Appeals court upholds Kentucky abortion law requiring clinics to have transfer agreements with hospitals
A federal appeals court on Friday upheld a Kentucky law that requires abortion clinics to have written agreements with a hospital and ambulance service in case of medical emergencies.
The 2-1 ruling from the 6th U.S. Circuit Court of Appeals reverses a 2018 district court ruling that found the law, first passed in 1998, violated constitutionally protected due process rights.
EMW Women’s Surgical Center first challenged the law in 2017 after a licensing fight with then-Gov. Matt Bevin (R). EMW was the only clinic that provided abortions at the time, and Bevin claimed that it lacked proper transfer agreements and took steps to shut it down.
Planned Parenthood of Indiana and Kentucky joined the suit later on, claiming that Bevin had used these transfer agreements to block its request for a license to provide abortions. After Democratic Gov. Andy Beshear took office in 2019, the two clinics were allowed to provide abortions.
The court wrote that the “district court erred in concluding that Kentucky would be left without an abortion facility,” according to The Associated Press, and dismissed the clinics’ argument that they were at risk of closing. It further said that the law allows clinics to apply for a 90-day waiver if they are denied a licensing agreement, which they could theoretically reapply for and continue to operate.
“(We) must presume that the Inspector General will consider waiver applications in good faith and will not act ‘simply to make it more difficult for (women) to obtain an abortion,’” the ruling read.
In his dissenting opinion, Judge Eric Clay wrote that it “condones the evisceration of the constitutional right to abortion access in Kentucky.”
“At the end of the day, no matter what standard this Court is bound to apply, the majority’s decision today is terribly and tragically wrong,” he wrote.
The American Civil Liberties Union of Kentucky, which represented the clinics, said in a statement that Kentucky’s law means abortion providers have to navigate “needless red tape every 90 days” and warned that the state could be the first without any abortion providers if the governor refuses to grant the waiver.
“This is what it looks like when politicians chip away at protections under Roe — pushing medically unnecessary laws that jeopardize abortion access without ever overturning Roe,” Chris Charbonneau, CEO of Planned Parenthood of Indiana and Kentucky, said in a statement.
“It must be stated that we are in a dangerous moment for abortion rights and what this moment calls for is leadership to put all people before politics and do what’s necessary to ensure every person has access to the care they need and deserve,” Charbonneau added.
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For 50 years, the United Family Medicine clinic on St. Paul’s West Seventh Street has catered to the working poor and underinsured patients, including today many East African immigrants and residents.
And the nonprofit health center has done so hand-in-hand with Allina Health, a 12-hospital, 90-clinic health network that has provided the majority of the clinic’s physicians, 21 medical residents, electronic records, lab services and even their phone line.
Now, Allina is in the process of pulling out all 21 medical residents and finding another location near United Hospital where the students can complete their three-year rotations in family medicine.
By the end of the year, the faculty physicians are expected to follow them, leaving the clinic nearly devoid of primary care doctors. Physician assistants and nurse practitioners are expected to pick up the slack in the clinic’s new team-based care model.
“The pandemic certainly has accelerated changes in the healthcare system,” said Sara Criger, president of United Hospital, who said medical residents and faculty had complained of patient scheduling and other issues at the clinic, hurting the reputation of Allina’s residency program.
Criger added: “There were problems that United Family Medicine needed to address. As the clinic made changes, we had to determine if they meet our requirements or not, and it became apparent that they did not.”
The deteriorating relationship between the community health clinic and Allina has led to finger-pointing on at least three sides.
CALLS FOR CEO TO RESIGN
Alarmed by a lengthy period of employee furloughs and other emergency management steps, a group of former United Family Medicine board members and West Seventh Street advocates have laid blame on the health clinic’s leadership and called for them to step down.
Those advocates include former United Family Medicine board chair Andrea Marboe, longtime West Seventh Street activist Marit Brock, former St. Paul City Council Member Dave Thune and St. Paul Public Works Director Sean Kershaw, who was recently a nonprofit leader.
“We’ve totally lost confidence in the program and they should stop funding them,” said Thune, who is circulating a petition calling for major funders to sever ties and for United Family Medicine Chief Executive Officer Ann Nyakundi to resign.
“We want a neighborhood clinic with doctor-patient relationships, real family physicians that follow you to the hospital,” Thune said. “She walked in and six months later turned the clinic upside down. We just prefer she leave now.”
Nyakundi and Jonathan Watson, CEO of the Minnesota Association of Community Health Centers, said operations at the clinic have stabilized since the start of the pandemic.
“When I inherited the clinic, our 2020 budget at the start of the year was actually worse than it is now,” said Nayakundi, who stepped in as CEO last October after the previous CEO resigned. “We’ve done a really good job efficiently navigating the pandemic and staffing to demand. We temporarily had furloughs, but we’ve brought all of the staff back, and we’re actually