Off the Kuff Rotating Header Image

January 4th, 2023:

Mifepristone can now be offered at retail pharmacies

Good news, for at least some of the country.

For the first time, retail pharmacies, from corner drugstores to major chains like CVS and Walgreens, will be allowed to offer abortion pills in the United States under a regulatory change made Tuesday by the Food and Drug Administration. The action could significantly expand access to abortion through medication.

Until now, mifepristone — the first pill used in the two-drug medication abortion regimen — could be dispensed only by a few mail-order pharmacies or by specially certified doctors or clinics. Under the new F.D.A. rules, patients will still need a prescription from a certified health care provider, but any pharmacy that agrees to accept those prescriptions and abide by certain other criteria can dispense the pills in its stores and by mail order.

The change comes as abortion pills, already used in more than half of pregnancy terminations in the U.S., are becoming even more sought after in the aftermath of last year’s Supreme Court decision overturning the federal right to abortion. With conservative states banning or sharply restricting abortion, the pills have increasingly become the focus of political and legal battles, which may influence a pharmacy’s decision about whether or not to dispense the medication.

The F.D.A. did not issue an announcement but planned to update its website to reflect the decision. The two makers of the pill, Danco Laboratories and GenBioPro, released statements saying the agency had informed them of the action.

The action is the latest step taken by the federal government to expand access to abortion pills by easing some of the restrictions that have applied to mifepristone since it was approved in 2000.

In December 2021, the F.D.A. said it would permanently lift the requirement that patients obtain mifepristone in person from a health provider, a step that paved the way for telemedicine abortion services which conduct medical consultations with patients by video, phone or online questionnaires and then arrange for them to receive the prescribed pills by mail.

On Tuesday, the F.D.A. officially removed the in-person requirement from its regulatory rule book for mifepristone, leaving in place the remaining two requirements: that health providers be certified to show they have the knowledge and ability to treat abortion patients and that patients complete a consent form.

See here for some background. My understanding of the action taken in 2021 was that it allowed mifepristone to be prescribed via telehealth. I’m a little fuzzy on how much of a difference-maker this announcement is, but whatever it is, every little bit helps. Just, you know, not everywhere.

Whether large pharmacy chains and local drugstores would opt to make the pills available was not immediately clear Tuesday. The steps for pharmacies to become certified to dispense mifepristone are not difficult, but they involve some administrative requirements that go beyond the process pharmacies use with most other medications, such as designating an employee to ensure compliance. Given the time and resources required by those steps, some pharmacies may not consider it worthwhile to offer a medication that only a small percentage of their customers may use.

But while abortion pills may constitute a small percentage of a pharmacy’s sales, they could have a big impact on its public profile. Calculations about public perception and the highly polarized political landscape are also likely to influence a pharmacy’s decision.

In about half the states, abortion bans or restrictions would make it illegal or very difficult for pharmacies to provide abortion pills.

In states where abortion remains legal, pharmacies may face customer demand for the medication or public pressure from abortion rights advocates and health providers. National chains could decide to offer the medication in those states while not providing it in their stores in restrictive states.

I can say with 100% certainty that you won’t be able to walk into your local CVS here in Texas and find any mifepristone. The real question is what the Lege will try to do to prevent people from going out of state to get any kind of abortion care, or to punish people not in Texas who provide that care; the corollary questions will be about what the courts will do with the resulting litigation. We’re still a few months out from that, but it’s coming. In the meantime, at least some people will get to benefit from this.

Katy ISD challenged over at large districts

This was from before Christmas but I didn’t have a chance to write about it until now.

The NAACP Legal Defense and Educational Fund sent a letter Tuesday to Katy ISD accusing the district of disenfranchising Black and Latino voters by adhering to an at-large voting system in violation of federal civil rights law.

The letter, addressed to Katy ISD board of trustees President Greg Schulte, says the at-large system — in which board members are elected to represent the entire district, by voters across the entire district — “dilutes the votes of Katy ISD’s voters of color and may violate the Voting Rights Act because it prevents Black and Latinx voters from electing their preferred candidates to the Board of Trustees and from participating in the electoral process on an equal footing.”

The Legal Defense and Educational Fund, or LDF, filed the letter after being approached by a group of Katy ISD parents concerned with the lack of diversity on the district’s seven-member board. Currently, the letter says, all seven trustees “reside in a concentrated area of the district south of Interstate 10 and do not reflect the geographic or racial and ethnic diversity of the district,” where Black and Latino children make up nearly half of the student body, according to the Texas Tribune.

The letter was first reported by NBC News.

Cameron Campbell, a former Democratic candidate for state legislature and a Katy ISD parent, said debates over book bans and other “microagressions” and “dog whistles” led the parents group to think critically about the makeup of the school board and who it serves.

“We can all agree on keeping our kids safe, learning and prospering, but if there’s not equal representation, it is absolutely impossible for our school boards to serve our kids adequately,” Campbell said. “I’m a proud Katy ISD parent and the teachers do a fantastic job, but the school board is broken and it’s an embarrassment.”

You can see a copy of the letter and a proposed district map at that NBC News tweet. The district had no comment in the story and I didn’t see any followup news since this ran in the Chron, but there are some more details given by the Katy Times.

According to its website, Katy ISD has an enrollment of 92,914 students as of Dec. 26. Here is a breakdown of students by ethnicity:

Asian: 15,542, or 16.7%.
Black: 13,204, or 14.2%.
Hispanic, 33,766, or 36.3%.
Native American: 208, or 0.2%.
Pacific Islander: 108, or 0.1%.
Two or more races: 3,963, or 4.3%.
White: 26,123, or 28.1%.

Much of the growth is taking place in the north and northwest areas of the district. The district’s northernmost high school, Paetow, 23111 Stockdick School Road, opened in 2017. It has a student population breakdown that is 49% Hispanic, 23% Asian, 17% White, 6% Black, and 3% two or more races, according to the district.

[NAACP assistant counsel Antonio Ingram II] provided an example figure that illustrated how a single-district representation map might look. Under this plan, Ingram wrote that four of the districts would be majority-minority districts.

Ingram wrote that the example was one of several versions of a seven-single-member school board map that can be drawn with multiple majority-Black and Latinx districts in northern Katy.

While most school districts in Texas have at-large representation exclusively, not all of them do. Richardson ISD, near Dallas, recently adopted single-member districts. According to its website, five of the seven trustees on the Richardson ISD board are elected from single-member districts. The other two trustees are elected at-large.

The single-member district issue has been raised in at least one previous Katy ISD trustee campaign. Local attorney Scott Martin called for single-member districts in an unsuccessful 2018 trustee campaign.

Not immediately clear now is whether the NAACP is approaching only Katy ISD for such changes, or whether it is approaching other school districts in a similar fashion.

But other options are available to trustees, Ingram wrote. Among these are:

Cumulative voting in at-large elections.
Requirements for more diverse representation on the board, such as a requirement that all board members reside in different school attendance zones. According to the map Ingram provided, all seven trustees live south of Interstate 10.
Moving the election date to November, when other significant races are on the ballot, therefore increasing voter turnout.

“Whatever method or methods the Katy ISD Board of Trustees chooses to ensure a more fair and equitable electoral process for choosing its members, we urge the board to act with all deliberate speed, as failure to act could expose the Katy ISD to liability under the VRA (Voting Rights Act),” Ingram wrote.

This caught my eye for a number of reasons, including of course because of the LULAC lawsuit over Houston City Council at large districts. There’s no indication at this time that the NAACP LDF might file a lawsuit, but that is certainly a possible outcome if there’s no movement from Katy ISD. A similar lawsuit was filed against Spring Branch ISD in 2021. There hasn’t been much news about that since then – the law firm representing Spring Branch ISD withdrew from the case a few months after the suit was filed, and there’s a Fairly comprehensive update on the SBISD website, the short version of which is that there was not one but two changes in who the presiding judge was and as a result there hasn’t been a hearing yet – one for October was cancelled – and nothing has been set yet. Federal lawsuits move at their own pace, y’all.

Anyway. I’ll keep an eye on this. I don’t have a lot of optimism about any use of the Voting Rights Act these days, but you never know. Katy ISD will have its next election this May, and the filing deadline is January 18.

Here come some hydrogen-powered trucks

There’s more than one way to do no-emissions transportation.

The first time Rodrigo Peña climbed into the Hyzon truck’s cabin and eased his foot off the break, it wasn’t the awe of being inside the first hydrogen-powered freight truck to be operated in Texas that struck him.

It was the silence.

“I could hear rocks pinging off the gravel in the yard — I could hear people blocks away,” he said. “It was like being in a huge golf cart.”

Peña and two other drivers for logistics company Talke will drive the Lone Star State’s inaugural hydrogen-powered freight truck route, delivering plastic resins from Mont Belvieu to the Port of Houston for Exxon Mobil as part of a two-week pilot.

While the pilot is temporary, civic and corporate leaders along the Ship Channel expect it to help jumpstart new investments and government incentives aimed at using hydrogen to help decarbonize the shipping and trucking sectors. Five entities, including the University of Texas at Austin, Chevron, Air Liquide and the Center for Houston’s Future announced last month that they had applied to the U.S. Department of Energy to be designated as one of as many as 10 regional clean hydrogen hubs, a distinction that could bring the region a slice of $7 billion in federal funding for hydrogen projects.

Subsidies like that will be key to get hydrogen trucking off the ground, said Parker Meeks, president and interim CEO of Mendon, New York-based Hyzon Motors. He said the hydrogen hub funding would help on the fuel side, but it doesn’t include funding for the trucks. That changed with the Inflation Reduction Act signed into law this year, which will pump $400 billion into clean energy funding, including funding to help lower emissions at ports.

“This transition at the start is quite expensive, and if we put all that on operators it will take a long time,” Meeks said. “We don’t anticipate being on subsidy longer than we need to, but the IRA gives us that immediate opportunity. We always planned on getting a truck to Houston, and that time is now that we’re getting that subsidy money to Houston.”

Houston is already the largest producer of hydrogen in the country, used largely for refining and petrochemical processes. But the region, and much of the country outside of California, lacks the infrastructure to make it feasible for use in freight trucks or cargo ships. Even the hydrogen used for the Port of Houston pilot projected was shipped from an Air Liquide facility in North Las Vegas, Nevada, even though an Air Liquide facility produces hydrogen just up the road in La Porte.

The Nevada facility is one of a handful of sites in the country that can liquify hydrogen, packaging it at a pressure of 7,500 pounds per square inch, said Laura Parkan, Air Liquide’s vice president of hydrogen energy for the Americas. Only three hydrogen fueling stations exist for heavy trucks, all in the greater Los Angeles area.

This was a two-week pilot program, and I drafted this before Christmas so you probably missed it. But hydrogen power makes sense for larger vehicles, because they can require batteries that are too large to be of practical use. This is one reason why Metro is seeking to test hydrogen-powered buses along with electric buses, as they look for alternatives to fossil fuels. Another consideration is the ability of the electric grid as it now exists to handle a new fleet of electric trucks. I’m of the belief that we should be open to all reasonable options. If that also turns out to be a boon for Houston and the result of the Biden infrastructure bill, so much the better.