The Politics of School Immunization Some 20 states now allow parents to request exemption from compulsory school vaccination on the grounds that the parents have "philosophical or personal beliefs" about immunization. The states are part of a growing trend to give parents more say about whether their children must be vaccinated before they can attend school, and the new permissiveness is raising serious public health concerns, according to researchers who study childhood immunization. No one doubts that huge public health benefits that have come from compulsory school vaccination in the past several decades, say Daniel Salmon and colleagues, who write about immunization in the current issue of the American Journal of Public Health. "The utility of U.S. school vaccination requirements in preventing disease and introducing new vaccines has been well documented." But the very effectiveness of compulsory school immunization may be creating opposition to vaccination on the part of parents. "With the success of immunization programs … public attention has shifted from the risks of disease to the risks of vaccination," the researchers note. Parents who have never seen a case of measles, mumps, or whooping cough may find it hard to take those diseases seriously. On the other hand, parents can read well-documented reports of occasional ill effects such as fevers and seizures from vaccination, and they have access to widespread allegations on the Internet that vaccination may be linked to disabilities such as autism. Concerns about the new "personal/philosophical" exemptions include speculation about "herd immunity." States have always granted some exemptions from school vaccination--on medical grounds, or if parents have religious objections to vaccination--but that has generally involved a relatively small number of children in any given school or classroom. In that case, the unvaccinated children benefit from herd immunity—when most of a population is immunized, disease is not likely to take hold, and all of the population, including the non-immunized, will remain well. The non-immunized are in effect "free riders," relying on the efforts of more compliant peers to keep them safe. There are no reliable data at present on how many "personal/philosophical" exemptions to compulsory school vaccination states are granting. But in most states there is no public health oversight of the exemptions, leaving researchers and public health authorities to speculate about what will happen if large numbers of children come to school unvaccinated. In any resulting epidemic, they point out, not only children who are unvaccinated because of parental objections may fall ill, but also children who could not be immunized for medical reasons and the small number of vaccinated children in any population whose immunizations don’t give them full protection. Weighing the possibilities, researchers point out that "The risks associated with granting nonmedical exemptions may be very low if the number of exemptions is small and exempted individuals are randomly distributed throughout the population; conversely, the risk increases as the prevalence of exempted individuals increases and/or exempted individuals cluster into geographical or social spheres." One State’s Experience and a Possible Model Salmon and his colleagues studied what happened in one state—Arkansas—when bills were introduced in the state legislature allowing parents to "opt out" of their children’s immunization requirements. Arkansas had historically not allowed any exemptions except medical, though a religious exemption was enacted in 1967. Under the religious exemption, Arkansas Department of Health officials required parents to submit proof of membership in "a recognized church or religious denomination," a provision that federal courts struck down as an unconstitutional interference with free exercise of religion by the parents. That legal finding served as a rallying point for groups opposed to mandatory immunization, and bills were introduced to allow a new and broader exemption. In response, a coalition of health advocacy groups, clinical providers, and insurance companies came together to oppose what they perceived to be a threat to immunization programs and public health. The Arkansas Department of Health, unable as a state agency to lead the discussion of what was seen as a political question, asked stakeholders including the American Academy of Pediatrics, the Johns Hopkins Institute for Vaccine Safety, and the Arkansas Medical Society to draft an alternative exemption proposal. The Arkansas General Assembly ultimately passed a philosophical/personal beliefs exemption that contained many of the coalition’s recommendations, including signed and notarized statements by parents requesting an exemption and a provision for annual renewal of the request. In addition, the Arkansas law requires the Department of Health to conduct surveillance and assess disease risks associated with the exemption, and the law requires annual reporting of the rates of exemption and incidence of disease to the State Vaccine Medical Advisory Board. At this point it’s hard to know how the recently enacted Arkansas law will play out in practice, the researchers say, but what the Arkansas experience highlights is how complex issues can become "at the juncture of politics and public health." At the very least, they say, "States should proactively review nonmedical exemptions to increase the likelihood of proper time and consideration being given to this important issue." The article, "Public Health and the Politics of School Immunization Requirements," by Salmon and colleagues from the Johns Hopkins Institute for Vaccine Safety and the Center for Law and the People’s Health, and from the University of Arkansas for Medical Sciences and other Arkansas agencies and organizations appeared in the May issue of the American Journal of Public Health. Reprints are available at dsalmon@jhsph.edu.
The View from Pediatricians In a Clinical Report published the same month as the American Journal of Public Health article, the American Academy of Pediatrics offered advice to its members on how to respond to parental refusals of immunization of children. Noting that "the immunization of children against a multitude of infectious agents has been hailed as one of the most important health interventions of the 20th century," the report notes that even so, seven of ten pediatricians say they have had a parent refuse an immunization on behalf of a child, with measles-mumps-rubella vaccine the most frequently refused, followed by varicella vaccine, pneumococcal conjugate vaccine, hepatitis B vaccine, and diphtheria and tetanus toxoids vaccines. For childhood vaccination programs to be successful, parents must comply with recommendations for immunization, but what is a pediatrician to do when parents refuse? The best advice, the authors conclude, is to keep in mind the best interests of children and to provide parents the risk and benefits information necessary to make informed decisions. That may involve correcting misinformation or misperceptions that may exist, such as the belief on the part of many parents that repeated immunizations weaken a child’s immune system. It may also help to point out that when parents choose not to immunize, their children may pose a risk to other persons. It may come as a new thought to parents that by not immunizing they take advantage of the benefit created by assumption of vaccine risks by others—a "moral responsibility" that the authors concede many parents might not consider compelling. But if parents continue to refuse immunization, after a physician has attempted to explain risks and benefits, perhaps the parents should be referred to numerous websites that provide information about specific diseases. Physicians should also recognize that the cost of immunization may be a barrier for many parents, in which case the physician should "work with the family to help them obtain appropriate immunizations." And if all else fails, the report concludes, it may be necessary for a physician who believes strongly in immunization to help parents who refuse vaccinations to find alternative sources of health care. The American Academy of Pediatrics Clinical Report, "Responding to Parental Refusals of Immunization of Children," by Dr. Douglas Diekema, appeared in the May 2005 issue of the journal Pediatrics. See also CDC Sets New Safety Goals for Childhood Vaccines (www.healthinschools.org/ejournal/2005/march1.htm)
and Recommended Childhood and Adolescent Immunization Schedule, United
States, January - June 2005 (www.healthinschools.org/ejournal/2005/jan4.htm).
A Look at Health as a Factor in School Readiness Although racial and ethnic gaps in school achievement have narrowed over the past 30 years, test score disparities among racial and ethnic groups remain significant, and it is now believed that sizable gaps already exist by the time children enter kindergarten, according to a report on school readiness by the Brookings Institution and Princeton University’s Woodrow School of Public and International Affairs. But while there is agreement that a problem exists, it is less clear what to do about it, say authors who contributed to an exhaustive examination of possible reasons for racial and ethnic gaps in school readiness. Among those possible reasons, the writers explore issues such as the adequacy of parenting, genetic differences, family socio-economic resources, early childhood care and education, the validity of tests used to assess children at school entry, low birth weight, and health disparities. Of those, disparities in the health care preschool children receive in the years between birth and school entry are especially hard to evaluate, says author Janet Currie. But taking specific health conditions such as attention deficit hyperactivity disorder, asthma, lead poisoning, and maternal health problems and behaviors into account, she estimates that differences in the care children receive for those and other health conditions may account for a quarter of the racial gap in school readiness. Currie looks at the data on ADHD, asthma, and lead poisoning and the relationships that have been found between those conditions and cognitive functioning, but she also devotes a good deal of attention to other chronic childhood conditions where the relationship may be less clear, such as dental caries, allergies, and ear infections. She notes that for two of the overall conditions—asthma and allergies—there seems to be a connection between environmental exposure to hazardous substances, which is presumed to be more common in racially and ethnically isolated communities, and the severity of childhood illness. On another front, Currie examines the likelihood that racial or ethnic factors enter into the medical attention preschool children receive. "Disadvantaged children are not only more likely than better-off children to have particular health conditions, they are also less likely to be treated for them," she notes. This may not be entirely a matter of whether the children have health insurance--recent expansions of public health insurance under Medicaid and the State Children’s Insurance Program (SCHIP) seems to insure that most poor and near-poor children are eligible for health insurance. But the fact remains that many eligible children are not signed up for these programs, and even if they are, they may receive only acute and not preventive care. Publicly insured children also have the poorest access to specialist care, and in some cases to any health care providers prepared to care for them. While it is beyond doubt that there are "pervasive differences" in health between black and white children in the United States, Currie is not sure that those disparities explain the racial gap in school readiness, though she concedes they may be a contributing factor. And insurance may not make a critical difference, she says; health disparities persist in countries such as Canada and the United Kingdom, for example, which have universal public health insurance. The author finds the best hope for reducing racial disparities in school readiness in preschool programs that have a built-in health component, such as Head Start, WIC, and family-based services and home visiting programs. "Clearly, health conditions can impair school readiness in individual children," she says. "Whether racial health differences are responsible for a large fraction of the black-white gap in school readiness is a more complex question." The report, "School Readiness: Closing Racial and Ethnic Gaps,"
published by the Brookings Institution and the Woodrow Wilson School
of Public and International Affairs, is the most recent publication
in the Future of Children series and is available online at www.futureofchildren.org.
See also Covering Kids: Health Insurance Matters at www.healthinschools.org/coveringkids.asp.
A Summary of Data on Teen Childbearing Teen birth rates are continuing to decline but there are still many reasons to be concerned about teen childbearing in this country, according to a summary of reproductive data from the organization Child Trends. Data compiled by the National Center for Health Statistics show that in 2003 there were 41.7 births per 1,000 15- to 19-year olds, a significant drop from the 1991 peak rate of 61.8 births per 1,000 for the age group. Those figures are encouraging, Child Trends says, but if those birth rates continue in the future, it can be assumed that 17 percent of current 15-year-olds will give birth before they reach age 20, one of the highest rates of teen pregnancy in the developed world. There is no longer much of a gender gap between males and females when it comes to having sex as teenagers--45 percent of non-Hispanic white females reporting having had sex, compared with 41 percent of males, and for Hispanics the ratio was 49 percent of females and 55 percent of males. Among non-Hispanic blacks, 63 percent of males and 57 percent of females had had sex. Most never-married teens reported using contraception the most recent time they had sex, and one-quarter said they used multiple methods, such as hormonal medication and a condom. Adolescents continue to be more susceptible to sexually transmitted diseases such as chlamydia and gonorrhea than older adults, for reasons that include greater numbers of sexual partners, physical immaturity, and obstacles to receiving adequate preventive care (lack of insurance, need for transportation, and worries about confidentiality). Between the years 1998 and 2002, rates of chlamydia for all racial/ethnic groups in the 15- to 19-years age range increased by about 17 percent, due perhaps wider screening and more sensitive tests for chlamydia, though the rates of gonorrhea decreased an encouraging 13 percent. Child Trends notes that evaluation studies indicate intensive interventions that focus on youth development with sex education components may complement more traditional sexuality education programs in schools. The report cites Reach for Health, the Teen Outreach Program, and the Children’s Aid Society-Carerra Program as showing reductions in the initiation of intercourse and sexual activity, more effective use of contraceptives, and lower pregnancy and birth rates among females. The report also mentions two early childhood programs that appear to have delayed childbearing and out-of-wedlock births years later—the Carolina Abecedarian Project and the High/Scope Perry Preschool Project. The Child Trends report finds current trends "positive" but points out that "there are important reasons to be concerned about teen childbearing in this country." On the basis of experience so far, 17 percent of current 15-year-old girls will give birth before age 20, and one in five of those births will be repeat births. And within the United States, the teen birth rate varies widely, from a low of 20 births per 1,000 15- to 19-year-old girls in New Hampshire to 65 births per 1,000 in Mississippi. The report also notes that more than half of the states do not require that providers of health insurance include contraceptive methods and services in their prescription drug coverage. For state-by-state data on teen childbearing and the full text of
the statistical summary "Facts at a Glance 2005," go to the
Child Trends websites at www.childtrends.org
and www.childtrendsdatabank.org.
IN CONGRESS Lawmakers are rushing to get their favorite projects considered by Congress before this session ends, and bills related to health, education, and the wellbeing of children are among those introduced during the past month. Here is some of the child-related legislation that Congress may or may not consider this year. Health Coverage
Dental Care
Mental Health
Bullying
Please note that two pieces of federal legislation are described
in the News Alerts for April 2005 section of this newsletter. They are
S. 799, "Prevention of Childhood Obesity Act," introduced
April 15 by Senator Edward Kennedy (D-MA) and House bill HR. 748, the
"Child Interstate Abortion Notification Act," passed by the
House of Representatives April 27 and now pending in the Senate. WORTH NOTING Clinical Trial Finds ‘Lazy Eye’ Can Be Treated in Older Children Many children ages 7 through 17 with amblyopia (lazy eye) can benefit from treatments more commonly used on younger children, according to a nationwide clinical trial funded by the National Eye Institute in the National Institutes of Health. "This study shows how important it is to screen children of all ages for amblyopia," said study co-chairman Dr. Richard Hertle. The study concluded that the opportunity to treat lazy eye does not end with the preschool years, as has previously been thought. In the trial, one group of children with the eye condition was treated with glasses only; others were given eye patches, special eye drops, and near vision activities. The standard for treatment success was a child’s ability to read at least two more lines on an eye chart using the eye with amblyopia, though researchers stressed that this may not be the maximum benefit that can be achieved. Amblyopia is a leading cause of vision impairment in children; the most common causes are crossed or wandering eye or significant differences between the eyes in refractive error, such as astigmatism, farsightedness, or nearsightedness. Information about amblyopia is available at www.nei.nih.gov/ats3/background.asp. See also Childhood Vision: Public Challenges and Opportunities (www.healthinschools.org/sh/visionmain.asp), and Childhood Vision: What the Research Tells Us (www.healthinschools.org/sh/visionfs.asp). Foodborne Illnesses Decline A report released by the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), and the U.S. Department of Agriculture (USDA) in April showed declines in foodborne infections due to common bacterial pathogens in 2004. From 1996 to 2004, cases of E. coli 0157 infections, one of the most severe foodborne diseases, decreased 42 percent; Campylobacter infections decreased 31 percent; Cryptosporidium dropped 40 percent, and Yersinia decreased 45 percent. Salmonella infections dropped 8 percent overall. The incidence of Shigella, which is found in a wide variety of foods, did not change significantly from 1996 to 2004. Authorities credited the declines in foodborne illness to a variety of factors, including technological improvements in the slaughter of food animals and greater consumer awareness of safe poultry handling and cooking methods. The full report, "Preliminary FoodNet Data on the Incidence of Infections with Pathogens Transmitted Commonly Through Food," appeared in the CDC’s Morbidity and Mortality Weekly Report April 15 and is available online at www.cdc.mmwr.gov. How Healthy Are U.S. Children? Current measures to assess child health are not the correct ones, according to an article in the April 13 issue of the Journal of the American Medical Association (JAMA). Standards usually used to measure adult health, such as the absence of disease and premature death, are inadequate for children, say researchers Ruth Stein, Bonita Stanton, and Barbara Starfield. Instead, they say, assessment of child health requires a developmental perspective "with attention to the biological, environmental, social, and policy pathways that interact and are critical to the health of young children"—a process that does not fit well with current mechanisms of data collection that focus on cross-sectional data. The text of the article is available from corresponding author Ruth Stein at rstein@aecom.yu.edu. April News Alerts The following information appeared during the month of April 2005 in the News Alerts section of the website of the Center for Health and Health Care in Schools, at www.healthinschools.org. April 4, 2005 In a letter to U.S. Secretary of Health and Human Services (HHS) Michael Leavitt March 30, 145 advocacy and public health organizations expressed "dismay" that a recently launched government website that encourages parents to talk to their children about sexuality contains false and inaccurate information. The organizations asked that the website be taken down immediately and an inquiry launched into its content. The organizations also expressed concern that the only group credited with helping HHS develop the website is the National Physicians Center for Family Resources, which the advocacy groups charge "represents views that are far outside the values of mainstream Americans and the public health community." The HHS website can be accessed at www.4parents.gov. A list of the 145 organizations that signed the letter to Leavitt is available at www.siecus.org. April 5, 2005 Looking to speed up the process for producing influenza vaccine, in light of last season’s shortages and fears about a worldwide pandemic, the U.S. Department of Health and Human Services (HHS) announced April 1 that it has awarded a $97 million contract to a pharmaceutical manufacturer to develop cell-based rather than egg-based flu vaccines. Up to now, flu vaccines have been made by growing virus strains in chicken eggs, a process that can take many months. The new approach would use mammalian cells to grow the influenza viruses, and because such cells could be frozen and stored in advance of an epidemic, or developed rapidly in response to an epidemic, they could more easily meet "surge capacity needs." The new process would also have the advantage that the vaccine could be given to people who are allergic to eggs, who can’t receive the current vaccines, and it would guard against poultry-based diseases that sometimes contaminate vaccines made from eggs. The new cell-based vaccines may not be available for some years; the pharmaceutical company, Sanofi Pasteur, is just now making plans to build a cell-based manufacturing facility in the United States. April 6, 2005 The National Mental Health Association (NMHA), and advocacy group, said March 28 that "an increasing number of states have introduced legislation that prohibits mental health screening of children in schools and limits the ability of school personnel to make recommendations or even have dialogue with parents about behavioral health issues." As an example, the NMHA cited a bill introduced in the Alaska legislature that would prohibit school personnel from conducting a psychiatric or behavioral health evaluation of a child; recommending a specific licensed physician, psychologist, or other health specialist to a parent or guardian for a child; or making recommendations for administration of a psychotropic medication or psychiatric or psychological treatment or evaluation of a child. Legislation limiting schools’ ability to make medical recommendations for minors has also been introduced in Florida, Georgia, New Hampshire, New Mexico, New York, Pennsylvania, Tennessee, and Vermont. A bill that sought to prohibit school personnel from making certain medical recommendations for a minor, including the use of psychotropic drugs, was recently vetoed by the governor of Utah. NMNH position statements are available at www.nmha.org. April 8, 2005 Two days after the state of Connecticut announced that it plans to sue the federal government over President Bush’s education law, the "No Child Left Behind’ act, on the grounds that the law requires the states to spend millions of dollars on new tests without giving them federal money to cover the costs, federal Education Secretary Margaret Spelling announced a minor change in the law’s requirements for testing students with disabilities. But Spelling’s change may not be enough to satisfy Connecticut, where the attorney general says he is contacting other states to join him in taking legal action against the law, which Connecticut charges is an illegal and unconstitutional "unfunded mandate" that requires states to take actions without providing them the necessary funds. The federal law requires that students be tested for academic progress every year in grades three through eight. In a letter to Spelling in January, Connecticut state education commissioner Betty Sternberg pointed to Connecticut’s "effective 20-year history of testing in alternate years" and asked to be relieved of the requirement for annual testing, a request that Spelling refused. The change announced by Spelling April 7 would allow schools to exempt as many as 3 percent, instead of 1 percent, of their students from a federal requirement that students be tested every year in grades three through eight. This would allow schools to use alternative ways of evaluating the progress of 3 percent of students—which might include most students with disabilities--instead of giving them the same tests that are administered to all other students. Local school systems have complained that including scores on standardized tests taken by students with disabilities would lower schools’ overall test scores, which will be used to determine if the schools are succeeding or failing in making the academic progress required by the federal law. Spelling, in a meeting attended by some state school officials, did not address two major objections raised by critics of the federal law—that it imposes an "unfunded mandate" on the states, and that it intrudes the federal government into decisions about education that are left to states and local governments under the Constitution. April 11, 2005 Following up on his state’s decision to challenge the federal government on the "No Child Left Behind" education law (News Alert, April 8), Connecticut Senator Chris Dodd (D), introduced legislation April 7 that would make three changes in the disputed law. Dodd’s bill, S. 724, would:
Noting that appropriations for No Child Left Behind are $39 billion below what was promised when President Bush signed the law, which requires yearly testing of students in grades three through eight, Dodd said the shortfall has "left students and their teachers grappling with new burdens and little help to bear them." Dodd indicated that he supports improving the quality of education in America, but he said the law is being enforced by the administration "in a manner that is inflexible, unreasonable, and unhelpful to students." Dodd’s bill has been referred to the Senate Committee on Education for consideration. It and other bills can be tracked by logging on to the Library of Congress website, http://thomas.loc.gov and entering the bill number. April 12, 2005 Today, April 12, is the 50th anniversary of the day in 1955 when it was announced that a vaccine developed by Jonas Salk and a team of scientists at the University of Pittsburgh had been found to be "safe, effective, and potent" in preventing polio, an illness that had paralyzed as many as 20,000 persons—many of them children—each year in the United States. In the 50 years since the first vaccinations were given using the Salk vaccine, the United States and the whole Western Hemisphere have been declared to be free of the wild poliovirus, and the Smithsonian Institution in Washington is mounting a year-long exhibition titled "Whatever Happened to Polio?" The exhibition also highlights the work of another polio researcher, Dr. Albert Sabin, whose oral polio vaccine was licensed in 1961. The Sabin vaccine, which delivers an attenuated live form of the polio virus, was widely given to children and is still used in polio eradication campaigns in parts of the world that experience polio, because of its ease of administration. The Salk vaccine, which requires an injection, delivers an inactivated polio virus and is now the recommended childhood immunization in the United States, after the Sabin vaccine was found to cause occasional cases of polio. Information about polio disease, vaccine, and eradication efforts is available at www.cdc.gov/nip. Information about the Smithsonian exhibit is available at www.americanhistory.se.edu. April 13, 2005 The Senate Health, Education, and Labor Committee this morning abruptly cancelled a scheduled meeting at which the committee was expected to approve the nomination of Lester Crawford to be commissioner of the Food and Drug Administration (FDA). The action followed announcement by two senators—Hillary Clinton (D-NY) and Patty Murray (D-WA)--that they intended to put a hold on the Crawford nomination pending explanation of Crawford’s reasons for refusing to allow over-the-counter sale of the "morning after" contraceptive known as Plan B, after an advisory group had recommended such sale. Crawford, currently acting commissioner of the FDA, gave as his reason for denying over-the-counter status to Plan B that the method, which involves prompt use of a combination of regular birth control pills, would not be properly used by women in their teens. Critics of his action charged that it was politically motivated as part of the administration’s "abstinence only" approach to reproductive health. The Health Committee has not indicated when it may act on the Crawford nomination. April 14, 2005 During the week of April 18 to 22, the Substance Abuse and Mental Health Services Administration (SAMHSA) will focus on getting anti-drinking messages into fifth and sixth grade classrooms, following SAMHSA studies that show drinking by young teens leads to alcohol abuse or dependence later in life. In the year 2002, for example, surveys found that 35 percent of persons who were admitted to treatment for alcohol use or dependence had become intoxicated for the first time when they were 15 to 17 years old, and one-quarter had begun drinking between the ages of 12 and 14. "While we know that the majority of youth do not drink," said Charles Curie, administrator of SAMHSA, "these new SAMHSA data confirm that the vast majority of those in treatment for alcohol misuse had an early initiation into intoxication." Now in its fourth year, the "Reach Out Now" program is providing SAMHSA materials to fifth and sixth grade teachers to educate youngsters before they become teens about the dangers to young bodies associated with alcohol, and public figures are scheduled to conduct at least one teach-in in every state. Reach Out Now materials are available at www.teachin.samhsa.gov. April 18, 2005 In the most comprehensive anti-obesity legislation proposed so far, Senator Edward Kennedy (D-MA) introduced a bill April 15 that would "make the current epidemic a national public health priority" by:
The bill notes that childhood obesity is preventable but will require changes in the environments to which children are exposed, including the estimated 40,000 television advertisements children see each year for candy, high sugar cereals, and fast food. The bill calls for virtually all federal agencies to get involved in the anti-obesity push, including the Department of Education, which could require local education agencies that receive federal funds to ban vending machines that sell foods of poor or minimal nutritional value in schools. The Centers for disease Control and Education would establish centers to disseminate evidence-based practices on childhood obesity prevention, and the National Institutes of Health would give priority to research on prevention of childhood obesity. The bill, S. 799, "Prevention of Childhood Obesity Act" has been referred to the Senate Committee on Health, Education, Labor, and Pensions. The bill’s progress through Congress can be tracked on http://thomas.loc.gov. April 19, 2005 The U.S. Department of Agriculture today unveiled a new nutrition guidance system that replaces the Food Guide Pyramid introduced in 1992. Secretary of Agriculture Mike Johanns said the new symbol, "MyPyramid," represents the recommended proportion of foods from each group and focuses on the importance of "making smart food choices in every food group, every day." Johanns noted that the new symbol has been kept deliberately simple in order to encourage consumers to monitor their own diets, and he pointed out that individuals should now consider their levels of physical activity in determining which foods they eat and in what amounts. To work out a personalized dietary recommendation, adults can go to website www.MyPyramid.gov. Johanns said a "child-friendly" version for teachers and children is being developed, aimed at children 6 to 11 years old "with targeted messages about the importance of smart eating and physical activity choices." The new pyramid is based on the 2005 Dietary Guidelines for Americans, which are available at www.healthierus.gov/dietaryguidelines. April 20, 2005 The National Education Association, the nation’s largest teachers’ union, announced today that it has filed suit against the U.S. Education Department on requirements in the federal No Child Left Behind (NCLB) education law. Charging that the federal government is not providing the funds necessary for the annual student testing required by the law, the teachers’ group and school districts in three states are asking the United States District Court for the Eastern District of Michigan to grant an injunction declaring that school districts are not required to spend non-NCLB funds to comply with the NCLB mandate. They also ask that the court enjoin Education Secretary Margaret Spelling and "any other officer or employee of ED" from withholding from states and school districts any funds they are entitled to under the NCLB "because of a failure to comply with the mandates of the NCLB" if that failure to comply is attributable to the states’ or districts’ refusal to spend non-NCLB funds to achieve such compliance. The lawsuit details the experiences of a number of states and school systems in trying to meet NCLB requirements and charges that the administration’s failure to provide funding for testing constitutes an "unfunded mandate" that’s specifically forbidden in the law. The lawsuit was filed by schools and school districts in Michigan, Texas, and Vermont, and by the National Education Association and its affiliates in 10 states. April 21, 2005 In an announcement today, the Safe and Drug-Free Schools program in the U.S. Department of Education said that beginning this fiscal year, it will give priority to grant proposals that include testing of students for drug use. "We intend for these priorities to increase the use of drug testing as a means to deter student drug use," the announcement said. The proposed priority would give federal assistance to eligible applicants to "develop and implement, or expand, school-based random or voluntary drug-testing programs for students in one or more grades 6 through 12." The proposed "requirements, priorities, and selection criteria" for future Safe and Drug-Free Schools grants appeared in the Federal Register for April 21 (Volume 70, Number 765). The Federal Register can be accessed online at wais.access.gpo.gov. Comments on the proposed priority are due on or before May 23. Today’s announcement was not a request for proposals, which will be published later. April 28, 2005 After hours of debate, the United States House of Representatives voted 270 to 157 April 27 to make it a federal offense for a third party to transport a minor across state lines for an abortion in order to circumvent a parental notification law in the minor’s home state. The law would also require doctors who are asked to perform such abortions to inform the minor’s parents in person or by certified mail before performing the abortion. The bill would subject persons who help minors cross state lines for abortions and doctors who fail to notify parents to fines of $100,000 or a year in jail or both. During debate on the bill, supporters pointed out that 44 states have enacted some form of parental involvement statute and 23 have laws that require the consent or notification of at least one parent or court authorization before a young girl can obtain an abortion. Critics of the proposed law called it an unconstitutional effort by the federal government to force the law of one state on another and charged that it is part of an effort by Republicans to "please anti-choice extremists." The House bill, H.R. 748, the Child Interstate Abortion Notification Act, now goes to the Senate. The full text of debate on the bill in the House is available on website http://thomas.loc.gov. |