An Ohio judge issued a stay on Monday allowing the Capital Care Network abortion provider to remain open while the state court decides its appeal.
Capital Care Network (CCN), the only abortion provider in Toledo and one of the few remaining in northwest Ohio, had its license revoked by the state health department at the end of July. Without a license, the clinic was set to close this Tuesday, but CCN attorney Terry Lodge filed an appeal of the health department’s decision and asked the court to let the clinic remain open for the time being.
As Rewire previously reported, the state Department of Health sent an adjudication order, signed by then-director Lance Himes, to revoke the clinic’s license to operate because it did not hold a transfer agreement with a local hospital.
By law, facilities that provide abortions in Ohio must have such agreements. Proponents of the law say that it ensures women getting an abortion will be swiftly transferred to a hospital in the case of an emergency. But, as pro-choice advocates point out, abortions are an overwhelmingly safe procedure, with only 0.05 percent of first-trimester abortions resulting in hospital visits.
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The clinic in Toledo had a transfer agreement with the University of Michigan Health System, but the state Department of Health’s letter said the contract must be made with a “local” hospital.
In court documents, the clinic’s lawyer argued that its closure would hurt women’s health: “Thousands of women depend upon Capital Care for safe pregnancy termination services each year, however, if the state forces Capital Care to close its doors, women in the Toledo area will have to cross the border to Michigan or travel hours away to Cleveland or Columbus.”
“It causes us great concern when we think about vulnerable populations ... [who] may need to use these clinics for things like getting their contraception prescribed and who would never think that when they went into a Walgreens they would be restricted by Catholic doctrine,” Lorie Chaiten, director of the women’s and reproductive rights project of the ACLU of Illinois, told Rewire.
One of the largest Catholic health systems is set to begin running health clinics inside 27 Walgreens stores in Missouri and Illinois next week. The deal between Walgreens and SSM Health has raised concerns from public interest groups worried that care may be compromised by religious doctrine.
Catholic health systems generally follow directives issued by the U.S. Conference of Catholic Bishops that restrict access to an array of services, including abortion care, contraception, tubal ligations, vasectomies, and fertility treatments.
“We are concerned that the clinics will likewise be required to follow the [directives], thereby severely curtailing access to important reproductive health services, information, and referrals,” MergerWatch, the National Health Law Program, and the American Civil Liberties Unions of Illinois and Missouri wrote in a letter to Walgreens on Wednesday. They also sent a letter to SSM Health.
In a statement emailed to Rewire, Walgreens said its relationship with SSM Health “will not have any impact on any of our current clinic or pharmacy policies and procedures.”
SSM Health emailed a statement saying it “will continue to offer the same services that are currently available at Walgreens Healthcare Clinics today.” If a patient needs services “that are beyond the scope of what is appropriate for a retail clinic setting, they will be referred to a primary care physician or other provider of their choice,” the statement read.
A spokesperson for SSM Health demurred when Rewire asked if that would include referrals for abortion care.
“I’ve got to check this part out, my apologies, this is one that hadn’t occurred to me,” said Jason Merrill, the spokesperson.
Merrill later reiterated SSM Health’s statement that it would continue to offer the same services.
Catholic health systems have in recent years expanded control over U.S. hospitals, with one in six acute-care hospital beds now in a Catholic-owned or -affiliated facility. Patients in such hospitals have been turned away while miscarrying, denied tubal ligations, and refused abortion care despite conditions like brain cancer.
Catholic health systems have also expanded into the broader landscape of outpatient services, raising new questions about how religion could influence other forms of care.
“The whole health system is transforming itself with more and more health care being delivered outside the hospital,” Lois Uttley, director of MergerWatch, told Rewire. “So we are looking carefully to make sure that the religious restrictions that have been such a problem for reproductive health care at Catholic hospitals are not now transferred to these drug store clinics or to urgent care centers or free-standing emergency rooms.”
Walgreens last year announced a similar arrangement with the Catholic health system Providence Health & Services to bring up to 25 retail clinics to Oregon and Washington. After expressing concerns about the deal, the ACLU of Washington said it received assurances from both Walgreens and Providence that services at those clinics would not be affected by religious doctrine.
Meanwhile, the major urgent care provider CityMD recently announced a partnership with CHI Franciscan Health–which is affiliated with Catholic Health Initiatives–to open urgent care centers in Washington state.
“We’re seeing [Catholic health systems] going into the urgent care business and into the primary care business and in accountable care organizations, where they are having an influence on the services that are available to the public and to consumers,” Susan Berke Fogel, director of reproductive health at the National Health Law Program, told Rewire.
GoHealth Urgent Care, which describes itself as “one of the fastest growing urgent care companies in the U.S.,” announced an agreement this year with Dignity Health to bring urgent care centers to California’s Bay Area. Dignity Health used to be called Catholic Healthcare West, but changed its name in 2012.
“This is another pattern that we’ve seen of Catholic health plans and health providers changing their names to things that don’t sound so Catholic,” Lois Uttley said.
In the letters sent Wednesday, the National Health Law Program and other groups requested meetings with Walgreens and SSM Health to discuss concerns about the potential influence of religion on the clinics.
“It causes us great concern when we think about vulnerable populations, we think about low-income people… people who… may need to use these clinics for things like getting their contraception prescribed and who would never think that when they went into a Walgreens they would be restricted by Catholic doctrine,” Lorie Chaiten, director of the Reproductive Rights Project of the ACLU of Illinois, told Rewire.
The new clinics in Walgreens will reportedly be called “SSM Health Express Clinics at Walgreens.” According to SSM Health’s website, its initials “[pay] tribute” to the Sisters of St. Mary.
“We are fairly forthcoming with the fact that we are a mission-based health care organization,” Merrill told Rewire. “That’s something we embrace. I don’t think it’s anything we would hide.”
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“This law would have been especially burdensome to communities of color and people with low income who already often have the least access to care—this law would have made a bad situation worse,” said Iris E. Harvey, president and CEO of Planned Parenthood of Greater Ohio.
Judge Michael R. Barrett of the U.S. District Court of the Southern District of Ohio on Friday ruled in Planned Parenthood’s favor, granting a permanent injunction on an anti-choice state law.
The court ruling will keep Richard Hodges, the Ohio Department of Health director, from enforcing HB 294.
The 2015 law, sponsored by Rep. Bill Patmon (D-Cleveland) and Rep. Margaret Conditt (R-Butler County), would have redirected $1.3 million in state and federal taxpayer funds from Planned Parenthood’s 28 clinics in Ohio.
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The law would have required the state department to keep federal funds and materials that the health department receives from being distributed to entities that perform or promote non-therapeutic abortions, or maintain affiliation with any entity that does.
Funding that would’ve been cut off from the state health department went to the Violence Against Women and Breast and Cervical Cancer Mortality Prevention acts, the Infertility Prevention Project, Minority HIV/AIDS and Infant Mortality Reduction initiatives, and the Personal Responsibility Education Program.
Planned Parenthood in a lawsuit argued that the Republican legislation violated the First Amendment and the Due Process Clause and Equal Protection Clause of the 14th Amendment.
Barrett had temporarily blocked the law after Planned Parenthood affiliates filed the lawsuit and requested a preliminary injunction. The judge had issued an opinion contending that some legislators passed the law to make it difficult for people to access abortion care, as Rewire reported.
Iris E. Harvey, president and CEO of Planned Parenthood of Greater Ohio, praised the judge’s temporary order.
“This law would have been especially burdensome to communities of color and people with low income who already often have the least access to care—this law would have made a bad situation worse,” Harvey said in a statement.
Kellie Copeland, NARAL Pro Choice Ohio’s executive director, said in a statement that the Ohio legislature passed the anti-choice measure in an effort to appeal to conservative voters in early primary states during Kasich’s presidential campaign.
Copeland said that while the legislation made no effort to reduce the number of abortions performed, “it actively blocked critical health care for low-income women and families.”
Planned Parenthood said those services included 70,000 free STD screenings, thousands of HIV tests for at-risk community residents, and the largest infant mortality prevention program in the state.
In the 23-page court order and opinion, Barrett, an appointee of President George W. Bush, acknowledged that the law would have deterred “patients from seeking these potentially life-saving services.”
Planned Parenthood noted that the recent ruling in Ohio makes it among the ten states where courts have blocked anti-choice laws following June’s landmark Whole Woman’s Health v. HellerstedtU.S. Supreme Court ruling.