A federal judge on Wednesday ruled that Missouri may not revoke the license of a Planned Parenthood clinic prior to its expiration, saying the state's move to revoke the license likely was motivated by "political pressure," the AP/Sacramento Bee reports (Ballentine, AP/Sacramento Bee, 5/11).
Background
Under Missouri law, abortion clinics are required to meet ambulatory surgical center requirements. To meet those requirements, physicians who provide surgical abortions must have admitting privileges with a nearby hospital.
In 2014, University of Missouri Health Care granted "refer and follow" privileges to Colleen McNicholas, a physician who began providing medication abortions at the Columbia-based Planned Parenthood of Kansas and Mid-Missouri's (PPKM) clinic on Aug. 3, 2015.
In August 2015, conservative state senators and the health department director in Missouri debated at a hearing whether the Columbia clinic met state licensing requirements when it received its license in July 2015. During the hearing, state Sen. Kurt Schaefer (R) -- chair of the Missouri Senate Appropriations Committee, as well as an interim committee investigating Planned Parenthood -- said the clinic failed to meet the ambulatory surgical center standards because the clinic's abortion provider does not have admitting privileges. However, Gail Vasterling, director of DHSS, said the standard does not apply because the clinic only provides medication abortions, not surgical abortions. Physicians at the clinic or the clinic itself would need to obtain admitting privilege requirements only if the clinic started to offer surgical abortion.
Following a unanimous vote by a committee of executive staff, MU Health Care announced that it would cease refer and follow privileges, which permit physicians to provide medication abortions, beginning Dec. 1, 2015.
The Columbia clinic on Nov. 23, 2015, stopped offering abortion care in anticipation of McNicholas losing her privileges. MU interim Chancellor Hank Foley said he would support MU Health Care's decision to end refer and follow privileges. McNicholas currently is seeking other privileges at MU Health Care.
In December 2015, U.S. District Judge Nanette Laughrey issued a ruling that blocks DHSS from revoking the clinic's license until the lawsuit over the clinic's licensure is resolved. In her ruling, she stated that PPKM was subject to unfair treatment because it provides abortion care, and that revoking the clinic's license would cause irreparable harm. The Missouri Attorney General's office appealed the ruling.
Hearing details
At a hearing last week, attorneys representing Planned Parenthood said the court should issue a permanent injunction against state officials because the state's actions were politically motivated and violated state licensure laws and Planned Parenthood's right to due process.
Melissa Cohen, an attorney for Planned Parenthood, added that the state did not give the clinic time to find a physician. She noted that the state had allowed another clinic, the Surgical Center of Creve Couer, several opportunities to address issues when the state sought to revoke that clinic's license. Further, according to Cohen, Planned Parenthood is not requesting for the license to be extended past its expiration date, which is June 30.
James Layton, an attorney with the state attorney general's office, at the hearing said the state had notified the clinic of the license revocation in October and the clinic had not yet proposed a plan for correction (Women's Health Policy Report, 5/3).
Ruling details
In Wednesday's ruling, Laughrey wrote that the department's actions "likely were the result of political pressure being exerted by Missouri legislators and the Department's perception that if it did not act in accordance with the legislature's desires, its budget would be cut."
Laughrey stated that the "disparate treatment" of the clinic "cannot be justified by political pressure or public opposition." Further, she noted differences between the state's handling of the Planned Parenthood case and the state's actions in the only other case where it sought to revoke an ambulatory surgical center's license. She noted that the department gave the other facility time to submit a correction plan and return to compliance before the state acted.
Per Laughrey's ruling, the clinic may keep its license until it expires in June.
PPKM CEO Laura McQuade said the ruling confirms that Missouri "unfairly targeted Planned Parenthood and its staff for providing safe, legal abortion" (AP/Sacramento Bee, 5/11).
