SUBJECT
Title
STRENGTHENING ACCESS TO REPRODUCTIVE HEALTH CARE: CONDUCTING A COMPREHENSIVE ASSESSMENT OF REPRODUCTIVE HEALTH CARE SERVICES IN THE COUNTY OF SAN DIEGO AND ADVOCATING FOR STATE LEGISLATION AND FUNDING FOR SUCH SERVICES AND RIGHTS (DISTRICTS: ALL)
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OVERVIEW
The United States Supreme Court is poised to rule on a case that directly challenges Roe v. Wade, the landmark case that held the right to privacy protects a pregnant person’s right to choose whether to have an abortion. This ruling has the possibility of magnifying the inequities of access to abortion care in the nation.
Based on California’s leadership on reproductive health care rights and the County of San Diego’s (“County”) stated commitment to health equity and reproductive freedom, ensuring that there is broad public access to a full scope of reproductive health care services is paramount. The County is responsible for the public health in our region and therefore has a duty and responsibility to assess our role in ensuring that people have access to reproductive health care.
This Board Letter requests that the County develop a comprehensive understanding of the scope of reproductive health care services offered by the County of San Diego and County health care contractors. Additionally, the Board Letter recommends advocating for regulatory, budgetary, and legislative efforts to support full access to reproductive health care services and the protection of reproductive rights in California.
RECOMMENDATION(S)
VICE CHAIR NORA VARGAS AND CHAIR NATHAN FLETCHER
Direct the Chief Administrative Officer to:
1. Conduct a comprehensive assessment of reproductive health care services offered by the County of San Diego and County health care contractors, including barriers to care, opportunities to optimize reproductive health care services and to expand partnerships with reproductive health care providers, opportunities to reduce and address health disparities for marginalized communities, and report back to the Board of Supervisors in 150 days.
2. In support of the findings from Recommendation One, and in accordance with Board Policies M1 and M2, advocate for regulatory, budgetary, and legislative efforts that strengthen access to reproductive rights and health care services, including abortion.
EQUITY IMPACT STATEMENT
Restrictions and bans that violate reproductive health care options disproportionately impact populations that already face barriers to accessing care-people of color, people with low incomes, immigrants, and young people. The implications of changes in national law could magnify this inequity both in other regions of the country and here in San Diego. Reproductive health care access is tied to maternal and infant mortality outcomes and sexually transmitted infection rates, treatment, and prevention. By assessing issues related to access to services, the County can find ways to reduce health disparities for people who have traditionally had difficulty obtaining services.
FISCAL IMPACT
There is no fiscal impact associated with today’s recommended actions though they may result in future fiscal impacts. Staff will return to the Board for consideration and approval of any such impacts. There will be no change in net General Fund cost and no additional staff years.
BUSINESS IMPACT STATEMENT
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ADVISORY BOARD STATEMENT
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BACKGROUND
In 1973, the U.S. Supreme Court decided Roe v. Wade (“Roe”) and held that the right to abortion is constitutionally protected under the right to privacy. Roe has guaranteed the right to abortion for nearly five decades. However, access to reproductive health care in large parts of the country continues to be a right in name only, with many people unable to access care due to restrictive laws, financial hardships, and other barriers. While the State of California has broad laws protecting the legal right to reproductive health care, these financial hardships and other barriers also create obstacles to care for people here in San Diego County.
The United States Supreme Court is poised to rule on a case that directly challenges the holding of Roe and could undo the legal protection for abortion. This ruling has the possibility of magnifying the inequities of access to reproductive health care both in the nation and here in San Diego County. The Governor of California and legislative leadership have declared their intent that California be open to out-of-state people seeking access to full scale reproductive health care. This statewide intention is mirrored and supported by the County of San Diego’s commitment to health equity and reproductive freedom. On September 14, 2021, the Board of Supervisors adopted a resolution declaring the County of San Diego a champion of reproductive freedom.
Abortion is healthcare and the broad access to abortion care is inherently tied to a myriad of other outcomes including infant and maternal health, sexually transmitted infection rates, and health outcomes more broadly, including physical health, and social and economic stability and well-being.
Preserving our resident’s access to quality reproductive health care services, while serving others seeking the same services, is critical. To address the full health and wellness of our community, the County should develop a comprehensive understanding of the scope of reproductive health care services offered by the County and County health care contractors, with particular attention to disparities in marginalized communities. This assessment should include an analysis of the barriers to care, opportunities to optimize reproductive health care services, and a wholistic look at the system of reproductive health care within the County. As part of this assessment, the County should consider how to expand partnerships with reproductive health care providers. While the County conducts its assessment of the wholistic landscape of reproductive health care services, the County legislative advocates should work to advocate for regulatory, budgetary, and legislative efforts to support full access to reproductive health care services and rights.
The County of San Diego can meet this historical moment both for our residents and those that seek care in our jurisdiction.
Based on the foregoing, we urge your support for the above recommendations.
LINKAGE TO THE COUNTY OF SAN DIEGO STRATEGIC PLAN
The requested action supports the County’s 2022-2027 Strategic Plan initiatives of Health Equity and Resiliency by reducing health disparities and ensuring equal opportunity for health and well-being as well as ensuring the capability to respond and recover to immediate needs in the region.
Respectfully submitted,
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Nora Vargas Supervisor, First District |
NATHAN FLETCHER Supervisor, Fourth District |
ATTACHMENT(S)
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