Minimum wage savings for the state mean multi-million dollar burden for counties

Good morning. TGIT. We have some good news and some bad news. 

The good news: Last year’s deal to increase the minimum wage won’t cost the state nearly as much as was projected. 

The bad news: Providing certain health care services just became way more expensive for counties. 

The Brown administration is ending a program that coordinated care for seniors and low-income families because it was no longer cost effective. As a result, the state will save $626 million this year, forcing counties to pick up the check. 

CalWatchdog has more. 

In other news:

• Foreclosures: “New housing data show foreclosure activity in California dropped to an 11-year low in 2016. But the state is still working through a backlog of homes purchased with bad loans during the last housing bubble.” Capital Public Radio has more. 

• School bond oversight: “Gov. Jerry Brown, who last year registered deep skepticism about the $9 billion statewide school construction bond, is withholding the proceeds until the Legislature approves more rigorous independent auditing procedures.” The Sacramento Bee has more. 

• Battle with the feds: “California is friendly territory, but a national defunding push worries Planned Parenthood,” writes the Los Angeles Times. 

• Drought: “A year ago this week, only 3 percent of the state was classified as not being in drought conditions. But now because of this winter’s soaking, 42 percent is.” The San Jose Mercury News has more. 

Legislature:

• Back on Friday. 

Gov. Brown:

• Speaking at MLK breakfast for the Legislative Black Caucus at 8 a.m. in Sacramento. 

Tips: matt@calwatchdog.com

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New follower: @libertytotenews

Harris, embarked on a campaign to replace outgoing Sen. Barbara Boxer, D-Calif., promised lawmakers to “carefully review” the organization behind the tapes for “any violations of California law,” according to the Sacramento Bee.

The lawmakers, four Congressional Democrats, had “asked Harris and U.S. Attorney General Loretta Lynch to determine if officials from the Irvine-based Center for Medical Progress broke any laws when they posed as workers for a biotech company while recording Planned Parenthood physicians without their consent,” the Bee reported.

“Reps. Jan Schakowsky, Zoe Lofgren, Jerry Nadler and Yvette Clarke cited reports that founder David Daleiden filed paperwork to create a phony entity. They also asked the state’s top law enforcement official to look into possible violations of the Invasion of Privacy Act, which bars recording people without their permission.”

Swift litigation

Jason Taellious / flickr

Unlike previous efforts by activists to cast an unflattering light on the organization, the videos produced by the Center for Medical Progress captured lurid remarks concerning the sale and use of aborted fetal body parts and organs. In addition to creating a public relations mess for Planned Parenthood, the videos also raised alarms for a company that acts as procurement middleman between the abortion provider and researchers desirous of the parts.

The company, StemExpress, swiftly filed suit to protect themselves, drawing a temporary restraining order from Los Angeles Superior Court. According to the Associated Press, the order “prohibits the Center for Medical Progress from releasing any video of three high-ranking StemExpress officials taken at a restaurant in May. It appears to be the first legal action prohibiting the release of a video from the organization.”

In one video, a former StemExpress employee told the Center for Medical Progress that she expected to be “drawing blood” rather than “procuring tissue from aborted fetuses,” according to the Federalist.

Center for Medical Progress David Daleiden hit back at the StemExpress suit in a statement, calling the litigation “meritless” and accusing StemExpress of fostering an “illegal baby parts trade,” AP added.

High-stakes politics

Although the abortion issue has not dominated the national political scene for a number of years, the shock and surprise surrounding Daledien’s videos provoked an immediate response. “Republicans called on Congress to withhold federal funding for Planned Parenthood, and GOP lawmakers in several states opened investigations of their own,” the Bee observed. “Democrats pushed back by focusing scrutiny on the producer of the videos[.]” Despite the videos’ Irvine origin, the Golden State has remained a bulwark of pro-choice public sentiment.

“In liberal-leaning California, nearly 70 percent of adults say the government should not interfere with access to abortion, according to a Public Policy Institute of California Poll last year. That number is similar to majorities registered in Field Poll surveys since the 1980s.”

One reason for the political furor: the market for fetal body parts has not been tightly regulated. “Companies that obtain the tissue from clinics and sell it to laboratories exist in a gray zone, legally,” according to the New York Times. “Federal law says they cannot profit from the tissue itself, but the law does not specify how much they can charge for processing and shipping.” Planned Parenthood denied it broke these laws.

Big business

But the trade in fetal parts, which offers access to organ stem cells impossible to obtain in other ways, has become a quietly lucrative endeavor, especially for the two small California companies that have met much of researchers’ demand. The founder of StemExpress, for instance, “started StemExpress with $9,000,” the Times reported. “An article last November in Sacramento Business Journal said that the company had grown more than 1,300 percent in three years. Its revenue was $2.2 million, according to a report in August 2014 in Inc. magazine.”

AB 154 by Assemblywoman Toni Atkins, D-San Diego, will allow nurse practitioners, certified nurse-midwives and physician assistants to perform abortions.

Ironically, the 1973  Supreme Court decision in Roe v. Wade was made to put an end to unsafe abortions, performed by non-physicians. The decision made it possible for women to get safe, legal abortions from well-trained physicians.

An important Democrat political issue and campaign strategy for many years has been the claim that women needed access to doctor-performed abortions instead of illegal back-alley abortions by non-physicians.

“Many women died or suffered serious medical problems after attempting to self-induce their abortions or going to untrained practitioners who performed abortions with primitive methods or in unsanitary conditions,” the National Abortion Federation wrote in its “history of abortion.” “During this time, hospital emergency room staff treated thousands of women who either died or were suffering terrible effects of abortions provided without adequate skill and care.”

This time around, Planned Parenthood claims this bill is necessary to “integrate abortion care into current practice settings.”

The San Diego ACLU calls AB 154, a “reproductive health bill.”

Companion bill — AB 980

Assemblyman Richard Pan, D-Sacramento, authored another bill, AB 980, which will remove the current requirements that abortions are to be done in a medically surgical and sterile setting, with a post-abortion recovery area adequate for recovering patients, and a counseling area that is maintained and provides privacy for patients requesting it. Gov. Brown signed AB 980, as well.

Planned Parenthood, the bill’s sponsor, says the existing requirements are contrary to public interest and are even unconstitutional.

AB 980 “Prohibits the CBSC from adopting building standard regulations for construction requirements that differ between primary care clinics providing medication or aspiration abortion services and certain other primary care clinics.”

Access to abortion clinics

Atkins and proponents of the bill claim many women in California do not have access to abortion clinics, and end up waiting longer to obtain an abortion.

But as of 2009, California had 107 Planned Parenthood clinics around the state, the most of any state in the country. And that is just Planned Parenthood clinics; there are many clinics affiliated with Planned Parenthood, and many private doctors perform abortions.

Misinformation campaign

“Fifty-two percent of the counties do not have accessible abortion providers,” state Sen. Hannah-Beth Jackson, D-Santa Barbara, testified at one committee hearing on AB 154. “Women must delay care or drive long distances, especially in rural areas.”

Jackson said there is a growing shortage of facilities to assist women with their “reproductive decisions.”

Statistics

Unfortunately, authoritative abortion numbers are hard to come by. Statistics come from two sources, the federal Centers for Disease Control and the The Guttmacher Institute, a private foundation.

California has not complied with CDC requests for abortion data in many years. And since CDC California totals are routinely incomplete, lawmakers turn to the Guttmacher Institute for data. But without data from California, Guttmacher reports are not reliable for our state.

California does not keep statistics on how many abortions are performed each year. Nor does the state report abortion statistics to the Center for Disease Control, as 48 other states do. So claims of a reduction in abortion access are questionable.

Overall, the U.S. abortion rate for 2009 was 15.1 abortions per 1,000 women of child-bearing years, 15 to 44 years old, according to the CDC. The abortion ratio was 227 abortions per 1,000 live births.

Guttmacher Institute

The Guttmacher Institute, the source of most abortion data, was founded in 1968 by Alan F. Guttmacher, former Planned Parenthood president and former vice president of the American Eugenics Society.

Planned Parenthood receives more than $360 million each year from taxpayers. It continues to fund the Guttmacher Institute, which has an annual budget of approximately $17 million. The Institute’s annual report lists more about its sources of funding.

Perspective

“The impact on lives, on the mother and the baby, and yes, there is a baby, is a leveling down of health care for women,” said Sen. Jim Nielsen, R-Gerber, at a committee hearing for AB 154. “It’s not a ‘procedure’ — it’s an operation. This is very dangerous.”

Supporters of AB 154 claim there is a growing problem of  access to abortion services in California. “Fifty-two percent of the counties do not have accessible abortion providers,” state Sen. Hannah-Beth Jackson, D-Santa Barbara, testified Monday. “Women must delay care or drive long distances, especially in rural areas.”

Jackson said there is a growing shortage of facilities to assist women with their “reproductive decisions.”

AB 154 and rights

“The impact on lives, on the mother and the baby, and yes, there is a baby, is a leveling down of health care for women,” said Sen. Jim Nielsen, R-Gerber, at the hearing. “It’s not a ‘procedure’ — it’s an operation. This is very dangerous.”

“Rural women deserve the same level of health care as women in cities,” said Sen. Joel Anderson, R-San Diego. He argued that AB 154 would diminish the quality of health care provided to women. He said it was ironic because, back in the 1960s and early 1970s, it was Democrats who fought so hard to get abortions out of alleys and performed by medical doctors in clinics and hospitals. “No woman should lose her life,” he said. “It puts women’s lives at risk.”

Sen Ted Gaines, R-Rocklin, brought up another issue with the bill. “I represent 11 counties, three-quarters of which are rural,” Gaines said. “There is not an issue of access to doctors. This should not be left to anyone but a doctor.”

“Access to reproductive rights and abortion services are constitutionally guaranteed,” replied Sen. Mark Leno, D-San Francisco. “Access is available in only one-third of California counties.”

The bill’s backers include:

Statistics

Unfortunately, authoritative abortion numbers are hard to come by. Statistics come from two sources, the federal Centers for Disease Control and the The Guttmacher Institute, a private foundation.

California does not keep statistics on how many abortions are performed each year. Nor does the state report abortion statistics to the Center for Disease Control, as 48 other states do. So claims of a reduction in abortion access are questionable.

Overall, the U.S. abortion rate for 2009 was 15.1 abortions per 1,000 women of child-bearing years, 15 to 44 years old, according to the CDC. The abortion ratio was 227 abortions per 1,000 live births.

Guttmacher Institute

The Guttmacher Institute, the source of most abortion data, was founded in 1968 by Alan F. Guttmacher, former Planned Parenthood president and former vice president of the American Eugenics Society.

Planned Parenthood receives more than $360 million each year from taxpayers. It continues to fund the Guttmacher Institute, which has an annual budget of approximately $17 million. The Institute’s annual report lists more about its sources of funding.

California has not complied with CDC requests for abortion data in many years. And since CDC California totals are routinely incomplete, lawmakers turn to the Guttmacher Institute for data. But without data from California, Guttmacher reports are not reliable for our state.

On its website, in a section titled, “Where Do Women Obtain Abortions?” Guttmacher reports:

• “In 2008, there were 1,793 abortion providers in the United States. This is virtually unchanged from 2005, when there were 1,787 abortion providers. Thirty-four percent of these providers were hospitals, 21 percent were abortion clinics (clinics where more than half of all patient visits were for abortion), 26 percent were clinics where fewer than half of all visits were for abortion, and 19 percent were private physicians’ offices. Seventy percent of all abortions were provided at abortion clinics, 24 percent at other clinics, 4 percent at hospitals and 1 percent at private physicians’ offices.

• “In 2008, there were 522 abortion providers in California. This represents a 23 percent increase from 2005, when there were 424 abortion providers.

• “In 2008, 87 percent of U.S. counties had no abortion provider. One-third of American women lived in these counties, which meant they would have to travel outside their county to obtain an abortion. Of women obtaining abortions in 2006, nonhospital providers estimate that 27 percent traveled at least 50 miles.

• “In 2008, 22 percent of California counties had no abortion provider. One percent of California women lived in these counties.”

But links to Guttmacher’s data merely lead to national studies also done by the Guttmacher Institute, as well as information from their own prior testimony to the Committee on Preventive Services for Women for the National Institute of Medicine. So it’s hard to corroborate Guttmacher’s data with sources outside itself.

By Dave Roberts

California women abort their unborn children at a significantly higher rate than the rest of the country, accounting for nearly one in five abortions in the United States. But for many Democratic politicians and abortion providers there aren’t enough abortions in the Golden State. Rather than keeping it safe, legal and rare, as the slogan goes, they are determined to expand abortion access, even if it might result in more injuries to women.

State Sen. Christine Kehoe, D-San Diego, has authored SB 1338, which expands the professions that are allowed to perform surgical abortions. Currently only licensed physicians and surgeons are allowed to do so. Anyone else would be subject to a $10,000 fine and imprisonment. SB 1338 would allow registered nurses, nurse practitioners and certified midwives who have received training by the end of the year also to perform aspiration abortions.

Aspiration is the most common type of abortion, primarily done in the first trimester, in which the baby is vacuumed out of the uterus. The technique is considered the safest abortion method — provided, of course, that you’re not the one being aborted. But it’s still an invasive procedure with sharp instruments, and complications can arise.

Those complications and whether they will increase when less skilled, less educated and less experienced people are allowed to vacuum uteruses were at the heart of the debate on SB 1338 in the Senate Business, Professions and Economic Development Committee meeting on Thursday.

“A rigorous, state-approved pilot project has demonstrated that clinicians can perform with high rates of patient safety and satisfaction,” Kehoe told the committee. “Advanced clinicians already perform surgical and non-surgical procedures: IUD insertion and removal, biopsies and some forms of insemination.”

Kehoe’s bill originally applied to all nurses, practitioners and midwives. But she watered it down to apply to those 41 people in the state who have received aspiration abortion training through a University of California, San Francisco study. It’s possible that more people could be trained, however, by the January deadline. Representatives of the California Nurses Association said there are 16,000 nurse practitioners in the state who might also want to perform abortions.

The more the better, as far as Kathy Kneer, president and CEO of Planned Parenthood Affiliates of California, is concerned. “Over half the counties do not have  providers who will perform abortions for Medi-Cal patients,” said Kneer. “That requires women to drive long distances. We believe it’s very important that patients have access to early, safe abortion procedures. We believe that practitioners who they see for their regular routine care should also be able to offer this so they can provide continuity of care.”

Abortion study

Also leading the drumbeat for more abortions is Tracy Weitz, a UCSF associate professor in obstetrics, gynecology and reproductive science, who led the abortion study.

“We know that two things make abortion safer: making it legal, and doing it as early as possible in the pregnancy,” Weitz told the committee. “The widespread use of aspiration abortion technique as a preferred method for ending pregnancies in the first trimester is what has made abortion incredibly safe. The question of who can safely perform those procedures can now be answered by scientific evidence.”

During her four-year demonstration project, 41 clinicians performed nearly 8,000 abortions. It took about seven days and 45 abortions for each clinician to gain sufficient competency. Only 1.6 percent of the procedures resulted in complications, according to the study, with only six women requiring hospital care. All recovered “without any long-term physical harm,” Weitz said.

But the reliability of those numbers and the ethics of the study’s procedure came under assault by Assemblywoman Linda Halderman, R-Fresno, who is also a licensed surgeon. She has witnessed aspiration abortions, and said that the procedure can include the use of extremely sharp instruments in the blood-filled cervix to scrape its fetal contents.

“Incomplete abortion means that some of the fetal parts are left inside,” she said. “And that is in fact a known complication that is uncommon, but it’s reported in this procedure. However, there are additional complications that are reported. These are associated normally with surgical procedures done by board-certified obstetricians and gynecologists. The published rates (of complications) are between 3 and 5 percent. And they consist of incomplete abortions, failed abortions, hemorrhaging, excessive bleeding, anesthesia-related complications, bleeding within the uterus walls themselves, infections, cervical injury including cervical tear, and uterine injury which rarely requires hysterectomy.”

‘Disturbing’

Given all of those possibilities of something going wrong, Halderman said she found it “disturbing” that, in data published by pro-choice ob-gyn organizations, there is a 3-5 percent rate of complications when abortions are done by experienced doctors and surgeons, but Weitz’s study asserts that there was only a 1.6 percent rate of complications in abortions performed by nurses and midwives learning the procedure.

Halderman is concerned that there was not adequate follow-up about potential problems. Less than 10 percent of the women were interviewed in person after their abortion. Most interviews were done by phone or a mailed survey and some women were not contacted at all. She pointed out that the study has yet to be published in a medical journal, undergoing peer review.

“This is so outside the standard of research care that I am concerned that there may be violations here that may be of a legal magnitude,” said Halderman. “In particular, locations that were chosen for these pilot projects have substantial portions of minority women. And if the purpose is to increase access to early abortion, I don’t think the way we want to do that is to compromise women’s safety.”

Informed consent?

Halderman is also concerned that the women who participated in the study were not all provided with informed consent forms in their native languages (only English and Spanish forms were provided).

“It is for these reasons that I regretfully ask that you must vote no on this project until we have some data, until we have some proof and until we have some real answers on whether or not protocols of research were actually followed,” Halderman concluded.

Also speaking against SB 1338 was Carol Hogan, communications director for the California Catholic Conference. She said that a majority of Californians oppose allowing nurse practitioners and physician assistants to perform first trimester abortions, citing a poll of 778 people conducted in late March by Smith Johnson Research.

“The author’s rationale is to increase access to abortion, thereby increasing the actual number of abortions performed in California,” said Hogan. “For almost any medical procedure, people with either private or government health insurance have to schedule their appointments well in advance and may well have to travel some distance. Even toenail surgery or earwax removal is not available on the same day or the same week that the patient desires it. To have an abortion is a serious decision, one that ends the life of an unborn child and may change the life of the woman. Does it need to be as available as an aspirin at the corner drug store? They claim that abortions should be safe, legal and rare. This law would make abortion less safe and less rare.”

Wynette Sills, a Sacramento pro-life activist, said, “They are increasing the certification for pet groomers to ensure the health of our pets. So why would we turn around and lower the health standards of women? Women deserve better. In this pilot study with 8,000 women hurt and 8,000 human lives killed, it was found to be fairly safe for the women. Yet the intent is to expand abortion throughout the state. While it might have been found safe under rigorous research conditions, as you move away from UCSF and out into the Central and Imperial Valley, I don’t think we can ensure the same level of supervision and safety for women.”

Although the committee has a 6-3 Democrat majority, surprisingly it deadlocked 4-4 on SB 1338 with two Democrats voting against it. One of those Democrats, Juan Vargas, who represents Chula Vista, said he could not support a policy affecting women’s health based on a study that had yet to be published and peer reviewed.

Mark Wyland, R- San Juan Capistrano, agreed that the committee had insufficient information to make an informed decision on such a technical issue. “It seems to me, given what we know, that it’s a big leap to say people who have had a few days’ training and a few supervised procedures should be doing something like this,” he said. “I just think that’s an awfully big leap.”

Although the bill failed to make it out of the committee, it has not been, well, aborted. Kehoe’s representative said she plans to bring it back to the same committee on May 7 for a vote only, no testimony allowed.