Isabelle Jung / Sun Graphics Editor

Various resolutions such as S.A. Resolution 15 prompted a discussion at a recent roundtable event regarding reproductive health care.

September 27, 2023

Students Assess Future of Gynecological Care at Cornell at Roundtable Event

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“Why are you here today? Why is this important to you? What experiences have you had with accessing reproductive health care at Cornell Health or in a different area?” asked Eliza Salamon ’24, treasurer of Cornell’s chapter of Planned Parenthood Generation Action, at Tuesday’s Reproductive Healthcare at Cornell Roundtable

Approximately 22 students attended the roundtable at the Big Red Barn, hosted by the Pelvic Pain Association at Cornell, PPGA and the President’s Council of Cornell Women. At the event, students sat in small groups and discussed various questions posed to the group by PPGA leadership. 

Taisa Strouse ’24, co-president of PPGA, said the club’s abortion pill subcommittee organized the event.

“We proposed the [Student Assembly resolution on ensuring access to medicated abortion available at Cornell] at the end of last semester that [President] Martha Pollock denied, so now it’s just going from there,” Strouse said. “I think having a full community discussion about it was the first step, and then we’re opening a survey so people can share what they want. Do [survey participants] want a gynecologist? Do [they] think there’s [a] need?”

Strouse said that after talking to the community, the next steps for the club include talking to Administration and Cornell Health about the budget and limitations on care Cornell Health can provide.

The following issues were most pressing in the responses of students.

M.D. Gynecologist Proposal

Attendees extensively discussed Pollack’s rejection of S.A. Resolution 15 — which requested that the University fund an M.D. gynecologist — on Feb. 10. Pollack stated Cornell Health’s primary care clinicians are trained in gynecological services.

Arielle Johnson grad, a Ph.D. candidate who is also the co-founder and current treasurer of PPAC, told The Sun about developing the proposal for an M.D. gynecologist.

“This started in 2021 [when] we wrote an op-ed in the Cornell [Daily Sun] calling for a gynecologist who could treat pelvic pain conditions. Following that, we passed resolutions through four out of Cornell’s five assemblies — all but the employee assembly — calling on Cornell to hire an M.D. gynecologist,” Johnson said.

The Employee Assembly did not progress to voting on the resolution, Johnson said, because members felt the resolution was not directly relevant to employee welfare as Cornell Health does not provide primary care medical services or mental health care for Cornell employees. 

“Our hope was to pass [the resolution] through all five of the shared governance organizations and push it to the Board of Trustees for consideration. We’re still potentially looking at taking this issue to the Board of Trustees. We think that this is a University-wide equity issue that is something that the Board of Trustees might want to look at,” Johnson told The Sun. “But we would have to reach out to our student-elected trustee representative — who we have been in contact with — and other Board of Trustees members directly to make that happen.”

Anna Cecilia Fierro ’27 expressed concern about the lack of an M.D. gynecologist on Cornell Health’s staff based on her personal experience with inadequate care at Cornell Health. Fierro said that when she visited Cornell Health, it seemed that reproductive health concerns were directed towards the female doctors in general, rather than specialists in OBGYN.

In an interview with The Sun in May, Pollack reaffirmed her support for uplifting women’s health, but stated that hiring an M.D. gynecologist would be impractical at Cornell Health.

“Cornell Health provides primary care — that’s its mission. That’s what it does. We don’t have the population to have specialists,” Pollack said. “Not only isn’t there a good model, enough patients and enough financial model to hire a full-time gynecologist, but for a full-time gynecologist to be certified, they have to do a certain amount of surgery,”

Since Cornell Health does not directly offer surgeries, Pollack said, patients are referred to local and regional providers. Pollack instead noted Cornell Health’s recently implemented referral service to Weill Cornell Medicine providers for obstetrician and gynecologist conditions that Cornell Health cannot address in-house. 

“Now, when a student or a Cornell Health clinician needs advanced consultation in caring for a student’s GYN concerns, gynecologists from Weill Cornell will be available for telehealth visits,” said Rachel Clark, a nurse practitioner at Cornell Health who also serves as the clinical director of women’s and sexual health, in an email to The Sun on March 10. “When combined with a physical exam summary from a Cornell Health primary care provider, Weill Cornell’s services will complement and enhance the services available through Cornell Health.”

Clark told The Sun providers from Weill Cornell are compatible with most insurance plans, and Cornell Health’s nurses can help patients through the referral process.

However, there are still many gynecology care gaps since many conditions require in-person appointments to diagnose, according to Johnson. For example, the diagnosis for vulvodynia — chronic vaginal pain — may include a pelvic exam, a cotton swab test, a biopsy and/or a blood test.

“We’re still not sure how Cornell is going to be able to address those specific care needs if they’re only offering virtual visits with M.D. gynecologists, but we are grateful to be listened to,” Johnson said.

During the roundtable discussion, students, including Tobie Bertisch ’25, discussed the importance of having on-campus access to all forms of health care.

“College-age kids may not feel supported or comfortable at home. It’s hard to do things privately at home, and many offices are closed on holidays,” Bertisch said during the group discussion. “When some issues are sensitive, and you don’t necessarily want to share them with your parents, it’s important to have the space here [at Cornell].”

Bertisch also said outsourcing health care in the larger community poses a barrier for students who lack access to cars or other personal transportation.

PPGA currently provides transportation to Planned Parenthood and other medical clinics for free.

Some present, including Katherine Esterl ’24, co-president of PPGA, and Kathleen McCormick grad, a Ph.D. student in psychology, expressed the importance of valuing reproductive care in the same regard as other types of medical care.

“Excluding reproductive health care [from Cornell Health] makes the statement that it is peculiar or different when it should really be treated like anything else, like any other type of health care,” Esterl said to the audience at the Roundtable event. “Reproductive health care is health care,” McCormick said during the group conversation. 

Make Cornell Pay — for Gynecology Care

Attendees of the event, such as McCormick, said that putting the weight of student health care on the City of Ithaca is one symptom of a more significant imbalance between the University’s input and output into the community. 

“The Cornell community should be responsible for covering the care of the community rather than inundating the City of Ithaca, which may not have the resources to support so many people,” McCormick said.

Strouse said that the club’s reasoning for implementing a survey is to be able to present to Cornell Health and the Administration the number of patients referred from Cornell Health to local providers such as Planned Parenthood or Cayuga Medical Center.

“It’s an undue burden,” Strouse said. “I see it under the bigger Make Cornell Pay umbrella where Cornell is not providing as much to Ithaca as it should.”

The “Make Cornell Pay” sentiment refers to a group advocating for greater contributions from Cornell to the City of Ithaca through payments in lieu of taxes in their memorandum of understanding, with the current MOU of $1.6 million annually in PILOT contributions set to expire in June 2024.

On Sept. 18, the Ithaca Democratic Socialists of America rallied in response to an informal agreement for Cornell to pay $4 million annually to the City, arguing that Cornell should provide more significant financial support to the City of Ithaca. The Common Council originally planned to vote on the agreement on Sept. 20, but Mayor Laura Lewis (D) announced the vote had been postponed to Oct. 11 to provide for more opportunity for public comment at that night’s meeting.

Strouse added that while she thinks the local Planned Parenthood health center can provide all these services, she feels local providers should not have to shoulder the entire burden.

Discontinuation of Student Health Plan Plus

Students who qualify for New York State Medicaid were informed on June 9, 2023 that the Student Health Plan Plus program would be terminated as of June 30 at midnight. SHP Plus combined the standard Student Health Plan with Medicaid, with no annual fee for students — unlike the standard SHP. It also equipped students with health, adult dental and vision coverage without premiums, copays or coinsurance. 

This discontinuation occurred due to a loss in funding from the New York State Department of Health — the source of funding for SHP Plus for about a decade. The University, however, committed to covering the cost of the standard SHP for students for the month of July to prevent a gap in coverage for impacted students.

All degree-seeking students at Cornell are required to enroll in SHP or to waive SHP with eligible outside insurance. For Fall 2023 returning students and all fully-funded graduate students, the SHP costs $1,896 for both the fall and spring semesters. For all 2023 new students, SHP costs $1,580 for the fall semester and $1,896 for the spring semester. 

According to the University, the 378 returning students and 69 newly matriculated students who indicated an interest in SHP Plus enrollment were already enrolled in regular NYS Medicaid and would receive comparable coverage as they did on SHP Plus through their Medicaid Managed Care plan. However, the two local MMC programs — Fidelis Care and Molina — provide smaller networks than SHP Plus, which facilitates network care nearly anywhere in the United States.

Roundtable attendees discussed the potential implications of the end of the SHP Plus program.

Fierro told The Sun she is interested in the health care Cornell provides as a whole, referencing insurance and accessibility as specific issues she wanted to learn more about.

“New York State just cut ties with the funding that was previously going to the SHP Plus, that was providing health care for students who were low income on a lot of financial aid,” Fierro said. “And with that also comes students who are not going to be able to afford getting an OBGYN or access to health care at all… Not being able to access getting an abortion in a safe way is really scary on a college campus.”

Fierro said that even for non-reproductive-related medical issues, students under SHP have to go out of their way to pay many out-of-pocket fees. 

“When I inquired about funding for student health insurance, Cornell told me to just take out a loan because New York has stopped giving them funds,” Fierro said. 

Support for Sexual Assault Victims

Discussions also connected access to reproductive health care to resources for sexual assault victims following a recent instance of sexual assault on campus on Sept. 14.

Sexual assault has also been a widely discussed topic on campus due to the Interfraternity Council’s Nov. 6, 2022 decision to suspend fraternity functions following at least four drugging incidents and a sexual assault allegation. This policy lasted throughout the Fall 2022 semester.

The Cornell Student Assembly adopted Resolution 24 on Thursday, Sept. 21, which called on the University to take steps to protect the safety of students. 

The resolution specifically urged the Administration and the Office of Institutional Equity and Title IX to engage in conversation with the S.A. and the student body regarding the current limitations of Title IX training for first-year students, release a statement addressing the incident, offer information about Cornell’s sexual assault resources and create supplementary first-year orientation courses.

Liz Grosul ’24 told The Sun Cornell Health could improve students’ access to reproductive health care by making resources more visible.

“There are certain resources that are kind of hidden. Today we found the Victim Advocacy [Program — a group that assists members of the Cornell community suffering from harmful, threatening or violent incidents], and we didn’t know that existed and that was never advertised [to me], and I feel like there should be more awareness,” Grosul said. “Reproductive and sexual health care should be at the forefront of advertising.”