ACLU Continues to Seek Clarity on Walgreens-Providence Collaboration

There continues to be a lack of clarity as to whether the health clinics to be opened in Washington and Oregon through a collaboration of Walgreens and Providence Health & Services will be bound by religious doctrine. The ACLU is pleased to have received assurances from Walgreens that its pharmacies will continue to provide services free of religious restrictions. But we are disappointed that we have not received similar assurances regarding the soon-to-open clinics.

On December 14, the ACLU of Washington along with 18 other public interest organizations that advocate for patients’ rights and comprehensive health care access sent a letter to Walgreens requesting information about its strategic collaboration for the opening of up to 25 clinics in Washington and Oregon with Providence Health & Services, a Catholic health care provider. Walgreens is the nation’s largest drug store chain.

The organizations sought to learn whether religious doctrine will limit access to important medical services, information, and referrals at the clinics, and will limit Walgreens pharmacies’ ability to fill prescriptions.

In response, Walgreens provided assurances that its pharmacies which house these clinics will not be limited by religious doctrine and will be able to fill prescriptions in the same manner as other Walgreens pharmacies across the country. This is welcome news, as Walgreens is ensuring that its pharmacy customers will continue to have access to a full range of prescriptions, including prescriptions for birth control.

However, Walgreens was not able to offer the same assurances in relation to the clinics. Walgreens advised that the clinics will be owned and operated by Providence, and Providence will determine what services, information, and referrals are available.

Providence is a Catholic health care system that is required to follow the Ethical and Religious Directives (ERDs) promulgated by the United States Conference of Catholic Bishops. These directives forbid or severely restrict critical reproductive and end-of-life health care services at Catholic health facilities. Some religious health systems also restrict the information and referrals that their health providers are allowed to give to patients.

The Seattle Times has reported that Providence said it did not expect services at its Express Care clinics to go beyond treatment of minor illnesses. It said that other issues will be referred to primary or specialty-care providers. And that “all patients, no matter their sexual orientation or gender identity or expression, would be treated with the same respect, care, and compassion.”

While these statements are reassuring, we continue to be concerned that certain services such as referrals and one-time renewals of birth control at the clinics may be limited on the basis of religious doctrine. Many of our central questions remain unanswered:

1. Will these clinics be bound by the Ethical and Religious Directives?
2. Will these clinics provide prescriptions for one-time renewals of birth control, similar to other Walgreens’s clinics? On a telephone call, Walgreens advised that they believed that the new clinics would not provide prescriptions for birth control but they could not confirm this. Further, while the Seattle Times article reported Walgreens stated that contraceptive services would continue to be offered at the more than 400 health-clinic locations it manages, this does not address whether these services will be available at the soon-to-open clinics.
3. And, importantly, will these clinics provide direct referrals to providers who provide services that are unavailable at the clinics and contrary to the ERDs?

The initial six clinics are set to open at the end of February. Walgreens customers are entitled to assurances that they will be able to receive important care and referrals at clinics placed within Walgreens stores. We continue to urge Walgreens and Providence to make clear to their customers what services, information and referrals will be available at these clinics.