Legislative Forum

Friday, December 9, 2011, 9:00 a.m.

Stoney Creek Inn & Conference Center

Hosted by Comprehensive Strategy

 Welcome:  Barbara Aalfs, Comprehensive Strategy Chair

Introductions/Process:  Kevin Grieme, Director, Siouxland District Health Department, (712) 279-6119, kgrieme@sioux-city.org.

Background: A few points made through the research….

•     Economic future of our states/country and the dropout problem are related.

•     Suggests as much as a 12% increase in earnings post-high school.

•     Students less likely to report being unemployed, having health problems, being depressed, and working in lower-skilled jobs.

•     People with more schooling report higher levels of satisfaction with their lives overall.

•     A compulsory school age helps raise expectations among students, their parents, school authorities, and the general public.

 Current Law/Regulation

 Iowa

Iowa Code, Chapter 299, covers compulsory school attendance and truancy:

“The parent, guardian, or legal or actual custodian of a child who is of compulsory attendance age (6-16 years old), shall cause the child to attend some public school, an accredited nonpublic school, or competent private instruction.”

 Nebraska

July 1, 2005Nebraskalegislation made attendance at school compulsory until age 18. The rationale behind this enactment was a strong commitment to all students earning a high school diploma. More importantly is the new legislation that requires each district to report attendance to the state on a monthly basis and requires that students with excessive absences to be reported to and prosecuted by the County attorney.

 South Dakota

Effective July 1, 2008, South Dakota passed legislation making attendance compulsory until age 18 unless students have earned a high school diploma or have completed a school based GED program passing the GED test from the Dept. of Labor.

 TEEN PREGNANCY

 Background:

• Page 5 of Comprehensive Strategy June 2011 Progress Report—percentage of teen pregnancies for Woodbury County, State of Iowa, Dakota County and State of Nebraska
  • Handout: Sioux City’s rate of teen childbirth compared to Urban 5 in Iowa 
  • Handout: The Cost of Teenage Pregnancy
  • Handouts (3): The Public Costs of Teen Childbearing in Iowa, Nebraska and South Dakota
    • Handout: Other Information Related to Teenage Pregnancy

 Data Highlights:

• Teen pregnancy rates have been increasing since 2007 in both Woodbury and Dakota counties.
• According to a Geo-mapping Study using grant funding that was completed using teen births in 1997-1999,
  • The race breakdown of “urban” teen mothers was:
    • 85% Caucasian
    • 8% Native American
    • 5% Black
    • 2% Asian
    • The race breakdown for “rural” teen mothers was:
      • 93% Caucasian
      • 7% Asian
      • Public Costs of Teen Childbearing in 2008:
        • $99 million in Iowa
        • $67 million in Nebraska
        • $23 million in South Dakota
        • In 2008 costs to taxpayers in Iowa, Nebraska and South Dakota associated with the children of teen mothers were:
          • $36 million for public health care
          • $64 million for child welfare
          • $28 million due to increased rates of incarceration
          • $49 million in lost tax revenue
          • Teen pregnancy coincides with other problem behaviors being addressed by Comprehensive Strategy for Positive Youth Development:
            • Economic deprivation
            • Availability of alcohol and other drugs
            • Academic failure

 What works to reduce teen pregnancy:

• • Comprehensive sex education:  curriculum-based education that encourages both abstinence and contraceptive use.
  • Service learning programs that engage youth in their communities.
  • Youth development programs that encourage participants to plan for their future.
  • Parent programs that involve parents and youth and seek to improve communication.
  • Community-wide programs that encourage involvement from the entire community.

 Current Human Sexuality/Development Education Begins:

• Iowa: Sioux City Public Schools’ current curriculum is to introduce puberty via fifth grade human growth and development class. The Sioux City Catholic Schools do teach human sexuality courses and their curriculum is abstinence-only.
• Nebraska: South Sioux City’s current curriculum is 4-6 grade girls get information on menstrual cycles and body changes associated with puberty. All 5-6grade boys are educated about body changes associated with puberty. No additional education is completed.   
• South Dakota: Dakota Valley’s current curriculum is to introduce puberty and male/female development during an informational talk during fifth grade science class.

What We Know and Want You to Know…and Continue to Fund:

• Prevention education is key:
  • While teen sexual activity is down among most teens, it has risen among girls younger than 15. Terry, E., & Manlove, J. (2000). Trends in Sexual Activity and Contraceptive Use Among Teens. Washington, DC: National Campaign to Prevent Teen Pregnancy.
    • We recommend broadening the span of human sexuality education within schools’ core competency—starting early and provide ongoing education.
    • We also recommend that schools and parents allow the surveying of students to help target more effective programming and education. (For example: Substance Abuse survey/decreasing usage; new Mental Health screening/identifying depression)
    • Parents have a definite role (and are vital) in reducing teenage pregnancy.
      • Teenagers want to talk to their parents about sex, love, relationships and birth control:
        • A study showed that 7 of 10 teens interviewed said that they were ready to listen to things parents thought they were not ready to hear.
        • Another study found that when asked about the reasons why teenage girls have babies, 78% of white and 70% of African-American teenagers reported that lack of communication between a girl and her parents is often a reason teenage girls have babies. Premarital Sexual Experience Among Adolescent Women – U.S. 1970-1988. Morbidity and Mortality Weekly Report, Vol. 39, Nos. 51 & 52, (January, 1991). Princeton Survey Research Associates for the Henry J. Kaiser Family Foundation. (1996, June). The 1996 Kaiser Family Foundation Survey on Teens and Sex: What Teens Today Say They Need to Know, and Who They Listen To. Menlo Park, CA: Author.
        • According to TheNationalCampaign.org,age-appropriate conversations about relationships, sex, love, and intimacy should begin early in a child’s life and continue through adolescence. Having the stereotypical “talk” once with your child is not enough and often occurs too late.
          • We recommend somehow integrating core competency and parental engagement—possibly having parents determine level of education and when, etc. Reinforced communication and education from both schools and parents will only aid in preventing teenage pregnancy.

Siouxland should prioritize funding to conduct a new geo-mapping study as well as begin a study of “best practices” from other Iowa counties and states where teen pregnancy rates are low to better understand teen pregnancy in our area and to help target more effective programming and education.

• Investing in programs that provide education and prevention of teenage pregnancy and that allow teen parents to continue to gain independence, will save taxpayers in the long run.  An effective example is the child care center for Sioux City high schools.

 SUBSTANCE ABUSE, ADDICTION, AND MENTAL HEALTH SERVICES

 Children:

• 11.9% of children live with a parent that is addicted or abuse alcohol and/or drugs.
• Children are the largest growth population and most children are being raised in poverty and by a single parent (mother).
• 28% ofUSchildren, between the ages of 12-20, on average drink 6 times per month and have 5 or more drinks per drinking episode.
• 50% of all mental illness begins by age 14.
• 20% of all children suffer from mental illness.

 Robert Wood Johnson Foundation calls Addiction the number one public health problem.

• Costs the American economy $275 billion a year.
• Total expenditures for treatment only $18 billion.
• Cost benefit ratio (without cost of corrections) is for each $1 spent on treatment there is a $7 return.
• If you count corrections savings – the ratio is for each $1 spent on treatment results in a $12 return.

 Recommendations:

1. Fund in-jail Treatment:  The Phoenix Program inWoodburyCounty works!  All State and Federal funding has been eliminated after October of 2012.  The Phoenix Program has demonstrated its effectiveness by outside objective evaluation conducted by theUniversity ofIowa Substance Abuse Consortium.  The Phoenix Program has been credited with helping prevent the need for a new jail. 
2. Utilizing tax credits as a way to incent business to grow or invest in capital does not work for not-for profits.  The substance abuse treatment and prevention system would benefit from a sales tax exemption like those already provided hospitals, schools, etc.
3. The Mental Health System inIowaneeds to be redesigned and funded adequately. 
4. A standardized set of core mental health services need to be available to all Iowans.
5. Substance abuse treatment is a specialty that demands highly trained professional staff.  Addiction is a diagnosis historically that does not respond to general mental health or physical health intervention.  It is imperative that the addiction treatment specialty not be lost in any attempts to redesign the mental health system or state government realignment.  We strongly believe that the SA system is best placed in the Department of Public Health and that the payment system should not be merged with the mental health system in the redesign.  We believe both systems are underfunded and the merger of two underfunded systems only creates a new exceedingly underfunded system without focus and priority.
6. A full continuum of substance abuse and mental health treatment should be included as an essential benefit in any health care reform benefit design inIowa. 
7. Regional child and adolescent crisis stabilization and evaluation units are essential services that are missing in the current continuum of care.
8. In-school mental health and substance abuse programs need to continue to be funded.

Background: 

Alcohol abuse results in deaths, injuries, violence, teen pregnancy, school absenteeism, and crime, to name a few. Many times cities, counties, and states bear the burden of alcohol abuse in the form of law enforcement, court and health care costs. 

Research has shown that implementing alcohol environmental strategies as part of a comprehensive plan is effective in reducing costs associated with the alcohol abuse as well as underage drinking.  Locally, our alcohol environmental strategies include keg registration, enforcement of underage drinking laws, holding adults responsible for teen parties, compliance checks, party patrols, and responsible beverage server training.  Another equally important environmental strategy is the raising of the beer excise tax.  Raising the beer excise tax will reduce youth access to alcohol and will provide much-needed funds for prevention, treatment, corrections, and enforcement services, all of which can help reduce the use of alcohol and the associated costs.    

Iowa 

Current Beer Excise Tax Rate:  $0.19 per gallon (ranked as the 26^th state from the top-Alaska is 1^st at $1.07 per gallon).  Wine tax inIowa is $1.75 per gallon.  The beer excise tax inIowa has not been raised since July 1, 1986.  Inflation adjustment is not built in so we continue to lose revenue.  In 2010,Iowa’s Beer Excise Tax was $14,488,000, compared to $14,657,000 in 2009.

Impact:  An increase in the beer tax of 54 cents per gallon would be about a 5 cent per serving increase in a typical 12 oz. serving of beer (128 ounces in a gallon divided by 12 oz. serving is approximately 11 of the 12 oz. servings=5 cents per serving).

• The proposed tax would add $0.60 to the cost of a 12-pack of beer.
• The proposed tax would cost a light drinker (two beers a week) $5.20 per year.
• The proposed tax would cost a heavy drinker (twelve beers a week) $31.20 per year.
• The proposed increase would generate approximately $41.6 million dollars annually based upon FY2009 beer sales of just over 77 million gallons of beer statewide.

 Nebraska  

Current Beer Excise Tax Rate:  $0.31 per gallon (ranked 14^th state).  Wine tax inNebraska is $0.95 per gallon.  In 2009,Nebraska’s Beer Excise Tax was approximately $14,380,000.

 Impact:  An increase in the beer tax of 42 cents per gallon would be about a 4 cent per serving increase in a typical 12 oz. serving of beer (128 ounces in a gallon divided by 12 oz. serving is approximately 11 of the 12 oz. servings=4 cents per serving).

• The proposed tax would add $0.48 to the cost of a 12-pack of beer.
• The proposed tax would cost a light drinker (two beers a week) $4.16 per year.
• The proposed tax would cost a heavy drinker (twelve beers a week) $24.96 per year.
• The proposed increase would generate approximately $19.5 million dollars annually based upon FY2009 beer sales of just over 46 million gallons of beer statewide.

South Dakota

Current Beer Excise Tax Rate:  $0.27 per gallon (ranked 16^th state).  Wine tax inSouth Dakota is $0.93 per gallon.  In 2009,South Dakota’s Beer Excise Tax was approximately $5,900,000. 

 Impact:  An increase in the beer tax of 46 cents per gallon would be about a 4 cent per serving increase in a typical 12 oz. serving of beer (128 ounces in a gallon divided by 12 oz. serving is approximately 11 of the 12 oz. servings=4 cents per serving).

• The proposed tax would add $0.48 to the cost of a 12-pack of beer.
• The proposed tax would cost a light drinker (two beers a week) $4.16 per year.
• The proposed tax would cost a heavy drinker (twelve beers a week) $24.96 per year.
• The proposed increase would generate approximately $10.4 million dollars annually based upon FY2009 beer sales of just over 21 million gallons of beer statewide.

Utilization of revenue:  The increase in revenue could be used to fund drug enforcement, corrections, treatment, and prevention services.  These services might include, but are not limited to, drug courts, jail-based treatment, multi-jurisdictional drug task forces, prevention programs, and other treatment services.