, and why? Who pays for and who provides medical malpractice insurance for school practitioners? Who performs peer review and other quality assurance functions?

Fourth, how are records kept confidential, and what happens when allegations of mental health problems, for example, appear in the records of a student? Are these children destined for denial of entry into the military, college, or other avenues of education? Children can now be labeled, in permanent records, for life, with physical and mental disorders identified by school personnel. The ramifications of these scenarios are terrifying but real. In Pennsylvania and Kentucky, we have discovered that Medicaid officials have provided the names of Medicaid-eligible children to the school districts, so that the schools can bill for Medicaid. Had this been done by private sector actors, it would be Medicaid fraud.

Finally, we must consider how vulnerable the children in public schools are; they are a captive audience for any corporation that supplies consumer goods. Johnson & Johnson, for example, can supply everything a school clinic needs, from Q-tips to condoms. Should our schools be transformed into captive markets for such corporate giants to use taxpayers' dollars to swell their profits?

The Pennsylvania Legislature discovered that school clinics were being instituted and Medicaid monies used to fund school health services, but that no legislative authority existed for the conduct of these activities. The Medicaid expenditures were out of control. Certain members of the Education Committee wanted to find out how to explain the skyrocketing Medicaid budgets. The committee called state officials from the Department of Education, the Department of Public Welfare, and the Department of Health to testify, but could not determine an answer to their repeated questions asking, where did this idea come from, and where did you get authority for a school health services program?

The committee filed document requests, asking for all grant proposals and applications for funds filed by the state agencies. The documents showed shocking instances of secret meetings between foundation officers and their consultants with state officials, promises by state officials, including the governor and certain state legislators, to provide the necessary Executive Orders and narrow legislative authority for certain activities, and promises to fund foundation programs with taxpayer dollars if the foundation would initially fund the program with a small amount of seed money. In fact, the foundations were buying legislation and buying regulatory changes.

The Flow of Foundation Funding

To give you an idea of the types of programs the RWJF has operated, I will describe a few of those we found in Pennsylvania. All these are national programs which the Foundation tries to replicate all over the country.

The 1979, the RWJF gave a grant to Pennsylvania to improve school health services. The RWJF is worth $5.5 billion, with 85% of its assets invested in Johnson & Johnson stock, representing about 46 million shares. Johnson & Johnson is the world's largest manufacturer and marketing company for professional, industrial, and consumer health care products. Johnson & Johnson makes and markets heart valves, Q-tips, and condoms. It has 56 subsidiaries, including a managed care company. Most of its money is made overseas.

The President's Statement in the 1979 Annual Report of the Robert Wood Johnson Foundation, written by David E. Rogers, introduces the Foundation's National School Health Services Program, states on page 16:

"School Health Services Program. It would appear that the increasing number of families in which both parents or the sole parent is employed, the disappearance of older, close-knit communities, and the increasing number of teenage parents are among the important factors that make it difficult for children to get the medical care they need. One approach that seems to have worked in a number of communities faced with this situation is to shore-up the traditional school nurse system to offer more primary care services within the school.

"More than 37,000 children in rural Utah, North Dakota, Colorado, and New York are now receiving medical attention under the Foundation's School Health Services Program. In these states, school nurses trained as nurse practitioners are assuming more responsibilities for the actual care of a broader range of child-health problems. Backed up by a supervising physician working in the community, these nurses are managing problems of minor trauma and most episodic, acute illnesses. In addition, these nurses have gained additional skills enabling them to work with parents and physicians to help care for children with chronic diseases and to ensure that children referred for special care actually receive the needed medical services."

Beginning in 1979-80, the RWJF undertook a $6.5 million, five-year demonstration project that was conducted in 8 predominantly medically underserved locations in 18 school districts in Colorado, New York, North Dakota, and Utah. The Foundation discovered that certain "barriers" prevent school districts from using the school nurse to provide comprehensive school health clinic services. These "barriers," according to the RWJF's Special Report: National Health Services Program were:

  1. "Some states have policies-in particular, those regulating the scope-of-practice of nurse practitioners-that hamper the ability of these highly trained personnel to work at their full capacity. . ."

  2. "A school health program should be part of a larger organization, whose primary mission is health, rather than education. This established health structure would provide peer review, a means for referrals, access to support services, and assistance in negotiating funding.

  3. "When replicating the program in high schools, explicit attention must be given to addressing the sociomedical problems of adolescence-birth control and pregnancy, drug and alcohol abuse, and violence prevention, for example.

  4. "The Foundation's program was more expensive than the usual, more limited school health program: nationally, on average, school districts spend $25 per child per year on health. The annual per capita amounts spent in the demonstration sites ranged from $43 to $82."

The "barriers" identified by the Foundation, therefore, are state laws on restrictions of practice, the fact that schools are educational rather than health institutions, certain "sociomedical" problems, and financial restrictions.

The RWJF admits that it influenced the State of New York to pass "a special statute authorizing nurses to diagnose, treat, and prescribe under established protocols. The law covered the demonstration period and subsequently has been extended (Special Report, page 10).

Financial problems faced by taxpayers who are forced to fund the new expanded role of school nurses did not daunt the Foundation:

"Utah recently created the full-time position of school health consultant in the state health department. . . . Voters in Kidder County, North Dakota, approved a new tax levy in 1982 to pay for their first public health nurse, after several previous rejections of such measures. State health officials underscore the significance of this accomplishment and believe the school health program was instrumental in gaining acceptance for public health nursing... Also in North Dakota, a new School Health Services Task Force, consisting of officials of the state health and education departments and others who were involved in the demonstration, now meets regularly to plan new approaches to school health services throughout the state (Special Report, page 13).

The Foundation in 1985 set forth "Funding Strategies" dreamed up, supposedly, by Foundation officials and grantees, in order to continue the expanded school health programs. All of the Foundation's solutions draw on public monies:

  • Newburgh, New York, obtained an annual contract-$97,000 for the 1982-83 school year-to provide screening and primary care for Medicaid-eligible children under the state's Child Health Assurance Program (New York's version of the federal Early and Periodic Screening, Diagnosis, and Treatment program).

  • In 1983, Newburgh also obtained a $75,000 grant from the State Department of Social Services for an adolescent pregnancy project, renewed for the school year commencing September 1984.

  • Commerce City's school health corporation has an annual contract ($14,500 in 1984-85) to provide physical examinations and a wellness program for school district employees. It also receives some of the county's revenue-sharing funds (Special Report, page 16).

With chagrin, the Foundation noted that there was no "significant reimbursement" from private insurers for school health-and noted the reason is that "supervisory" and "preventive" services for children were usually not covered (Special Report, pages 16-17). The Foundation expresses the hope that parents-especially the large percentage of employed mothers of which the Foundation had become aware-would understand the convenience of school health services and force insurers to change this.

The Foundation suggested other solutions to financing: (1) raising local school district property taxes; (2) have the school district negotiate to have itself designated as a preferred provider organization (PPO) and negotiate with insurers and the Medicaid program on that basis; (3) work with the local health department to have the local school districts provide services under "various federal child health programs," listed by the Foundation as block grants for maternal and child health services; alcohol, drug abuse, and mental health services; primary care, and preventive health and health services; or WIC (the special supplemental food program for women and children); (4) school districts could seek funding from the United Way (Special Report, page 17).

All elements of the Foundation's plans are now in existence all over the country. Several states, including Pennsylvania and Kentucky, are attempting to make school districts into Medicaid providers, and schools into health clinics. Thirteen states are now participating in the U.S. Department of Education's Integrated Services Project "Creating Schools That Work for Everyone," including: California, Florida, Kentucky, Louisiana, Maine, Michigan, Minnesota, Mississippi, New Mexico, Oregon, Pennsylvania, Tennessee, and Texas.

The states are being assisted by the National Alliance for Restructuring Education and the New American Schools Development Corporation, which specifically are working with the Farrell Area School District of Pittsburgh the states of Arkansas, Kentucky, New York, Vermont, and Washington, and the cities of Rochester, NY, White Plains, NY, and San Diego, CA. These organizations call for the integration of health and human services with the schools. The National Alliance claims that these five states and four cities account for 12% of the nation's schoolchildren.

Genevieve Young is an attorney and director of the Center on Exempt Organization Responsibility, based in Danville, KY.

(Last part of this article can be found in the February issue.)

Education Reporter is published monthly by Eagle Forum Education & Legal Defense Fund with editorial offices at 7800 Bonhomme Ave., St. Louis, MO 63105, (314) 721-1213. The views expressed in this newsletter are those of the persons quoted and should not be attributed to Eagle Forum Education & Legal Defense Fund. Annual subscription $25. Back issues available at $2.

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