Calif. Clinics to Skirt Abortion Gag Rule Policy

A White House policy that bars family planning clinics from discussing abortion with patients will be tested by 220 clinics in California whose administrators have devised a plan to technically comply with while thwarting the intent of the so-called gag rules.

The rules, first imposed by the Reagan Administration and continued by President Bush, have survived four years of court challenges, congressional assaults and presidential tinkering. Opponents say the gag rules deny women information about their legal rights.

Clinic officials in California are gambling that the Bush Administration will accede to their plan rather than tangle anew with the abortion issue during a close presidential race. Bush is an avowed foe of abortion and has repeatedly vetoed legislation lifting the gag rules, but Republicans who support abortion rights have expressed growing discomfort with the Administration’s stance.

“The intent was to muzzle us, but we are very committed to continuing to provide our clients with comprehensive family planning information,” said Carol Classic, executive director of Planned Parenthood of Central California.

The California clinics’ plan hinges on bookkeeping maneuvers that the administrators hope will meet federal restrictions while leaving abortion counseling and other services intact. Put simply, the clinics want to use their federal money to pay for contraceptive counseling and other federally approved services, while using state and private funds to pay the salaries of staff who counsel pregnant women.

The accounting plan was crafted to meet a Sept. 23 deadline for implementing the federal rule. Previous deadlines have come and gone without enforcement because of legal challenges mounted by family planning advocates.

Federal officials declined comment, saying the plan offered by the California clinics is under review.

In San Diego, four community clinics and six county-run clinics have been affected by the gag rules. Community clinic spokesmen were unavailable to comment on their plans. However, county officials say they will toe the line and not discuss abortion at the family-planning clinics.

“We made a decision that it was more important to keep those funds and keep the birth control available even though it is going to be more cumbersome,” said Nancy Bowen, chief of the county’s Maternal and Child Health division.

About half of the low-income women who would need family planning services have it available in San Diego, Bowen estimated. “So we just didn’t think it would be good to decrease our access even further or risk being cut off.”

In the six county clinics, this translated to shuffling and separating birth control and pregnancy testing facilities. In the past, a woman could obtain a pregnancy test and explore her birth control options in one visit to one facility. Now, women must get their pregnancy tests in one office, where they also get abortion counseling, and their birth control in another.

“This is going to be difficult for some of our clients,” Bowen said. “I’m afraid some of our clients, with having to go to the extra clinic, may not go through with it and get birth control that they ordinarily would.”

Despite these concerns, Bowen vowed to obey the letter as well as the spirit of the law.

Officials from other family planning organizations--including Planned Parenthood--that do not accept federal funding watched from the sidelines as the controversy deepened Thursday.

“The clinics are attempting to head President Bush off at the pass,” said Heidi Minch, spokeswoman for Planned Parenthood of San Diego and Riverside Counties, which has 10 family planning clinics in San Diego and one in Riverside. “The administration is trying to implement the gag rule for political reasons; it’s exactly for these reasons that the clinics have to take action now.”

Clinic administrators in California have been outspoken opponents of the abortion gag rules, bolstered by a state law that directly contradicts the federal mandate. To receive state family planning funds, clinics here must agree to include abortion among the options presented to pregnant women.

Thomas C. Kring, executive director of the California Family Planning Council, said more than a year ago that the clinics would forfeit federal assistance rather than deny women full discussion of their pregnancy options. The clinics decided to try the new plan after a favorable court ruling and recent Bush Administration wavering on the rule’s scope.

“We are just going to do it until they tell us we can’t,” said Kring.

Clinics in other states are watching with interest, according to Judith DeSarno, executive director of the National Family Planning and Reproductive Health Assn., which represents 90% of the nation’s federally funded family planning agencies.

At stake nationally is about $150 million--California’s share is $12 million--in family planning funds under Title 10 of the Public Health Services Act. About 4,000 clinics that annually serve about 4 million poor women and teen-agers count on the grants to meet their operating expenses.

The controversy actually centers on a much smaller group--roughly 200,000 women who seek pregnancy testing and counseling at these clinics.

Clinic operators say most of these women have little notion of the political and philosophical arguments mounted in their behalf.

“Many of our patients read at no more than the third-grade level and about 40% do not speak English,” said Kay Truesdale, executive director of Family Planning Program Inc., which serves about 7,000 women in rural Tulare County.

The original law, passed in 1970, prohibited using abortion “as a method of family planning,” but the federal rules guiding the law’s use permitted doctors and nurses to inform pregnant women that abortion was one of their options.

In 1988, President Ronald Reagan ordered the rules changed to explicitly prohibit all discussion of abortion, even if patients asked for information. The rules then were interpreted as binding on all of the clinic’s services, not just on those paid for with federal money.

Family planning advocates challenged the legality of the rules, but the U.S. Supreme Court upheld the regulations in 1991. Congress took up the cause, with many members outraged by what they considered judicial and administrative tampering with the law’s original intent.

Legislation specifically requiring abortion counseling has since been passed several times--most recently last month. But Bush successfully vetoed the earlier bills and is expected to do so again. The Senate Appropriations Committee voted 26 to 0 Thursday to impose a moratorium on implementing the rules.

Times staff writer Nora Zamichow contributed to this story.