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When Colorado lawmakers rejected a bill to help fund the Colorado Family Planning Initiative in April, they halted the most successful teen pregnancy prevention program in the nation. The CFPI will run out of funding June 30 and local health clinics, including the Pueblo City-County Health Department, are scrambling to find a way to keep the program going.

Colorado saw a 39 percent drop in its rate for teen mothers ages 15 to 19 from 2007 to 2012, making it the most dramatic decrease in the nation, according to an August 2014 Centers for Disease Control and Prevention report. The teen abortion rate during the time period dropped by 35 percent.

The CFPI, which provides the state with funding for long-acting reversible contraception products, has been largely responsible for the dramatic decrease since its creation in 2009.

The overall decrease in teen pregnancy for the United States during the same time period was 29 percent.

“Through the Colorado Family Planning Initiative, we were able to purchase those products and then give them to our clients for free, so we were able to increase our access to care and decrease their barriers, which is huge when it comes to decreasing pregnancy rates,” said Stacy Herrera, clinic program manager at the Pueblo City-County Health Department.

Now that the funding has been slashed from the state budget, the department will have to rely on its existing stock of products either until they run out or find a new source of funding.

“We’re not going to have access to purchase those products because they are super expensive. Each product is about $1,000 apiece,” Herrera said.

Six years ago the initiative was introduced after the Susan Thompson Buffett Foundation, an organization headed by Warren Buffett, provided the state of Colorado with a $23 million private grant. At the time, the donation was anonymous.

“Youth born to teen moms are highly likely to become teen mothers themselves. We’ve seen the cyclical action in Pueblo several times.” – Stacy Herrera, Pueblo City-County Health Department

The recently rejected bill would have provided the initiative with $5 million worth of public funds. Supporters of the funding said it was a good investment. For every dollar invested into the program it saved Colorado $5.85 in Medicaid dollars.

“It was a proven program in Pueblo County,” said Rep. Daneya Esgar, D-Pueblo. “We fought very hard and it was hard to watch it fall to partisan politics.”

The funding died in a senate committee on a 3-2 party line vote.

Sen. Larry Crowder, R-Alamosa, told the Denver Post he didn’t support funding the program because the Affordable Care Act should cover the contraceptives.

“I do believe we have to safeguard the taxpayer’s purse on this,” he told the Post.

Ironically, the day before the vote the state received an award for the program from the National Family Planning and Reproductive Health Association for being among the best public health access programs in the country.

Since the initiative began, around 30,000 intrauterine devices have been provided to Colorado women.

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A highly controversial form of birth control, IUDs work by releasing hormones to prevent sperm from fertilizing an egg. They can last from three to 12 years and are more effective than traditional forms of birth control largely because once inserted, women don’t have to think about the device again until they want to replace or remove it.

Opponents argue that this form of contraception is abortion. In the rare event that sperm still fertilizes an egg, IUDs prevent it from implanting on the uterine wall.

But regardless of the debate behind them, IUDs and other forms of long-acting reversible contraception products, like the Nexplanon hormonal implant, have been instrumental in reducing the teen pregnancy rate in Colorado.

Teen pregnancy and Pueblo

For years, Pueblo has had one of the highest teen pregnancy rates in Colorado. Herrera accounts for the county’s high rate through a combination of cultural messages and a lack of proper sexual health education among Pueblo teens.

“Youth born to teen moms are highly likely to become teen mothers themselves. We’ve seen the cyclical action in Pueblo several times,” Herrera said.

Occasionally, Herrera sees grandparents in their 30s, the result of a cycle in which the children of teenage parents also get pregnant in their teens.

“Sometimes some of the parents, not real often but I’ve heard it, will say, ‘I want to be a grandma.’ They’re 32 and 35 and they’re saying, ‘I don’t have any grandkids yet,’” she said.

Because of efforts like the CFPI and the community health improvement plan, Pueblo has seen a 40 percent decrease in its teen pregnancy rate. It has also been making strides in education and changing cultural messages about sex in the community.

Introduced in 2013, the community health improvement plan intends to lower the obesity and teen pregnancy rates in Pueblo. The plan’s two main objectives are based on the results of a state-mandated community health assessment.

“In Pueblo County alone, between 2009 and 2013, our teen pregnancy rates for 15 to 19-year-olds dropped 40 percent. During those years, we had a decrease of 391 births,” Herrera said.

Now that the Family Planning Initiative is without a source of funding Herrera said she thinks the teen pregnancy rate will increase again in Pueblo.

“That was one of our fears. We were hoping for a downward trend with receiving that $5 million from the state to hopefully get it as close to zero as we could’ve. Unfortunately, with decreased access to the LARC products, we probably will see another increase again,” she said.

The department will continue to offer free birth control to Pueblo women, but it will be limited to more traditional forms, like the pill and the Depo-Provera birth control shot, which are generally less effective at preventing pregnancy.

On a national basis, the failure rate for IUDs is 0.8 percent, according to the CDC. The pill, on the other hand, has a failure rate of 9 percent and the Depo-Provera shot has a failure rate of 6 percent. Condoms have a failure rate of 18 percent.

“We still have birth control pills and the Depo shot available, which are good methods. But they are methods that have a huge rate of human error factored into that,” Herrera said. “Teens who use traditional birth control methods, such as the pill or the Depo shot are 20 times more likely to become pregnant than a girl on LARC in the same age group.”

Methods like the pill and the Depo-Provera birth control shot require women to consistently take action to ensure their birth control is working. The pill requires daily use and the Depo-Provera shot requires women to visit their clinic every 12 weeks for administration in order to be effective.

Herrera said IUDs and other long-acting forms of birth control are more realistic.

“Unfortunately, with decreased access to the LARC products, we probably will see another increase again.” – Stacy Herrera

“Once you put it in, it makes sense. Once you put it into your arm, you’re done thinking about it for three to five to 10 years, depending on what device you received,” she said.  “You know, we as women, have busy lifestyles. We work, we go to school, we have social gatherings, we have social events and life just happens. That human error factor is just really high sometimes.”

The health department has an onsite pharmacy, where it stores immunizations and birth control.

“I currently have long-acting reversible products available for about five to six months and so we’ll continue to offer those products,” Herrera said. “We are currently looking for more funding to purchase more products but unfortunately, there’s just not a lot of grants or monies to be had surrounding those specific types of birth control.

“So, we’re going to work vigorously along with the CDP and the state health department, to continue to look for monies and for further funding.”

In the meantime, the department plans to continue with its sexual health education efforts in the community.

Lowering the rate

Recently, a major focus of the department has been to normalize the conversation about sex by encouraging parents to be “askable” adults. After conducting research, the department discovered that nine out of 10 teens would prefer to get information about sex from their parents.

pregnancy3“We understand that it’s a difficult conversation and we know it’s difficult to bring that up, but we’ll give them some tips on how to talk to their parents because we want those conversations to go on. What we’re trying to do is normalize the conversation,” Herrera said.

“So, talking about sexual reproductive health is no different from what most parents feel is a safe conversation. You know, I talk to my kids about vegetables and driving and wearing a helmet when they ride a bike and wearing a seatbelt. It’s the same thing.”

The department’s biggest educational focus, though, is on the teens themselves. Before teens make an appointment at the clinic, they can ask nurses questions about reproductive health, which has been an effort to increase access to care.

The clinic navigator, for example, is available to answer questions via telephone prior to making an appointment. The clinic also has a texting service called Go Ask Tara, which allows teens to ask reproductive health questions anonymously.

“So when people get a little bit skittish about asking those sexual reproductive health questions, it’s nice to kind of be able to have that access,” Herrera said.

The department also encourages teens to plan for their future.

“We’ll ask youth, ‘what do you want to do in life?’” Herrera said, “and sometimes they’ll say, ‘I’ve never been asked that. I have no clue. I just thought about tomorrow.’”

“We’re able to start that fire and set that spark in their mind and help them start visualizing and thinking about the future and how their decisions today will affect them in years and generations to come,” she said.

The health department also offers services like immunizations, so patients are not necessarily only there for birth control. In the clinic, there is a sign that lists the multiple services provided by the department, an effort that helps de-stigmatize the environment.

In 2014, the department received a grant from the state to renovate its clinic rooms to make visits more comfortable. After conducting a focus group, the department decided to redecorate the rooms based on teen opinions.

“We applied for the extra grant monies with the state and we were one of the only two clinics statewide to do the improvements so we are very excited,” Herrera said.

The loss of a clinic

Recently, the clinic has seen a slight increase in appointments. Pueblo’s only Planned Parenthood closed in February after the landlord of the building it was located in declined to renew its lease. Those patients were directed to other clinics around Pueblo and in Colorado Springs.

“We would love to have those patients. We currently have the capability to accept new patients and so if someone wants to come in and join our clinic, we would love to have them,” Herrera said.

Pueblo’s A Caring Pregnancy Center, which offers services to women with unintended pregnancies, has not seen a dramatic increase in patients since Planned Parenthood closed.

Sen. Larry Crowder, R-Alamosa, told the Denver Post he didn’t support funding the program because the Affordable Care Act should cover the contraceptives.

“We’ve noticed an increase in calls and we’re fully booked,” said executive director Tamra Axwothy, but the clinic is not sure whether they are receiving those calls as a result of Planned Parenthood’s closing.

Because ACPC’s clinic is so small, they do not offer birth control. Instead, their emphasis is on offering services to women who are already pregnant. Twenty percent of their clients are teens.

ACPC offers counseling for women who have unplanned pregnancies, specifically those who are considering having an abortion. While the clinic does not necessarily discourage women from having abortions, they place an emphasis on the pregnancy and parenting classes they offer.

Axworthy said ACPC does not plan to change any of their services to accommodate for Planned Parenthood’s closing.

“We’re not changing who we are or what we do as a result of their closing,” she said.

Many low-income Pueblo women looking for birth control options may be turning to the health department.

The Pueblo health department is a Title X clinic, which means it receives money from the state to offer services on a sliding fee scale.

“Based on income, that means that services are free to low cost. For 19-year-olds and under, services are always free. That includes breast exams, gonorrhea and chlamydia testing, birth control, everything,” Herrera said. pregnancy1

But as more clients turn to the health department, they will have to rely on a limited supply of the most effective forms of birth control until more funding is found.

“Here at the clinic, once those products run out, unfortunately if I can’t get any more, we’ll continue to offer the traditional birth control,” Herrera said. “We’ll continue to look for more funding. Hopefully we’ll find something.”

 

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1 Comment
  • Fartrell Cluggins

    The idiot GOP strikes again. If it makes sense and works, then by all means, kill it, then blame the “left” when teen pregnancy goes up, because sin.

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Push to legalize marijuana upends governor’s race in New Mexico

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ALBUQUERQUE, N.M. — Democratic gubernatorial candidate Jeff Apodaca on Thursday called for the expansion of New Mexico’s medical marijuana program and for legalization of recreational use, saying the poverty-stricken state is missing out on millions of dollars in tax revenues and jobs that could be spurred by the industry.

Apodaca released his plan solidifying his position as a supporter of legalization as the race for governor heats up.

Apodaca pointed to New Mexico’s history as the first state to allow for research and experimentation with marijuana as a therapeutic drug. It was his father, then-Gov. Jerry Apodaca, who signed that legislation in 1978.

The research program stalled and it wasn’t until 2008 that New Mexico rolled out its medical cannabis program.

“Why are we shooting for being the last to legalize cannabis for adult use?” Apodaca said.

The push for legalization comes as New Mexico’s medical marijuana program has grown exponentially in just the last two years. Producers licensed under the program reported record sales of more than $86 million in 2017 and the number of patients enrolled now tops 50,000.

“We know the medical benefits of it. And we also know the opportunities of legalization for adult use,” Apodaca said, suggesting expansion of the long-standing medical marijuana program along with legalization could result in an estimated $200 million of additional tax revenues for the state.

The state’s largest producer, Ultra Health, announced that it has acquired farmland in southern New Mexico and has plans for what the industry says could be the largest cultivation facility in North America.

The property spans nearly one-third of a square mile (81 hectares) in Otero County. It will include 20 acres (8 hectares) of indoor cultivation, 80 acres (32 hectares) of outdoor cannabis fields and another 100 acres (40 hectares) of outdoor hemp fields.

Ultra Health president and CEO Duke Rodriguez said the company is preparing for a future in which New Mexico stands to benefit from expanded medical use and possibly recreational use.

Apodaca’s plan calls for lifting the current limits on the number of plants producers can grow and reducing costly licensing fees.

Other Democratic candidates have been more cautious.

U.S. Rep. Michelle Lujan Grisham said she would work with state lawmakers to ensure there are adequate health, safety and enforcement measures in place. She called for a “thorough analysis” of recreational pot programs in other states as part of that effort.

Lujan Grisham was in charge of the state Health Department when the medical marijuana program began. Aside from the legalization debate, she said supporting producers to create the latest medicines and methods to help patients would help create jobs and expand the industry.

State Sen. Joseph Cervantes, another Democratic candidate, has sponsored unsuccessful legislation to decriminalize possession of small quantities of pot but has said the state is lacking infrastructure and isn’t ready yet to legalize.

Cervantes recently lauded efforts at the local level by the state’s largest city — Albuquerque — to decriminalize possession of small amounts. He said he would do the same as governor and that it would mark a first step.

Republican congressman and gubernatorial candidate Steve Pearce expressed reservations about legalization at a forum earlier this month. He said it might create a stumbling block for people trying to climb out of poverty and addiction to other drugs.

“I just don’t see how it fits that we’re going to deal with addiction and yet we’re going to tell people, ‘This one is OK.’ I’ve watched it for a lifetime. I just am very nervous with recreational marijuana,” he said.

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‘For fun’ killing reveals vulnerability for homeless Native Americans in New Mexico

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The morning a homeless man was shot and killed in Albuquerque, police say surveillance videos showed him running down a street before sunrise, and then gunfire flash in the dark.

Native Americans make up only 4 percent of the population, but account for 44 percent of people living on the streets, raising the likelihood they will be victimized when there is an attack on the homeless.

Ronnie Ross, a 50-year-old from the Navajo Nation town of Shiprock, had been shot a dozen times, including once in the forehead and temple, and four times in the back, according to a criminal complaint. Police say the two teenage suspects charged with murder this week apparently shot him “for fun” as they came and went from a hotel party nearby.

The homicide marked the latest in a series of brazen killings and assaults of homeless Native Americans in the city. In Albuquerque, Native Americans make up only 4 percent of the population, but account for 44 percent of people living on the streets, raising the likelihood they will be victimized when there is an attack on the homeless.

A 2014 survey showed 75 percent of homeless Native Americans in Albuquerque had been physically assaulted.

“Just being harassed is part of everyday life, but it’s not as much harassment as it is overgrown bullying,” said Gordon Yawakia, who works at the Albuquerque Indian Center and was once homeless himself. “What do you do when people are against you and then the authorities are against you and you’ve got nobody, you know?”

In 2014, Allison Gorman and Kee Thompson, both Navajo, were beaten to death as they slept in a vacant lot. While authorities did not say the men were targeted because they were Native American, activists disagreed and the deaths spurred the creation of a city task force to address Native American homelessness that now-former Mayor Richard Berry said could set the stage for changes for the population across the Southwest.

Now, Ross’ death is underscoring how difficult it may be to protect and find solutions for the city’s Native American homeless population.

“When I hear a story like this it adds fuel to the fire,” said Dawn Begay, who is the city’s tribal liaison, and works with the homeless through a local nonprofit. “Where we’re headed is a good direction but it has to happen faster.”

Ross’ killing in March came three months after the body of Audra Willis was found decapitated in an area not far from the Sandia Mountains that line the city’s east side. The 39-year-old had come from To’hajiilee, a tiny Navajo community west of Albuquerque, and records show she had multiple addresses during her time in the city, including at the Albuquerque Indian Center.

Willis’ especially grisly death sent shockwaves through Albuquerque, just as the beatings of Thompson and Gorman had three years earlier.

The two men had been killed on a July 2014 night when authorities say three boys — ages 15, 16 and 18_returned home from a night of drinking and decided to attack them as they slept on a mattress. The men were beaten with a wooden table leg, cinder blocks, and other objects, police said. One young suspect later told authorities that the teens had beaten dozens of homeless people, though apparently none others fatally.

In Ross’ death, the complaint filed against the 15- and 17-year-old suspects does not identify a motive, but says the two teenagers bragged to friends about the shooting.

According to police, friends and acquaintances of the boys — whom The Associated Press is not naming because of their ages — said the suspects had been showing off a gun at the party, and had said to others that they had shot a man. At one point, the younger boy also said to a close friend at the party that he shot a “hobo” in the back.

The boys made one more stop at the scene to find Ross still alive, prompting the older boy to shoot him multiple times, according to the complaint.

“It’s completely disturbing,” said Officer Simon Drobik, an Albuquerque police spokesman, said Tuesday. “They just shot this guy for fun.”

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The Last Castro; Raul retires as Cuban president

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Raul Castro turned over Cuba’s presidency Thursday to a 57-year-old successor he said would hold power until 2031, a plan that would place the state the Castro brothers founded and ruled for 60 years in the hands of a Communist Party official little known to most on the island.

Castro’s 90-minute valedictory speech offered his first clear vision for the nation’s future power structure under new President Miguel Mario Diaz-Canel Bermudez. Castro said he foresees the white-haired electronics engineer serving two five-year terms as leader of the Cuban government, and taking the helm of the Communist Party, the country’s ultimate authority, when Castro leaves the powerful position in 2021.

“From that point on, I will be just another soldier defending this revolution,” Castro said. The 86-year-old general broke frequently from his prepared remarks to joke and banter with officials on the dais in the National Assembly, saying he looked forward to having more time to travel the country.

In his own half-hour speech to the nation, Diaz-Canel pledged to preserve Cuba’s communist system while gradually reforming the economy and making the government more responsive to the people.

“There’s no space here for a transition that ignores or destroys the legacy of so many years of struggle,” Diaz-Canel said. “For us, it’s totally clear that only the Communist Party of Cuba, the guiding force of society and the state, guarantees the unity of the nation of Cuba.”

Diaz-Canel said he would work to implement a long-term plan laid out by the National Assembly and communist party that would continue allowing the limited growth of private enterprises like restaurants and taxis, while leaving the economy’s most important sectors such as energy, mining, telecommunications, medical services and rum- and cigar-production in the hands of the state.

“The people have given this assembly the mandate to provide continuity to the Cuban Revolution during a crucial, historic moment that will be defined by all that we achieve in the advance of the modernization of our social and economic model,” Diaz-Canel said.

Cubans said they expected their new president to deliver improvements to the island’s economy, which remains stagnant and dominated by inefficient, unproductive state-run enterprises that are unable to provide salaries high enough to cover basic needs. The average monthly pay for state workers is roughly $30 a month, forcing many to steal from their workplaces and depend on remittances from relatives abroad.

“I hope that Diaz-Canel brings prosperity,” said Richard Perez, a souvenir salesman in Old Havana. “I want to see changes, above all economic changes allowing people to have their own businesses, without the state in charge of so many things.”

But in Miami, Cuban-Americans said they didn’t expect much from Diaz-Canel.

“It’s a cosmetic change,” said Wilfredo Allen, a 66-year-old lawyer who left Cuba two years after the Castros’ 1959 revolution. “The reality is that Raul Castro is still controlling the Communist Party. We are very far from having a democratic Cuba.”

After formally taking over from his older brother Fidel in 2008, Raul Castro launched a series of reforms that led to a rapid expansion of Cuba’s private sector and burgeoning use of cellphones and the internet. Cuba today has a vibrant real estate market and one of the world’s fastest-growing airports. Tourism numbers have more than doubled since Castro and President Barack Obama re-established diplomatic relations in 2015, making Cuba a destination for nearly 5 million visitors a year, despite a plunge in relations under the Trump administration.

Castro’s moves to open the economy even further have largely been frozen or reversed as soon as they began to generate conspicuous displays of wealth by the new entrepreneurial class in a country officially dedicated to equality among its citizens. Foreign investment remains anemic and the island’s infrastructure is falling deeper into disrepair. The election of President Donald Trump dashed dreams of detente with the U.S., and after two decades of getting Venezuelan subsidies totaling more than $6 billion a year, Cuba’s patron has collapsed economically, with no replacement in the wings.

Castro’s inability or unwillingness to fix Cuba’s structural problems with deep and wide-ranging reforms has many wondering how a successor without Castro’s founding-father credentials will manage the country over the next five or 10 years.

“I want the country to advance,” said Susel Calzado, a 61-year-old economics professor. “We already have a plan laid out.”

Most Cubans have known their new president as an uncharismatic figure who until recently maintained a public profile so low it was virtually nonexistent. Castro’s declaration Thursday that he saw Diaz-Canel in power for more than a decade was likely to resolve much of the uncertainty about the power the new president would wield inside the Cuban system.

“The same thing we’re doing with him, he’ll have to do with his successor,” Castro said. “When his 10 years of service as president of the Council of State and Council of Ministers are over, he’ll have three years as first secretary in order to facilitate the transition. This will help us avoid mistakes by his successor, until (Diaz-Canel) retires to take care of the grandchildren he will have then, if he doesn’t have them already, or his great-grandchildren.”

Cuban state media said Russian President Vladimir Putin congratulated Diaz-Canel and thanked Castro for the many years of cooperation between the two countries, while Chinese President Xi Jinping also reaffirmed his country’s friendship with Cuba and expressed interest in deeper ties.

At the U.S. State Department, spokeswoman Heather Nauert expressed disappointment at the handover, saying Cuban citizens “had no real power to affect the outcome” of what she called the “undemocratic transition” that brought Diaz-Canal to the presidency.

Vice President Mike Pence tweeted at Castro that the U.S. won’t rest until Cuba “has free & fair elections, political prisoners are released & the people of Cuba are finally free!”

Diaz-Canel said his government would be willing to talk with the United States but rejected all demands for changes in the Cuban system.

With Castro watching from the audience, Diaz-Canel made clear that for the moment he would defer to the man who founded the Cuban communist system along with his brother Fidel. He said he would retain Castro’s cabinet through at least July, when the National Assembly meets again.

“I confirm to this assembly that Raul Castro, as first secretary of the Communist Party, will lead the decisions about the future of the country,” Diaz-Canel said. “Cuba needs him, providing ideas and proposals for the revolutionary cause, orienting and alerting us about any error or deficiency, teaching us, and always ready to confront imperialism.”

Diaz-Canel first gained prominence in central Villa Clara province as the top Communist Party official, a post equivalent to governor. People there describe him as a hard-working, modest-living technocrat dedicated to improving public services. He became higher education minister in 2009 before moving into the vice presidency.

In a video of a Communist Party meeting that inexplicably leaked to the public last year, Diaz-Canel expressed a series of orthodox positions that included somberly pledging to shutter some independent media and labeling some European embassies as outposts of foreign subversion.

But he has also defended academics and bloggers who became targets of hard-liners, leading some to describe him a potential advocate for greater openness in a system intolerant of virtually any criticism or dissent. International observers and Cubans alike will be scrutinizing every move he makes in coming days and weeks.

As in Cuba’s legislative elections, all of the leaders selected Wednesday were picked by a government-appointed commission. Ballots offered only the option of approval or disapproval and candidates generally receive more than 95 percent of the votes in their favor. Diaz-Canel was approved by 604 votes in the 605-member assembly. It was unclear if he had abstained or someone else had declined to endorse him.

The assembly also approved another six vice presidents of the Council of State, Cuba’s highest government body. Only one, 85-year-old Ramiro Valdes, was among the revolutionaries who fought with the Castros in the late 1950s in the eastern Sierra Maestra mountains.

___

Associated Press writer Ben Fox contributed to this report.

 

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