April 18, 2014

Senate GOP asks Democrats to bring up tele-med abortion ban

Republicans are asking for a vote in the legislature to ban tele-med abortions.

Republicans are asking for a vote in the legislature to ban tele-med abortions.

Republicans in the Iowa Senate are calling on the Senate’s Democrats to help advance a bill that would ban so-called tele-med abortions — and key Democrats, in return, say they won’t join what they call the GOP’s “war on women.”  Senator Amy Sinclair, a Republican from Allerton, says that’s offensive.

“Trying to protect the life and well-being of women by banning a procedure that doesn’t even meet a humane standard of care is a war on women? Seriously?” Sinclair said during a statehouse news conference. “Honestly, that statement doesn’t even deserve an intelligent response.”

The Iowa Board of Medicine voted last year to forbid doctors from remotely dispensing abortion-inducing drugs via a video-conferencing system. Planned Parenthood of the Heartland has challenged that decision in court, so the ban has not taken effect. In February, the Republican-led Iowa House voted to ban telemedicine abortions and Senator David Johnson, a Republican from Ocheyedan, said there are Democrats in the senate who would vote to ban tele-med abortions, although he’s not naming names.

“We know that this is not health care because we don’t hear from that third person in this decision and that’s the unborn child,” Johnson said during today’s news conference.

The House bill to ban tele-med abortions is not eligible for senate debate, as it did not clear a senate committee by last Friday’s deadline. Therefore, it would require the drafting of another bill — cosponsored by the Republican and Democratic leaders of the senate — to have the senate consider the issue. Senator Joe Bolkcom, a Democrat from Iowa City, issued a written statement, saying the ban denies rural women access to “affordable, safe” abortion services.

Iowa House votes to ban “tele-med” abortions

The Iowa House has passed a bill that would forbid doctors from remotely dispensing abortion-inducing drugs via a video-conferencing system. Representative Kevin Koester, a Republican from Ankeny, was among the 55 House members who voted for the bill.

“I support this bill for many reasons, primarily due to the unsafe practice that impacts the use of this technique for terminating pregnancies in our state,” Koester said during today’s debate of the bill.

Representative Beth Wessel-Kroeshell, a Democrat from Ames, disagreed.

“First night of debate in the Iowa House for this session and what do we have?” she asked. “A bill that’s limiting a woman’s right to choose.”

The bill is not likely to be considered in the Iowa Senate where Democrats control the debate agenda. The Iowa Board of Medicine voted last year to ban so-called tele-medicine abortions, but that decision is being challenged in court by Planned Parenthood of the Heartland. A judge issued a temporary injunction which has prevented the Board of Medicine’s ban from going into effect.

Judge temporarily halts rule banning tele-med abortions

A judge has placed a temporary hold on a proposed Iowa Board of Medicine rule that would ban doctors from dispensing abortion-inducing pills via a video-conferencing system at 15 Planned Parenthood clinics in Iowa.

The rule was scheduled to go into effect Wednesday, but Polk County District Court Judge Karen Romano today issued a temporary stay that prevents it from taking effect. In her 16-page ruling, Romano called the Board of Medicine’s rule “peculiar” because it requires in-person meetings between a doctor and a patient for a chemical abortion, but not for other tele-medicine practices in Iowa.

The judge also said she “strains to understand how decreasing the number of apparently safe abortion services offered” in Iowa protects the health and safety of Iowa women. The judge wrote that denying access to abortions-by-prescription early in a pregnancy would increase the need for “more invasive and risky” surgical abortions and might prompt some women to choose to “self-terminate their pregnancies…which is…the least safe” option of all.

The Board of Medicine voted 8-2 in August to ban so-called “tele-med” abortions and require a physician to conduct a physical exam of the patient and personally hand her the prescription drugs that would end her pregnancy. Under the video-conferencing system, the doctor presses a button to open a drawer in the room that contains the pills. Critics say that doctor should be the one to conduct the physical exam and talk face-to-face with the patient.

Planned Parenthood of the Heartland officials say they’ll no longer offer medication abortions at 10 of their clinics if the rule goes into effect.

The judge’s temporary injunction will remain in effect as the lawsuit makes its way through the state’s court system.

Lawyers argue lawsuit over telemed abortion ban

A judge heard the lawyers’ arguments Wednesday in a case involving so-called “webcam” abortion services in rural Iowa.

Planned Parenthood is challenging an Iowa Board of Medicine rule that will put a stop to medication abortions in which a doctor gives the prescription to the patient over a video conferencing system. Planned Parenthood attorney Sharon Malheiro said 10 rural clinics will quit offering medication abortions if the rule goes into effect November 6.

“If implemented, this rule will adversely impact the ability of women to have access to early, lawful abortion services,” she told the judge. “…The sole purpose that is to prevent women in rural areas of Iowa from receiving timely access to a procedure that is safe, effective and no different from similar telemedicine services which continue to be permitted.”

Deputy Attorney General Julie Bussanmus spoke on behalf of the Board of Medicine.

“The board set practice standards for physicians using abortion-inducing drugs to protect the health and safety of women,” Bussanmus told the judge.

The rule would require a doctor to conduct a physical exam of a woman before handing her the prescription drugs that cause an abortion during the early weeks of a pregnancy.

“While this is a politically charged and divisive topic, the issue here is not a debate on the policy of abortion, the politics of abortion, the court’s beliefs on abortion or the board members’ beliefs on abortion,” Bussanmus said.

The judge said she will decide by next Tuesday whether to issue a temporary injunction that would prevent the rule from going into effect until the case makes its way through the court system.

Legislative panel rejects idea of delaying ban on so-called “telemed” abortions (AUDIO)

A legislative committee this afternoon voted down an attempt to delay rules from the Iowa Board of Medicine that are scheduled to forbid so-called “telemed” abortions, starting a month from now.

“I am not a doctor,” said Senator Mark Chelgren, a Republican from Ottumwa. “I don’t pretend to be one, but I do respect the decision of this board on what they’re trying to accomplish.”

The legislature’s Administrative Rules Review Committee voted along party lines to reject a Democrat’s bid to delay the rules until January. Senator Tom Courtney, a Democrat from Burlington, said if doctors cannot prescribe abortion-inducing pills via a video-conferencing system, then doctors should not use telemedicine links to prescribe “terrible, big time drugs” to heart attack or stroke victims.

“I don’t see the difference, other than the fact that I won’t be having an abortion because 66-year-old men don’t have abortions,” Courtney said.

Representative Dawn Pettengill, a Republican from Mount Auburn who is chairwoman of the Administrative Rules Review Committee, told Board of Medicine executives the issue was emotional for her.

“I’m really happy that you’re doing this,” she said.

Jeanine Freeman of the Iowa Medical Society told lawmakers Iowa doctors are concerned the board is imposing a disciplinary rule written by a “silent author” and included in a petition to the Board of Medicine.

“We have no idea the expertise of the party that wrote this rule,” Freeman said. “We have no idea of what was considered in terms of writing this rule and its consistency or inconsistency with medical practice standards or other criteria that might be appropriate.”

Planned Parenthood of the Heartland has filed a lawsuit, trying to get the courts to block the ban so Planned Parenthood doctors may continue prescribing medication abortions over a video connection. Sharon Malheira, Planned Parenthood’s lawyer, urged legislators to block the rule.

“There was no evidence submitted to the Board of Medicine that Planned Parenthood’s telemedicine delivery system is unsafe,” Malheira said. “In fact, the evidence is to the contrary and the new rule would cause harm to Iowa women.”

Malheira argued rural Iowa women will find it more difficult to obtain a medication abortion and be forced to wait to schedule a more complicated surgical abortion.  The Board of Medicine held a lengthy public hearing in late August and then the board voted in September to adopt the new rule, which will go into effect November 6 if the courts don’t intervene.

AUDIO of 54-minute discussion of rule during AARC meeting

Planned Parenthood seeks court review of rule banning telemed abortions

Planned Parenthood of the Heartland has filed a request for judicial review of the decision of the Iowa Board of Medicine to adopt a rule that prevents Planned Parenthood from prescribing medical abortions via a video-conferencing system.

Planned Parenthood attorney, Sharon Malheira, says they are asking the court to review three issues regarding the decision on the rule. “We’re saying that their action is inconsistent with the agency’s prior practice or precedent without credible reasons sufficient to indicate a fair and rational basis for the inconsistency. And by that we mean, in 2010  this process was reviewed by the Board of Medicine — very thoroughly I might add –  and they felt there was no reason to have any restrictions on the rule,” Malheira says.

She says a second point alleges the decision was political. “We are also claiming that the actions of the board were motivated by an improper purpose,” Malheira says. “And that is that they were being guided more by ideology and philosophy as opposed to  fact-based medicine.”

And the final point she argues involved the constitutionality of the tele-med abortion ban. “Actions of the board are violating Planned Parenthood and their patient’s  constitutional rights under Article one of the Iowa Constitution for liberty, equality and due process. And then finally, that the actions violate the  equal protection and due process clause of  the United States Constitution,” Malheira says.

The procedure has a doctor dispense abortion pills to the patient via a video link. The request for review also includes a request that the court prevent the rule banning the procedure from being carried out until the court decides if the Board of Medicine’s action was proper. “Our argument is that it would be more appropriate to stay the implementation of the rule because Planned Parenthood has been performing these medical services for the last five years and there is not evidence that there is anything improper, or that there is any harm to the patients,” Malheira explains.

The board voted 8-2 for the ban on August 30th, with the majority of the board’s members arguing the best standard of care for women seeking an abortion is to have a doctor do a physical exam and talk face-to-face with the patient. Malheira says she expects a decision on the stay of the rule sometime next week. She says if they are not granted a stay of the rule, she would likely seek an expedited case.

Malheira says as long as the rule is in place they have clients who will not be served.


Board of Medicine votes to ban “tele-med” abortions in Iowa (AUDIO)

Monsignor Frank Bognanno, (on right), speaks to the board.

Monsignor Frank Bognanno, (on right), speaks to the board.

The Iowa Board of Medicine has given final approval to a rule that will forbid Planned Parenthood of the Heartland from prescribing medication abortions via a video-conferencing system. 

“This is a big deal,” said Monsignor Frank Bognanno, a public member of the board. “This isn’t like taking an aspirin.”

The majority of the board’s members argued the best standard of care for women seeking an abortion is to have a doctor do a physical exam and talk face-to-face with the patient.

Bognanno said he’s concerned certified medical assistants have been doing some of the ultrasounds and physical exams before the remote video conference with a doctor.

“I’m thinking: What’s wrong with this picture? I mean is this standard of practice? I mean, this is Iowa. This isn’t Tanzania, you know,” Bognanno said. “What’s going on here?”

Dr. Greg Hoversten of Iowa City, the board’s chairman, opened the board’s nearly hour-long discussion of the issue by indicating he would vote for the ban.

“How can any of us possibly find that a medical abortion performed over the internet is as safe as one provided by a physician in person, at the bedside?” Hoversten asked.

Eight members of the board voted to adopt the rule. Two members voted against it. Ann Gales, a lawyer from Bode who is a public member of the board, argued for “more examination” of the issue.

“I’m concerned about kind of the reputation of our board…and a lot of people have a concern that we’re rushing to this,” she said. “If this is the right rule, it will still be the right rule after we engage in a more thorough discussion.”

AUDIO of board discussion, runs 48:37

Based on state government’s rule-making process, this ban on so-called “tele-med” abortions could take effect in early November. However, a lawyer for Planned Parenthood told reporters after the board’s decision that “all options are on the table,” and that includes legal action to try to prevent the rule from taking effect.