Board Members,

I respectfully provide the following comments for your consideration and, hopefully, implementation:

1. Reinstate all of the health and safety measures the Board unlawfully watered down during its last amendment process.  The Board procedures used were questionable at best, unlawful at worst.
2. Require all OLC inspections to verify that ultrasounds have been performed at least 24 hours prior to every abortion performed.  It is well demonstrated that one gets what they inspect and not what they expect. Think NOKO and Iran.
3. Require annual inspections on abortion facilities instead of biennial.  One of the highest determinants of the quality of care received in a nursing home is the number of visits the patient receives.  "Eyes on" are important.
4. Remove the ability of the Commissioner to grant permanent variances.  "Absolute power corrupts..."
5. Reinstate the definition of "first trimester" as being the first twelve weeks from conception, not "13 weeks and 6 days after last menstrual period."  Use scientific observation, not anecdotal evidence (although it can inform).
6. Reinstate the ability of the department to deny, suspend, or revoke the license to operate an abortion facility for violating "any provision of Article 1 (§ 32.1-123 et seq.) of Chapter 5 of Title 32.1."  If there is any error, make it on the side of patient safety and protection, not company profit or staff livelihood.
7. Reinstate the requirement that abortion facilities provide information on post-abortion counseling to its patients.  A truly simple, caring action that acknowledges the strong body of evidence gathered since 1973 that patient physical or psychological harm has more likely than not accompanied the abortion. 
8. Reinstate the requirement that the abortion facility ensure that it has removed all of the fetal body parts from inside of the female patient upon the performance of an abortion.  It is not unreasonable to expect a high level of certainty that success accompanies an invasive medical procedure, especially one with such a signicant risk of sepsis.
9. Reinstate the requirement that abortion facilities report to OLC any incidents reported to the malpractice insurance carrier.  Who is the Peoples' first level of medical protection, their government to whom they ceded such a right or a third party profit-making institution?  What is the justification for not reporting an incident?  "Sunshine" is best.
10. Reinstate the reasonable design and construction standards that provided for things such as hallways wide enough to carry patients out on stretchers in cases of emergency.  This common sense expectation of an abortion facility has particular meaning to me because of a childhood event.  When a sophomore, I was home sick from high school for a single day one February and on this day, my little sister decided it was a good time to be born.  So, in less than an hour my 40 year old step-mother delivered her first child, while at home in bed, with the assistance of my older brother and I. The ambulance crew arrived a few minutes later, literally "wrapped things up" and carried mother and child to the hospital.  However, the gurney transport within the home's narrow hallways caused her to be stood on end twice in order to make the turns necessary for egress.  I see absolutely no reason not to require a medical facility to be designed such that the pain and tissue damage my Mom endured during those turns or in any elevator would absolutely be avoided "at all costs."  No doubt the many other design and construction requirements previously required have equal importance as well.

?Respectfully,

John Dillender

Virginia Resident