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THURS: New Mexico CYFD Secretary to resign, + More

Barbara J. Vigil, right, and New Mexico Gov. Michelle Lujan Grisham. The governor announced Vigil is resigning from her position by the end of the month. She will transition to serving on the agency's Policy Advisory Council instead.
Morgan Lee
/
AP
Barbara J. Vigil, right, and New Mexico Gov. Michelle Lujan Grisham. The governor announced Vigil is resigning from her position by the end of the month. She will transition to serving on the agency's Policy Advisory Council instead.

New Mexico CYFD Secretary to resign KUNM News, Albuquerque Journal 

The secretary of the state’s Children, Youth and Families Department will resign by the end of the month, according to the Governor’s Office.

In a statement Thursday, Gov. Michelle Lujan Grisham announced that Sec. Barbara Vigil will move into a role on the Policy Advisory Council instead — a body that was formed by executive order in February to aid in accountability for the agency that the governor has characterized as “dysfunctional.”

The governor’s Chief Operating Officer Teresa Casados will take over the department charged with protecting children in state custody. She said in a statement that there’s a need for “long-lasting, fundamental changes” to the state’s child welfare system.

The Albuquerque Journal reports Lujan Grisham opposed legislation this year that would have enhanced oversight of the agency and vetoed a bill to create a civil rights division to investigate abuse.

Gallup and NM Environment Department compromise on water safety standards instead of legal fight - By Megan Gleason, Source New Mexico

Testing measures are changing for how Gallup dumps treated wastewater into the Rio Puerco.

The city’s agreement with the New Mexico Environmental Department to dump up to 1.25 million gallons of wastewater every day into the local tributary was altered to eliminate certain water tests if Gallup meets chemical standards. It also requires the city to cap three wastewater wells and build a new one to meet groundwater monitoring guidelines.

The settlement between Gallup and the state’s environmental department was unanimously approved Tuesday by the New Mexico Water Quality Control Commission and helps avoid a contentious legal battle.

“We entered into a settlement agreement to provide alternative methods,” said Jason Herman, program manager at the state’s Ground Water Quality Bureau.

The Gallup Wastewater Treatment Facility receives and treats 3.5 million gallons of wastewater per day. The city is permitted by the state to discharge over a third of that — 1.25 million gallons — into the Rio Puerco every day.

When the New Mexico Environment Department published revisions to that practice in May 2022, the state issued the changes in August 2022 despite objections by officials in Gallup.

So the city took the matter to the Water Quality Control Commission. Gallup asked the agencyin September 2022 to review the permit with concerns that standards that required well plugging and testing standards would take up unnecessary time and resources.

This led to a monthslong review of the permit. Gallup and the New Mexico Environment Department eventually agreed not to enter an even lengthier legal process and committed instead in January 2023 to come to a settlement.

The agreement was finalized in March. It supersedes the revised 2022 permit issued by the state.

N.M. Environment Department spokesperson Matthew Maez said via email the agreement benefits both parties.

“It specifies the actions that Gallup must perform to meet the requirements of the permit, avoiding a protracted legal dispute, while protecting groundwater and public health,” Maez said.

TWO MAJOR CHANGES

Herman testified at the Water Quality Control Commission meeting on Tuesday and said the agreement addresses two main issues the city had.

The first update changes a clause that required quarterly tests for arsenic. The city could’ve asked to stop testing if arsenic levels were low enough after four consecutive samples.

Gallup then argued that arsenic isn’t present in the facility’s wastewater and having to regularly test for it would “be costly and burdensome.”

The settlement amends this section so Gallup can ask to stop testing if two — instead of four — consecutive samples contain minimal amounts of dissolved arsenic.

The other change has to do with replacing monitoring wells that analyze groundwater. The 2022 permit required that Gallup plug, abandon and replace three wells that the state said were constructed improperly.

Gallup said replacing the working wells would waste time and resources.

Under the new agreement, the city still has to abandon those three wells. Gallup would also have to install a new well, testing it to ensure that it follows state health and safety standards.

Maez said the well installation will help the city “better understand the local geology” and figure out if operations at the Gallup Wastewater Treatment Plant have impacted groundwater.

Gallup also told the Water Quality Control Commission last year that construction renovations would be difficult, if not impossible, to meet due to supply chain constraints. Maez said if that’s still an issue, the Environment Department can extend deadlines.

The state’s water commissioners did not have many questions about the agreement or any objections. Robert Sanchez, who helps counsel the commission, said it’s a pretty clear settlement.

“I think they know what they need to do to stipulate the settlement agreement,” he said.

Lujan Grisham vetoes bills meant to treat, not punish, addiction - By Austin Fisher, Source New Mexico

New Mexico has for decades led the nation around harm reduction policies that try to address substance use disorders without incarcerating people. Two different but related proposals to strengthen those protections were passed by the legislature but vetoed by Gov. Michelle Lujan Grisham.

Last week, Lujan Grisham vetoed two sentencing reform bills which could have stopped New Mexico from incarcerating people for simple drug possession, potentially saving millions of dollars on jail time that the state’s public defenders and civil rights attorneys say could be better spent on treatment and harm reduction.

Emily Kaltenbach is the senior director of criminal legal and policing reform at the Drug Policy Alliance. Their group works to decriminalize drug possession altogether. She’s extremely disappointed in the governor’s vetoes and concerned about the continued negative impact the criminal legal system has on people struggling with problematic drug use.

“Our criminal system should not be the gatekeeper to treatment,” Kaltenbach said. “Both of these pieces of legislation were a first step in really treating addiction as a health issue and not a criminal issue.”

Nayomi Valdez, director of public policy for the American Civil Liberties Union of New Mexico, said the bills could have greatly reduced the senseless incarceration of people for minor technical violations and failed drug tests, and helped thousands get their lives back on track.

The argument the governor adopted in vetoing the bills is that the state needs the threat of imprisonment or actual imprisonment to bring about treatment, said Bennett Baur, chief public defender at the Law Offices of the Public Defender.

“I think that not only misperceives the way addiction treatment generally works, but also just the actual damage that imprisonment does,” Baur said. “Imprisonment isn’t neutral. Putting people in and out of jail, or in prison, actually does damage.”

SENTENCE ENHANCEMENTS

Senate Bill 187 would have no longer allowed courts to count a drug possession charge or a DWI charge from another jurisdiction when considering sentencing someone as a “habitual offender.”

Drug possession is a felony in New Mexico, and the bill would not have changed that, Baur said. It would have taken away prosecutors’ power to stack more years in prison on top of existing sentencing options.

“There’s almost nobody that gets better because of the threat of additional prison,” Baur said.

In her veto message, Lujan Grisham wrote prosecutors use the habitual offender enhancement as a tool to encourage defendants to get treatment for their addiction.

Ninth Judicial District Attorney Quentin Ray, along with the entire state prosecutors association, opposed the bill. Ray told lawmakers the enhancement allows people to “hit bottom” in prison.

“It gives the opportunity for us as prosecutors to push people, as a hammer, so to speak,” he said. “You have to have something that says, ‘If you’re not willing to change, we need to take you out of society.’”

It ends up being an undue bargaining chip in the plea bargaining process, said Kim Chavez-Cook, an appellate public defender and public defenders’ go-to legislative expert. Prosecutors sometimes tell defendants if they don’t violate probation, then the habitual offender enhancement will not be imposed, she said.

“By taking away this tool, we risk losing an important incentive for defendants to get the help they need,” Lujan Grisham wrote.

Prisons and jails are not void of drugs, Kaltenbach said, and there are as many drugs in the criminal system as there are outside of it.

PROBATION AND PAROLE VIOLATIONS

Senate Bill 84 would have revised the state’s probation and parole system and tied punishments to the severity of the violation — rather than the crime that originally sent them to prison.

The way it currently works, Chavez-Cook said, is if someone on probation commits a technical violation like getting a positive result on a drug test, they must serve their entire sentence.

These kinds of sanctions proposed to go statewide in the bill are already in practice locally in Santa Fe, Albuquerque, in the southeast corner of the state, and in Catron, Torrance, Sierra and Socorro Counties.

The judicial districts in those places each opted-in to their own voluntary technical violation programs where probation and parole officers can impose graduated sanctions before reporting someone to the parole board or local prosecutors.

Even in those places, if a client doesn’t sign up for it, there is nothing preventing the state prison system or a particular probation officer or a future Corrections Department secretary from putting someone in prison for a technical violation, Chavez-Cook said.

Incarcerating people for technical violations and failed drug tests does not make us any safer or help the people who are locked up, Valdez said, and those who can’t make appointments or grapple with substance use disorder need help and treatment.

“The millions of dollars wasted on incarcerating them could be invested in addressing the underlying causes of crime – substance use disorders and behavioral health issues,” Valdez said. “Needlessly incarcerating people only harms them and their families further and fails to make any of us safer.”

Lujan Grisham wrote the legislation “failed to get the support of the district attorneys and other stakeholders” and “ignores practicalities that could further endanger both parolees and our communities.”

“This could be a step backwards,” she wrote.

In her veto message, Lujan Grisham defended her administration’s record on substance use disorder treatment over the past four years: “Individualized supervision methods have led to improved measures on recidivism and participation in treatment and specialty courts,” she wrote.

Specialty courts are extremely effective for some clients, Baur said, but most of them only intervene after someone is convicted.

“We need to focus on diversion,” he said, and get someone out of the criminal legal system at the earliest possible time. “To say that just building up specialty courts is going to address it, I think, is a fairly narrow view.”

The fact that progress has been made doesn’t mean we don’t need the other pieces of the puzzle, Chavez-Cook said.

Recovery is not linear, Kaltenbach said, and people shouldn’t be punished for relapsing. Behavior doesn’t change with punishment, she said.

“Evidence shows criminalization does not reduce recidivism, nor does it reduce long-term drug use,” she said. “I question why we have such a regressive perspective in this state when we’ve done so many great things.”

Snowmelt leads to heavy flooding from Southwest to Rockies - Associated Press

A rapid spring snowmelt after an unusually wet winter is unleashing flooding from the Southwest to the Rockies, causing residents there and in the Upper Midwest to stock up on sandbags amid surging creeks and rivers.

In Flagstaff, Arizona, neighbors on one street have been working side by side since Tuesday with shovels to stave off floodwaters from their homes.

Three creek-retention basins installed last year helped initially, city emergency officials said. But water has engulfed the shoulder of a local highway, and roads and sidewalks are closed. Even sections of urban trails are submerged.

Officials are calling it an unprecedented amount of water, something that was impossible to plan for.

"It would be nice to have an exact model of what we need to do. But we don't," Flagstaff Vice Mayor Austin Aslan told the Arizona Daily Sun. "We don't know what the next fire will look like, or where that scar will be. There's small differences that will direct water to one neighborhood or another."

Sandoval County in north-central New Mexico issued an emergency disaster declaration in the wake of severe flooding in communities near the Jemez River. The river was 7.5 feet high as of Thursday afternoon, according to the U.S. Geological Survey. Residents of the village of Jemez Pueblo, known for its mineral hot springs, were collecting sandbags as a precaution.

The deluge of water also led to spillover from a wastewater treatment plant, which was contributing to a rise in the Jemez River. The U.S. Forest Service is cautioning the public not to go fishing or drinking water south of the plant.

In Salt Lake City, Mayor Erin Mendenhall signed an emergency order late Wednesday aimed at helping residents whose homes were threatened by flooding in the southeastern part of the city. Rapidly melting snow in the nearby mountains sent water coursing through a creek in the neighborhood, prompting the voluntary evacuation of about 100 homes.

The water was receding as cooler weather moved into the area. Even so, multiple mudslides were reported on canyon roads, including one that forced the temporary closure of Interstate 80 southeast of the city early Thursday.

On Wednesday, local officials north of Salt Lake City issued evacuation orders for at least 20 homes in Kaysville, where flooding ripped a large gash that damaged a street, sidewalks and driveways in a subdivision that was under construction.

Meanwhile, heavy snowpack and highs expected to reach 60 degrees Thursday were causing flooding in northwest Colorado, where transportation officials closed Highway 40 between Craig and Steamboat Springs, a popular ski area that has received more than 400 inches (1,016 centimeters) of snow this winter.

Flooding in the small mountain town of Hayden forced the closure of schools for the day, and rain was possible in the area Thursday afternoon before turning to snow overnight.

The Colorado Department of Transportation posted photos online showing Dry Creek spilling over its banks at a bridge in Hayden, as well as floodwater threatening several parked recreational vehicles.

The National Weather Service issued a flood advisory through midday Saturday, warning that some roads may become impassable and urging motorists not to drive through flooded river crossings.

There were no reports of major damage in Utah or Colorado as of Thursday.

As rapid snowmelt and possible April showers stoke fears of heavy flooding in the Northern Plains, state officials are announcing flood response plans, and residents are assembling thousands — if not hundreds of thousands — of sandbags to combat floods themselves.

The Red River Valley, which includes Fargo in North Dakota and Moorhead in Minnesota, is facing flood threats as warm weather melts the snow left behind from one of the snowiest winters on record in the two states.

And given the spring timing, "significant rain could have a major impact on the magnitude of the flood crest," Moorhead city engineer Bob Zimmerman said to Minnesota Public Radio. "That's the one wild card at this point that we really can't predict."

North Dakota Gov. Doug Burgum has declared a statewide emergency for spring flooding and made the National Guard available to help fight floods in the coming weeks, the Bismarck Tribune reported. The city of Bismarck opened sites for residents to fill their own sandbags.

Dairy farm explosion injures 1 person, kills 18,000 cattle - Associated Press

An explosion at a dairy farm in the Texas Panhandle that critically injured one person and killed an estimated 18,000 head of cattle is the deadliest barn fire recorded since the Animal Welfare Institute began tracking the fires.

Castro County Sheriff Salvador Rivera has said the Monday fire and explosion at Southfork Dairy Farm near Dimmitt was likely caused by overheated equipment and would be investigated by state fire marshals.

"This would be the most deadly fire involving cattle in the past decade, since we started tracking that in 2013," institute spokesperson Marjorie Fishman said Thursday.

The institute also tracks barn fires that kill other livestock, including poultry, pigs, goats and sheep.

"The deadliest barn fire overall since we began tracking in 2013 ... was a fire ... at Hi-Grade Egg Producers North, Manchester, Indiana, which killed 1 million chickens," according to Fishman.

A 2022 report by the institute noted "several instances in which 100,000 to 400,000 chickens were killed in a single fire."

A phone call to South Fork Dairy rang unanswered on Thursday.

A spokesperson for the state insurance department, which oversees the fire marshals' office, said only that the fire is under investigation and referred questions to Rivera, who did not immediately return phone calls for comment Thursday.

Insurance department spokesperson Gardner Selby declined comment on the injured person's condition.

Dimmitt is about 50 miles southwest of Amarillo and 50 miles east of the New Mexico border.

Juul Labs agrees to pay $462 million settlement to 6 states — Karen, Matthews, Associated Press

Electronic cigarette-maker Juul Labs Inc. will pay $462 million to six states and the District of Columbia, marking the largest settlement the company has reached so far for its role in the youth vaping surge, the attorneys general in several states announced Wednesday.

The agreement with New York, California, Colorado, Illinois, Massachusetts, New Mexico and Washington, D.C. is the latest in a string of recent legal agreements Juul has reached to settle lawsuits related to the way it marketed addictive nicotine products. Critics said Juul was trying to lure children too young to smoke.

Like some other settlements reached by Juul, this latest includes restrictions on the marketing and distribution of the company's vaping products. For example, it is barred from any direct or indirect marketing that targets youth, which includes anyone under age 35. Juul will also limit the amount of purchases customers can make in retail stores and online.

"Juul lit a nationwide public health crisis by putting addictive products in the hands of minors and convincing them that it's harmless," New York Attorney General Letitia James said in a statement. "Today they are paying the price for the harm they caused."

A spokesperson for Juul said with Wednesday's settlement, the Washington D.C.-based company was "nearing total resolution of the company's historical legal challenges and securing certainty for our future."

The spokesperson added that underage use of Juul products has declined by 95% since 2019 based on the National Youth Tobacco Survey. According to the CDC though, since surveys were administered online instead of on school campuses during the pandemic, the results cannot be compared to prior years.

Juul rocketed to the top of the U.S. vaping market about five years ago with the popularity of flavors like mango, mint and crème brûlée. But the startup's rise was fueled by use among teenagers, some of whom became hooked on Juul's high-nicotine pods.

Parents, school administrators and politicians have largely blamed the company for a surge in underage vaping.

District of Columbia Attorney General Brian Schwalb said in a statement that Juul "knew how addictive and dangerous its products were and actively tried to cover up that medical truth."

In September, Juul agreed to pay nearly $440 million over a period of six to 10 years to settle a two-year investigation by 33 states into the marketing of its high-nicotine vaping products to young people. That settlement amounted to about 25% of Juul's U.S. sales of $1.9 billion in 2021.

Three months later, the company said it had secured an equity investment to settle thousands of lawsuits over its e-cigarettes brought by individuals and families of Juul users, school districts, city governments and Native American tribes.

The vaping company, which has laid off hundreds of employees, recently agreed to pay West Virginia $7.9 million to settle a lawsuit alleging the company violated the state's Consumer Credit and Protection Act by marketing to underage users, West Virginia Attorney General Patrick Morrisey announced Monday. Last month, the company paid Chicago $23.8 million to settle a lawsuit.

Minnesota's case against Juul went to trial last month with the state's Attorney General Keith Ellison asserting that the company "baited, deceived and addicted a whole new generation of kids" as youth cigarette smoking rates fell.

Scientists challenge US wildlife director's qualifications — Susan Montoya Bryan, Matthew brown, Associated Press

Lawsuit: Guards beat, taunt inmate with, 'You can't breathe' — Morgan Lee, Associated Press

Advocates for prisoners' rights have filed a civil rights lawsuit against state corrections officers who allegedly ignored requirements that they videotape a prison-cell encounter with an inmate who says he was sexually abused, beaten without provocation and taunted with words that evoked the 2020 death of George Floyd at the hands of police.

The New Mexico Prison & Jail Project filed the lawsuit Tuesday seeking damages in U.S. District Court on behalf of a Black inmate against five state Corrections Department officers, in an April 2021 confrontation at the Northeast New Mexico Correctional Facility in Clayton.

The advocacy group reconstructed events from the testimony of the plaintiff and other inmate witnesses, along with unredacted portions of an internal investigation by the Correction Department's Office of Professional Conduct. The Associated Press does not identify alleged victims of sexual assault unless they consent to be named.

Officers told investigators that the inmate was restrained physically and with pepper spray after swinging an elbow at an officer. They denied the inmate's account of abuses.

The lawsuit alleges that the plaintiff was face-down on the ground, when a corrections officer placed a foot on his back and said, "Let me guess, you can't breathe."

Attorneys for the Prison & Jail Project say the date of the encounter on April 15, 2021, corresponded with the murder trial of former Minneapolis Police officer Derek Chauvin in the killing of Floyd. Chauvin pinned Floyd to the ground with his knee for 9 1/2 minutes. The case centered around excruciating bystander video of Floyd gasping repeatedly, "I can't breathe." The case triggered worldwide protests and a reexamination of racism and policing in the U.S.

Chauvin was convicted of murder and manslaughter on April 20, 2021.

Several officers involved in the New Mexico altercation acknowledged to Corrections Department investigators that a video camera should have been used inside the cell.

"Its use could have prevented questions, provided answers and the truth would have come out," one officer told investigators.

Prison & Jail Project Director Steven Robert Allen said video recordings were required because the use of force by corrections officers was planned and not reactive. The Corrections Department declined to release a copy of its policy to the AP.

Corrections Department spokeswoman Carmelina Hart said the agency does not comment on pending litigation. She said four corrections officers out of five in the complaint still work at the agency.

The lawsuit alleges that corrections officers retaliated against the plaintiff after he spoke out earlier in support of another inmate who was surrounded by officers. Those events also are chronicled in a separate 2022 lawsuit alleging battery and sexual abuse by corrections officers against another inmate.

The new lawsuit says at least five corrections officers and a manager later entered the plaintiff's cell and ordered a cellmate to leave.

The lawsuit alleges that one officer pushed his crotch up against the plaintiff's backside. It says the plaintiff objected and wasn't provoked into retaliating, but he was thrown to the ground, beaten and taunted further.

The inmate in New Mexico "thought he was going to die, and why wouldn't he?" Allen said. "That kind of terrorizing of a Black prisoner in a prison here in New Mexico is completely unacceptable."

The lawsuit alleges battery, cruel and unusual punishment and violations of free speech rights, seeking unspecified compensation.

The inmate initially filed an administrative complaint under provisions of the Prison Rape Elimination Act. It is unclear whether officers were disciplined. No criminal charges have been filed. The inmate is serving a sentence after pleading guilty to armed robbery in 2016.

New Mexico man arrested for actions in Jan. 6 Capitol breach including assaulting officer - KUNM

A Chama man has been arrested in connection with his actions at the U.S. Capitol on Jan. 6, 2021.

The U.S. Department of Justice said 62-year-old Rockne Earles, formerly of North Dakota, has been charged with felonies that include assaulting, resisting, or impeding officers, and civil disorder. He also faces misdemeanor charges including entering a restricted building or grounds and engaging in physical violence.

According to court documents, a video shows Earles grabbing and throwing a U.S. Capitol Police Officer against stairs outside the Capitol building with significant force. Two other rioters joined Earles in shoving and assaulting the officer, who later reported to have been struck with a flagpole, and being punched in the head.

The officer suffered a concussion and missed 45 days of work.

Earles was due to make his initial appearance in the District of New Mexico yesterday. The case is being prosecuted by the U.S. Attorney’s Office for the District of Columbia and the Department of Justice National Security Division’s Counterterrorism Section.

Abortion clinics reassure worried patients, set backup plans — Laura Ungar Heather Hollingsworth, Associated Press

Since a court ruling threatened the availability of a key drug used in medication abortion, calls have been pouring in to the clinics Adrienne Mansanares oversees.

Patients from near and far are "incredibly worried about whether or not they still have a valid appointment, whether they can obtain the care that they need. It's heartbreaking," said Mansanares, president and CEO of Planned Parenthood of the Rocky Mountains, which has clinics in Colorado, New Mexico and Nevada.

For now, the clinics — and many others around the country — are trying to assure patients that nothing has immediately changed while also devising backup plans in case the ruling stands.

U.S. District Judge Matthew Kacsmaryk in Texas said the approval of the drug mifepristone should be revoked, a decision handed down at the same time a federal judge in Washington ordered the government to make the drug more easily accessible. The Supreme Court is expected to eventually settle the matter.

If mifepristone becomes unavailable, many doctors say they would replace the usual two-drug regimen with a slightly less effective method using only the other drug, misoprostol.

Mansanares said her staff has been sending text messages to patients to make sure they know they can still come in for care.

Clinics are also telling people they're still offering mifepristone — although many providers worry patients will question its safety in the wake of the ruling and news coverage about it. Currently, more than half of all U.S. abortions are medication induced, and some clinics offer no other options.

"Please understand that this judge's decision does not mean that medication abortion is not safe," Dr. Iffath Hoskins, president of the American College of Obstetricians and Gynecologists, said on a call with journalists this week. "It is safe. It is effective. And it should be an available option for all who seek abortion care."

Mifepristone, approved by the U.S. Food and Drug Administration in 2000, blocks the hormone progesterone and is also used to treat miscarriages. Millions of women around the world have used the drug, and medical groups say complications occur at a lower rate than with routine medical procedures such as wisdom teeth removal and colonoscopies.

With its future in peril, doctors are laying the groundwork for other safe options.

Mansanares said she and her colleagues pulled together a task force of clinical experts to create a misoprostol-only protocol, "so that if we needed to, we could flip the switch" from the two-drug regimen. She said nearly three-quarters of patients in her health centers choose medication abortions over surgical procedures.

In Pennsylvania, Dr. Becca Simon, a family medicine doctor who provides abortions, said she would also offer abortion procedures and one-drug medication abortion.

The one-drug option is "safe, effective, and actually in some ways can be a little quicker than" the two-drug regimen, said Simon, a fellow with Physicians for Reproductive Health. "It may have some more side effects, but we have medications" to help patients deal with them.

Dr. Gopika Krishna, an OB-GYN in New York and another fellow in the group, said she and her colleagues are still weighing their options but are also considering the one-drug method. She pointed out that it's the subject of recent guidance from national medical organizations, is considered safe by the World Health Organization and is used in other countries where mifepristone isn't available.

But some doctors said the one-drug regimen is not ideal. The two-drug combination is about 95% to 99% effective in ending a pregnancy. Used alone, misoprostol is less effective. Some research rates it around 85% effective, although other studies say it's closer to that of the two-drug combination.

Dr. Iman Alsaden, medical director of Planned Parenthood Great Plains, said staff at her clinics in Kansas are gearing up to provide misoprostol-only abortions if needed. Consent forms and patient information sheets have been prepared. Staff has been trained.

"It would not be the most medically sound thing to do. But if we have to comply with the law, we will," Alsaden said.

She's worried about what could happen if misoprostol fails to end a pregnancy, especially for out-of-state patients driving up to 12 hours for care.

"There's going to be people that, you know, came to Kansas from Texas, and they don't have the means or funds or ability to come back," she said. "And now you're in a situation where that person is forced to be pregnant."

Andrea Gallegos, administrator of the Alamo Women's Clinic in the southern Illinois city of Carbondale, has much the same concern, and is waiting to see how the lawsuits are resolved before making any decisions about what care to offer.

Wisp, a company that provides telehealth medication abortions in nine states, would definitely offer a misoprostol-only regimen if necessary. But spokeswoman Jenny Dwork said the switch would involve website updates and other changes, meaning the company wouldn't be able to provide their services for around two weeks — "further restricting access to those who need it."

Denise Harle, senior counsel for the Alliance Defending Freedom, which filed the lawsuit in Texas, said she was "very concerned" doctors were considering misoprostol-only abortions.

"To me, that would suggest, again, putting profit from abortion over the health and safety of women," she said, adding that it was "premature to discuss" whether the single-drug protocol would prompt future litigation.

But doctors pushed back.

"Part of the tactic from anti-abortion groups is to create a sense where people feel like abortion is confusing, that abortion isn't safe," Krishna said. "That's not true."

Alsaden said she's scared for the patients.

"I will continue to serve them as long as I can," she said. "But it's just like totally devastating."

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Amanda Seitz contributed to this story from Washington, D.C. Ungar reported from Louisville, Kentucky and Hollingsworth from Mission, Kansas.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute's Science and Educational Media Group. The AP is solely responsible for all content.