News Abortion

Judge Orders Two Michigan Abortion Clinics Closed

Eartha Melzer

Eaton County Circuit Judge Calvin Oosterhaven has issued a temporary restraining order against two Michigan abortion clinics that are charged with practicing medicine as an unlawfully-formed corporation.

Eaton County, Michigan Circuit Judge Calvin Oosterhaven has issued a temporary restraining order against two Michigan abortion clinics that are charged with practicing medicine as an unlawfully-formed corporation.

On Nov. 7, Michigan’s Attorney General Bill Schuette filed suit to dissolve Health Care Clinic, Inc, in Delta Township and Women’s Choice Clinic Inc. in Saginaw — clinics that provide a range of services including abortion up to 24 weeks gestation and have been operating since 1983.

The AG argued that the clinics are violating state law that specifies that only licensed medical professionals may provide medical services as a for-profit corporation.

According to the complaint, clinic owners Richard and Mary Remund of Kewadin and the officers of their corporation are not medical professionals, but set up and administered the clinics and hired doctors to perform abortions.

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In an order issued the next day, Eaton County Judge Calvin Oosterhaven suggested that this business structure threatens public safety.

“Absent the requested temporary restraining order, the harm to the People of Michigan will be irreparable because the provision of medical services can never be recalled for reversed once delivered. The harm is also immediate, as Defendants continue to provide unlawful medical services to Michigan residents each day. The People of Michigan are entitled to be provided with medical care services only by a person or business that is operating lawfully pursuant to the statutes of Michigan.”

Health Clinic Inc. and Women’s Choice Inc. have been the subject of intense scrutiny since last April when anti-choice activists claimed that they found fetal tissue and unshredded client medical records in the dumpster of the Delta Township clinic.

The allegations triggered sensational media coverage but a state police investigation ordered by the AG’s office found no evidence of improper medical waste disposal or violations of patient privacy laws.

It appears that the issue of the clinics corporate structure was recognized by state officials and treated as a technicality for years.

Documents provided to the court by the AG include a Jan. 25, 2000 letter from the state Dept. of Labor and Economic Growth’s Corporations Division that advises the Remund’s to modify their corporate filings with the state.

“It appears that the corporations are providing medical services and therefore should be organized as Professional Service corporation. Domestic Profit corporations cannot provide medical services …” the letter states. “To change the corporations from Domestic Profit corporations to Professional Service corporation, complete the enclosed [form]. The filing fee is $10.00 per corporation.”

Exhibits filed by the AG also show that in 2002 Richard Remund changed the stated purpose of the corporations from “medical clinic office” and “medical office” to “administrative service provider for doctors.”

The attorney for the Remunds and the attorney generals office did not respond to requests for interviews, and so far the closure of the clinics has not garnered media coverage beyond anti-choice web sites.

Right to Life of Michigan is “extremely pleased” with Schuette’s action, Legislative Director Ed Rivet said, adding that the AG’s office is in ongoing contact with the group about the status of the case.

“It’s not like we have to wait for a press release,” he said. “They are keeping us apprised. As things develop we kind of get a report.”

Rivet said that he believes that there will be a settlement in the case and he hopes it will include an order blocking the operators of the two clinics from ever opening another facility.

“With most of the events that go on with the abortion issues there is a subjective, emotional component,” he said. “But no one can deny that the corporate papers were not in order — these are just the facts on the ground.”

Rivet said the shutdown of the two clinics has motivated Right to Life to undertake a detailed review of the enforcement of rules and regulations governing Michigan abortion clinics and that they plan to share this with the AG and the public in the near future.

John Keserich, director of political field operations for Planned Parenthood Advocates of Michigan, said the closure of the two clinics is sure to adversely affect the availability of abortion in a state where few clinics provide abortion up to 24 weeks and where rural and young women already face steep hurdles in accessing services.

“Women who find themselves in circumstances where they are seeking abortion services after 20 weeks are almost always seeking them because of severe fetal anomalies or severe threats to their own health,” he said.

Keserich characterized the AG’s case against the clinics as part of a broad war on womens health.

“The political climate that we exist in is ripe for the AG to take action based on ideological positions on abortion services,” he said. “We think that the situation of the closing of these clinics is part of that.”

News Health Systems

The Crackdown on L.A.’s Fake Clinics Is Working

Nicole Knight

"Why did we take those steps? Because every day is a day where some number of women could potentially be misinformed about [their] reproductive options," Feuer said. "And therefore every day is a day that a woman's health could be jeopardized."

Three Los Angeles area fake clinics, which were warned last month they were breaking a new state reproductive transparency law, are now in compliance, the city attorney announced Thursday.

Los Angeles City Attorney Mike Feuer said in a press briefing that two of the fake clinics, also known as crisis pregnancy centers, began complying with the law after his office issued notices of violation last month. But it wasn’t until this week, when Feuer’s office threatened court action against the third facility, that it agreed to display the reproductive health information that the law requires.

“Why did we take those steps? Because every day is a day where some number of women could potentially be misinformed about [their] reproductive options,” Feuer said. “And therefore every day is a day that a woman’s health could be jeopardized.”

The facilities, two unlicensed and one licensed fake clinic, are Harbor Pregnancy Help CenterLos Angeles Pregnancy Services, and Pregnancy Counseling Center.

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Feuer said the lawsuit could have carried fines of up to $2,500 each day the facility continued to break the law.

The Reproductive Freedom, Accountability, Comprehensive Care, and Transparency (FACT) Act requires the state’s licensed pregnancy-related centers to display a brief statement with a number to call for access to free and low-cost birth control and abortion care. Unlicensed centers must disclose that they are not medical facilities.

Feuer’s office in May launched a campaign to crack down on violators of the law. His action marked a sharp contrast to some jurisdictions, which are reportedly taking a wait-and-see approach as fake clinics’ challenges to the law wind through the courts.

Federal and state courts have denied requests to temporarily block the law, although appeals are pending before the U.S. Court of Appeals for the Ninth Circuit.

Some 25 fake clinics operate in Los Angeles County, according to a representative of NARAL Pro-Choice California, though firm numbers are hard to come by. Feuer initially issued notices to six Los Angeles area fake clinics in May. Following an investigation, his office warned three clinics last month that they’re breaking the law.

Those three clinics are now complying, Feuer told reporters Thursday. Feuer said his office is still determining whether another fake clinic, Avenues Pregnancy Clinic, is complying with the law.

Fake clinic owners and staffers have slammed the FACT Act, saying they’d rather shut down than refer clients to services they find “morally and ethically objectionable.”

“If you’re a pro-life organization, you’re offering free healthcare to women so the women have a choice other than abortion,” said Matt Bowman, senior counsel with Alliance Defending Freedom, which represents several Los Angeles fake clinics fighting the law in court.

Asked why the clinics have agreed to comply, Bowman reiterated an earlier statement, saying the FACT Act violates his clients’ free speech rights. Forcing faith-based clinics to “communicate messages or promote ideas they disagree with, especially on life-and-death issues like abortion,” violates their “core beliefs,” Bowman said.

Reports of deceit by 91 percent of fake clinics surveyed by NARAL Pro-Choice California helped spur the passage of the FACT Act last October. Until recently, Googling “abortion clinic” might turn up results for a fake clinic that discourages abortion care.

“Put yourself in the position of a young woman who is going to one of these centers … and she comes into this center and she is less than fully informed … of what her choices are,” Feuer said Thursday. “In that state of mind, is she going to make the kind of choice that you’d want your loved one to make?

Rewire last month visited Lost Angeles area fake clinics that are abiding by the FACT Act. Claris Health in West Los Angeles includes the reproductive notice with patient intake forms, while Open Arms Pregnancy Center in the San Fernando Valley has posted the notice in the waiting room.

“To us, it’s a non-issue,” Debi Harvey, the center’s executive director, told Rewire. “We don’t provide abortion, we’re an abortion-alternative organization, we’re very clear on that. But we educate on all options.”

News Abortion

Study: Telemedicine Abortion Care a Boon for Rural Patients

Nicole Knight

Despite the benefits of abortion care via telemedicine, 18 states have effectively banned the practice by requiring a doctor to be physically present.

Patients are seen sooner and closer to home in clinics where medication abortion is offered through a videoconferencing system, according to a new survey of Alaskan providers.

The results, which will be published in the Journal of Telemedicine and Telecare, suggest that the secure and private technology, known as telemedicine, gives patients—including those in rural areas with limited access—greater choices in abortion care.

The qualitative survey builds on research that found administering medication abortion via telemedicine was as safe and effective as when a doctor administers the abortion-inducing medicine in person, study researchers said.

“This study reinforces that medication abortion provided via telemedicine is an important option for women, particularly in rural areas,” said Dr. Daniel Grossman, one of the authors of the study and professor of obstetrics, gynecology, and reproductive sciences at the University of California San Francisco (UCSF). “In Iowa, its introduction was associated with a reduction in second-trimester abortion.”

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Maine and Minnesota also provide medication abortion via telemedicine. Clinics in four states—New York, Hawaii, Oregon, and Washington—are running pilot studies, as the Guardian reported. Despite the benefits of abortion care via telemedicine, 18 states have effectively banned the practice by requiring a doctor to be physically present.

The researchers noted that even “greater gains could be made by providing [medication abortion] directly to women in their homes,” which U.S. product labeling doesn’t allow.

In late 2013, researchers with Ibis Reproductive Health and Advancing New Standards in Reproductive Health interviewed providers, such as doctors, nurses, and counselors, in clinics run by Planned Parenthood of the Great Northwest and the Hawaiian Islands that were using telemedicine to provide medication abortion. Providers reported telemedicine’s greatest benefit was to pregnant people. Clinics could schedule more appointments and at better hours for patients, allowing more to be seen earlier in pregnancy.

Nearly twenty-one percent of patients nationwide end their pregnancies with medication abortion, a safe and effective two-pill regime, according to the most recent figures from the U.S. Centers for Disease Control and Prevention.

Alaska began offering the abortion-inducing drugs through telemedicine in 2011. Patients arrive at a clinic, where they go through a health screening, have an ultrasound, and undergo informed consent procedures. A doctor then remotely reviews the patients records and answers questions via a videoconferencing link, before instructing the patient on how to take the medication.

Before 2011, patients wanting abortion care had to fly to Anchorage or Seattle, or wait for a doctor who flew into Fairbanks twice a month, according to the study’s authors.

Beyond a shortage of doctors, patients in Alaska must contend with vast geography and extreme weather, as one physician told researchers:

“It’s negative seven outside right now. So in a setting like that, [telemedicine is] just absolutely the best possible thing that you could do for a patient. … Access to providers is just so limited. And … just because you’re in a state like that doesn’t mean that women aren’t still as much needing access to these services.”

“Our results were in line with other research that has shown that this service can be easily integrated into other health care offered at a clinic, can help women access the services they want and need closer to home, and allows providers to offer high-level care to women from a distance,” Kate Grindlay, lead author on the study and associate at Ibis Reproductive Health, said in a statement.

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