Lawsuits Filed to Challenge “Conscience Rule.”
On May 21, 2019 the Trump administration published its final health care refusal rule in the Federal Register. The final rule seeks to significantly expand the ability of health care providers to withhold treatment counseling or medical information based on their religious or moral beliefs-without any regard for the needs of patients. California Attorney General Xavier Becerra has filed a lawsuit challenging this new rule. New York, along with 18 other states and the District of Columbia, also filed a lawsuit in the Southern District of New York, seeking to block the rule from taking effect. Two separate lawsuits were filed by the city of San Francisco as well as a coalition of civil rights groups in coordination with Santa Clara County.
CA Makes Moves to Expand Access to Essential Health Care Services
California is pushing forward to expand access to health care and improve health outcomes across the state. Earlier this month, Governor Newsom embarked on a “California for All” tour, including a stop in San Diego to reaffirm the state’s commitment to ensuring that Californians can get the sexual and reproductive health service they want and need. The event also celebrated the pending historic state investment of $100 million to support augmented payments for family planning services provided to patients enrolled in Family PACT and Medi-Cal and the state’s commitment to expanding Medi-Cal eligibility to more low-income Californians, and for STD and HIV prevention. The Legislative Budget Conference Committee has been set, and the final budget was sent to the Governor for signature in June.
CITIZENS FOR CHOICE POSITIONS ON LEGISLATION – 2018
(Legislation was supported unless otherwise noted.)
SELECT COMMITTEE ON WOMEN’S REPRODUCTIVE HEALTH ANNOUNCES INVESTIGATIVE HEARINGS INTO FEDERAL GOVERNMENT POLICIES
March 6, 2019
SACRAMENTO—Today, Assemblymember Rebecca Bauer-Kahan (D 16) announced the first hearings of the newly created Select Committee on Women’s Reproductive Health will focus on the federal government’s attack on reproductive health.
“The new Select Committee on Women’s Reproductive Health is going to shine a light on the federal government’s attempt to dismantle the reproductive health safety net,” said the Chair of the Select Committee, Assemblymember Rebecca Bauer-Kahan. “Reproductive health care is health care. I am honored to have the opportunity to chair the Select Committee on Women’s Reproductive Health. I look forward to working with my colleagues in the Assembly and reproductive health care providers and advocates, like Planned Parenthood, to ensure that California is able to protect and expand access to essential health care services.”
The formation of the Assembly Select Committee on Women’s Reproductive Health comes at a crucial time. Reproductive health care continues to be under threat from the Trump Administration. Most recently, publishing the Title X Gag Rule that will harm doctors and health centers that provide abortion care, announcing the proposed “public charge” rule that closes legal paths to citizenship if immigrants purse health care, and the attempted rollback of birth control coverage under employer insurance.
“I am proud to support the creation of the Assembly Select Committee on Women’s Reproductive Health. As the federal government works to roll back reproductive rights, in California we are moving forward,” said Speaker of the Assembly Anthony Rendon. “Access to reproductive health care will give more Californians the opportunity to plan their families, contribute to their communities, and reach for their dreams.”
The Select Committee is already planning an investigative hearing in June to discuss the public health ramifications and consequences of the Title X Gag Rule and other dangerous federal proposals.
“While the Trump Administration gags and defunds—the California Legislature delivers,” said Crystal Strait, President & CEO of Planned Parenthood Affiliates of California. “Access to comprehensive reproductive health care is essential to overall health and wellbeing. Planned Parenthood is excited about the creation of the Assembly Select Committee on Women’s Reproductive Health and is thankful for California’s bold leadership to advancing reproductive health care.”
HR 9 (Burke) International Day of Maternal Health and Rights (ADOPTED 4/02/2018)
Assembly Resolution to declare April 11 International Day of Maternal Health and Rights, and urging the United Nations to officially recognize the day to show its support for universal, comprehensive, respectful and rights-based maternal health. The commemorative day was launched in 2014 by the Center for Health and Gender Equity, and is supported by a consortium of maternal health organizations, including the International Planned Parenthood Federation.
Ensures that foster youth and non-minor dependents have access to gender-affirming health and behavioral health care.
AB 2153 (Thurmond, Gonzales-Fletcher) LGBTQ Cultural Competency Training for Teachers and Staff (VETOED 9/30/2018)
Would give teachers and school staff the training they need to provide culturally competent support for lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ) students who may be facing harassment or lack of acceptance at school, rejection at home, or discrimination in the broader community – subject to appropriation of funds.
AB 2719 (Irwin) Recognizing the Needs of LGBTQ Older Adults (BECAME LAW 8/24/2018)
Ensures that lesbian, gay, bisexual, transgender, and queer (LGBTQ) older adults are recognized as a population in need of special attention, and that they can access the services and support they need to maintain their health and live their lives with dignity.
AB 2289 (Weber) Young Parents Right to Education Act (BECAME LAW 9/30/2018)
Mandates parental leave to young parents still in school, and provides mandatory guidelines for make-up plans or independent study to ensure students can return to their school and classes with minimal academic interruption. The bill designates parental leave as a protected time of 6 weeks for the birthing parent (8 weeks for complications/cesarean) and 4 weeks for the parenting partner. It aims to increase young parent high school graduation rates and support their need to bond with their new child.
AB 2601 Sex Ed in Charter Schools (Weber) (BECAME LAW 9/18/2018)
Extends the California Healthy Youth Act requirements regarding comprehensive sexual health education to charter schools. California now has 1,275 charter schools, serving 10% of California’s student population. Currently, charter schools are not required to provide the quality, comprehensive sex education mandated for public school students. The bill provides significantly more flexibility than for the state’s public schools, e.g., for curriculum and grades of instruction. Public schools must provide comprehensive sexual health and HIV prevention instruction to all students in grades 7 to 12, at least once in middle school and once in high school.
AB 2682 (Burke) Improving Access to Quality Maternity Care (expand access to Certified Nurse
Midwives) (FAILED TO MOVE IN SENATE COMMITTEE)
The bill would expand access to midwifery care and patient autonomy in choosing reproductive health providers, for care from family planning to birth. It would help address California’s current problem of lack of providers for maternity care.
SB 320 (Leyva) College Student Right to Access: providing medication abortion (VETOED 9/30/2018)
Would require California public university on-campus student health centers to provide medication abortion. It applies to University of California and California State University campuses. The requirements are phased in, becoming fully applicable by January 1, 2022. Presently, most public colleges and universities do not offer on-campus medication abortion services. (Medication abortion is effective up to 10 weeks of pregnancy.) Would establish a medication abortion fund, to be administered by the state Treasurer and an advisory council whose members s/he appoints, to allow for private money grants to on-campus student health centers at public and private colleges and universities, with priority given to public universities. Implementation is contingent on the sufficiency of private funding to cover all costs, for which universities have no obligation to provide General Fund or student fee funding. (An earlier version of the bill also covered community colleges.)
SB 1023 (Hernandez) Mobile telehealth reproductive health coverage (HELD ON THE ASSEMBLY FLOOR, BUT EXPECTED TO BE PARTIALLY IMPLEMENTED ADMINISTRATIVELY)
SB 1023 seeks to expand access to sexual and reproductive health services, including contraception and STD testing, prevention, and treatment, by enhancing coverage for those services through mobile telehealth technologies like video, phone and smartphone applications. It seeks to eliminate barriers to access, especially for Californians in rural and urban regions and low-income communities, by:
(1) allowing commercial and Medi-Cal managed health plans to cover sexual and reproductive health services delivered through mobile telehealth technologies like video, phone and smartphone applications;
(2) requiring the Family PACT program to cover family planning and related services provided through mobile telehealth systems; and
3) allowing Family ACT providers to determine client eligibility and enroll patients online.
SB 1190 (Sen. Skinner and Beall, Asm. Limon) Eugenics Sterlilization Compensation Program (HELD IN ASSEMBLY APPROPRIATIONS COMMITTEE)
Bill would compensate survivors of state-coerced sterilization under CA eugenic laws of 1909-1979. Most of the 20,000 people sterilized under the state eugenics laws were women and Latina/os. All were classified as having disabilities and lived in state mental institutions, although some were institutionalized only because they were poor or sexually active. Their reproductive capacity was taken away from them without proper consent because they were deemed by the state as “unfit to reproduce.” The bill would provide funding and procedures for payment.
CA BUDGET ISSUES for FY 2018-19 (Budget Act of 2018: AB 1806, SB 839)
Introduced in Assembly and Senate on January 10, 2018.
STD prevention: Request for budget increase of $10 million annually (INCREASED BY $2 MILLION, ALONG WITH $5 MILLION INCREASE FOR HIV/AIDS PREVENTION, JUNE 2018)
After hitting a record high for the third year in a row, California now ranks first in the country for the most cases of chlamydia, gonorrhea, and syphilis. Nearly half a million Californians were infected with these in 2016. This is no longer an epidemic. It’s a crisis, impacting the most vulnerable populations in our state: young people under the age of 30, men who have sex with men (MSM) populations and communities of color. A significant investment is required to have a long-term public health impact. To address alarmingly high STD rates across California, STD prevention advocates are urging the legislature to allocate an additional $10 million in the state budget to the STD Control Branch for STD prevention activities and outreach and education efforts. Funding would be prioritized to support activities targeting communities disproportionately impacted by STDs in partnership with local organizations.
Eugenics Sterilization Compensation: Request for one-time budget increase of $5.5 million (NO BUDGET INCREASE PROVIDED)
Would provide funding for compensation to victims of California’s sterilization policies, as described in the description above of the bill authorizing compensation, SB 1190 (Skinner), which Citizens for Choice is also supporting. The budget allocation would establish and fund the California Eugenics Sterilization Compensation Program, to redress past harm caused to those involuntarily sterilized under the State’s eugenics laws.
Funding for California Department of Education Sexual Education positions (BUDGET INCREASE OF $600,000 INCLUDED IN FINAL BUDGET)
Request for budget funding of $600,000 for two positions at the California Department of Education (CDE) focused on sexual health education guidance and oversight, and on LGBTQ student protections. Without state funding, these positions will be lost, derailing California’s progress in providing students with the sexual health education they need and that the law requires.
Title X proposed rule change of June 1, 2018 (PENDING)
The U.S. Department of Health and Human Services proposed new regulations that would drastically alter and undermine family planning programs supported by Title X, the ONLY federal program dedicated to funding family planning.
Opponent of the rule change argue that it would:
- Reduce low-income individuals’ access to the full range of contraceptive methods and services;
- Impose onerous separation requirements on Title X providers, upending the Title X network and leaving low-income individuals without access to adequate care and services;
- Restrict abortion referrals and counseling in ways that would prevent patients from receiving full and accurate information about their pregnancy options;
- Deter minors from seeking needed services, putting their health and wellbeing at risk; and
- Redefine “low-income family” to be contrary to the text and purpose of Title X.
Citizens for Choice comments were sent to HHS on 7/31/2018). (Tracking number 1k2-94jv-j8cl on site regulations.gov). HHS is considering comments before taking further action.
SUPPORTING FULL IMPLEMENTATION OF CALIFORNIA LAWS
AB 329 (Weber), California Healthy Youth Act (sex education)(ONGOING ADMINISTRATIVE ACTIONS)
The bill promotes the health of California youth by mandating sexual health education in public schools, integrated into the current HIV/AIDS prevention education mandate. The bill will strengthen existing law to ensure that students receive both HIV prevention education and comprehensive sex education that is medically accurate, objective and unbiased, in grades 7 – 12 (at least once in junior high or middle school and once in high school). It authorizes optional age appropriate instruction in lower grades, as well. It will update outdated information and bolster existing requirements.
AB 329 was enacted in 2015, effective January 1, 2016. In order to implement the new requirements, the California Health Curriculum Framework sections on sex education need to be updated, to address how to teach to the standards. A draft revision received approval from a key evaluation committee on March 23, 2018. A final revised framework is projected to be completed and adopted by March, 2019, after which instructional materials may be adopted and an updated textbook on sex education published.
Meanwhile, school districts may be reimbursed for some implementation costs. A model policy has been prepared by the School Boards Association and a toolkit and other implementation resources are available from the ACLU.
AB 775 (Chiu, Burke), Reproductive FACT (Freedom, Accountability, Comprehensive Care, and Transparency) Act (CPC required disclosures) (U.S. SUPREME COURT FOUND SOME DISCLOSURE REQUIREMENTS VIOLATED THE FIRST AMENDMENT FREDDOM OF SPEECH PROTECTIONS)
The bill , enacted in 2015, requires certain licensed providers of pregnancy-related services to provide specific information (by posting or distributing) to those served about their reproductive health rights, including:
(1) rights under the Reproductive Privacy Act to use birth control, bear a child or have an abortion; and
(2) health insurance coverage of reproductive health services for lower-income individuals, with a contact phone number.
Further requires unlicensed providers of pregnancy-related services to clearly post and include in their advertising a statement that they are not medical facilities licensed by the state of California and do not have a licensed medical provider on staff.
The bill aimed to ensure that California women receive the information they need to make well-informed decisions regarding their pregnancy options and obtain the care they need. One reason the bill was seen as needed was to make prospective and current clients of crisis pregnancy centers aware that the centers are not medical facilities, are not licensed, and do not provide prenatal care or comprehensive reproductive healthcare or referrals. Noncompliance by either type of facility is subject to fines: $500 for the first violation if not corrected within 30 days, and $1,000 for subsequent offenses.
The law was challenged in Federal and state courts soon after enactment. All California courts denied preliminary injunction relief.
NIFLA v. Becerra: The case challenging the FACT Act, in the context of the injunction decisions by the lower courts (not after trial on the merits), was appealed to the U.S. Supreme Court. That case is National Institute of Family and Life Advocates (NIFLA) v. Becerra. The issue the Court considered is whether the disclosures required by the California Reproductive FACT Act violate free speech under the First Amendment. Reversing the 9th Circuit, the Court decided in favor of the crisis pregnancy centers, in a 5-4 decision, on June 26, 2018.