Getting There...

I like this short blurb from TIME magazine because it draws attention to the fact that racial tensions in America are increasingly gaining meaning as class tensions, and not merely as issues of color. Race still matters, but in this modern age of interracial offspring and the black middle-class, the conflict lies more in cultural and lifestyle differences than in differences of complexion. In the future, it would be prudent for the NAACP to pay attention to the growing rift between the haves and have-nots in the black community. At the same time, they would be wise to use this moment in history to integrate black disadvantages into the more generalized picture of American poverty. I don't deny that poor blacks face somewhat unique circumstances, but to continue to stand apart from Americans in general - that is, to insist that their economic history is fundamentally and permanently different - invites only division, and not useful discourse.

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National Association for the Alleviation of Credit Pandemonium

Nov 19th 2008

At 100, the NAACP still has a mission

Corbis

The struggle of the century

Barack Obama’s campaign for the White House raised many questions, for all Americans, about what it means to be black in America today—just in time for the centenary of the nation’s oldest civil-rights organisation, the National Association for the Advancement of Coloured People

The NAACP was formed on February 12th 1909 (itself a centenary, of Lincoln’s birth) by a bi-racial group of reformers. It promised to fight for equal rights and opportunities for black Americans. Primarily using litigation and legislation, it has been fighting the good fight, with varying degrees of success, ever since.

Does the election of the first African-American as president mean the battle has at last been won? NAACP members gathering in New York in July 2009 for its 100th annual convention could be forgiven for wondering how much their organisation still matters. Mr Obama and other young black leaders, such as the Massachusetts governor, Deval Patrick, embody the successful black middle class; and for many 20-something African-Americans the NAACP’s mission apparently means little when they feel overt discrimination is no longer an issue.

Hoping to make the NAACP relevant to that new generation is Benjamin Todd Jealous, a 36-year-old Californian who is the youngest chief executive in the NAACP’s history. Mr Jealous has plenty to do.

When he took over the helm in September 2008, the NAACP had been in turmoil for several years. Never a mass organisation, its membership now languishes at around 300,000, from a high of around 600,000, the association claims, just after the second world war.

Mr Jealous launched his tenure with an ambitious online voter-registration programme aimed at young blacks. As priorities for the coming year the NAACP is also targeting discrimination in the criminal-justice system, improving public schools, increasing black political and economic empowerment and boosting African-American representation, for example as surgeons, in the upper reaches of the health sector.

However, the credit crunch could prompt a shift in that strategy. African-Americans account for a disproportionate share of subprime loans, and tougher lending rules and tighter credit threaten to erode many of the gains made in recent years by black households.

The NAACP is suing 14 mortgage companies for discriminatory practices but it will need to do more, from expanding financial-literacy programmes to helping its constituents recover from financial crisis. In doing so, the NAACP might just find it matters once more.

(facts courtesy of the Guttmacher Institute for Sexual and Reproductive Health. Information is current as of Nov 1, 2008.)

Sexual Education and Family Planning

Issue: Sexual Education

Nation: Most states require that public schools teach some form of sex or STI/HIV education. Guidance on sexual activity is heavily weighted toward stressing abstinence; contraception, if it is covered, is not required to be stressed. Most states also have opt-out clauses so parents can remove their children from sex ed classes.
Georgia: Sexual education is mandatory in the state of GA, and abstinence must be covered whereas contraception does not. Information about STI/HIV must also be covered, with the emphasis on abstinence again. Parents can opt their children out of the curriculum.

Issue: Family Planning Funding

Nation: Beginning in the 1990s, a small number of states imposed abortion-related restrictions on state family planning funds. Some ban the use of state family planning funds to provide abortion counseling and referrals to women who have unintended pregnancies. Additionally, these restrictions often require strict separation between organizations providing state-funded family planning services and organizations providing abortion-related services. Currently, 4 states explicitly prohibit the use of state family planning funds for abortion counseling and referral.
Georgia: Guttmacher offers no information on Georgia legal restrictions on family planning funding, but as of Nov 11^th, Georgia’s state budget for family planning clinics was cut by a whopping 34%. Governor Sonny Perdue had only specified that state programs be cut by 6%.

Issue: Physician and Pharmacist Refusal

Nation: Most states allow private physicians and individual institutions to refuse to perform abortions. The real issue here is the topic of referral. ACOG has more or less stated that it is a medical obligation to refer to a professional that will provide the services you refuse.
Georgia: Allows both individual physicians and institutions to refuse to provide abortions. 1 of 4 states that allows pharmacists to refuse to dispense contraception, although pharmacies themselves are not given explicit permission to refuse. As for the topic of referral, community sentiment decides whether Georgia healthcare providers will give meaningful referrals.

Issue: Emergency Contraception

Nation: On August 24, 2006, the FDA approved Plan B as an over-the-counter medication for those aged 18 and older; it remains a prescription-only drug for minors. 16 states require hospital emergency rooms to provide emergency contraception–related services to sexual assault victims. 15 states require emergency rooms to provide information about emergency contraception. 4 states explicitly allow pharmacists to refuse to dispense contraceptives, including emergency contraception.
Georgia: No laws mandating that ERs provide information on EC or dispense it upon request. No rules to allow pharmacists to dispense EC without physician prescription, even though the FDA has recommended it as OTC for individuals over 18 YO. No requirements that pharmacies stock or fill valid prescriptions for EC. Explicitly allows individual pharmacists to refuse to dispense EC (one of 4 states).

Issue: Insurance Coverage of Contraception

Nation: 27 states require insurers that cover prescription drugs in general to provide coverage of the full range of FDA-approved contraceptive drugs and devices; 18 of these states specifically require coverage of related outpatient services.
Georgia: Requires that insurance covers prescription drugs and devices, but not outpatient services. No provisions allowing for refusal to provide for employers, insurers, etc.

Abortion

Issue: Who can legally provide abortions?

Nation: Most states require that only licensed physicians (and hence not Physician Assistants or licensed nurses) perform abortions, and that a 2^nd physician be involved after a certain point in fetal development (often after viability or 3^rd trimester).
Georgia: Pretty much in line with the rest of the nation. Georgia prohibits abortions except in cases of mother’s health after the 3^rd trimester (28 weeks GA).

Issue: Reporting Abortions

Nation: For the last three decades, the CDC has collected aggregate statistics on abortion in the US; states are not required to submit abortion data but the overwhelming majority of them do. Information gathered generally includes information about the facility, the patient’s demographic characteristics and medical history, and the abortion procedure itself, including the method used and gestational age.
Georgia: Required reporting with information on the procedure performed.

Issue: Funding

Nation: First implemented in 1977, the Hyde Amendment, which forbids the use of federal funds for abortions except in cases of life endangerment, rape or incest, has guided public funding for abortions under the joint federal-state Medicaid programs for low-income women. 32 states and the District of Columbia prohibit the use of state funds except in those cases where the woman’s life is in danger or the pregnancy is the result of rape or incest. In defiance of federal requirements, South Dakota limits funding to cases of life endangerment only. 4 states restrict coverage of abortion in private insurance plans to cases of life endangerment.
Georgia: Public funding of abortion limited to cases of rape/incest/endangerment. However, anecdotal stories support the idea that women rarely use state or federal monies for their abortions due to the burdensome requirements placed upon the women to acquire that money. Georgia has no limitations to coverage by private insurance.

Issue: Mandatory Counseling

Nation: 17 states mandate that women be given counseling before an abortion that includes information on at least one of the following: the purported link between abortion and breast cancer (6 states), the ability of a fetus to feel pain (8 states), long-term mental health consequences for the woman (7 states) or information on the availability of ultrasound (6 states).
Georgia: All women receive verbal counseling about the specific procedure they are getting, while receiving written information on all common abortion procedures. They are verbally told the gestational age of their fetus, while given written material on fetal development throughout pregnancy. Patients are given both verbal and written information on the ability of the fetus to perceive pain. According to Guttmacher, the written materials detailing the risks of abortion and the emotional responses thereafter are accurate, although some abortion clinics may still be using outdated (and inaccurate) state pamphlets on abortion.

Issue: Ultrasound

Nation: Some laws and policies require that a woman seeking an abortion receive information on accessing ultrasound services, while others require that a woman undergo an ultrasound before an abortion. Since routine ultrasound is not considered medically necessary as a component of first-trimester abortion, the requirements appear to be a veiled attempt to personify the fetus and dissuade a woman from obtaining an abortion. Moreover, an ultrasound can add significantly to the cost of the procedure. Only a few states (6) require verbal counseling or written materials to include information on accessing ultrasound services.

Georgia: Providers must give verbal information on how to access ultrasound services. If an ultrasound is performed as part of the procedural workup, the patient must be offered an opportunity to view it.

Issue: Waiting Periods

Nation: 24 states require a woman seeking an abortion to wait a specified period of time, usually 24 hours, between when she receives counseling and the procedure is performed. 6 of these states have laws that effectively require the woman make two separate trips to the clinic to obtain the procedure.
Georgia: Mandatory 24 hour waiting period, but no mandatory trips to the clinic for counseling (can be done over phone prior to procedure).

Issue: If Roe v. Wade were Overturned

Nation: 20 states have laws that could be used to restrict the legal status of abortion.

4 states have laws that automatically ban abortion if Roe were to be overturned
13 states retain their un-enforced, pre-Roe abortion bans.
7 states have laws that express their intent to restrict the right to legal abortion to the maximum extent permitted by the U.S. Supreme Court in the absence of Roe.

Georgia: Has not passed any explicit resolutions in this matter recently, but there is good reason to believe that Georgia legislators would attempt to impose restrictions on abortions should Roe v. Wade be overturned (see recent legislation proposed in Georgia: NARAL ProChoice BillTracker and Planned Parenthood Legislative Update )

Issue: Choose Life License Plates

Nation: 17 states allow production of “Choose Life” license plates. 7 states donate the monies to anti-choice organizations, 13 states donate the money to agencies or organizations that provide adoption assistance, and 8 states specifically prohibit using the funds raised from aiding organizations that provide abortion services, counseling, referrals or advertising.
Georgia: Choose Life plates are allowed, although Choose Choice plates are not allowed. Funds go explicitly to maternity/adoption services agencies. Unclear which these agencies are (for example, Crisis Pregnancy Centers, which are notoriously anti-choice in their operations).

Parenthood and Minors Access

Issue: Minor’s Access to Prenatal Care

Nation: 35 states allow minors to access confidential prenatal care. Of those, 12 allow physicians to inform parents that their minor daughter is seeking or receiving services when they deem it in the best interests of the minor.
Georgia: Explicitly allows minors to consent for prenatal care, without any rules allowing the physician to notify parents.

Issue: Minor’s Access to Contraception

Nation: Most states have adopted laws supporting Supreme Court rulings that extend the constitutional right to privacy to a minor’s decision to obtain contraceptives.
Georgia: Explicitly allows all minors to consent to contraceptive services

Issue: Parental Involvement in Minors’ Abortions

Nation: 22 states require one or both parents to consent to the procedure, while 11 require that one or both parents be notified and 2 states require both parental consent and notification. All of these states also provide for an alternate way of obtaining the procedure in the absence of parental consent, usually via judicial bypass. Some states even allow grandparents or other adult relatives to be involved instead of the minor’s parents, and some states waive the consent altogether in cases of rape or incest
Georgia: Georgia has a parental notification law, as opposed to a parental consent. There is an option for a judicial bypass if parental notification is not done. There is an exception to this rule in cases of a medical emergency, but not in cases of abuse/assault/incest/neglect.

Issue: Minor’s Rights as Parents

Nation: Though most states require parental involvement in a minor’s decision to terminate a pregnancy, they overwhelmingly consider minors who are parents to be capable of making critical decisions affecting the health and welfare of their children without their own parents’ knowledge or consent. Nearly every state permits minor parents to place a child for adoption. Moreover, most states authorize minor parents to make health decisions for their children, and some allow minor parents to authorize surgery.
Georgia: Minors can consent to placing their children up for adoption without 3^rd party involvement, and minors can consent for medical procedures/services for their child.

Issue: Drug Use During Pregnancy

Nation: No state specifically criminalizes drug use during pregnancy. However, several states had expanded their child-welfare requirements so that prenatal drug exposure can provide grounds for terminating parental rights on an individual basis (DFACS involvement, usually). Further, some states authorize civil commitment (such as forced admission to an inpatient treatment program) of pregnant women who use drugs. A number of states also place a priority on making drug treatment more readily available to pregnant women.
Georgia: Legally, in GA, substance abuse during pregnancy is neither considered grounds for child abuse or for civil commitment. There is no state required reporting or testing. There are no targeted programs for pregnant women, but they are given priority in general treatment programs.

Issue: Safe Haven Laws

Nation: Every state, beginning with Texas in 1999, has enacted a provision intended to provide a safe and confidential means of relinquishing an unwanted infant. These infant abandonment measures—also referred to as “safe haven” or “safe surrender” provisions—typically allow a parent or other specified party to relinquish an infant under certain circumstances without threat of prosecution for child abandonment.
Georgia: Parents may abandon their children up to age 7 days to any health care provider. There is no specific law protecting anonymity. The acceptor does not need to provide ID bracelets, ask for health information, or investigate “missing child” status.