Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Michael P. Callagy, County Executive
Peggy Jensen, Assistant County Executive
Subject: Action Plan to Further San Mateo County’s Unwavering Support for Women’s Reproductive Freedom and Healthcare Privacy
RECOMMENDATION:
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Adopt a resolution:
A) Creating a Board subcommittee on Women’s Reproductive Freedom and Healthcare Privacy and appoints Supervisor Dave Pine and Supervisor Warren Slocum to that subcommittee; and
B) Accepting the proposed components of the San Mateo County Action Plan to Support Women’s Reproductive Freedom and Healthcare Privacy; and
C) Allocating up to $1,000,000 in two tranches, $549,312 for immediate purchase of technology and medical equipment for clinics operated by Planned Parenthood Mar Monte, and up to an additional $450,688 to be allocated later based on Board consideration of recommendations from the Women’s Reproductive Freedom and Healthcare Privacy Subcommittee; and
D) Authorizing the County Executive to enter into an agreement with Planned Parenthood Mar Monte for the purchase of technology and medical equipment in the amount of $549,312; and
E) Directing staff to present a Women’s Reproductive Freedom and Healthcare Privacy advocacy agenda to the Board for consideration no later than August 2, 2022.
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BACKGROUND:
On May 17, 2022, the Board of Supervisors adopted a resolution that affirmed San Mateo County’s unwavering support for women’s reproductive freedom and healthcare privacy. The resolution also directed the County Executive to develop an action plan to further the Board’s commitment to these principles and present the action plan to the Board of Supervisors for its review and approval at the Board’s meeting of June 14, 2022.
To develop the action plan, staff met with leaders of Planned Parenthood Mar Monte (PPMM), which serves residents of Northern California including San Mateo County. PPMM has three clinics in San Mateo County (located in South San Francisco, San Mateo, and unincorporated Redwood City) that provide comprehensive sexual and reproductive health care, gender-affirming care, behavioral health, and family medicine services. Together, these clinics serve about 13,000 San Mateo County residents a year, including low-income residents, immigrants, LGBTQ+ community members, those who face language barriers, and individuals from Black, Indigenous, and other communities of color.
According to a report released in October 2021 by the Guttmacher Institute, if Roe v. Wade is overturned or gutted, 26 states are certain or likely to ban abortion. The actions by those states would increase the number of out-of-state patients seeking abortion care in California from 46,000 to 1.4 million-an increase of nearly 3,000 percent. Between July of 2021 and May of 2022, PPMM provided abortion care to 87 patients from out-of-state. Those services were provided to 5 patients at the PPMM clinics in San Mateo County.
To protect patients seeking services at Planned Parenthood clinics, some cities have adopted buffer zone ordinances preventing the harassment, intimidation or obstruction of patients entering women’s health facilities. In the Bay Area, buffer zone ordinances have been adopted by the City of San Mateo, San Francisco, Walnut Creek, and the City of Oakland. The City of San Mateo ordinance creates a 100-foot buffer zone around the clinic entrance and requires everyone within that buffer zone to stay at least eight feet away from any individuals entering or exiting the clinic. The County Attorney’s Office is currently developing a buffer zone ordinance for the unincorporated areas of San Mateo County at the request of Supervisors David Canepa and Carole Groom.
DISCUSSION:
Staff is proposing a Women’s Reproductive Freedom and Healthcare Privacy Action Plan that includes four components: financial support for PPMM to provide increased abortion care, creation of a buffer zone ordinance for the unincorporated areas of the County, development of an advocacy agenda, and an information campaign to let patients know that the San Mateo County Health System continues to offer reproductive services. Each component of the plan is described below.
Financial Support for PPMM
PPMM has been and will continue to be the provider of abortion services to patients with limited resources coming to San Mateo County from out-of-state. For that reason, to develop the plan requested by the Board, staff met with leaders of PPMM including Medical Director for San Mateo County, Dr. Laura Dalton and Lauren Bibb, Vice President of Public Affairs, to discuss their organizational needs and the framework for an action plan.
From that meeting and follow-up discussions with PPMM, staff recommend that $1,000,000 be allocated in two tranches to support the County’s commitment to reproductive rights. The first tranche of $549,312 in funding would support the immediate purchase of the following technology and equipment by PPMM to allow for increased patient capacity at its clinics.
• $216,056 for the conversion of 5 years of ultrasound scans to Viewpoint, an online system that will automatically upload scans to the PPMM health record system. Currently, staff print the images, cut, and paste them onto paper, and then scan them into the medical records system. Converting ultrasound scans to Viewpoint, will increase the effectiveness and the efficiency of the PPMM medical and support staff. This investment will benefit clients of all PPMM clinics in San Mateo County.
• $145,040 for 16 new exam tables to be distributed between the San Mateo and Redwood City clinics. The new tables will be ADA compliant, allow patients to be weighed on the tables, and improve health center workflow by giving medical providers better patient access.
• $140,216 for 4 new ultrasound machines for the San Mateo and Redwood City clinics. These machines are needed for abortion related care and will enable staff to continue to meet the needs of San Mateo County residents and be prepared for additional patients coming from out-of-state.
• $40,800 for 4 additional ultrasound probes. Infection prevention protocols require sterilization of ultrasound probes between each use. Additional probes allow ongoing use of the ultrasound machines and increased health center workflow.
The second tranche of funding, up to $450,688, would be held in reserve for use as needs emerge. An expenditure plan for these funds would be developed through ongoing meetings between PPMM leaders, the Women’s Reproductive Rights Subcommittee, and County staff. At these meetings, participants will explore changes in patient numbers at San Mateo County clinics, as well as the needs of patients from out-of-state and the best ways to meet those needs. Proposed expenditure of the second tranche of funds would be brought back to the Board for review and approval.
Buffer Zone
A draft buffer zone ordinance for unincorporated San Mateo County clinics that protects patients and employees from harassment, intimidation, and obstruction when accessing a PPMM clinic while also balancing First Amendment rights will be brought to the Board of Supervisors at the June 28, 2022 meeting. The ordinance will be modeled on the City of San Mateo buffer zone ordinance.
Advocacy Agenda
In response to the leak of the Supreme Court draft opinion that would overturn Roe v. Wade, the state and federal governments are considering legislation and funding for women’s reproductive health and healthcare privacy. Numerous court cases are also being filed. To ensure the County is informed and can weigh-in on proposed bills and court cases, a women’s reproductive freedom and healthcare privacy advocacy agenda will be developed. The County Legislative Liaison, Connie Juarez-Diroll, will work with the Commission on the Status of Women, County Attorney’s Office, County staff and the Board subcommittee to develop a proposed advocacy agenda for consideration at the August 2, 2022 Board meeting.
Supporting Women’s Reproductive Freedom Services Provided by the San Mateo County Health System
The San Mateo County Health System provides women’s health services to over 16,000 patients a year. These services, which include medical and surgical abortions, are provided to California residents, primarily people living in San Mateo County, almost all of whom are covered by Medi-Cal. People coming to San Mateo County from out-of-state would be referred to PPMM since their services are provided free-of-charge for patients who cannot pay, and out-of-state patients would not be covered by Medi-Cal. However, staff will check-in monthly with Health System leaders about changes, up or down, in the number of Health System patients seeking abortion services. A downward trend in patients could indicate a lack of accurate information about services available to San Mateo County residents.
FISCAL IMPACT:
The up to $1,000,000 in funding for PPMM technology and medical equipment would come from Measure K reserves as a one-time allocation to improve women’s access to abortion and other reproductive health care services. If there are additional costs associated with the other components of the action plan, they will be presented when the Board considers future action.