Philosophy, Law and Politics

How Do Federally Funded Entities Provide for the Family Planning of Minors and Vulnerable Adult Populations?

The Comments Letter below was Submitted Today Regarding  Proposed Rulemaking  by the U.S. Department of Health and Human Services.

 

Lori Gayle Nuckolls, Esq.

July 22, 2018

Office of the Assistant Secretary for Health

Office of Population Affairs

Attention: Family Planning

U.S. Department of Health and Human Services

Hubert H. Humphrey Building, Room 716G

200 Independence Avenue, S.W.

Washington, D.C. 20201

Via Electronic Submission to: www.regulations.gov                                                        

                         Re: Docket No.: HHS-OS-2018-0008 (“Family Planning”)

Dear Assistant Secretary,

            I write with interest in the proposed amendment of 42 C.F.R. Part 59, and, specifically, the promulgation of regulations, to be codified at 42 C.F.R. § 59.17, by the Department of Health and Human Services (“HHS” or, alternatively, the “Department”). The proposed rules concern current agency restrictions upon funding pursuant to 42 U.S.C §§300-300a-6, originally enacted in 1970 as the Public Health Service Act (P.L. 91-572) (the “PHS Act” or the “Act”).  Please consider this letter formal comments upon this proposed rule in response to the Department’s notice of proposed rulemaking and request for comments, as published in the Federal Register, on June 1, 2018. (83 Fed. Reg. 25502-25533). I support this proposed rule, in part, and I believe it achieves the primary objectives of the Act, “to support preventive family planning services, population research, infertility services and other related medical, information, and educational activities.” (H.R. Rep. No 91-1667, at 8-9 (1970) (Conf. Rep.) (as quoted in 83 Fed. Reg. at 25502).

            The Department envisions that proposed new rule 42 C.F.R. §59.17 will aid in the achievement of the expressed statutory purpose in the new rule’s implementation of a requirement that entities receiving funding for the authorized purpose, both public and private not-for-profit, duly comply with all applicable State and Local laws requiring notification or reporting of sex crimes against both minor and adult clients. See, Consolidated Appropriations Act, 2018, P.L. 115-141, Div. H, sec. 208, 132 Stat. 348, 736 (2018) (83 Fed. Reg. at 25519-25520). In providing this protection to both minors and vulnerable adult populations, the proposed rule imposes an ongoing obligation upon funded family planning counselors to “comply with all State and local laws requiring notification or reporting of child abuse, child molestation, sexual abuse, rape, incest, intimate partner violence or human trafficking (collectively, ‘State notification laws’),” regardless of the age of the client. (to be codified as 42 C.F.R. §59.17(a)).

          Under the proposed rule, each funded entity would reconcile this broader purpose with its prefunding certification attestation as to compliance with a further duty that it: “encourages family participation in the decision of minors to seek family planning services.” Consolidated Appropriations Act, 2018, Public Law 115-141, Div. H, sec. 207, 132 Stat. 348, 736 (2018)(quoted in 83  Fed. Reg. at 25503). This narrower duty also requires that it “provides counseling to minors on how to resist attempts to coerce minors into engaging in sexual activities.” Id. And, as previously stated, in doing the foregoing “no provider of services … shall be exempt from any State law requiring notification or the reporting of child abuse, child molestation, sexual abuse, rape, or incest.” Consolidated Appropriations Act, 2018, Public Law 115-141, Div. H, sec. 208, 132 Stat. 348, 736 (2018) (as quoted at 83 Fed. Reg. 25503).

              Apart from the regulatory provisions setting forth the type of family planning counseling funded under the proposed amendment of 42 C.F.R. Part 59, the Department should consider that the concern intended to be met by this amendment envisions that certain adults and certain unemancipated minors are residents within compromised households and relationships. They are without full exercise of their legal privilege and right of self-governance, and, as presumed by the current and proposed regulations, live without legal recourse. Most importantly, many in a compromised living situation, act improperly and contrary to criminal law prior to becoming the victim envisioned by the proposed rule.  They engage in what is properly denominated criminal conduct when acting in self-defense so that they do not, if able, become the type of victim this proposed rule seeks to aid. In remedy, perhaps the Department should impose upon funding receipts a similar requirement to report all instances of general criminal conduct within the family unit or relationship, as to all adults and all children, even if the possible misconduct is not related to acts of sexual abuse.

          In the explanation of the proposed rule, the Department acknowledges that funded family service providers at times do not inquire as to the age of the child or teenager receiving services, for maintaining confidentiality encourages young people to seek counseling. (83 Fed. Reg. 25520). Similarly, compromised adults and children might not disclose problems of nonsexually related criminal conduct. Yet, compromised individuals develop an unfounded sense of personal shame and self-blame, even when they are not those who act in self-defense before services are needed.

         Perhaps, in remedy, the Department should require funded providers to not only notify or report as to the possibly victimized client to whom services are provided. But, providers should, as well, notify or report to State and Local governments all suspected criminal offenses, committed by minors as well as adults, of which a provider becomes aware in assessing the needs and living situations of their client. Specifically, in addition to reporting putatively criminal  facts  learned of when counseling vulnerable adults, the funded entity would notify or report as to all possible criminal activity of which it becomes aware when complying with the provider’s obligation under the new rule “to conduct a preliminary screening of any [minor under the legal age of consent] who presents with a sexually transmitted disease (STD), pregnancy, or any suspicion of abuse, in order to rule out victimization of a minor.” (to be codified as 42 C.F.R. 59.17(b)(1)(iv).

         In summary, proposed new rule 42 C.F.R.  §59.17 provides, as intended, that “minors and vulnerable populations” within the United States are protected by requiring family planning providers to comply with State and Local laws as to possible abuse. Yet, the providers might also include within their mandatory reporting all possible criminal offenders learned of in the course of providing counseling to both minors and adults, even if the activity does not constitute sexual abuse.  Children, their parents, as well as adults and their families, alike, should benefit fully from guidance made possible with authorized Federal funds, to the extent of present law. With adequate legal monitoring, through notice and reporting, adults, children and their family members may not, not disclose, fully, the factual circumstances resulting in their compromised living situation. For, such difficulty is often a result of criminal activity that proceeds sexual abuse. Only, with adequate disclosure, discussion and remedy will Federally funded family planning guidance be effective.

          The Department’s amendment of 42 C.F.R. Part 59 places the burden of compliance upon the funded provider which must possess adequate procedures for meeting the requirements of relevant State and Local law as a precondition of funding approval. And, this achieves the Department’s purpose of providing for minors and vulnerable populations upon whom the burden would never lie. Perhaps, the Department need only expand this protection to require funded family counselors to apprize State and Local governing officials of all suspected criminal activity within personal relationships, to the extent permitted or required by law.

          I thank you greatly for considering my comments on this rule. And, I may certainly be contacted as indicated above.

Sincerely,

Lori G. Nuckolls

Lori G. Nuckolls

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Philosophy, Law and Politics

Is the Mandatory Reporting of Convictions to Relevant Agencies Necessary for Fairness and Justice in Our Courts?

Adequate diligence and complete information are necessary for fair and sound decisions by judges, in both civil and criminal matters. Might States benefit from an enhanced requirement that criminal convictions of licensed professionals, for both  lesser and more severe offenses, be reported to the State agency governing the defendant’s profession?

A measure before the New York State Legislature, Assembly (A11057-A) and Senate (S8909-A), would amend the New York education law to require reporting to the governing  New York State Education Department the criminal convictions and determinations of professional misconduct of persons licensed by the Education Department.  The District Attorney for each county within the State of New York would be required to report each conviction of a licensee to the Professional Conduct Officer of the Education Department. The licensee is similarly bound by an obligation of self-reporting. The licensee must self-report criminal convictions to the Education Department. The licensee is also required to report determinations of professional misconduct to the Education Department, regardless of jurisdiction.

A statutory system of fair reporting and due information provides those governed, such as those licensed by the New York Education Department, with both an incentive for proper professional conduct and a deterrence of nonprofessional conduct, before any ill deed is done. Professional codes provide learning within one’s professional disciple throughout one’s career, long after one’s formal academic training. And, a system of fair reporting insures that employers and the courts make fair, adequate and just determinations.

In founding the first American newspaper,  Publick Occurrences, first  sold in Boston on September 25, 1960, Benjamin Harris stated in his prospectus:

“That something may be done toward the Curing, or at least the Charming of that Spirit of Lying, which prevails amongst us, wherefore nothing shall be entered, but what we have reason to believe is true, repairing to the best fountains for our Information. And when there appears any material mistake in anything that is collected, it shall be corrected in the next. Moreover, the Publisher of these Occurrences is willing to engage, that whereas, there are many False Reports, maliciously made, and spread among us, if any well-minded  person will be at the pains to trace any such false Report, so far as to find out and Convict the First Raiser of it, he will in this Paper (unless just Advice be given to the contrary) expose the Name of such Person, as A malicious Raiser of a false Report. It is suppos’d that none will dislike this Proposal, but such as intend to be guilty of so villainous a Crime.”

Neither the public nor the courts benefit from acting upon an absence of information. And, no one subject to a mandatory reporting requirement benefits if deprived of the rehabilitative purpose of ostensibly putative measures by inadequate information.

Lori Gayle Nuckolls, Esq.

Philosophy, Law and Politics

Promoting Reasonable and Consistent State Agency Regulation in Ohio

Proposed new regulations of Ohio Executive Agencies are reviewed for adequacy by the Ohio Joint Committee on Agency Rule Review, composed of members of the Ohio Senate and House.  In the current proposed revision of Ohio law governing the Joint Committee on Agency Rule Review (SB 221, amending Ohio Revised Code 106.021), perhaps it should be made mandatory that JCARR undertake review of whether a proposed regulation is contrary to law and similarly be required to request an invalidation of a proposed rule by the Ohio General Assembly upon making a finding that a proposed regulation is contrary to law. Under current law, both are left to JCARR’s discretion.

Mandatory review and invalidation is necessary because JCARR should be precluded from permitting unreasonable proposed rules and regulations to become effective. A regulation must be reasonable to be lawful. Agencies should adequately justify their decision making with sufficient analysis and explanation. It is the duty of JCARR to ensure as a balance and check on government that the agencies make wise and reasoned policy choices. JCARR does not supplant its policy choices for that of the agency, rather it only looks to the due and proper procedure and basis upon which the agency relies for the rule its seeks to promulgate. Such a requirement of reasonableness would result in regulation that is consistent with and does not conflict with governing law, without first relying upon a court for judicial review after the harm has been done. No committee of a state legislature should have within its discretion non-action upon arbitrary and capricious proposed agency regulation.

A review of the possible “adverse impact” of a proposed regulation is a preexisting requirement as to Ohio Revised Code 106.021(F). Usually neither an analysis nor finding of a possible adverse impact is reported for consideration as to the validity of a proposed regulation. Review of potential adverse impact usually merely addresses fiscal, business considerations, and not the substantive analysis required in legal drafting.

SB 221, Line 103, amending Ohio Revised Code 101.352, proposes to permit JCARR to seek an agency’s appearance to explain whether current rules reflect the principles and policies of the agency, or rather whether the agency should propose new rules that establish its present basis for regulation. Yet, this duty is permissive and subject to JCARR’s discretion and is not mandatory, even if JCARR is on notice that an agency’s regulations are not up to date? Would a mandatory provision place too great an administrative burden upon JCARR?

SB 221, Line 134, amending Ohio Revised Code 101.352, similarly permits that upon initiating review of an agency’s regulations and receiving an agency’s testimony at a hearing, JCARR “may” but is not required to vote upon whether to recommend that the agency review its regulations. Would making the vote mandatory create a violation of the separation of powers among the legislative, judicial and executive branches? Or, would it no more enhance the power and authority currently permitted JCARR than the creation of its power to review proposed executive agency regulations in the first instance?

SB221, Lines 1541-1619, amending Ohio Revised Code 121.931, permits a person to petition an agency to request a review of whether the agency has not properly revised or restated its regulations. If the agency denies the petition, the petitioner may appear at an agency hearing. In such a proceeding, how is the agency’s standard of review – that the petitioner has shown that the agency’s action in not revising its regulation is “erroneous” – to be defined? Is the burden of proof borne by the petitioner – that the agency’s previously stated “intention to deny the petition [for revision] is erroneous” — the same as a required showing of erroneousness by the petitioner as to the agency’s rationale for not granting the petition and undertaking a revision or restatement of the rule?  Does an inquiry as to whether the agency’s action is erroneous go only to questions of fact or also to whether the agency may have committed an error of law? Is a finding of erroneousness too high a standard for the petitioner to bear? Given that a petitioner may not appeal a denial of a petition within the agency, is an agency denial of a petition a final agency action permitting judicial review?