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Judge Hears Arguments Over Columbia, Mo., Clinic License

A federal judge on Friday heard arguments over issuing a preliminary injunction to stop the Missouri Department of Health and Senior Services from revoking a Planned Parenthood clinic's license to provide abortion, the St. Louis Post-Dispatch reports.

Judge Hears Arguments Over Columbia, Mo., Clinic License

December 22, 2015 — A federal judge on Friday heard arguments over issuing a preliminary injunction to stop the Missouri Department of Health and Senior Services from revoking a Planned Parenthood clinic's license to provide abortion, the St. Louis Post-Dispatch reports.

U.S. District Judge Nanette Laughrey did not specify when she would issue a ruling (Stuckey, St. Louis Post-Dispatch, 12/18).

Background

Under state law, abortion clinics are required to meet ambulatory surgical center requirements. To meet those requirements, physicians who provide surgical abortions must have admitting privileges with a nearby hospital.

In 2014, University of Missouri Health Care granted "refer and follow" privileges to Colleen McNicholas, a physician who began providing medication abortions at the Columbia-based Planned Parenthood of Kansas and Mid-Missouri's clinic on Aug. 3.

In August, conservative state senators and the health department director in Missouri debated at a hearing whether the Columbia clinic met state licensing requirements when it received its license in July. During the hearing, state Sen. Kurt Schaefer (R) -- chair of the Missouri Senate Appropriations Committee, as well as an interim committee investigating Planned Parenthood -- said the clinic failed to meet the ambulatory surgical center standards because the clinic's abortion provider does not have admitting privileges. However, Gail Vasterling, director of the Missouri Department of Health and Senior Services, said the standard does not apply because the clinic only provides medication abortions, not surgical abortions. Physicians at the clinic or the clinic itself would need to obtain admitting privilege requirements only if the clinic started to offer surgical abortion.

Following a unanimous vote by a committee of executive staff, MU Health Care announced that it will cease refer and follow privileges, which permit physicians to provide medication abortions, beginning Dec. 1. Planned Parenthood in September said it would take legal action against MU for its decision to discontinue the privileges.

The Columbia clinic on Nov. 23 stopped offering abortion care in anticipation of McNicholas losing her privileges. MU interim Chancellor Hank Foley said he would support MU Health Care's decision to end refer and follow privileges. Meanwhile, McNicholas currently is seeking to obtain other privileges at MU Health Care.

On Nov. 30, Laughrey temporarily blocked Missouri DHSS from pulling the Columbia Planned Parenthood clinic's license to offer abortion care (Women's Health Policy Report, 12/1). Laughrey later extended that order to Dec. 28.

Arguments

Planned Parenthood attorney Diana Salgado said permitting the clinic to keep its license would allow it to open without delay after obtaining the necessary privileges, while losing its license would require the clinic to reapply, which can take several months. "We will be able to start up services immediately," she said, adding, "That's the meaningful difference here."

Meanwhile, state Solicitor General James Layton contended that revoking the license would not irreparably harm the clinic because it currently does not have a physician who meets state requirements to offer abortion care (Ballentine, AP/Columbia Missourian, 12/18).

Salgado also argued that DHSS did not given the clinic enough time to create a plan of correction before trying to revoke its license. According to the St. Louis Dispatch, state law requires that centers notified of a deficiency create and implement a correction plan, which must be approved by DHSS. Salgado said DHSS had made only two phone calls to Planned Parenthood about the matter, noting, "It seems [DHSS] is trying to argue [Planned Parenthood] failed to submit a plan of correction and that somehow the conversations ... (are) sufficient ... but that is not the process that the [DHSS] goes through with every other ambulatory surgical center when it discovers license deficiencies."

However, Layton maintained that the two informal telephone conversations with Planned Parenthood were sufficient.

Salgado added that DHSS experienced internal pressure to revoke Planned Parenthood's license from Schaefer, who chairs the state Senate budget committee and is running for attorney general in 2016. "The evidence is clear ... that [DHSS] was under enormous pressure to revoke [PPKM's] license," she said, adding, "The record contains evidence that the department was concerned about backlash and potential ramifications for its budget" (St. Louis Post-Dispatch, 12/18).