SEATTLE — The American Civil Liberties Union of Washington on Thursday sued a Skagit County hospital district and sent warning letters to three others in what it described as the start of a campaign to make sure public health care facilities are following the state’s abortion rights law.
The Reproductive Privacy Act, adopted by citizen initiative in 1991, prevents the state from interfering with a woman’s right to have an abortion. It requires the state to pay for voluntary abortions for low-income women, and says that if a public hospital provides maternity services it must also provide “substantially equivalent” abortion services.
At Skagit Valley Hospital — operated by the state’s third-biggest public hospital district, Skagit Regional Health — patients have been routinely referred to Planned Parenthood or other private clinics when they seek abortions, rather than provided such services on-site, the ACLU said.
The dispute boils down to whether such off-site referrals are substantially equivalent to the maternity care the hospital offers.
In an opinion on the topic in 2013, the Washington Attorney General’s Office expressed “no opinion on exactly how hospital districts may comply with this requirement, or what constitutes ‘substantially equivalent benefits, services, or information.”’
Skagit Valley Hospital performed 1,200 deliveries in 2012 — nearly three-quarters of all births in Skagit County — but never performs abortions by medication and rarely performs surgical abortions, the ACLU said. At a news conference Thursday, the ACLU called the referrals an unacceptable barrier to abortion rights.
In a phone call with reporters, two hospital district executives — Dr. Connie Davis, its chief medical officer, and Balisa Koetje, its chairwoman — said Skagit Regional Health follows the law, which specifies that private hospitals and clinics are not required to offer abortions, and that no person can be compelled to provide them.
They directed reporters to their written policy: “Skagit Regional Health permits its healthcare professionals to opt-out of participating in services that violate their conscience or values. In such circumstances, the hospital will use reasonable efforts to arrange for other healthcare professionals to deliver the care for the patient.”
They said that they do provide some onsite abortions, though they did not know how many or when the last one was.
“I don’t believe we feel there is a controversy,” Koetje said. “Services are provided.”
Asked why it mattered if women were referred to a different clinic for abortion services, ACLU of Washington Executive Director Kathleen Taylor said: “What’s the harm in having to go to another lunch counter? … If you are a facility that serves the public, you don’t get to choose.”
The ACLU is bringing the case on behalf of Kevan Coffey, a 29-year-old Mount Vernon nurse practitioner. Coffey said she worked at Skagit Valley Hospital for two years until last June, when she left to pursue her doctorate in nursing.
When she would call the hospital’s women’s health department for a patient who wanted or needed to terminate a pregnancy, the department would tell her to refer the patient to Planned Parenthood.
“It was just accepted that we didn’t really have those services available,” she said.
She said it’s also a personal issue: She takes medication that can cause severe birth defects, and she would need an abortion if she were to become pregnant.
Leah Rutman, health care policy counsel with the ACLU of Washington, said the organization was studying the effect mergers between public and religious hospitals could have on access to abortions when it learned that some public hospitals appeared not to be providing them.
The ACLU also sent letters to hospital districts in Jefferson County, Mason County and on Whidbey Island.
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