It was a seemingly minor mistake and fixed within hours, but it came with political fallout during the early stages of policy and legislative changes that within the next few years could close every abortion clinic in the western half of the state.
Records show Ohio Department of Health officials accidentally renewed an application for an abortion clinic in Sharonville, just north of Cincinnati, in October 2012. That approval was quickly rescinded and state leaders launched an internal investigation that led to the unpaid suspensions of five employees, including the division chief.
Two bureau chiefs retired after the incident, with the state making a note to not rehire them.
The Women’s Med Center in Sharonville is now open under a temporary court order after state officials revoked its license. It is one of four clinics in Dayton, Cincinnati and Toledo at risk for closure because of recent state law changes.
Abortion clinic advocates say the state records demonstrate that the Kasich administration is on a mission to shutter abortion clinics because it refers to a “licensing watch” for clinics like these to get extra scrutiny.
At least one person caught up in the ensuing probe of the renewal said state officials over-reacted because of political pressure.
“Somebody had to pay for something that basically was not acceptable to the administration of the department of health and the administration of the governor,” said Roy Croy, one of the health department’s retired bureau chiefs, in an exclusive interview this week. “Politics are politics.”
Records label the premature approval email to the owner of Women’s Med Center in Sharonville an “embarrassing” mistake and note that facilities such as abortion clinics in Dayton, Cincinnati and Cleveland receive increased scrutiny compared to other outpatient surgery centers.
Changes made in last year’s budget bill banned public hospitals and their doctors from entering into patient-transfer agreements with abortion clinics. A policy change made with input from Gov. John Kasich’s office in 2011 gave the health department’s director more leeway to close clinics for not having transfer agreements, records show.
Ohio Health Director Dr. Ted Wymyslo of Dayton announced this week he is stepping down at the end of the month to return to private practice. Pro-life groups praised his service — though some wanted him to act faster — while pro-choice groups accused him of putting politics over health.
Local clinics impacted
Wymyslo has set his sights on closing clinics in Sharonville and Dayton owned by Dr. Martin Haskell. They have operated for years under a variance allowing them to stay open without required transfer agreements.
In a transfer agreement, a local hospital agrees to take a patient if there is a medical emergency. Public hospitals are now banned from signing them under state law, and private hospitals often won’t for political or moral reasons. Some say the agreements are pointless because hospitals have to take a patient in an emergency. Others say it’s a requirement for all outpatient surgery centers, so abortion clinics shouldn’t get special treatment.
State health department officials ordered the Sharonville clinic to close last month over the transfer agreement, but a judge issued a stay on Jan. 31 to keep it open.
A Planned Parenthood abortion clinic in Cincinnati had to end its transfer agreement with a public hospital because of the law and is waiting for state officials to grant a waiver to continue operations. A Toledo clinic has been unable to find a hospital to partner with for a transfer agreement since last year and is fighting the state over a proposed license revocation.
Ohio Right to Life Executive Director Paula Westwood said Haskell is facing scrutiny because of state rules violations — health officials said he didn’t previously fulfill the terms of his variance — not because the state is picking on abortion clinics. She said the fate of the clinics “will depend on whether there’s an activist judge.”
“From what I’ve seen from this case with Sharonville, the Ohio Department of Health is following the letter of the law,” she said.
Clinics on ‘watch list’
The state investigation says the health department has kept track of “clinics of note” to “be very careful with.” It specifically named the abortion clinics in Dayton and Cleveland. After the investigation it says the state created a “watch list” of clinics needing extra scrutiny.
Jennifer Branch, the attorney representing the clinics in Dayton and Cincinnati, said the investigative documents show the state is on a mission to shutter abortion clinics.
“I’m not surprised that these records from the department show what we’ve always known: their goal is not to give transfer agreements to abortion clinics if they can,” Branch said.
Branch said she will use the health department’s mistaken renewal of the clinic’s license as an argument in the legal proceedings over the state-ordered closure of the clinic.
A spokeswoman for the health department acknowledged that certain outpatient surgery clinics — whether they be Lasik centers, nursing homes or abortion clinics — are sometimes given extra scrutiny because of extenuating circumstances.
“The ‘clinics of note’ on the ‘watch list’ could include any facility licensed by the Ohio Department of Health,” said Tess Pollock, a health department spokeswoman. “Most commonly, it is because a facility is undergoing enforcement actions, like a proposed license revocation.”
A timeline of the investigation spells out what happened before the renewal. It starts in October 2011 when the Lebanon Road Surgery clinic in Sharonville received a one-year variance. The clinic had been operating under a variance for more than a decade.
A month later the state revised its variance protocol “with assistance of (the) Governor’s Office,” records say.
For more than a decade, the health department typically would approve licenses for abortion clinics that didn’t have a written patient transfer agreement with a nearby hospital, as required under state law, but instead identified a “back-up doctor” who has admitting privileges to a hospital as an alternative, Croy said.
That changed in 2011 when the Kasich administration took over, he said. He said the department was directed to no longer procedurally approve backup doctors as an alternative to written transfer agreements.
Meetings were held to design a review process. But miscommunication and employee mistakes led to a backlog of license renewals that filled four pages by the time LRS applied for a renewal in 2012. State records indicate that two employees were hurriedly trained, and one of them accidentally renewed the application. When this was caught, a letter was sent hours later to the clinic’s owner reversing the department’s license renewal.
“Overall, this is a case of inaction over time which created an environment allowing mistakes,” concluded Labor Relations Administrator Monica Rausch in October 2012.
Croy, the health department’s chief of inspections at the time, said the clinic’s license renewal was an accident — nothing more than the push of a wrong button. He called the response “unusual” and “overkill.”
“If my retirement hadn’t been timely, I had no question in my mind that I would have been disciplined just because I was the bureau chief,” Croy said. “An example had to be made, that’s what took place.”
Governor’s office spokesman Rob Nichols wouldn’t comment on how involved the administration was in revising the department’s policy or its internal investigation, citing the ongoing lawsuit.
In a statement, Pollock said the punishment handed out to department of health employees was necessary.
“If we’re going to hold Ohio’s health care providers to tough standards we also have to hold ourselves, the regulators, to tough standards, whether we like it or not,” she wrote.
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