The Robert J. Wood Foundation (RWJF)
has invested heavily in school-based health clinics, and it has sought
imaginative ways to implement them in the states under the guise of other
programs. Beginning in 1989, Pennsylvania's Department of Welfare was
awarded a planning grant of $100,000, and in 1990 was awarded a Phase I
Implementation Grant for a total of more than $1.4 million under a RWJF
program entitled Mental Health Services for Youth. The stated purpose of
the program, according to the Foundation's brochure...was "to
maximize the functional abilities of young people with serious mental
disorders."
The brochure describes plans for
"expanding funding strategies" and "coordinating existing
mental health services agencies" at the state level and promoting the
development of new mental health services for youth at the community
level. In fact, the program was designed to create the impetus for the
development of school-based health clinics. Facts demonstrate that there
was no clamor from Pennsylvanians for this program...they were selected by
the Foundation.
In Call for Proposals, RWJF directs
state governments to form "state-community partnerships that can make
major changes in financing, organization, and delivery of services... The
state's participation will involve mental health, child welfare, juvenile
justice, education, Medicaid, and health planning agencies."
Clearly, by combining "mental
health," "education" and "Medicaid," along with
"health planning agencies," the Foundation was directing the
state to develop school-based health clinics. Foundation documents
were...specific about the objectives it planned to achieve, stating the
expectation that "every grant dollar is expected to leverage five
dollars in public monies" and that by establishing interagency
coordination agreements concerning mental health for youth, the way would
be paved to achieve comprehensive health reform.
The Call for Proposals suggest that
"diverse strategies" can be used to "broaden the array of
mental health services for youth," including:
- expanding private insurance coverage for these services through
negotiations with insurers or through enactment of statutes;
- expanding Medicaid coverage by taking advantage of existing optional
services categories, waivers, the case management option, the EPSDT
(Early Periodic Screening, Diagnosis, and Treatment) Program, or by
better leveraging of state dollars through increasing Medicaid
reimbursement rates (which automatically increases federal dollars for
these covered services);
- blending mental health, education, juvenile justice, and child
resources to increase the availability of services for which there are
joint agency responsibilities
- developing third-party billing plans to ensure that school systems
recover some of the cost of supplying health and supportive services
to emotionally disturbed children.
By combining such strategies, states
can build on the existing service and financing infrastructure in
developing a comprehensive, balanced system of care.
As in the case of the National School
Health Program, every RWJF solution involves capturing more public monies,
which essentially means changing laws--an activity the Foundation is
prohibited from influencing because of its tax-exempt status. It is
changing law, policy, and financing, without the knowledge, consent, or
approval of the legislature.
In 1995, RWJF funded its Making The
Grade Program: State and Local Partnerships to Establish School-Based
Health Centers in the following nine states: Colorado, Connecticut,
Louisiana, Maryland, NC, Oregon, Rhode Island and Vermont.
1995 Grants relating to school-based
clinics and children's health were provided to the National Conference of
State Legislatures, the National Governors Association, and the University
of North Carolina at Chapel Hill School of Medicine.
1995 Grants relating to reducing
so-called practice barriers to non-physicians such as nurse practitioners,
went to state universities in Arkansas, Colorado, Michigan, North
Carolina, Idaho, New York, Minnesota, New Mexico, Illinois, Wisconsin and
Planned Parenthood.
Source: Education Reporter, 2/97
Texas and the Robert Wood Johnson Fdn.: The same deceptive
strategy Genevieve Young has written about in Pennsylvania is being
perpetrated on Texas by the RWJF. In a letter dated October 29, 1996 to
Gov. Bush, RWJF offered to assist Texas "to develop and implement
policies aimed at expanding health insurance coverage and controlling
health care costs" using their State Initiatives in Health Care
Reform program. The State Initiatives program is to "support the
development and implementation of state reforms" including
"direct expansion of insurance coverage, including strategies
involving Medicaid.... The program will also fund related health care data
initiatives and the restructuring of state government health programs to
reflect new roles and functions." (See the March '97 Torch which
explains the goal of turning our schools into quasi-hospitals funded by
Medicaid.) Gov. Bush responded to RWJF in a letter dated November 25, 1996
that he would advise his Health and Human Services Commissioner Dr. Mike
McKinney of the offer. Texas' Request for Project Support was received by
RWJF on December 23, 1996.
On January 29, 1997, the RWJF
notified Gov. Bush of a $394,825 grant approval "to the State of
Texas, Texas Dept. of Mental Health and Mental Retardation in 36-month
support of its participation in the Foundation's program,
Self-Determination for Persons with Developmental Disabilities." On
February 14, 1997 Texas Health & Human Svcs. Commissioner Dr. Mike
McKinney applied for another grant from the RWJF "to develop and
implement a managed care model which creates incentives for clients and
HMOs to voluntarily integrate Medicare and Medicaid into a seamless
continuum of care."
School-based clinics were established
in Pennsylvania via the RWJF grant program entitled "Mental Health
Services for Youth." The infamous abuse of pre-teen girls given
genital exams without parental notice or consent resulted from this
"mental health" program.
The RWJF is the "tool"
being used by the Tucker-Clinton-Magaziner plan (see page 1) to establish
school-based clinics. While it is illegal for the non-profit foundation to
participate in changing state laws; their proposals do just that. The
entity should be investigated because of abuse of the federal tax code.
Texas' House Bill 3 would establish
the "Texas Healthy Kids Corp." which "shall establish a
program to provide...health benefits for eligible children...." This
is NOT a program for poor children; they're already covered by Medicaid.
There is NO uninsured children crisis according to the U.S. Census Bureau;
this legislation is unnecessary. This new corporation is simply a conduit
for state, federal and foundation monies which, as in other states, could
be used to establish school-based clinics.
Like "Hillarycare's" failed
boondoggle which would have required universal coverage, this
"corporation may require that the parent...is responsible for
premiums for coverage under the program...." It is anti-free market
to FORCE parents into a state-run program for which the bill's author has
asked taxpayers for an additional $50 million.
The "providers" are
required to market the program.
Further discomposing the free market,
the corporation is not subject to any licensing requirement imposed under
the Insurance Code or other insurance law. Every other insurance provider
MUST be licensed; HB 3 proposes an unlevel playing field.
While the corporation must obtain
informed written consent from a child's parent in order to access a
child's medical records, that information is exempt from disclosure and
discovery in a civil action. That provision is irresponsible and leaves a
parent no recourse if a child is mistreated.