Social, Religious Values Clashing at School Social and religious interests collide over a health clinic that would offer birth-control devices and information at heavily Catholic, Latino San Fernando High School. : Student Clinic: Clashing Values

A plan to open a San Fernando High School health clinic--which would include birth-control advice and the dispensing of contraceptives--is creating a controversy in the heavily Catholic, Latino neighborhoods the school serves.

In the months since the Los Angeles Unified School District decided to establish a clinic at the campus in hopes of reducing the dropout rate and teen-age pregnancies, opposition has emerged in the northeast San Fernando Valley.

Sunday Masses at the five Roman Catholic churches within San Fernando High’s attendance area have included admonishments about the clinic, as have church bulletins.

For example, Father David Ullrich, pastor of Santa Rosa Catholic Church in San Fernando, wrote in a pastoral letter: “I was hopeful that the planned clinics would help meet some of the health needs of our community. That’s a big need we have. But the more I looked into the plan, the more disappointed I became.

“It has become clear to me that the school board’s principal concern is not health. If it were, then the board would have proposed health care in elementary and junior high schools. The school board’s real concern is to control teen-age pregnancy by the distribution of birth-control devices to high school students.

“If you are in favor of this approach, then you will be happy with the school’s plan. However, if you, like me, do not think we can solve teen-age pregnancy by passing out condoms and pills, let your voice be heard at San Fernando High.”

Clinic opponents said they have gathered 7,000 signatures on petitions against the clinic. There have been two candlelight marches along Van Nuys Boulevard, each drawing about 2,000 chanting protesters. The marches ended at the Pacoima offices of Northeast Valley Health Corp., the agency selected by the school district to run the clinic.

Also, a group called Parents and Students United in the San Fernando Valley, whose members include many non-Catholics, has been formed to try to stop the clinic.

The opposition was foreshadowed by the early reaction of Archbishop Roger M. Mahony of the Archdiocese of Los Angeles. He denounced the concept of such campus clinics even before the Board of Education, led by members Roberta Weintraub and Jackie Goldberg, last fall approved the San Fernando clinic and two others.

After the board’s unanimous vote for the clinics, Mahony urged Catholics and others “who value the family” to put pressure on the board to rescind it. He said the birth-control services would “send a message to students legitimizing behavior contradicting our Judeo-Christian ethic” and undermine parental roles in helping students make “serious health decisions.”

The project has stirred little community debate around Jordan High School in Watts and Los Angeles High School in the mid-Wilshire District, the other campuses chosen for clinics. But things have been far from quiet around San Fernando High.

About 83% of the school’s 2,350 students are Latinos. Church and school officials believe that the majority of them are Catholic. The debate over the clinic has become a clash of social and religious values.

The school district’s aim to reduce teen-age pregnancies, in part by offering contraceptives, runs counter to the Catholic Church’s prohibition on any artificial kind of birth control. Some parents are worried that the clinic will unwittingly encourage sexual promiscuity. Some think that the clinic would be taking over the family’s traditional role of instilling moral values.

The concern about the school taking over for parents is part of what led San Fernando Mayor Jess Margarito, an early supporter of the clinic, to change his mind and join opponents after several meetings with local Catholic church leaders, parents and students.

“I sat around for two months and thought about this,” Margarito said. “I just don’t think this is a positive thing for our community.

“I went to San Fernando,” he said. “I have a daughter who will go to San Fernando next year. As a parent and as a member of the San Fernando community, I have to get involved. This is being imposed against the will of the community.”

His sentiments are shared by Maurillo Torres, president of a youth group at Mary Immaculate Catholic Church in Pacoima. Torres started a petition drive against the clinic.

5 Sisters

“I have five sisters, three of whom go to San Fernando,” Torres said. “I would not be against the clinic if it did not dispense contraceptives. When I found out that this was going to happen, I talked to people to see what they think. They were against it.”

But Weintraub, who represents the East Valley on the school board and who has begun a crusade for the clinic, believes it holds the key to a better future for San Fernando’s students.

“We have to do something about babies having babies if we are ever going to do something about the dropout rate and make a real attempt to put an end to this never-ending cycle of poverty,” she said.

Maria Reza, coordinator of the district’s clinic program, said she believes the best way to win over the community is to open the clinic.

“I don’t know what we can do to make them believe us except to establish the clinic and let them watch it operate,” Reza said.

School officials are proceeding with plans for the clinic. They hope to open it this summer and offer full service in September.

The three clinics are to be financed privately. The district has applied to Robert Wood Johnson Foundation of Princeton, N. J., for much of the money. The project is expected to cost $600,000 the first year, with about $355,000, including donated services, needed for the San Fernando clinic.

The foundation is the largest underwriter of school-based health clinics in the nation.

Last month, when Wood Foundation officials toured the San Fernando campus, clinic opponents hired a plane to fly overhead towing a banner that read “No Clinic Here.”

Criteria used by the school district in selecting the three schools included the local teen-age birthrate, the actual or perceived lack of health services in the community and the availability of space on campus for the clinic.

Operation of the three clinics is contingent on whether the district receives enough money from private donations and several philanthropic foundations. If the district does not receive money to run all three clinics, it will go ahead with one or two. According to district officials, no decision has been made on which school would be given the priority in clinic financing.

Planned Services

Besides birth-control counseling and contraceptives, the clinic would offer physical examinations and diagnoses, immunizations and treatment of illnesses. It would include such specialty services as mental-health counseling, dermatological care, weight control, treatment of drug and alcohol abuse, vision and dental screening and the diagnosis and treatment of sexually transmitted diseases. The clinic would also offer pregnancy testing and prenatal care.

The clinic’s array of health services has won it the support of local legislators, community organizations, business and other civic groups.

The project reflects a local version of a nationwide movement to establish on-campus clinics that include birth control among their services. According to Sharon Lovick, director of the Center for Population Options in Houston, 76 such clinics operate throughout the United States, with another 100 on the drawing board.

Most are at schools where most students come from poor families. The aim is to take health services to students who, because of pregnancy, chronic illnesses or other problems are likely to be high-school dropouts or underachievers.

No one is arguing against offering free medical services to students of San Fernando High, a 90-year-old institution nestled on a 33-acre site northeast of the junction of the Golden State and Simi Valley freeways.

Slightly more than 18% of the families within its attendance area receive federal Aid to Families with Dependent Children. About 20% of the students have recently immigrated to the United States. A school health official said many students’ families cannot afford private medical or dental care and have no health insurance.

Aftereffects of Polio

The school sends more students to a free, PTA-sponsored eye and dental clinic than any other in the Valley. Some immigrant students arrive with the crippling aftereffects of polio, a rarity among American-born children today, the school official said.

More than half of San Fernando High’s students--52%--do not graduate. School officials believe that pregnancy and other medical conditions account, at least indirectly, for many of the dropouts.

No records are kept on the number of pregnant teen-agers at the school. But a Los Angeles County-sponsored survey of the surrounding area ranked it in the top 25% of communities in the county with mothers under 18. Other county data shows that, in 1984, 191 babies were born in the school’s attendance area to mothers from the ages of 11 to 18.

San Fernando is one of two high schools in the district to have an infant day-care center on campus. The center helps teen-age mothers return to school and graduate instead of dropping out to care for their babies. According to Margaret Galloway, center director, 20 teen-age mothers are using the facility, and there is a waiting list of 40.

San Fernando is one of four campuses with a district-funded program for pregnant students. The 54 students now enrolled in San Fernando High’s program do not represent all the pregnant girls at the school, Principal Bart Kricorian said. Some continue in regular classes, and many drop out of school altogether, he said.

Need for Clinic

“We certainly have need of the services that a health clinic would provide,” said Kricorian, who, along with other administrators at the school, is a staunch supporter of the clinic.

Because teen-age pregnancy is a big concern to school officials, clinic proponents say there is little likelihood that the project will be revised to exclude birth-control-related programs, as many opponents are suggesting.

San Fernando High students, who appear to be divided on whether the clinic is a good idea, have a pretty clear idea of its primary purpose.

“I don’t see what all the controversy is about,” 10th-grader Rene Anchondo said. “It’s not like people are going to stop having sex, so why not have something that will help them prevent pregnancy?”

Several unanswered questions revolve around student use of the clinic. Would parents withhold permission for their teen-agers to use the clinic? Would students use it primarily for sex-related purposes or take advantage mainly of its other services? And would the clinic eventually help lower the school dropout rate?

School officials have few means of predicting the answers. But proponents point to the experience of a school clinic in St. Paul, Minn. At first, student use of the clinic was low, according to a study by researchers from St. Paul-Ramsey Hospital and the University of Minnesota. However, by the end of the third year, 50% of the students had used the clinic at least once. The pregnancy rates for the school dropped by 56% in three years, and the after-delivery dropout rate for teen-age mothers declined from 45% to 10%.

Making Clinic More Palatable

In an attempt to make the campus clinic more palatable to the San Fernando High community, the school district and administrators are trying to inform parents and others about the clinic’s services and to listen to and accommodate their concerns when possible.

For example, when parents said they were worried that their youngsters might forge signatures on clinic permission forms, administrators considered having parents go to the school to sign the forms.

A community advisory board has been formed to oversee clinic operations, including reviewing all forms and procedures before they are implemented.

During the next few weeks, the school will mail surveys to parents, asking them what services they would like the clinic to offer. On campus, Rena Shpegal, liaison between the agency that will run the clinic and the high school, is speaking to every health and English-as-a-second-language class about the purpose of the clinic and who would be eligible to use it.

Principal Kricorian said there will be more meetings among clinic advocates, small groups of parents and organizations such as the School Advisory Council, the Bilingual Council and the PTA.

Much of the discussion will center on clinic services and operations.

The clinic would be staffed by physicians from UCLA School of Medicine. It would be free to students and would operate during and for a short time after school. It would be in a bungalow in the center of the campus.

Parental Permission

A student could not use the clinic for any reason without having written parental permission on file. This requirement is aimed at assuring parents who oppose the clinic that their children will not be allowed to use it. However, once permission is given, the student would have unlimited access to all its services, and a parent would not be informed of the child’s visits.

Because it is almost certain that at least some parents will not give permission for their youngsters to use the clinic, school officials said, the traditional school nurse services will not be eliminated once the clinic opens.

The district has developed strict guidelines regarding the clinic’s sex-related services. For example, if girls asked for contraceptives, medical personnel would first discuss abstinence.

“We will tell them that it is all right to say no,” Shpegal said.

If a girl insisted on contraceptives, the doctor would encourage her to discuss her decision with her parents, a practice now followed at the agency, Shpegal said.

If the girl still wanted contraceptives, a medical examination would be performed and appropriate contraception would be prescribed-- condoms, foam, diaphragm or pills.

If a pregnant student came to the clinic and asked for information about an abortion, she would be handed a list of a woman’s three legal options--to have the baby and keep it, to have the baby and put it up for adoption or to have an abortion if she is in the first three months of the pregnancy.

Encouraged to See Doctor

The guide encourages the girl to see her doctor. If she does not have one, the sheet lists the names and addresses of nearby public clinics. The nurse would encourage the girl to talk to her parents, her clergyman and to start prenatal care as soon as possible, Shpegal said.

“This is exactly the same procedure used at San Fernando right now,” said Carol Burke, an assistant principal at the school. “There would be no change in policy. There would be no abortion counseling, and there certainly would be no abortions performed at the clinic.”

School officials are paying particular attention to parents’ fears of relinquishing control over their teen-agers’ actions and are trying to take steps to alleviate those fears.

There is also discussion of making consent forms valid for only one year, and there is some consideration of dispensing contraceptives off campus rather than at the clinic.

That idea, however, is not favored by clinic advocates, who believe the program’s effectiveness would be undermined if students had to follow through with an off-campus stop. It is also not likely to mollify opponents.

“I don’t believe that would be a real concession,” said Father Peter Irving, associate pastor of Guardian Angel Catholic Church in Pacoima.

“What is to stop the board from adding these services at a later date?” Irving said. “I think the only answer is not to have a clinic at all.”

THE CLINIC

The proposed medical clinic for San Fernando High School, part of a three-campus pilot project by the Los Angeles Unified School District, would begin limited operation this summer and offer full services in September.

Purpose: Clinic advocates hope to reduce the high-school dropout rate by removing some of the health-related impediments to graduation.

Services: The clinic would offer examinations and diagnoses, immunizations, treatment of illnesses; specialty services such as mental-health counseling, dermatology, treatment for drug and alcohol abuse, weight control, vision and dental screening, and diagnosis and treatment of sexually transmitted diseases. Controversial services planned are counseling about contraceptives, pregnancy testing and prenatal care.

Operation: The clinic would be housed in a bungalow on campus and operate during school hours and for a short time after school. Students could be seen anytime during the day. Urgent care could be given anytime the clinic is open.

Access: Students wanting to use the clinic would first have to obtain written permission from a parent. The permission slips, good for a minimum of one school year, would cover all clinic services, giving parents an all-or-nothing choice. Permission could be rescinded at any time.

Management: Northeast Valley Health Corp., under contract with the school district, would operate the clinic. UCLA School of Medicine would provide physicians. A community advisory board has been chosen to oversee operations.

Cost: About $355,000, including an estimated $155,000 in donated services, the first year. The district is seeking private contributions and has pledged not to spend taxpayer dollars on the project. All services would be free to students.

Supporters: Los Angeles Board of Education, led by board members Roberta Weintraub and Jackie Goldberg; SFHS administrators and the 31st District PTA, which serves the San Fernando Valley; Los Angeles Mayor Tom Bradley; area legislators Assemblyman Richard Katz (D-Sepulveda), state Sen. Alan Robbins (D-Van Nuys) and Rep. Howard Berman (D-Panorama City). Also, community organizations El Nido Services, El Proyecto del Barrio, San Fernando Valley chapter of the Mexican-American Political Assn., and such business groups as the San Fernando and Pacoima chambers of commerce and the San Fernando chapter of Business and Professional Women.

Opponents: Catholic church leaders and local parishioners, ranging from the Archdiocese of Los Angeles to the five parishes within SFHS attendance boundaries; San Fernando Mayor Jess Margarito; and Parents and Students United in the San Fernando Valley, an umbrella group of Catholics and Protestants formed recently to fight the clinic.

THE DEBATE

Criticism:

Its contraceptive and pregnancy counseling services would run counter to the Catholic Church’s prohibition on abortion and any artificial kind of birth control. It would encourage promiscuity by telling teen-agers how to have “safe” sex, thus implying that teen-age sex is acceptable.

Response:

Use of the clinic, including its birth-control services, is strictly voluntary; students seeking birth-control counseling would first be encouraged to “say no” to sex; neither abortion counseling nor abortions would be performed.

Criticism:

The school would be meddling in matters that should be handled within the family.

Response:

Families do not or cannot handle these issues effectively.

Criticism:

Because the services would be confidential, parental control would be eroded; consent forms could be forged.

Response:

Students would be encouraged to tell parents about their health- or sex-related problems; school officials are considering having parents sign the consent forms at school to guard against forgery.

Criticism:

A state law enables minors 12 and older to seek contraceptives, abortions and treatment of drug or alcohol problems and sexually transmitted disease without a parent’s knowledge or consent. That law could render meaningless the school district’s policy of requiring written parental permission for a student to use the clinic.

Response:

Legal experts do not believe that the state law precludes the district’s parental-permission policy. They say the district is not required to provide the services just because a teen-ager asks. There is a slight possibility that the district policy could be challenged on constitutional grounds.