UPDATE: Health board adopts abortion clinic regulations

4:30 p.m.

The state Board of Health Thursday approved regulations that will effectively regulate Virginia's 21 abortion clinics as hospital surgical centers.

 The vote on the 15-member board was 12-1, with all nine appointees of Gov. Bob McDonnell, an anti-abortion Republican, voting for the regulations, along with three appointees of former Gov. Timothy M. Kaine, a Democrat. Consumer member James H. Edmondson Jr., appointed by Kaine, was the only board member to vote against the regulations. Two other Kaine appointees were not in attendance.

 Adoption of the new rules followed an emotional public comment period in the morning attended by more than 100 abortion-rights and anti-abortion advocates, and a three-hour review of the regulations by the board in the afternoon during which virtually no changes were made to the draft regulations composed by the Virginia Department of Health.

 "My personal view is that the law was not about making health care safer for women -- it had to do with trying to limit access to abortions," Edmondson said moments after the vote. "Perhaps they succeeded, but maybe in the long run they won't."

 Edmondson said he thinks there are "some major constitutional issues that will be in play that haven't been in play before with other states. This is only the beginning of the process, it certainly isn't the end."

The anti-abortion Family Foundation of Virginia welcomed the vote.

 “Today’s action by the Board of Health ensures that those women who make the unfortunate choice of abortion will at least go to abortion centers that have met minimal safety standards," said vice president Chris Freund. 

 "Despite the deceptive rhetoric of the abortion industry, the Board recognized the necessity of bringing oversight to an industry that has gone with none for far too long.  We are confident that these regulations will withstand any potential legal challenge.”

 While not unexpected, abortion-rights advocates were devastated by the vote, which will force nearly all of the clinics operating in the state to undergo costly retrofitting or face closure. Some advocates were too emotional to speak during a brief recess after the vote.

"I'm profoundly disappointed in the Board of Health," said Dr. Wendy Klein, a women's health advocate. "They have rubber-stamped the regulations written by the attorney general's office, and they do not protect the interests of women in the commonwealth. They do not protect patient privacy. They are pretending that this is not a special circumstance. It is a highly charged situation --  it is not a nursing home or a veterinary clinic." 

 Edmondson, a developer, proposed 17 amendments, ranging from reducing the burden on clinics to meet new building standards, to limiting the discretion of the commissioner to revoke a clinic license for any violation, to further safeguarding the privacy of patient and abortion provider information.

Three of Edmondson's amendments were adopted; an amendment that provides for inspections of the clinics from every year to at least every two years, and a requirement that any health inspector identify himself before conducting an inspection of the clinic.  The board also agreed to an amendment that requires patient information and addresses to be redacted if health officials remove any records from a clinic.

The regulations now go to the governor's office for executive review. Health Department officials, the attorney general's office and other executive branch offices. Neither the board nor the public will have further input. The regulations will take effect on an emergency basis for one year  beginning Jan. 1 and McDonnell can extend them for an additional six months while permanent regulations are formulated.

4:05 p.m.

The state Board of Health today approved regulations that will, in effect, regulate Virginia's 21 abortion clinics as hospital surgical centers.

The vote of the 15-member board was 12-1, with all nine appointees of Gov. Bob McDonnell, an anti-abortion Republican, voting for the regulations, along with three appointees of former Gov. Timothy M. Kaine, a Democrat.

Consumer member James H. Edmondson Jr., appointed by Kaine, was the only board member to vote against the regulations. Two other Kaine appointees were not in attendance.

The Department of Health composed the regulations under a legislative mandate narrowly passed this year by the General Assembly and signed by McDonnell.

The rules will require the existing clinics to comply with standards for surgery centers constructed after 2010 — from expanding the width of hallways and the size of operating rooms to providing covered entrances and increasing the number of parking spaces at a facility.

The rules will apply only to abortion services and not to medical practices where invasive procedures such as colonoscopies, plastic surgery, eye surgery and oral surgery are performed.

They also will require increased medical staffing and allow for unannounced inspections of the clinics and reviews of individual patients' records.

The regulations will take effect on an emergency basis on Jan. 1, because the law stipulated that the rules be produced within 280 days. They can remain in effect up to 18 months until permanent regulations are written. Clinics would be given time to submit plans for compliance and to make changes to meet the requirements.

Adoption of the new rules followed an emotional public comment period in the morning attended by more than 100 abortion-rights and anti-abortion advocates, and a three-hour review of the regulations by the board in the afternoon, during which virtually no changes were made to the draft regulations composed by the Virginia Department of Health.

Earlier today, proponents for access to legal abortions and those against abortion altogether engaged in rhetorical battle for nearly 90 minutes over the series of proposed regulations.

In two-minute intervals, speakers walked up to the podium in the crowded conference room at the Wyndham Airport Hotel in Henrico County to address the Board of Health, which is scheduled to vote on the regulations later today.

Proponents of the regulations varied their reasons, arguing alternately that abortion amounts to killing and that the clinics must be more stringently regulated to ensure safety of the women who use them.

Abortion-rights advocates -- who accounted for the majority of the 120 or so people in the room and roughly two-thirds of the 32 speakers who addressed the board -- argued that the restrictions imposed by the regulations would effectively outlaw abortion in the state by forcing changes that the clinics could not afford and intimidate women from using the services by violating their patient privacy.

"Because something is legal doesn't make it morally right," said Frances Bouton, 57, of Suffolk. The first to speak, she supplemented her remarks with large photographs of aborted fetuses and called abortion "a grave moral evil."

Louantha Kerr displayed pictures taken outside a clinic in Newport News, which she argued lacked adequate safety and cleanliness. "I wouldn't take my pet to a facility like this," she said.

The board also heard from Tosha Yingling, who said a women's health center -- which provides health care, counseling, contraception and screening for sexually transmitted diseases in addition to abortion services, was the only place she could turn when she discovered lumps on her breast and could not afford private medical care.

"These draft regulations also threaten women like myself who need access to health care," she said.

Patrick Hurd, CEO of Planned Parenthood of Virginia, told the board the regulations "single out abortion providers, treating us in a disparate and discriminatory manner based on politics, not sound medical science or historical practice."

Several times during the remarks, Board Chairman Bruce Edwards had to tell speakers to stop speaking when their time -- displayed by a digital clock projected on a screen in the room -- ran out. Applause and the outburst of one angry attendee prompted a sharp rebuke from Edwards.

"Please maintain appropriate decorum," he said in one instance.

"The police are here and they will remove you," he cautioned after another outburst.

Victoria Cobb, president of the anti-abortion Family Foundation and wife of Deputy Secretary of Health Matt Cobb, attended the hearing with her infant girl, born less than a month ago.

Also in attendance were roughly two dozen college-aged students, rounding out a crowd of nurses, doctors and other health-care providers who largely argued against the regulations and a number of older women who spoke in favor of their adoption.

Cathy Marshall, the wife of conservative Del. Robert G. Marshall, R-Prince William, delivered prepared remarks on his behalf. "There is no reason to discredit the argument of very minimal oversight," she read. "The abortion lobby should favor, not fight these minimal standards."

But Dr. William Nelson, an obstetrician and a former health director at the state Department of Health, said "there is no shred of evidence" that first trimester abortions performed in the state are unsafe.

He called the regulations "a sinister attempt to put it in the back corners of society, to make it seem dangerous, to make it seem wrong." And he said regulations allowing state access to unredacted health files of patients at the clinic is a "very serious threat" to the privacy and safety of providers and their patients.

Student Kate Fowler was among the few speakers who didn't use all of her time before the board. Instead, with about 45 seconds left, she stood in front of them in relative silence.

"Hopefully you're thinking a little bit about what you're voting for," she said, as the time ticked away. "About where young women are going to go for these procedures, about whether they're going to try and do them for themselves."

Abortion-rights advocates say the costly structural changes mandated by the regulations could force the closure of 17 or more of the clinics for noncompliance.