I am writing on behalf of Planned Parenthood South Atlantic (PPSAT) write to express my support for the changes proposed in the public comments submitted by the Virginia Coalition to Protect Women’s Health. Abortion providers in Virginia are already subjected to a plethora of regulations and standards, like any other medical provider.  TThese regulations help ensure that patients are afforded access to safe,  high quality access to safe reproductive healthcare in the Commonwealth. Consequently, there is no need for additional regulations targeted at  abortion providers.

As the Virginia Board of Health conducts its current review of chapter 12 VAC 5-412, I encourage the body to ensure that regulations are medically necessary and both the patient and provider safety is prioritized.

In particular, I urge the Board to amend its regulations surrounding facilities inspections. Abortion facilities, like other similarly situated health care providers, should be inspected to ensure patient safety. However, regulations around inspections should be tailored to patient safety, and providers should not be singled out for the type of care they provide. 

Currently, all abortion facility inspections are unannounced. The surprise nature of these inspections disrupts patient care and increases wait times, as medical staff are pulled away to answer inspectors’ questions, guide them around the clinic, and obtain patient consents for inspectors to observe patients. Unannounced inspections also expose patients unwillingly to contact with inspectors unwillingly, which is particularly harmful as many women patients strongly desire privacy during their abortion appointment. If clinics had seventy-two hours notice before an inspection, they could take steps to ensure the privacy and comfort of the patients receiving care that day. Facilities could schedule patients in such a way that staff could participate in inspections and answer inspectors’ questions without forcing patients to wait longer to receive care. Also, staff could notify warn patients that inspectors would be on site and and patients could reschedule patients accordingly if they preferred. Of course, as medical providers, we know the importance of allowing a credible complaint to be investigated without an announced inspection. PPSAT supports unannounced inspections in these specific cases.

In addition to reconsidering the unannounced nature of these inspections, the Board should also reconsider their timing. The Board should amend its regulations to reflect its statutory obligation to inspect all licensed hospitals, not just licensed abortion facilities. Although procedures in inpatient hospitals and outpatient surgical centers are far more invasive and carry far greater infection risks than abortion procedures, OLC is far behind in inspecting both of these hospital categories. Although OLC has conducted timely inspections of all currently licensed abortion facilities, it is overdue in inspecting ninety 90 percent of inpatient hospitals. Thirty-four percent of hospitals have not been inspected by VDH in five years. Another 36 percent have either not been inspected by VDH in ten years or VDH could not verify when the last inspection occurred. VDH has also missed deadlines for inspecting outpatient surgical hospitals. 

In 2017, HB 2300 was signed into law to ensure adequate hospital inspections. Specifically, this law requires that all for hospitals, hospices, home health care organizations and more, “no hospital shall receive additional inspections until all other licensed hospitals in the Commonwealth have also been inspected within the past two years.” (emphasis added). The law allows exceptions for violations and other safety concerns. Critically, this statutory requirement applies across all categories of hospitals--in other words, OLC is prohibited from re-inspecting abortion facilities unless it is also up to date in inspecting other categories of hospitals. 

This requirement should also be incorporated into the regulatory language in 12 VAC 5-412-100. 

“An OLC representative shall make periodic scheduled on-site inspections of each abortion facility biennially, subject to the requirements of Va Code §§ 32.1-111.7, 32.1-125.1, 32.1-126, 32.1-162.4, 32.1-162.10, and 35.1-22. Based on those requirements, no hospital shall receive additional inspections until all other licensed hospitals in the Commonwealth--regardless of the category of hospital licensure--have also been inspected within the past two years, unless the additional inspections are (i) necessary to follow up on a pre operational inspection or one or more violations, (ii) required by a uniformly applied risk-based schedule established by the Department, (iii) necessary to investigate a complaint regarding the hospital, or (iv) otherwise deemed necessary by the Commissioner or his designee to protect the health and safety of the public.”

I ask that you amend the regulations to ensure that OLC devotes its inspection resources in a way that is fair and medically reasonable, that serves the broader objective of protecting all Virginia patients, and that does not unduly disrupt patient care. I also encourage the Board to adopt the changes proposed by the Virginia Coalition to Protect Women’s Health. Removing unnecessary barriers to medical care is critical to ensuring the highest quality patient experience.

Thank you for your consideration.

Respectfully,

Jenny Black

President and CEO, Planned Parenthood South Atlantic