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N.C. Releases Proposed Abortion Clinic Regulations Under 2013 State Law

N.C. Releases Proposed Abortion Clinic Regulations Under 2013 State Law

December 2, 2014 — North Carolina's Department of Health and Human Services on Monday released a draft rule that proposes regulations for abortion clinics under a state law enacted last year (SB 353), WRAL's "@NCCapitol" reports (Leslie, "@NCCapitol," WRAL, 12/2).

The law, which contains several antiabortion-rights provisions, allows the state DHHS to "apply any requirement" for ambulatory surgical centers to abortion clinics, as long as the regulations do not impede access to abortion (Women's Health Policy Report, 7/11). Some of the law's provisions are being challenged in court.

Draft Rule Details

According to "@NCCapitol," the proposal does not appear to include changes that could potentially cause some clinics to close, such as requirements that abortion clinics meet the same building standards as ambulatory surgical centers. However, the proposed regulations do increase oversight of the state's abortion clinics.

For example, the draft rule would require each clinic to develop a governing authority board to meet once annually. The board would choose a CEO who has final say in the clinic's daily operations. In addition, clinics would be required to have a quality assurance board that includes at least one physician and meets quarterly to review clinic procedures, protocols and records.

Further, the proposal would require each clinic to choose a nursing supervisor, keep complete personnel records, and have procedure handbooks and equipment manuals available on site. Clinics also would be required to have a defibrillator on site and would have to give patients contact numbers that are staffed at all times in case of complications after an abortion.

The proposal also would require clinics to try to reach a "transfer agreement" with a local hospital, but the clinics would not be considered out of compliance if the attempt does not result in an agreement and the clinic owner has documentation of the attempt. According to state DHHS spokesperson Kevin Howell, ambulatory surgical centers are subject to the same requirement ("@NCCapitol," WRAL, 12/2).

Proposal Costs

According to estimates from nonpartisan legislative staff, the proposals would cost each abortion clinic around $7,500 during the first fiscal year and around $5,800 annually thereafter. The initial costs would be incurred while purchasing defibrillators and privacy curtains, the Charlotte Observer reports.

Meanwhile, North Carolina would spend about $20,000 annually to inspect the clinics (Jarvis, Charlotte Observer, 12/1).

Next Steps

The state DHHS will hold a public hearing on the proposal on Dec. 19 and is accepting public comments on the draft until Jan. 30, 2015.

If the agency approves the proposal after the public comment period, the draft would then go to the state Rules Review Commission for consideration. If the commission also approves the rule, it would take effect April 1, 2015. However, under state law, state legislators can rewrite the rule if at least 10 people submit written objections.

State Officials Comment

Howell noted that the drafting process included feedback from various medical experts. He said the proposed changes are "common sense measures" that aim to bolster patient privacy and care.

North Carolina Health Service Regulation Director Drexdal Pratt said in a statement, "The proposed rules meet constitutional requirements and comply with Senate Bill 353 by improving patient safety and privacy while preserving access to services" ("@NCCapitol," WRAL, 12/2).

State officials added that the proposed requirements should not cause any of the state's abortion clinics to close (Charlotte Observer, 12/1).

Groups React

North Carolina Planned Parenthood spokesperson Alison Kiser said the group's legal team is reviewing the draft rule. She added in a statement, "Planned Parenthood is committed to providing high-quality, nonjudgmental abortion services to the women of North Carolina and will comply with all regulations in order to keep our doors open to the patients that depend on us." She continued, "We were pleased to have our input sought in the DHHS regulatory process as a trusted health care provider and women's health care expert" ("@NCCapitol," WRAL, 12/2).

Suzanne Buckley, executive director of NARAL Pro-Choice North Carolina, in a statement noted that it is "critical" that the "rule-making process not be politicized by the same political interests and lawmakers that sought to eliminate access to abortion care in the first place."

Meanwhile, N.C. Values Coalition Executive Director Tami Fitzgerald criticized the proposal for not going "far enough in protecting women's health and safety." She also condemned officials for consulting with "abortion doctors and the abortion industry about these rules which will regulate their own clinics" and "plac[ing] the profits generated by the abortion industry above the health and safety of women" (Charlotte Observer, 12/1).