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Anti-Abortion Groups vs. the FDA | Colorado legislators seek big boost in Special Education funding | Catholic hospitals no longer performing tubal ligations after Dobbs decision | Cannabis legalization seems to be okay | RJD2 is the Concert Pick of the WeekWelcome to High Country - politics in the American West. My name is Sean Diller; regular listeners might know me from Heartland Pod’s Talking Politics, every Monday.Support this show and all the work in the Heartland POD universe by going to heartlandpod.com and clicking the link for Patreon, or go to Patreon.com/HeartlandPod to sign up. Membership starts at $1/month, with even more extra shows and special access at the higher levels. No matter the level you choose, your membership helps us create these independent shows as we work together to change the conversation.Alright! Let’s get into it: DENVER (AP) COLORADO NEWSLINE: Anti-Abortion Groups vs. the FDABY: LINDSEY TOOMER - JANUARY 31, 2023 3:45 AMReproductive rights advocates in Colorado were feeling optimistic following the U.S. Food and Drug Administration’s decision to expand access to the abortion pill mifepristone in early January — but a federal lawsuit filed just 10 days later has made the future of medication abortions uncertain. On Jan. 3 the FDA issued a decision that allows the abortion drug mifepristone to be picked up at a pharmacy if the patient has a prescription, eliminating a previous requirement that the drug be given directly from a health care provider. Dr. Kristina Tocce, medical director at Planned Parenthood of the Rocky Mountains, said the FDA’s decision is a “really big breakthrough” that should increase access across the country. América Ramirez, program director for the Colorado Organization for Latina Opportunity and Reproductive Rights, said it’s exciting to see expanded access and agreed it could be beneficial for people across the state, especially the Latina community. U.S. Rep. Diana DeGette, a Denver Democrat who co-chairs the Congressional Pro-Choice Caucus, said during a recent press conference with news reporters that the caucus is working with the Biden administration to ensure the U.S. Postal Service will be able to deliver abortion medications when prescribed by an out-of-state doctor. Karen Middleton, president of Cobalt, a Colorado-based reproductive rights advocacy organization, said the FDA’s decision will be particularly beneficial for Coloradans outside of the Denver metro area, so long as their pharmacies are willing to participate. But, she said while this is a positive step forward, there are still too many “bureaucratic and cost barriers” for those seeking abortion care.“We’ve known for years that medication abortion care is overwhelmingly safe and effective,” Middleton said in an email. “We hope that Colorado pharmacies, especially in rural areas, will make it available to patients as soon as possible and without bureaucratic delay.”But anti-abortion groups have sued to stop pharmacies from filling prescriptions for mifepristone, and the case will likely go all the way to the Supreme Court. The lawsuit argues the FDA “exceeded its regulatory authority” in approving the use of mifepristone and misoprostol to end a pregnancy, and seeks a preliminary and a permanent injunction that would remove the FDA’s approval. That would imply that Congress should decide, which is of course, dumb.Attorneys for the U.S. Justice Department said there are no examples in history where a court has second-guessed a determination from the FDA that a drug is safe and effective. Karen Middleton said the lawsuit was the anti-abortion groups’ only choice, as they “know that they’ll lose at the ballot box” since purple and red state voters repeatedly voted to protect abortion rights in 2022. “That’s why these radicals are bringing legal challenges in Federal District Courts with conservative judges — to weaponize the legal system to end legal abortion access,” Middleton said. Fawn Bolak, a spokesperson for Planned Parenthood of the Rocky Mountains, called the lawsuit a “politically-motivated attack” that has “no basis in science,” as the drug has been used safely and legally since it was approved by the FDA more than 20 years ago. This lawsuit is designed to push abortion care further out of reach for the most vulnerable.“Exploiting the legal system in an attempt to prevent people from accessing safe, essential health care is unconscionably cruel. Rest assured PPRM will continue to provide safe and legal abortion care to our patients — no matter the outcome in this case.”CHALKBEAT COLORADO: Education Committee backs big boost in Special Ed SpendingColorado would fund special education at the levels lawmakers promised back in 2006, under legislation recommended unanimously Friday by a special committee on school finance.The special education bill would reimburse districts $6,000 for each student with what’s known as a Tier B disability, and who requires more intensive support for students to be successful in school. These include dyslexia, autism spectrum disorders, developmental delays, deafness, blindness, emotional disabilities, and traumatic brain injuries, among others. The bill also calls for Tier B funding to increase every year by the rate of inflation.Both the federal and state governments require school districts to provide a “free and appropriate” education to all students, including those with disabilities, but they pay just a fraction of the cost. That won’t change with this bill.School districts would still bear about two-thirds of the additional cost of providing special education services, but a few years ago, the state was paying less than half of what it had promised. The new bill would add $40.2 million in special education funding to next year’s budget, bringing the total to at least $340 million, a 13% increase. The amount could be more, depending on how lawmakers handle requirements to respond to inflation. The bill could also get scaled back, in future budget committee negotiations.The special education bill, sponsored by state Sens. Rachel Zenzinger (D-Arvada) and Barbara Kirkmeyer, a Brighton Republican, along with state Reps. Kipp and Lisa Frizell, a Castle Rock Republican, will be the only bill to come out of the Interim Committee on School Finance this session.Sen Zenzinger, who also chairs the Joint Budget Committee and serves on the interim committee on school finance, sounded a note of caution even as she signed on as a prime sponsor of the funding increase bill. “We’ll put it out there as what we’d like to see, and we’ll see what’s available to us in the budget,” she said.Bureau Chief Erica Meltzer covers education policy and politics and oversees Chalkbeat Colorado’s education coverage. Contact Erica at emeltzer@chalkbeat.org.COLORADO SUN: Catholic hospitals crack down on contraceptionJennifer Brown4:00 AM MST on Jan 31, 2023Colorado has one of the least restrictive abortion laws in the country, but health care advocates say women in rural and mountain towns often lack reproductive health care accessWhen the only hospital in Durango with a maternity ward decided that it would no longer let women get their tubes tied, there was no public announcement. Mercy Hospital’s website doesn’t spell it out, either. Instead, a read-between-the-lines statement added to the Centura Health hospital’s website in September noted that Mercy is “responsible for conducting itself in a manner consistent with the ethical principles of the Catholic church ministry.” The hospital had recently completed a “re-education” of hospital staff and board members regarding the church’s ethical and religious directives, it said, adding that “patients are fully informed of all treatment options.” Doctors who deliver babies at Mercy said they were told that beginning April 15, they can no longer provide post-cesarean-section tubal ligations - a sterilization procedure in which the fallopian tubes are cut. Women who have decided not to have more children often have their tubes tied immediately after a C-section, when they are already under spinal anesthesia, sparing them from the risk, cost, and hassle of scheduling a separate second procedure.The hospital already prohibited tubal ligations after vaginal births, but had been allowing them after C-sections because of the undue burden it placed on patients. It’s been up to obstetricians to tell their pregnant patients that they will have to go elsewhere for permanent birth control. Dr. Kimberly Priebe, who delivers 90-100 babies a year and has been an obstetrician-gynecologist in Durango for 20 years said “Patients are furious. This decision undermines our patients’ trust in Centura.” Mercy’s prohibition of sterilization comes as health care advocates across the country are concerned about diminishing reproductive rights after the Supreme Court overturned Roe v. Wade.Even in Colorado, a state with statutory protection for abortion and one of the least restrictive abortion laws in the country, women are losing access to reproductive health care, particularly in rural and mountain areas where there is only one hospital in town.Mergers that have joined Catholic health systems with secular or protestant systems have created a confusing health landscape for patients seeking abortions or birth control.Centura Health, formed in 1996 by the merger of Catholic Health Initiatives and Adventist Health System, has 16 hospitals in Colorado and three in Kansas. The Catholic hospitals, including Mercy, follow the Catholic directives, while the Adventist hospitals do not. In Denver, doctors affiliated with Centura Health can steer patients who want their tubes tied to nearby hospitals. But in Durango - and other towns with just one hospital - that’s not an option. Sophia Mayott-Guerrero, senior organizing strategist with ACLU of Colorado said “We really are seeing a trend with hospitals, insurance companies, pharmacies, other health care entities, discriminating against people by denying basic care … all in the name of religion. The main target is reproductive access, including birth control, emergency contraception, sterilization and abortions.“We can’t really consider access to reproductive health care in Colorado universally protected until everybody in every corner of our state has access. There’s often this perception that everybody in Colorado has access to abortion and to reproductive health care and that is just fundamentally untrue, especially in the rural parts of the state where you just don’t have additional options.”It’s unclear why Mercy Hospital had been allowing tubal ligations after C-sections and what led to the change. CommonSpirit Health, the Catholic owner of Mercy and other Catholic hospitals, said they had no updates to provide. The Diocese of Pueblo, which includes all of southern Colorado, referred questions to Centura Health. Centura Health officials would not give an interview about the change at Mercy, or explain why it’s happening now, considering that Mercy has been Catholic since it was founded. The only exception is for women predisposed to cancerAfter the latest “reeducation” of the Catholic directives, Mercy said it would allow tubal ligations post C-section for only one reason — if the woman has a genetic predisposition to ovarian or breast cancer. — Dr. Kimberly Priebe, Four Corners Obstetrics and Gynecology said “This is a very small number of women, and what an arbitrary exception.”“What about women with hypertension, diabetes, blood clotting disorders, uterine abnormalities, and the many other risk factors that can make pregnancy deadly? It seems the Catholic church does not want a woman dying of cancer but during pregnancy is OK?”With the new Mercy policy prohibiting tubal ligations after C-section, doctors will send those patients to the local surgical hospital, though they are concerned about overwhelming the center. And, doctors say, forcing women to schedule the procedure separate from their hospital delivery puts them at unnecessary risk, disrupts their lives with more time away from work, and costs the health system more money. The Medicaid billing rate for a doctor performing a tubal ligation post C-section is a $90 add-on and takes about 10 minutes, doctors said, not including anesthesia and facility fees.Patients who go to Animas Surgical Hospital for a standalone tubal ligation would likely have to pay thousands of dollars for the procedure. The hospital’s cash-pay price for the procedure for people without insurance is $9,900.“Patients do not understand how a health care option can be refused when our hospital gets public money and purports to put patient care first,” Dr Priebe said. Pregnant patients in Summit County also face tough choices. Like in Durango, the only hospital is Catholic.St. Anthony Summit Medical Center in Frisco, part of Centura Health, does not provide tubal ligations. Dr. Amy Tomlinson, an OB-GYN in Summit County, has had to explain to hundreds of patients that they cannot get their tubes tied at the hospital where they plan to give birth. “Usually, honestly, it was a huff and a sigh and an eye roll,” she said. “Sometimes it was a jaw drop and a shake of the head. But I think women are so used to being second-class citizens in this society that I don’t think it was ever terribly surprising to people.” Summit County women have the choice of delivering at St. Anthony and then getting their tubes tied later at another hospital, or driving more than an hour to Denver to deliver their baby so they can have the procedure at the same time. And for women who already have a C-section scar on their uterus, it’s especially dangerous to ask them to drive that far in labor, Tomlinson said. “The Catholic position is, ‘If you don’t like it, you can go somewhere else,’” she said. “Well, it’s not like you can go across town when your hospital is the only one in a tri-county radius. We essentially become an island during snowstorms up here. Even if a patient wants to go elsewhere, she may not be able to get there. And then you are asking women to drive an hour or more while they are laboring. Why would we put women at risk for rupturing their uterus or for giving birth on the side of the road?”Tomlinson, who is opening her own practice but in the past worked at High Country Healthcare, recalled that while removing severe scar tissue from the uterus of a patient at St. Anthony Summit, she had to ask permission from the bishop to place an IUD in the woman’s uterus in order to keep it open and prevent pain. The woman had in the past had a tubal ligation so she was already sterile, but the Catholic hospital still required her to get permission to place the birth-control method, called an intrauterine device. And in 2010, Tomlinson gave a presentation to the St. Anthony Summit board to persuade them not to prohibit treatment of ectopic pregnancies. In the post-Roe v. Wade era, doctors across the nation have reported confusion about whether treating an ectopic pregnancy — which is when a fertilized egg implants in the fallopian tube instead of the uterus — is considered an abortion. In another large hospital system - SCL Health - Saint Joseph Hospital in Denver and St. Mary’s Medical Center in Grand Junction — operate under the ethical and religious directives, meaning they do not provide sterilizations. Two of SCL’s secular hospitals — Lutheran Medical Center in Wheat Ridge and Good Samaritan Medical Center in Lafayette — also operate under the same compliance with Catholic directives, said Gregg Moss, spokesman for SCL Health.Moss referred The Colorado Sun to an SCL Health webpage that explains the Ethical and Religious Directives for Catholic Health Care Services - they were first published by the U.S. Conference of Catholic Bishops in 1948.The hospital system’s webpage does not specifically mention birth control, tubal ligations or abortions, but says that in today’s society, Cathol…
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