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House | July 11, 2013 | Chamber | Session Part 2

Full MP3 Audio File

The house will come to order members please return to your seats. Senate bill 353 the clerk will read. [SPEAKER CHANGES] House comity substitute for senate for bill 353 bill ?? certain laws pertaining to abortion, to limit abortion coverage under the help insurance plan, covered under the health benefit exchange operating in North Carolina, or offer by county or municipality. To prohibit a person from performing or attempting to perform an abortion, when the sex of the unborn child is a significant factor in seeking the abortion. To direct the department of health and human services to mend rules and conduct a study pertaining to clinic, certified by the department of health and human services. To suitable facilities for the performances of abortions. To mend mend the Women’s Right to Know Act and to increase penalties for unsafe movement by drivers that threaten to the properties and safety of motorcycles. General assembly of North Carolina in act. [SPEAKER CHANGES] Representative Samuelson please state your purpose. [SPEAKER CHANGES] To debate the bill. [SPEAKER CHANGES] The lady is recognized to debate the bill. [SPEAKER CHANGES] Ladies and gentleman, we all know that this is a controversial bill and I would be lying if I didn't tell you some times this makes me a little nervous. This is the second time today I get to handle a senate bill and fortunately though this one. Most of it is a bill that we've all ready pass, but before we go into the details, I just wanted to reiterate. That this is all bout protecting the health and safety of women. We are not here trying to shut down, the words has been shut down every abortion clinic in North Carolina, except one. What we are attempting to do is protect the health and safety of women, by raising the standards of many of those clinics. Standards that have not been raise since 1994. there are a number of facts that will still, there true now that will still be true when we are done. One is roe v wade will still be legal. But the other fact is that problem do exist in our abortion clinics and we need to address some of those. And so that's what we will do. As I go into the detail of the bill. I'm going to skim through the fist part and focus most of my explanation on the parts that are new to this board, to this body. But there was one thing, sorry. I'll be less formal, I didn't wan to address the proses that got us to where we are right now. Over the course of this secession, we have pass a couple of other bills that are now incorporated in here, and now we sent them over to the senate. They took those pieces put them together added a piece of there own and sent it back over to us. The normal reaction, we would do, is ether concur or not concur. If we had chosen to concur the only debates on there changes would have been here on the house floor, no opportunity for amendments and only one debate. If we had chose not to concur, the normal action would be, we would not concur we would appoint a small conference comity those people would meet in private they would bring it back and the only public debate would be on this floor one time. By doing it the way we've done it here what we have allowed is for there to be a public hearing that we had on tuesday. I loose my days some times here. On tuesday to let the public to voice there interest there concerns about this bill, to let members do the same thing and most importantly to let the secretary boss of the DHHS address the concerns, that she and the governor had with some of the way the language had been done. We then took it before a comity and had the comity thoroughly debate the bill. Had opportunities for amendments. Now we are bring it back here under a very public proses. So I want some of the people who have complain about the process, and how this has happen. To understand that we have had more debate and more opportunity for change and discussion and correction, under this process, that we would if we would follow the process of concur or not concur. So with that said I like to go over the detail of the bill and then we will open it up for questions. On the first session witch start on page one line 18 the Health Care Conscience Protection Act, this portion all the way over till you get to part tree on page two was included originally in our conscience protection act, which was sponsored, as a reminder by representative Schaffer Martin, Conrad and Brown. Then if you get over to the next section, which was the part that says. ?? by law prohibits sex selective abortion. I was the primary sponsored on that. Once againg we had a lot of debate on that one, when we came through the first time, it was me, Pat McElraft, representative Turner and representative Schaffer. And all that goes around till we get to the portion that is new on the amendurum, Women's Right to Know Bill. And I will not forget to mention the motorcycles

Portion when I’m done. Amend women’s right to know act. What I’d like to do is go through those, and talk about the way it came over from the Senate and then how we fixed it based on what the feedback was that we got back from DHHS. The first section was amending the women’s right to know bill, having to do with the physical presence of the doctor during both the abortion, during the abortion whether it was a clinical abortion or whether it was through a pharmaceutical abortion. When we got it over from the Senate, it included a requirement that the doctor be physically present not only when they were performing the clinical procedure, but also for all three doses of the abortion pill. It can sometimes be two doses, often it’s three doses. The DHHS secretary had concerns about that, on the basis of the health and safety of the woman. Her complaint which we eventually began to agree with, was that when the woman takes that first dosage of her pill, and then she’s supposed to take the second one, there’s a timeframe within which that she should take that second pill, if for some reason, car breaks down, family crisis or whatever, she could not get back to the clinic in order to take that second dose in time, that could jeopardize the health and safety of the woman. So we agreed on that point and decided that we would make it so that the doctor is only physically required to be present for the first dosage of the pill. We felt like that was a reasonable concession for the health and safety of the woman. The other reason people asked us why does the doctor even have to be physically present for the first dose of the pill, was because part of the abortion procedure is making sure that the woman is at the point in the pregnancy where she is supposed to safely be able to take that pill. There had been concerns, and there had been anecdotal stories in the past, that there were women who had gone there, gotten their pills, taken them, and given them to someone else. So we wanted to make sure that her safety was protected by having her take the first dose there and then she could have the others to take home and take. The second section that’s new has to do with information on the state website. If you remember from the women’s right to know bill, we do have a state website now that gives all the information for women about abortion. The one thing we had not done is list the resources that a woman may contact for assistance if she finds out after the ultrasound that her unborn child may have disability or serious abnormality. And so we wanted to make sure that they knew where those resources were should they need that common information, which is one of those unfortunate things sometimes, as a mother of a child with special needs. Then we got to section four. This is the one that got the most controversy. The way it came over from the Senate was that the DHHS was to write rules to review the standards for our clinics that have not been reviewed since 1994, and it was to raise them up to the level of an ambulatory surgical care center. The concern had to do with the fact that an ambulatory surgical care center does things other than just abortions. It does, I don’t even know if they do abortions. But they do other things, and so therefore their standards were broader and different than what you might need for an abortion clinic. So what we did was we rewrote those so that they only apply if they’re relevant to the issue of having an abortion. It has on here that they must do so in order to not, standards applicable for clinics certified by the department to be suitable facilities for the performance of abortions. So the complaint that it would bring in all kinds of standards that would shut down the clinics has been taken care of in this adjustment. The other thing we added in there was the language that says they must make these changes while not unduly restricting access. The concern had been that if we made these standards too hard, we would be restricting access to women for the clinic, and so therefore we made sure that it says while not unduly restricting access. So we have made those standards, the DHHS secretary agrees with them, and as a little background I think one of my other members will speak later, they’ve got the documentation. While changes were made twice in the 70s, once in the 80s and once in the early 90s, those standards have not been updated since then and it’s time to look at them and make sure that the health and the safety of the women are up to current standards when they’re doing these types of procedures. Another new section that actually came out and I’ll thank Representative Insko, I don’t see her here, but she helped to bring this up when we were in the public hearing. The secretary mentioned concerns about inspections. That they’re supposed to do these inspections, but they can’t get them done as often as they should do them. And the secretary’s response was an issue with staffing, trying to know how often should they do inspections, how should the inspections be done. So we added a new section that directs the department to do a study and come back to us in the short session

And tell us what they think should be the protocol for our inspections, and how to get those inspections done, and how much would they need from us in an appropriation, to make sure those facilities are inspected on a regular basis. In a way, this also ties into the one about increasing standards. Doctor Folgem, in one of the meetings, brought up a correct statement, which the secretaries confirmed, which was, many of these clinics are up to really good standards. But they haven't been inspected in so long that we can't make sure that they are in compliance. So it's the combination of getting the standards where they need to be, and getting the inspections done in such a way that they can be handled safely. That's all the new part on the abortion clinics. The rest of it has to do with motorcycle safety. It's not motorcycle helmets, and many people asked if it was motorcycle helmets. It's not motorcycle helmets. It's basically for another safety issue. If someone's on a motorcycle, and you run them off the road, there out to be some sort of penalties. What they did is look at, how do we make sure that motorcycles who are sharing the road with cars, that if there is a violation, that they are appropriately dealt with legally. That's the gist of the bill. That's not the gist, necessary, of all the issues we will hear here today. Abortion is a very sensitive subject. I'm aware that it's a very sensitive subject. We have lots of different opinions on it. But I will say that, personally, it matters a lot to me that we respect the women who are faced with these decisions. But we do so in such a way as we did with the Woman's Right to Know bill, of making sure that they have all the information they need in order to make that abortion decision in a safe and informed manner. But on the other hand, we also need to make sure that the facilities that they go into are properly inspected, are properly up to standards, and that they are not putting their health in danger once they make that decision to move forward. I urge your support of this bill. [SPEAKER CHANGE] Ladies and Gentlemen of the House, at this time, the clerk advises the Chair that there are no amendments in possession of the clerk. Any member wishing to send forth an amendment will have a deadline of 1-15, I'm sorry, 2-15, to send forth an amendment, in order for it to be in order. Any amendments submitted after 2-15 will be ruled out of order. [SPEAKER CHANGE] Representative Avila, please state your purpose. [SPEAKER CHANGE] To debate the bill. [SPEAKER CHANGE] The lady is recognized to debate the bill. [SPEAKER CHANGE] There's not an awful lot, thank you Mister Chairman, that I can add to the wonderful comments that Representative Samuelson made, because I stand before you conflicted, as quite a number of us do, over this particular issue. A few weeks ago, I stood up and told you that I could not be judged on my votes by simply who I am, as a woman, as a Christian, as a Southerner, as a Republican. And I'm split between the people that I am and this vote. As a Christian, as a mother and a woman, I'm very much opposed to abortion. I believe in birth beginning at the moment of conception, and I believe all life is holy and should be honored. But I also understand that as a legislator, I am bound by my oath to enforce and support the laws of the land. Which, as Representative Samuelson pointed out, is Roe v. Wade. And I, as a State Representative, am in no position to bring about change at the level that that law is enforced. But what I am able to do as a State Legislator is to make sure and certain that every woman who faces that horrible decision and makes that choice to have an abortion because of her personal circumstances, is guaranteed by the state of North Carolina, that she's walking into the safest and most up-to-date facility to handle her at that moment of need. Whatever it may be, as simple or as complicated as it may turn out. It absolutely appalls me that for nineteen years, we have not looked at and reviewed and updated the standards and requirements of facilities that take this type of step, surgically, medically in a woman's life. Nineteen years ago, I'm pretty sure a lot of us walked into a doctor's office, and they reached over into a bottle of alcohol and pulled out a thermometer, and stuck it in your mouth. They don't do that today. They've got a digital thermometer that has a disposable cover, and when they finish with it, they throw it away.

Don't you think that there have been some changes that we need to look at, we need to consider, to make sure that the optimum safety for the women in the state of North Carolina is taken care of by the people in this body? Thank you. [SPEAKER CHANGES] Representative Conrad, please state your purpose. [SPEAKER CHANGES] To debate the bill. [SPEAKER CHANGES] The lady is recognized to debate the bill. [SPEAKER CHANGES] Thank you, Mr. Speaker. As Representative Samuelson pointed out, I was one of the primary sponsors on the original bill, that is section one and two of this new bill. Just to briefly remind you of what those were, it regarded health care workers who might have religious, moral, or ethical objections to participating in abortion procedure. And also that taxpayer funds would not be paying for abortions through the new exchanges set up by the Affordable Care Act. But I really want to address most of my comments today to the new section that was added by the Senate and clarified by the House, of a very open and deliberative procedure, and both the Health and Human Services Committee and also on Judiciary B, of which I am a member. I am really quite glad that this section was added actually, because I am very concerned about regulations and health care. We debate regulations on this House floor on a lot of issues--energy, building--for all types of businesses, and we have differing opinions on the degree or complexity or necessity of those regulations. But I would think on this issue, and I'm talking about broader health care, not just abortion procedures, that we would all be on the same page. That we could not have a deficiency in regulations and standards for the safety, regardless of what medical procedure you're going to have. I guess in my life I've had a unique combination of experiences that really emphasize the importance of this to me. I've had the opportunity to be on the board of trustees of one of the largest health care companies here in North Carolina for a dozen years, and we spent a lot of time talking about quality of care and regulations and what new procedures we need to put in place to protect the patients from something as simple as making sure all the employees wash their hands to more complicated procedures. I had the experience of one of my first positions of actually being a health care worker. I was a chemist and microbiologist in a laboratory, and I can tell you, you're very well trained in the importance of procedures. I often say that probably was the most stressful job I had, when you know that the accuracy of a test that you're doing could affect someone's life or their treatment. Or a doctor would give me a call and say what antibiotic is the one that's going to help my patient the most, and I had to give him an answer. I can tell you I have known the importance of health care regulations. Also, from a small child, I've had a lot of orthopedic surgery, from the time I was four years old until a couple of years ago. And as a patient you get a third dimension of perceptive of how important health care regulations are. And as many regulations as there are, there are often still significant events or things that go wrong in health care. But we need to do, whether we're talking about something as important as abortion, we need to make sure that the safety of those who are undergoing this procedure have no deficiencies. And we can't let the fact that we're dealing with something of such an emotional nature hinder us in pursuing inspecting on a more frequent basis these abortion clinics, but also imposing new and higher standards. And I ask for your support for this bill. [SPEAKER CHANGES] Representative Schaffer, please state your purpose. [SPEAKER CHANGES] To debate the bill. [SPEAKER CHANGES] The lady is recognized to debate the bill. [SPEAKER CHANGES] Thank you, Mr. Speaker. Ladies and gentlemen, we've already heard it mentioned a few times already, this issue of the abortion right that is protected under Roe versus Wade. Since 1973, when the court acknowledged that women had this right to an abortion, it has come up with some other very important qualifiers to that right. What we know is that a woman's right to an abortion does not exist in a vacuum. This very important qualifier is that the state has an important interest in promoting the health and safety of women who would seek an abortion. And as such, reasonable regulations and limitations may be placed on the method of abortion and the

[0:00:00.0] This is surrounding it so that we can promote the health and safety of women. Recent events in our state just as recently as this past Friday afternoon have indicated that we as a whole as a state we are doing a poor job and abdicating for that right and promoting that health and safety of women choosing an abortion on Friday, this past Friday afternoon DHSS shutdown The Baker Clinic for Women in Durham because “Conditions at the Backer Clinic for Women present an immediate danger to the health, safety and welfare of clients and that emergency action is required to protect the clients.” Now, I have the complaint I wanna read a few lines from that so as the investigate findings of real potential immediate threat to the health and safety of patients based on the survey findings the facility fail to ensure the quality control was performed in blood blanking, based on the survey findings the facility failed to perform quality control testing on 108 patients that received RHD testing fail to ensure that ___[01:01] NTD blood group in ___[01:03] manufacturers performance specifications are verified prior to patient testing fail to ensure a positive and negative red blood cell control material was tested at least once daily when RHD testing was performed fail to follow and I could go on. What we have here is… [SPEAKER CHANGES] Representative ___[01:20] Mr. Speaker… [SPEAKER CHANGES] Representative ___[01:26] please state your purpose? [SPEAKER CHANGES] I would like to ask lady a question. [SPEAKER CHANGES] Does the lady yell? [SPEAKER CHANGES] I will be happy to yell to my statements. [SPEAKER CHANGES] Thank you. [SPEAKER CHANGES] The lady may continue. [SPEAKER CHANGES] What we have here is that is a theme of problems in the laboratory, problems with blood testing and etcetera. Many have said that since the Baker Clinic was shutdown that means that our regulations are working if this was an isolated incident however I might be persuaded to that effect but that’s simply not the case. I have the copies of some of the complaints that have come against abortion clinics over last the last decade and a spreadsheet that list these recurring complaints and we find that they are coming against the same abortion clinics for the same reasons time and again I will give one brief example, we have in Raleigh preferred women’s health center. In 2008, no proper procedures for collecting blood specimens they did not meet HHS proficiency standards that lack for recorded proficiencies evaluations from some testing personnel then we have similar short time later further deficiencies listed for a laboratory incidence we have the same clinic time and again having problems with their RH blood testing, their HGC testing, we have a lot of breakdown in the laboratory. When you go through the full list and it really…[Chuckle] It’s a long list and we have this recurring theme there is delay in disregard for standards repeated lab deficiencies, failure to properly drugs and missing proper RH testing and HCG testing as I mentioned. We do have a problem here it is recurring and we need to do something to fix that, the current regulations and the inspections is few and far between as they are or simply not solving the problem for us. Now, I have a copy of the regulations governing our abortion clinics and they fail in detail in breadth in comparison to what we require for our ambulatory surgical centers. Interestingly enough not that I’m saying that we need to do at this way but they also fail in details and in breadth to what we have require of animal shelters and things promoting animal welfare I mean I will submit to you we need to be protecting and promoting the health and safety of women with at least the same amount of detail and the care that we would regulate what's going in our animal shelters. But off course we are talking about abortion so perhaps the discussion of animal shelters and even ambulatory surgical centers is bit misplaced and that being the case I would like to draw your attention to this packet that I have, this comes from the national abortion federation is the 2013 Clinical Policy Guidelines. The mission of the National Abortion Federation is to ensure that women have legal, safe, healthy access to the abortion procedure. So, everything that they are doing in this packet is to ensure the safety of women in approaching this medical procedure, this 55 page set of guidelines certainly overshadows the 11 pages of guidelines that we have for our current abortion clinics, one particular guideline that I would like to mention simply because it has been mentioned again in the complaints against the abortion clinics in the state has to do with RH testing, one of the standards that it says, RH Status must be documented in all women undergoing abortion and then it goes on to explain the reasons why the data supporting that there is not data that supports that a lack of that testing is okay. [0:04:59.9] [End of file…]

This is a repeated offense that's going on in our clinics and we must address this. Our regulations governing these abortion clinics have not been updated since 1994, as we've heard. We have major problems that are going on in this state. They need to be addressed. This bill simply authorizes HHS to review and update our rules and our regulations governing these abortion clinics so that we can fully promote that state interest that we have in protecting the health and safety of women. This gives HHS tools and their toolbox in terms of promoting health and safety of women. I urge your support of the bill. [SPEAKER CHANGES] Representative Earle, does the lady wish to state her question at this time? [SPEAKER CHANGES] Yes. [SPEAKER CHANGES] Ladies and gentlemen, just also for the purposes of time accounting, it is the opinion of the chair that any questions pose the time to-- pose the question and respond to the question will be counted against the fully allotted time for the member posing the question to debate the bill. The lady may state her question. [SPEAKER CHANGES] Thank you Mr. Speaker. In the committee of the day, the secretary indicated that if she had adequate funding, she could do more inspecting, and you mentioned, and it seemed to be a negative indication that there was a facility that was closed, in turn there was also one closed in Charlotte. Do you not think that is a good thing and an indication that the system is working? It was closed, so do you not think that was what should have happened? [SPEAKER CHANGES] Well, this is the point that I made, is that, when we have repeat offenders time and again that they are consistently being written up for the same offenses, for the same blood testing problems, with the same failure to do their duty under these regulations. Yeah, we do have a problem; the regulations aren't working because clinics are not upholding their duty under these regulations. They're being cited for the same problems time and again. [SPEAKER CHANGES] Follow up. [SPEAKER CHANGES] Does the lady yield? The lady yields. [SPEAKER CHANGES] Was there an indication that there was a continuation, or prior violations with either one of these? [SPEAKER CHANGES] Yes, there has been, there have been several problems with the Charlotte clinic. The Durham clinic has been open only for a few months, but I gave the few examples. I've got other clinics that I'm referring to, we have quite a bit of documentation that demonstrates that these clinics are engaging in repeat problems. They're failing to discharge their duty under these regulations and they're being cited time and again for the same problem. They're being shut down, and they're reopening when they get up to par, and then they're being shut down again when they violate. [SPEAKER CHANGES] Follow up. [SPEAKER CHANGES] The lady yields. [SPEAKER CHANGES] That was not the indication that we got from the committee, but again, is that not the way the system is supposed to work? If there is a violation, should they not be closed? And that is exactly what happened. [SPEAKER CHANGES] Absolutely, they should be-- [SPEAKER CHANGES] Yes and no, please, ma'am, if you don't mind. [SPEAKER CHANGES] No, I'm going to answer it the way I would like to answer it-- [SPEAKER CHANGES] The members will yield, the chair will direct the discussion, there will be no discourse after the question is stated, unless it's directed through the chair. [SPEAKER CHANGES] Absolutely, it is the way it should work, these clinics-- [SPEAKER CHANGES] Okay, thank you ma'am. [SPEAKER CHANGES] Representative Earle, the chair, again, will direct the lady. After the lady answers the question, the member will be provided time to answer the question. [SPEAKER CHANGES] Thank you, I was just acknowledging-- I appreciated her answer. [SPEAKER CHANGES] And the chair would like for the edification of the other members, up to and including thanking the chair or the member before the member is completed with answering the question will be out of order. The lady may proceed. [SPEAKER CHANGES] Thank you, Mr. Speaker. It is the way that the system should work, but the problem is that the system is not holding these clinics accountable, shutting them down time and again, time and again, time and again, shows that ultimately, these clinics are not operating the way that they need to be operating. If we can allow HHS to have further, more frequent inspections, that we can have standards that are more in line with what even the National Abortion Federation requests, our standards would not even come up to those standards. So ultimately, we do need to get these things up to par. [SPEAKER CHANGES] Members, also, with respect to the rule, the chair would ask any member interested with respect to the chair's ruling on any discourse or questions asked, members as they're speaking, to refer to page 52 of your Mason's Manual, section 61, paragraph 2. Representative Adams, please state your purpose.

Thank you, Mr. Speaker. I'd like to ask the bill's sponsor a question and I'd like to speak on the bill. [SPEAKER CHANGES] Representative Samuelson? [SPEAKER CHANGES] I yield. [SPEAKER CHANGES] The lady yields. [SPEAKER CHANGES] Thank you. Representative Samuelson, this bill you say is all about safety. And it does, as I look at it, target women's health clinics that provide abortions. My question is have you investigated other medical clinics or doctor offices that provide much higher risk procedures than abortion to determine if there have been violations? [SPEAKER CHANGES] Those have been done by others. It was not part of my research on this bill that came over from the Senate. I've been assured that they have. I also have confidence that our DHHS secretary will let us know if there's a need to change any of the standards in other branches or if they're having problems with inspections on those, as well. [SPEAKER CHANGES] Follow up? [SPEAKER CHANGES] The lady yields? [SPEAKER CHANGES] I yield. [SPEAKER CHANGES] So you're saying that you don't know or, I mean, you don't have any data that, at this point? [SPEAKER CHANGES] I know that these things have been done, but it's not the data that I was collecting at this point. That's not what I was charged with. I do know that ambulatory care centers do automatically have higher standards than what we've currently got for our abortion centers. Our abortion centers need to be brought into the 21st century. [SPEAKER CHANGES] OK. One last question, Mr. Speaker. [SPEAKER CHANGES] The lady yields. [SPEAKER CHANGES] You talk about the process and the procedure and you sort of said that it was open. I'm curious about why the public was not given notice about the bill change, especially when it went to the J committee and it comes out under another number and name? [SPEAKER CHANGES] Well, we gave four days notice, as I recall, on the public hearing that had to do with the health committee. On that particular one, yes it was quick. It's the end of session. Things move more rapidly at this time of year. However, as I pointed out, it was still an open process in a committee as opposed to a conference report, which is not an open process. [SPEAKER CHANGES] OK. One final question on that. [SPEAKER CHANGES] Does the lady yield? The lady yields. [SPEAKER CHANGES] I yield for all questions. [SPEAKER CHANGES] OK. And so you indicated, I was in the J committee when I heard that the meeting was going on. But you said you worked this out with secretary and the Governor the evening before? [SPEAKER CHANGES] No, we worked it out up to the last minute. [SPEAKER CHANGES] OK. Speak on the bill, please. [SPEAKER CHANGES] The lady is recognized to debate the bill. [SPEAKER CHANGES] Thank you. Members of the House, it does appear to me that there were meetings in private. And that there was not full disclosure around this bill. But I just want to stand in opposition to Senate Bill 353, a/k/a 695. As a woman, I am personally insulted by the maneuvers around getting this bill to the floor today. We appreciate the time that has been allotted to allow us to at least have some comment about it at this point, because actually I sat in when the bill was in the Senate and that bill came to that floor hurriedly. No input from legislators even, as well, until they got to the floor. But you know, we've made a mockery of women's health and safety by taking a motorcycle bill, gutting it in order to pass the most sweeping legislation that will effect women's lives. And I can't think of as long as I've been here what other bill that would focus on any other issue, especially health, that we would not allow, that we would not seek out input from stakeholders, from other professionals in those fields. None. Absolutely none. There was no input allowed or requested from any women's health center provider who offer health care services that include safe, legal abortions. No weigh in from physicians who provide abortion care about the restrictions and the regulations that will be required for them. And as contentious and sensitive as this bill is, we deliberately put up all kinds of barriers to keep the public out. There was no real transparency. There's been insufficient public notice about where and when the bill would be heard. As a matter of fact, the bill came under another name. The bicycle safety act or the motorcycle safety act. The bill targets... [SPEAKER CHANGES] Mr. Speaker? [SPEAKER CHANGES] It targets... [SPEAKER CHANGES] Representative, the lady will yield. Representative Stevens? [SPEAKER CHANGES] Point of order. I know...

I think she want’s to talk about the bill and we have mentioned process because it’s been such a big issue, but I believe she is going quite afar field here. [SPEAKER CHANGES] The point is well taken [SPEAKER CHANGES] This Bill Targets the women’s’ [SPEAKER CHANGES] Mr. Speaker. [SPEAKER CHANGES] Representative Larry Hall Please state your Purpose. [SPEAKER CHANGES] Point of Order [SPEAKER CHANGES] The gentleman may state his point. [SPEAKER CHANGES] Mr. Speaker if my memory serves me correctly. The prime bill sponsor took extensive time explaining the process by which the bill came to the floor and put that in the record and I would hope that we could also deal with the relevancy of that and addressing the bill. [SPEAKER CHANGES] Representative Hall you’ll note that the chair did not provide additional directions to Representative Adams. Some of representative Adams time has already been allocated for questions and if she wishes to speak on the contents of the bill it may be something that she wishes to keep in mind. [SPEAKER CHANGES] Thank you Mr. Speaker. The bill targets and it singles our women’s reproductive clinics that perform safe and legal abortions but it doesn’t target other agencies as well. It is an unnecessary bill, it’s not needed, regulations are in place and they’re working. So if it’s not broke why are we trying to fix it? [SPEAKER CHANGES] Representative Stephens please state your purpose. [SPEAKER CHANGES] I’d like to see if representative Adams would yield for a question. [SPEAKER CHANGES] No I will not yield. [SPEAKER CHANGES] The lady will not yield. [SPEAKER CHANGES] Laws in our state regulating clinics that provide safe legal abortions are working and have been working, and when we found instances where they weren’t working they were shut down. That’s exactly what should’ve happened. This bill is a decoy it’s an attempt to regulate something that’s already regulated. When rules already work, and when we find that they’re broke, we fix them. Now, without commenting on the intent of the bills sponsors, if these regulations are imposed and they are regulated. The end results will be that clinics that provide abortion care will be put out of business. The result will be the elimination of women’s access to safe and legal abortions. And that is a constitutional right that we have as women. Now of the 17 clinics in North Carolina. Only 1 would meet the standards outlined in this bill. And we still don’t what all of those standards will be. But when these clinics are shut down, safe legal abortions are no longer available to women who need them and other critically important health services that these clinics provide like preventative services and pap smears and cancer screenings. Those thins will not be available as well. SO if we really cared about women’s health, her safety, why are we rushing tis bill? What’s the rush? Now I realize this is a motorcycle bill, and they move pretty fast but why wouldn’t want to get to stakeholders and citizens, when we’re crafting this bill, why wouldn’t we want to get them involved? Why wouldn’t we want to get the input from abortion providers? Why wouldn’t we want to know what this bill costs? We don’t even have a fiscal note, and why have we been so afraid of public scrutiny? And why would we push so hurriedly for the establishment of rules when the DSS secretary has already said that they don’t have enough staff to do what’s required of them right now? Well let me tell you what I think. I think and I believe, I truly believe that this bill is about limiting choices for women. To make the choices that she needs to make about her body. We don’t need to be making those choices for her. This is not a compromise bill. It’s not about safety. It’s about choosing, or not allowing women to choose. It’s about limiting her right to make that choice. This bill, the way it was handled. Makes it clear to me that it’s about politics. It’s not about women’s health. It’s not about safety. Ironically, AKA 695 now 353, Family Faith and Freedom, it doesn’t do anything to support or respect women or me as a part of a family. It does nothing to restore my faith in this general assemblies ability to respect women to make personal decisions that only she and her doctor, and her family ought to make. Vote NO on this incredibly horrible bill.

Representative Farmer-Butterfield, please state your purpose. [SPEAKER CHANGES] To debate the bill. [SPEAKER CHANGES] The lady is recognized to debate the bill. [SPEAKER CHANGES] Thank you, Mr. Speaker. Ladies and gentleman, I strongly encourage all of you to vote against Senate Bill 353. This bill is just another ploy to control women's abortion rights by imposing excessive and unnecessary requirements. It is a trap. These antics did not work through Senate House Bill 695 so instead the Senate places almost identical language within Senate Bill 353. Senate Bill 353 was intended to keep motorcyclist safe, not to regulate abortions. The requirement of ambulatory surgical centers has been eliminated; however, instead the authority has been granted to the Department of Health and Human Services to apply the requirements for the licensure of ambulatory surgical centers and standards applicable. This can still close clinics in North Carolina depending on what the department decides to do. It might be cost prohibited. These other additions to the bill are still an attempt to control women's abortion rights rather than protect their health and safety. They limit. They restrict. They control. Senate Bill 351 would eliminate insurance coverage for abortion in certain insurance plans and limits the funding under other health plans, including county and city employees' plans. This is an attempt to limit access and the ability to pay for legal abortions. Women who want this medically legal procedure, whether surgical or chemical, should be assured that the decision is a private one controlled by them, their family, friends and physicians as Representative Adams said. Are these regulations really necessary to protect women's health? Or are they a decoy for another agenda? This is an anti-women's bill in disguise. A wolf in sheep's clothing and another attempt to try to slip in anti-abortion legislation with little public notice. Women seek to be in charge of this process, but some of our fellow legislators are trying to take control of this process. North Carolina already has intense regulations on abortions and clinics that perform them for safety purposes. This bill is not about safety. It is about limiting choice. There's no medical or scientific basis for actually promoting women's health and safety with these proposed restrictions. It is just an honorless and biased bill. More than half of the States now have laws instituting honorless and irrelevant licensing requirements known as targeted regulation of abortion provider laws. The trap. There needs to be more research done. Additional inspectors hired. Actual safety precautions instead of proposing anti-abortion legislation. That's where the money needs to be going as pointed out by Secretary Voss of the Department of Health and Human Services. These facilities need to be regulated by health service regulation section of the department. Yes, they need to be visited more than every three to five years to monitor and enforce. This is a trap. This is absolutely nothing to do with protecting us, women. And everything to do with shutting down clinics across these United States. This is a wolf in sheep's clothing. Don't fall for this trap and North Carolina is better than this. I plead you vote no on Senate Bill 353. Thank you. [SPEAKER CHANGES] Mr. Speaker? [SPEAKER CHANGES] Representative Stevens, please state your purpose. [SPEAKER CHANGES] I wanted to see if Representative Farmer-Butterfield would yield for a question. [SPEAKER CHANGES] Does the lady yield? [SPEAKER CHANGES] Yes, I will. [SPEAKER CHANGES] The lady yields. [SPEAKER CHANGES] Thank you. Representative Farmer-Butterfield, does it concern you that the rules have not been updated in 30 years? And don't include some of the National Abortion Foundation's recommendations? [SPEAKER CHANGES] I don't have a problem with the rules being updated. I think the key thing is that they don't need to avoid people having legal abortions in this State. And they don't need to be cost prohibitive. In fact, I wondered why no one in the Department of Health and Human Services in the 11 years that I've been here has even talked about the need to update these.

So I question whether or not it's more enforcement than rules and regulations, unless the experts tell me differently. I question that, because it hasn't been raised. [SPEAKER CHANGES]May I follow up. [SPEAKER CHANGES]Does the lady yield? [SPEAKER CHANGES]Yes. [SPEAKER CHANGES]The lady yields. [SPEAKER CHANGES]And, it would not bother you then, if a part of what they adopted as clinic rules where some of those particular standards that we've talked about for other clinics and other abortion clinics. That we bring up those standards. [SPEAKER CHANGES]Tell me specifically what standards you're referring to. [SPEAKER CHANGES]And I'll be happy to. [SPEAKER CHANGES]The chair will remind the members that to the extent possible, direct the discourse through the chair. [SPEAKER CHANGES]Representative Glazier, please state your purpose. [SPEAKER CHANGES]To debate the bill Mr. Speaker. [SPEAKER CHANGES]The gentleman is recognized to debate the bill. [SPEAKER CHANGES]Thank you. So members, let me get this straight. Out of a purported concern for women's health, and in light of the Constitutional rule of Roe Vs. Wade, and in an ostensible, at least, genuflect to the outcry over the Senate process and substance of the Senate bill, the majority in what it portrays as an admirable exercise of legislative restraint, abstains today from passive a bill that eliminating abortion access outright. It does so, because after all, that would mean a direct Constitutional confrontation it was sure to lose. So this bill emerges from yet another secret rewrite by moonlight to the early morning sun yesterday, under the intriguing an wholly non-transparent title of the Motorcycle Safety Act, with some minimalist change in the wording, but as Representative Samuelson conceded yesterday in committee, quote the same the same intent, unquote, as the widely criticized Senate bill. The result of course is precisely the same as the Senate bill, and no different than if the bill expressly eliminated access. No one really believes the majority's bait and switch today. No one is persuaded the bill is really about women's health, except those already persuaded, and not a dimes worth of difference in principle exists between the Senate bill, or this one, or one that would have directly eliminated reproductive choice. They all would take a slightly different route but they end up at the same intended destination, effective elimination of meaningful choice in this state, and any claims to the contrary are insulting to the intelligence. So let's start, since we're re-writing the law of abortion, with what the law of abortion is. In Planned Parenthood versus Casey, the court established the undue burden test for determining whether a statute restricting abortions could pass constitutional muster. Under Casey Laws, invalid if it places an undue burden on a woman's right to have a pre-viability abortion, and an undue burden exists if the state regulation has the effect of placing a substantial obstacle in the path of a woman's choice to that abortion. A state's discretion to regulate on the basis of maternal health does not permit it to adopt regulations that depart form accepted medical practice. In some quarters, those are known as constitutional principles, but not apparently in the North Carolin General Assembly. The majority today, in an attempt to show public relations compliance with the right to privacy suggest a general health rational to uphold the bill's 3 key provisions. One, a physicians presence, whatever that is, and supervision, however you define it, is needed throughout the quote, entire abortion procedure, end quote. And don't strain yourself looking for that definition, because it doesn't exist in the bill, or the law. And the floor managers yesterday in committee could not answer what the real definition is. Second, a physician's presence is mandated for the administration of any medication swallowed, designed to abort the fetus, but not for further doses as Representative Samuelson correctly acknowledged. And third, the Secretary of Health and Human services is given total discretion to decide on what procedures and rules are needed for clinic and patient safety, including, and let's be clear, because the bill says it, any option that's pertinent to ambulatory surgical facility regulations. When asked if these rules met the Casey standards, the majority repeatedly and robotically said they create no undue burden, they are necessary for a mother's health, and they ensure safety. Well, wrong, wrong, and wrong again. Repeatedly saying those phrases without content hardly gives them more merit. To answer the real constitutional issue raise by this bill, we need go no farther than asking if there are compelling facts as the

Law requires sufficient to justify these highly invasive governmental intrusions into a woman's fundamental right of privacy and her access to it. Well where to begin? Maybe where I just ended. Because not a single fact was truly presented in any serious form in either the senate or the house. And what's the first giveaway to that? Well the first giveaway is the absence of any legislative findings on the record, or in the bill. There's not so much as a preamble to this bill or this new section to support why the bill or these provisions are medically necessary, medically reasonable or legally valid. Across this nation there are a number of bills this session that have been filed and some passed in other states, seeking to change the law of abortion in those states. And what I would defy any of you is to go to any of those bills that were enacted and find a one that doesn't contain a copious legislative record or findings. The arrogance of the House determination to simply impose its ideological will here today without even attempting to create the findings to show why the provisions are necessary and reasonable medically and legally valid is breathtaking. of course good reason exists as to why there are no legislative findings in the bill and that's because there's no legislative record of evidence to support them. As to the first provision, the record here is stunning for its nonexistence. No testimony, no studies, no evidence of any kind was presented in the Senate, but of course why should any of us expect that to occur because the goal there was to move fast with no notice and no record, and they succeeded. Here we at least had as representative Samuelson has correctly stated a public hearing, but most of the concerns raised by many at that hearing, including requests by the secretary for long term review and study of dozens of issues occur, but no testimony other than a few brief three minute comments form members of the audience. There was no medical evidence requested, no studies introduced and the committee that listened to the comments was not even the committee that ended up being assigned in voting the bill. A first I would expect in the annals of state governance. Nor the committee comments for that matter transcribed for those of us who weren't there, although I was for part of it, to read, and at least say we had the comments in front of us. Next, the first provision of the three that I mention in this bill which hasn't been talked about in the previous discussions creates the physician requirement. It sets out whole new terms undefined in prior law and in this bill like the term entire abortion procedure. What does that mean? is the physician to be physically present with the patient an hour pre-op and an hour post-op as was suggested in the committee yesterday? and if so, what a surprise to the North Carolina Medical Society to learn that nearly all its surgeries for generation have been done wrong, since that's almost never occurs. And what does the term presence mean? Actual physical presence as some of the bills sponsors said? Construct a presence in the building as others suggested? Or maybe metaphysical in some way like telephonicly. And what does it mean if they can be in the facility? Within so many yards of the room, within so many feet, seconds away, could they go outside for a smoke? Well no one knows. The bill's that invade a constitutional right at least ought to define the terms of the invasion. As to the second provision, clearly the winner of the most feeble provision of the bill award, what possible reason exists to watch the pill being ingested? And if it's needed for the first, why not the second or third? And if it is to see if the woman is ready and it is the right time for her to take the pill well that's truly important and I agree with representative Samuelson there, but the physician doesn't have to be in the room when the nurse comes with the pill and she swallows it. That is absurd. And what a surprise I suspect it is to the anesthesiologist in this [??] stay, who earlier this session fought over the term supervision in bills before us. Supervision for them means in the building, they can be in several OR's at the same time as long as the CRNA is there and available if needed. Well let me suggest to you men and women who are anesthesiologists no longer guys, if it's medically necessary that supervision be physically present in the same room for the operation for abortion, it sure should be for anesthesiologists where someone could become brain dead and die because of a lack of oxygen. The consequences of what we do today...

the words that we have in this bill matter to all patients and all doctors and all facilities and it cannot be neatly ??? into abortions. But of course when we race to put on the calendar ideological bills without taking the time to talk with medical societies and boards and practitioners and facilities, do we expect a different result? Finally, as to the third provision in the bill that authorizes the study of what rules are needed but orders the effective date of compliance with those rules months before the study is to finish, someone else on our side will talk about that. But more important to me the bill provides no guidance whatsoever to practitioners or facilities of what is expected, when compliance will be expected, the costs of that compliance, how they can prepare to comply and indeed how they can comply. Just notice that any and everything is possible including all the mandates of an ambulatory surgical center, whatever they are, because we don't have it in the record what they are, and the Secretary saying the other day that there are serious issues that deserve long-term study, apparently at least a night's worth. Casey teaches us that health regulations which are unnecessary and not reasonably related to maternal health or depart from accepted medical practice cannot withstand constitutional scrutiny and must be invalidated. I assure you these will. In reality this bill is nothing but a legislative fusilade aimed at smothering the right to privacy and a woman's right to choose under any circumstances. The bill tramples on access and marches backward in time, all but eliminating any cost and time effective way to practice medicine in this arena and for facilities to plan and comply with what amounts to a standardless unbridled discretionary law changeable at the political whim of a department, a Governor, or a Legislature. It is a betrayal of settled expectations of the women of North Carolina to reproductive choice. And you know, it takes real cheek for the majority to assure us their only concern is women's health. And those who do abortions, says Senator Daniel, safely have nothing to fear from this law. When what has preceded before and succeeded since the filing of all these measures has been a virtual assault in public and private speeches on the concept of abortion by bill sponsors and co-sponsors and lectures on how abortion should be eliminated. For many in the majority the story of abortion is always black and white. Have an abortion, you've done a bad thing. But the truth of course is the majority of women in this State and nation and world know is far more complex. No one today should doubt the only restraint on the majority's reach on this and other issues like it is what it thinks it can get away with and the answer to that question lies with the courts and the electorate, both of whom we shall hear from soon enough. Some today have excoriated the process used to get this bill to the floor and to an extent I agree. But in a sense the majority has done us a favor. It has given us the most transparent view of what really underlies the bill. A pretension to power confined by neither the Constitution nor the current sentiment of a majority of North Carolinians. The bill is astounding to me. An unprecedented except it continues and takes to a new extreme the recent tendency in the House and the Senate to turn Constitutional protections for minority rights into a repealer of this state's traditions of tolerance and it is to me fundamentally wrong to use some newly found Constitutional protections as springboards for major changes like the Second Amendment with whom this Legislative body is conducting an amorous affair while treating others like senile relatives to be closeted in the attic until they quit annoying us like the right to privacy and bodily integrity and reproductive choice. In the end North Carolina should be scared of what this bill portends when a Legislature feels unrestrained by its oath, unrestrained by any sense of responsibility to cast a middle ground on a divisive issue in a centrist state, and unrestrained by any understanding of women and families who lead lives outside our narrow cultural lens as legislators. 1984 may have come a bit later than predicted but it is here at last and with all pretense to moderation shorn of its fictitious cover. Justice Kagan recently stated: to a hammer everything looks like a nail. And to an extreme legislative majority bent on eliminating the right to choice, everything looks like a health regulation ready to be abused and used to

...?? access to that choice. The House bills which we passed were bad enough. But it added, as I finish, Mr. Speaker, but it added the Senate provisions. In the end, I dissent from the procedural and substantive choices created today in the House, but at least the legislature has maintained the right of itself to make those choices. A right it now denies to the women of North Carolina. Thank you. [SPEAKER CHANGES] Mr. Speaker. [SPEAKER CHANGES] For what purpose does the gentleman from Guilford, Representative Blust, rise? [SPEAKER CHANGES] May I ask Representative Glazier a question? I guess that would go to any time I might have. [SPEAKER CHANGES] Does the gentleman from Cumberland yield to a question from the gentleman from Guilford? [SPEAKER CHANGES] Certainly. [SPEAKER CHANGES] He yields. [SPEAKER CHANGES] Representative Glazier, so much of what you said, it sounded nice but it's incorrect. I hardly know where to start. But I'll limit it to one question. Are you aware that the 4th Circuit has upheld a very similar law to this in South Carolina? [SPEAKER CHANGES] I've read the Greenville opinion from the year 2000, Representative Blust. And the Greenville opinion, which at the time obviously cert was denied 13 years ago. Had about 10 different provisions in it. It was a 2 to 1 decision, as you recall, with Judge Hamilton writing a brilliant dissenting opinion. And an awful lot of the provisions that we're talking about here, particularly the physician presence provision and the physician presence provision for medication weren't in that bill. The facility provision to some degree was but written entirely differently, and there, there were actually a whole series of standards. And in that case, Representative Blust, there were copious legislative findings. Cited by the majority opinion but Justice Niemeyer and cited by Judge Hamilton in his dissent. And in that case as well, there were a whole series of exhibits and evidence introduced before the South Carolina legislature. None of which are here. We are, as Representative Samuelson said, in a different time. So we can't rely on another State's finding 13 years ago, can we? And if we can't, where are ours. [SPEAKER CHANGES] For what purpose does the lady from Buncombe, Representative Fisher rise? [SPEAKER CHANGES] To debate the bill, Mr. Speaker. [SPEAKER CHANGES] The lady has the floor to debate the bill. [SPEAKER CHANGES] Thank you, Mr. Speaker, and ladies and gentlemen of the House. So we are told to believe that this is an improvement on what the Senate did last week while we in the House were given the week off. Well, this is just another version of the same political game playing. Maybe we could call it sneak attack on women's reproductive healthcare version 2.0. Because it does not matter what we call it, it is what it is. The deceitful hijacking of women's access to a constitutionally protected medical procedure. The republican majority must think that their constituents can't read or else they might have given some thought to dropping language that they criticize their Senate counterparts for having put into a sharia law bill into a motorcycle safety bill. Really? Well it does not matter where this language appears, it still does all of the same damage that the Senate version did. It renders this week's carefully orchestrated Health and Human Services Committee meeting on the Senate bill nothing but a charade. No lessons learned from last week. A bill with all the same ingredients. Still done in a rush. Still no stakeholder or Health and Human Services Department input until the last minutes. Still tells physicians how to do their jobs. Still interferes with local governments decision making and all of this happens still with no public notice. If the goal had been to protect the health and safety of women in this State, often what we do is we go and look at other examples in other States to see what they've done. I mean I know we've all been looking at Texas lately, but have we looked at Maryland? Maryland just tightened the oversight of their abortion clinics but it just came into force this year. Their regulations just came into effect...

This year, North Carolina has had regulations in effect since '94, way before now. If the goal is to protect the health and safety of women, why would we not look at other states who are just now getting around to it, who actually had people on both sides of the aisle in agreement? This is the thing I came here to do. To work toward agreement on both sides of the aisle. This Maryland bill had even the Maryland officials of Planned Parenthood, a group leery of regulations because, in its view, they are too often driven by politics, call these rules reasonable and helpful. We have to begin taking politics out of these legislative exercises and we need to begin to talk to the departments first. Or at least look at other states and what they're doing. Where does this bill leave women in North Carolina? Well, it looks like that the only facility that will qualify to provide services under this bill, just as in the Senate version, is in my district in Asheville. This is going to make it difficult, if not impossible, for women in the rest of the state, in particular rural areas, to access reproductive healthcare. Why is this happening, and under the guise of the safety and health of women? It is clear that this is about pushing a political agenda, not about protecting women. It is obvious with the numbers of voters that have signed petitions and that have appeared week after week on Halifax Mall that we must give women more respect than to ignore the democratic process. Let me just say that according to the Center for Disease Control, the medical record for abortions in the United States indicate that the procedure is quite safe, overall. Ten women died. [SPEAKER CHANGES] Mr. Speaker, point of order. [SPEAKER CHANGES] For what purpose does the lady from Surry, Representative Stevens, rise? [SPEAKER CHANGES] Are we back on the bill, or are we going to discuss abortion? I think we're here talking about clinics and the regulation of clinics as opposed to whether abortion is safe, period. [SPEAKER CHANGES] The chair will accept the lady's point of order. I would not rule the lady from Buncombe out of order, but I would encourage the lady from Buncombe to keep her remarks as relevant as possible to the bill without venturing off as much as possible [SPEAKER CHANGES] Thank you, Speaker, and I will say that this does address the matter of safety of women. This bill purports to be about the health and safety of women. And the CDC says that ten women died of abortion-related causes out of 1.2 million procedures in 2010 and that the number of deaths in 2009 was twelve. And for many years, the death rate has hovered around one per 100,000 procedures, according to Dr. David Grimes a professor of obstetrics and gynecology at the North Carolina School of Medicine. And today he is quoted as saying that having an abortion is safer than an injection of penicillin. So if this is about the health and safety of women, as I said earlier, we have seen numbers of voters that have signed petitions, that have appeared week after week on the Halifax Mall and it is clear that we must give women more respect than to ignore the democratic process. Ladies and gentlemen, we must listen to their voices. We must listen to their voices and vote no. Thank you. [SPEAKER CHANGES] For what purpose does the gentleman from Vance, Representative Baskerville, rise? [SPEAKER CHANGES] To debate the bill. [SPEAKER CHANGES] The gentleman has the floor

to debate the bill. [SPEAKER CHANGES] Thank you Mr. Speaker. I just want to take a few moments this afternoon to talk about this so-called Family Faith and Freedom Act. It started out as the Family Faith and Freedom Act, an act that was so important and vitally necessary that it was hastily buried in a motorcycle bill under the cover of darkness only to be resurrected in its current form under a different title, Health and Safety Law Changes. The procedure happened this way because that was the way that this majority party figured that they can get the legislation passed. It was done this way because all of the women in North Carolina know that this bill does nothing to protect their constitutionally guaranteed freedoms including that right to privacy and that it does nothing to improve women's health or safety. This bill in my opinion is yet another power grab by this Republican Party. The most recent example of our state being tutored by this Republican majority on what big government really looks like. Case in point: part 2 of the bill takes away authority from local officials to insure city and county employees as they see fit. Sections 2b and c dictates all the way from Raleigh down to the 100 counties in our state as to what those county commissioners and city councilmen can and cannot offer as a part of their health insurance package to their employees. Now I contend to you that local control works and if a county wants to offer more reproductive health coverage than what's offered to teachers and state employees then they ought to have the freedom to do that. No. But this big government Republican majority thinks they know better than all of the city councilmen and women, all of the county commissioners, what's best for their employees in their counties. I ask you, how does that section improve women's safety? How does that section protect individual freedoms? If you think I'm exaggerating here about this big government power grab let me tell you about what Dr. Aldona Wos, the Governor's Secretary of Health and Human Services, said in a Committee meeting. Dr. Wos essentially told us that her agency couldn't even accommodate all the new authority. They couldn't even handle all the new power that this Legislature wants to give to them. I interpreted her remarks to mean that this bill is a bridge too far. But instead of compromising and paring down the bill this new version gives even more power, even more government authority, to the current Secretary of HHS as well as all future secretaries of HHS to impose whatever new rules or regulations they want to. The Department is authorized to apply any requirement for ambulatory surgical centers to certify abortion facilities. This legislation is forcing the Department to do the dirty work for this sweeping right wing agenda. But if you look at Section 4 of this bill, this bill literally allows this Legislature to invade the privacy of the doctor's office and literally dictates to the doctor, once again all the way from Raleigh, how long that doctor must be in the room for these procedures. That is the very embodiment of big brother looking over your shoulder. That is a decision that should be made between a woman and her doctor at that time, in the privacy of the doctor's office, and this Legislature ought to respect that right and that privacy. Now to the men and women in North Carolina, when you hear my Republican colleagues profess to you that they believe in privacy and that they believe in personal liberties and individual freedoms I want you to think back to today. Think back to this unprecedented big government intrusion into the private lives of women, their families

And their doctors. The actions today are not only detrimental to women's health, it's also detrimental to our economy. Business are not inclined to come to a state where they'll be subjected to hastily crafted, sweeping legislation at the drop of a dime with no public notice. But you don't have to make my word for that. You can follow the most recent survey by CNBC that ranks the competitiveness of all fifty sates in America. This year we will rank the twelfth most competitive state of business. [Speaker Changes] Mr. Speaker point of order. [Speaker Changes] The lady from Surry has the floor to state her point of order. [Speaker Changes] We're now coming from clinics and regulating clinics to our standing as business friendly. I think we've moved very far afield here now. [Speaker Changes] To the Representative Baskerville the Chair would ask: I realize this is an emotional issue and that there's a little bit of political discussion that's somewhat permitted on this. The Chair is trying to get wide latitude but would ask the member to try to contain his remarks more relevant to the issues at hand. [Speaker Changes] I appreciate your indulgence Mr. Speaker. When I get a point of order that means I'm really cooking; that means I'm on to something. [Laughter from audience.] Now last year we were ranked fourth, this year we're ranked twelfth. You know why? Because we fell to thirtieth out of fifty states of quality of life. Quality of life impacts our business competitiveness here in this state. Believe business leaders read these bills. They read the headlines that explain how this body has taken a regressive turn for the worst. They see the thousands of protesters who gather here weekly to decry the legislative measures that impact their quality of life. Kudos to our Republican controlled legislature for fulfilling the campaign promises of creating a business friendly environment. I think that some of my colleagues might... [Speaker Changes] The gentleman would be reminded to contain his remarks to the bill if he wishes to continue to have the floor of debate. [Speaker Changes] Yes sir. I think that some of my colleagues––and I'm wrapping it up. I think that some of my colleagues will speak more to this issue, but I just wanted to say one last thing, and it literally comes from my friend and colleague on the other side, Representative Jeter, speaking passionately about the airport, he said, "The decision I make is my own; my decision is personal. The airport is in my backyard." That is what millions of North Carolina women are trying to tell us. Their decision that they want to make is their own decision. That's a personal decision to them. Now, they don't have an airport in their backyard, but this is their body we're talking about. And I have faith in our women, that they will exercise their Constitutional freedoms to make the right choice for their families. I ask that you vote no. [Speaker Changes] For what purpose does the gentleman from Union, Representative Arp rise? [Speaker Changes] To ask my esteemed colleague, Representative Baskerville, a question. [Speaker Changes] Does the gentleman from Vance yield to the gentleman from Union? [Speaker Changes] I will for the gentleman from Union. [Speaker Changes] Thank you very much. You begin your comments regarding the freedom offered of abortion services to –– through municipalities and so forth, and then ended up the comments regarding the personal choice. Is it your position that you want to force taxpayers to pay for those abortions through taxpayer dollars. [Speaker Changes] May I answer? [Speaker Changes] The gentleman yielded the question and may answer. [Speaker Changes] No sir, that's not my personal position. My position is that if a local city counsel or a local county commission, who are directly elected by those constituents, decide that they want to offer additional abortion services on their health insurance plans, they ought to be allowed to do that. And I veto by Raleigh that they can. [Speaker Changes] Follow up? [Speaker Changes] Does the gentleman yield? [Speaker Changes] Yes. [Speaker Changes] The gentleman yields. [Speaker Changes] The local funds that would used to pay for those services would be tax dollars. Is that correct? [Speaker Changes] Well, the... I know that the Affordable Care Act already bans any...

Funding for abortions and insurance plans [Speaker Changes] Mr. Speaker [Speaker Changes] Representative Hamilton please state your purpose [Speaker Changes] Inquiry of the chair please [Speaker Changes] The lady may state her inquiry. The gentleman is in the middle of answering a question to another member. Is it relevant to this discourse here or can the lady wait? [Speaker Changes] It is. I'm curious as to who's time is being used during this discourse. [Speaker Changes] As stated by the chair at the beginning of the meeting, the time that the gentleman spends responding to a question is allocated against the time of the person asking the question. The gentleman may proceed. Just as that time was allocated to representative Hamilton. The gentleman may proceed. [Speaker Changes] I'm done, thank you. [Speaker Changes] Representative Stevens please state your purpose [Speaker Changes] To speak on the bill. [Speaker Changes] The lady is recognized to debate the bill. [Speaker Changes] Thank you Mr. Speaker. Members of the House, I want to get to some of the questions that you've been asking over there, as if this were just pulled magically out of the air that here was no need for this bill. Let me first tell you we got the information from the Department of Health and Human Services. There have been 205 citations issued against these clinics in the last 10 years. A preferred woman's health in Raleigh had 33 citations since 2001. A preferred woman's health in Charlotte has had 41 citations. This is a clinic that was just closed in the last month, but the investigation had been going on for 3 years. A woman's choice in North Carolina, in Greensboro, had 5 complaints since 2001. All of these are since 2001 to the extent that they have been open. A woman's choice of Raleigh has had 13 citations. These are not just the inspections itself, but these are the problems that were found. Chris clinic for women in Jacksonville had 9 complaints. Easton OBGYN in Chapel Hill had had 15 citations. Family reproductive of Charlotte had had 4. Hallmark woman's clinic had had 14. Piedmont Carolina's medical had had 8. Planned Parenthood of Central North Carolina and Chapel Hill had had 11. Planned Parenthood of Wilmington had had 9. Planned Parenthood of Winston Salem had 19. Woman's health alliance of Chapel Hill had had 10. And the Baker clinic, that had only been open for 6 months, had already received 6 citations in those 6 months. Yes the system is set up properly, but the problem is repeat offenders are hard to get to. Now, the rest of you talked about these rules. And what was in these rules? And I challenge to see how many of you in fact have read these rules. They are less than 10 pages of rules that currently govern clinics that were set up in 1974. I believe that is the correct statement. They were set up in 1974 and have not been revised in almost, what is that, 40 years we are coming up on. Things have changed during that time. The standards and needs have changed during that time. Now were these frivolous little complaints? No. We've looked at the documented complaints. As Representative Schaffer says she has a timetable showing these complaints. These complaints were things such as, breaking open a vile of intravenous medicine to divide it among four patients. Both of which were violations, breaking open the tube, and giving it to multiple different patients. They found dirty unsterilized equipment that was going to be used on women in some of these clinics. They found dried blood on the lamps that were used to investigate these women. So don't tell me this is not about health and safety, that's exactly what it's about. We need very specific rules. The National Abortion Foundation, which we looked at their manual that was sent to us, has standards. They go on for 50 pages with standards that are a bare minimum of what you should do. Then they have recommendations, that are sort of steering. And then they have other things that are optional. North Carolina's not bothered to look at that because the National Abortion Foundation did't come into a factor and set up its standards and rules until 1996. All we've done with this bill is give the authority to Health and Human services to do what needs to be done. In the last 6 months, they've had to close 2 clinics. And I will bet it took an act of Congress, because there is very little in those rules that they can rely on. So you know these things had to be egregious. I'll be happy to share them with any of you, and share the information.

[Speaker Changes] I could tell you there’s a box of documents downstairs. I could tell you there’s a file folder on Ruth Samuelson’s desk that has all the complaints about the one clinic that did get closed down. I could tell you that this is not been treated lightly, and it is very much concerned over women’s health and safety. There is not a war on women. There is a group of people here trying to make sure that those people who go in at that most vulnerable time are provided safe and effective healthcare, under the best standards and conditions possible. And I’m sorry if you don’t believe that, but thats the truth. We know that Roe vs. Wade is the law, we know that abortion is out there. But it should be safe, and clean, and sterile, as well as legal, and that’s what we’re here for. [Speaker Changes] Representative Richardson, please state your purpose. [Speaker Changes] Thank you Mr. Speaker, to debate the bill. [Speaker Changes] The Lady is recognized to debate the bill. [Speaker Changes] I’ve been sitting and listening and I’m not gonna be as eloquent as many of the other speakers. But I question the motive and the authenticity of this bill, because for the very citation that Representative Stevens just spoke of. [Speaker Changes] Mr. Speaker. [Speaker Changes] Representative Stam, please state your purpose. [Speaker Changes] A point of order, did the lady say, “I question the motives of”? [Speaker Changes] Of the bill, I mean, not of the people, of the bill. [Speaker Changes] The chair will remind, for the third time today, that the chair will continue to ask the member to suspend. That the discourse is managed by the chair. Every member will wait until the chair acknowledges the members right to continue speaking, before they speak. Discussions will be ruled out of order and the remaining time for that member for that opportunity to debate will be ended at that time. They will be recognized for a second time, should they have it, after I rule them out of order. The lady has the floor. [Speaker Changes] Thank you Mr. Speaker, I apologize. I would like to correct that statement. I question the motive of the bill, if we are saying that the bill has been written for the safety of women health, when there is no fiscal note on this bill and we have given the secretary of DHHS the authority to make rules and to come back to this committee with the necessary resources that will be needed to implement this. Which seems to say to me that we have no intentions of putting money into correcting the issues that were cited, because there is no fiscal note. We have asked that this bill go into effect October 1, 2013, but we don’t have to have temporary rules until January of 2014, and then we wait until April of 2014 to report back what those findings are. So I question why we don’t have a fiscal note, knowing that the Secretary has stated to us that her office and her staff are not capable of being able to implement these regulations or to follow up with any more frequent monitoring of such facilities because she does not have enough resources. So I do question the motive of the bill in the sense that it said that it’s for safety reasons. I question why we would propose a bill without studying it to find out what the fiscal responsibilities would be for the state, for the provider, and what financial impact it would have upon women who access those clinics that may possibly be closed, whether they are safe or not. Thank you. [Speaker Changes] Representative Brandon, please state your purpose. [Speaker Changes] To speak on the bill. [Speaker Changes] The gentleman is recognized to debate the bill. [Speaker Changes] Thank you Mr. Chair, Mr. Speaker. I have listened to this debate of this bill, and it is really almost laughable, at the arguments that I hear. I continue to be amazed at our ability to demagogue in this general assembly, on important issues concerning this state. We all know what this bill is about. This bill has nothing to do with the safety of women no matter how much we want to continue to say it. This is a radical bill, that gives the ability for radical politicians to oppose radical beliefs on the rights of women. That’s all this is about. If you wanted to increase the safety of women and have quality access to healthcare, you….

[Speaker changes.]...abdicated your responsibility by denying the Medicaid expansion or the Affordable Healthcare Act... [Speaker changes.] Representative Brandon, the gentleman...be mindful of the scope of his comments. [Speaker changes.] It is...ok...I apologize Mister Chair but we do have to talk about...when we talkin' about the safety and the healthcare of women, we have to talk about all of the things that we've done in this General Assembly that goes along with that and we can't just come up today and all of a sudden, we care about it when we have proof for many, many bills that we might not have cared about it but I just want to...I really want to talk about what this does is if you are a pro-life person...and a lot of people on the other side who claim that and I'm not gonna be long in my comments because I just really wanna make this point for you guys that, if you are pro-life, pro-life exists after birth. And that's just a fact. We can't continue to deny people healthcare. We can't deny people unemployment coverage. We can't deny people earned income tax credits and then... [Speaker changes.] Representative Brandon, that will be the last time the Chair allows you to run that far afield. Gentleman may continue. [Speaker changes.] Mister Speaker, I continue to maintain that this is an overall point of I'm trying to make in terms of the point of the bill that everyone continues to try to make that this about the healthcare of women and about the protection of women and I'm trying to correlate how other bills in this General Assembly has not actually correlated with this one but I understand your point and my point is this...folks, if we're gonna really do some work, if we're really gonna be able to deal with the issues, if we really wanna deal with healthcare for women, if we really wanna make things safe, then we really need to look at a comprehensive way in the way that we deal with our lawmaking and we need to deal with a comprehensive way and make sure that all women have access to healthcare, not just at an abortion clinic but in all clinics...and we need to make sure that when they wanna make a decision...this important decision that they have adequate services and adequate ways to be able to do that and that includes making sure that once the baby is born that they are able to be able to take care of that...and my position continues to and maintains to be, even if it's out of order, that we have not done that and we need to continue to do that. Thank you. [Speaker changes.] Representative Presnell, please state your purpose. [Speaker changes.] To speak on the bill. [Speaker changes.] The lady is recognized to debate the bill. [Speaker changes.] I've been standin' here listenin' and I been tryin' to put myself in the shoes of a young woman going into an abortion clinic. I personally would never and will never attend anyplace like that but I'm tryin' to put myself in the state of mind of what these women are gonna go in there and see. They're not gonna see the blood on the table or the surgical instruments that have not been sterilized. I would hope in their mind they are asking the Lord, is this the right thing to be doing. I don't think they're looking at the infectious diseases that could be transmitted through the surgical instruments that have not been sterilized at all. On a tour in December 11th of 2012, which is only about two weeks before Christmas...at 10AM with a surgical procedure scheduled to begin around 11:30, there was dried blood on observed on an exam light, on a chair and the doorjam in procedure number two...room number two. There was thick dust on the exam table in number three. The tour of the procedure room in number one revealed dead insects in the window. This young lady is not gonna have that on her mind. We, as legislators, have gotta do something that will take care of these women when they're in there having a procedure like this done. It is ludicrous to think that that woman is gonna have in her mind, looking at stuff and saying...it's not clean for me to be here and maybe I need to leave. That's not what she should have on her mind. I'm just tired of listening to this whole thing and I just had to tell you how I feel. Thank you. [Speaker changes.] Mister Speaker, can I ask a question please? [Speaker changes.] Representative Holley, please state your purpose. If the lady's purpose is to ask a question, may she direct the...to whom does she wish to direct the question? [Speaker changes.] To Representative Presnell. [Speaker changes.] Representative Presnell, does the lady yield? [Speaker changes.] Yes, I will. [Speaker changes.] The lady yields. [Speaker changes.] Representative Presnell, I understand what you're saying. And, there are exceptions to every rule and there will be facilities that are like that but would you prefer her to go to some back alley with a nasty coat hanger? [Speaker changes.] I prefer that she plan ahead.

There are a lot of procedures that you can take care of in the way of birth control. But know there's other places that are clean that she could possibly go to if that's what she has in mind. [SPEAKER CHANGES] I just want to [SPEAKER CHANGES] Does the lady wish to ask a followup question? [SPEAKER CHANGES] Followup. [SPEAKER CHANGES] Does the lady yield? [SPEAKER CHANGES] Yes. Thank you. [SPEAKER CHANGES] The lady yields. [SPEAKER CHANGES] All I'm saying is that we need to be careful when we say one incident is the norm, because it's not. You can also go into a dental clinic and see the same things. You can go into a number of facilities. I'm just pointing out that the alternatives sometimes can be worse, and this is not. You can't use the instances of one facility to blanket everything. Thank you. [SPEAKER CHANGES] Mr. Speaker. [SPEAKER CHANGES] Representative Blust, please state your purpose. [SPEAKER CHANGES] Point of order. [SPEAKER CHANGES] The gentleman may state his point. [SPEAKER CHANGES] Listen to the debate, and it's been several of the speakers. I'm listening intently. Would it be in order to do what we do for resolutions and have the bill read in its entirety? Particularly section 4, because I'm not sure the members are debating the bill as it's written. [SPEAKER CHANGES] The Chair would hope that those who take this matter seriously would have taken time to read the bill and the implications of the implementation of the bill, but the Chair would not take your question to have the bill read in its entirety. Representative Cunningham, please state your purpose. [SPEAKER CHANGES] To speak on the bill, Mr. Speaker. [SPEAKER CHANGES] The lady is recognized to debate the bill. [SPEAKER CHANGES] Thank you very much. I have received numerous emails from medical professionals in my county, Mecklenburg County. I'm gonna read just one to you. As a charlatan?? and a physician, I am saddened by the bill, especially the latest version that placed limitations on simple, safe procedures for women. This bill would institute unneeded barriers to care, both financially and by limiting availability. We recognize the need to keep abortion safe, legal, and rare, but this provision would place women at risk. Medical abortions are extremely safe and simple, and requiring a physician's presence would be the equivalent of requiring a doctor to supervise a diabetic injecting insulin. Furthermore, meeting the the requirements of ambulatory surgery centers is insufficient, high cost, and not medically necessary. I urge you not to support the bill. Dr. Eifert, medical physician. Now I will make my comments. As a health care provider and a member of the American Nursing Association, I believe the health care client has the right to privacy and the right to make decisions on personal health based on full information and without coercion. It is the obligation of the health care provider to share with the client all relevant information about health choices that are legal and to support that client regardless of the decision the client makes. Abortion is a reproductive alternative that is legal and that the health care provider can objectively discuss when counseling clients. If the state limits the provision of such information to the client, an unethical and clinically inappropriate restraint will be imposed on the provider, and the provider/client relationship will be jeopardized. Just as the client has rights, the nurse also has rights, including the right to refuse to participate in a particular case on ethical grounds. However, if the nurse becomes involved in such a case and the client's life is in jeopardy, the nurse in obliged to provide for the client's safety to avoid abandonment and to withdraw only when assured that alternative sources of nursing care are available to the client. The fact that thousands of North Carolina women are seeking abortion is a symptom. It is not a disease. The treatment lies in addressing the problems

...belying a deteriorating social fabric. Healthcare providers have the right and the responsibility to seek viable solutions to these problems that signal social failure. Such as any effective family planning, deficient prenatal care, drug and alcohol abuse treatment, domestic violence, unsuccessful parenting, sexually transmitted disease, and inadequate child care. Today we are restricting access to women in North Carolina whom are determined, determined, to make their own reproductive choices. I want to believe you want to help the women of North Carolina to live productive lives. The women of North Carolina are intelligent, strong and capable of making these vital decisions for themselves. We should allow them to make their own life changing decisions for themselves. You want to help women? Then institute equal pay. Reinstate their unemployment benefits so they can support their children. [SPEAKER CHANGES] Representative Cunningham, if the member will remember the admonishment from a prior speaker, the Chair would appreciate if the lady focuses on the scope of the bill. [SPEAKER CHANGES] Thank you. I will continue. Thank you. A system with family planning tools, increased funding to women, infant, children programs to provide care for their children. [SPEAKER CHANGES] Representative Cunningham, this will be the last time the Chair tries to provide the member with the proper direction on scope before the lady is ruled out of order in her first time to debate. [SPEAKER CHANGES] Thank you, Mr. Speaker. I will try to stay with the content, but my point of view is that this is not a one sided issue where only one thing affects one thing. This is a full view. One thing always affects another. For social...we'll move on. The social failures that I have mentioned above, if addressed can empower the women of North Carolina and their families. When women are whole, their families are whole. Let the women of North Carolina determine their own destiny. I ask you to vote for the women of North Carolina by voting no for this bill. Thank you. [SPEAKER CHANGES] Representative Queen, please state your purpose. [SPEAKER CHANGES] Thank you. To debate the bill. [SPEAKER CHANGES] The gentleman is recognized to debate the bill. [SPEAKER CHANGES] I find it quite ironic to stand here in this General Assembly and talk to you about regulating healthcare. This General Assembly has been all about regulatory reform, reducing the regulatory burden. Whether it's been about fracking or aquifers, or job safety, or conservation issues. We've been about regulatory reform and that has been about reducing regulation. Streamlining aspects of our economy. But when it comes to women's healthcare, we find that government can really use regulation to be an obstructionist. To add hurdles, to add cost, to add inconvenience and delay, to access to, again, an important service for women in this State. And women's healthcare in general. Because the attempt of this bill is really, the outcome of this bill, is to make it harder for healthcare professionals to provide women access to their constitutionally protected medical procedures. It's not about safety. It is quite clear that what we are doing here is using government's power to make it more difficult to have access to quality care. Access to quality care is what creates safety. What creates better outcomes. Now I do think there is room to improve all medical procedures. My wife is a physician. I've been on my hospital's foundation board. Designed hospital facilities. Designed medical facilities. I'm an architect as you know. To use the division of a...

Services, to make it harder to create access, is just contrary to common sense and decency in this state. We have had these women’s clinics in North Carolina for 40 years. And our state has regulated them carefully, thoughtfully. They have provided services adequately and safely. But like any hospital, like any clinic, like any health care facility, there is room for improvement. Room for improvement in safety. Three or four years ago when I was in the Senate, we had an initiative to save 100,000 lives from the Hospital Association. There were 100,000 lives in America in a year that were lost through preventable causes in hospitals. There is absolutely room to improve safety in every kind of medical facility. But this approach, with no findings, no research, no authentic looking at the facts, reviewing the facts, including experts to help you identify what would be an initiative that would have positive results? I think there’s plenty of room for our Department of Health and Human Services to look at all our health care facilities and come up with such strategies and procedures. So I’m not opposed to that thought. But it’s transparent to me that this is just government obstruction for women’s rights, and I will be voting against this bill and I hope you will. And I hope we can actually be sincere about how much we could improve health care if we took it seriously to discover the possibilities for improvement through good research, through real fact-finding and real research in this regard. Thank you. [SPEAKER CHANGES] Representative Earle, please state your purpose. [SPEAKER CHANGES] To speak on the bill. [SPEAKER CHANGES] The lady is recognized to debate the bill. [SPEAKER CHANGES] Thank you. Mr. Speaker and members, I’ll be very brief, but I’ve two reasons that I really need to speak. One is that I ride a motorcycle and I want to let my motorcycle buddies know that when I vote against this it’s not because I’m not concerned about their safety on the highway. So I felt it necessary to make that point. The other thing is much of what I’ve wanted to say has already been said so I’m not going to go over it, but this legislation, this bill is supposed to be different. But it has basically the same language that closes these facilities. And of course, we’re hearing some of the safety rhetoric that we heard in committee when we were dealing with the Senate bill. I just want to be very clear on some things that I have gathered from the legislation. To me, this is just another backdoor way of attacking Roe vs. Wade. You know, abortion is legal in North Carolina and is legal in this country. But if you continue to chip away at the infrastructure, you basically the limit the choices that women have. And I also want to say to that, this is not about safety issues or health issues for women because when you start closing these facilities and it’s my understanding that all of them would be closed with the exception of maybe one or maybe two, but for all practical purposes you’re closing all of these facilities. Well that’s going to drive women to go to these back room places that existed before we had these facilities come into existence. And if we’re going to talk about the health of these

Women. Then I would think that that would be a major consideration because you're going to be sending them to unsanitary places and probably providers that have not been trained. And that ought to be major consideration because the need or the desire for abortion is not going to go away just because you close the facility. And I just want to mention too that in my opinion here, we have done more legislation that impact women than we have that creates jobs or has a major impact on the economy. So we are basically focusing, not just in North Carolina but across this country, a huge amount of legislation that's dealing with restricting the rights of women. Now I don't know if that's what I keep hearing that folk didn't campaign on those kinds of issues. They campaigned on jobs and the economy and all. But basically that's what we are doing. And the message that I got from the Secretary is that if she had more resources, she could effectively do a better job at looking at all of the abortion centers, the ambulatory surgical centers across the state and that was one of her major concerns. And I also kind of questioned the fact that there were two facilities that were closed. And then we hear about the other citations. Obviously, the Secretary did not feel that it was necessary to close the facilities or else she would have closed those also. And if we look and make some comparisons when we look at restaurants when they have received citations or whatever they are called, basically we give them opportunity to correct it and stay open and they could have a negative impact on our health as well. But we allow them to make the corrections that are necessary and to stay open and to move on. And as I said, evidently these citations that they receive, the DHHS obviously didn't think that they were severe enough to close them. They have the oversight. But basically, I just think that we need to rethink this. This is not very much different from the legislation that came over from the Senate. And if we didn't think that that was good, the leadership didn't think that was good, then we ought not think that this is good. And we should also consider any office that does a surgical procedure, then we should make sure that they come under these same guidelines. If we are going to put these kind of stipulations and set rules for abortion centers, then we should look at putting all of these different offices, dental offices. Some time ago I had a foot surgery done in an office. So we need to look at every office that does a surgical procedure and putting them under some kind of guidelines and regulations and the same ones that we do for abortion. And I would ask you not to support this at this particular time. Thank you. [SPEAKER CHANGES] Representative Hamilton, please state your purpose. [SPEAKER CHANGES] To debate the bill. [SPEAKER CHANGES] The lady is recognized to debate the bill. [SPEAKER CHANGES] Thank you, Mister Chairman. I rise today to speak on another provision in this bill that has been less prominent in our discussions today and somewhat overlooked. It's our rights as citizens of this country and in this great state to privacy where our healthcare is concerned unless the individual chooses to disclose that information. This bill requires the court to make the decision regarding a woman's private healthcare and medical treatment. If she has already refused to consent to allowing a party who is bringing a lawsuit against her to disclose her identity. I'll quote the bill. The court shall rule whether the anonymity of any woman upon whom an abortion has been performed or attempted shall be preserved. Further, the court shall make the ruling determining that the woman's anonymity should be preserved. End quote. So, the patient

?? is either obliged to consent to the disclosure of her identity or a judge will make the decision for her. It seems to me like this wasn't the face of our HIPPA Laws, if not in fact certainly in the spirit of their intent of the law which allows all citizens of our country to their privacy in their medical treatment. So not only are my colleagues limiting access to healthcare for women, they are also eliminating patience rights to privacy regarding their medical care. I urge you strongly to vote against this bill. [SPEAKER CHANGES] Representative of ?? please state your purpose. [SPEAKER CHANGES] To debate the bill a second time [SPEAKER CHANGES] The ladies recognize to debate the bill a second time. [SPEAKER CHANGES] Thank you ?? speaker. Ladies and gentlemen, I wasn't planning to speak a second time, but as the scientist in me, a couple of comments caught my eye, and based on personal experiences as a second reason, I felt I needed to speak about the quality of care and training that we seem to be lacking in some of these facilities. First of all it was Representative Schaffer who went through the list of some of the issues with her documentation. It was followed up by Representative Stevens enumerating some of the issues that were found in clinics. The one in particular that caught my ear was the RH factor and this handling of blood diagnosis and evaluation. Personally I have history with that particular issue. My mother was an RH negative factor, blood. I as a first born, was an RH positive. At the time I was born, my mothers body began to develop antibodies to any future RH positive babies that she might have, which turned out to be my younger sister. My younger sister, who was born in 1958 before the immunoglobulin shot was developed, was severely jaundiced. And over a period of months She had to have an entire blood transfusion, cc by cc. And I sat in the hospital where she was being given those shots to remove her blood and to replace it. And it was horrible because you can imagine the size of a blood vessel of a baby that size. With the mishandling of the blood work that's being done in these clinics, we are opening that door to a lot of women who are not getting the kind of counseling and the kind of analysis of their blood that will let them know that they may have a future problem. That's where I feel like we need to clamp down extremely hard. I've read through the restrictions, I've read through the rules, I don't see anything about what the certifications are for the people who are doing the blood work. Where is that? Show me that in statute or in our rules that demand the type of quality care of the people who are taking the blood, making an analysis that's going to affect the future of that women whose going through a terrible choice of an abortion that may want to have a child in the future. We have got to tighten up, and we have got to hold the kind of people accountable. Just like every position whose have ever been held accountable for every surgery I've ever had in the two times that I've delivered my children. I strongly ask for your support for the health and safety of the women of North Carolina, thank you. [SPEAKER CHANGES] Representative McManus please state your purpose. [SPEAKER CHANGES] To ask the bill sponsor four questions if I may? Then to debate the bill. [SPEAKER CHANGES] Representative Sanderson does the lady yield? [SPEAKER CHANGES] I yield, I yield, I yield, I yield. [SPEAKER CHANGES] The lady yields. [SPEAKER CHANGES] Okay. I got confused in part of this bill, and I did want to ask what something refers to. On the bill page three, lines, basically 43 down, there's a definition of an attempt to perform an abortion and I couldn't find what that related to anywhere else in the bill. Does it? This is a legitimate question, I'm not trying to make a point or anything. [SPEAKER CHANGES] Yes this is the part that is related to the clarify law prohibit sex selection abortion which we passed earlier in the session, so it goes with that portion. [SPEAKER CHANGES] I'll look at that later, thank you. My next question also refers to something in the bill...

...page 4, lines 14, 15, 16, 17, it talks about the physician performing a surgical abortion shall be physically present during the performance of the entire abortion procedure. And I was curious as to entire abortion procedure, whether that included, okay, they treat the cervix first and then there's a waiting period while that medication takes effect before an abortion's performed. And then there's a recovery procedure. Does it refer to all of that as the abortion procedure or is it actually referring to the actual surgical abortion? This was the question that Representative Glazier brought up and I would say misinterpreted the answer he received from Representative Stam. I asked around in the meantime and was told that the abortion part is the actual abortion itself. The procedure of the abortion itself. [SPEAKER CHANGES] OK. Good. Thank you. And then in section 4 on that same page, it says that the, it talks about Department of Health and Human Services. The Department is authorized to apply any requirement for the licensure of ambulatory surgical centers to the standards applicable to clinics certified by the department to be suitable facilities for the performance of abortions. And, this is just because I don't know this because of lack of experience, but would those be entirely up to that department or were those something that would come back to be approved by this body? [SPEAKER CHANGES] It's part of the rules making process. There were some complaints earlier that there would be no input from the clinics and such on these rules. That's where that would come in. When they go through the rules making process, they ask for public input and then they make the rules. But the department would make the rules. [SPEAKER CHANGES] OK, well, when I'm looking at the current rules, they all have like... [SPEAKER CHANGES] Representative McMannis, this will be the last question before the Chair goes back to the more classical process of engaging in the discussion because you asked for four questions, you yielded four times. [SPEAKER CHANGES] I really didn't understand these things, so I didn't know if the, I'm still not clear if the body will, if we approve those. Because there's like approval dates under these rules. [SPEAKER CHANGES] We do not. It goes through the rules making process, the formal rules making process. There's public input, there's time for people to object. They look at what would be viewed as, were they suitable facilities for the performance of abortions and if people think they were unsuitable, either because they were too broad or not broad enough, the public would be able to file letters of complaint and that sort of thing. [SPEAKER CHANGES] Thank you, very much. I just needed clarification on some things, so I do appreciate that. Now, if I could, I would like to debate the bill. [SPEAKER CHANGES] The lady is recognized to debate the bill. [SPEAKER CHANGES] OK. In 1973, the United States legalized abortions nationwide and almost immediately after that, pregnancy related deaths and hospitalizations due to complications of unsafe abortions effectively ended in the U.S. They pretty much disappeared after that. Whereas prior to that there were a lot of hospitalizations. Abortions are currently one of the safest surgical procedures for women in the United States. Fewer than 1/2 of 1% of women obtaining abortions experience a complication. And the risk of death associated with abortion is about 1/10th of that associated with child birth. If we pass laws that decrease access to abortion, then there are going to be more illegal, unsafe, unsanitary abortions. And I'm afraid it will make some of those criticisms and the abortion clinics look like nothing. Those are bad and I admit it and I thought about some of these... [NOTE: This tape stopped at 3:55. I downloaded it twice just to make sure.]

access to abortions. we're going to see illegal ones again, and the public health tragedy costs by unsafe abortions is especially tragic because it's largely preventable. We don't have to make it so. By increasing access to safe services and improving the quality and ability of post-abortion care, we're protecting women, we're protecting their safety. And because almost every abortion is proceeded by an unintended pregnancy, the expanding access to contraceptive care, HIPPO, and services is another factor that would protect women. According to the World Health Organization, unsafe abortion is the cause of 70,000 maternal deaths worldwide each year, or 1 in 8 pregnancy related deaths among women. That translates to 7 women per hour dying from a maternal death from an unsafe abortion in this world. The cost in women's lives and health because of unsafe abortions are a human tragedy, but then there are other costs to society. Actual financial costs. Each year an estimated 5 million women are hospitalized for the treatment of abortion complications world wide. Mr. Speaker? Representative Stevens, please state your purpose. What I'm hearing in essence is going worldwide, as opposed to this bill, and it actually goes to supporting this bill to make sure abortions are safe, but we're going for the worldwide. Representative McManus will yield to Representative Stevens. The chair is going to allow some latitude. I do think abortion statistics are important. And no, right now we don't have as many illegal, unsafe abortions because we have had widespread access in North Carolina. But if we start limiting it, we may be looking at the same problems that they have had worldwide. As I was saying, an estimated 5 million women a year are hospitalized because of treatment of abortion complications at a cost of at least $460 million, and that's in countries with much lower per spending, per capita spending on health care. I worry about what we're doing to young women because these are options I don't think anyone chooses lightly. When Representative Presnell said she could not ever imagine doing that, I would agree. And yet, through my husbands medical practice, I've seen a lot of people who thought they would never imagine doing that, until their child was the one that was pregnant, and it was different. We don't know what we would do until we're in that situation. We think we do, and I think I know what I would do. We had an unplanned pregnancy in my extended family a year ago. And it was my nephew's girlfriend. They had not been dating that long. He was in school, and my brother called to tell me about this, that I don't know what we're going to do, I can't tell mom and dad, I can't believe this happened, they said they were using birth control and it failed. He said, I never thought I would wish somebody would have an abortion, but I kind of wish that's what she would choose right now, because I'm afraid my son won't finish school, won't finish college if she has this baby. Now, she did choose to have the baby. Her mother kicked her out, her mother wanted her to have the abortion, but her mother kicked her out, she moved in with my brother's family, and they're now the parents of a beautiful, almost 1 year old daughter, she'll be 1 in August. She made the right choice for her, but she had the option of making a choice, and she had the availability no matter what choice she did make. And that's why I pleading with people to vote against this. This bill, when you try to read it

And this is not a criticism of the bill sponser, it's a messy looking bill. All the pieces in it don't seem to flow and fit well. It was obviously put together quickly. We shouldn't be doing this kind of thing and haste, these are decisions that are too big to do in haste. So I ask that we wait, that we vote no this time. That we come back, I agree, that maybe perhaps regulations need to be looked at, on these facilities. Though actually, when there was a question about where was it that it says what kind of person administers different things. There is a portion of the regulations, because they actually compared all the regulations for the ambulatory care versus the abortion clinics, and there is a page in there that says that abortion clinics must comply with the rules governing sanitation of hospitals, nursing and rest homes, sanitariums, sanitoriums, and eduational and other institutions contained in 15a NCAC 18a .1300, and if you look those up, they're pretty detailed. And they were actually a large portion of them were updated more recently than the ambulatory surgical care center information, because some of them were updated as recently as 2003 and 2004. Actually, the ambulatory surgical care were only updated in 2003, so that's been 10 years too. So they are operating under the same guide that says hospitals and nursing homes. So there are actually good regulations in there, you just have to take a step further, and look at what it refers to, to see what they are. I spent a lot of time of this, because I think it is so important. It's such a personal decision, and I think we should leave that up to individuals. Taking care of facilities, yes, but not in a way that limits and restricts them. That's the wrong choice for North Carolina. I ask that you vote against this bill please. [SPEAKER CHANGES] For what purpose does the lady from Guilford, representative Adams rise. [SPEAKER CHANGES] Speak a second time, speaker. [SPEAKER CHANGES] Ladies recognize to debate the bill, a second time. [SPEAKER CHANGES] Thank you, Mr. Speaker. Like a thief in the night to steal women's reproductive rights, this bill came hurriedly through the Senate, rerouted through the House on a motorcycle, we think. No input from stakeholders, no public scrutiny, no transparency, no fiscal note. But when you look at the overall outcome of this bill, it's safe to say that it's really not about safety, it's about limiting women's choices, her freedoms, her access, and her privacy. Restricting local governments from providing abortion care self services in the plans that they offer to their employees, eliminating abortion care and health exchanges or local state health plans. And it really discrminates unfairly, forcing women to spend more on their medical care than men. I'm not going to talk about the men in here, cause some body will stand up and say I'm off the target. But it is targeting, this bill does target, I think unfairly, centers that provide abortion care. It is a very bold, in your face, disrespectful, vicious attack on women's health, and it would as the outcome, if all of this is put in place, it would restrict women's access to safe and legal reproductive health care. It does deny her choice, it does deny her right to privacy. Now, I believe that no woman can call herself free, who does not own and control her own body. That's not my quote, I'm sure you know who made it. But eliminating safe and legal abortions in this state, it's already been said but we need to remember, that it will not reduce the need for abortions. They're going to happen. So what would the next step be? Well, we're gonna go back to the days that none of us should want to relive again. When abortions we're not legal, when they were not safe, but they were fatal. And we won't go back, representative McElraft, to the dark houses. But we'll go to the dark alley ways.

With surgical instruments. [CHANGE SPEAKER] Mister Speaker. Mister Speaker. [CHANGE SPEAKER] Hold on. [CHANGE SPEAKER] I hear. I'm here. Representative ?? [CHANGE SPEAKER] For what purpose does the lady from Randolph, Representative Hurley rise? [CHANGE SPEAKER] To ask Representative Adams a question please. [CHANGE SPEAKER] Does the lady from Guilford yield to a question from the lady from Randolph? [CHANGE SPEAKER] Yes [CHANGE SPEAKER] She yields [CHANGE SPEAKER] Representative Adams, don't we still have hospitals? He keeps talking about alleys. It really bothers me because I really. As a Christian, I am very concerned about this in listening all day to this debate, but we still have hospitals. And women can go to hospitals where they are clean and where they are taken care of. If they have to go anywhere, they do this. If they don't plan ahead, they can go to hospitals, can't they? [CHANGE SPEAKER] Is that a question? [CHANGE SPEAKER] The lady has the floor to respond to the question. [CHANGE SPEAKER] I suppose they could go, and I am concerned and I am a Christian too. Let me say that for the record. But let me go back and say again that we are going to go back to those days and there will be people who can't afford to go. We've got a lot of women right now who have no medical, no health insurance. And some of these surgical centers that are in place right now provide preventive care, other kinds of service, so there won't be anywhere for them to go. But we know if you go back to those days, it will be the dark alleys. And the surgical instruments that they'll use won't be the surgical instruments that they might be using in these centers, but they're going to be coat hangers. And what a terrible day for North Carolina women. Shame on us. That's what's going to happen: Coat hangers. Do we want that blood on our hands? I do not. [CHANGE SPEAKER] For what purpose does the lady from Mecklenburg, Representative Carney rise? [CHANGE SPEAKER] To ask the bill's sponsor a question and comment on the bill. [CHANGE SPEAKER] Does the lady from Mecklenburg yield to a question from the lady from Mecklenburg? [CHANGE SPEAKER] I yield [CHANGE SPEAKER] She yields [CHANGE SPEAKER] Thank you Representative Samuelson and Mister Speaker. After the public hearing that was held and you all said in there that you were committed to not closing facilities. But you also said that you were committed to protecting the health of women going to these centers. Did you all, in your overnight working to correct the other bill from the Senate, did you give any consideration to just bringing forward a bill that dealt just with these clinics across the state that have had problems in updating those codes and standards? [CHANGE SPEAKER] Can I ask her to clarify her question a moment? [CHANGE SPEAKER] If the lady yields, yes. [CHANGE SPEAKER] I'm not sure I understand what the alternative you are asking? Should we consider only addressing the needs in those clinics that have been shut down? [CHANGE SPEAKER] Mister Speaker, may I? I'm sorry. The clarification is, did you give any consideration to just addressing that issue that's in section four that you've given to the Secretary that authority to study and move forward? Was there any consideration given to just addressing that issue along with the safety of the, the helmet safety I know you need in the bill instead of adding all the other bills that we've already voted on in this House? [CHANGE SPEAKER] No. That did not come up when we met with the Secretary. We only dealt with her questions and her questions and concerns were just in the new portion that had been sent over by the Senate. So we addressed her concerns and made sure that she was comfortable with this. And part of that was making sure that the direction for them to make rules were reasonable to ensure that we would not unnecessarily be shutting down clinics. She was also concerned about not making the standards so tough that they were not able to be complied with. [CHANGE SPEAKER] Thank you Mister Speaker. To speak on the bill. [CHANGE SPEAKER] The lady is recognized to debate the bill. [CHANGE SPEAKER] Ladies and gentlemen, I asked that because several people have said all this bill does is address the health and safety of the women in this state. When the bill that is before us, and I've read it and I've underlined it and gone back over it and asked questions and taken notes. There are five sections to this bill, or four rather. And that is, those are bills that we have already passed

him us some conflict is the why we needed to have that Sam is available along with addressing that issue that we hardly from the public. we heard again from from the secretary if they are, and we've heard from everybody here. we heard from representing Fisher writing the Maryland situation where they have address those concerns in a bipartisan way with the act, entities like Planned Parenthood at the table if that is truly the goal of what we're trying to accomplish in here today for the women of this day and why are we not dealing with that one issue. while was this not a priority of the majority from the Senate and the House that beginning of this session. if you know all these violations have been going on in all of these one and all of the center 's lot was that not a priority to set it up and available standing on its own work with the department work with their healthcare providers work with the people in those clinics and let's take those standards and modernize in bipartisan way, but we all know that this came as a shock when we were on our spring break is my granddaughter, then that I can spring my from the General assembly for the Fourth of July, but wewere out of town and I happen to have here tonight and we come back, and yes to the credit of the house. we had a public hearing after the fact, after the outcry in the outpouring. what are you doing him him and now today, after that we have in the AL. I understand that in the session. I've been here ten years. but not on issues like this. not all major decisions that are impacting numerous people got down the chain. it's not just that one is faced with a horrific decision, and I cannot begin to walk in any one of those women chose to even think what it would be like to walk and even have to comprehend being extremely poor. not having anybody to stand beside me, and I'm scared that and I'm young and I'm helpless and vulnerable. I can't even take care of myself and yet some new male l got me pregnant that I intend for that to happen. now I don't know it is so complex as certificated just blanket say all these bills we've already passed in here at voted against the sex selection. the lemons like nine talent doctors like you've got a digital one. and in that office. what you've got a net or look at an ultrasound on and on and all. not one person has taken the time to go out. they are into these impoverished areas of North Carolina child poverty rate in the state and its day young girls that young girls that are getting right now where we begun to address contraception, you know that pregnancy is the leading cause for adolescent death did you know that you are one thing to put pennies. they'll have to take these ten easy on girls and young women on contraception you want to avoid all the stuff about abortion lands teach our young people like to do it with our taxpayer dollars a month and that might help him. let's address poverty. let's enjoy it. as young women who don't have anybody like your are daughters and granddaughters are nieces and nephews are friends again. we have a network, ladies and gentlemen wake up the North Carolina has a huge problem with pot poverty and that is where a lot of these abortions are coming from. it's not you maybe their homeland and that are in the highway and of income that are getting abortions, but they're getting them through the process of hospitals with health insurance

?? that are qualified to do it. What are we doing? I believe we are headed down a road to make this worse. I agree, and I think every woman in here, every woman in this balcony, every woman in this state says "Yes, if you're gonna have an abortion, make it safe, make it accessible and make it clean." But that's not what we're doing here. We’re passing it off. We're passing it off to the Secretary. We're passing off our responsibility of studying it, of looking at the issue seriously, looking at what those recommendations should be from us as lawmakers. Not go look at it, Madam Secretary, who said, "Our department can't handle all this." Go look at it. You study it. You come back to us, and then we'll decide. But in the meantime, once again we're waiving in a bill -- all the bills we've already debated in here that have passed -- and we've said to our motorcycle friends, who need our help, with taking the safety piece in this bill, by adding this in, that's what we do when we tack on bills to another bill. Those of us over here who think that this is too much too quickly and we've had a whole long session to deal with this, and it came overnight. What we're saying, we'll will be voting against the Motorcycle Safety Act when we voted for it to begin with. What are we doing? I just ask you to think about it. We are not being deliberative and doing what we are charged to do, and that is to come up here and look seriously at what laws we impose on the people of this state. I ask you please to reconsider and vote No, and yet again today I'm asking you take your time, go back to the table. Let's make a bill, let's bring a bill in here that addresses these centers that everybody's been saying -- all the citations and the closings and the re-openings -- if that needs to be addressed, let's do it and let's do it bi-partisanally, and let's do it with the medical profession at the table. Thank you, Mr. Speaker. [SPEAKER CHANGES] Rep. Fulghum, please state your purpose. [SPEAKER CHANGES] To speak on the bill. [SPEAKER CHANGES] The gentleman is recognized to speak on the bill. [SPEAKER CHANGES] I really struggle with keeping my mouth shut because I worked in the medical fields for over 35 years. There are 254 facilities in this state that are currently licensed to do abortions. Sixteen abortion clinics do the majority. Probably far more than the majority. And all the ambulatory surgical centers are licensed to do abortions. All the hospitals are licensed to do abortions, so let's just can this back-alley nonsense. Now, the Secretary said that despite the Planned Parenthood representative's comment in her interview with Skip Stanwell? on the record, these abortions clinics are not inspected every year. They're lucky to get inspected every 3-5 years for medical purposes. The current regulations from 1994 are pretty good. They call for recovery room, procedure room, corridors to accommodate stretchers, elevators to accommodate patients, and medical procedures that are set up to take care of medical records and staffing requirements and so on. Making regulations is a waste of time unless you enforce them. They're not being enforced on a regular basis, but we're doing better than Pennsylvania did. Gov. Ridge decided, politically, to not enforce the annual inspections in Pennsylvania during his administration, and look what that got him. For 17 years, they didn't do annual inspections. They had a horror show on their hands. I'm not claiming we have something like that in North Carolina. We don’t need to. No other state should. but we have the opportunity here, and the Secretary has agreed to co-operate with how many staffing problems she has to be able to enforce this, to get the job done to bring these 16 abortion [CUTS OFF]

…clinics, none of which preceded building in 1994. When I asked the Division Head of Health Service Regulation were they in compliance with the current regulations, he said, “We assume so.” I really didn’t want to get out of my chair and go over and ask him again, but I felt like I should. I think this Bill gets us to a place where we ought to be. I honestly don’t think it’s going to hurt anybody as we have seen in the last six months, HHS is in the saddle and doing a better job. I encourage passage of this Bill. Thank you. [SPEAKER CHANGES] Representative McManus, please state your purpose. [SPEAKER CHANGES] To debate the Bill again. [SPEAKER CHANGES] The lady is recognized to debate the Bill a second time. [SPEAKER CHANGES] Actually I just wanted to share a bit of information since there was a question about, “Could they not go to hospitals and have abortions?” So, I’m going to share just a bit here. In North Carolina…Well, in the South, let me back up a moment. First, the percentage of ob-gyns performing abortions in the United States dropped 14 percent by 2008, from 22 to 14 percent in 2008. Ob-gyns who were least likely to provide abortion services included doctors located in rural communities in the South and Southwest. Southern doctors accounted for just eight percent of ob-gyns that reported providing abortions. 70 percent of all abortions were provided in abortion clinics. 24 percent in other types of clinics. Only four percent in hospitals and one percent in private physician offices. In 2008 there were 31 abortion providers who actually were providing in North Carolina. Other places are licensed but don’t necessarily provide. This represents a 16 percent decline from 2006 when there were 37. So, it’s rare that it happens in a hospital unless it’s medically necessitated. Only 17 percent of ob-gyns even nationwide report doing abortions, and only eight percent in North Carolina. So it’s unlikely to happen in a hospital. That’s what I wanted to share, thank you. [SPEAKER CHANGES] Representative McElraft, please state your purpose. [SPEAKER CHANGES] To speak on the Bill. [SPEAKER CHANGES] The lady is recognized to debate the bill. [SPEAKER CHANGES] I’ve sat here and listened about safe, healthy access and that’s exactly what this Bill is about, whether you believe it or not, on the other side. Poor women should not have any less access to clean conditions, to sanitary conditions than those who can afford to go to that one facility in Asheville that you talk about that would meet these requirements. Let me just give you some of the organisms that are life threatening that can be transferred from unsterilized medical, surgical equipment. Staphylococcus aureus which can be Methicillin-resistant. Streptococcus pyogenes which is the flesh-eating bacteria. Chlamydia. Neisseria gonorrhoeae. HIV, herpes simplex two… [SPEAKER CHANGES] Representative Fisher, please state your purpose. [SPEAKER CHANGES] Thank you, Mr. Speaker. Point of order. [SPEAKER CHANGES] The lady may state her point. [SPEAKER CHANGES] Thank you. I guess my question is, “Are these not things that could happen anywhere, not just in clinics that provide abortion or abortion services?” [SPEAKER CHANGES] Representative Fisher, the Chair is not a medical professional. I think that the lady is trying to suggest that they do at least happen in these conditions, that if the conditions are not sterile, that I assume from her comments that they may be more likely. The lady may proceed. [SPEAKER CHANGES] Thank you, Mr. Speaker. I’ll answer that question. Yes, these can be organisms that are transported in other clinics too. But other clinics of the ambulatory status and licensing are different than what these certified North Carolina abortion clinics are. They have higher standards. They’re inspected by not only our Public Health department but they’re inspected by CAP and Joint Chiefs and some of the other…

eight. how different that they did a proficiency testing and operating companies are not. these are organisms that, not how many of them– in all organisms that can be transmitted from patient to patient. do these women deserve to not have that kind of an operation where they have to go in there and wonder if the equipment is sterile or not they have been through a lot. they have made a hard decision, and when they dealt about abortion, they need to know that these facilities are up to the car of any secure facility that you would expect to have any kind of surgery also wanted to mention something represented Fisher was bragging about the Maryland abortion clinics. I think y'all think this passenger death. it was interesting to me that they are forcing players are licensed, not certifying also interesting to me that they were investigated and found it was common practice to administer a draft. the abortion drug without the presence of the doctor and they shut him down for that reason it is loudly one a.m. alighted natural or trying to Emily in this in this bill in you talk about simply an anesthetic. who better to do a study that are health officials who have medical backgrounds. that's what the rulemaking process is all about. that's why she and the secretary even went about what this image, yet instead we are getting a temporary rules, let us do temporary rules until we have time to make the permanent rules. she now answered in the six months you've been here they close down to abortion clinics. I'm sorry but you a lot when you are worrying times over. they are him many times did you take all of the discrepancies in you are sure we all try to focus.) these four women who are on the release of questions like that should have been shut down. yes, what atoms we are back in those days, and some of these clinics and I'm tired of these poor women didn't put through something like that. it is time that we do our job in the state of North Carolina in rabies clinic up to the standards of patient me for these women. the reason I don't want to bring them up to the standards, it's all about money. it's all about money. some of these facilities are nothing but moneymaking facilities, and it's all about money. I was not one to have adopted beer when you administer a abortion drive. I was not to have adopted the air when you are doing and method calls surgical abortion. it's all about money. we need to protect the women of our state. we need to let that Department of Health and Human Services do what should've been done years ago under different administrations and was not done. it's time that we take control of these clinics in bringing them to the standards they should be so all women designed for soccer anymore presented Adams Wednesday twelve is then presented don't route. this was real happy to you. thank you within the government. you mentioned that we didn't do this before I think you've been here quite a while. did you raise this issue in which we had even when Democrats win control. we took up bills that you all might have brought to this to this body granted those in May. I glanced out the answer that I visit out on such a least two abortion clinics were shut down this year. I didn't realize how bad I will understand that you will have all of these just let her think about abortion clinic, then you didn't do anything is not about health and safety of women is about abortion on demand at any cost to the women, and we need to protect these women. they need to know that these unsterilized instrument that they are glad again be battered in these facilities. we need a clean it up so that you have the same light as someone who had a lot of money at Qingdao to an ambulatory facility 's figure presented atoms with exuberant mating birds in America. rep is in radio, the latest on you, ladies and gentlemen, just as a time, Jack New York organizes me that the minority coccus has twenty minutes remaining. the majority caucus as to administer my

Representative Lucas, please state your purpose. [SPEAKER CHANGES] Thank you, Mr. Speaker, to speak briefly on the bill. [SPEAKER CHANGES] The gentleman is recognized to debate the bill. [SPEAKER CHANGES] Thank you, I really hadn't plan to speak at all but I've sat here for about a little better than three hours now as we've bantered back and forth over an issue that the Supreme Court decided many years ago that the process was legal. And, for the life of me and these three hours of debate, I don't think we've made one inch of progress one way or the other. And I wish that we could just stop this debate. I know that we're talking about something that's very sensitive to everybody and it's sensitive to me too but these sensitive issues are better settled in the confines of our homes and our communities and not on this floor. I wish we could stop this. We need, we, in the analogy of the sports arena, we in overtime, well past overtime and we ought to be getting out of here. Thank you. [SPEAKER CHANGES] Representative Cunningham, please state your purpose. [SPEAKER CHANGES] To speak finally on the bill just to clarify. [SPEAKER CHANGES] The lady is recognized to debate the bill a second time. [SPEAKER CHANGES] Thank you, Mr. Speaker. Something that Representative McElraft said about poor women, it's not only poor women that seek out abortion in the state of North Carolina. Women of all financial status seek out abortion. It's just that they may not have to go to an abortion clinic. Sometimes they can get their obstetricians or gynecologists to admit them and they have the procedure in a well, well nice equipped facility. And all narcicoma infections, those are infections that you get inside of facilities. Not only can you get it in an abortion facility, you can get it in a hospital. You can get it in a nursing home. You can get a narcicoma internal infection anywhere in a medical facility. Clarity, nursing homes, hospitals, all types of facilities at some point in their history come up with a violation of something that is required by regulatory. So this is not unusual that you would find a couple of facilities that are not within compliance. It is not unusual. Lots of hospitals are out of compliance right here today. Lots of nursing home facilities are out of compliance here today. How do I know? Because I've been in them. They've often given the opportunity to correct those issues. Once they are corrected then they are back in compliance and they operate as usual until the next inspection comes along. If regulatory is done where the inspections can be done properly and on time, effectively, and with a normalcy of when they should occur within a period of time these issues can be corrected without going any further stipulating that a facility increase what is in their facility which is not going to help with the safety of the client when the help is not in the building but is in the hands of the people that care for them. Thank you. [SPEAKER CHANGES] Representative Farmer-Butterfield, please state your purpose. [SPEAKER CHANGES] To ask the bill sponsor a question. [SPEAKER CHANGES] Representative Samuelson, does the lady yield? [SPEAKER CHANGES] I yield. [SPEAKER CHANGES] The lady yields. [SPEAKER CHANGES] Representative Samuelson, tell me if there have been any deaths or women negatively harmed by use of abortion centers in North Carolina in the last few years. [SPEAKER CHANGES] I am not personally aware of any deaths but I have heard of negative harm. I would have to ask somebody else for the details on it. I was, not something I've been keeping the stats on. [SPEAKER CHANGES] Representative Farmer-Butterfield, the Chair understands that Representative Stam may be able to answer your question. Does the lady wish to redirect? Representative Stam, does the gentleman yield? [SPEAKER CHANGES] I just wanted to ask the women, that's okay. [SPEAKER CHANGES] I yield. [SPEAKER CHANGES] The gentleman yields. [SPEAKER CHANGES] Representative Farmer-Butterfield, Ms. Nancy had a safe, legal abortion here at, I believe at the Fleming Center in Raleigh by Dr. Clarence Washington, that evening she went and bled out and died up at Rocky Mount. He was uninsured, insolvent, later went to prison for federal tax evasion and had his license removed but he did thousands of abortions before that. [SPEAKER CHANGES] Follow-up. [SPEAKER CHANGES] Does the gentleman yield? [SPEAKER CHANGES] I do. [SPEAKER CHANGES] The gentleman yields. [SPEAKER CHANGES] How many other incidents

Representative: How many others in NC within the last 3 years or 5? Representative: You wouldn’t know because they go to places to die. Representative: I will speak. Speaker: The house will come to order. Representative: Follow up question? Speaker: Does the gentleman yield? Representative: I do. Speaker: The gentleman yields. Representative: Are you insinuating that women go out of state? Representative: No, they are very rarely likely to go back to the clinic. Not necessarily out of state, but they do not necessarily go to the clinic for serious complications; nor do they go back to the clinic when they are in the next pregnancy, they have a pre-term birth, and about 100 a year die in NC because of that prior induced abortion. Representative: One last question Mr. Speaker. Speaker: Does the gentleman yield? Representative: I do. Speaker: The gentleman yields. Representative: If Representative Stamp can answer this question, I will be glad for the lady to do so. Exactly which one of the standards in the [xx] service centers will make abortions safer in NC at the clinics? Representative: I will tell you the defect in the clinic certification is that you do not have to even be an OBGYN to do abortions at an abortion clinic: you can be a foot doctor, a brain surgeon, a doctor of osteopathy. The clinics only say that you have to bring an OBGYN if there is a complication. Representative: Comment? Speaker: The lady is recognized to debate the bill a second time. Representative: I really believe that this debate today indicates the importance of this issue and the fact that women are articulate; they are bright; they have a mind of their own; and they are good decision makers. This body is representative of that. It is also representative of the fact that there are a lot of competent people in the state of NC, and there are a lot of competent legislators in this body, and we should all be able to sit down, address this issue, and come up with a solution. But we are not transparent and we hide things in spite of the fact that we are in a majority situation when you have 78 members in this body, so you know you have the votes, and for the life of me, I do not understand why this could not have been more open and transparent than it was. Therefore, it leads to situations like this: distrust. Thank you. Speaker: Further discussion, further debate? Representative Samuelson, please state your purpose. Representative: To debate a second time. Speaker: The lady is recognized to debate a second time. Representative: Members we have had a lengthy debate on a bill that, otherwise, would have only been here on concurrence. There have been a number of things that have been said about the bill: some of them correct, some of them incorrect. I am not going to correct all of them. I just want to address two because I thought stood out and needed to be addressed. Representative Hamilton brought up some concerns about a part of the bill we have not debated much. I just wanted to alleviate your concerns on the privacy piece. Those are contained only in the sex selection abortion piece and only come into play if there is a legal lawsuit against the doctor who is accused for performing an abortion for sex selection. It is a very narrow application in those very specific instances, but that brings up a question that Representative Carney and others brought up which is why this bill has all these parts in it? Well because that is the way the senate sent it to us. So, the senate said that we want to put all those bills we sent over to them in one piece, and that is the way they did it. So that is why they are put together. The question of why we did not earlier address the question of standards and say, well gee, if the standards needed to be updated, why didn’t we start this process six months ago, and do all that before we came up? Well frankly that was before the incident in Philadelphia, where a doctor up there is now going to jail for the horrendous conditions in his abortion clinic, which caused some people to say, well gee, are these kinds of things starting to happen in NC? As they looked around they say, gee, we have got some problems with some of the situations in NC. In fact, we have recently had two abortion centers closed. So, yes, it would have been nice if that was done earlier. It could have been done in previous administrations

And a horrid incident in another State caused us to look again in what’s happening in our State. In fact Representative Blust was kind enough to send an article about some abortion deaths in Maryland, which makes me go to the point that has caused me the most ?? in all of this is the issue of this being cost prohibitive. You don’t increase safety because it’s cost prohibitive. You don’t raise standards because it’s cost prohibitive. People are dying in abortion clinics. Maybe they didn’t die in the abortion clinic in North Carolina but do we want even one person to die in an abortion clinic in North Carolina before we raise the standards? And in terms of whether raising the standards is legally verifiable if passed in South Carolina in the courts? Alright, so there is precedence in this. There is a reason to say, we are not going to wait until women die in an abortion clinic for us to raise the standards. We have consulted with the DHA State Secretary, who by the way is a strong woman if you haven’t met her. She is one of the few that can intimidate me. And she is a strong woman and she has acknowledged that our standards need to be reviewed. She has also acknowledged that we need to increase the amount of inspections. And our Speaker said to me the other day and may have said it in committee, I can’t remember, but that if we need to do some audits, let’s go to the DHA Secretary and ask her, “How much would it cost for you to audit?” Every abortion clinic or every abortion facility we could ask her and figure out what she’d want between now and when we come back and if we can afford it lets look at how much that would cost and find a way to put it in our budget now. This is a problem that needs to be addressed. It should have been addressed years ago. As someone said to me earlier, we need our standards to be in the twenty first century. We’ve been in the twenty first century for thirteen years and we haven’t increased our standards since way before that! This is not about shutting down sinners. This is not about making abort illegal. Women will still have the right to choose but as a result of this Bill, they will have the right to make that choice in a safe facility. I urge your support. [SPEAKER CHANGES] The question before the House is to pass it to the House Committee Substitute, the Senate Bill 353 on its second reading. All in favor vote aye. All opposed vote no. The clerk will open the vote and the machine will be open for an extended period to allow members to return to the chamber. All members please record. The clerk will lock the machine and record the vote. Seventy four have voted in the affirmative and forty one in the negative. The House Committee Substitute the Senate Bill 353 has passed its second reading and will now be read a third time. [SPEAKER CHANGES] ?? North Carolina ?? [SPEAKER CHANGES] The question before the House is to pass it to the House Committee Substitute the Senate Bill 353 on its third reading. Ladies and gentlemen, because of the nature of the vote the Chair has a discretion to go voice vote, we’re going to record this vote. . All in favor will vote aye. All opposed will vote no. The clerk will open the vote. All members please record. The clerk will lock the machine and record the vote. Seventy four have voted in the affirmative and forty one in the negative. The House Committee Substitute the Senate Bill 353 has passed its third reading and will be sent to the Senate. Representative Wilkins, please state your purpose. [SPEAKER CHANGES] Enquiry on the ?? [SPEAKER CHANGES] The general may state his inquiry. [SPEAKER CHANGES] Mr Speaker, do you share with me the feeling that our gallery heights did really, really well today? [SPEAKER CHANGES] Yeah, the Chair was just about to make that recommendat, to make that, ladies and gentlemen, I know there are, there are people on the gallery on both sides of this issue And I think that you were extraordinary and your respect to this institution. And I hope that you were able to learn something from what we did here and the members themselves. I know there’s great emotion on both sides of this issue.

The gallery will be cleared to the right. Up to this point, I shared my sentiment with Representative Wilkins. I’m not really sure why someone thinks that that’s really respectful of this body, but it is what it is. Ladies and gentlemen, we still have another bill on the calendar. It’s Senate Bill 112. I’m going to provide everyone with about a ten minute recess. We will return at 4:30 and, for your planning purposes, the Chair understands that there will be an objection to third reading on this bill; therefore, it is the intention of the Chair to have session tomorrow at 10:30 a.m. Members who were thinking about calling committee meetings this evening may want to consider, instead, having the committee meetings in the morning. We will return at 4:30. If the members will yield for just a moment. Representative Moore, please state your purpose. [SPEAKER CHANGES] Mr. Speaker, a motion pertaining to the calendar. [SPEAKER CHANGES] The gentleman may state his motion. [SPEAKER CHANGES] Mr. Speaker, we have three bills to add to today’s calendar that are non-controversial. The first is House Bill 569, which is an act removing restrictional satellite annexations for the village of Foxfire. [SPEAKER CHANGES] Without objection, so ordered. [SPEAKER CHANGES] House Bill 1015, an act annexing certain described property to the corporate limits of the city of Bessemer City. [SPEAKER CHANGES] Without objection, so ordered. [SPEAKER CHANGES] Senate Bill 159, an act to correct general appraisals resulting in property values that do not comply with the requirements of North Carolina law. [SPEAKER CHANGES] Without objection, so ordered. The House will return at 4:30. [SPEAKER CHANGES] Mr. Speaker. [SPEAKER CHANGES] Representative Floyd, please state your purpose. [SPEAKER CHANGES] 112 can not be calendared for Monday? [SPEAKER CHANGES] It is the intent of the Chair to move the bill out before we leave this week. [SPEAKER CHANGES] The bills that he just added, the three, are they-- [SPEAKER CHANGES] They will be considered today. The Chair does not anticipate lengthy debate.