Stopping Bullying in Schools

The outcry following the suicides of two Massachusetts students, who killed themselves after being subjected to intense bullying in the past year, culminated in Gov. Deval Patrick signing anti-bullying legislation on May 3rd.  The Massachusetts House and Senate passed the bill unanimously, following more than a decade of work by advocates.  The law prohibits actions that cause emotional or physical harm to students, including taunting over the Internet.  Faculty and students are required to have anti-bullying training and parents must be informed of incidents at school.  School employees, including custodians and cafeteria workers, must report incidents of suspected bullying and principals must investigate each case. 

Massachusetts now joins 42 other states with an anti-bullying bill, leaving Michigan, Wisconsin, North Dakota, South Dakota, Alabama, Hawaii (last introduced in 2009), Mississippi, and Montana yet to join them.  Wisconsin's SB 154 is on Gov. Doyle’s desk and would require school boards to enact anti-bullying policies and implement procedures for investigating and disciplining incidences of bullying.  A Michigan bill (HB 4580) is stalled in committee, but Gov. Granholm has stated she will sign the bill if it reaches her desk. 

Protecting LGBT Youth:  In Michigan, the sticking point, as with many other more recent state bills, is whether or not to give specific mention to LGBT youth.  A compromise not pleasing to either side is in negotiations, tweaking the language to read, “[Bullying] is reasonably perceived to be motivated by animus or by actual or perceived characteristic.”  The American Family Association of Michigan is lobbying hard to kill the bill.  Similar socially conservative "family" organizations have fought anti-bullying bills in other states.

Studies have shown that LBGT youth are especially targeted for bullying.  A 2007 report by the Gay, Lesbian and Straight Education Network (GLSEN) found that 9 out of 10 LGBT students (86.2%) experienced harassment at school in the past year, three-fifths (60.8%) felt unsafe at school because of their sexual orientation and about a third (32.7%) skipped a day of school in the past month because of feeling unsafe.

Advocates in Massachusetts were disappointed that LGBT youth were not specified as a class in need of protection in the bill just enacted there.  On the other hand, North Carolina last year passed SB 526, requiring schools to adopt strong policies against bullying and harassment, including bullying based on sexual orientation and gender identity, despite a protracted and oftentimes mean-spirited fight.  This was the first time the terms "sexual orientation" and "gender identity" appear in the North Carolina General Statutes -- a significant victory for Equality North Carolina, which joined forces with a statewide school violence prevention coalition and other allies to support the bill, sponsored by Rep. Rick Glazier.

Upgrading Old Statutes:  Many states with existing anti-bullying legislation are experiencing “upgrade” bills to include cyberbullying, training and/or to add “sexual orientation or gender identity” to the list of protected students.  Cyberbullying -- defined as communicating harmful, violent and/or malicious words and/or pictures through the means of technology -- has been a growing area of harassment that states are increasingly seeking to address. 

This legislative session, Illinois lawmakers passed an upgrade to their existing bill, now including LGBT students specifically and mandating tolerance training.  The Senate bill passed with all but two senators supporting it; the House passed the bill unanimously.  Gov. Quinn is expected to sign the bill within the week.

The key focus of all these anti-bullying laws is to hold school officials accountable for developing policies to prohibit bullying.  Where they vary is in the details of bullying prevention programs, training for staff, and accountability measures to require individuals to report school bullying incidents.  And regardless of the statute language, assuring they are interpreted and implemented appropriately is an ongoing challenge.

States Decide on High Risk Pools

The choice of whether or not to establish high-risk insurance pools represents the first major decision that states are facing with the March 2010 passage of the Patient Protection and Affordable Care Act (PPACA). While twenty-nine governors -- 22 Democrats and 7 Republicans -- decided to create the pools themselves, most conservative governors failed to take advantage of the option to shape health care for their constituents and instead just kicked the issue back to the federal government, which will establish its own high-risk insurance pool in states that fail to take action.

While temporary in nature, lasting only until 2014, these high risk pools are designed to help people with pre-existing and chronic health conditions who cannot find affordable health insurance. But the decisions the governors are reaching are revealing with respect to whether or not states intend to foster a collaborative relationship with the federal government in implementing the vast array of PPACA provisions.

How the States Responded: The federal law allocated $5 billion to the high risk pool programs which are scheduled to begin July 1 of this year and last until through January 1, 2014, when the state insurance exchanges begin to operate. With last Friday as the deadline for states to respond to HHS, 29 states plus the District of Columbia said they would operate the pools themselves (not all of the rest have made a final decision). Of those twenty-nine, only seven are led by Republican governors in Alaska, California, New Jersey, Connecticut, Rhode Island, South Dakota and Vermont.

While it was conservative governors in the eighteen states who turned down the opportunity to administer the pools, the irony is that expansion of high risk pools was one of the major proposals promoted by conservative Members of Congress. Some state leaders raised the concern that the $5 billion set aside for the pools would be insufficient to assist the potential number of beneficiaries, but the continued pattern of non-cooperation highlights the suspicion that conservatives leaders have just made saying no an ongoing obstructionist tactic.

HHS told state officials in a recent conference call that states will not be asked or expected to contribute any state dollars, since there is absolutely no provision in the PPACA that even hints at such a possibility. But it's critical to remember that the most important feature of the temporary risk pools is that uninsured people around the country, who have been denied coverage for years, will soon have access to an affordable coverage option.

State Allocations: Each state’s allocation is based on population and need, not on whether it’s a state or federally operated program. California would receive the largest allocation of money, $761 million, while North Dakota, Vermont and Wyoming receive the smallest, each getting $8 million. An HHS website details the amounts of each state’s allocation for funding the high risk pools. Examples of Implementation include:

• Iowa:  Governor Chet Culver decided to accept the federal funds. Iowa already was one of 35 states with high risk pools prior to enactment of the PPACA with about 3,000 members, most of whom have serious medical conditions, such as kidney disease, cancer or hemophilia.  HIP Iowa is currently financed by members’ premiums, plus payments from every company that sells health insurance in the state. By state law, HIP Iowa premiums may not be more than 150 percent of standard insurance rates for an Iowan of the same age and gender as an applicant, although the rules for the federal pool may require new standards for additional folks covered by the federal funds.
• Ohio:  While it's too soon for patients to know what Ohio's new program will look like, Gov. Strickland says he would like to build on an existing private-sector program, with the potential for up to $152 million in help from Washington. Seeking guidance from HHS before deciding on specifics, Ohio Department of Insurance Director Mary Jo Hudson presented several potential ways in which Ohio might design its own program. One would be to expand Ohio's "open-enrollment" program, which kicked in this year as an alternative to high-risk pools. The program requires private carriers who sell insurance on the open market to also sell to people who don't have other available coverage -- these are people who don't qualify for low-income, government programs -- and to limit their premiums, although they still can be 150 percent above others' premiums. To pay for the program, other clients who buy insurance on the open market are charged with a small rate hike.