By Seth Daniel
The Revere School Committee has voted recently to allow the Mass Generalâ€™s school-based health center in Revere High School (RHS) to dispense contraceptive services to students enrolled in the center.
Those services will include condoms, birth control pills, birth control shots and even emergency contraception pills (the morning after pill), according to Dr. Roger Pasinski, director of the Mass General Revere health center.
The controversial vote took place rather quietly on February 24, after a few months of discussing the matter with the School Committee and administration.
The vote wasnâ€™t unanimous, with School Committee members Carol Tye, Dan Maguire, Donna Wood Pruitt and Mayor Tom Ambrosino voting for the measure while members Ann Raponi and Michael Ferrante voted against it. Member Fred Sannella was absent for the vote.
â€œI couldnâ€™t in good conscience vote for it,â€ said Raponi last week. â€œIn my opinion, I felt the money appropriated with this grant could be used more wisely in educating students on dangers of early sex and sex in general…It increases promiscuity rather than having it be a deterrent to early sex. Education is far more important than having condoms and birth control distributed.â€
Mayor Tom Ambrosino, though, is an adamant supporter of the new policy, which will be included in the RHS Student Handbook next year.
â€œWe have a serious problem with teen pregnancy, and this was recommended to us by health professionals as an effective way to target that problem,â€ said the mayor. â€œWe canâ€™t put our heads in the sand and think high school kids arenâ€™t having sex. They probably were 30 years ago and they probably were 60 years ago. We canâ€™t just ignore the problem. Parents who object have an absolute right to ensure their children are not part of the policy.â€
Teen Pregnancy Now a Problem
Dr. Pasinski told the Journal that after the discussion concerning teen pregnancy in Gloucester last year, he and his staff began to look at teen pregnancy at RHS.
Those statistics, he said, showed there had been a 50 percent increase in teen pregnancy at RHS from 2005-2006 to 2007-2008.
â€œThere was a pretty good spike in teen-age pregnancy,â€ he said. â€œThat was the data, particularly, that made us decide to go to the School Committee and let them know this was worrisome and this was a problem and to discuss with them what could be done. I think we came up with the best choice.â€
After meeting a couple of times behind semi-closed doors, MGH officials presented their plan to the School Committee at the February 24th public meeting. However, that presentation wasnâ€™t listed on the School Committeeâ€™s public agenda.
The policy that was approved that night allows students who are enrolled in the school-based health center to receive several forms of contraception if their parents sign up for the service when they enroll.
Parents have the right to opt out of such services on the form. Due to the stateâ€™s Emancipated Minor Law, which requires that health professionals provide birth control to teens who demand it, even without parental consent, not all scenarios have such an opt-out control.
â€œThis does give parents much more control than that,â€ he said. â€œJust the way we function in our office, and given the fact that we are school-based, we rewrote a form we send out to all parents that allows students to be treated. We have taken that stance because it is a school-based health center, and we want to be sensitive to parents and at the same time service these kids.â€
Said Superintendent of Schools Paul Dakin, â€œI look at it as choices for parents…I donâ€™t see it as dictatorial. People may make stupid choices and they may make choices that donâ€™t agree with my morality, but we have to let them make choices. We didnâ€™t condone or not condone this. These are open services and choices for parents.â€
The school-based health center serves approximately 400 families. No concrete number was available. MGH pays for and runs the center without any school funds. However, the school allows the clinic to use its facilities rent-free.
The new program would run under the ABCD grant program.
Pasinski and Ambrosino said a full slate of birth control would be offered at the school to those students who are signed up for the services.
Services will include offering condoms, prescription birth control pills, prescription birth control injections and emergency birth control – which is also known as the morning after pill, a once controversial treatment that prevents a pregnancy from forming if taken within 72 hours of sexual activity.
â€œWe would never have anybody on that all the time,â€ said Pasinski. â€œIf a female student was in and had sexual activity the night before or the Saturday before a Monday and the condom ruptured and she was concerned about being pregnant, we would administer it in that case.â€
One thing that is also offered is constant discussion about including parents in important health decisions, even though state law that doesnâ€™t require it.
â€œWe always strongly recommend they get their parents involved,â€ he said. â€œWe push them to talk with their parents.â€
Dakin added that, as he understands it, the clinic always pushes parental involvement first.
â€œYou want them to talk with their parents about these things,â€ said Dakin. â€œThatâ€™s step one, two and three of the process. Even at the school-based health center, they work from the perspective in that they say this is not a good thing that the kids are doing. However, there are some kids who say, â€˜I donâ€™t care, Iâ€™m doing it anyway.â€™ They can be that brash.â€
One thing Pasinski and others said wouldnâ€™t happen is that they wouldnâ€™t go down the road of offering abortions. Because of the nature of this issue, there are many who believe that offering contraceptive services is a slippery slope to offering abortions.
â€œThatâ€™s totally off-base,â€ said Pasinski. â€œWe donâ€™t perform any abortions at our huge health center on the Beach. Even at the Beach, we donâ€™t perform a single abortion – never have, never will. Weâ€™re not licensed to and we have no intention in ever doing that.â€
Said the mayor, â€œAbsolutely not. This has nothing to do with abortion.â€
Dakin added, â€œI hope it doesnâ€™t go down that road.â€
What about Broadway?
A major point of discussion with the School Committee was about outlets, and there is already an outlet in the city providing confidential adolescent contraceptive services to local teens.
That clinic is also run by MGH and is located in the Post Office on Broadway. Any teen can get any of the above-mentioned contraception services there.
Pasinski said they formerly referred students to that clinic for such services, but it appeared the teens werenâ€™t following through.
â€œWhat would happen is the teens wouldnâ€™t show up anywhere else [after being referred],â€ he said. â€œThey trusted the school-based health center, but didnâ€™t follow through outside of it. Thatâ€™s one of the reasons we saw the big spike in pregnancy.â€
Mayor Tom Ambrosino said he thought it was an easy decision to help kids gain access. â€œIt seemed ridiculous to me that they would refer people up the street to the clinic and have some not make it there,â€ he said. â€œI think itâ€™s very reasonable.â€
However, School Committee member Raponi disagreed.
â€œI didnâ€™t see a need for it, especially since there is an outlet on Broadway outside of the school wherein they can obtain birth control contraception without parental permission,â€ she said.
A number of people in the community, from priests to politicians to parents, after hearing about the vote, expressed real concerns with the new policy, mostly because of the message they think it sends to the overall youth population.
Father George Szal of Immaculate Conception said he and the Catholic Church take a strong stance against all such forms of birth control, but especially giving it to children.
â€œItâ€™s not good,â€ he said. â€œWe adults are saying we canâ€™t control ourselves and we expect that you young people canâ€™t control yourselves, either. Weâ€™re depersonalizing everyone here. Weâ€™re taking the easy way out, and that easy way out certainly has consequences. Weâ€™re giving up and saying, â€˜We canâ€™t do it.â€™ Weâ€™re not being disciplined, and so weâ€™re not teaching our children any discipline.â€
He said he believes it also hurts the way that children understand sex.
â€œItâ€™s not good for children because weâ€™re telling them that sex is a mechanical thing,â€ he said. â€œItâ€™s not about love, marriage, family or children. Itâ€™s all about me.â€
Raponi said she would rather see money spent to explain the consequences of sexual activity.
â€œI believe education is a better way of approaching the problem,â€ she said. â€œIâ€™d like to see the money in classrooms to explain the ramifications of what would happen.â€
Dakin said he didnâ€™t think the overall message is as bad as some might believe. He said it was more about offering choices than condoning any sort of behavior.
â€œItâ€™s not like we have a shop set up saying, â€˜What would you like?â€™â€ said Dakin. â€œItâ€™s more about parents making conscious choices.â€
Ward 4 Councillor George Rotondo came out against the policy this week after hearing about it from a constituent. He said the message is very damaging.
â€œI clearly donâ€™t care what the [Emancipated Minor] law says because itâ€™s my child and my responsibility until the day I die, not until the day those people die,â€ he said. â€œFrankly, it sounds like social engineering to me.â€
Another major aspect of the issue is that it happened so quickly and without much – if any – public discussion on the topic.
The presentation to the School Committee on February 24 wasnâ€™t even mentioned on the meeting agenda. Neither were any semi-private committee meetings held beforehand on at least two occasions.
Dakin said he discussed the matter with his citywide Parent Teacher Association (PTA) and that group was split on the issue.
Other than that, there were no fliers or big announcements that such a controversial issue was going to be breached at the public meeting.
â€œThere were certainly no wholesale solicitations of [parents],â€ he said. â€œI would say we did a little more than when we created the school-based health center.â€
Raponi said she thought there was very little parent involvement.
â€œThey should have had some correspondence and let the people have some information from the school,â€ she said. â€œIâ€™m not sure what the response would be, but it certainly would have been worth doing.â€
Mayor Tom Ambrosino shocked some with his stoic stance indicating it was a done deal and over with.
â€œParents have every right to come to the School Committee,â€ he said. â€œI donâ€™t think it will change anyoneâ€™s position. [Teen pregnancy] is a serious problem in the city of Revere.â€
Rotondo disagreed, saying he believed there needed to be a very big discussion with a lot of questions and a lot of answers.
â€œWhy are we imposing our social norms on other people?â€ he asked. â€œI find it troubling that discussion did not take place. This comes down to losing grant money for MGH. Iâ€™m less concerned about making sure some grant money gets used as I am about what an outside agency thinks is acceptable in our school system. The public needed to know.â€
Pasinski said MGH approached it from a public health standpoint, and that it was the School Committee that allowed it. He said, from his end, they are just concerned about the success of teens.
â€œA healthy community means our teens are successful in school and graduating Revere High School with a diploma and, hopefully, a lot of them are going on to college,â€ he said. â€œI think everybody knows every teen-ager engages in risky behavior and our role is to make the adolescent years as less risky as possible from the standpoint of sexually-transmitted diseases [STDs] and sexual activity. If they become pregnant and keep the baby, itâ€™s very hard for them to complete high school and go to college. Thatâ€™s one factor that holds communities back.â€