Medical abortion services at the Columbia, Missouri Planned Parenthood clinic are under threat, due, in part, to political pressure from the Missouri legislature. This clinic is one of only two places in the state where a woman can get an abortion, but following an announcement made by the University of Missouri Health Care system last Thursday, they may not be available for much longer.
University of Missouri Health Care (known as MU Health Care) announced it was eliminating a category of physician privileges known as “refer and follow” as of December 1, 2015. Without these privileges—which allow a doctor to refer patients to the hospital when necessary—the Planned Parenthood clinic will lose its license to perform abortions.
Medical abortions were made available here this August for the first time since 2012, after Planned Parenthood’s Dr. Colleen McNicholas went through a lengthy credentialing process to receive these hospital privileges.
Missouri state law requires an abortion provider to have a formal relationship with a hospital within 15 minutes driving time and/or 30 miles of the clinic.
A spokesperson for MU Health Care, Teresa Snow, said this was an administrative decision that could “improve the privilege-granting policy and procedures.”
"We were outraged that an independent university, an institution of higher learning, would cave to political pressure."
But Laura McQuade, the President and CEO of Planned Parenthood of Kansas and Mid-Missouri, argues that the decision is a result of pressure from the state legislature.
She points out that the elimination of "refer and follow" privileges only affects two physicians on the MU Health Care staff, and one of them is Dr. McNicholas. Now, the Planned Parenthood clinic will have to start the credentialing process again – it took six months the first time, but McNicholas only has until December 1, 2015, to obtain new privileges.
“We were outraged that an independent university, an institution of higher learning, would cave to political pressure, and in their own press release would cite that this was prompted by Kurt Schaefer's Sanctity of Life committee,” McQuade said.
The committee she’s referring to is the Senate’s Interim Committee on the Sanctity of Life that was created in July to examine the two Planned Parenthood facilities in Missouri – both the Columbia clinic and the St. Louis clinic. Since the committee first convened, members have been calling for the University of Missouri to cut ties with Planned Parenthood.
MU Health Care's news release about the elimination of privileges acknowledges that the change was “prompted by inquiries from various members of the legislature and public.”
Republican Lawmakers Celebrate MU’s Action
Members of the state senate’s Sanctity of Life committee say they are pleased with the university’s decision.
“You know, I think the university absolutely did the right thing in reviewing that and making a determination that that’s not appropriate for the university,” said State Senator Kurt Schaefer who is the chair of the committee. “And for whatever reason they made the determination – I’m glad they're getting out of the abortion business.”
Schaefer is also the chair of the Senate appropriations committee, which monitors and makes recommendations on all state spending – including funding for higher education.
Schaefer is running for Attorney General and his election campaign issued a press release on September 24 declaring “Schaefer secures victory for unborn,” as a response to the University’s decision to withdraw “abortion doctor privileges.”
Senator David Sater, the co-chair of the Sanctity of Life committee, said he was “thrilled” to hear about MU Health Care’s decision. He said the committee wanted to ensure state laws were being followed properly.
“We just didn't want any taxpayer money, which goes from the State of Missouri to the University of Missouri, supporting Planned Parenthood,” Sater said.
"I'm glad they're getting out of the abortion business."
An Argument Over Credentials
MU Health Care’s Teresa Snow said in a written statement the decision to eliminate “refer and follow” privileges was made because this specific type of privileges are no longer necessary for physicians to follow the progress of their admitted patients.
“Today, any healthcare provider can refer patients to our facility and follow their progress,” she wrote. “This type of access does not require the provider to hold any privileges at MU Health Care facilities.”
Planned Parenthood’s McQuade criticized this comment. If this category of privileges was outdated and unnecessary, McQuade asks why Dr. McNicholas was not “grandfathered in” or “shifted to another category of clinical privileges.”
“She had met all of the standards and requirements put out by MU [University of Missouri],” McQuade said.
Because state law requires any clinic offering abortion services to have admitting privileges before it can be licensed, revoking the privileges guarantees the Columbia Planned Parenthood will lose its license to perform abortions unless it can get another hospital to grant them.
There is only one other hospital, Boone County Hospital, that meets these requirements for the Planned Parenthood clinic in Columbia.
Planned Parenthood's McQuade said they are doing everything they can to get new privileges for Dr. McNicholas – either a different category of privileges through MU Health Care, or through Boone County hospital.
“We will attempt to do all that we can to ensure that we will have alternative privileges for our doctor on December 1,” McQuade said.
She added that Planned Parenthood will begin the application process as soon as possible, but there is no guarantee privileges will be reinstated by the beginning of December. This means Missouri women could once again live in a state with a single provider.
Snow has said the University of Missouri Health Care system would be open to receiving and reviewing new applications for different types of privileges from the doctor at Columbia’s Planned Parenthood clinic.
A Public Response
On Tuesday, following this decision, about 1000 people gathered on the University of Missouri campus in support of Planned Parenthood. While the event was a part of the national “Pink Out Day,” Laura McQuade said last week’s decision sparked additional local interest.
It also came to light in September that the University had canceled contracts with Planned Parenthood for medical and nursing students to do optional rotations at the clinic.
”I think that this community feels let down by the University,” McQuade said.
The Planned Parenthood clinic and those supporters who gathered had several demands for the University.
“We would like Dr. McNicholas's privileges to be reinstated,” McQuade said. “We would like our contracts with the school of nursing and the medical school to be reinstated. We would like a public apology for this behavior.”
McQuade added that the Planned Parenthood clinic is debating filing a complaint through the federal Department of Health and Human Services, but does not have the ability to sue the University over this decision – to eliminate “refer and follow” privileges – at this time.
