No sex, please -- or we'll audit you

Why are some nonprofit organizations that don't agree with the Bush administration's "abstinence only" philosophy repeatedly investigated by the government, while faith-based groups get a free pass?

Published October 28, 2003 8:56AM (EST)

Saddam Hussein, Osama bin Laden, condoms: George W. Bush has a lot of enemies. And the question is finally starting to be asked, just what steps is his administration willing to take in order to silence them? Network anchormen and coffee-break pundits alike were abuzz over the did-they-or-didn't-they CIA leak scandal. But the outing of Valerie Plame isn't the only instance where the federal government has been suspected of using its resources in direct, if somewhat sneaky, retaliation against its political opponents. Ruining the lives of CIA agents may make for dynamic headlines, but recent evidence shows that the Bush administration also has much smaller fish to fry.

Take Advocates for Youth, a national nonprofit organization that provides teens with accurate and informative sex education. In 18 years as a federal grantee, it has never been subjected to a government financial audit. That is, until it was suddenly hit with three in less than a year (one by the Centers for Disease Control back in October 2002, a second by the General Accounting Office in early 2003, and the third just two months ago, by a different arm of the CDC). The organization is crying conspiracy -- saying that it's being unfairly targeted because of its negative views toward the administration's abstinence-only education policies -- and the claims appear to be more than just paranoia.

In July 2001 the Washington Post published a leaked memo from the Department of Health and Human Services in which Advocates for Youth was described as "ardent critics of the Bush administration." This charge apparently came as the result of several Advocates for Youth press releases that railed against the president's backing of the "global gag rule" that prohibited any funding to foreign agencies that performed or facilitated abortions. In the leaked memo, it was also suggested that the Advocates for Youth programs did not go over well with the HHS because "the secretary [Tommy Thompson] is a devout Roman Catholic."

While Advocates for Youth may be near the top of Tommy Thompson's Most Wanted list, it is certainly not alone. After a group of activists booed Thompson at an international AIDS conference in Barcelona last year, a cadre of congressional Republicans called for investigations of the hecklers' various organizations. The CDC has conducted three reviews in the past 10 months of San Francisco's STOP AIDS program in an effort to make sure that none of its federal grant dollars have gone toward funding workshops that may promote sexual activity. And the New York-based Sexuality Information and Education Council of the United States (SIECUS) has been audited twice this year (its first audits ever, despite a decade of receiving federal grants), evidently because it created No New Money for Abstinence-Only-Until-Marriage Programs, a Web site designed to educate the public about the possible dangers of abstinence-only education and to call for grassroots campaigns against the continued funding of these programs.

So far, Advocates for Youth, STOP AIDS and SIECUS have come through all of their audits with flying colors. But last year, as it turns out, a number of federal grantees were found guilty of misusing their government money. They were faith-based organizations.

In Louisiana, a number of sex-education programs funded by Gov. Mike Foster's Program on Abstinence were found guilty in a federal court of openly violating the constitutional tenet of separation of church and state. The American Civil Liberties Union sued the governor's program after discovering numerous violations, including the use of grant money to teach abstinence through scripture, to perform skits with Christ as a character, to purchase Bibles, and to fund prayer vigils at abortion clinics. Though those Louisiana nonprofits are now required to turn in regular reports to the governor about their activities, none, to date, have been put before an HHS audit.

"Our complaint is not with getting audited," says Advocates' president James Wagoner. "Our complaint is with the selective and political nature of these audits. Ideology is invading -- if not subverting -- science within the Department of Health and Human Services [which houses the CDC], and we ended up on the audit table because we are one of the organizations pointing that out."

Advocates for Youth has continually stood behind its time-tested, research-backed policy of comprehensive sex education and HIV prevention, as opposed to adopting the Bush-backed method of abstinence-only education. Through its varied and numerous programs -- ranging from peer counseling and educator training to the creation of lesson plans and instructional videos -- Advocates for Youth has worked nationally and internationally to, as their mission statement reads, "help young people make informed and responsible decisions about their sexual and reproductive health." This includes providing them with information about contraceptives as well as abstinence and brings with it a sensitivity toward all forms of sexuality.

Comprehensive sex education has, for years, had the backing of the scientific community as an excellent preventive measure against teen pregnancy and sexually transmitted diseases. Its proponents -- the American Medical Association, the National Institutes of Health, and the American Academy of Pediatrics among them -- will point to studies in publications such as the American Journal of Public Health, the Journal of Adolescent Health and the Journal of School Health, to back up their claims.

Support for the other side comes mostly from non-science sources, like Robert Rector of the conservative Heritage Foundation. In a much quoted April 2002 diatribe against comprehensive sex education, Rector cited a study from the Journal of the American Medical Association to back up his claims that abstinence-only programs work. He pointed out that the results of this study showed that teens who take "virginity pledges" exhibited a delay in their initiation of sexual activity. He failed to include, however, information from that same study that also reported that virginity pledges did not work for children under 14 or over 17; that they didn't work in communities where more than 30 percent of the teens took the pledge; and that teens who broke their pledges were far less likely to use contraception.

There is a clear lack of scientific data to back up the efficacy of abstinence-only programs, yet they have the full and complete support of the federal government. Hence James Wagoner's fears about ideology interfering with public health.

Wagoner is not the first one to charge the CDC with manipulating science for ideological purposes. In 1999, the CDC posted a page on its Web site listing sex-education "Programs That Work" from around the country that had curricula proven to be effective. All of the cited programs were comprehensive and included information about both abstinence and contraception; none were abstinence-only programs. Despite repeated outcries from proponents of abstinence-only, the list remained intact. That is, until George W. Bush came into office.

That Web page has vanished from the CDC's site, as have positive statements about condom use. Research results showing that abortions have no definitive link to breast cancer were taken off the National Cancer Institute's Web site, which is part of HHS. And now with these suspiciously motivated audits, it appears that HHS has graduated from simply hiding scientific information that offends the religious right, to retaliating against groups that disseminate that information.

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There are three streams of revenue from which the federal government has chosen to award grant money to abstinence-only education programs: the Adolescent Family Life Act, started by President Reagan in 1981; the Welfare Reform Act of 1996; and the newly developed Special Programs of Regional and National Significance, which puts federal money directly into the hands of community-based organizations. All of these initiatives share a strictly delineated eight-point definition of "abstinence-only" that any program must meet to receive funding. Basically, this amounts to teens being taught that the only way to avoid pregnancy or STDs is to abstain from any and all sexual activity until marriage. For a program to comply with the eight-point definition, it must teach students that "a mutually faithful monogamous relationship in the context of marriage is the expected standard of sexual activity." Teachers in these programs are not allowed to endorse the use of condoms or other forms of contraception. However, they are apparently allowed to use instructional texts containing lines such as, "Is it fair to make a baby die because of a bad decision his or her parents made?" and "What if a girl came to school in a crop top, just barely covering her bra, and shorts starting three inches below her navel? What 'game' would she be playing?"

The abstinence-only drive was labeled a priority for HHS almost immediately after George W. Bush stepped into office. Starting in 2002, Congress has granted more than $100 million each year to organizations that sponsor abstinence-only programs; the average spending on these programs during the Clinton administration was about $60 million a year. Currently the only avenue through which organizations supporting comprehensive sex education can acquire federal grants is the Department of Adolescent Sexual Health, a division of the CDC that offers money strictly for HIV/AIDS prevention and gives out approximately $10 million a year divided among more than 40 organizations.

SIECUS' No New Money Web site urges people to contact their representatives and demand that funding to abstinence-only programs be stopped. That call to arms is what provided all the fodder the right wing needed to begin its retribution.

Only a few weeks after No New Money went live last August, 24 House Republicans, led by Joseph Pitts, R-Pa., jotted off a letter to HHS Secretary Thompson asking that both SIECUS and Advocates for Youth (which was listed on the site along with more than a hundred other "supporting organizations") be investigated. The letter pointed out that current law forbids the use of grant money for lobbying and explained that this group of congressional representatives just wanted to be absolutely sure no government dollars had gone into the construction or maintenance of No New Money. "I requested the audit of Advocates for Youth because I was concerned that the group was using taxpayer money to engage in political activities, not to help people," Pitts said in an e-mail to Salon. "And I intend to continue keeping an eye on how taxpayer money is spent, both here in Washington and by private groups."

Pitts has eagerly taken on a crusade against what he has called the "waste of taxpayer money." In a statement last month on his official Web site, he even called for an investigation into the spending practices of the NIH, suggesting that funding should perhaps be pulled from the venerable institution if it could not "provide a clear accounting and explanation for how it spends taxpayer money." He voiced his fears about "government agencies engaged in clearly useless activities" and illustrated this with examples from the NIH, such as research on female sexual arousal, gays and lesbians in the Native American community, and methods for better promotion of the morning-after pill. He insists that he is "not criticizing the objectives of these studies" but is "questioning the wisdom of using taxpayer resources to engage in research that has, at best, spurious benefits to our nation."

It isn't difficult to find a pattern in the type of programs that Pitts has targeted for possible defunding: The two specific Advocates for Youth programs that are funded by federal grant money -- and that are therefore at risk of being shut down by the findings of these audits -- are HIV prevention for young women of color and HIV prevention for gay, lesbian, bisexual and transgender youth.

Pitts happens to be an ardent supporter of providing federal funding to faith-based charities. ("Rather than preempt these organizations with a government program that would never be as effective, we want to partner with them," he said in a September press release.) It shouldn't be too hard to see why groups like Advocates are feeling singled out.

The letter about No New Money that Pitts and his colleagues sent to HHS was cited to both Advocates for Youth and SIECUS as the impetus for all of their audits thus far. Strangely, CDC itself seems somewhat confused about exactly what they've been doing to these nonprofits, both of which were given the disclaimer that the investigations they went through in September were not audits. "In this case, CDC does not have official audit authority," explained CDC spokesperson Kathryn Harben. "So what we're doing is referred to as a 'business and financial review evaluation.'"

However, Enrique Tessada, president of Tessada & Associates, the independent firm contracted by the CDC to perform its most recent "business and financial reviews," wrote in his company's Spring 2003 newsletter that his staff was "auditing community-based organizations... [that] receive grants to conduct HIV/AIDS prevention and training nationwide."

Semantics aside, no one can disguise the fact that, regardless of results, these audits can have a punitive effect on nonprofits. "Each one of these rounds costs our organization enormous amounts of time and money," says Wagoner. "In many ways it can grind you to a halt if you have to go back through every book, pull every piece of paper, and so on."

When asked why Advocates and SIECUS were being subjected to so many reviews in such a short period of time, Harben said she thinks "it was really more poor planning [on the government's part] than anything else." When asked if every grantee organization was equally subject to CDC review, Harben said that "the history of that is probably not consistent." She also indicated that the reviews "could take anywhere from a couple of days to four or five days," but the groups under investigation report a lengthier time commitment. Preparation included, Advocates for Youth says it lost almost four weeks to its last audit, and SIECUS about two weeks.

"If they can't bury our heads in the sand about abstinence-only," says Wagoner, "they're going to try to bury our organization in audits."

Rep. Henry Waxman, D-Calif., fearing an abuse of federal audit power, has emerged as Advocates for Youth's greatest defender in this struggle. He and a contingent of 11 other congressional Democrats have voiced their concerns about the motivation behind these audits in letters to Tommy Thompson. In those letters they ask that HHS provide information about its auditing criteria in order "to determine whether there is sound scientific foundation for HHS' actions." Waxman's first letter received a response that was both delayed and abbreviated and left most of his questions unanswered. His follow-up letter, sent on Aug. 14 and requesting answers by Aug. 29, has yet to receive any response.

While attempting to get a response out of Tommy Thompson has become a Sisyphean task for Henry Waxman, it appears that all Joseph Pitts needs to do is mutter something under his breath and HHS will jump into action. On October 2nd, Pitts and some of his Republican colleagues presented the House Energy and Commerce Committee a list of 10 scientists whose work is funded by NIH grants, including some of those whose projects he questioned on his web site. The NIH has already made calls to these researchers, along with over 100 others, whose names turned up on a longer list  one which apparently originated with the Traditional Values Coalition , an ultra-conservative organization dedicated to fighting the "evils of abortion" and the "homosexual agenda." So far, no action has been taken against any of these NIH grantees and they have only been notified of their inclusion on what Waxman has referred to as the "hit list," but several have contacted the California Democrat to tell him that they now fear the loss of their funding. On Monday, Waxman picked up his pen once again, demanding that Thompson take a stand and denounce this "scientific McCarthyism."

The true danger is, as Waxman says, "that some organizations will stop offering comprehensive education programs as a result of these audits, causing public health to suffer."

That is also the biggest fear of Advocates for Youth. "This is not about the left vs. the right," says Deb Mauser, Advocates' vice president. "It's about what works at keeping young people safe and healthy. It's a human right to have effective science-based strategies available to young people who are facing an [AIDS] epidemic. Ultimately, Advocates [which receives only a third of its total funding from government grants] will survive. Whether young people will get the service they deserve is questionable."

"On one level, we feel vindicated by the audit process," says Wagoner, "but on another, we can not deny the impact of this kind of tool being used on nonprofits, and not just the intimidation on a group like ours -- we're going to wake up in the morning, come to the office, do the work we're always going to do -- but there's the residual intimidation of other organizations in this field. There are lots of them that get government money, that don't have diversified funds. And they may look at Advocates and say, 'There but for the grace of God go I. And if it's because Advocates is raising concerns about the subverting of science and research, if it's because they're raising their heads up a little too high, well, that tells us we'd better keep ours down real low.'

"You cannot convince me that this campaign isn't aimed at making an example out of us for the rest of this field," he continues. "My only hope is that it backfires, that those who have committed their lives to this field and to young people or to any other group that needs good quality public health -- we will not take it lying down. We will go back to work. We will do what's right."

This story has been corrected since it was originally published.

By Christopher Healy

Christopher Healy's writing has appeared in The Washington Post, Teen People, and "Out of the Ordinary: Essays on Growing Up With Gay, Lesbian and Transgender Parents."

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