Topeka Kansas will require annual, unannounced inspections of abortion clinics, impose new health and safety rules specifically for them and prevent them from using telemedicine systems to dispense pregnancy-terminating drugs under legislation signed Monday by Gov. Sam Brownback.
The new law takes effect July 1. Abortion opponents said the changes will protect patients, but abortion rights supporters fear they will drive one or more of Kansas' three abortion clinics out of business.
Brownback, an anti-abortion Republican who took office in January, has publicly called on the GOP-dominated Legislature to create "a culture of life," and it has responded by passing a raft of measures.
Along with mandating annual inspections, the new law directs the Kansas Department of Health and Environment to write standards for exits, lighting, bathrooms and equipment. KDHE would issue annual licenses, have the power to fine clinics and could go to court to shut them down.
The law comes with new rules for administering abortion-inducing medications, such as RU-486. Now, only a licensed physician can provide the drugs, and the doctor must be present when they're dispensed. Both sides agree clinics won't be allowed to dispense such drugs to patients at far-away sites through telemedicine systems.
"In order to make money doing abortions, they have to do a lot of them. Medical regulations slow them down," said Mary Kay Culp, executive director of the anti-abortion group Kansans for Life. "Anything we could do to require the clinics to care more about women than about their profit margins is a good thing."
Kansas' three abortion clinics are all on its side of the Kansas City metropolitan area. A Planned Parenthood of Kansas and Mid-Missouri clinic and the Center for Women's Health are both in Overland Park, and the Aid to Women clinic is in Kansas City, Kan.
The late Dr. George Tiller's clinic in Wichita was among a few in the U.S. known to perform late-term abortions, but it has been closed since he was shot to death in May 2009 by an activist professing strong anti-abortion views.
Center for Women's Health employees declined comment, but Peter Brownlie, president and chief executive officer of Planned Parenthood of Kansas and Mid-Missouri, said the goal of the abortion opponents who pushed the legislation was limiting access to such procedures.
"It has definitely put the clinics in Kansas in a vulnerable position," said Julie Burkhart, a former Tiller employee who founded the abortion rights political action committee Trust Women.
Jeff Pederson, the Aid for Women clinic's administrator, said it will be forced to spend $10,000 immediately on a new exit mandated by the law. He said a requirement that physicians at a clinic have privileges with a hospital within 30 miles is problematic because anti-abortion groups pressure hospitals into revoking or not granting such privileges.
Pederson said he hopes KDHE will write reasonable rules but added, "It may cause some sort of a lawsuit if it becomes unreasonable."
So-called telemedicine abortions are an issue because of the increased use RU-486, which accounted for 26 percent of the abortions in Kansas in 2010. That's about 2,200 abortions, more than double the number in 2005.
A Planned Parenthood affiliate in Iowa uses a telemedicine system to dispense RU-486 through 16 clinics, making the practice an issue for legislators there and in Nebraska. In Kansas, abortion opponents worry that Planned Parenthood of Kansas and Mid-Missouri has plans for a similar program.
"There's some concern about abortions occurring without face-to-face consultations or close supervision by physicians," said Rep. Jan Pauls, a Hutchinson Democrat who opposes abortion. "The closer a woman is supervised, the better on that — for the safety of women."
Brownlie said his Planned Parenthood affiliate has no plans for such a program but added the new Kansas law will make using RU-486 more difficult by requiring patients to make several trips to a clinic.
The new law's enactment ends years of frustration for abortion opponents, who've long argued that the state was lax in regulating the clinics and enforcing restrictions on abortion. Similar clinic regulations were vetoed in 2003 and 2005 by Democratic Gov. Kathleen Sebelius, an abortion rights supporter.
The health department regulates 158 hospitals and 72 surgical centers, which include the Planned Parenthood clinic and previously included Tiller's clinic. But dozens of other offices and clinics do surgeries under rules imposed by the State Board of Healing Arts, which regulates physicians.
The Board of Healing Arts can suspend or revoke a doctor's license if it finds unsafe conditions or medical practices, but abortion opponents have long accused it of being slow to act. In 2005, the board forced a physician to shut down a Kansas City, Kan., abortion clinic, but the move came two years after complaints surfaced.
"We plead guilty to trying to stop access to negligent and just plain bad medicine," Culp said, arguing that abortion providers aren't likely to face malpractice lawsuits because women feel ashamed about their unwanted pregnancies.
Abortion rights supporters said it's hypocritical to target abortion without addressing other office surgeries that come with a higher risk of complications.
"The only effect is to make the services more expensive and more difficult to obtain, or more difficult to provide," Brownlie said.