A new law is expected to shutter all but five abortion clinics in Texas. Can a newly formed non-profit be the last hope in saving Texas’ doomed abortion centers? Photo by Mary Tuma
The new law, passed by a conservative majority in July, forces women to follow outdated protocol when taking abortion drugs, outlaws abortion after 20 weeks and mandates abortion doctors secure admitting privileges at a hospital no further than 30 miles where the procedure is performed. Those restrictions take effect on Oct. 29 and are already causing clinic directors to worry. Additionally, the law asks abortion centers to upgrade to the same standards as Ambulatory Surgical Centers (ASCs)– changes considered too expensive, time-consuming and medically unnecessary to be of real benefit to these clinics and their patients. This final requirement, set for enforcement one year from now, is seen as perhaps the most overwhelming burden to abortion clinics, even forcing some centers to shut down in advance, the Current’s August 14 cover story previously reported.
In an effort to prevent clinic closures, Dr. Richard Chudacoff and Charles Cohen created the Texas Women’s Reproductive Health Initiative Inc., a direct response to the law. To be funded exclusively through individual and corporate donations, the non-profit hopes to generate enough money to finance outpatient surgery centers in Houston, Dallas and San Antonio by September 2014. The goal is to then use revenue generated from those densely populated areas to subsidize surgical centers in less populous and undeserved cities.
“The reality is abortion is legal in this country. But Gov. Perry and the Texas Legislature have made an effort to limit access,” said Cohen. “We don’t believe that [the law] is necessary but the fact is, it passed; it’s the law of the land in Texas now. And we need to be able to maintain capacity so women can continue to have choices.”
Cohen boasts 25 years in the ASC biz, while Chudacoff comes from more than 20 years as a practicing OB-GYN. After the abortion bill got the green light, the two close friends began cultivating a strategy. Based on their collective background and the outcome of HB2, they explored a way to create the access that was bound to be lost as a result of the law.
“We’re very good friends, so it just seemed perfect,” said Chudacoff. “Chuck being an expert in ASC build up; myself in reproductive health. And being the type of person that doesn’t feel liberties should be restricted in any way, it also fit with our philosophy.”
With an estimated 88 percent of the clinics in Texas now providing abortion access on the verge of forced closure come next September—whittling 42 clinics down to just five—the two medical professionals saw a chance to act.
“That left either a huge void as it relates to capacity for abortions in Texas or an opportunity for a charitable venture to jump in or be created to jump in to seek private donations to generate capital required to build these facilities,” said Cohen.
And a non-profit model made the most sense—without the debt overhead a commercial venture might experience, the group won’t need to pass along cost to patients. They say the ASCs would even be able to provide secondary reproductive health procedures like vasectomies and tubal ligations (getting your “tubes tied”).
“I would imagine that part of the law was crafted knowing existing centers would not do terminations and who would be crazy enough to build ambulatory surgery centers solely for the purpose of termination?” said Chudacoff.
“It’s not cost effective,” Cohen chimed in, “unless you can do it in the form of a non-profit and get donations.”
The ideal is to swoop in and purchase a soon-to-be-out of business or closed ASC and convert it to an abortion center. If that doesn’t pan out, the team plans to look for an existing building conducive to transforming into an ASC. Building from scratch—the priciest option—is the group’s last choice. All of the options are “currently being explored” said Cohen.
In San Antonio, an existing ASC property hasn’t been found yet, but the group plans to scour the city come late October for tenant space or new land to build on. They hope to have a site picked out in SA by December. The team admits it’s been tough to find those spaces in their key cities but feel confident they’ll get the ball rolling—with about 420 ASCs in Texas, they at least have somewhere to start.
While both Cohen and Chudacoff agree the law is certainly intended to curb abortion access, they argue the ASC upgrades do, in fact, improve patient care—a claim continually touted by anti-choice legislators promoting the bill with little to no evidence. However, unlike the conservative lawmakers who blindly sold the ASC argument, the non-profit founders admit those structural changes—like expanded hallway widths and updated air ventilation systems—aren’t completely necessary. In the end they say, the point is null and void as the new law trumps the question itself.
“The standard of care is higher. Is it overkill? Possibly in some cases, possibly in many cases, but that doesn’t negate the fact that the standard of care is higher,” said Cohen.
And regardless, he says, with only five centers left after next September, “this is a must.”
In its infancy, the non-profit plans to kick off its first donation campaign in the next day or so, armed with a sizable list of some 70,000 pro-choice supporters. With estimates for structural changes to start at $2.25 million at minimum and up to $4 million for the construction of a building from the ground up, the new charitable organization has their work cut out for them. But with a “sleeping giant” awoken—as pro-choice state legislators put it earlier this summer–by the abortion bill’s controversy and unprecedented attention on Texas’ draconian women’s health policies, it wouldn’t be a surprise if the checks came rolling in.