I approve this regulation to proceed to public comment.  In addition to considering public comments, I ask the Board of Health to consider making the following amendments to the regulation:  

1.  In Part 1, Definitions and Requirements for Licensure, strike the following language:  “‘First trimester’ means the first 12 weeks from conception based on an appropriate clinical estimate by a licensed physician as determined in compliance with §18.2-76 of the Code of Virginia.” 

2.  In section 230(A), after “first trimester of pregnancy” insert the following language: ", meaning 13 weeks and 6 days after last menstrual period or based on an appropriate clinical estimate by a licensed health care provider.”

3.  In section 230(A), after “estimate by a licensed physician” strike the language:  “as determined in compliance with §18.2-76 of the Code of Virginia.”

4.  In section 230(B), after “authorized person” strike the language:  “which shall be notarized as required by §16.1-241 of the Code of Virginia.”

5.  In section 370(A), strike the following language:

“Abortion facilities A. All construction of new buildings and additions, or major renovations to existing buildings for occupancy as an abortion facility shall comply with conform to state and local codes, zoning, and building ordinances and the Virginia Uniform Statewide Building Code (13VAC5-63). In addition, abortion facilities All construction of new buildings and additions, or major renovations to existing buildings for occupancy as an abortion facility that perform only surgical abortions or a combination of surgical and medication induced abortions shall comply be designed and constructed consistent with Part 1 and sections 3.1-1 through 3.1-8 and section 3.7 section 3.8 of Part 3 of the 2010 2014 Guidelines for Design and Construction of Health Care Hospitals and Outpatient Facilities of the Facilities Guidelines Institute, which shall take precedence over the Virginia Uniform Statewide Building Code pursuant to § 32.1-127.001 of the Code of Virginia.  Abortion facilities that perform only medication induced abortions shall be designed and constructed consistent with Part 1 Section 1.1, 1.3 and 1.4 of the 2014 Guidelines for Design and Construction of Hospitals and Outpatient Facilities of the Facilities Guidelines Institute.”

Insert the following language:

“A.  All construction of new buildings and additions, or major renovations to existing buildings for occupancy as an abortion facility shall conform to state and local codes, zoning ordinances and the Virginia Uniform Statewide Building Code  (13 VAC5-63).  All construction of new buildings and major additions, renovations, alterations, or repairs to existing buildings for occupancy as an abortion facility that perform only surgical abortions or a combination of surgical and medication induced abortions shall be designed and constructed consistent with Part 1 and section 3.8, excluding subsections 3.8-3.2, 3.8-7, and 3.8-8, of Part 3 of the 2014 Guidelines for Design and Construction of Hospitals and Outpatient Facilities of the Facilities Guidelines Institute, pursuant to §32.1-127.001 of the Code of Virginia. All construction of new buildings and major additions, renovations, alterations, or repairs to existing buildings for occupancy as abortion facilities that perform only medication induced abortions shall be designed and constructed consistent with Part 1 Section 1.1, 1.3 and 1.4 of the 2014 Guidelines for Design and Construction of Hospitals and Outpatient Facilities of the Facilities Guidelines Institute.”

6.  In section 370(B), strike the following language:

“B. In order to determine whether the abortion facility's design and construction is in compliance consistent with this provision the applicable sections of the 2014 Guidelines for Design and Construction of Hospitals and Outpatient Facilities of the Facilities Guidelines Institute, the commissioner may obtain additional information from the facility or its architect concerning the design and construction of the facility.”