Hospital reaffirms the compliance of its employee medical procedure opt-out policies in letter to US Department of Health and Human Services
University of Vermont Medical Center The University of Vermont Medical Center sent a letter today to the United States Department of Health and Human Services (HHS) Office for Civil Rights (OCR) reaffirming its compliance with federal laws that provide hospital employees the ability to reasonably opt-out of participating in medical procedures they oppose on religious or personal beliefs, which include reproductive care, sterilizations, blood transfusions, and others.
The letter is in response to December 11 and December 14 correspondence from HHS threatening the hospital with federal enforcement stemming from an August 2019 “Notice of Violation” OCR issued to UVM Medical Center and the press, despite lacking any legal authority to do so.
The administration’s new threat of litigation is an abrupt turnaround by HHS’s and OCR’s leaders, who agreed late last year to not recommend any further enforcement of OCR’s 2019 allegations, following multiple decisions by federal courts rejecting OCR’s interpretation of the law.
In the letter, UVM Medical Center informed HHS that it declined to further alter its opt-out policies and practices in a manner that would create barriers to the delivery of safe, legal, and effective reproductive health care and is also not required by law.
In fact, since receiving OCR’s “Notice of Violation” last summer, the hospital has only strengthened its already-compliant provider opt-out policies and practices.
For instance, the hospital has improved the way it schedules both patients and staff for pregnancy termination procedures, utilizing regular, designated operating room times for those procedures whenever possible and staffing them with providers who have opted into participating. Through this and other recent changes, UVM Medical Center’s goal is to eliminate those instances – already exceedingly rare – in which employees’ religious or moral beliefs come into conflict with the hospital’s patient care obligations, while enhancing the care provided to patients.
“As the primary tertiary care center for our region, we have an obligation to provide access to safe and legal reproductive health care to our patients who rely on us,” said Stephen Leffler, MD, President and Chief Operating Officer of UVM Medical Center. “At the same time, since we were first contacted by OCR last year, we have taken a thorough look at all of our policies and practices and have modified and strengthened them to respect the many beliefs of the thousands of care givers that work here. OCR’s latest threats are not just baseless from a legal standpoint, they’re an attack on reproductive care and we will do everything we can to protect our patients’ access to the services they need.”
The response by UVM Medical Center points out that the latest threat by HHS defies recent decisions issued by federal courts across the country, which have rejected the legal theory on which the current presidential administration is relying in its attempt to prevent the hospital from providing pregnancy termination services.
Statement from Meagan Gallagher, President and CEO, Planned Parenthood Vermont Action Fund:
"For patients, health care is personal, not political. Government interference should never determine patient care. Barriers to safe, legal abortion infringe on people’s rights and dignity, and go against every commitment we make to patients as health care providers. This latest attack on the UVM Medical Center is nothing more than a political game by a lame duck administration. As health care providers we will continue doing everything we can to ensure that patients have access to compassionate abortion care.”
Attorney General Donovan’s Statement in Support of UVM Medical Center and the Right to an Abortion
The Vermont Attorney General’s Office continues to stand with the University of Vermont (UVM) Medical Center in its opposition to the U.S. Department of Health and Human Services’ (HHS’s) unwarranted issuance of a notice of violation in August 2019 based upon UVM Medical Center’s decision to offer elective abortions and its Conflict of Care policy. A conflict of care policy is a medical center’s policy regarding instances in which a medical provider may wish to remove themselves from a procedure due to religious or moral conflicts.
In contrast to HHS’s notice of violation, UVM Medical Center’s Conflict of Care policy presents a reasonable balance between honoring the religious objections of its employees and its obligation to provide essential health care to patients in predominately rural communities with limited access to providers.
Significantly, HHS’s notice of alleged violation against UVM Medical Center continues to raise serious constitutional concerns as an attack against the long-established, fundamental right to access abortion services. It also presents serious constitutional issues in light of the Establishment Clause of the First Amendment to the U.S. Constitution, which forms the principle of separation of church and state.
Abortion is legal and constitutional. HHS’ latest threat of enforcement action represents a last-ditch effort by the Trump Administration to restrict a woman’s access to abortion—a theme that has permeated throughout Donald Trump’s presidency.
Last year, my office joined a coalition of 22 other states and cities suing to stop the Trump Administration from jeopardizing patient care by vastly expanding the ability of any health care worker to opt out of any procedure at any time, without regard for patient needs. The court agreed with our coalition and blocked the rule from taking effect because it was contrary to laws passed by Congress. The court’s decision means that the Trump Administration’s attack on UVM Medical Center stands on shaky legal ground at best.
My office has been, and remains, committed to protecting access to health care for all Vermonters, including abortion services.
Incoming House and Senate Leaders Statement in Support of UVM Medical Center:
December 16, 2020
We object to the unwarranted threats of litigation against UVM Medical Center from the federal Office of Civil Rights (OCR) within the US Department of Health and Human Services. We commend UVM Medical Center for their commitment to provide access to safe and legal reproductive health care to patients across a large region of our state, while balancing the religious and moral beliefs of their employees.
As incoming legislative leadership, we strongly support the right to personal reproductive liberty for all Vermonters. In the midst of a global pandemic when our hospitals are under siege, we reject this ideological stunt by the outgoing administration to intimidate medical providers and those seeking reproductive services across the country.
Speaker of the House – Elect, Jill Krowinski
Senate President Pro Tempore – Elect, Becca Balint
House Majority Leader, Emily Long
Senate Majority Leader, Alison Clarkson
Chair of House Committee on Human Services, Ann Pugh
Chair of Senate Committee on Health and Welfare, Ginny Lyons
Chair of House Committee on Judiciary, Maxine Grad
Chair of Senate Committee on Judiciary, Dick Sears
Background
On August 28, 2019, HHS OCR sent UVM Medical Center a “Notice of Violation,” alleging that it had violated the “Church Amendments,” which provide health care workers a qualified right to opt-out of participating in certain medical procedures, such as sterilizations or abortions, due to religious or moral objections. It was OCR’s position that employers must allow employees to opt out of procedures at any time, regardless of the impact on patient safety or the availability of legal health care services.
At the same time OCR issued the notice to UVM Medical Center, a number of states (including Vermont) and interest groups sued HHS, challenging the administration’s novel interpretation of the Church Amendments and similar provisions of federal law.
In the fall of 2019, two separate federal district courts explicitly rejected HHS’ position that the Church Amendments provided an unqualified opt-out right to health care workers.
HHS has appealed those trial court decisions, and HHS has been enjoined from enforcing its new regulations while its appeals are pending.
In the wake of those decisions and in response to UVM Medical Center’s strengthened policies and practices, in November 2019, senior HHS and OCR representatives stated they would recommend that HHS not continue to pursue enforcement action against UVM Medical Center, at least until the appeals are resolved.
UVM Medical Center heard nothing further from HHS on this matter until this week—more than a year later. The threats issued by HHS this week are directly at odds both with its prior representations to UVM Medical Center and last year’s federal court decisions.
Source: Burlington, VT – The University of Vermont Medical Center 12.16.2020