How Abortion Providers Are Inspected In Arizona

By  Stina Sieg
March 19, 2014

(Photo by Stina Sieg-KJZZ)
Dr. Gabrielle Goodrick runs Camelback Family Planning and has been providing abortions for more than a decade. She says increased regulations may close independent abortion providers in the state.
(Photo by Stina Sieg-KJZZ)
Arizona's nine abortion providers, like Camelback Family Planning, get a 10-day heads up before a health department inspection. A new bill is trying to change that.

The way abortion clinics are inspected in Arizona might be changing. The State House of Representatives recently passed a bill allowing the health department to conduct inspections without prior notice. It now moves on to the Senate – and possibly Gov. Jan Brewer’s desk.

As it stands now, the Arizona Department of Health uses the same methods to inspect all outpatient medical facilities. The Bureau Chief for Medical Facilities, Connie Belden, said that includes urgent care centers, physical therapy offices and clinics that perform five or more abortions a month. Her team inspects about 2,600 medical centers across Arizona, nine of which provide abortions.

She said each gets the same treatment from a registered nurse, or team of RNs.

“We’re looking to see that if there’s any health or safety risk, obviously that’s going to be a citation because that puts the patient at risk,” Belden said.

Inspectors work through observations, interviews and reviews of documents, like patient files and policies. They’re checking, for instance, to see if a clinic has a disaster plan or if employee experience matches up with job duties. If it passes, the facility gets a stamp of approval for up to 24 months.

“All of the surveys are unannounced,” Belden said.

But there’s one big exception. Abortion providers get a 10-day heads up. It’s been that way since their inspections began in 2010. That was part of a settlement reached after a legal battle with a Tucson abortion provider.

The only time notice is not required is when there’s a complaint. In that case, inspectors need a search warrant. The bill moving through the legislature would take away the 10-day notice, as well as the need for a warrant.

Belden said that won’t change much of what inspectors do once inside a clinic.

“Throughout the survey process, we will let them know if we’re identifying a non-compliance to one of the rules,” she said. “And that also gives them an opportunity to give us more information that we may not we may not be seeing as we’re doing the investigation.”

Dr. Gabrielle Goodrick is one of the abortion providers who recently went through this process, for two days. Her office has about 12 big binders filled with polices and procedures. She said two health department inspectors spent the bulk of their time paging through them, plus 10 patient files. They also spent about two hours looking at the rooms where abortions are provided and patients recover.

The inspectors found issues, she said, like not having a label on a sink that shows which side is dirty and which side is clean. They also said her patient files are danger of water damage because they’re kept in racks beneath a sprinkler system.

“That’s probably part of their job, but it’s very difficult for a solo practitioner, you know,” Goodrick said. “To look into that kind of equipment or get that kind of safety for their charts.”

In other states, like California, Goodrick could provide abortions as part of her practice, much the way vasectomies or circumcisions are treated. But here, it means adding extra rules and attention to her practice. Goodrick said her clinic’s inspection took five hours in 2012. This year, she said it took 16 hours.

“I can’t see where any private doctor would open an office and do abortions at this point in the state of Arizona,” she said.

Opponents of the bill say that may be the point of switching to unannounced inspections. But supporters insist it would protect women by subjecting abortion clinics to the same scrutiny faced by all other outpatient medical facilities.