Screwed by bureaucracy? Planned Parenthood's foes exploit a paperwork SNAFU

Right-wing conservatives in the Texas lege are putting Planned Parenthood on the hot seat this week, and the timing couldn't be worse. Allegations that the South Central Texas chapter of the nationally respected organization was administering the abortion pill without a license follow the near (and by no means final) death of a budget rider that would have stripped the nonprofit of the federal funding that it uses to provide family-planning services to low-income clients.

But Planned Parenthood SCTX President and CEO Jeffrey Hons says that the charges leveled by members of the Texas Conservative Coalition omit a key point: They were following instructions given to them by the Department of State Health and Human Services in October 2004.

The San Antonio-based chapter of PP offers in-clinic abortions in one facility in San Antonio, while the abortifacient mifepristone â?? which can only be used to terminate a pregnancy during the first eight weeks â?? is administered at four other locations in the city. Hons said that Planned Parenthood recorded and transcribed the 2004 conversation with Julie Long, head of TDSHS's licensing division, in which they were told that mifepristone-only clinics did not need a license to perform abortions.

“But I did bounce this off our attorney, and I went through all the different scenarios,” Long reportedly told the organization. The scenarios they discussed included Planned Parenthood's plans for dealing with an incomplete mifepristone termination. If that was handled onsite at the same clinic, the facility would need a license. But Planned Parenthood told Long they would send patients in that situation to the clinic that was already licensed for in-clinic abortion care. “And therefore it's not a physician performing a procedure, and it doesn't come under the definition of the law,” Long reportedly told them at the time.

Planned Parenthood operated under Long's instructions for more than four years. This January, Hons was reviewing proposed family-planning regulations and realized that the language indicated an assumption that mifepristone-only clinics also required a license. Planned Parenthood called the department and were told that Long had left the agency a short time earlier. So PP applied for permits for its four San Antonio mifepristone-only clinics, well before the news made headlines this month.

“They found out because we told them,” said Hons. “If we were trying to hide something, why did we tell them?”

Based on research his staff conducted, says Hons, it appears the licensing requirements were changed about a year ago. “We found a change on their website that makes it more clear that they want mife-only places to have a license,” said Hons, but the agency never notified them.

When department inspectors came to inspect the four clinics for their license applications, says Hons, Planned Parenthood told them they had been offering the service at those locations since 2004, and showed them the Long transcript.

“What surprised them was that their own administrator told them we didn't need licenses,” he said.

The department issued a cease-and-desist letter instructing them to temporarily cease abortion services at the four mifepristone-only clinics on April 3, and Planned Parenthood is complying with that order while they await the outcome of their license applications. Abortion-care services are still available at their in-clinic location, which has been licensed by the state since 1996.

Hons says that mifepristone is increasingly more popular with clients who decide to end a pregnancy than traditional in-clinic procedures. In 2008, 52 percent of the 2,476 clients who obtained an abortion (less than 10 percent of all clients served at the South Texas PP's nine facilities) chose mifepristone, a 17 percent increase over 2007.

“It's only possible in the earliest weeks,” he said. “So what it does is it focuses us on the earliest stages of pregnancy, where there is less opposition `to abortion`.

“It's earlier, it's safer, and it's more private. And that's why the opponents dislike it so much.”

While this regulation flap could reignite opposition to mifepristone, Hons also worries that foes of reproductive rights will use the news to build support for damaging legislation. In addition to the budget rider â?? which was stripped earlier this session but could be reintroduced before the budget is finalized â?? right-wing radio darling Senator Dan Patrick has authored a bill that would require physicians to show women seeking an abortion an ultrasound; it's currently awaiting a vote in the full Senate. (There's another budget angle, here, too, that foes might try to exploit, regarding the state's required separation of abortion and family-planning services; more on that shortly.)

A mystery that deserves further scrutiny: Shortly after TDSHS received Planned Parenthood's license applications on March 11, members of the Texas Conservative Coalition according to the Express-News asked the department to investigate whether Planned Parenthood was “performing illegal abortions in unlicensed facilities.”

The coincidence isn't lost on Hons: “I think what goes on in Texas, is that `someone is` under instruction to send word to these right-wing lawmakers.”


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