State health officials on Monday proposed new regulations for abortion clinics, which they said should not force any clinics to close if they are already providing adequate care.
The regulations were required by a law enacted last year that pitted anti-abortion advocates, who said updated safeguards were needed to ensure women’s health, against abortion-rights supporters, who argued the move was part of a strategy aimed at forcing clinics to close.
When he signed the law in July 2013, Gov. Pat McCrory insisted that his administration would take a measured approach to rewriting regulations that hadn’t been revised in nearly 20 years, while protecting women’s access to the procedure. Whether the administration’s proposal will withstand challenges will most likely be settled next year.
The N.C. Department of Health and Human Services’ proposed regulations were formally published in the state register Monday. That begins a process of public comment before the final regulations are adopted. If 10 or more people object, which is common with a controversial set of rules, then the General Assembly will have to make a final determination, and the abortion debates would begin again in the House and Senate.
“We believe it’s critical that this 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,” Suzanne Buckley, executive director of NARAL Pro-Choice North Carolina, said in a statement.
Tami Fitzgerald, executive director of the N.C. Values Coalition, said the proposed rules fall short of what the legislature intended. “Although there are some improvements, they clearly do not go far enough in protecting women’s health and safety,” she said in an emailed comment.
The revised rules follow the law’s requirements to address on-site recovery after surgery, to protect patient privacy, to provide measures of quality assurance and to ensure medical attention is available for patients with complications, while not unduly restricting access. Agency spokesman Kevin Howell said the regulations aren’t so severe that they would cause any clinics to close if they “are already providing adequate care.”
Highlights of the proposal include requiring each clinic to have a defibrillator device, written agreements with nearby hospitals for emergency transfers (or to document that they tried to secure an agreement), quality assurance committees and a 24-hour phone line for complications that is staffed by a person, not a recording, and to improve post-operative care.
The proposals were developed in consultation with the medical community – including physicians, professional licensing agencies, DHHS staff and an abortion provider. Among those who helped write the rules was a representative of a Planned Parenthood abortion clinic.
“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,” said Alison Kiser, a spokeswoman for Planned Parenthood affiliates in North Carolina.
Fitzgerald said Planned Parenthood shouldn’t have been involved.
“It was a mistake for Gov. McCrory and DHHS to consult abortion doctors and the abortion industry about these rules which will regulate their own clinics, and this places the profits generated by the abortion industry above the health and safety of women,” she said.
There are 14 clinics certified to provide abortion services in North Carolina and two others seeking certification.
A financial analysis by the nonpartisan legislative staff estimates the cost to abortion clinics would amount to about $7,500 each in the first fiscal year, and about $5,800 each in subsequent years. Initial expenses would be to buy automated external defibrillators and privacy curtains for post-op rooms. The state would spend about $20,000 a year on annual inspections.
One of the key changes would be the requirement that abortion clinics have written agreements with a nearby hospital for emergencies. In other states, that has been a roadblock when hospitals refused to sign such agreements.
But this provision says clinics are in compliance if they can document their unsuccessful attempts to secure agreements. The legislative analysis notes that, under federal law, hospitals are required to treat anyone who shows up with an unstable medical condition anyway, which makes such agreements increasingly obsolete.
Another concern when the legislation was being debated was a provision that gave the state authority to regulate abortion clinics as stringently as same-day surgery centers. But the law only requires the state to impose that standard when “applicable,” and in only a few instances do these proposed regulations do that – including having to do with quality assurance monitoring and defining roles for the administration of each clinic.