Education

St. Paul Group Seeking Rescue Plan for City’s Troubled Teen-Pregnancy Clinics

By Austin Wehrwein — April 23, 1986 3 min read

ST. PAUL--A communitywide emergency task force here is working to devise a private-sector rescue plan for the city’s pioneering and nationally acclaimed teen-age-pregnancy program.

Threatened by a budget deficit that could total $761,700 by the new fiscal year, the Maternal Infant Care/Adolescent Health Services Project [MIC] faces the closing of at least one of its four school clinics and curtailed operating hours for the remaining three unless it receives swift cash transfusions from some source, officials say.

A day-care center operated at one of the high schools served by the program would also be affected by budget reductions, the officials add.

Now in its 14th year, the MIC has served as a model for a growing number of similar pregnancy-clinic projects across the nation. Its financial crisis--due primarily, officials say, to cuts in federal funding and rising costs---comes at a time when increasing public attention to the problem of teen-age pregnancy has aroused national concern and made school pregnancy-prevention programs the subject of heated debate in some areas.

The project, which operates clinics at four of the city’s six high schools, is run by the St. Paul-Ramsey Medical Center, the combined city-county hospital complex, with an annual operating budget of $1.4 million. Its projected deficit is approximately $311,700 for this year and $450,000 for next year.

Ann Ricketts, a project administrator, described the current situation as “very foggy,” but said she was “optimistic that with community support services will be maintained.”

The newly formed task force, headed by Leonard Wilkening, head of the Wilder Foundation, is expected to urge that MIC be absorbed by a new private, nonprofit, tax-exempt entity. It would be governed by a board with members from the Wilder Foundation and other private-sector organizations, as well as representatives from the medical center, the city, the county, and the school district.

‘Stable Overseer’ Sought

According to members, the task force envisions a flexible, financially stable overseer organization that could attract substantial support from foundations, individuals, and other private sources, including the United Way. Such an entity would contract with the district and the medical center for pregnancy and related services in the school clinics, they say.

Ms. Ricketts cited Kansas City’s Adolescent Resources Corporation as one such arrangement already in existence.

Federal Funds Cut

The lion’s share of MIC’s $1.4-million budget has come from the U.S. Health and Human Services Department through a Title V maternal and child-health block grant and Title XX funds from the Adolescent Pregnancy Project.

But such federal funding was eroding even before the Gramm-Rudman cuts, officials say. Now, they add, the program faces deeper federal cuts, with an operating budget that remains dependent on Washington for about half of its expenditures.

Current foundation support amounts to only $66,000, they say, with money from the state accounting for much of the remaining portion of the budget. The St. Paul School District provides no cash, but Ms. Ricketts estimated the value of the district’s “space and overhead” contributions at about $40,000 annually.

A political debate is expected if the proposed new board presses the district for more financial support. The issue will be whether the pregnancy-health clinics meet a “health” or an “educational” need-for example, the reduction of the dropout rate. A related issue will be whether the state, the city, or the county should bear the cost along with the district.

Clinics’ Impact

Although the evidence is more anecdotal than statistical, MIC officials claim credit for a dramatic reduction in teen-age pregnancies and for a growing sense of responsibility among sexually active male students. Live births at the schools with clinics, they note, fell from 59 per thousand in the 1976-77 school year to 35 per thousand in 1984-85.

Nationally, 50 percent of the teenage girls who have children before they are 18 never finish high school and 30 percent are pregnant again within two years. But within the clinic schools, where social-work counseling goes hand in hand with medical counseling, the dropout rate is 20 percent and the rate of repeat pregnancies is 2 percent.

Besides family planning--and aid for pregnant girls--MIC provides health and “wellness” services, from immunizations to mental-health counseling.

The medical staff hopes to include information about acquired immune-deficiency syndrome in its program, if the budget permits. One side effect of urging students to use contraceptives as a preventive measure against AIDS, one staff member points out, would be a reduction in pregnancies.