Alabama Public Health Committee Approves Changes To Abortion Clinic Regulations

The Alabama Committee on Public Health on Wednesday unanimously voted to approve changes to regulations for clinics providing abortion services that would boost requirements for substitute physicians and increase the responsibility of medical directors, the AP/AlabamaLive.com reports (Hunter, AP/AlabamaLive.com, 9/20). According to an Alabama Department of Public Health regulation implemented in 2003, clinics must have a physician with admitting privileges at a local hospital to replace on-staff doctors when they are away. State officials have been examining the rule since the Montgomery, Ala., clinic Reproductive Health Services during an Aug. 2 inspection was found to have been operating without a backup physician for about a year. The clinic was closed for about one month but was allowed to reopen on Tuesday under a provisionary license (Kaiser Daily Women's Health Policy Report, 9/21). Under the proposed rule changes, a staff member trained in CPR must always be present when a clinic is open, and medical directors are responsible for implementing a clinic's regulations and ensuring that staff meet state requirements. In addition, all physicians associated with a clinic must be board certified or eligible in obstetrics and gynecology except for family doctors who are trained in several abortion-related procedures, such as hysterectomies. According to State Health Officer Don Williamson, the need for rule changes became apparent after investigators earlier this year found many violations at clinics in the state -- including medical abortion drugs being administered by medical staff instead of physicians, as well as negligent bookkeeping and maintenance. The proposed rules now go to the state licensure board for consideration, and Williamson said that a public hearing on the proposals could be held as early as November and that the rules could be implemented by February 2007.

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"These proposed rules will set a new, higher standard for medical management, equipment maintenance and medication administration," Williamson said, adding that the most "substantive effect of the rules" would be that they would "pu[t] the responsibility for the care of the patient squarely on the person performing the abortion from the time the patient enters the facility until the time they are covered and outside the range of complication." Some abortion-rights advocates in the state have said many local physicians have been reluctant to serve as backups at abortion clinics because of fears they will be targeted and harassed by abortion-rights opponents, AP/AlabamaLive.com reports. Williamson said names of substitute physicians have not "historically been seen as public information" and would not be publicly released. Larry Rodick, director of Planned Parenthood of Alabama, said that he has not seen the new rules but that initial reports he heard did not sound "too unreasonable." Alabama Alliance Against Abortion President James Henderson said the proposed rules do not address all the changes that are needed (AP/AlabamaLive.com, 9/20).

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