By JoANNE
YOUNG / Lincoln Journal Star
Sunday, Jul 08, 2007 - 12:26:55 am CDT
Charles
Housman said the notice came in late spring 2005: Gov. Dave Heineman’s office
was clamping down on what state Health and Human Services System programs could
say in communication with the public.
And what they couldn’t.
No controversy. No sex. The governor’s office was to review everything before it
was published or released, said Housman, who quit his state job last month as
public education coordinator for HIV prevention. Approval would be sought before
conference speakers were hired.
Housman got the information from someone in his department; there was no
official memo. But he said it became general operating procedure from that time
on, and he heard frequently that something had to be run past the governor’s
office.
Other workers in HHSS heard the same message, as did some in outside health
agencies.
Minutes from a public health management team meeting Nov. 4, 2005, confirmed the
system’s adherence to a pro-life philosophy and to avoiding controversy.
Dr. Joann Schaefer, newly appointed chief medical officer and director of HHSS
regulation and licensure, “reminded staff that this is a pro-life administration
and she supports that,” the minutes read.
“We have a process in place to look at anything that could be controversial.”
Sure enough, Housman said, over the next two years, communications and
conference plans were scrutinized, sometimes changed and, in some cases,
eliminated.
This spring, for example, planners of a conference for state public health
workers on sexual health were notified they would have to change its name from
“Issues Impacting Sexual Health” to “HIV, STDs and Reproductive Health: A
Topical Update.”
“I thought it was a joke,” Housman said. “If we can’t say the word sexual in a
sexual health conference, this is sad. It’s beyond sad.”
Kathie Osterman, Health and Human Services department spokeswoman, said the
first title was ambiguous and did not provide information on what was to be
covered in the conference. It needed to convey that the conference was not about
reproductive health only.
The March seminar had speakers on such topics as the effect of sexual activity
on adolescents, working with difficult clients, understanding infant adoption,
depression and sexual health, culturally competent health care, women’s
sexuality and media pressure, intimate partner violence and new sexually
transmitted disease treatment guidelines and HIV testing recommendations.
In addition to changing seminar titles, Housman and others said, workers have
gotten the word that brochures, posters, Web sites and conference speakers must
conform to the goal of avoiding controversy.
Pat Tetreault, University of
Nebraska-Lincoln sexuality education coordinator, was told by an HHSS staff
member she was in danger of being dropped from a panel scheduled for the
spring conference because the communications staff looked up her name on the
Internet and saw she was associated with gay and lesbian issues.
Osterman said the communications staff simply did not have enough information
on the speaker. When she heard one of Tetreault’s programs had a state grant,
she was allowed to speak.
“If the program staff thought (her speaking invitation) was in jeopardy,
that’s unfortunate,” she said.
Tetreault said that although she was allowed to be on the panel this year, “it
might impact whether I am ever invited back again.”
Dr. Bruce Trigg, a New Mexico
public health physician and pediatrician with 19 years of experience in public
health, was not allowed to participate in this year’s sexual health conference
because Osterman Googled his name and found out he was involved in an
abstinence-only controversy and dropped as a panelist at a national Centers
for Disease Control conference. Trigg said he had planned to discuss recent
scientific research that concluded abstinence-only programs were ineffective.
Canceling his appearance was “pretty clearly an example of censorship,” Trigg
said in an interview.
“It goes counter to public health.”
Osterman said that when she found out about the CDC controversy, she asked
conference planners if there were other speakers who could give a broader
perspective.
“There was an unwillingness (by staff) to share that information,” she said.
A poster printed by HHSS’ reproductive health
program to alert underage girls that having sex with a man 19
or older was against the law was not allowed to be distributed. It quoted a
state law verbatim that used the word “sexual” but, workers said, officials
did not want the word used on the poster.
Osterman said the communications staff had signed off on the poster, but
apparently Dr. Richard Raymond, who was the state’s chief medical officer from
1999 to 2005 and held other positions during that time, would not allow it to
be distributed to clinics across the state.
A brochure for people with diabetes
that had a list possible symptoms eliminated “a change in sexual
functioning.”
Said Osterman: “We decided to take it out. … I don’t remember why. I suppose
because that is kind of a personal issue. … We wondered, ‘What will people
think?’”
This
spring, some members of two Health
and Human Services diversity teams quit because department
leaders removed a speaker from a family diversity forum who was in a same-sex
partnership and stopped a program in which a panel was to focus on gay and
lesbian issues.
HHSS Director Chris Peterson explained the department’s decision this way:
Diversity teams must limit topics to the protected classes under federal law.
Homosexuals are not a protected class.
Osterman said at the time the governor or his staff did not direct HHSS to
limit the diversity program topics.
Housman said that as administrator of the state’s HIV prevention Web site, he was not allowed to post information about human sexuality week. Earlier, he said, he couldn’t post an announcement about National Condom Week.
Whether the
governor’s office is concerned about such matters is a question. Was there a
requirement to run all controversial material by the governor’s office or did
the communications staff do it informally?
Osterman said she would sometimes use the governor’s staff as a sounding board.
No policy said she had to do that, she said.
She is working on putting the health department communication practices into a
policy, however. Its goal would be to provide information in a way everybody
understands, a way that’s not ambiguous and a way less likely to cause confusion
or controversy.
“But not being controversial is not the guiding force,” she said.
Heineman spokeswoman Ashley Cradduck also said there’s no directive, but it’s in
the best interest of the state and the people of Nebraska for the governor’s
office and Health and Human Services to work together.
Osterman said that when Schaefer told managers she supported the governor’s
pro-life philosophy, she meant that the governor has the discretion to set
boundaries, “and both he and the Legislature have said we’re a pro-life state.”
As department managers and workers were writing grants or developing programs,
they needed to be aware of the pro-life context for those programs, she said.
Cradduck said “we’re a pro-life state” means the governor believes in the value
of human life, values adoption over abortion and believes in policies that
support families.
The Legislature passed an intent law in recent years declaring its support for
protecting the lives of unborn children and deploring destruction of unborn
human lives.
Osterman
said that even before Heineman became governor, agency directors had concerns
about conference speakers, reports and how information was communicated to the
public. And she might have said to department staff from time to time that she
was going to run something past the governor’s office, she said.
The public views and interprets information in different ways, she said, and the
department has to be careful not to cross a line between information and
advocacy.
“Our role isn’t advocacy,” Osterman said. “Our role is to provide information
and education.”
That information, she said, has to be provided in such a way as to be inclusive
and to not offend people.
“We do look carefully at what we get from the program areas,” she said. “I don’t
see it as political.”
But they do take into consideration what the Legislature has had to say about a
particular issue and what the governor may have said publicly about an issue.
Housman said he left his job after nine years, in part, because he was
frustrated with the policies.
“You expect HHS to push the envelope,” he said. “That’s the last thing they
wanted to do.”
He was willing to “bang his head against the wall” for a while, he said, but he
got tired of the fight.
He plans, at 46, to go back to school for a master’s degree.
Was he disgruntled?
“Only that I couldn’t do what I needed to do,” he said. “I had to decide my
future, and it was not with the state of Nebraska.”
Reach JoAnne Young at 473-7228 or
jyoung@journalstar.com .