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Are Utah hospitals prepared to handle patients seeking abortion care? This study suggests not.

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Are Utah hospitals prepared to handle patients seeking abortion care? This study suggests not.


A bill passed by Utah lawmakers earlier this year, framed by both sponsors and the governor as a “cleanup” to an oftentimes vague 2020 abortion trigger ban held up in court, has left many health care workers with more questions than answers.

While abortions in Utah remain legal up to 18 weeks, that law attempted to circumvent a court-issued injunction by prohibiting abortion clinics and moving all abortions to hospitals. Those hospitals, however, are ill-equipped to direct patients to care, a report published this month found.

Researchers with the University of Utah’s ASCENT Center for Reproductive Health called 50 hospitals throughout the Beehive State, asking staff, “If someone needed abortion care, could they receive it at your hospital?”

The answers researchers got back from workers in both emergency and labor and delivery departments varied widely. Some said abortion is illegal, or, “We don’t do that here.” Others were confused, the study noted, while a staffer at a larger hospital explained that there was a specific line to which they could connect patients with questions about abortion policies.

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The spectrum of responses suggests to researchers that many of the state’s hospitals don’t have the systems in place to help employees navigate questions about abortion or offer such care in a “destigmatizing, supportive, timely way.”

“Right now, the hospitals are not well set up to route that person to the type of care they need,” said Jami Baayd, a public health researcher who led the project. “And we know there are really well-intentioned and excellent providers all across the state. This isn’t an issue of medical providers not necessarily wanting to provide the care, but it’s figuring out within the systems how to connect those individuals to care.”

Baayd said after an exchange between lawmakers in a committee hearing on HB467 — the enjoined law that would effectively ban abortion clinics — she realized there was a need to probe whether hospitals have the infrastructure in place to take on abortions.

‘Cascade of interpretation’ burdens hospitals

In a Senate Health and Human Services Committee meeting debating HB467, Minority Leader Luz Escamilla of Salt Lake City asked bill sponsor Rep. Karianne Lisonbee, R-Clearfield, whether her legislation could keep Utahns from accessing legal medical procedures.

“I don’t think that’s an issue in Utah,” Lisonbee responded. “In fact, we worked very closely with the hospitals to ensure that the language allowed them to perform these emergency services. So, I really don’t think that’s an issue. I don’t know of a hospital in Utah who isn’t performing these services [abortion care] for emergency patients.”

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(Rick Egan | The Salt Lake Tribune) Rep. Karianne Lisonbee and Sen. Dan McCay discuss HB467 during a Senate committee meeting on Wednesday, Feb. 22, 2023.

About 1% of abortions in Utah are performed in hospitals, according to data from the Guttmacher Institute, a research and policy firm dedicated to advancing sexual health and reproductive rights worldwide, shared with news website The 19th earlier this year.

“In most cases,” the ASCENT study states, “hospital staff are not prepared to discuss what abortion services they provide.”

Researchers successfully connected with 29 of the 50 hospitals they called. Questions directed at staff, the report says, were not handled with the same “efficiency and neutrality” researchers expected from staffers about other medical procedures.

Continuing the conversation, the research team asked workers whether the hospital had a written policy regarding abortion and if it was posted online. They also queried whether the hospital had facilitated any discussions about abortion care and its legal status in Utah.

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The goal was to find out whether staff were aware of where their hospital stood on providing abortion, not whether hospitals had established a policy about it.

Most frequently, the study found, staff members said they knew of internal protocols but not an official policy. Some said their hospital didn’t have a policy or they weren’t sure whether one existed, and most respondents didn’t know where members of the public could access the hospital’s abortion policy.

Some respondents said there were regular staff meetings discussing shifting abortion laws and hospital policy, helping them feel “confident” that they were working with up-to-date information. But in smaller hospitals, and those that aren’t part of a larger system, such conversations were less likely to happen.

One nurse manager told researchers, “We just want to take good care of people, and all of these policies make that confusing.”

When abortion laws change, as they have multiple times over the last couple of years, hospitals have to adjust their policies, and various departments within the hospital have to change their protocols.

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“This cascade of interpretation burdens hospital systems — particularly when legislation is complex or unclear — and places onus on providers, who must interpret and bear responsibility for the laws while providing the best patient care they can,” researchers wrote.

“Further, abortion care is only a very small part of the care provided by these hospitals, which means they likely have few opportunities to fully develop and implement their protocols around abortion care.”

One of Utah’s largest hospital systems, the state-owned University of Utah Health, is prevented by statute from providing abortions under many circumstances. Other hospital systems with religious affiliations have policies against offering the procedure.

In Utah, The Salt Lake Tribune has previously reported, there is no mechanism to track what services hospitals provide, and hospitals are not legally required to disclose those.

Without an abortion policy distributed to staff, individual providers are often left to make decisions themselves as to whether abortion is a legal choice for a pregnant person.

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In other states with bans, many of which have language similar to the one paused in Utah, confusion over where the line is drawn for exceptions has often resulted in people whose circumstances legally qualify for an abortion not being able to find a provider to give them one.

That consequence is one ASCENT officials say they are hoping to work with hospitals to help patients in the Beehive State avoid.

Murky legislation faces uncertain future

(Rick Egan | The Salt Lake Tribune) Planned Parenthood in Salt Lake City on Monday, April 10, 2023.

Lawmakers passed the near-total ban in 2020, crafting the legislation to go into effect if the U.S. Supreme Court overturned Roe v. Wade, the 1973 decision that protected abortion as a constitutional right.

When the court undid the landmark ruling last year in Dobbs v. Jackson Women’s Health Organization, the trigger law went into effect. It was soon blocked by a district court judge after Planned Parenthood Association of Utah sued to stop the ban.

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If the courts allow the ban to take effect, abortion would only be allowed in limited circumstances — when it’s necessary to prevent the mother’s death or “a serious physical risk of substantial impairment of a major bodily function,” when the fetus has a fatal abnormality, and before 18 weeks in cases of rape or incest.

A separate Utah law passed this year, HB467, would — among other measures — effectively ban abortion clinics and require the procedure to be offered at a facility that could provide the same level of care as a hospital. That measure is now also on hold as part of Planned Parenthood’s lawsuit.

The organization has repeatedly argued that hospitals will not duplicate the services it provides pregnant people.

As Utahns wait to see whether a Beehive State without abortion clinics will become the new reality, ASCENT wants to make sure hospital staff have the knowledge to provide the full range of care they are able to under state law, and that they are transparent with patients when their policies or capabilities prevent them from providing medical services.

“A piece of [the study] was to really ask [hospitals] what resources they needed moving forward to make sure that they were able to provide the care that they are capable of and wanted to, and are within the legal bounds of the law without that chilling effect that we’ve seen in other states,” said Jessica Sanders, the research director at ASCENT.

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How researchers say laws, hospitals could improve

(Rick Egan | The Salt Lake Tribune) Jessica Sanders of the ASCENT Center for Reproductive Health speaks during a news conference on Capitol Hill, Wednesday, March 1, 2023.

The study found routine and emergent abortion “has no real home in Utah’s hospital systems,” but there are ways that both hospitals and the state can lessen the impact of an abortion clinic ban on patients and staff.

Researchers recommended Utah officials create and distribute statewide training materials to educate providers on navigating abortion laws while caring for patients, as well as how to counsel people with unwanted pregnancies on their options.

The state could also designate “safe haven” hospitals where patients know they can access the full range of care for pregnancy emergencies, the report concluded.

Researchers also suggested removing provisions in the state’s near-total ban that would stick medical providers with criminal penalties for violating state abortion laws.

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A spokesperson for the Utah Department of Health and Human Services said the report’s recommendations could only be implemented through legislative action.

“The report asks important questions that highlight some of the complex challenges that come with providing reproductive health care,” the spokesperson wrote in a statement. “DHHS does not mandate specific hospital policies about reproductive care, and all maternal care that is offered through DHHS programs or community collaborations follows current Utah law.”

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Lisonbee, the lawmaker who sponsored HB467, did not respond to requests for an interview or answer questions about whether she would consider introducing any of the report’s recommendations in a bill.

Outside the Capitol, the report recommended, hospital officials should consider being more transparent about their policies and designate a place for both employees and patients to go for help with abortion-related questions.

Officials at medical centers should also review their policies alongside state law to ensure they aren’t unintentionally imposing additional restrictions.

“While in some cases these policies may intentionally be more restrictive — reflecting specific religious views, for example — in other cases the policies may be a result of misunderstanding the law, unexamined tradition, political pressure, or concerns about loss of funding,” the report reads.

The Utah Hospital Association did not respond to requests for comment, but, in a post on its website after HB467 passed, urged hospitals to look over the law with their legal counsel. The organization’s spokesperson previously told The Tribune that each health care system would “need to determine how to respond” to the bill’s passage, and later added, “all Utah hospitals will follow state law.”

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Sanders, the research director at ASCENT, emphasized that the report is merely a snapshot of how hospitals might approach abortion moving forward, and that ASCENT hopes to keep an open dialogue with health care systems as it adapts to evolving policies.

“Understanding the nuance to abortion care as part of the full spectrum of reproductive health is critical,” she added.

Both Sanders and Baayd, however, said pregnancy is ultimately safer when abortion is legal. Research in states with the strictest abortion bans indicates that more restrictions can lead to worse health outcomes for pregnant people.

“I think the legislators really want it to be true that you can excise abortion, like there’s this whole spectrum of care and you can just neatly cut out the borders of this specific type of abortion care that they would like to target and leave all the rest of the spectrum of care in place,” Baayd said. “And that, from a public health standpoint, certainly is categorically untrue.”



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Opinion: Utah Inland Port wants 9K acres in Weber Co. You should weigh in.

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Opinion: Utah Inland Port wants 9K acres in Weber Co. You should weigh in.


Residents have issued their own warning about what could be permanently lost.

(Trent Nelson | The Salt Lake Tribune) Weber County property slated for an inland port on Friday, April 5, 2024.

Weber County has some of the most stunning lands and vistas in the state of Utah. Now the Utah Inland Port Authority is poised to turn almost 9,000 acres of largely undeveloped land, near the imperiled Great Salt Lake and the Harold Crane and Ogden Bay waterfowl management areas, into industrial concrete and asphalt projects.

More than 2,000 years ago in ancient Greece, the storyteller Aesop issued a warning that will be ignored at our peril. He told of a farmer who owned a wonderful goose that each day laid a golden egg. The farmer grew rich, but he just had to have more. One day, his greed and impatience got the best of him because he wasn’t getting rich fast enough. He killed the goose to dig out all the eggs inside her. Sadly, there were none, as she could only lay one a day. And now his lovely goose was dead.

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Residents of western Weber County have beautiful golden eggs — wetlands, open spaces, wildlife habitat, clear skies, peace and quiet — riches by anyone’s definition. But UIPA and the Weber County Commission, which has voted to support UIPA’s plans, want their goose for different kinds of riches.

The residents are pushing back. They have issued their own warning about what could be permanently lost, requesting that the final decision be put on hold until the repercussions are fully studied, and more citizens are made aware of them.

The statement reads, “This project area cedes local control and budget authority to a state-appointed board. Various groups across the political spectrum are calling on Weber County to study the full impact, including the budget burden to local taxpayers, attracting heavy truck traffic to an area that does not have it now, bright lighting, destruction of wetlands, inestimable noise and attracting sources of air pollution.”

John Valentine, head of the Utah Tax Commission, spoke about a different kind of golden egg at a recent meeting of the Utah Taxpayer Association. This golden egg is our tax base that pays for schools, parks, road repairs, emergency services, fire and police protection.

According to Fox13 News, Valentine warned, “Some of the projects that we’ve passed in the state are eroding the tax base by sales tax diversions and tax increment financing.” He included the inland port as one example.

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UIPA’s Weber County inland port project will keep 75% of all property and sales taxes it generates to be used at the board’s discretion and give back only 25% of those revenues to local governments.

In other words, UIPA and developers will build the port, but government entities will have only 25% to provide critical services. UIPA will build infrastructure, but they will not maintain it.

Rusty Cannon, president of the taxpayers’ association, issued his own warning about projects that have been adding up over decades.

“It’s just death by a thousand cuts. It’s been coming and it’s starting to hollow out our tax base.” he said.

This could lead to increased taxes for the part of the county that is not in the project area.

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At a meeting in February, Weber County commissioners questioned whether 25% will be enough to provide all the services needed. Scott Wolford, Vice President of the Business Development Team for the Utah Inland Port Authority, stated, “We don’t have to get it right today. We’re just taking our best guess. We will adjust through the 25 years.”

He assured the commissioners that they can vote later to take a certain parcel out of the inland port project area if the tax structure doesn’t work. All they have to do, he said, is to ask the UIPA board, “Please remove this from the project area, and our board will take it out.”

Wolford admitted, however, there is no statutory protection for Weber County and that the five-member, appointed board has final authority. He made an unwritten promise, based on nothing but his word, that UIPA’s decisions can be easily reversed.

He also applied pressure for a quick decision by reporting that we have “a lot of communities stacked up for project areas,” so Weber County could lose its place in line.

If UIPA approves the project at its meeting on Monday, it looks like they and the taxpayer-subsidized developers will keep the miraculous goose. Once she’s dead, her bones will be tossed back to the people.

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You can’t resurrect a dead goose, and you can’t restore acres and acres of land taken away from future generations and destroyed forever.

Aesop always gave us the moral of his stories for those of us who miss the point. “Those who have plenty want more and so lose all they have.”

Ann Florence taught English and journalism and now teaches therapeutic poetry at the Youth Resource Center for unsheltered young people. She finds solitude, healing and inspiration in nature.

Ann Florence teaches therapeutic poetry at the Youth Resource Center and believes that a connection to the land is essential for all of us, especially young people, to flourish.

The Salt Lake Tribune is committed to creating a space where Utahns can share ideas, perspectives and solutions that move our state forward. We rely on your insight to do this. Find out how to share your opinion here, and email us at voices@sltrib.com.

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John ‘Frugal’ Dougall is running for Congress to make the GOP the party of ideas again

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John ‘Frugal’ Dougall is running for Congress to make the GOP the party of ideas again


State Auditor John Dougall thinks the best place for a congressman to serve Utah is in the weeds.

After two decades of working to lighten Utah’s tax load and shed light on government waste, Dougall says he wants to bring his penchant for problem-solving to the nation’s Capitol representing the state’s 3rd Congressional District.

But selling constituents on the importance of welfare reform and budget reduction is a problem to solve all on its own.

As a former state lawmaker and tech entrepreneur, with graduate degrees in electrical engineering and business from Brigham Young University, Dougall said he believes the Republican Party of late has been less interested in outcomes than political point-scoring.

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“The Republican Party used to be the party of big ideas,” Dougall said. “We have nothing but infighting, squabbling, performative politics.”

Dougall was ready for retirement from public service following his 10 years in the Utah House of Representatives and 11 years overseeing the state auditor’s office, he said. But he said the absence of “any real budget hawks back in D.C.” drew Dougall to Rep. John Curtis’ soon-to-be-open seat.

“I’ve got a unique skill set when it comes to these issues,” Dougall said. “And I think the financial matters, the debt, the out of control spending, the dysfunction in Washington, D.C., this is one of the top national crises.”

Creative solutions to the nation’s biggest money problems

For those who don’t feel the same sense of urgency about the country’s balance sheets, Dougall has a thought experiment.

Imagine a Utah household making $100,000 a year and spending $130,000 with the help of a credit card. The monthly minimum credit card payment would exceed most Utahns’ biggest budget item, their mortgage, Dougall said, making it harder to pay for essential needs and leaving the family at the mercy of steep interest rates.

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In fiscal year 2024, Dougall pointed out, the United States is expected to pay more on interest payments to service the national debt than on national defense — a sober milestone that comes on the heels of federal debt surpassing $34.5 trillion for the first time, increasing by a rate of roughly $1 trillion every 100 days.

Dougall has incorporated an interactive “Balance the Federal Budget” tool into his campaign website to help voters visualize the problem. The feature is similar to the property value and public education tracking tools that he developed as auditor to help Utahns follow their tax dollars and access government information.

The country’s biggest problem has “no single silver bullet” solution, Dougall said, but “we can’t just keep doing the same thing because we’re going to get the same results. We’ve got to try and be more innovative, we’ve got to try and push big ideas to try and solve these very, very difficult problems.”

For Social Security — the retirement benefit program that drives more than one-fifth of federal spending — Dougall proposes a shift to state sponsored retirement trust funds modeled after 529 college savings plans.

This would allow workers to opt out of Social Security benefits, which are projected to be cut by 20% in a decade. Workers would then be able to invest that portion of their payroll tax into a state sponsored investment fund “to get them a better, more secure retirement” while giving Democrats the government oversight they demand to protect all workers, Dougall said.

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Such a massive overhaul of Social Security would have to be phased in, with different age cohorts being allowed to allocate more or less of their payroll tax, Dougall said.

When it comes to government-provided health care for the elderly, however, Dougall said an overhaul doesn’t go far enough.

“I don’t want the federal government running Medicare better,” Dougall said. “I want to get the federal government out of health care.”

Enabling competition with government provided health care, facilitating direct care models and reimbursing procedures the same regardless of location would result in hundreds of billions of dollars in savings, Dougall said.

“It won’t balance the budget, but it’s a big step in the right direction,” Dougall said. “And it can put patients more in control of their health care so they can get better quality care.”

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Subsidized health care programs for low income Americans, like Medicaid, also need to be stripped of federal involvement, Dougall said, with funds and oversight being handed over to the states, instead of the “split-funded” system currently in place that creates a “mismatch of accountability” that incentivizes states to grow Medicaid rolls, Dougall said.

Block-granting Medicaid funding to the states and expanding work requirements for “able-bodied individuals” would result in another $100 billion in annual savings, Dougall said — far short of the $1.7 trillion deficit in 2023, but one of the many trade offs needed to make federal spending look more like a responsible home budget.

The government watchdog candidate

Dougall has more time in government than any of his four opponents in the Republican Party primary election. The crowded field of five also includes Roosevelt Mayor JR Bird, Sky Zone CEO Case Lawrence, commercial litigator Stewart Peay and state Sen. Mike Kennedy.

Dougall took over the state auditor’s office in 2013 after ousting a longtime incumbent in a primary election. As auditor, Dougall held officials accountable and reviewed the state’s COVID-19 expenditures, database security and implemented programs to make government financial information available for “essentially every state and local entity in Utah.”

Dougall also emphasized transparency during his 10-year tenure as a state lawmaker which immediately preceded his time as a state auditor. He contributed to the public meeting notice website and pushed to repeal the state’s vehicle inspection program, which required added bureaucracy with little benefits to show for it, he said.

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In 2005, Dougall was a member of the Tax Reform Task Force that led to the passage of Utah’s biggest restructuring of the tax-code in decades, which included a 5% single-rate income tax.

These policy wins were the result of focusing on how to get a solution across the finish line without worrying about “who gets the credit” or “the next election cycle,” Dougall said — an attitude he plans to bring to the contentious halls of Congress.

“I will work with anybody who’s willing to fight out-of-control spending, to try and rein in the federal government, to try and balance the budget,” Dougall said. “I’ll work with anybody, I don’t care who they are, because that’s what it’s going to take.”

Dougall’s other priorities include securing the southern border and ensuring American energy dominance. He also believes the U.S. should continue to provide “targeted assistance” to Ukraine to stop Russia’s advance and prevent a bigger war in Europe.

Dougall — John ‘Frugal’ Dougall on the ballot — will face his four primary opponents on June 25. The Republican who wins the primary will face off against Democratic candidate Glenn Wright on Nov. 5.

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Correction: An earlier version said Dougall has spent 10 years as state auditor and that he was co-chair of the Tax Reform Task Force. He has been state auditor for 11 years and was a member of the task force, but not co-chair.



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Rent costs are up nationally, but what about Utah?

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Rent costs are up nationally, but what about Utah?


SALT LAKE CITY — While some aspects of inflation are cooling down, the cost of renting is going up.

According to the latest Consumer Price Index, rent was 5.4% more expensive in April than last year.

Dejan Eskic, who studies the housing market at the Kem C. Gardner Policy Institute at the University of Utah, said that’s a little surprising.

“We’ve had so much apartment inventory across every major metropolitan area in the country,” Eskic said.

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That includes Utah. Eskic said just this year, about 8,000 new apartments are hitting the market.

Because of that “record new supply,” he said rental prices along the Wasatch Front have actually decreased slightly.

“We’ve seen rents drop just a little bit under 2%,” Eskic said, adding that he believes rents will stay flat or drop slightly over the next 12 to 18 months.

But that won’t continue forever.

“As we move further out, there’s less and less new construction happening,” Eskic said, “and so we do expect in about two years rents to start increasing again like we’ve experienced previously.”

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Jed Coon, who lives with his wife and daughter in Tooele, is tired of paying rent.

“It’d be very nice to just have it go down,” he said. “It’s frustrating.”

Over the years, as a renter, Coon said he’s noticed one trend – rent keeps going up.

“We started off $1,000, $1,200 – cheap rundown places – and now it’s up to $1,700, $1,800,” he said.

Coon said he and his family plan to move back in with parents to try to get a leg up in this difficult market. Rent is a big part of their budget, and it’s tough to pay for everything.

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“We’re barely getting by,” Coon said. “It’s rent and then the utilities, and that’s it, so not so much for everything else.”



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