Issue Overview
Unregulated Pregnancy Clinics (UPCs) often present themselves as free medical clinics to mislead clients seeking abortion. Their primary goal is to prevent clients, through persuasion, misinformation, or delay, from having an abortion.81 While these organizations have the right to oppose abortion, most use misleading tactics, including ads, signs, and websites presenting their facilities as conventional medical clinics, even, at times, as abortion providers.82,83 Inside, they often resemble medical offices, with waiting rooms and exam rooms outfitted with medical equipment, and staff in lab coats and scrubs. Clients must often fill out intake forms that ask for private health information.84
The vast majority of UPCs advertise medical or quasi-medical services. Nearly all offer free pregnancy tests85 readily available at any pharmacy. Between one-quarter86 and one half87 advertise free STD/STI tests, and approximately three-quarters advertise free ultrasounds, 88 typically performed by someone presenting as a medical professional.
Some UPCs have off-site doctors listed as medical directors or employ on-site RNs or LPNs, but they do not diagnose medical conditions, write prescriptions, or refer people for treatment. Because most of these centers are not regulated as conventional medical clinics, they are not required to follow standard rules on client confidentiality, medical accuracy, or even basic sanitation.89
The state has a responsibility to protect people from misleading or unethical practices. The Society for Adolescent Health and Medicine and the North American Society for Pediatric and Adolescent Gynecology jointly stated support for this policy position: “[We] urge all governmental, regulatory (e.g., medical and nursing boards), and accrediting bodies with responsibility for enforcing medical and ethical practice standards to ensure that health care professionals providing services at CPCs and services delivered at CPCs adhere to established standards of care.”90 Similarly, the American Medical Association “urges the development of effective oversight for entities offering pregnancy-related health services and counseling.”91
Qualified Oversight in Reproductive Care Act
Summary
The Qualified Oversight in Reproductive Care Act requires a facility that provides obstetric ultrasound examinations to identify its medical director to the Department of Health and to clients.
SECTION 1. SHORT TITLE
This Act shall be called the “Qualified Oversight in Reproductive Care Act.”
SECTION 2. FINDINGS
The legislature finds that:
- Most Unregulated Pregnancy Clinics (UPCs) do not have a physician, physician assistant or nurse practitioner who supervises, in person, medical services provided at the facility.
- However, many UPCs without an on-site medical supervisor nevertheless represent to clients that the facility has a medical director without naming that medical professional. The claim that such a facility has a medical director gives clients a false sense of security.
- It is vital for clients to access early and reliable medical care to confirm pregnancy, gestational age, identify ectopic pregnancy, fetal anomaly, issues with the placenta or amniotic fluid, and any factors that could make the pregnancy high risk or dangerous. Such medical care may also be important for the health of the fetus.
- If a pregnancy clinic asserts that it has a medical director, then that individual should be named. Clients receiving physical or mental health services require and deserve this information.
SECTION 3. MEDICAL DIRECTOR RESPONSIBILITY
After section XXX, the following new section XXX shall be inserted:
(A) DEFINITIONS—In this section:
- “Qualified medical provider” means a physician licensed under [cite state law], a nurse practitioner licensed under [cite state law], or a physician assistant licensed under [cite state law], acting within their scope of practice.
- “Unregulated clinic” means a facility, including a mobile facility, that provides obstetric ultrasound examinations but is not a “covered entity” under the federal Health Insurance Portability and Accountability Act (HIPAA).
(B) DISCLOSURE—An unregulated clinic shall be required to:
- Have a qualified medical provider who provides or supervises, and takes responsibility for, the provision of medical care at the facility;
- Notify the [Department of Health], in accordance with rules promulgated by the [Department], of the name and contact information for its qualified medical providers.
- Disclose to a client, upon request, the name and contact information for any qualified medical provider who provides or supervises medical care to that client.
(C) ENFORCEMENT
- Any person who believes that a violation of this section has occurred may file a complaint with the [Department]. Within thirty [30] days of receiving such complaint, the [Department] shall investigate such complaint and determine whether a violation has occurred.
- Any unregulated clinic violating the provisions of this section shall be subject to a civil fine of not less than five hundred dollars and not more than one thousand dollars on the first violation and not less than one thousand dollars and not more than five thousand dollars on the second and all subsequent violations. [Adjust the civil penalty amounts to what is conventional in your own state.]
- The Attorney General may commence an action in any court of competent jurisdiction for injunctive relief to compel compliance with the provisions of this section, and for civil penalties for violations.
- Prior to commencing an action in court, the Attorney General shall give written notice to the unregulated clinic to cure such violations not later than 10 business days after receipt of the written notice.
SECTION 4. EFFECTIVE DATE
This law shall become effective on July 1, 20XX.
