Some Virginia abortion clinics uncertain about status of tough restrictions

July 28, 2012

Rosemary Codding has tried for months to scrape together enough to pay for a costly renovation to her Falls Church clinic, where women get checkups, Pap smears and abortions.

Codding is still short of the up to $1 million it would take to update the 50-year-old building — it needs wider hallways, new ventilation systems and additional patient rooms — after Virginia enacted some of the nation’s toughest restrictions on abortion clinics.

The General Assembly voted last year to require the guidelines, which were quickly adopted by the state’s Board of Health. In a surprise move, the panel later exempted the state’s existing clinics, including Codding’s on busy Lee Highway.

But Attorney General Ken Cuccinelli II (R) refused to sign off on the board’s decision, arguing that it lacked the legal authority to exclude the operating clinics.

Cuccinelli’s legal opinion has led to confusion — and uncertainty — among many of those who lead the state’s 22 clinics that perform abortions, because it’s unclear how the board would interpret his position. Since the board first voted, Gov. Robert F. McDonnell (R) has added three new members to the board, including a doctor who opposes abortion and helped draft the original regulations.

“All of this is so ridiculous,’’ said Codding, who runs the Falls Church Healthcare Center. “If you think everything is reasonable, you’re on the wrong track.’’

Abortion rights supporters say that Cuccinelli and McDonnell are trying to circumvent the panel’s decision and that the guidelines are a way to shut down clinics.

“Both actions are evidence of the coordinated effort by the attorney general, the governor and their radical right-wing partners to stop at nothing in their crusade to take away the rights of Virginia women,’’ according to a statement by a coalition of women’s rights advocates.

Both Cuccinelli and McDonnell have said they are constitutionally obligated to act and deny that they are trying to sidestep the board’s authority.

State inspectors have already fanned out across Virginia to determine what the clinics must do to be in compliance. Two of the 22 clinics have told state officials that they would have to move because they can’t afford the renovations specified by the guidelines. An additional 10 said they may need to move.

According to state figures, the expense for clinics requiring significant renovations will be $525 per square feet — or more than $2.6 million for a 5,000-square-foot facility.

Codding said she will know exactly how much the renovations would cost when an inspector visits her clinic but said she has already spent $13,000 for an architect’s assessment. She said she has been turned down for bank loans and is seeking investors or grants.

In one of its most contentious debates, the General Assembly voted last year to regulate abortion clinics like outpatient surgical centers. State officials wrote emergency regulations that include where to store patient records and the size of an exam room. Clinics have two years to make the changes.

“I don’t understand or begin to see how this serves any purpose,’’ said Gail Frances, owner of the Annandale Women and Family Center, who opened the first abortion clinic in the state after the procedure became legal almost four decades ago. “They’re not doing it for safety. They’re doing it for access.’’

But anti-abortion advocates say the rules will make Virginia’s clinics safer for women because the regulations would treat the facilities more like ambulatory surgery centers that require hospital-type regulations.

“I continue to believe a $1 billion industry can come up with the costs needed to be safe and can find the funds to do whatever is needed to operate,’’ said Victoria Cobb, executive director of the Family Foundation, which for years lobbied for the changes.

The requirements are based on guidelines for health-care facilities from the Facility Guidelines Institute, a nonprofit group.

The rules specify size of exam rooms (minimum “clear floor area of 80 feet”), corridors that are at least five feet wide and ceiling heights of 7 feet 10 inches or more. The 46 pages of requirements include hands-free faucets on sinks, the types of airflow and temperature for certain rooms, and a phone available for patients.

In addition, the regulations require inspections, medical procedures and record-keeping; dictate that clinics enter into agreements with nearby hospitals; and mandate an infection-prevention plan.

Paulette McElwan, who runs a Planned Parenthood facility in Richmond, said thather clinic complied with the guidelines in 2009, although the rules were not mandated at the time. She estimates that half of the $4.6 million cost to move into its Richmond location, including buying the building, went toward the changes, including larger exam and procedure rooms and halls as well as new ventilation systems. Her facility is one of two in the state that needs little renovation, officials said.

Still, McElwan will spend about $100,000 to put a water cooler in the lobby, buy an EKG machine, move computer servers to a separate room, ensure that there are 10 inches between the faucet and the bottom of a sink, and install a duct system.

“It makes no difference if we have eight-foot halls,’’ McElwan said. “This is not for patient safety.’’

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