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Ohio clinics continue efforts to meet TRAP requirement

Abortion clinics in Ohio are continuing to seek variances to state patient transfer agreement requirements that clinics say do not improve and may ultimately impede access to care, the Dayton Daily News reports (Wedell, Dayton Daily News, 11/15).

State regulations

Ohio's 2014-2015 budget (HB 59) included a requirement for abortion clinics in the state to have a patient transfer agreement with a hospital. Public hospitals are prohibited from entering into such agreements with abortion clinics. Gov. John Kasich (R) last year signed a state budget (HB 64) that required abortion clinics to arrange a patient transfer agreement with a hospital no more than 30 miles away or request a variance from the requirement.

The law also requires the state health director to grant or deny a clinic's variance request within 60 days. Clinics unable to obtain a variance within 60 days are required to close, although they are permitted to reopen if they obtain approval at a later time. If the clinic's variance request is denied, its operating license is automatically suspended (Women's Health Policy Report, 5/31).

Court rules transfer agreement unconstitutional

In July, an Ohio appellate court in a unanimous ruling agreed with a lower court decision that found the requirement to be unconstitutional. The case involved Capital Care clinic in Ohio.

Applying standards set forth in a recent Supreme Court ruling striking down targeted regulations of abortion providers in Texas, the Ohio court found that the Ohio transfer agreement provision imposed a burden on abortion care that outweighs the regulation's purported benefits. The court stated, "The need to transport a patient from Capital Care to a hospital for treatment is just about nonexistent." In contrast, by closing the Toledo clinic, the regulation would force a woman to have to travel for abortion care, which would cause her to incur additional expenses. Further, the court noted that "the influx of these patients to alternate clinics may be onerous and burdensome to the existing patient base."

The Ohio attorney general appealed the decision (Women's Health Policy Report, 8/1).

Women's Med Center of Dayton

Last month, the Ohio Department of Health (ODH) denied a variance request from a different clinic in the state, Women's Med Center of Dayton, which is the area's sole abortion clinic, the Daily News reports.

According to the Daily News, ODH last year told the clinic it must have contracts with at least three physicians. The clinic's latest application included three contracts, but Ohio Director of Health Richard Hodges denied the request, claiming that the contracts did not "provide the same level of patient health and safety that a written transfer agreement with a local hospital assures for 24/7 backup coverage."

Despite the variance denial, the health department website states that Women's Med Center's operating license remains active. However, the clinic is in the process of an administrative appeal following the state's move last year to revoke its license. A hearing administrator in September recommended the state proceed with the revocation because of the transfer agreement requirement.

Nonetheless, Melanie Amato, an ODH spokesperson, said while the state could proceed with the revocation, there is "no time frame to act on the hearing officer's recommendation."

Separately, Jennifer Branch, an attorney for Women's Med, said the clinic likely would challenge a license revocation in court (Dayton Daily News, 11/15).

Founders Women's Health Clinic

In related news, ODH on Friday rejected Founder's Women's Health Clinic's variance request, the Columbus Dispatch reports.

Founder's previously held a patient transfer agreement with Grant Medical Center. Earlier this year, Grant refused to extend the agreement without citing a reason. According to the Dispatch, the only other clinic in central Ohio, a Planned Parenthood facility, has a long-standing transfer agreement in place with Grant.

Following Grant's decision, Branch, who also represents Founder's, on Sept. 14 wrote to ODH to seek a variance. Branch in her application wrote that the clinic had tried to establish a patient transfer agreement with all local hospitals without success.

Hodges said he would reconsider Founder's variance request if the clinic adds a third doctor to its staff. Currently, the clinic has two doctors, both of whom have admitting privileges at nearby hospitals.

Branch said Founder's will resubmit the request.

NARAL Pro-Choice Ohio denounces requirements in light of SCOTUS ruling

Citing the U.S. Supreme Court's ruling in the Texas case, Kellie Copeland, executive director of NARAL Pro-Choice Ohio, noted that the high court has found transfer agreements and variances to be "an undue burden on access to abortion care and do not improve women's health" (Johnson, Columbus Dispatch, 11/15).

Copeland stated, "These sorts of regulations are not being used to improve women's health." She added, "They are trying to use them as a way to sneak around the constitution and try to limit access to abortion" (Dayton Daily News, 11/15).