Originally published in the Summer 2017 issue of The Torch

What good are reproductive rights if you can’t exercise them? What does it matter if abortion is safe and legal if the nearest abortion provider is hundreds of miles away? What does your right to birth control count for if you can’t afford the doctor’s visit for the prescription? What if you have a prescription for reproductive health medications, but your pharmacist—for personal reasons of their own—refuses to fill it?

The shameful truth in America is that your access to reproductive healthcare has a lot more to do with where you live and your income than anything else. We believe that people’s rights shouldn’t be contingent on zip codes, tax-brackets, or the personal religious beliefs of others. That’s why the ACLU isn’t just fighting to ensure that reproductive rights exist on paper; we’re fighting to ensure we can actually use them as well.

Winning Prescriptive Authority

Here in New Mexico, the ACLU has made several important strides in recent months towards guaranteeing meaningful access to reproductive healthcare in our communities. Behind the scenes for over a year now, we’ve been working with community partners, pharmacists, and the medical community to change the rules in our state so that pharmacists now have prescriptive authority for certain types of contraception. That means that any pharmacist who undergoes the proper training and certification can directly prescribe birth control to anyone who needs it, no separate doctor’s visit necessary.

Allowing pharmacists to prescribe contraception is a game changer for New Mexico. Our state is huge and many of our communities are very remote. That combined with ongoing shortages of primary health care providers, especially in rural areas, along with high rates of poverty mean that many New Mexicans struggle to access prescriptions as basic as birth control. If you don’t have health insurance to cover a doctor’s visit or can’t take time off from work to make an appointment, the barriers to accessing birth control and other preventive care can be nearly insurmountable.

New Mexico is only the fourth state in the country to give pharmacists the ability to prescribe birth control, after Oregon, California, and Colorado. The American College of Obstetrics and Gynecology has long recommended that oral contraceptives be available over the counter, and the practice has gained widespread acceptance in the medical community. With advocacy from the ACLU of New Mexico, Young Women United, and the New Mexico Pharmacists Association, the pharmacy, nursing, and medical boards in New Mexico approved the new rules governing prescriptive authority in New Mexico in June.

“Allowing trained pharmacists to prescribe and fill contraception is a huge win for our rural communities, which are most profoundly impacted by our state’s healthcare and provider shortages,” said Denicia Cadena, Policy Director at Young Women United. “This policy change will significantly impact the lives of real people currently navigating barriers to the care they need, including transportation and cost. As someone raised in rural New Mexico, I am proud to have worked alongside our partners making needed healthcare more accessible to families like mine.”

Dale Tinker, the executive director of the New Mexico Pharmacists Association, told the Santa Fe New Mexican that they would begin offering the training that will allow the state’s pharmacists to become certified, and that they expect the College of Pharmacy at the University of New Mexico to include the training for new pharmacists moving forward.

Fighting Discrimination at Walgreens

Coincidentally, the other major move the ACLU of New Mexico made this summer to protect access to reproductive healthcare was also pharmacy related. You may recall that back in 2012, the ACLU of New Mexico represented a woman named Susanne Koestner who was denied birth control at a Walgreen’s Pharmacy in Albuquerque. The pharmacist on duty at the time refused to fill her prescription explaining that “it’s against my religious beliefs.”

“I needed my medication immediately and couldn’t wait until the next day,” Koestner said. “I was forced to drive to a different part of town to get my prescription filled. Walgreens put the burden on me to find a pharmacist that had no personal objections to the medication my doctor prescribed me.”

Photo: Susanne Koestner

Koestner contacted the ACLU of New Mexico, and our attorneys threatened to file a complaint against Walgreens unless it provided assurances that it would take steps to ensure that women received the appropriate care regardless of the individual beliefs of its employees. Walgreens eventually responded by providing assurances that it had developed policies and procedures to ensure that accommodations of individual employees’ personal religious beliefs would not impose any burdens on the customer or come at the cost of women’s healthcare.

They did not deliver.

Late last year, Jane* walked into her local Walgreens pharmacy with three prescriptions to fill for her teenage daughter in preparation for an IUD insertion the following day. The pharmacist on duty filled the first two prescriptions, but told Jane she would have to get the third medication, misoprostol, at another location. When Jane asked for an explanation, the pharmacist on duty told her that, despite having the medication currently in stock, he refused to fill the prescription because of his “personal beliefs.”

Angry and embarrassed, Jane asked to speak to a manager and confronted the pharmacist about the denial of service. As Jane explained to the Albuquerque Journal earlier this year:

“I told him he was discriminating against me. That he should be ashamed for judging us, that he didn’t know my daughter’s medical history or her complications or conversation with her doctor. That he didn’t know what the medication was for. And he just looks at me and says, ‘Oh, I have a pretty good idea.’”

Misoprostol is prescribed for a variety of uses and conditions. It can be used to soften a woman’s cervix in preparation for IUD insertion, it can be used by both men and women to decrease bleeding in stomach ulcers, and when used in combination with mifepristone, it can be used to end a pregnancy. The pharmacist saw the name of the drug and, because the patient was a woman, made an automatic (and erroneous) judgement about what it was for and refused to fill it.

Unfortunately, Walgreens’ policy under these circumstances is to turn women away and send them to a different pharmacy location. This is unacceptable, no matter how conveniently located the alternate pharmacy may be. Many women lack transportation, store hours may vary and pose barriers, and some communities lack nearby alternatives altogether. More importantly, women like Jane are forced to experience the real and lasting emotional impact of being denied a service and turned away because of their sex and related health needs.

Jane took her complaint to the Southwest Women’s Law Center, who partnered with the ACLU of New Mexico to write another letter to Walgreen’s demanding they address this persistent discrimination. After Walgreen’s representatives failed to provide adequate assurances that they intended to address this problem, the ACLU of New Mexico filed official complaints with the New Mexico Human Rights Commission alleging that the denial of service related to women’s reproductive health is sex-based discrimination.

“Women should be able to walk into any pharmacy that serves the public with full confidence that they will receive the care and medicine they need without being disrespected and discriminated against,” explained ACLU attorney Erin Armstrong.

“Birth control and other medications related to reproductive health are a vital part of healthcare for women. Walgreens can work to accommodate the personal beliefs of its employees, but they must not do so by permitting discriminatory denials of care that burden their patients and customers.”

There’s an old saying about freedom that goes, “My right to swing my fist ends where your nose begins.” Everyone is entitled to their own personal religious beliefs; no idea is more fundamentally American than that. But employees’ beliefs do not permit businesses to discriminate against or harm others. Open for business means open to everyone.

Your Rights in the Real World

While the ACLU is best known for defending the lofty principles enshrined in the Constitution, we are equally dedicated to ensuring that those principles actually mean something where the rubber meets the road. Nowhere is this more important than in the realm of reproductive rights. Roe v. Wade established that women have a constitutional right to abortion more than 40 years ago, but anti-abortion activists have been erecting barrier after barrier to accessing that right ever since. In some states, those barriers make accessing abortion nearly impossible for a majority of women.

New Mexico is fortunate in that we have successfully blocked these types of abortion restrictions from becoming law in our state, but that doesn’t mean there aren’t a host of other barriers preventing women from fully accessing basic reproductive healthcare. It’s not enough for reproductive healthcare to be legal, it has to be available, accessible, and affordable as well. By opening up prescriptive authority in New Mexico pharmacies and ensuring those pharmacies are not allowed to discriminate, the ACLU of New Mexico and its partners made huge strides this summer in the struggle to ensure that our rights are fully realized out in the real world.

Learn more about religious refusals on our Religious Refusals issue page.

Originally published in the Summer 2017 issue of The Torch

Robby Heckman, like many ACLU volunteers, experienced something in his personal life that shook him to the core and drove him to action. Robby was selected as a juror in the trial of Keith Sandy and Dominique Perez for the shooting and killing of James Boyd, a man living on the literal and figurative margins of our community.

For Robby, the experience was incredibly challenging on an intellectual and emotional level. The trial laid bare the enormous threats that people suffering from mental illnesses or homelessness face when confronted by inadequately trained police and it left him feeling deeply unsettled.

“I strongly believe that an important measure of our society is how we treat our most vulnerable,” he said.

Robby is an archaeologist by trade and works for a cultural resource management firm in Albuquerque. He and his family moved here from Tucson in 2006, and they live in the Northeast Heights. Robby and his wife Susan have three children - Jay is at the University of New Mexico, Ryan is a senior at El Dorado High School, and their daughter Maggy is in 3rd grade.

Many people with commitments like Robby, to work, family, and church, would have quickly returned to their busy lives after the trial concluded. But that unsettled feeling kept gnawing at him and compelled him to act.

“I couldn’t stop thinking about the trial and all of the problems I saw with APD. So, I began to immerse myself in the police reform process, learning about the developments that have unfolded since APD entered into a consent decree with the Department of Justice in 2014.”

"My experience as a juror [on the James Boyd case] appropriately dislodged me from my comfortable and privileged position in our community and compelled me to become involved..."

He eagerly read the Court Approved Settlement Agreement (CASA) and each of the subsequent reports filed by the Independent Monitoring Team. While he found the reports informative, they were hundreds of pages long, incredibly dense, and consisted entirely of narrative descriptions. Robby knew from his professional life managing large and complex archaeological data sets that there might be an alternative way to track and monitor APD’s compliance progress.

“By trade, I’m an archaeologist so I study human systems, how societies organize themselves, and how they address and resolve conflict. I believe every human institution is imperfect and flawed in some way and that institutions such as APD require checks and balances. So, I created a relational database that compiled all of the Monitoring Team’s reports, resulting in a single, cumulative data set to more easily facilitate tracking APD progress toward the reforms set out in the CASA. I wanted to make the results of the Monitor’s findings more easily digestible and accessible to the community to ensure accountability and transparency,” said Robby.

Once the database was complete, Robby wasn’t sure where to turn next – he was in possession of a powerful tool but unsure how to put it to work. Robby decided to share the database with his pastor Trey Hammond of La Mesa Presbyterian Church and he immediately recognized he was looking at something special. La Mesa Presbyterian is a member of the APD Forward coalition, a diverse group of people and organizations, including the ACLU of New Mexico, which work towards police reform. Trey knew APD Forward would be the perfect place for Robby to leverage his archaeological skill set unearthing hidden truths to advance the fight for police reform.

All of us have special talents, skills, and expertise that make us uniquely equipped to fight for justice in our communities. Like Robby, we just need to ask ourselves where we can plug in and put those talents and love to work.

APD Forward and the ACLU are fortunate to have volunteers like Robby and dozens of people just like him, who contribute hundreds of hours in passionate service to a cause they believe in. We are honored to work with him and so many other wonderful, smart, and committed individuals. If you’re not already connected with the ACLU of New Mexico’s volunteer program, we’d love to hear from you. We’re always looking for the next archaeologist, photographer, or tax accountant to help us fight for equal justice for all.

Find out more at www.aclu-nm.org/act 

Originally published in the Summer 2017 issue of the Torch

Year after year the cycle of violence continues. 

According to the New Mexico Interpersonal Violence Data Central Repository, a staggering 17,757 domestic violence cases were reported to law enforcement in 2015, and a report from the same year by the Violence Policy Center found that our state had the third highest rate of female homicides by male offenders in the nation. These sobering statistics do not even capture the countless additional incidents that go unreported each year. We must put an end to the domestic violence crises that deprives victims of their fundamental ability to live with dignity, but the solutions currently in place are not working.

The United States is addicted to punishment. Despite lip service to concepts like ‘rehabilitation’ and ‘correction,’ when you scratch the surface our criminal justice system is really just a machine for the administration of punishment. Insert a crime, the machine spits out a prison sentence. We’ve fallen prey to the insidious idea that if we can only punish harshly enough, people will stop hurting others. But if our criminal justice system only punishes the symptoms without ever tackling root causes of the problem, our communities will never be any safer.

The ACLU of New Mexico believes that our communities will be safer in the long run if we stop using outdated and ineffective tactics like mass incarceration, and move towards a more holistic, evidence based, and community-centered approach to fighting crime. That’s why we are working with a new coalition we helped launch last year called New Mexico SAFE, which is dedicated to reforming our criminal justice system so that it addresses the root causes of crime and violence. An important part of that work is partnering with formerly incarcerated people and survivors of violence to learn more about how we can provide lasting justice to those who are hurt by crime, as well as get offenders the treatment and rehabilitative services they need to break out of their destructive behavioral patterns.

We sat down with Tanya Romero who is Residential Shelter Services Director at Esperanza Shelter for Battered Families, to hear about her first-hand experiences with domestic violence as well as her thoughts on how we can make lasting transformative change.

Can you tell me about your personal experience with domestic violence?

The abuse started roughly about eight years ago. I’ve been married twice in my life. My second husband was my offender. After my first marriage of fifteen years ended, I reconnected with my eventual offender who I knew from high school. We reconnected on social media and at that point I was still vulnerable and new to being out of my marriage.

I started to see signs like him asking, “Why are you wearing that?” “Why are you trying to bring attention to yourself?” “How come you visit your family so often? “ “Don’t you love me?” And I took him as, “My gosh. This guy is really into me. He’s really protective of me.” And I’d never had that type of affection to that extreme. Then about four months into the relationship he said either I marry him or he would leave me. And at this point I had totally fallen for him so I said, “ok I’ll go ahead and marry you.” That’s when the violence started to escalate. The physical violence started. The threats started. My children were impacted by that as well, as far as being emotionally, verbally - and in the case of my youngest child - physically abused.

Knowing that I wasn’t ready to leave the relationship, I stayed with my offender and I put my daughters in care of my mother and my son with his father. It was probably the hardest thing I’ve ever had to do, but I knew they weren’t safe. I continued to stay in the relationship for another three and a half years. He had me right where he wanted. No kids, no friends. My job was suffering. I got a restraining order and then I would break that restraining order.

Then one day he physically assaulted me with a weapon. I managed to escape, go to a public location and call the police. It was the first time I’d ever called the police to report the violence. They asked, “Do you have a safe place to go?” and I didn’t. By this time I’d burned bridges with family and friends so the police said, “well how about Esperanza shelter?”

So I stayed in the shelter and it was really tough. I was scared, but I knew I had to be there to be safe. Esperanza is where I found my sisterhood among other survivors.

My offender is no longer here due to an overdose. He was an addict. There were also behavioral and mental health issues at play. They added fuel to the fire.

Is it how I wanted it to end? Absolutely not. I wanted him to get the help that he needed.

How did you end up working as an advocate for domestic violence survivors?

I worked on myself for two years after my offender passed away. After that, I got started volunteering at a crisis treatment center taking calls from sexual assault and domestic violence victims, and then I began my career in Rio Rancho working at a shelter. Now I’m here at Esperanza. It’s been about a total of almost eight years.

What are the stigmas around domestic violence?

There’s always the stigma that it’s your fault. Why didn’t you leave? Why did you stay? That’s probably the most common, and it’s so unfair. People have no idea what it takes for someone to share their story. Education is key. I teach in schools, and its powerful how education can prepare others to be safe and raise awareness about what domestic violence is. It needs to start at a young age because that’s where kids often learn the pattern because they see a parent being violent.

What do you think some of the leading causes of domestic violence are?

Lack of resources and lack of jobs are some of the causes I see. It’s also generational, it’s historical violence and it has to start somewhere. I have compassion for that, and many people don’t understand why I would have compassion for that after what I’ve been through. I’ve taken a lot of initiative to educate myself.  Domestic violence is a learned pattern, a learned behavior. These individuals are not born as evil or as monsters, it’s because they themselves have been hurt. How do we start to fix the cycle of violence?

You have an offenders program aimed helping those who have abused others to change their lives. Why is it important to offer that program rather enhancing the punitive measures already in place?

I feel putting more punitive measures in place would do more harm than good. These are quick solutions that don’t really focus on the individuals who need the help. After long-term incarceration, offenders come out even more violent. There’s no follow up within the legal system as to what programs are they going to for rehabilitation and recovery. Where are the programs after incarceration for offenders? We release them back to society without the tools that they need.

What are the barriers that undocumented immigrants are facing with domestic violence?

It’s the fear of being taken. It’s the fear of families being broken apart. We are a sanctuary city in Santa Fe so it feels safer for many to reach out here. But immigrants are still afraid. When you’re undocumented, that’s part of the cycle of abuse because offenders use their victims’ immigration status against them or threaten to report them or take away the kids. With our current administration it’s really scary.

How can we break the cycle of violence?

When it comes to court hearings, it would be beneficial to make it a state law to mandate offenders to the batter intervention program (BIP) and there should be oversight to ensure that offenders are actually attending the program. We’re here to help break the cycle, and that involves offenders. It doesn’t exclude them. The BIP program that we have here has been going strong for a number of years and we’ve seen positive results from that. I’m very proud to work for an agency that supports that because not many agencies are like that in this field.

I also feel that it would help if there was more support from the state with addiction and mental health issues in the community. We need more laws that support both victims and offenders and my vision of that involves more resources and education in the community.