It is good government that will correct an injustice.   Thank you Board of Health for voting to begin the amendment process of 12-VA5-412 through this NOIRA.  Hundreds of medical experts - including the Virginia Chapter of the American College of Obstetricians and Gynecologists – want the amendment process begun. Approving this NOIRA was the first and crucial step toward ensuring that rules for women’s health centers are based in science and medical need.

Through appropriate amendments, we have an opportunity to return to the true traditions of Virginia Department of Health. That tradition ensures public health of Virginians, preserves full access to healthcare, protects small businesses, involves a panel of stakeholders in regulation revision, ensures healthcare for minorities and truly, truly understands how full reproductive healthcare including choice to end a pregnancy has a positive impact on the stability of the family –especially a family’s authority and rights, education, nurture and supervision. 

Unfortunately under political pressure, many required elements of the Virginia Administrative Process Act were summarily dismissed or simply not followed in 2011, 2012 and again in 2013 during the promulgation of 12VAC5-412. I am hopeful that the amendments and resulting regulations will demonstrate a:

• Commitment to providing health-based regulations that serve the small medical practices and women of Virginia and that expand access to reproductive healthcare for minorities and all women through VDH and private medical practices and physicians;
• Commitment to protecting the doctor / patient relationship and the privacy of that relationship; and
• Commitment to ensuring implementation of regulations that are realistic for a small medical practice or ensuring that appropriate alternatives will be offered for small medical practices.

Because of your vote to proceed and your courage to keep public health the focus instead of political agendas or extreme religious beliefs, we have a chance to get back to the public health traditions that I learned from my parents who served over 25 years at VDH.   I welcome amendments that clarify alternatives for achieving health-based goals in the most affordable way.

I welcome supportive licensure tied to thoughtfully scheduled inspections. We’re all committed to ensuring patient health and safety, but these regulations as they stand only add confusion, restrictions and inappropriate requirements, both administrative and structural, requiring redirection of financial resources and most valuable staff time away from patient care improvements. The challenges of complying, if indeed even possible,  with certain onerous medical and structural modifications for a single health center would be tremendous yet results in no proven medical or safety benefits to patients.

You have opened the door to ensuring medically unnecessary regulations are revised so that safe, trusted women’s health care centers that provide important wellness and abortion services can continue to serve Virginians. As a stakeholder to these regulations I am separately submitting recommendations for amendments, and stand ready to offer my assistance as we move forward in the process.

The aspiration D & C used for first trimester abortion care, as well as other gynecological care, is minimally invasive, has a history of uncomplicated quick medical recovery and is one of the safest in-office procedures provided in Virginia. Look at the medical facts when amending regulations for Virginia’s medical practices. Recognize the fact there is not a public health crisis with abortion care in Virginia.

I look forward to an enlightened revised and amended 12VAC5-412 such that health-based best practices will be consistent with all similar in-office provision of out-patient care. I look forward to an enlightened Virginia regulatory system when abortion care providers are not singled out for medically inappropriate regulation.

As I stated at the beginning of these comments, it is good government that will correct an injustice.   Thank you for bringing good government back to our Commonwealth.