Working to expand and improve abortion access through complex care strategies

Care management & redesign Strengthening ecosystems of care Pregnancy & children

By Roxanne Sutocky, Director of Community Engagement, Cherry Hill Women’s Center

For nearly 40 years, Cherry Hill Women’s Center has been the premiere abortion care center for families in Camden County, New Jersey. We provide compassionate abortion care and reproductive health services, inspired by our belief in the autonomy of the individual and our commitment to strengthening communities and building a better future. We strive for excellence in healthcare provision, and we work for reproductive rights and social change. 

Cherry Hill Women’s Center meets monthly with the Camden Coalition of Healthcare Providers at the Camden Coalition’s Camden Care Management Meetings. Through these meetings, we have developed relationships with other Camden-area healthcare providers and learned more about the Camden Coalition and the National Center housed within it.

We were impressed with the work developing from the National Center right in our backyards. As we began investigating complex care, we realized that this work was in line with our values. We theorized that implementing strategies from this burgeoning field could help improve access to abortion care services. Reproductive healthcare providers work to provide patient-centered care and follow the leadership of those most impacted, which are some central themes of complex care

In December 2018, we had the opportunity to attend the Putting Care at the Center conference, where we were able to investigate practical applications of the Blueprint for Complex Care that could be integrated into our work. The most helpful of these have been the creative plans presented around working in coalition with payers, providers, and legislators, and around building financial sustainability for work that is traditionally under-resourced. 

Partnering for change

This year, we collaborated on the development of a statewide reproductive health coalition called Thrive New Jersey. Inspired by what we’ve learned from the complex care field, we’ve broadened our coalition-building to include legislators, advocates, former patients, and folks who work on closely related issues like immigration and sexual violence. In partnership with other groups and advocates across New Jersey, Thrive NJ has already promoted legislative victories that will improve the lives of vulnerable individuals and communities.

In July of this year, Governor Phil Murphy signed a bill to expand New Jersey’s Address Confidentiality program, originally in place for people who have experienced domestic violence or stalking, to include reproductive health patients and providers, as well as sexual assault survivors. We were able to support our partners Unitarian Universalist Faith Action and New Jersey Coalition Against Sexual Assault to bring to the table stories of providers and patients who have been harassed to share their stories, contributing to the bill’s eventual passage.

We have also been working with Thrive NJ and partners across the state on campaigns that specifically impact populations with complex health and social needs. These efforts include ending solitary confinement for folks who are pregnant or who have recently been pregnant, expanding access to driver’s licenses, and ensuring all children in New Jersey have health insurance coverage.

Along with building statewide coalitions for advocacy and change, Putting Care at the Center 2018 emphasized the importance of learning from leaders from across the country. Late last year we invited Atlanta-based Spark Reproductive Justice NOW to host an introduction to reproductive justice for legislators, legislative staff, and community partners. Their intersectional reproductive justice framework, along with the complex care framework of the National Center, has helped us begin to weave together many of the issues we advocate for that may not be traditionally seen as “reproductive health” issues, but that are deeply important to the work that we do and the communities we serve.

Working toward sustainability

Financial sustainability is a major issue in reproductive healthcare, just as it is for many complex care programs. Years of regulation have shuttered reproductive health clinics across the country, which means there are fewer providers to ensure adequate access to abortion care. This is especially true for community members with limited resources and for those living in rural areas of the state. We serve as the only provider of first and second trimester abortion care in the southern part of the state. We already care for a substantial number of patients travelling from out of state, and the current political landscape around reproductive rights means we anticipate seeing more patients crossing state lines for abortions.

The Cherry Hill Women’s Center does not turn patients away due to inability to pay. Our team works hard to research and connect patients with funding, transportation, insurance coverage, mental health services, substance abuse programs, and other services to supplement their care. In order to maintain and ideally expand the reproductive healthcare infrastructure in our state, we need to ensure financial stability.

In New Jersey, residents can use their insurance for abortion care procedures without the types of restrictions that exist in most other states. However, low reimbursement rates and the unique operating costs abortion providers incur, such as high-level security, still create barriers to care as outlined in the recent New Jersey Policy Perspective report: Defending Reproductive Rights in New Jersey by Improving Access to Healthcare for All

The strategies highlighted at Putting Care at the Center were hugely helpful in envisioning a more sustainable future for the Cherry Hill Women’s Center and beginning to envision the partnerships required to get there. As we work to build a reproductive health coalition and advocate for more accessible services, we have leaned on the lessons learned from healthcare systems successfully solidifying sustainable funding and effective policies to build effective complex care programs.

Building our power

Many medical providers are looking to expand the care they provide to be more holistic. Through our engagement with the complex care field, we’ve realized that the Cherry Hill Women’s Center and many other reproductive health organizations have already been providing this kind of integrated, whole-person care for a long time. We feel that reproductive health providers have the potential to help to inform the work of complex care, and look forward to working together to improve access to care for everyone with complex health and social needs.

We face big challenges and know that change will not come quickly, but we left Putting Care at the Center with practical tools and a better sense of direction. As Stacy Stanford of the Utah Health Policy Project shared at the conference, “Trying to make big systematic change feels like walking uphill in the snow barefoot — it doesn’t feel sexy. So we need to celebrate the incremental wins.”