Virginia officials prepare to release draft abortion regulations

August 25, 2011

Virginia health officials are planning to release draft emergency regulations for abortion clinics as soon as Friday that reproductive-health activists say could impose strict physical, staffing and equipment requirements and could force many of the state’s clinics to close.

The General Assembly passed legislation this year mandating that Virginia’s abortion clinics be regulated like hospitals. Currently, they are treated like doctor’s offices.

Although clinic operators say they haven’t received specifics about the regulations, they say state health officials have told them that the rules are modeled on those adopted by South Carolina, which has some of the nation’s most-restrictive rules, activists said. Among the state’s 46 pages of requirements, for example, is one that says sinks must have hands-free faucets and others that govern air flow and temperature in clinics.

“These really have nothing to do with patients and everything to do with making it harder to provide abortion services,” said Elizabeth Nash, a public- policy analyst for the Guttmacher Institute, a nonprofit reproductive health research center that gathers the most comprehensive data on abortion in the United States.

Antiabortion activists have long been urging that Virginia abortion clinics be treated like ambulatory surgical centers, arguing that doing so would make the clinics safer.

“After more than two decades of hiding behind a veil of politically motivated secrecy, abortion centers in Virginia now face real, tangible regulations,’’ said Victoria Cobb, executive director of the conservative Family Foundation. “We look forward to seeing the proposed regulations and working with the administration in the coming weeks to ensure that the final regulations adequately protect women in Virginia.”

The rules would affect only facilities that perform first-trimester abortions. Virginia law requires that second-trimester abortions be performed at hospitals.

The state Health Department is expected to release the draft regulations as soon as Friday, officials said. The 15-member Board of Health, which has a majority appointed by Gov. Robert F. McDonnell (R), is scheduled to vote on the rules Sept. 15.

The public will be able to comment online before then and for an hour at the meeting. McDonnell, an abortion opponent, will have the final say before the emergency rules would take effect Dec. 31. After that, health officials would begin crafting permanent rules, which could take up to two years to implement.

The emergency regulations would fast-track the process and expand the Health Department and the gubernatorial staff’s power to write rules.

Even if permanent regulations adopted through the longer process were less restrictive, abortion rights advocates say they fear that tough emergency rules would force clinics to close.

On Thursday, representatives from several abortion-rights groups said they are concerned that Virginia might join other states that have enacted regulations aimed primarily at restricting access to abortion.

This year, states have enacted 85 abortion restrictions, more than double the previous record of 34 enacted in 2005, according to the Guttmacher Institute.

The District is again restricted by Congress from using its own Medicaid money to fund abortions except in cases of life endangerment, rape and incest.

Abortion rights activists say states such as Maryland and Delaware have taken a different tack.

Maryland officials are proposing regulations that focus broadly on safety and sanitation in abortion clinics but allow each facility to be treated differently. In Delaware, a new law that accredits abortion clinics also regulates other facilities that perform invasive medical procedures, such as colonoscopies.

Joe Hilbert, director of legislative affairs for the Virginia Health Department, said staff members reviewed the regulations of 22 other states, including South Carolina.

He declined to provide specifics of the draft Virginia rules. South Carolina’s rules were promulgated in 1996 and took effect in 2001 after an unsuccessful legal challenge.

“The regulations we are finalizing address numerous health-care topics, including infection prevention and quality [of care] improvements,” he said. Virginia officials have sought to incorporate the “great increase in knowledge and awareness” that has occurred since South Carolina drafted its rules, he said.

About 25,000 abortions were performed in Virginia last year, according to Health Department statistics.

Those include abortions performed at hospitals and private doctor’s offices. The state has 22 abortion clinics.

A review of the hospital-type abortion regulations by the American Journal of Public Health found that in Texas, the number of abortion providers fell from 20 in 2003, before the regulations, to four in 2007. In South Carolina, the number of providers dropped from 14 before the hospital regulations to three, activists said.

Abortion opponents such as Cobb said some physical changes are about safety despite what abortion rights groups argue. Regulating hallway and doorway widths, for example, relates to whether emergency personnel can move their equipment through the clinic, she said.

But such requirements would make it difficult for some facilities to operate.

The Planned Parenthood clinic in Falls Church, which had 5,000 patients last year and performed 800 abortions, rents its space, so it would be virtually impossible for the clinic to do any remodeling, said Laura Meyers, its chief executive officer.

Moreover, she said, clinics are allowed to perform only first-trimester abortions, which typically involve medication rather than surgery.

“Why would a wider hallway have anything to do with taking a pill?” she said.

Staff researcher Lucy Shackelford contributed to this report.

Lena H. Sun is a national reporter for The Washington Post, focusing on health.
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