The Family Foundation urges the Board of Health to retain the strong existing regulations for abortion center health and safety.  Since inspections began in 2012, over 400+ violations have been cited including untrained staff, bloody and unsterilized equipment, abortions performed on minors without evidence of parental consent, and substantial narcotics distribution violations.  To roll back any of the regulations would be unconscionable and lacking in medical judgment in the face of such egregious violations. 

Critics of the regulations point to the construction standards and argue for their repeal; but the truth is, if these facilities cannot be trusted to direct their staff to simply wash their hands before performing invasive surgery, why should they be trusted to self-regulate and maintain safe, structurally sound, and medically accessible facilities?  Furthermore, evidence has been submitted in previous inspection reports proving that these facilities are not currently safe.  One center was documented in inspection reports to have a three foot wide gaping hole in the wall, black-colored mold, and water dripping through the exterior for a significant period of time prior to correction (Virginia Women’s Wellness, March  2014).  Another center was cited to have curbs not maneuverable by a wheelchair - a detail that is critical for post-sedation/operative patients (Falls Church Healthcare Center).  Another facility operates on the second floor of a building with no elevator access and merely an open staircase, challenging for EMS to navigate in the case of an emergency.  Abortion centers claim that they are “safe” but this is clearly far from accurate.

The Family Foundation was pleased to see that the Department of Health reviewed and verbally addressed at the previous Board meeting each specific amendment suggested in the previous public comment period.  Confident that the same standard will be extended for this public comment period, The Family Foundation suggests the following amendments to strengthen the regulations in the categories put forth for consideration by the Commissioner:

• Parental Consent:  In compliance with § 18.2-76 of the Code of Virginia, if a doctor/facility violates parental consent, upon discovery through inspections, the violation and the name/license number of the offending doctor shall be reported immediately to the Board of Medicine for assessment of a $2,500 civil fine (as directed in subsection G of the above referenced Code section).  Additionally, if the child is 15 or younger, a report of possible suspected child abuse or neglect should be filed with either local law enforcement or the Department of Social Services.  There is documented violation of parental consent laws at both the Roanoke Medical Center for Women and Charlottesville Medical Center for Women.  
• Anesthesia Service:  Drugs shall be administered according to FDA guidelines.

• Administration, Storage & Dispensing of Drugs:  There are three suggested amendments in this category:  1) To protect the conscience rights of those dispensing medication or performing procedures, facilities should include in their policy manuals, language reflected in the Code of Virginia: that employees should not be required to dispense or administer medical treatment (including medication and procedures) that conflict with their deeply-held moral or religious beliefs and that refusal to participate shall not form the basis for any claim of damages or for any disciplinary or recriminatory action against the employee.  2) Violations of federal or state drug laws and the name and DEA license number (if applicable) of the offending person should be reported immediately upon discovery to local law enforcement, the Virginia Board of Pharmacy, the Virginia Board of Medicine, and the DEA.  The Charlottesville and Richmond Medical Centers for Women both had inspection reports in the last year citing egregious drug handling/transporting/dispensing/recording/administering violations.  3) Drugs shall be administered according to FDA guidelines.  A March 2014 inspection of Virginia Women’s Wellness discovered that for 36.6% of patients that had medical abortions (i.e. RU-486) in January 2014, a second medication or surgical procedure was required to complete the abortion – a remarkable failure rate.  RU-486 is only to be used until 49 days gestation and if used according to FDA guidelines has an 8% failure rate.  Virginia Women’s Wellness’ solution to their complication rate being more than four times the average was stated in the inspection report as: “These cases will no longer be documented in the complication log.”

• Emergency Service:  In the case of medical emergency or transfer to a hospital, the time, date, and specific complication shall be reported to Department of Vital Records.

Thank you in advance for your consideration and verbal response at the next Board meeting to the specific suggested amendments.  When facing the difficult decision of abortion, the women of Virginia deserve to know that at least their physical health and safety are not in jeopardy because the center they have chosen is held by the Board of Health to the highest of medical standards.  Again, The Family Foundation urges the Board to retain strong abortion center health and safety standards for the benefit of the women of the Commonwealth.  Thank you.