Daily Women's Health Policy Report

  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
Syndicate content
Daily Women's Health Policy Report by the National Partnership for Women & Families
Updated: 2 min 6 sec ago

States Increasingly Penalize Pregnant Women for Drug Misuse

Thu, 08/13/2015 - 16:51

Some states are working to penalize pregnant women who misuse drugs, countering advice from medical groups that recommend treatment instead, the Daily Beast reports.

States Increasingly Penalize Pregnant Women for Drug Misuse

August 13, 2015 — Some states are working to penalize pregnant women who misuse drugs, countering advice from medical groups that recommend treatment instead, the Daily Beast reports.

In some cases, the states are responding to reported increases in drug misuse. For example, heroin use among U.S. adults ages 18 to 25 increased by more than two-fold over the last decade, according to CDC. Further, neonatal abstinence syndrome has also become increasingly prevalent over about the same time period, now affecting 3.39 per 1,000 hospital births, up from 1.2 in the past.

States Penalize Pregnant Women

CDC has suggested states respond to the increase by boosting access to substance use disorder treatment, but some states instead have tried to address the uptick in NAS cases by imposing criminal penalties on pregnant women who misuse drugs.

Overall, according to a report from the Guttmacher Institute, 18 states currently classify drug misuse by a pregnant woman to be a form of child abuse, and few of them overlap with the 19 states that have established or funded programs designed to treat pregnant women who misuse drugs. Specifically, 10 of the 18 states that classify drug use as a form of child abuse have not established drug treatment programs for pregnant women. Similarly, only six of the 15 states that impose mandatory reporting requirements for suspected drug misuse have funded or established such programs.

Meanwhile, some states have imposed additional penalties on pregnant women who misuse drugs. For example, Tennessee in 2014 became the first state to pass a law (SB 1391) designed specifically to penalize pregnant women who misuse drugs. Under the law, a pregnant woman who misuses certain drugs can be charged with aggravated assault, which can carry a prison sentence of 15 years. A woman was charged under the law weeks after it took effect, the Daily Beast reports.

According to the Daily Beast, five states have sought to pass measures similar to the Tennessee law. For example, in North Carolina, lawmakers advocated for a measure (SB 297) that would classify substance use by a pregnant woman as assault. Meanwhile, pregnant women also have faced charges under "fetal homicide" or "fetal harm" laws, many of which were designed to punish individuals who harmed pregnant women.

Separately, the Daily Beast reports that the Alabama Supreme Court in 2013 upheld the convictions of two women who had used drugs while pregnant, ruling that the women's drug use constituted "chemical endangerment of a child." Similarly, the South Carolina Supreme Court in 1997 held that substance misuse during a pregnancy "could be considered criminal child abuse."

Different Approach Advised

The American Congress of Obstetricians and Gynecologists and the American Civil Liberties Union, among other groups, have criticized the penalization of pregnant women for drug misuse.

For example, CDC and ACOG have urged states to reduce substance use among pregnant women through treatment programs instead. ACOG and ACLU also have noted that laws such as Tennessee's discourage women from seeking prenatal care rather than seeking substance use disorder treatment.

Similarly, the American Psychiatric Association in a 2001 position statement said that "societal resources (should) be directed not to punitive actions but to adequate preventive and treatment services for these [women] and children." In addition, the American Medical Association, which opposed the Alabama ruling, has argued against laws that criminalize substance use during pregnancy.

Ohio Program Focuses on Treatment

The Daily Beast highlights one new program in Cincinnati that will test all new mothers or infants for drugs and send women who test positive to treatment programs while providing continued care for their infants.

According to the Daily Beast, the program has spurred controversy among some advocates who support a screening program rather than mandatory testing. However, the Daily Beast reports that if such testing "can be effective anywhere, it would be in a state like Ohio where there are no criminal consequences for drug-using pregnant women, no mandatory reporting requirement, and state-funded treatment available for pregnant women" (Allen, Daily Beast, 8/12).


ACLU of Washington Calls On Hospital District To Comply With Reproductive Privacy Act

Thu, 08/13/2015 - 16:50

The American Civil Liberties Union of Washington State on Monday again called on San Juan County Public Hospital District No. 1 to comply with state law on providing abortion services, the Journal of the San Juan Islands reports.

ACLU of Washington Calls On Hospital District To Comply With Reproductive Privacy Act

August 13, 2015 — The American Civil Liberties Union of Washington State on Monday again called on San Juan County Public Hospital District No. 1 to comply with state law on providing abortion services, the Journal of the San Juan Islands reports (Smith, Journal of the San Juan Islands, 8/11).

Background

The state's Reproductive Privacy Act, adopted in 1991, says the state cannot deny or interfere with a woman's right to have an abortion. It also requires medical facilities in the state that provide maternity care to also offer abortion services.

In February, ACLU of Washington sent letters to three hospitals in the state. One of those hospitals, Jefferson Healthcare, subsequently approved a new reproductive health policy including abortion care. In addition, ACLU also filed a lawsuit against Skagit Regional Health, the third-largest public hospital district in Washington and the operator of several clinics and a large hospital, for allegedly not complying with the law (Women's Health Policy Report, 7/21).

ACLU Request

ACLU of Washington State in a blog post Monday reiterated its July letter to the hospital board of commissioners for San Juan County Public Hospital District No. 1, notifying them that the district's contract with PeaceHealth, a religiously affiliated health care provider, does not comply with RPA (Journal of the San Juan Islands, 8/11).

According to ACLU, San Juan County Public Hospital District No. 1 contracted with PeaceHealth to offer health care services, which are provided through Peace Island Medical Center (Bouchtia, ACLU of Washington State blog, 8/10). PIMC has stated that abortion services are not offered "in any PeaceHealth-owned, operated or leased facility" (Journal of the San Juan Islands, 8/11).

In the blog post, ACLU stated that PIMC "asserts that it offers prenatal services as well as 'ongoing pregnancy care' on site but consistently refuses to provide abortion services or even direct referrals to providers willing to provide abortion services," and thus the hospital district, via the contract with PIMC, is violating RPA (ACLU of Washington State blog, 8/10).

Further, ACLU stated, "Local access to reproductive healthcare is a particularly important issue to the San Juan community as San Juan Island is exactly that -- an island," adding, "The hospital district's failure to provide termination information and services limits reproductive health care access to women who already face barriers to care, including the isolated nature of the island and the costs of leaving (and returning to) the island to obtain care" (Journal of the San Juan Islands, 8/11).


HHS Warns Ala., La. Blocking Medicaid Funding for Planned Parenthood Could Violate Federal Law

Thu, 08/13/2015 - 16:50

The Obama administration has warned Alabama and Louisiana that recent efforts to block Planned Parenthood from receiving Medicaid funds could violate federal law, the Wall Street Journal reports.

HHS Warns Ala., La. Blocking Medicaid Funding for Planned Parenthood Could Violate Federal Law

August 13, 2015 — The Obama administration has warned Alabama and Louisiana that recent efforts to block Planned Parenthood from receiving Medicaid funds could violate federal law, the Wall Street Journal reports.

The states moved to stop Planned Parenthood from receiving the funds in the wake of a series of videos targeting the organization (Armour, Wall Street Journal, 8/12).

Background

The videos, which depict Planned Parenthood staff discussing fetal tissue donation, were released by an antiabortion-rights group called the Center for Medical Progress. CMP secretly filmed the videos by meeting with Planned Parenthood staff while posing as buyers of fetal tissue.

Planned Parenthood has stated that the videos were heavily edited and that the filmed officials did not conduct any illegal activities. The organization said it does not profit from fetal tissue donations and only receives reimbursement for costs associated with such donations, which is legal. Meanwhile, supporters of Planned Parenthood said the videos are part of a decades-long campaign against the organization (Women's Health Policy Report, 8/12).

Several States Target Planned Parenthood's Medicaid Funding

Last week, Alabama Gov. Robert Bentley (R) said the state would cut Medicaid funding for Planned Parenthood. Similarly, Louisiana Gov. Bobby Jindal (R) has ended a state contract under which Planned Parenthood received Medicaid funds.

Meanwhile, the New Hampshire Executive Council last week voted to defund Planned Parenthood centers in the state (Women's Health Policy Report, 8/7). Because New Hampshire has only moved to block state funding to the centers, the effort is not subject to federal oversight, according to the Journal.

HHS Issues Warning

In a notice to the states, HHS said Medicaid law authorizes beneficiaries to obtain services from any qualified provider, including Planned Parenthood. As a result, efforts in Alabama and Louisiana to cut off Medicaid funding for Planned Parenthood could violate federal law by restricting beneficiaries' access to the provider of their choice (Wall Street Journal, 8/12). HHS spokesperson Ben Wakana added, "By restricting which provider a woman could choose to receive care from, women could lose access to critical preventive care, such as cancer screenings" (Sullivan, The Hill, 8/12).

HHS also provided the states with guidance the agency released in June 2011, noting that states are not allowed to exclude providers from Medicaid because of the types of medical services they offer. According to the guidance, states are only permitted to exclude providers from Medicaid in specific situations, such as if the providers committed certain criminal acts.

Next Steps

Planned Parenthood said it is considering how to respond to the defunding efforts. Further, the organization said it is remaining alert for possible defunding efforts in Pennsylvania and Wisconsin.

According to the Journal, states can request hearings on the matter if the issue is not resolved informally between states and federal officials. If the issue is still not settled following a hearing, CMS could cut states' federal Medicaid funding for failing to comply with federal law (Wall Street Journal, 8/12).

According to The Hill, federal courts in the past have blocked states' attempts to cut Medicaid funding for Planned Parenthood (The Hill, 8/12). For example, a federal appeals court in 2011 blocked an attempt by Indiana to prohibit Medicaid funding for Planned Parenthood, citing federal "freedom of choice" requirements for the program (Rovner, Kaiser Health News, 8/13).

Comments

Dawn Laguens, executive vice president at Planned Parenthood, praised HHS' notice to the states. "It's good to hear that HHS has clarified what we already know -- blocking women's access to care at Planned Parenthood is against the law" (The Hill, 8/12).

Separately, Sara Rosenbaum, a law professor and Medicaid expert at George Washington University, said the states are not likely to succeed if they take their battles to court. She noted that using Planned Parenthood "is a right for beneficiaries going back to the original statute" (Kaiser Health News, 8/13).

Meanwhile, officials in Louisiana and Alabama defended the legality of their actions. A spokesperson for Jindal said Louisiana's contract with Planned Parenthood permitted either party to cancel the contract at will, as long as a 30-day notice was provided. Similarly, Bentley's press secretary said Alabama's contract with the provider "allow[ed] either party to terminate on 15 days written notice" (Wall Street Journal, 8/12).

NEJM Supports Planned Parenthood

In related news, the New England Journal of Medicine in a recent editorial expressed support for Planned Parenthood, Politico Pro reports.

NEJM in the editorial applauded Planned Parenthood for providing millions of people with health care services. In addition, NEJM praised Planned Parenthood for procuring and donating fetal tissue for medical research, noting the organization complies with all legal and ethical guidelines when doing so. "It is shameful that a radical antichoice group whose goal is the destruction of Planned Parenthood continues to twist the facts to achieve its end[s]," NEJM wrote (Mershon/Ehley, Politico Pro, 8/13).

Ga. Officials Say Abortion Providers Follow Law

In other related news, Georgia Department of Public Health Commissioner Brenda Fitzgerald said Wednesday that an investigation of five abortion providers in the state, including Planned Parenthood Southeast, has found no evidence that any of the providers are violating state law by donating fetal tissue, the AP/Washington Times reports.

According to the AP/Times, Georgia law requires fetal remains be cremated or buried. Gov. Nathan Deal (R) ordered the investigation last month following the release of the video series (AP/Washington Times, 8/12).


States Increasingly Penalize Pregnant Women for Drug Misuse

Thu, 08/13/2015 - 16:48

Some states are working to penalize pregnant women who misuse drugs, countering advice from medical groups that recommend treatment instead, the Daily Beast reports.

States Increasingly Penalize Pregnant Women for Drug Misuse

August 13, 2015 — Some states are working to penalize pregnant women who misuse drugs, countering advice from medical groups that recommend treatment instead, the Daily Beast reports.

In some cases, the states are responding to reported increases in drug misuse. For example, heroin use among U.S. adults ages 18 to 25 increased by more than two-fold over the last decade, according to CDC. Further, neonatal abstinence syndrome has also become increasingly prevalent over about the same time period, now affecting 3.39 per 1,000 hospital births, up from 1.2 in the past.

States Penalize Pregnant Women

CDC has suggested states respond to the increase by boosting access to substance use disorder treatment, but some states instead have tried to address the uptick in NAS cases by imposing criminal penalties on pregnant women who misuse drugs.

Overall, according to a report from the Guttmacher Institute, 18 states currently classify drug misuse by a pregnant woman to be a form of child abuse, and few of them overlap with the 19 states that have established or funded programs designed to treat pregnant women who misuse drugs. Specifically, 10 of the 18 states that classify drug use as a form of child abuse have not established drug treatment programs for pregnant women. Similarly, only six of the 15 states that impose mandatory reporting requirements for suspected drug misuse have funded or established such programs.

Meanwhile, some states have imposed additional penalties on pregnant women who misuse drugs. For example, Tennessee in 2014 became the first state to pass a law (SB 1391) designed specifically to penalize pregnant women who misuse drugs. Under the law, a pregnant woman who misuses certain drugs can be charged with aggravated assault, which can carry a prison sentence of 15 years. A woman was charged under the law weeks after it took effect, the Daily Beast reports.

According to the Daily Beast, five states have sought to pass measures similar to the Tennessee law. For example, in North Carolina, lawmakers advocated for a measure (SB 297) that would classify substance use by a pregnant woman as assault. Meanwhile, pregnant women also have faced charges under "fetal homicide" or "fetal harm" laws, many of which were designed to punish individuals who harmed pregnant women.

Separately, the Daily Beast reports that the Alabama Supreme Court in 2013 upheld the convictions of two women who had used drugs while pregnant, ruling that the women's drug use constituted "chemical endangerment of a child." Similarly, the South Carolina Supreme Court in 1997 held that substance misuse during a pregnancy "could be considered criminal child abuse."

Different Approach Advised

The American Congress of Obstetricians and Gynecologists and the American Civil Liberties Union, among other groups, have criticized the penalization of pregnant women for drug misuse.

For example, CDC and ACOG have urged states to reduce substance use among pregnant women through treatment programs instead. ACOG and ACLU also have noted that laws such as Tennessee's discourage women from seeking prenatal care rather than seeking substance use disorder treatment.

Similarly, the American Psychiatric Association in a 2001 position statement said that "societal resources (should) be directed not to punitive actions but to adequate preventive and treatment services for these [women] and children." In addition, the American Medical Association, which opposed the Alabama ruling, has argued against laws that criminalize substance use during pregnancy.

Ohio Program Focuses on Treatment

The Daily Beast highlights one new program in Cincinnati that will test all new mothers or infants for drugs and send women who test positive to treatment programs while providing continued care for their infants.

According to the Daily Beast, the program has spurred controversy among some advocates who support a screening program rather than mandatory testing. However, the Daily Beast reports that if such testing "can be effective anywhere, it would be in a state like Ohio where there are no criminal consequences for drug-using pregnant women, no mandatory reporting requirement, and state-funded treatment available for pregnant women" (Allen, Daily Beast, 8/12).


House Lawmakers Ask President Obama To Clarify Helms Amendment

Thu, 08/13/2015 - 16:47

In a letter sent earlier this month, a group of 81 House lawmakers called on President Obama to clarify that the Helms Amendment permits the use of U.S. foreign aid funding for abortion in the event of rape, incest of danger to a woman's life, the Washington Times reports.

House Lawmakers Ask President Obama To Clarify Helms Amendment

August 13, 2015 — In a letter sent earlier this month, a group of 81 House lawmakers called on President Obama to clarify that the Helms Amendment permits the use of U.S. foreign aid funding for abortion in the event of rape, incest of danger to a woman's life, the Washington Times reports (Wetzstein, Washington Times, 8/12).

The amendment, enacted in 1973, states that "no foreign assistance funds may be used to pay for the performance of an abortion as a method of family planning or to motivate or coerce any person to practice abortions." However, in practice, the amendment has been applied as a total ban on U.S. foreign aid funds for abortion care, according to supporters of abortion rights (Women's Health Policy Report, 1/16).

Letter Details

The lawmakers in the letter asked Obama to "take swift action to end the unduly strict interpretation of the Helms Amendment," which they said has been "incorrectly construed as an outright ban on the use of U.S. aid for abortion services" since it was passed. Specifically, they asked Obama "to issue guidance to the State Department, USAID and other relevant agencies to clarify that the Helms Amendment permits exceptions in the events of rape, incest or danger to a woman's life."

According to the lawmakers, interpreting the Helms Amendment as a complete ban on using U.S. funds for abortion services "is both overly restrictive and inconsistent with established legal precedent." They noted that the amendment has been interpreted to permit exceptions in instances of rape, incest or life endangerment in Medicaid, Medicare and CHIP, and that those exceptions have been proposed for women in the military and for members of the Peace Corps. The lawmakers wrote, "Failing to extend those exceptions to women outside of the United States does not align with precedent or Congressional intent" (Congress members' letter, 8/3).

Jon O'Brien -- president of Catholics for Choice, which shared the letter on Wednesday -- noted that the lawmakers' request is "certainly" within the administration's control (Washington Times, 8/12).


ACLU of Washington Calls On Hospital District To Comply With Reproductive Privacy Act

Thu, 08/13/2015 - 16:47

The American Civil Liberties Union of Washington State on Monday again called on San Juan County Public Hospital District No. 1 to comply with state law on providing abortion services, the Journal of the San Juan Islands reports.

ACLU of Washington Calls On Hospital District To Comply With Reproductive Privacy Act

August 13, 2015 — The American Civil Liberties Union of Washington State on Monday again called on San Juan County Public Hospital District No. 1 to comply with state law on providing abortion services, the Journal of the San Juan Islands reports (Smith, Journal of the San Juan Islands, 8/11).

Background

The state's Reproductive Privacy Act, adopted in 1991, says the state cannot deny or interfere with a woman's right to have an abortion. It also requires medical facilities in the state that provide maternity care to also offer abortion services.

In February, ACLU of Washington sent letters to three hospitals in the state. One of those hospitals, Jefferson Healthcare, subsequently approved a new reproductive health policy including abortion care. In addition, ACLU also filed a lawsuit against Skagit Regional Health, the third-largest public hospital district in Washington and the operator of several clinics and a large hospital, for allegedly not complying with the law (Women's Health Policy Report, 7/21).

ACLU Request

ACLU of Washington State in a blog post Monday reiterated its July letter to the hospital board of commissioners for San Juan County Public Hospital District No. 1, notifying them that the district's contract with PeaceHealth, a religiously affiliated health care provider, does not comply with RPA (Journal of the San Juan Islands, 8/11).

According to ACLU, San Juan County Public Hospital District No. 1 contracted with PeaceHealth to offer health care services, which are provided through Peace Island Medical Center (Bouchtia, ACLU of Washington State blog, 8/10). PIMC has stated that abortion services are not offered "in any PeaceHealth-owned, operated or leased facility" (Journal of the San Juan Islands, 8/11).

In the blog post, ACLU stated that PIMC "asserts that it offers prenatal services as well as 'ongoing pregnancy care' on site but consistently refuses to provide abortion services or even direct referrals to providers willing to provide abortion services," and thus the hospital district, via the contract with PIMC, is violating RPA (ACLU of Washington State blog, 8/10).

Further, ACLU stated, "Local access to reproductive healthcare is a particularly important issue to the San Juan community as San Juan Island is exactly that -- an island," adding, "The hospital district's failure to provide termination information and services limits reproductive health care access to women who already face barriers to care, including the isolated nature of the island and the costs of leaving (and returning to) the island to obtain care" (Journal of the San Juan Islands, 8/11).


HHS Warns Ala., La. Blocking Medicaid Funding for Planned Parenthood Could Violate Federal Law

Thu, 08/13/2015 - 16:47

The Obama administration has warned Alabama and Louisiana that recent efforts to block Planned Parenthood from receiving Medicaid funds could violate federal law, the Wall Street Journal reports.

HHS Warns Ala., La. Blocking Medicaid Funding for Planned Parenthood Could Violate Federal Law

August 13, 2015 — The Obama administration has warned Alabama and Louisiana that recent efforts to block Planned Parenthood from receiving Medicaid funds could violate federal law, the Wall Street Journal reports.

The states moved to stop Planned Parenthood from receiving the funds in the wake of a series of videos targeting the organization (Armour, Wall Street Journal, 8/12).

Background

The videos, which depict Planned Parenthood staff discussing fetal tissue donation, were released by an antiabortion-rights group called the Center for Medical Progress. CMP secretly filmed the videos by meeting with Planned Parenthood staff while posing as buyers of fetal tissue.

Planned Parenthood has stated that the videos were heavily edited and that the filmed officials did not conduct any illegal activities. The organization said it does not profit from fetal tissue donations and only receives reimbursement for costs associated with such donations, which is legal. Meanwhile, supporters of Planned Parenthood said the videos are part of a decades-long campaign against the organization (Women's Health Policy Report, 8/12).

Several States Target Planned Parenthood's Medicaid Funding

Last week, Alabama Gov. Robert Bentley (R) said the state would cut Medicaid funding for Planned Parenthood. Similarly, Louisiana Gov. Bobby Jindal (R) has ended a state contract under which Planned Parenthood received Medicaid funds.

Meanwhile, the New Hampshire Executive Council last week voted to defund Planned Parenthood centers in the state (Women's Health Policy Report, 8/7). Because New Hampshire has only moved to block state funding to the centers, the effort is not subject to federal oversight, according to the Journal.

HHS Issues Warning

In a notice to the states, HHS said Medicaid law authorizes beneficiaries to obtain services from any qualified provider, including Planned Parenthood. As a result, efforts in Alabama and Louisiana to cut off Medicaid funding for Planned Parenthood could violate federal law by restricting beneficiaries' access to the provider of their choice (Wall Street Journal, 8/12). HHS spokesperson Ben Wakana added, "By restricting which provider a woman could choose to receive care from, women could lose access to critical preventive care, such as cancer screenings" (Sullivan, The Hill, 8/12).

HHS also provided the states with guidance the agency released in June 2011, noting that states are not allowed to exclude providers from Medicaid because of the types of medical services they offer. According to the guidance, states are only permitted to exclude providers from Medicaid in specific situations, such as if the providers committed certain criminal acts.

Next Steps

Planned Parenthood said it is considering how to respond to the defunding efforts. Further, the organization said it is remaining alert for possible defunding efforts in Pennsylvania and Wisconsin.

According to the Journal, states can request hearings on the matter if the issue is not resolved informally between states and federal officials. If the issue is still not settled following a hearing, CMS could cut states' federal Medicaid funding for failing to comply with federal law (Wall Street Journal, 8/12).

According to The Hill, federal courts in the past have blocked states' attempts to cut Medicaid funding for Planned Parenthood (The Hill, 8/12). For example, a federal appeals court in 2011 blocked an attempt by Indiana to prohibit Medicaid funding for Planned Parenthood, citing federal "freedom of choice" requirements for the program (Rovner, Kaiser Health News, 8/13).

Comments

Dawn Laguens, executive vice president at Planned Parenthood, praised HHS' notice to the states. "It's good to hear that HHS has clarified what we already know -- blocking women's access to care at Planned Parenthood is against the law" (The Hill, 8/12).

Separately, Sara Rosenbaum, a law professor and Medicaid expert at George Washington University, said the states are not likely to succeed if they take their battles to court. She noted that using Planned Parenthood "is a right for beneficiaries going back to the original statute" (Kaiser Health News, 8/13).

Meanwhile, officials in Louisiana and Alabama defended the legality of their actions. A spokesperson for Jindal said Louisiana's contract with Planned Parenthood permitted either party to cancel the contract at will, as long as a 30-day notice was provided. Similarly, Bentley's press secretary said Alabama's contract with the provider "allow[ed] either party to terminate on 15 days written notice" (Wall Street Journal, 8/12).

NEJM Supports Planned Parenthood

In related news, the New England Journal of Medicine in a recent editorial expressed support for Planned Parenthood, Politico Pro reports.

NEJM in the editorial applauded Planned Parenthood for providing millions of people with health care services. In addition, NEJM praised Planned Parenthood for procuring and donating fetal tissue for medical research, noting the organization complies with all legal and ethical guidelines when doing so. "It is shameful that a radical antichoice group whose goal is the destruction of Planned Parenthood continues to twist the facts to achieve its end[s]," NEJM wrote (Mershon/Ehley, Politico Pro, 8/13).

Ga. Officials Say Abortion Providers Follow Law

In other related news, Georgia Department of Public Health Commissioner Brenda Fitzgerald said Wednesday that an investigation of five abortion providers in the state, including Planned Parenthood Southeast, has found no evidence that any of the providers are violating state law by donating fetal tissue, the AP/Washington Times reports.

According to the AP/Times, Georgia law requires fetal remains be cremated or buried. Gov. Nathan Deal (R) ordered the investigation last month following the release of the video series (AP/Washington Times, 8/12).


Federal Appeals Court Upholds Contraceptive Coverage Accommodation

Thu, 08/13/2015 - 15:45

A federal appeals court panel on Friday ruled that four not-for-profits that hold themselves out as religious are not substantially burdened by an accommodation in the contraceptive coverage rules that ensures they do not have to pay for or directly administer such coverage, the New York Times reports.

Federal Appeals Court Upholds Contraceptive Coverage Accommodation

August 10, 2015 — A federal appeals court panel on Friday ruled that four not-for-profits that hold themselves out as religious are not substantially burdened by an accommodation in the contraceptive coverage rules that ensures they do not have to pay for or directly administer such coverage, the New York Times reports (Clifford, New York Times, 8/7).

According to AP/Modern Healthcare, the ruling affects more than 25,000 employees at six hospitals, three nursing homes, two high schools and several not-for-profits (AP/Modern Healthcare, 8/7).

Background

The rules, which are being implemented under the Affordable Care Act (PL 111-148), require most employers to offer contraceptive coverage to their workers, although houses of worship are exempt from the mandate (Women's Health Policy Report, 12/17/13). Not-for-profits that hold themselves out as religious are eligible for an accommodation that enables them to notify their insurer or third-party administrator of their objection so the insurer or third-party administrator can facilitate contraceptive coverage for members of their health plans (Women's Health Policy Report, 7/10).

The Roman Catholic Archdiocese of New York and four affiliated not-for-profits in the state -- Catholic Health Care System, Catholic Health Services of Long Island, Cardinal Spellman High School and Monsignor Farrell High School -- challenged the rules on the grounds that the accommodation violated their religious freedom. The government later clarified that the archdiocese itself is exempt from the mandate but that the affiliated organizations must comply with the accommodation.

In December 2013, a federal judge granted the not-for-profits a permanent injunction against the contraceptive coverage rules. U.S. District Court Judge Brian Cogan ruled that requiring the not-for-profits to authorize a third party to provide contraceptive coverage violated the religious beliefs of the organizations, even if the organizations are not required to financially support the coverage (Women's Health Policy Report, 12/17/13).

Panel Overturns Lower Court's Ruling

On Friday, a three-judge panel of the appeals court unanimously ruled to overturn the lower court's permanent injunction. The panel in its ruling noted that six other circuit courts throughout the U.S. had made similar rulings.

In the ruling, 2nd U.S. Circuit Court of Appeals Judge Rosemary Pooler also noted the "modicum" of paperwork required for the accommodation "relieves, rather than imposes, any substantial burden" on the plaintiffs' religious rights. Pooler wrote, "Eligible organizations are provided the opportunity to freely express their religious objection to such coverage as well as to extricate themselves from its provision. At the same time, insured individuals are not deprived of the benefits of contraceptive coverage."

In addition, Pooler noted that when "[v]iewed objectively, completing a form stating that one has a religious objection is not a substantial burden." She wrote, "There must be some method by which the government can be notified of the objection. Otherwise there is no way that the government can know which organizations it needs to accommodate. Here, the government has provided flexible, largely effortless and essentially cost-free options for notification" (New York Times, 8/7).

The judges added that the burden was not substantial "even if the religious objector sincerely finds the ultimate actions taken by the government and third parties offensive." The ruling stated, "To the contrary, the accommodation relieves them of providing contraceptive coverage, and instead enlists third-party administrators to provide such coverage" (AP/Modern Healthcare, 8/7).

Reaction

Brigitte Amiri -- an attorney at the American Civil Liberties Union, which filed an amicus brief in the lawsuit -- called the ruling "a huge victory for all the female employees who work at the organizations." She added, "The scorecard is really 7-0 in the Courts of Appeals on this issue" (New York Times, 8/7). According to AP/Modern Healthcare, four of the cases have been appealed to the Supreme Court (AP/Modern Healthcare, 8/7).

Meanwhile, Joseph Zwilling, a spokesperson for the archdiocese, said the group's attorneys are reviewing the ruling (New York Times, 8/7).


Blogs Comment on Life-Saving Benefits of Birth Control, Sharing Personal Abortion Narratives, More

Thu, 08/13/2015 - 15:45

Read the week's best commentary from bloggers at the Center for American Progress' "ThinkProgress," Feministing and more.

Blogs Comment on Life-Saving Benefits of Birth Control, Sharing Personal Abortion Narratives, More

August 7, 2015 — Read the week's best commentary from bloggers at the Center for American Progress' "ThinkProgress," Feministing and more.

CONTRACEPTION: "New Proof That Birth Control Pills Can Help Save Women's Lives," Tara Culp-Ressler, Center for American Progress' "ThinkProgress": "The birth control pill has prevented hundreds of thousands of cases of endometrial cancer, and can help reduce women's risk of developing cancer even long after they stop using it, according to new research that analyzes data collected between 1965 to 2014," Culp-Ressler writes. According to Culp-Ressler, researchers found that "taking birth control pills for just five years can reduce a woman's risk of developing this type of cancer by 25 percent," adding, "They estimate oral contraceptives have prevented about 400,000 cases of endometrial cancer since 1965 -- including 200,000 cases in the last decade alone." Further, the study "found that the protective effect persists for at least 30 years even after women stop taking oral contraception," she adds. Culp-Ressler writes that even though "hormonal contraception has been legal for decades, it often becomes entangled in contentious political debates." She notes medical professionals have cautioned that such debates "ultimately obscure birth control's potential to save lives" and cites other benefits of birth control, such as curbing the unintended pregnancy rate and "giv[ing] women more control over the economic course of their lives" (Culp-Ressler, "ThinkProgress," Center for American Progress, 8/6).

ABORTION-RIGHTS MOVEMENT: "Lessons on the 10 Year Anniversary of My Abortion," Renee Bracey Sherman, Feministing: Writing on the tenth anniversary of her abortion, Bracey Sherman discusses the lessons she has learned since she "made one of the best and most empowered decisions of [her] life." She writes that after six years of staying silent about her abortion, she found "[t]he ability to speak openly and freely with friends and family allowed [her] to connect with them in a deeper way." Further, she found that sharing her story publicly created a community with others who have had similar experiences while also challenging abortion-rights opponents to "think differently about how they treat those in their lives who have abortions." She writes that abortion is "just one of many reproductive experiences," and discusses how she has "found men to be great allies in the fight for reproductive freedom." According to Bracey Sherman, " [B]eing public about [her] abortion isn't easy," and she notes that if she remains silent, abortion-rights opponents "can continue to make up whatever narrative they want about [her], and those like[her], and [she] cannot allow that to happen" (Bracey Sherman, Feministing, 8/4).

What others are saying about the abortion-rights movement:

~ "'What The F*ck Has Planned Parenthood Done?' Tumblr Shows That Planned Parenthood Does Much, Much More Than People Realize," Claire Warner, Bustle.

ANTIABORTION-RIGHTS MOVEMENT: "A Timeline of Attempts To Defund Planned Parenthood," s.e. smith, Care2: "Despite the best efforts of [conservative lawmakers], an attempt to defund Planned Parenthood failed on Monday, illustrating that Congress is still committed to women's health despite a recent series of shock videos designed to smear the reputation of the venerable family planning organization," smith writes. According to smith, the most recent "attempt at defunding" Planned Parenthood "certainly wasn't the first, and it likely won't be the last, demonstrating just one of the many reasons it's important to vote for pro-choice politicians." For example, smith discusses several antiabortion-rights policies over the last few decades -- including the Hyde Amendment, a 2011 effort to defund Planned Parenthood, and the Mexico City Policy or Global Gag rule -- and the efforts of lawmakers who support abortion rights to overturn or revoke some of those policies, such as former President Bill Clinton and President Obama (smith, Care2, 8/4).

CPCs: "Democrats Push To Hold Crisis Pregnancy Centers Accountable," Emily Crockett, RH Reality Check: "House Democrats reintroduced a bill [HR 3378] last week that would prohibit so-called crisis pregnancy centers (CPCs) from falsely advertising that they provide abortion services," Crockett writes. Specifically, she explains that the measure "would direct the Federal Trade Commission to create rules against deceptive advertising of abortion services, and let the FTC investigate reports of misleading CPC advertisements just like any other consumer product or service." According to Crockett, CPCs "are anti-choice facilities that try to persuade women not to get abortions," which "may offer free ultrasounds or pregnancy tests, but often no other medical services." Further, she notes that the centers often offer biased counseling that "includes overtly misleading information about abortion, including anti-choice myths that abortion causes breast cancer or sterility." In addition, CPCs "routinely use deceptive advertising, especially online, to suggest" women might be able to receive abortion services at the clinics, she writes (Crockett, RH Reality Check, 8/4).

REPRODUCTIVE JUSTICE: "Latinas Need Reproductive Justice -- Not Luck," Kelli Garcia, National Women's Law Center's "Womenstake": "Reproductive justice requires that all people -- not just a lucky few -- have the economic means, social capital, and political power to make and exercise decisions about their own health, family, and future," Garcia writes, noting that her own professional and personal accomplishments would have been "derailed" without adequate health care and childcare. She explains that Latinas face high rates of childhood poverty, which "mak[es] it hard for Latina students to succeed in school"; are less likely than other populations to have health insurance; and "more likely to work in low-wage jobs with no benefits." Noting that "reproductive justice for Latinas must include a comprehensive plan for economic security," Garcia lists several key aspects of what reproductive justice means for Latinas. According to Garcia, such factors include: raising the minimum wage; "[i]vest[ing] in childcare and early childhood education"; improving financial aid for students; expanding Medicaid in all states; guaranteeing that all health plans cover "comprehensive reproductive health care including the full range of contraception and abortion"; protecting pregnant women's rights in the workplace; "[p]rotect[ing] family caregivers from employment discrimination"; ensuring paid time off for employees; and "[e]nsur[ing] that Latinas receive equal pay for equal work" (Garcia, "Womenstake," National Women's Law Center, 8/4).


Okla. Judge Blocks Medication Abortion Restriction

Thu, 08/13/2015 - 15:44

An Oklahoma judge on Monday struck down a state law (HB 2684) that aimed to limit medication abortion, ruling that the law was unconstitutional because such restrictions are not applied to other medications, Reuters reports.

Okla. Judge Blocks Medication Abortion Restriction

August 11, 2015 — An Oklahoma judge on Monday struck down a state law (HB 2684) that aimed to limit medication abortion, ruling that the law was unconstitutional because such restrictions are not applied to other medications, Reuters reports (Brandes/Herskovitz, Reuters, 8/10).

Aaron Cooper, a spokesperson for the state Attorney General's Office, said the office plans to appeal the ruling (Talley, AP/Minneapolis Star Tribune, 8/10).

Case Background

The law would have required physicians to administer medication abortion drugs according to FDA protocol and banned use of the method after 49 days of pregnancy, which goes against common medical practice. It was challenged by the Center for Reproductive Rights.

In October 2014, Oklahoma District Court Judge Roger Stuart allowed the underlying law to take effect but granted the plaintiffs' request to block portions of the measure that would have made abortion providers liable if they did not follow the law. The Oklahoma Supreme Court in November 2014 temporarily blocked enforcement of the law, which had taken effect on Nov. 1, 2014, until it was "fully and finally litigated."

In January, the plaintiffs filed a motion for partial summary judgement, arguing that the law illegally delegates authority to FDA by requiring providers to follow out-of-date FDA protocols when administering medication abortion drugs (Women's Health Policy Report, 2/6). CRR attorney Autumn Katz also argued that the law interfered with physicians' discretion to treat their patients and did not serve a valid state interest. Katz said physicians under the law would have had to treat women using an outdated method even though the up-to-date method is safer, more effective and less costly.

According to Guttmacher Institute, five other states have passed similar laws.

Latest Ruling

Oklahoma County District Judge Patricia Parrish in her ruling Monday said she was bound by a 2012 state Supreme Court decision. The 2012 decision affirmed a lower court ruling to strike down a 2011 law that effectively prohibited medication abortion in the state (AP/Minneapolis Star Tribune, 8/10).

Elizabeth Nash, senior state issues associate for Guttmacher, said, "For women in Oklahoma, this ruling means they can access abortion methods that are best for them" (Reuters, 8/10).


Judge Lifts Restraining Order on Tenn. Antiabortion-Rights Law

Thu, 08/13/2015 - 15:44

A federal judge on Monday conditionally lifted a restraining order that prevented Tennessee officials from enforcing an antiabortion-rights law (Pub. Ch. 419) requiring new licenses for clinics that provide abortions, The Tennessean reports.

Judge Lifts Restraining Order on Tenn. Antiabortion-Rights Law

August 12, 2015 — A federal judge on Monday conditionally lifted a restraining order that prevented Tennessee officials from enforcing an antiabortion-rights law (Pub. Ch. 419) requiring new licenses for clinics that provide abortions, The Tennessean reports (Wadhwani, The Tennessean, 8/10).

Background

The law, which was scheduled to take effect on July 1, would require all facilities or physician offices that perform more than 50 surgical abortions annually to be licensed as ambulatory surgical centers.

Four of the six abortion clinics in the state that provide surgical abortions currently meet the licensing standards, while a fifth provider, in Knoxville, only provides medication abortion and therefore is not subject to the requirement. Bristol Regional Women's Center and the Women's Center in Nashville are the two remaining clinics that provide surgical abortions and are not licensed as ambulatory surgical centers.

Lawsuit Details

The Center for Reproductive Rights in June filed a lawsuit against three antiabortion-rights laws, including the ambulatory surgical licensing requirement, on behalf of three abortion clinics and an ob-gyn in the state. CRR filed suit on behalf of the Bristol and Nashville clinics; CHOICES, the Memphis Center for Reproductive Health; and Wesley Adams, an ob-gyn who provides abortion care at the Bristol and Nashville clinics (Women's Health Policy Report, 7/13).

The other antiabortion-rights laws challenged in the lawsuit include a 2012 statute requiring physicians who provide abortion care to have admitting privileges at a nearby hospital. According to CRR's lawsuit, two clinics have closed under the law. Meanwhile, the third contested law (SB 1222), which took effect July 1, imposes a mandatory delay and requires that women receive in-person counseling from a physician prior to having an abortion, forcing women to make an additional trip to the clinic prior to the abortion procedure (Women's Health Policy Report, 7/26).

CRR asked the court to block the ambulatory surgical center requirement while the lawsuit against all three laws continues. According to lawsuit, the Bristol and Nashville clinics risk closure because they do not meet the ambulatory surgical center standards.

U.S. District Judge Kevin Sharp in June blocked the ambulatory surgical center requirement and in July extended the restraining order, allowing the two clinics to remain open (Women's Health Policy Report, 7/13).

New Developments

On Monday, Sharp lifted the order after the clinics and state licensing officials began work toward approving the clinics' licenses. However, he indicated that he could revisit his decision as soon as Thursday.

Separately, Scott Tift, an attorney representing the clinics, said physicians at the two clinics were concerned that they could be prosecuted if the local district attorneys filed criminal charges against them for violating the new law. "The concern on the part of these doctors is about the potential to lose their licenses or be charged with a crime," he said.

Meanwhile, Steven Hart, special counsel with the Tennessee attorney general's office, said, "There is no indication either of the district attorneys are intending to prosecute."

Sharp on Monday allowed the plaintiffs to amend their lawsuit to include the district attorneys in Nashville and Sullivan Counties, where the two affected clinics are located, and to ask them to formally state that they will not prosecute the physicians. Sharp said he would reassess his decision during an emergency hearing on Thursday if the district attorneys do not agree to submit such statements (The Tennessean, 8/10).


Ohio Clinic Partners with University of Toledo Medical Center To Train Residents on Abortion Care

Thu, 08/13/2015 - 15:44

The sole abortion clinic in Toledo has partnered with the University of Toledo Medical Center to train physicians in how to perform abortions and related care, the AP/Idaho Statesman reports.

Ohio Clinic Partners with University of Toledo Medical Center To Train Residents on Abortion Care

August 11, 2015 — The sole abortion clinic in Toledo has partnered with the University of Toledo Medical Center to train physicians in how to perform abortions and related care, the AP/Idaho Statesman reports.

According to the AP/Statesman, the arrangement allows the clinic, Capital Care Network, to help the university meet its curriculum requirements. However, state law still prohibits the university from partnering with the clinic on a required patient-transfer agreement (Franko, AP/Idaho Statesman, 8/9).

Background

Under Ohio's 2014-2015 budget (HB 59), signed in 2013, abortion clinics in the state are required to have a patient transfer agreement with a hospital. Clinics are prohibited from making such arrangements with public hospitals. Further, Gov. John Kasich (R) recently signed into law a state budget (HB 64) that requires abortion clinics to arrange a patient transfer agreement with a hospital no more than 30 miles away (Women's Health Policy Report, 8/5).

Last year, Lance Himes, then-interim director at the Ohio Department of Health, signed an adjudication order revoking the license for Capital Care Network. The order was based on a recommendation from a state hearing examiner that the clinic be closed because it does not have a valid emergency transfer agreement with a nearby hospital, which is required by state law. The clinic currently has a transfer agreement with a hospital 50 miles away.

The order was deemed unconstitutional in June, a decision that is being appealed by Ohio Attorney General Mike DeWine (R) (Women's Health Policy Report, 7/15).

Agreement Details

David Burkons, a doctor at Capital Care Network, and UTMC signed the training agreement in the spring.

According to the AP/Statesman, an accreditation council requires the medical school to provide abortion training, although residents can opt out of the program if they have studied how to provide pre-procedure counseling and assessments, as well as pertinent law. Meanwhile, Burkons, who also works with several other abortion clinics, said he has had similar training arrangements in the past with other northeast Ohio providers, including at least one hospital that would not provide the clinic with a transfer agreement.

Under the agreement, residents will work in one-month rotations for two to three days each week to learn about assessments, counseling, surgical procedures and follow-up services. The university pays the residents, and the clinic and the university did not make any financial arrangements beyond providing certain insurance coverage.

Comments

Burkons said, "I enjoy teaching, and I think that's how you're going to get people, you know, interested in maybe doing this."

Meanwhile, UT spokesperson Jon Strunk said that the absence of a patient-transfer agreement would not bar the hospital from providing care if needed. "UTMC will in every circumstance provide medical care to any patient regardless of the reason that care is needed or the choices a patient makes prior to his or her arrival at [the] hospital," he said (AP/Idaho Statesman, 8/9).


Blogs Comment on Supporting Subsidized Contraception, Abortion Access in Texas, More

Thu, 08/13/2015 - 15:44

Read the week's best commentary from bloggers at Bustle, Center for American Progress' "ThinkProgress" and more.

Blogs Comment on Supporting Subsidized Contraception, Abortion Access in Texas, More

August 11, 2015 — Read the week's best commentary from bloggers at Bustle, Center for American Progress' "ThinkProgress" and more.

CONTRACEPTION: "4 Arguments Against the Government Paying for Birth Control & How To Totally Shut Them Down," Josephine Yurcaba, Bustle: Some individuals "believe that Planned Parenthood should be shut down by virtue of the fact that it uses any federal funds for the general reproductive healthcare of women," a claim that essentially boils down to "whether the government should subsidize birth control," Yurcaba writes, outlining four possible responses to arguments against subsidized contraception. For example, in response to claims that using subsidized birth control suggests a lack of personal responsibility, Yurcaba notes that "women who are actively seeking effective birth control, even if they can't afford it, are being responsible" rather than having unprotected sex. Further, she counters claims that subsidizing contraception will lead to subsidies for unrelated products, noting that subsidizing birth control "falls under the healthcare category." Yurcaba also points out that subsidized birth control will save money in the long term, as it curbs the number of unintended pregnancies, and she refutes religious objections to contraception, citing the separation of church and state and noting that such objections have "no basis in healthcare or modern science" (Yurcaba, Bustle, 8/4).

ABORTION RESTRICTIONS: "Anti-Abortion Activists Trying To Pretend Women in Texas No Longer Have Right To Choose," Tara Culp-Ressler, Center for American Progress' "ThinkProgress": Texas throughout "the past several years ... has made national headlines for passing particularly harsh restrictions on abortion that have shuttered dozens of clinics, sparking a complicated legal battle that threatens to make its way up to the Supreme Court," Culp-Ressler writes. Citing abortion providers and abortion-rights activists in the state, Culp-Ressler writes this "rapidly changing landscape" has "created a serious knowledge gap among the real people who live in" Texas, with some residents unsure about whether clinics are open or whether the procedure is legal. Further, according to NARAL Pro-Choice Texas, "crisis pregnancy centers (CPCs) that work to dissuade women from choosing to end a pregnancy ... now outnumber abortion clinics" in the state, making their "misinformation tactics ... even more effective," Culp-Ressler writes. In response, abortion-rights groups such as the Lilith Fund, NARAL Pro-Choice Texas and Shift have "launched a comprehensive website" that "details everything a pregnant person may need to know about accessing abortion services in" Texas, such as directions to open clinics, resources on funding assistance for abortion care and an outline on Texas' abortion laws (Culp-Ressler, "ThinkProgress," Center for American Progress, 8/9).

What others are saying about abortion restrictions:

~ "Repro Wrap: Alabama Special Session Shows 'Pro-Life' Is Subjective," Robin Marty, Care2.

~ "Judge Blocks Oklahoma Medication Abortion Restriction -- Again," Jessica Mason Pieklo, RH Reality Check.

ANTIABORTION-RIGHTS MOVEMENT: "Planned Parenthood Investigations Uncovering No Wrongdoing," Teddy Wilson, RH Reality Check: Investigations into Planned Parenthood sparked by a series of misleading, secretly filmed videos that depict organization officials discussing fetal tissue donation "have shown Planned Parenthood didn't violate any laws," Wilson writes. Specifically, he notes that conservative "lawmakers in states around the country have called for investigations and hearings, and inquiries have been announced in Arizona, Indiana, Florida, Kansas, Georgia, Louisiana, Ohio, and Texas," as well as South Carolina and Tennessee. However, he notes that some lawmakers -- Virginia Gov. Terry McAuliffe (D) and Missouri Gov. Jay Nixon (D) -- have pushed back or refused to investigate the organization. Meanwhile, Massachusetts Attorney General Maura Healey (D) "last week announced that her office found no evidence that the Planned Parenthood League of Massachusetts is operating a fetal tissue donation program," while "[a]n Indiana State Department of Health investigation into Planned Parenthood-affiliated reproductive health-care clinics in the state found them in compliance with the state's fetal tissue regulations" and an investigation in Florida "did not find any evidence that fetal tissue was being sold illegally" at clinics in the state, Wilson writes. Separately, he cites concerns expressed over the group behind the videos, the Center for Medical Progress, whose "deceptive tactics, ideological agenda, and connections to radical and violent anti-choice activists" have been questioned and notes that the group "is also the subject of two lawsuits" (Wilson, RH Reality Check, 8/6).

What others are saying about the antiabortion-rights movement:

~ "University Caves to Anti-Choice Pressure, Suspends Fetal Tissue Acquisition From Some Vendors," Jason Salzman, RH Reality Check.

ABORTION-RIGHTS MOVEMENT: "I Had an Abortion at Planned Parenthood -- and I'm Not Ashamed," Alexis Rhiannon, Salon: Rhiannon writes about her experience obtaining an abortion at Planned Parenthood -- a decision she has "never regretted ... for a second since" -- noting that the organization "supported [her] at a time when [she] desperately needed it, and [she] want[s] to support them now." Rhiannon notes that when she had her abortion in 2012, she "didn't have to convince" Planned Parenthood that she "deserved their respect and kindness," nor did she have to apologize. She adds that while she "was sure of [her] decision" to have an abortion, she felt scared immediately prior to the procedure. Rhiannon noted that while she expected her "feelings to be dismissed ... instead, the doctor who'd introduced herself as the woman completing the surgery ... told [Rhiannon] it was OK and reached her hand up to hold [Rhiannon's] as [Rhiannon] went under." Rhiannon concludes by thanking Planned Parenthood for her abortion, adding that she "stand[s] with" Planned Parenthood because Planned Parenthood "stood with" her (Rhiannon, Salon, 8/10).

SEXUALITY EDUCATION: "John Oliver Creates the Perfect Video to Help With America's Lack of Sex Education Standards," Inae Oh, Mother Jones: Oh discusses a segment on the latest episode of "Last Week Tonight with John Oliver," in which Oliver lambasts the "'weird patchwork system'" of sexuality education in the U.S. According to Oh, "[i]n the United States, sex education is legally mandated in only 22 states, with just 13 requiring that information to be medically accurate." She writes, "The lack of accurate information, combined with educators' continued efforts to avoid the issue altogether, has major consequences for young people across the country." She adds that "the effects can be alarming: In Mississippi, where sex education deems homosexuality a crime and condom demonstrations are banned, the state ranks second in teenage pregnancy, with a third of all babies born to teenage mothers." She cites Oliver, who in the segment said, "'There is no way we'd allow any other academic program to consistently fail to prepare students for life after school. And human sexuality, unlike calculus, is something you actually need to know about for the rest of your life'" (Oh, Mother Jones, 8/10).


House Lawmakers Ask President Obama To Clarify Helms Amendment

Thu, 08/13/2015 - 15:17

In a letter sent earlier this month, a group of 81 House lawmakers called on President Obama to clarify that the Helms Amendment permits the use of U.S. foreign aid funding for abortion in the event of rape, incest of danger to a woman's life, the Washington Times reports.

House Lawmakers Ask President Obama To Clarify Helms Amendment

August 13, 2015 — In a letter sent earlier this month, a group of 81 House lawmakers called on President Obama to clarify that the Helms Amendment permits the use of U.S. foreign aid funding for abortion in the event of rape, incest of danger to a woman's life, the Washington Times reports (Wetzstein, Washington Times, 8/12).

The amendment, enacted in 1973, states that "no foreign assistance funds may be used to pay for the performance of an abortion as a method of family planning or to motivate or coerce any person to practice abortions." However, in practice, the amendment has been applied as a total ban on U.S. foreign aid funds for abortion care, according to supporters of abortion rights (Women's Health Policy Report, 1/16).

Letter Details

The lawmakers in the letter asked Obama to "take swift action to end the unduly strict interpretation of the Helms Amendment," which they said has been "incorrectly construed as an outright ban on the use of U.S. aid for abortion services" since it was passed. Specifically, they asked Obama "to issue guidance to the State Department, USAID and other relevant agencies to clarify that the Helms Amendment permits exceptions in the events of rape, incest or danger to a woman's life."

According to the lawmakers, interpreting the Helms Amendment as a complete ban on using U.S. funds for abortion services "is both overly restrictive and inconsistent with established legal precedent." They noted that the amendment has been interpreted to permit exceptions in instances of rape, incest or life endangerment in Medicaid, Medicare and CHIP, and that those exceptions have been proposed for women in the military and for members of the Peace Corps. The lawmakers wrote, "Failing to extend those exceptions to women outside of the United States does not align with precedent or Congressional intent" (Congress members' letter, 8/3).

Jon O'Brien -- president of Catholics for Choice, which shared the letter on Wednesday -- noted that the lawmakers' request is "certainly" within the administration's control (Washington Times, 8/12).


HHS Warns Ala., La. Blocking Medicaid Funding for Planned Parenthood Could Violate Federal Law

Thu, 08/13/2015 - 15:05

The Obama administration has warned Alabama and Louisiana that recent efforts to block Planned Parenthood from receiving Medicaid funds could violate federal law, the Wall Street Journal reports.

HHS Warns Ala., La. Blocking Medicaid Funding for Planned Parenthood Could Violate Federal Law

August 13, 2015 — The Obama administration has warned Alabama and Louisiana that recent efforts to block Planned Parenthood from receiving Medicaid funds could violate federal law, the Wall Street Journal reports.

The states moved to stop Planned Parenthood from receiving the funds in the wake of a series of videos targeting the organization (Armour, Wall Street Journal, 8/12).

Background

The videos, which depict Planned Parenthood staff discussing fetal tissue donation, were released by an antiabortion-rights group called the Center for Medical Progress. CMP secretly filmed the videos by meeting with Planned Parenthood staff while posing as buyers of fetal tissue.

Planned Parenthood has stated that the videos were heavily edited and that the filmed officials did not conduct any illegal activities. The organization said it does not profit from fetal tissue donations and only receives reimbursement for costs associated with such donations, which is legal. Meanwhile, supporters of Planned Parenthood said the videos are part of a decades-long campaign against the organization (Women's Health Policy Report, 8/12).

Several States Target Planned Parenthood's Medicaid Funding

Last week, Alabama Gov. Robert Bentley (R) said the state would cut Medicaid funding for Planned Parenthood. Similarly, Louisiana Gov. Bobby Jindal (R) has ended a state contract under which Planned Parenthood received Medicaid funds.

Meanwhile, the New Hampshire Executive Council last week voted to defund Planned Parenthood centers in the state (Women's Health Policy Report, 8/7). Because New Hampshire has only moved to block state funding to the centers, the effort is not subject to federal oversight, according to the Journal.

HHS Issues Warning

In a notice to the states, HHS said Medicaid law authorizes beneficiaries to obtain services from any qualified provider, including Planned Parenthood. As a result, efforts in Alabama and Louisiana to cut off Medicaid funding for Planned Parenthood could violate federal law by restricting beneficiaries' access to the provider of their choice (Wall Street Journal, 8/12). HHS spokesperson Ben Wakana added, "By restricting which provider a woman could choose to receive care from, women could lose access to critical preventive care, such as cancer screenings" (Sullivan, The Hill, 8/12).

HHS also provided the states with guidance the agency released in June 2011, noting that states are not allowed to exclude providers from Medicaid because of the types of medical services they offer. According to the guidance, states are only permitted to exclude providers from Medicaid in specific situations, such as if the providers committed certain criminal acts.

Next Steps

Planned Parenthood said it is considering how to respond to the defunding efforts. Further, the organization said it is remaining alert for possible defunding efforts in Pennsylvania and Wisconsin.

According to the Journal, states can request hearings on the matter if the issue is not resolved informally between states and federal officials. If the issue is still not settled following a hearing, CMS could cut states' federal Medicaid funding for failing to comply with federal law (Wall Street Journal, 8/12).

According to The Hill, federal courts in the past have blocked states' attempts to cut Medicaid funding for Planned Parenthood (The Hill, 8/12). For example, a federal appeals court in 2011 blocked an attempt by Indiana to prohibit Medicaid funding for Planned Parenthood, citing federal "freedom of choice" requirements for the program (Rovner, Kaiser Health News, 8/13).

Comments

Dawn Laguens, executive vice president at Planned Parenthood, praised HHS' notice to the states. "It's good to hear that HHS has clarified what we already know -- blocking women's access to care at Planned Parenthood is against the law" (The Hill, 8/12).

Separately, Sara Rosenbaum, a law professor and Medicaid expert at George Washington University, said the states are not likely to succeed if they take their battles to court. She noted that using Planned Parenthood "is a right for beneficiaries going back to the original statute" (Kaiser Health News, 8/13).

Meanwhile, officials in Louisiana and Alabama defended the legality of their actions. A spokesperson for Jindal said Louisiana's contract with Planned Parenthood permitted either party to cancel the contract at will, as long as a 30-day notice was provided. Similarly, Bentley's press secretary said Alabama's contract with the provider "allow[ed] either party to terminate on 15 days written notice" (Wall Street Journal, 8/12).

NEJM Supports Planned Parenthood

In related news, the New England Journal of Medicine in a recent editorial expressed support for Planned Parenthood, Politico Pro reports.

NEJM in the editorial applauded Planned Parenthood for providing millions of people with health care services. In addition, NEJM praised Planned Parenthood for procuring and donating fetal tissue for medical research, noting the organization complies with all legal and ethical guidelines when doing so. "It is shameful that a radical antichoice group whose goal is the destruction of Planned Parenthood continues to twist the facts to achieve its end[s]," NEJM wrote (Mershon/Ehley, Politico Pro, 8/13).

Ga. Officials Say Abortion Providers Follow Law

In other related news, Georgia Department of Public Health Commissioner Brenda Fitzgerald said Wednesday that an investigation of five abortion providers in the state, including Planned Parenthood Southeast, has found no evidence that any of the providers are violating state law by donating fetal tissue, the AP/Washington Times reports.

According to the AP/Times, Georgia law requires fetal remains be cremated or buried. Gov. Nathan Deal (R) ordered the investigation last month following the release of the video series (AP/Washington Times, 8/12).


Quote Round Up: Reproductive-Rights Advocates Laud Medication Abortion Ruling, Blast Attacks on Planned Parenthood, More

Thu, 08/13/2015 - 14:32

Media outlets and key stakeholders in women's health comment on an Oklahoma Court ruling that blocks a law limiting medication abortion access, lambast efforts to defund Planned Parenthood and more.

Quote Round Up: Reproductive-Rights Advocates Laud Medication Abortion Ruling, Blast Attacks on Planned Parenthood, More

August 13, 2015 — Media outlets and key stakeholders in women's health comment on an Oklahoma Court ruling that blocks a law limiting medication abortion access, lambast efforts to defund Planned Parenthood and more.

"For women in Oklahoma, this ruling means they can access abortion methods that are best for them." -- Elizabeth Nash, senior state issues associate for the Guttmacher Institute, on a state court ruling to block a law (HB 2684) designed to restrict medication abortion access. The law requires physicians to administer medication abortion drugs according to FDA protocol and bans use of the method after 49 days of pregnancy, which goes against common medical practice (Women's Health Policy Report, 8/11).

"The recent attacks on Planned Parenthood ... lay bare the deep disconnect between the highly-charged political rhetoric deployed to defund clinics and deny women health care and the real-world health needs of women and their families." -- Neera Tanden, president of the Center for American Progress, in an MSNBC opinion piece discussing conservative lawmakers' efforts to defund Planned Parenthood (Women's Health Policy Report, 8/10).She writes that "the real irony of this backward tactic by anti-choice factions is this: Defunding Planned Parenthood wouldn't just limit women's right to abortion services; it would also prevent millions of women from accessing contraception that prevents unintended pregnancies, 40% of which end in abortion" (MSNBC, 8/8).

"There is not a justifiable medical reason for this restriction." -- Amesh Adalja, a Pittsburgh-based physician, writes in a Pittsburgh City Paper opinion piece debunking the claims behind telemedicine abortion bans. "Telemedicine is path-breaking technology that will revolutionize health care and improve access to care, control costs and open up whole new avenues for innovation. It must not be left susceptible to government interference that clearly vitiates the once-sacrosanct U.S. Constitution's principle of liberty," he writes (Women's Health Policy Report, 7/30).

"By ensuring full reproductive health access, the EACH Woman Act means every woman is able to make the important personal decisions that enable her to control her own destiny." -- Columnist Marlo Barrera, in an opinion piece for the Baton Rouge Advocate on how the proposed EACH Woman Act (HR 2972) would help women access the full range of reproductive health care. According to Barrera, "[t]he bill would ensure that every woman who receives health care or insurance through the federal government is provided with complete reproductive health care, including abortion care," and "prohibit politicians from interfering with decisions by private health insurance companies to provide this type of coverage in their health plans" (Women's Health Policy Report, 7/29).

"It is time to put the [antiabortion-rights] forces on the defensive for who they are and what they really stand for: Preventable deaths of healthy young women." -- Rita Henley Jensen, editor in chief of Women's eNews, on how "laws and policies that limit abortion's availability, especially for women and teens who need it most," are "literally killing us." She calls on abortion-rights supporters "to transform the political landscape to the point that being anti-choice is toxic for anyone running for public office" (Women's Health Policy Report, 7/28).

"This is the state of Wisconsin making pregnancy more dangerous for women." -- Nicole Safar, director of government relations at Planned Parenthood Wisconsin, on the myriad abortion restrictions that are driving Wisconsin residents across state lines to access abortion care. The state has several abortion restrictions -- including a 20-week abortion ban (Act 56) and a 24-hour mandatory delay before abortions -- and only four abortion clinics (Women's Health Policy Report, 7/27).

"Decisions regarding medical care -- including reproductive rights -- are appropriately between a patient and his or her medical professionals." -- Washington Attorney General Bob Ferguson (D), praising a decision from a panel of the 9th U.S. Circuit Court of Appeals that upheld a state law requiring pharmacies to dispense all medicine, including emergency contraception, regardless of whether owners have religious objections. Attorneys for the plaintiffs said they would appeal the decision either to the full 9th Circuit or to the Supreme Court (Women's Health Policy Report, 7/27).

"Today's decision reaffirms that the U.S. Constitution protects women from the legislative attacks of politicians who would deny them their right to safely and legally end a pregnancy." -- Nancy Northup, president and CEO of the Center for Reproductive Rights, on a ruling from the 8th U.S. Circuit Court of Appeals striking down North Dakota's fetal heartbeat abortion ban (HB 1456). The state has not yet decided whether to appeal the ruling (Women's Health Policy Report, 7/23).

"Women in this study overwhelmingly felt that the decision [to have an abortion] was the right one for them." -- Corrine Rocca of the University of California-San Francisco's Bixby Center for Global Reproductive Health and colleagues, on the findings in their PLOS ONE study. The researchers found "at all time points over three years, 95 percent of participants reported abortion was the right decision, with the typical participant having a greater than 99 percent chance of reporting the abortion decision was right for her" (Women's Health Policy Report, 7/14).

States Increasingly Penalize Pregnant Women for Drug Misuse

Thu, 08/13/2015 - 14:22

Some states are working to penalize pregnant women who misuse drugs, countering advice from medical groups that recommend treatment instead, the Daily Beast reports.

States Increasingly Penalize Pregnant Women for Drug Misuse

August 13, 2015 — Some states are working to penalize pregnant women who misuse drugs, countering advice from medical groups that recommend treatment instead, the Daily Beast reports.

In some cases, the states are responding to reported increases in drug misuse. For example, heroin use among U.S. adults ages 18 to 25 increased by more than two-fold over the last decade, according to CDC. Further, neonatal abstinence syndrome has also become increasingly prevalent over about the same time period, now affecting 3.39 per 1,000 hospital births, up from 1.2 in the past.

States Penalize Pregnant Women

CDC has suggested states respond to the increase by boosting access to substance use disorder treatment, but some states instead have tried to address the uptick in NAS cases by imposing criminal penalties on pregnant women who misuse drugs.

Overall, according to a report from the Guttmacher Institute, 18 states currently classify drug misuse by a pregnant woman to be a form of child abuse, and few of them overlap with the 19 states that have established or funded programs designed to treat pregnant women who misuse drugs. Specifically, 10 of the 18 states that classify drug use as a form of child abuse have not established drug treatment programs for pregnant women. Similarly, only six of the 15 states that impose mandatory reporting requirements for suspected drug misuse have funded or established such programs.

Meanwhile, some states have imposed additional penalties on pregnant women who misuse drugs. For example, Tennessee in 2014 became the first state to pass a law (SB 1391) designed specifically to penalize pregnant women who misuse drugs. Under the law, a pregnant woman who misuses certain drugs can be charged with aggravated assault, which can carry a prison sentence of 15 years. A woman was charged under the law weeks after it took effect, the Daily Beast reports.

According to the Daily Beast, five states have sought to pass measures similar to the Tennessee law. For example, in North Carolina, lawmakers advocated for a measure (SB 297) that would classify substance use by a pregnant woman as assault. Meanwhile, pregnant women also have faced charges under "fetal homicide" or "fetal harm" laws, many of which were designed to punish individuals who harmed pregnant women.

Separately, the Daily Beast reports that the Alabama Supreme Court in 2013 upheld the convictions of two women who had used drugs while pregnant, ruling that the women's drug use constituted "chemical endangerment of a child." Similarly, the South Carolina Supreme Court in 1997 held that substance misuse during a pregnancy "could be considered criminal child abuse."

Different Approach Advised

The American Congress of Obstetricians and Gynecologists and the American Civil Liberties Union, among other groups, have criticized the penalization of pregnant women for drug misuse.

For example, CDC and ACOG have urged states to reduce substance use among pregnant women through treatment programs instead. ACOG and ACLU also have noted that laws such as Tennessee's discourage women from seeking prenatal care rather than seeking substance use disorder treatment.

Similarly, the American Psychiatric Association in a 2001 position statement said that "societal resources (should) be directed not to punitive actions but to adequate preventive and treatment services for these [women] and children." In addition, the American Medical Association, which opposed the Alabama ruling, has argued against laws that criminalize substance use during pregnancy.

Ohio Program Focuses on Treatment

The Daily Beast highlights one new program in Cincinnati that will test all new mothers or infants for drugs and send women who test positive to treatment programs while providing continued care for their infants.

According to the Daily Beast, the program has spurred controversy among some advocates who support a screening program rather than mandatory testing. However, the Daily Beast reports that if such testing "can be effective anywhere, it would be in a state like Ohio where there are no criminal consequences for drug-using pregnant women, no mandatory reporting requirement, and state-funded treatment available for pregnant women" (Allen, Daily Beast, 8/12).


ACLU of Washington Calls On Hospital District To Comply With Reproductive Privacy Act

Thu, 08/13/2015 - 14:17

The American Civil Liberties Union of Washington State on Monday again called on San Juan County Public Hospital District No. 1 to comply with state law on providing abortion services, the Journal of the San Juan Islands reports.

ACLU of Washington Calls On Hospital District To Comply With Reproductive Privacy Act

August 13, 2015 — The American Civil Liberties Union of Washington State on Monday again called on San Juan County Public Hospital District No. 1 to comply with state law on providing abortion services, the Journal of the San Juan Islands reports (Smith, Journal of the San Juan Islands, 8/11).

Background

The state's Reproductive Privacy Act, adopted in 1991, says the state cannot deny or interfere with a woman's right to have an abortion. It also requires medical facilities in the state that provide maternity care to also offer abortion services.

In February, ACLU of Washington sent letters to three hospitals in the state. One of those hospitals, Jefferson Healthcare, subsequently approved a new reproductive health policy including abortion care. In addition, ACLU also filed a lawsuit against Skagit Regional Health, the third-largest public hospital district in Washington and the operator of several clinics and a large hospital, for allegedly not complying with the law (Women's Health Policy Report, 7/21).

ACLU Request

ACLU of Washington State in a blog post Monday reiterated its July letter to the hospital board of commissioners for San Juan County Public Hospital District No. 1, notifying them that the district's contract with PeaceHealth, a religiously affiliated health care provider, does not comply with RPA (Journal of the San Juan Islands, 8/11).

According to ACLU, San Juan County Public Hospital District No. 1 contracted with PeaceHealth to offer health care services, which are provided through Peace Island Medical Center (Bouchtia, ACLU of Washington State blog, 8/10). PIMC has stated that abortion services are not offered "in any PeaceHealth-owned, operated or leased facility" (Journal of the San Juan Islands, 8/11).

In the blog post, ACLU stated that PIMC "asserts that it offers prenatal services as well as 'ongoing pregnancy care' on site but consistently refuses to provide abortion services or even direct referrals to providers willing to provide abortion services," and thus the hospital district, via the contract with PIMC, is violating RPA (ACLU of Washington State blog, 8/10).

Further, ACLU stated, "Local access to reproductive healthcare is a particularly important issue to the San Juan community as San Juan Island is exactly that -- an island," adding, "The hospital district's failure to provide termination information and services limits reproductive health care access to women who already face barriers to care, including the isolated nature of the island and the costs of leaving (and returning to) the island to obtain care" (Journal of the San Juan Islands, 8/11).


Ariz. Health Official Files Emergency Rule on Fetal Tissue Donation

Wed, 08/12/2015 - 19:03

Cara Christ, director of the Arizona Department of Health Services, has submitted an emergency rule to the state attorney general's office that would require abortion clinics in the state to report on how they handle fetal tissue, Capitol Media Services/Arizona Capitol Times reports.

Ariz. Health Official Files Emergency Rule on Fetal Tissue Donation

August 12, 2015 — Cara Christ, director of the Arizona Department of Health Services, has submitted an emergency rule to the state attorney general's office that would require abortion clinics in the state to report on how they handle fetal tissue, Capitol Media Services/Arizona Capitol Times reports.

Background

Arizona Gov. Doug Ducey (R) last month called for a review of state statutes regarding fetal tissue after an antiabortion-rights group released a series of misleading videos that showed Planned Parenthood employees discussing fetal tissue donation.

Christ said during her review of state statutes, she found Arizona does not have any criminal statutes on the sale of fetal tissue, although the practice is prohibited under federal law. According to Christ, state statute only bans the use of fetal tissue resulting from an abortion in medical investigation and experimentation.

Proposed Rules

Christ said, under the proposed rule, abortion clinics would be required to submit reports on the final disposition of fetal tissue donations and any compensation received for the donations. According to Christ, the information would be included with reports that clinics are required to file for each abortion procedure.

Christ noted that if DHS believes any of the information is inaccurate, the agency would confer with the state attorney general's office about whether to launch an investigation.

According to Christ, clinics that violate the proposed rule by failing to submit the information could risk closure. However, she said criminalizing fetal tissue sale under Arizona law likely would require action from the state Legislature.

Next Steps

Christ said she would like to enact the rules on an emergency basis, which would mean they could take effect without prior public comment.

According to Christ, emergency rules can take effect for only 180 days and cannot be renewed more than one time. She said after that point, the Legislature likely would need to authorize DHS action (Fischer, Capitol Media Services/Arizona Capitol Times, 8/10).

Planned Parenthood Responds

Bryan Howard, president of Planned Parenthood of Arizona, said the organization does not provide fetal tissue donations. "It's not because we don't support it," he said, adding, "It's never been on our radar. It has been an all-consuming job just to focus on birth control and cancer screenings and the other preventive services that this state doesn't fund" (Fischer, Capitol Media Services/KJZZ, 8/10).

According to Howard, PPA will assess whether to challenge the emergency rule once it has been released, depending on how many additional reporting burdens it imposes on the clinics (Capitol Media Services/Arizona Capitol Times, 8/10).


Judge Lifts Restraining Order on Tenn. Antiabortion-Rights Law

Wed, 08/12/2015 - 19:03

A federal judge on Monday conditionally lifted a restraining order that prevented Tennessee officials from enforcing an antiabortion-rights law (Pub. Ch. 419) requiring new licenses for clinics that provide abortions, The Tennessean reports.

Judge Lifts Restraining Order on Tenn. Antiabortion-Rights Law

August 12, 2015 — A federal judge on Monday conditionally lifted a restraining order that prevented Tennessee officials from enforcing an antiabortion-rights law (Pub. Ch. 419) requiring new licenses for clinics that provide abortions, The Tennessean reports (Wadhwani, The Tennessean, 8/10).

Background

The law, which was scheduled to take effect on July 1, would require all facilities or physician offices that perform more than 50 surgical abortions annually to be licensed as ambulatory surgical centers.

Four of the six abortion clinics in the state that provide surgical abortions currently meet the licensing standards, while a fifth provider, in Knoxville, only provides medication abortion and therefore is not subject to the requirement. Bristol Regional Women's Center and the Women's Center in Nashville are the two remaining clinics that provide surgical abortions and are not licensed as ambulatory surgical centers.

Lawsuit Details

The Center for Reproductive Rights in June filed a lawsuit against three antiabortion-rights laws, including the ambulatory surgical licensing requirement, on behalf of three abortion clinics and an ob-gyn in the state. CRR filed suit on behalf of the Bristol and Nashville clinics; CHOICES, the Memphis Center for Reproductive Health; and Wesley Adams, an ob-gyn who provides abortion care at the Bristol and Nashville clinics (Women's Health Policy Report, 7/13).

The other antiabortion-rights laws challenged in the lawsuit include a 2012 statute requiring physicians who provide abortion care to have admitting privileges at a nearby hospital. According to CRR's lawsuit, two clinics have closed under the law. Meanwhile, the third contested law (SB 1222), which took effect July 1, imposes a mandatory delay and requires that women receive in-person counseling from a physician prior to having an abortion, forcing women to make an additional trip to the clinic prior to the abortion procedure (Women's Health Policy Report, 7/26).

CRR asked the court to block the ambulatory surgical center requirement while the lawsuit against all three laws continues. According to lawsuit, the Bristol and Nashville clinics risk closure because they do not meet the ambulatory surgical center standards.

U.S. District Judge Kevin Sharp in June blocked the ambulatory surgical center requirement and in July extended the restraining order, allowing the two clinics to remain open (Women's Health Policy Report, 7/13).

New Developments

On Monday, Sharp lifted the order after the clinics and state licensing officials began work toward approving the clinics' licenses. However, he indicated that he could revisit his decision as soon as Thursday.

Separately, Scott Tift, an attorney representing the clinics, said physicians at the two clinics were concerned that they could be prosecuted if the local district attorneys filed criminal charges against them for violating the new law. "The concern on the part of these doctors is about the potential to lose their licenses or be charged with a crime," he said.

Meanwhile, Steven Hart, special counsel with the Tennessee attorney general's office, said, "There is no indication either of the district attorneys are intending to prosecute."

Sharp on Monday allowed the plaintiffs to amend their lawsuit to include the district attorneys in Nashville and Sullivan Counties, where the two affected clinics are located, and to ask them to formally state that they will not prosecute the physicians. Sharp said he would reassess his decision during an emergency hearing on Thursday if the district attorneys do not agree to submit such statements (The Tennessean, 8/10).