GEORGIA. Georgia Code.
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TITLE 15.
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15-11-110.
This article shall be known and may be cited as the 'Parental Notification Act.'
15-11-111.
As used in this article, the term:
(1) 'Abortion' means the use or prescription of any instrument, medicine, drug, or any other substance or device with the intent to terminate the pregnancy of a female known to be pregnant. The term 'abortion' shall not include the use or prescription of any instrument, medicine, drug, or any other substance or device employed solely to increase the probability of a live birth, to preserve the life or health of the child after live birth, or to remove a dead unborn child who died as a result of a spontaneous abortion. The term 'abortion' also shall not include the prescription or use of contraceptives.
(2) 'Proper identification' means any document issued by a governmental agency containing a description of the person, the persońs photograph, or both, including, but not limited to, a driveŕs license, an identification card authorized under Code Sections 40-5-100 through 40-5-104 or similar identification card issued by another state, a military identification card, a passport, or an appropriate work authorization issued by the United States Immigration and Naturalization Service.
(3) 'Unemancipated minor' means any person under the age of 18
who is not or has not been married or who is under the care, custody, and
control of such persońs parent or parents, guardian, or the juvenile
court of competent jurisdiction.
15-11-112.
(a) No physician or other person shall perform an abortion upon an unemancipated minor under the age of 18 years unless:
(1)(A) The minor seeking an abortion shall be accompanied by a parent, or guardian, who shall show proper identification and state that the parent or guardian is the lawful parent or guardian of the minor and that the parent or guardian has been notified that an abortion is to be performed on the minor;
(B) The physician or the physiciańs qualified agent gives at least 24 hourś actual notice, in person or by telephone, to a parent or guardian of the pending abortion and the name and address of the place where the abortion is to be performed; provided, however, that, if the person so notified indicates that he or she has been previously informed that the minor was seeking an abortion or if the person so notified has not been previously informed and he or she clearly expresses that he or she does not wish to consult with the minor, then in either event the abortion may proceed in accordance with Chapter 9A of Title 31; or
(C) The physician or a physiciańs qualified agent gives written notice of the pending abortion and the address of the place where the abortion is to be performed, sent by certified mail, return receipt requested with delivery confirmation, addressed to a parent or guardian at the usual place of abode of the parent or guardian. Unless proof of delivery is otherwise sooner established, such notice shall be deemed delivered 48 hours after mailing. The time of mailing shall be recorded by the physician or agent in the minoŕs file. The abortion may be performed 24 hours after the delivery of the notice; provided, however, that, if the person so notified certifies in writing that he or she has been previously informed that the minor was seeking an abortion or if the person so notified has not been previously informed and he or she certifies in writing that he or she does not wish to consult with the minor, then in either event the abortion may proceed in accordance with Chapter 9A of Title 31; and
(2) The minor signs a consent form stating that she consents, freely and without coercion, to the abortion.
(b) If the unemancipated minor or the physician or a
physiciańs qualified agent, as the case may be, elects not to comply with
any one of the requirements of subparagraph (a)(1)(A), (a)(1)(B), or (a)(1)(C)
of this Code section, or if the parent or legal guardian of the minor cannot be
located, the minor may petition, on the minoŕs own behalf or by next
friend, any juvenile court in the state for a waiver of such requirement
pursuant to the procedures provided for in Code Section 15-11-114. The juvenile
court shall assist the minor or next friend in preparing the petition and
notices required pursuant to this Code section. Venue shall be lawful in any
county, notwithstanding Code Section
(c) No abortion shall be performed unless the requirements of subparagraph (a)(1)(A), (a)(1)(B), or (a)(1)(C) of this Code section have been met or the minor has obtained a court order waiving such requirements.
15-11-113.
Notwithstanding Code Sections
15-11-114.
(a) An unemancipated minor may participate in proceedings in
the court on such minorīs own behalf and the court shall advise such minor of
the right to court appointed counsel and shall provide such minor with such
counsel upon request or if such minor is not already adequately represented.
(b) All court proceedings under this Code section shall be
conducted in a manner to preserve the complete anonymity of the parties and
shall be given such precedence over other pending matters as is necessary to
ensure that a decision is reached by the court as expeditiously as is possible
under the circumstances of the case. In no event shall the name, address, birth
date, or social security number of such minor be disclosed.
(c) The requirement of
subparagraph (a)(1)(A), (a)(1)(B), or (a)(1)(C) of Code Section 15-11-112 shall
be waived if the court finds either:
(1) That the unemancipated minor
is mature enough and well enough informed to make the abortion decision in consultation
with her physician, independently of the wishes of such minoŕs parent or
guardian or
(2) That the notice to a parent
or, if the minor is subject to guardianship, the legal guardian pursuant to
Code Section 15-11-112 would not be in the best interests of the minor.
(d) A court that conducts proceedings under this Code
section shall issue written and specific factual findings and legal conclusions
supporting its decision and shall order that a record of the evidence be
maintained. The juvenile court shall render its decision within 24 hours of the
conclusion of the hearing and a certified copy of same shall be furnished
immediately to the minor. If the juvenile court fails to render its decision
within 24 hours after the conclusion of the hearing, then the petition shall be
deemed granted. All juvenile court records shall be sealed in a manner which
will preserve anonymity.
(e) An expedited appeal completely preserving the anonymity
of the parties shall be available to any unemancipated minor to whom the court
denies a waiver of notice. The appellate courts are authorized and requested to
issue promptly such rules as are necessary to preserve anonymity and to ensure
the expeditious disposition of procedures provided by this Code section. In no
event shall the name, address, birth date, or social security number of such
minor be disclosed during the expedited appeal or thereafter.
(f) No filing fees shall be required of any unemancipated minor who uses the procedures provided by this Code section.
15-11-115.
The requirements and procedures of this article shall apply to all unemancipated minors within this state whether or not such persons are residents of this state.
15-11-116.
This article shall not apply when, in the best clinical judgment of the attending physician on the facts of the case before him, a medical emergency exists that so complicates the condition of the minor as to require an immediate abortion. A person who performs an abortion as a medical emergency under the provisions of this Code section shall certify in writing the medical indications on which this judgment was based when filing such reports as are required
15-11-117.
Any physician or any person employed or connected with a physician, hospital, or health care facility performing abortions who acts in good faith shall be justified in relying on the representations of the unemancipated minor or of any other person providing the information required under this article. No physician or other person who furnishes professional services related to an act authorized or required by this article and who relies upon the information furnished pursuant to this article shall be held to have violated any criminal law or to be civilly liable for such reliance, provided that the physician or other person acted in good faith.
15-11-118.
Any person who violates the provisions of this article shall be guilty of a misdemeanor and any person who intentionally encourages another to provide false information pursuant to this article shall be guilty of a misdemeanor.
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TITLE 16. Criminal
Code of
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16-12-140.
(a) Except as otherwise provided in Code Section 16-12-141, a person commits the
offense of criminal abortion when he administers any medicine, drugs, or other
substance whatever to any woman or when he uses any instrument or other means
whatever upon any woman with intent to produce a miscarriage or abortion.
(b) A person convicted of the offense of criminal abortion shall be punished by
imprisonment for not less than one nor more than ten years.
16-12-141.
(a) Nothing in this article shall be construed to prohibit
an abortion performed by a physician duly licensed to practice medicine and
surgery pursuant to Chapter 34 of Title 43, based upon his or her best clinical
judgment that an abortion is necessary, except that Code Section 16-12-144 is a
prohibition of a particular abortion method which shall apply to both duly licensed
physicians and laypersons. [This
provision has been held to be unconstitutional and unenforceable]
(b)(1) No abortion is authorized or shall be performed after the first trimester unless the abortion is performed in a licensed hospital, in a licensed ambulatory surgical center, or in a health facility licensed as an abortion facility by the Department of Human Resources.
(2) An abortion shall only be performed by a physician licensed under Article 2 of Chapter 34 of Title 43
(c) No abortion is authorized or shall be performed after
the second trimester unless the physician and two consulting physicians certify
that the abortion is necessary in their best clinical judgment to preserve the
life or health of the woman. If the product of the abortion is capable of
meaningful or sustained life, medical aid then available must be rendered.
(d) The performing physician shall file with the commissioner of human resources within ten days after an abortion procedure is performed a certificate of abortion containing such statistical data as is determined by the Department of Human Resources consistent with preserving the privacy of the woman. Hospital or other licensed health facility records shall be available to the district attorney of the judicial circuit in which the hospital or health facility is located.
16-12-141.1.
(a)(1) Every hospital and clinic in which abortions are
performed or occur spontaneously, and any laboratory to which the aborted
fetuses are delivered, shall provide for the disposal of the aborted fetuses by
cremation, interment, or other manner approved of by the commissioner of human
resources. The hospital, clinic, or laboratory may complete any laboratory
tests necessary for the health of the woman or her future offspring prior to disposing
of the aborted fetus.
(2) Each hospital, clinic, and laboratory shall report, on a
form of the type and confidentiality provided for in subsection (d) of Code
Section 16-12-141, and provided by the commissioner of human resources, the
manner in which it disposes of the aborted fetus. Such reports shall be made
annually by December 31 and whenever the method of disposal changes. The
commissioner of human resources shall provide forms for reporting under this
Code section.
(b) Any hospital, clinic, or laboratory violating the provisions of subsection (a) of this Code section shall be punished by a fine of not less than $1,000.00 nor more than $5,000.00.
(c) Within 90 days after the
effective date of this subsection, the Department of Human Resources shall
prepare a reporting form for physicians which shall include:
(1) The number of females whose
parent or guardian was provided the notice required in paragraph (1) of
subsection (a) of Code Section 15-11-112 by the physician or such
physiciańs agent; of that number, the number of notices provided
personally under subparagraphs (a)(1)(A) and
(a)(1)(B) of Code Section
15-11-112 and the number of notices provided by mail under subparagraph
(a)(1)(C) of Code Section 15-11-112; and, of each of those numbers, the number
of females who, to the best of the reporting physiciańs information and
belief, went on to obtain the abortion;
(2) The number of females upon
whom the physician performed an abortion without providing to the parent or guardian
of a minor the notice required by subsection (a) of Code Section 15-11-112; and
of that number, the number of females for which subsection (b) of Code Section
15-11-112 and Code Section 15-11-116 were applicable;
(3) The number of abortions performed
upon a female by the physician after receiving judicial authorization pursuant
to subsection (b) of Code Section 15-11-112 and Code Section 15-11-114; and
(4) The same information described
in paragraphs (1), (2), and (3) of this subsection with respect to females for
whom a guardian or conservator has been appointed.
(d) The Department of Human
Resources shall ensure that copies of the reporting forms described in
subsection (c) of this Code section, together with a reprint of this Code
section, are provided:
(1) Within 120 days after the
effective date of this subsection, to all health facilities licensed as an
abortion facility by the Department of Human Resources;
(2) To each physician licensed or
who subsequently becomes licensed to practice medicine in this state at the
same time as official notification to that physician that the physician is so
licensed; and
(3) By December 1 of every year,
other than the calendar year in which forms are distributed in accordance with
paragraph (1) of this subsection, to all health facilities licensed as an
abortion facility by the Department of Human Resources.
(e) By February 28 of each year
following a calendar year in any part of which this subsection was in effect,
each physician who provided, or whose agent provided, the notice described in
subsection (a) of Code Section 15-11-112 and any physician who knowingly
performed an abortion upon a female or upon a female for whom a guardian or
conservator had been appointed because of a finding of incompetency during the
previous calendar year shall submit to the Department of Human Resources a copy
of the form described in subsection (c) of this Code section with the requested
data entered accurately and completely.
(f) Reports that are submitted
more than 30 days following the due date shall be subject to a late fee of
$500.00 for that period and the same fee for each additional 30 day period or
portion of a 30 day period in which they remain overdue. Any physician required
to report in accordance with this Code section who submits an incomplete report
or fails to submit a report for more than one year following the due date may,
in an action brought by the Department of Human Resources, be directed by a
court of competent jurisdiction to submit a complete report within a period
stated by court order or be subject to sanctions for civil contempt.
(g) By June 30 of each year, the
Department of Human Resources shall issue a public report providing statistics
for the previous calendar year compiled from all the reports covering that year
submitted in accordance with this Code section for each of the items listed in
subsection (c) of this Code section. The report shall also include statistics
which shall be obtained by the Administrative Office of the Courts giving the
total number of petitions or motions filed under subsection (b) of Code Section
15-11-112 and, of that number, the number in which the court appointed a
guardian ad litem, the number in which the court appointed counsel, the number
in which the judge issued an order authorizing an abortion without
notification, the number in which the judge denied such an order, and, of the
last, the number of denials from which an appeal was filed, the number of such
appeals that resulted in the denials being affirmed, and the number of such
appeals that resulted in reversals of such denials. Each report shall also
provide the statistics for all previous calendar years for which such a public
statistical report was required to be issued, adjusted to reflect any
additional information from late or corrected reports. The Department of Human
Resources shall ensure that none of the information included in the public
reports could reasonably lead to the identification of any individual female or
of any female for whom a guardian or conservator has been appointed.
(h) The Department of Human
Resources may by regulation alter the dates established by paragraph (3) of
subsection (d) and subsections (e) and (g) of this Code section or consolidate
the forms or reports to achieve administrative convenience or fiscal savings or
to reduce the burden of reporting requirements so long as reporting forms are
sent to all facilities licensed as an abortion facility by the Department of
Human Resources at least once every year and the report described in subsection
(g) of this Code section is issued at least once each year.
(i) The Department of Human
Resources shall ensure that the names and identities of the physicians filing
reports under this Code section shall remain confidential. The names and
identities of such physicians shall not be subject to Article 4 of Chapter 18
of Title 50
16-12-142.
Nothing in this article shall require a hospital or other medical facility or physician to admit any patient under the provisions of this article for the purpose of performing an abortion. In addition, any person who states in writing an objection to any abortion or all abortions on moral or religious grounds shall not be required to participate in procedures which will result in such abortion; and the refusal of the person to participate therein shall not form the basis of any claim for damages on account of such refusal or for any disciplinary or recriminatory action against the person. The written objection shall remain in effect until the person revokes it or terminates his association with the facility with which it is filed.
16-12-143.
A person who fails to file or maintain in complete form any of the written
reports required in this article within the time set forth is guilty of a
misdemeanor.
16-12-144. [These
provisions have been held to be unconstitutional and unenforceable]
(a) As used in this Code section, the term:
(1) 'Fetus' means the biological offspring of human parents.
(2) 'Partial-birth abortion' means an abortion in which the
person performing the abortion partially vaginally delivers a living human
fetus before ending the life of the fetus and completing the delivery.
(b) Any person who knowingly performs a partial-birth
abortion and thereby ends the life of a human fetus shall, upon conviction
thereof, be punished by a fine not to exceed $5,000.00, imprisonment for not
more than five years, or both. This prohibition shall not apply to a
partial-birth abortion that is necessary to save the life of the mother because
her life is endangered by a physical disorder, physical illness, or physical
injury, including a life-endangering condition caused by or arising from the
pregnancy itself, provided that no other medical procedure will suffice to save
the motherīs life.
(c)(1) The father of the fetus, and the maternal
grandparents of the fetus if the mother has not attained the age of 18 years of
age at the time of the abortion,r:line-break'>
(B) Statutory damages equal to three times the cost of the
partial-birth abortion.
(d) A woman upon whom a partial-birth abortion is performed may not be prosecuted under this Code section for violating this Code section or any provision thereof, or for conspiracy or for an attempt to violate this Code section or any provision thereof.
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TITLE 31
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31-9A-1.
This chapter shall be known and
may be cited as the 'Womańs Right to Know Act.'
31-9A-2.
As used in this chapter, the term:
(1) 'Abortion' means the use or
prescription of any instrument, medicine, drug, or any other substance or
device with the intent to terminate the pregnancy of a female known to be
pregnant. The term 'abortion' shall not include the use or prescription of any
instrument, medicine, drug, or any other substance or device employed solely to
increase the probability of a live birth, to preserve the life or health of the
child after live birth, or to remove a dead unborn child who died as the result
of a spontaneous abortion. The term 'abortion' also shall not include the
prescription or use of contraceptives.
(2) 'Medical emergency' means any
condition which, on the basis of the physiciańs good faith clinical
judgment, so complicates the medical condition of a pregnant female as to
necessitate the immediate abortion of her pregnancy to avert her death or for
which a delay will create serious risk of substantial or irreversible
impairment of a major bodily function.
(3) 'Physician' means a person
licensed to practice medicine under Article 2 of Chapter 34 of Title 43.
(4) 'Probable gestational age of
the unborn child' means the physiciańs best professional estimate of the
probable gestational age of the unborn child at the time an abortion is to be
performed.
(5) 'Qualified agent' means the
agent of the physician who is a patient educator, licensed psychologist,
licensed social worker, licensed professional counselor, licensed
physiciańs assistant, registered nurse, or physician.
(6) 'Secure Internet website'
means a website that is safeguarded from having its content altered other than
by the commissioner of human resources.
(7) 'Unborn child' or 'fetus'
means a member of the species homo sapiens from fertilization until birth.
31-9A-3.
No abortion shall be performed in
this state except with the voluntary and informed consent of the female upon
whom the abortion is to be performed. Notwithstanding any provision of law to
the contrary, except in the case of a medical emergency, consent to an abortion
is voluntary and informed if and only if:
(1) The female is told the
following, by telephone or in person, by the physician who is to perform the
abortion, by a qualified agent of the physician who is to perform the abortion,
by a qualified agent of a referring physician, or by a referring physician, at
least 24 hours before the abortion:
(A) The particular medical risks
to the individual patient associated with the particular abortion procedure to
be employed, when medically accurate;
(B) The probable gestational age
of the unborn child at the time the abortion would be performed; and
(C) The medical risks associated
with carrying the unborn child to term.
The information required by this
paragraph may be provided by telephone without conducting a physical
examination or tests of the patient, in which case the information required to
be provided may be based on facts supplied to the physician by the female and
whatever other relevant information is reasonably available to the physician.
Such information may not be provided by a tape recording but must be provided
during a consultation in which the physician or a qualified agent of the
physician is able to ask questions of the female and the female is able to ask
questions of the physician or the physiciańs qualified agent. If in the
medical judgment of the physician any physical examination, tests, or other
information subsequently provided to the physician requires a revision of the
information previously supplied to the patient, that revised information shall
be communicated to the patient prior to the performance of the abortion.
Nothing in this Code section may be construed to preclude provision of required
information in a language understood by the patient through a translator;
(2) The female is informed, by
telephone or in person, by the physician who is to perform the abortion, by a
referring physician, or by a qualified agent of either physician at least 24
hours before the abortion:
(A) That medical assistance
benefits may be available for prenatal care, childbirth, and neonatal care;
(B) That the father will be liable
pursuant to subsection (a) of Code Section 19-7-49 to assist in the support of
her child; and
(C) That she has the right to review
the printed materials described in Code Section 31-9A-4 and that these
materials are available on a state sponsored website at a stated website
address. The physician or the physiciańs qualified agent shall orally
inform the female that materials have been provided by the State of Georgia and
that they describe the unborn child, list agencies that offer alternatives to
abortion, and contain information on fetal pain. If the female chooses to view
the materials other than on the website, they shall either be given to her at
least 24 hours before the abortion or mailed to her at least 72 hours before
the abortion by certified mail, restricted delivery to addressee.
The information required by this
paragraph may be provided by a tape recording if provision is made to record or
otherwise register specifically whether the female does or does not choose to
review the printed materials other than on the website;
(3) The female certifies in
writing, prior to the abortion, that the information described in paragraphs
(1) and (2) of this Code section has been furnished her and that she has been
informed of her opportunity to review the information referred to in
subparagraph (C) of paragraph (2) of this Code section; and
(4) Prior to the performance of
the abortion, the physician who is to perform the abortion or the
physiciańs qualified agent receives a copy of the written certification
prescribed by paragraph (3) of this Code section and retains it on file with
the femalés medical record for at least three years following the date of
receipt.
31-9A-4.
(a) Within 90 days after this
chapter first becomes effective, the Department of Human Resources shall cause
to be published in English and in each language which is the primary language
of 2 percent or more of the statés population and shall cause to be
available on the state website provided for in subsection (d) of this Code
section the following printed materials in such a way as to ensure that the
information is easily comprehensible:
(1) Geographically indexed
materials designed to inform the female of public and private agencies and
services available to assist a female through pregnancy, upon childbirth, and
while the child is dependent, including adoption agencies, which shall include
a comprehensive list of the agencies available, a description of the services
they offer, and a description of the manner, including telephone numbers and
website addresses, in which they might be contacted or, at the option of such
department, printed materials including a toll-free, 24 hour telephone number
which may be called to obtain, orally or by a tape recorded message tailored to
the ZIP Code entered by the caller, such a list and description of agencies in
the locality of the caller and of the services they offer;
(2) Materials designed to inform
the female of the probable anatomical and physiological characteristics of the
unborn child at two-week gestational increments from the time when a female can
be known to be pregnant to full term, including any relevant information on the
possibility of the unborn child́s survival and pictures representing the
development of unborn children at two-week gestational increments, provided
that any such pictures must contain the dimensions of the fetus and must be
factually accurate for the stage of pregnancy depicted. The materials shall be
objective, nonjudgmental, and designed to convey only factually accurate
scientific information about the unborn child at the various gestational ages.
The material shall also contain objective information describing the methods of
abortion procedures commonly employed, the medical risks commonly associated
with each such procedure, the possible detrimental psychological effects of
abortion, and the medical risks commonly associated with carrying a child to
term; and
(3) Materials with the following
statement concerning unborn children of 20 weekś or more gestational age:
'By 20 weekś gestation, the
unborn child has the physical structures necessary to experience pain. There is
evidence that by 20 weekś gestation unborn children seek to evade certain
stimuli in a manner which in an infant or an adult would be interpreted to be a
response to pain. Anesthesia is routinely administered to unborn children who
are 20 weekś gestational age or older who undergo prenatal surgery.'
The materials shall be objective,
nonjudgmental, and designed to convey only accurate scientific information
about the unborn child at the various gestational ages.
(b) The materials referred to in
subsection (a) of this Code section shall be printed in a typeface large enough
to be clearly legible. All pictures and print appearing on the website shall be
clearly legible. All information and pictures shall be accessible with an
industry standard browser, requiring no additional plug-ins.
(c) The materials required under
this Code section shall be available at no cost from the Department of Human
Resources upon request and in a reasonably appropriate number to any person,
facility, or hospital.
(d) The Department of Human
Resources shall develop and maintain a secure Internet website to provide the
information described in this Code section. No information regarding who uses
the website shall be collected or maintained. The Department of Human Resources
shall monitor the website on a weekly basis to prevent and correct tampering.
31-9A-5.
(a) When a medical emergency
compels the performance of an abortion, the physician shall inform the female prior
to the abortion, if medically reasonable and prudent, of the medical
indications supporting the physiciańs judgment that an abortion is
medically necessary to avert her death or that a 24 hour delay will create
serious risk of substantial or irreversible impairment of a major bodily
function.
(b) Any physician who complies
with subsection (a) of this Code section shall not be held civilly liable to a
patient for failure to obtain informed consent to an abortion.
31-9A-6.
(a) Within 90 days after this
chapter first becomes effective, the Department of Human Resources shall
prepare a reporting form for physicians performing abortions in a health
facility licensed as an abortion facility by the Department of Human Resources
containing a reprint of this chapter and listing:
(1) The number of females to whom
the physician provided the information described in paragraph (1) of Code
Section 31-9A-3; of that number, the number to whom the information was
provided by telephone and the number to whom the information was provided in
person; and of each of those numbers, the number to whom the information was
provided by a referring physician and the number to whom the information was
provided by a physician who is to perform the abortion;
(2) The number of females to whom
the physician or a qualified agent of the physician provided the information
described in paragraph (2) of Code Section 31-9A-3; of that number, the number
to whom the information was provided by telephone and the number to whom the information
was provided in person; of each of those numbers, the number to whom the
information was provided by a referring physician and the number to whom the
information was provided by a physician who is to perform the abortion; and of
each of those numbers, the number to whom the information was provided by the
physician and the number to whom the information was provided by a qualified
agent of the physician; and
(3) The number of females who
availed themselves of the opportunity to obtain a copy of the printed
information described in Code Section 31-9A-4, other than on the website, and
the number who did not; and of each of those numbers, the number who, to the
best of the reporting physiciańs information and belief, went on to
obtain the abortion.
(b) The Department of Human
Resources shall ensure that copies of the reporting forms described in
subsection (a) of this Code section are provided:
(1) Within 120 days after this
chapter first becomes effective, to all health facilities licensed as an abortion
facility by the Department of Human Resources;
(2) To each physician licensed or
who subsequently becomes licensed to practice in this state, at the same time
as official notification to that physician that the physician is so licensed;
and
(3) By December 1 of each year,
other than the calendar year in which forms are distributed in accordance with
paragraph (1) of this subsection, to all health facilities licensed as an
abortion facility by the Department of Human Resources.
(c) By February 28 of each year
following a calendar year in any part of which this chapter was in effect, each
physician who provided, or whose qualified agent provided, information to one
or more females in accordance with Code Section 31-9A-3 during the previous calendar
year shall submit to the Department of Human Resources a copy of the form
described in subsection (a) of this Code section with the requested data
entered accurately and completely.
(d) Nothing in this Code section
shall be construed to preclude the voluntary or required submission of other
reports or forms regarding abortions.
(e) Reports that are not submitted
within a grace period of 30 days following the due date shall be subject to a
late fee of $500.00 for that period and the same fee for each additional 30 day
period or portion of a 30 day period the reports are overdue. Any physician
required to submit a report in accordance with this Code section who submits an
incomplete report or fails to submit a report for more than one year following the
due date may, in an action brought by the Department of Human Resources, be
directed by a court of competent jurisdiction to submit a complete report
within a period stated by court order or may be subject to sanctions for civil
contempt.
(f) By June 30 of each year, the
Department of Human Resources shall issue a public report providing statistics
for the previous calendar year compiled from all of the reports covering that
year submitted in accordance with this Code section for each of the items listed
in subsection (a) of this Code section. Each report shall also provide the
statistics for all previous calendar years adjusted to reflect any additional
information from late or corrected reports. The Department of Human Resources
shall ensure that none of the information included in the public reports could
reasonably lead to the identification of any individual who provided
information in accordance with Code Section 31-9A-3 or 31-9A-4.
(g) The Department of Human Resources
may, by regulation, alter the dates established by subsection (c) or (e) of
this Code section or paragraph (3) of subsection (b) of this Code section or
may consolidate the forms or reports described in this Code section with other
forms or reports for reasons including, but not limited to, achieving
administrative convenience or fiscal savings or reducing the burden of
reporting requirements, so long as reporting forms are sent to all facilities
licensed as an abortion facility by the Department of Human Resources at least
once every year and the report described in subsection (f) of this Code section
is issued at least once every year.
(h) The Department of Human
Resources shall ensure that the names and identities of the physicians filing
reports under this chapter shall remain confidential. The names and identities
of such physicians shall not be subject to Article 4 of Chapter 18 of Title 50.
31-9A-7.
In any civil proceeding or action
relating to this chapter or a breach of duty under this chapter, the court
shall rule whether the anonymity of any female upon whom an abortion has been
performed shall be preserved from public disclosure if she does not give her
consent to such disclosure. The court, upon motion or sua sponte, shall make such
a ruling and, upon determining that her anonymity should be preserved, shall
issue orders to the parties, witnesses, and counsel and shall direct the
sealing of the record and exclusion of individuals from courtrooms or hearing
rooms to the extent necessary to safeguard her identity from public disclosure.
Each such order shall be accompanied by specific written findings explaining
why the anonymity of the female should be preserved from public disclosure, why
the order is essential to that end, how the order is narrowly tailored to serve
that interest, and why no reasonable less restrictive alternative exists. This
Code section may not be construed to conceal the identity of the plaintiff or
of witnesses from the defendant.
31-9A-8.
If any one or more provisions,
Code sections, subsections, sentences, clauses, phrases, or words of this
chapter or the application thereof to any person or circumstance is found to be
unconstitutional, the same is declared to be severable, and the balance of this
chapter shall remain effective notwithstanding such unconstitutionality. The
General Assembly declares that it would have enacted this chapter and each Code
section, subsection, sentence, clause, phrase, or word thereof irrespective of
the fact that any one or more provisions, Code sections, subsections,
sentences, clauses, phrases, or words would be declared unconstitutional.
* * *
-----------------------------------------------------
* * *
290-5-32-.01
Definitions. Amended.
Unless a different meaning is
required by the context or pertinent statutes, the following
terms as used in these Rules
and Regulations shall have the meaning hereinafter
respectively ascribed to
them; except, these Rules and Regulations do not apply to
hospitals owned or operated
by the United States Federal Government.
(a) "Induced
Abortion" means the procedure by which pregnancy is purposely terminated
with the intent to result in
other than a live birth.
(b) "First
Trimester" means the first thirteen completed weeks after the first day of
the last
normal menstrual cycle.
(c) "Second
Trimester" means the second thirteen weeks or gestation.
(e) "Hospital"
means a facility which is subject to regulation and control under Section
Institutions) as well as the
Rules and Regulations duly promulgated thereunder and in
particular the Rules and
Regulations embodied in Chapter 290-5-6 entitled "Hospitals"
duly promulgated by the
Georgia Department of Human Resources, as such law and
regulations now exist or may
subsequently be amended.
(f) "Ambulatory Surgical
Treatment Centers" means any institution, building, or facility,
or part thereof, devoted primarily
to the provision of surgical treatment to patients not
requiring hospitalization, as
provided under provisions of Code Section
Official Code of
which normally requires
overnight stay, nor provide accommodations for treatment of
patients for periods of
twenty-four (24) hours or longer.
(g) "Abortion
Facility" means a facility licensed by the Department as a hospital or
ambulatory surgical treatment
center.
(h) "Department"
means the Department of Human Resources of the State of
(i) "Commissioner"
means the Commissioner of the Department of Human Resources of
the State of
(j) "Board" means
the Board of Human Resources of the State of
290-5-32-.02 Regulation
of Abortion Procedures Subsequent to the First
Trimester. Amended.
(1) No abortion is authorized
nor shall be performed after the first trimester unless the
abortion is performed in an
abortion facility; provided, however, that abortion procedures
performed in an ambulatory
surgical treatment center shall be limited to dilatation and
evacuation procedures (D
& E).
(2) No abortion is authorized
nor shall be performed after the second trimester unless the
attending physician and two
consulting physicians certify in writing and make such
statement a part of the
medical records of the patient that said abortion is necessary in
their best clinical judgment
to preserve the life or health of the woman. If the product of
such abortion is capable of
meaningful or sustained life, medical aid then available must
be rendered in order to
achieve this result.
(3) Nothing in these Rules
and Regulations shall require an abortion facility or physician
to admit any patient for the
purpose of performing an abortion. In addition, any person
who shall state in writing an
objection to any abortion or all abortions on moral or
religious grounds shall not
be required to participate in procedures which will result in
such abortion, and refusal of
such person to participate therein, shall not form the basis
for any claim for damage or
account of such refusal or for any disciplinary or
recriminatory action against
such person. The written objection shall remain in effect
until such person shall
revoke it or terminate his association with the facility with which
it is filed.
290-5-32-.03 Procedure
for Filing Certificate of Abortion. Amended.
(1) ln addition to the
medical records requirements of Chapters 290-5-6 and 290-5-33 of
the Rules and Regulations of
the Georgia Department of Human Resources, the physician
who performs the abortion
shall file with the Commissioner of Human Resources or his
designee, within ten (10)
days after an abortion procedure is performed, a Certificate of
Abortion. It is expressly
intended that the privacy of the patient shall be preserved and, to
that end, the Certificate of
Abortion shall not reflect the name of the patient but shall
carry the same facility
number, or other identifying number reflected on the patient's
medical records. A duplicate
of the Certificate of Abortion will he made a part of the
patient's Medical record and
neither the aforesaid duplicate certificate nor the Certificate
of Abortion which is filed
with the Commissioner or his designee shall be revealed to the
public unless the patient
executes a proper authorization which permits such a release or
unless the records must be
made available to the District Attorney of the Judicial Circuit
in which the hospital or
health facility is located as provided by Code Section 16-12-141
(d) of the Official Code of
(2) The Certificate of
Abortion required in the above rule shall contain the following
statistical data, to wit:
(a) age;
(b) race;
(c) education;
(d) county of residence;
(e) marital status;
(f) duration of pregnancy;
(g) previous pregnancy
history including previous abortion(s);
(h) method of abortion;
(i) fetal defects if fetus
survives; and
(j) history of use of drugs
and/or alcohol.
290-5-32-.04
Severability. Amended.
In the event that any rule,
sentence, clause or phrase of any of these rules are in conflict
with any superior law or,
should be declared or adjudged invalid or unconstitutional, such
determination or adjudication
shall in no manner affect the remaining rules or portions
thereof and such remaining
rules or portions thereof shall remain in full force and effect
as if such rule or portions
thereof so determined, declared or adjudged invalid or
unconstitutional were not originally
a part hereof.
290-5-32-.05
Enforcement. Amended.
In addition to the penal
provisions of Section 16-12-143 of the Official Code of Georgia
Annotated, which states that
any person who fails to file or maintain, in complete form,
any of the written reports
required in that Chapter (as further reflected in these rules
relating to abortions) within
the time set forth shall commit a misdemeanor, and Section
16-12-140(b) of the aforesaid
Code which states that a person convicted of criminal
abortion shall be punished by
imprisonment for not less than one (1) nor more than ten
(10) years, except that a
person convicted of failure to file the forms and records required
by this Chapter shall be
punished under Section 16-12-143, the administration and
enforcement of these Rules
and Regulations shall be as prescribed in Section
entitled "Administration
and Enforcement" of the Official Code of Georgia Annotated
and in conformity with the
Administrative Procedure Act (Section 50-13-1 of the Official
Code of Georgia Annotated),
as amended.
* * *
290-5-33-.01
Definitions. Amended.
Unless a different meaning is
required by the context, the following terms as used in these
rules and regulations shall
have the meaning hereinafter respectively ascribed to them:
(a) "Ambulatory Surgical
Treatment Centers" means any institution, building, or facility,
or part thereof, devoted
primarily to the provision of surgical treatment to patients not
requiring hospitalization, as
provided under provisions of Georgia Code Section 88-1901.
Such facilities do not admit
patients for treatment which normally requires overnight stay,
nor provide accommodations
for treatment of patients for period of twenty-four (24)
hours or longer;
(b) "Governing
Body" and/or "Management" means the Board of Directors and/or
Trustees, the partnership,
the corporation, the association, or the person or group of
persons who maintain and
control the operation of the ambulatory surgical treatment
center and who are legally
responsible for its operation;
(c) "Center" means
an ambulatory surgical treatment center as defined in these rules and
regulations;
(d) "Board," unless
otherwise indicated, shall mean the Georgia Board of Human
Resources;
(e) "Commissioner" means
the Commissioner of the Georgia Department of Human
Resources or his designee;
(f) "Department"
means the Georgia Department of Human Resources;
(g) "General
Anesthesia" means any drug, element or other material administered to
eliminate all sensation and
which, when administered, is accompanied by a state of
unconsciousness;
(h) "Licensee"
means the person or body to whom the license or permit is issued and who
is held responsible for
compliance with all required rules, regulations, and minimum
standards;
(i) "Permit" or
"license" means an authorization granted by the Department to an
applicant to operate an
ambulatory surgical treatment center providing one or more types
or classifications of
services;
(j) "Provisional
Permit" means an authorization granted by the Department to an applicant
to operate an ambulatory
surgical treatment center on a conditional basis to allow a newly
established center a
reasonable but limited period of time to demonstrate that operational
procedures are in
satisfactory compliance with these rules and regulations, or to allow an
established and operating
center a specified length of time to comply with these rules and
regulations, provided said
center shall first present a plan of improvement which is
acceptable to the Department;
(k) "Plan of
Improvement" means a written plan submitted to the Department by the
person or persons responsible
for the center, and acceptable to the Department. The plan
shall identify the existing
areas of noncompliance of the facility, together with the
proposed procedures, methods
and period of time to correct the areas of noncompliance;
(l) "Professional
Staff" means the group of persons or body appointed by the Governing
Body to provide patient
services, and who require special licensure or registration.
Normally, the professional
staff will be restricted to currently licensed medical, dental,
and podiatrist practitioners.
Other personnel, for example, registered nurses, may be
appointed to the professional
staff to assist the practitioners in the development,
interpretatioe;text-autospace:none'>(o) "Dentist" means
any person who is currently licensed to practice dentistry in the State
of
84-7,
(p) "Podiatrist"
(Chiropodist) means any person who is currently licensed to practice
podiatry (chiropody) in the
State of
Act, Chapter 84-6,
(q) "Registered
Nurse," "Registered Professional Nurse," or "R.N."
means a person who
is currently licensed to
practice as a licensed registered nurse under provisions of Chapter
84-10,
(r) "Licensed Practical
Nurse" or "L.P.N." means a person currently licensed to practice
as
a licensed practical nurse
under provisions of Chapter 84-68, Georgia Laws, Ann.;
(s) "Private
Office(s)," "Office(s)," and/or "Treatment Rooms"
means any area or place
established and maintained by
a currently licensed individual practitioner, professional
association, or group
practice of such practitioners, in his/her/their private individual or
private group practice, in
which he/she/they primarily see(s), consult(s) with, examine(s),
and/or treats private
patients on a regular and on-going basis, and in the operation of
which such currently licensed
practitioners have full control of all financial,
administrative, and
professional arrangements with said patients;
(t) "Hospital"
means any facility which meets the requirements of and is currently
licensed as a hospital under
Georgia Laws and rules and regulations pertaining thereto;
(u) "Procedure
Room" means any room or area of the ambulatory surgical treatment
center in which surgical
procedures are performed;
(v) "Patient" means
any individual who receives medical/surgical treatment in facilities
governed by these
regulations;
(w) "Qualified
Counselor" means a person who assists the professional staff by talking
with and informing patients regarding
expectations and probable outcomes associated
with services in an
ambulatory surgical treatment center, and who possesses the following
minimum qualifications: at
least a bachelor's degree from an accredited college or
university in nursing, psychology
or social work, or in some related field, or who has
special training in
counseling which is deemed acceptable by the Department; provided,
however, that any such
counselor shall function only under the direct supervision of the
responsible practitioner.
290-5-33-.02 Exemptions.
Amended.
The following types of health
care facilities are exempt from the requirements of these
regulations:
(a) currently licensed
hospitals, or a facility as specified in 290-5-33-.03 (12);
(b) a practitioner's private
offices or treatment rooms in which a practitioner primarily
sees, consults with, and
treats patients;
(c) facilities owned and
operated by the Federal Government.
290-5-33-.03
Organization and Administration. Amended.
(1) Each ambulatory surgical
treatment center shall be organized with an identifiable
governing body that
establishes the objectives, sets the policies and assumes full legal
responsibilities for the
overall conduct of the center and for compliance with all
applicable laws and
regulations pertaining to the center. The membership of the
governing body shall be
identified in the application to the Department for licensure.
(2) The ownership of the
center shall be fully disclosed in the application to the
Department. This disclosure
shall include the names and addresses of all corporate
officers and any person(s)
having a five percent (5.0%) or more financial interest.
(3) The governing body of the
center shall be responsible for appointing the professional
staff and shall establish effective
mechanisms for quality assurance and to ensure the
accountability of the
center's medical and/or dental staff and other professional personnel.
(4) The organizational
objectives of the ambulatory surgical treatment center shall be
clearly stated in the
procedures and policies of the governing body and on the application
for licensure.
(5) The governing body shall
inform the Department of the name(s) of the
administrator(s) to whom the
responsibility for the day-to-day management of the center
is delegated, including the
implementation of rules and policies adopted by the governing
body.
(6) Each center shall be at
all times under the immediate personal and daily supervision
and control of the
administrator or his designated representative, whose authority, duties
and responsibilities shall be
defined in writing and which shall be available to the
Department upon request.
(7) The Department shall be
notified with a new application, or written amendment to the
current application, when
there are changes in location, ownership, management or
operational objectives.
(8) Individual patients shall
be discharged within twenty-four (24) hours of admission, in
an ambulatory condition which
will not endanger their continued well-being, or shall be
transferred to a licensed
hospital or other treatment facility. There shall be written
procedures and assigned
responsibilities for implementing such procedures, including
provisions for
transportation. Patients requiring emergency services shall be accompanied
by a member of the
professional staff of the center.
(9) Each center shall have an
organized professional staff which is responsible for the
development of patient care
policies and procedures and for maintaining the level of
professional performance
through a continuing program of staff education, review and
evaluation of patient care.
(10) Each center shall at all
times have a professional director designated by the
governing body, who shall be
responsible for the direction and coordination of all
professional aspects of the
center programs.
(11) The practitioners
applying for staff privileges shall be required to sign an agreement
to abide by the staff bylaws
and required State laws and rules and regulations.
(12) Nothing in these rules and
regulations shall prevent a licensed hospital from
organizing and providing an
ambulatory surgical treatment service as a part of a licensed
hospital under the
controlling authority of a hospital board, so long as all hospital
licensure standards are met
and the provided services are included in the application
under which the hospital
license is granted.
290-5-33-.04
Classifications of Services. Amended.
Each ambulatory surgical
center, when applying for a permit shall designate the type(s) or
classification(s) of services
to be provided in or by the center. These classifications may
include, but are not
necessarily limited to the following: general surgery; eye, ear, nose,
and throat; plastic surgery;
oral and maxillofacial; obstetrical-gynecological; oncological;
ophthalmological; and
urological. Provided, however, that any facility providing labor
and delivery services must
meet the requirements of Rules and Regulations for Hospitals,
Maternity and Obstetrical and
Newborn Services, Chapter 290-5-6, Rules 290-5-6-.16
and 290-5-6-.17, dated
ambulatory surgical treatment
center may cover one or more types of services. Each
ambulatory surgical treatment
center shall provide only those services listed on the face of
its permit.
290-5-33-.05 Application
for Permits. Amended.
(1) Any person or persons
responsible for the operation of an ambulatory surgical
treatment center as defined
and classified in these regulations, or who may hereafter
propose to establish and
operate such an institution, shall submit an application to the
Department for a permit to
operate said institution using forms provided by the
Department. No such
institution shall be operated in
which shall be displayed in a
conspicuous place within the center. Failure or refusal to
file an application for a
permit within ninety (90) days of the effective date of these
regulations shall constitute
a violation of law and shall be dealt with as provided in
Chapter 88-3 of the
"Georgia Health Code."
(2) The applicant for a
permit to operate an ambulatory surgical treatment center shall
submit a completed
application with character references and a certification that the
applicant is able and willing
to comply with the minimum standards for an ambulatory
surgical treatment center and
with the rules and regulations lawfully promulgated. Each
application shall be
accompanied by a statement from the local (city or county) fire safety
authority stating that an
inspection has been made of the premises and that state and local
fire safety requirements have
been met.
(3) The application shall
include full and complete information concerning the name and
address of the applicant and
the classification(s) of services to be provided; the ownership
of the property and
operation; in case a center is organized as a corporation, the names
and addresses of each officer
and director of the corporation; in case the center is
organized as a partnership,
the names and addresses of each partner; the identity of the
professional director of the
facility; the days and hours the center is normally operated;
and any other information
which the Department may require.
(4) Ambulatory surgical
treatment centers are subject to review by the State Health
Planning and Development
Agency, pursuant to the Georgia Certificate of Need Law.
Evidence of completion of
this review shall be made a part of the application for a permit.
(5) Plans for ambulatory
surgical treatment centers shall be submitted to the Department
for review and approved in
three stages of development:
(a) schematic drawings;
(b) design-development
drawings; and
(c) final working drawings
and specifications.
(6) A permit shall be issued
to the person or persons named only for the premises listed
on the application for
licensure.
(7) Permits are not
transferable or assignable.
(8) Changes in ownership
shall be subject to prior review and approval by the State
Health Planning and Development
Agency (SHPDA) pursuant to Section 1122 of the
Social Security Amendment.
Each planned change of ownership or lease shall be reported
to the Department thirty (30)
days prior to such change with an application being
submitted from the proposed new
owners for a new permit.
290-5-33-.06 Permits.
Amended.
(1) Following inspection and
classification of the institution for which application for a
permit has been made, the
Department may issue a permit or a provisional permit or
refuse to reissue or continue
a permit or provisional permit. Each permit or provisional
permit shall indicate the
classifications of services to be provided and patient capacity of
the center.
(2) Permits issued shall mean
that the Department grants authorization to the governing
body of the applicant
institution to operate an ambulatory surgical treatment center and
signifies compliance with
these rules and regulations. Permits issued shall remain in force
and effect until revoked or
suspended.
290-5-33-.07 Provisional
Permits. Amended.
Provisional permits may be
issued for a limited period specified by the Department based
on an acceptable written plan
for correcting one or more deficiencies (plan of correction)
found during an inspection;
provisional permits issued shall remain in force and effect for
such limited period of time
as specified by the Department, unless earlier revoked due to
prevailing circumstances
which are not acceptable to the Department. Centers which are
established and operating
prior to adoption of these rules and regulations may be
considered for extension of a
provisional permit when needed to meet physical plant
standards. If the
Departments decision is that a deficiency is of such nature that it would
jeopardize the life of a patient,
a provisional permit will not be issued.
290-5-33-.08
Inspections. Amended.
(1) The ambulatory surgical
treatment center shall be available at all reasonable and/or
scheduled operating hours for
observation and examination by properly identified
representatives of the
Department.
(2) The governing body shall
notify the Department of the anticipated opening date of a
newly constructed center in
order that a preopening licensure inspection of the center may
be conducted to determine
compliance with these rules and regulations.
(3) The administrator or his
representative shall accompany the Department
representative on all tours
of inspection and shall sign the completed checklist.
(4) Each center shall be
periodically inspected to determine whether the center is
continuing to meet these
requirements or is making satisfactory progress on approved
plans of correction.
290-5-33-.09
Professional Services.
(1) All services provided by
or in the center shall be provided by persons who are
currently licensed to perform
the services they render when such services require
licensure or registration
under the laws of the State of
number of qualified staff
members to adequately provide for patient needs based on
services provided and the
number of patients served.
(2) Each center shall have a
professional director who shall be a practitioner currently
licensed in
medical aspects of the center
program.
(3) General anesthesia shall
be administered by an anesthesiologist, a physician
anesthetist, an oral surgeon,
or a certified R.N. anesthetist under the direction and
responsibility of a currently
licensed physician with training and experience in anesthesia,
as specified in Georgia Code
84-10A. After administration of a general anesthetic,
patients shall be constantly
attended (at bedside) by a person qualified as above or by an
R.N. until reactive and able
to summon aid.
(4) All nursing services shall
be under the supervision of a registered nurse (R.N.). Each
center shall have a
sufficient number of currently licensed nurses present and on duty to
attend to patients at all
times patients are receiving treatment or recovering from
treatment up to and including
the time of discharge. Additional staff shall be on duty and
available to assist the
professional staff to adequately handle routine and emergency
patient needs.
(5) Each center shall
establish written procedures for emergency services which will
insure that a professional
staff member who has been trained in emergency resuscitation
procedures shall be on duty
at all times when there is a patient receiving treatment or
recovering from treatment, up
to and including the time of discharge.
(6) The written procedures
shall provide that an appropriate practitioner be designated on
call and available to provide
timely response to emergencies which may occur with any
patient in the center.
(7) Each center shall have a
hospital affiliation agreement and/or the medical staff must
have admitting privileges or
other acceptable documented arrangements to insure the
necessary backup for medical
complications. The center must have the capability to
transfer a patient
immediately to a hospital with adequate emergency room services.
(8) Each center will have
effective policies and procedures for handling infection control
and for recording
complications which occur during or after surgery, which includes a
reporting mechanism for
patients who develop infections or postoperative complications
after discharge.
(9) Either prior to, or at
the time of admission, each patient who is admitted to the center
without an appointment with a
specified practitioner shall be provided (in writing) with
the name, address and phone
number of the practitioner who is serving him/her. The
practitioner or a qualified
counselor designated by the practitioner, shall explain the
surgical and medical
procedures, its potential complications, and postoperative
complications and other
alternatives to surgery; this shall be confirmed by the patient who
shall sign an informed
consent form as provided under Georgia Laws, Chapter 88-29.
Prior to dismissal, each
patient shall be provided with both verbal and written instructions
for posttreatment care and
procedures for obtaining emergency care, if needed during the
period of recuperation.
(10) All ancillary supportive
health or medical services such as radiological services,
pharmaceutical services, or
clinical laboratory services provided in or by the center shall
be in accordance with
applicable rules and regulations of the State of
(11) Each center shall
establish policies for patient care and procedures for maintaining
these policies.
290-5-33-.10 Physical
Plant and Operational Standards.
The following minimum
physical plant and operational standards shall be met by an
applicant or licensee as a
prerequisite for the issuance and continuance of a permit to
operate an ambulatory
surgical treatment center. The failure of any licensee to comply
with the minimum standards
may result at any time in the denial, revocation, or
suspension of licensure to
operate an ambulatory surgical treatment center, pursuant to
provisions of
(a) Rooms and/or areas shall
be planned and provided with sufficient space and
equipment to provide for
patient and visitor waiting area; presurgical examination and
treatment; procedure rooms;
patient recovery; and staff and administrative areas.
(b) The physical plant of the
center shall meet all Federal, State and local laws, codes,
ordinances, and regulations
which apply to its location, construction, maintenance and
operation.
(c) Equipment, electrical
appliances, wiring, elevators, heating and cooling systems,
surgery rooms and special
service areas shall be constructed so as to assure the safety of
all occupants. It shall be
the responsibility of the governing body to assure that the center
is in a safe condition at all
times and that a fire inspection record is maintained on
equipment, systems, and areas
that may present a hazard to occupants.
(d) Except where additional
requirements are specified herein, or are required by State or
local ordinances or regulations,
the construction of an ambulatory surgical treatment
center shall meet the
requirements for Health Care or Business Occupancies as specified
in Chapter 10 and/or Chapter
13, as applicable, of the 1976 Life Safety Code, as currently
adopted and amended by
regulations of the Georgia Safety Fire Commissioner, Chapter
120-3-3,
(e) Entrances for patients
shall be connected to the public right-of-way by a
hard-surfaced, unobstructed
walkway in good repair. Handicapped patients confined to a
wheel chair or otherwise
impaired shall be able to access the center building without
climbing any stairs or steps.
A ramp with handrails over existing stairs or steps may be
utilized in meeting this
requirement. A hard-surfaced, unobstructed road or driveway for
use by ambulances or other
emergency fire or police vehicles shall run from at least one
entrance of the building to
the public right-of-way. The doorway of such entrance shall be
immediately adjacent to the road
or driveway.
(f) Ambulatory surgical
services provided in multistory buildings shall be accessible by
an elevator of adequate size
to accommodate date a standard wheeled litter patient and
two attendants. A stairway or
ramp of adequate dimensions shall be available for transfer
of a patient in case of power
failure.
(g) All procedure rooms shall
be constructed, equipped, and maintained to assure the
safety of patients and
personnel. The following requirements shall apply within the
patient treatment/procedure
rooms and adjoining areas:
1. Procedure rooms shall be
designed and located to prevent traffic through them to any
other part of the center;
2. The walls and floors in
procedure rooms shall be of material that will permit frequent
washing and cleaning;
3. Sterilizing equipment
shall be provided within the center and shall be convenient to the
procedure rooms;
4. Staff dressing rooms and
scrubup facilities shall be convenient to the procedure rooms,
and shall include a knee or
elbow operated scrub sink, soap dispenser, and brushes;
5. An equipment cleanup area
with adequate plumbing, including a sink with counter,
shall be provided outside the
procedure room;
6. Enclosed storage
facilities for sterile supplies and equipment shall be provided within
the procedure areas;
7. Scrub clothing worn by
personnel outside the procedure area shall be changed before
returning to the procedure
area;
8. Locations using flammable
anesthetic agents shall comply with the following:
(i) Floors, furniture and
equipment in operating rooms shall be of electrically conductive
material. Conductive flooring
shall extend into contiguous rooms and at least ten (10) feet
into the entrance traffic
area.
(ii) Clean conductive
footwear testing device shall be maintained in the procedure rooms.
(iii) An anesthesia supply
and equipment storage room shall be provided within the
procedure area.
(iv) Separate storage
enclosures shall be provided for flammable gases and
combustion-supporting gases.
Such enclosures shall be constructed of building material
with a fire resistive rating
of at least one hour and shall not communicate directly with
anesthetizing locations or
each other. Air shall be adequately exhausted by gravity or
spark proof forced
ventilation from the flammable storage enclosure to the exterior of the
building at a rate of not
less than two (2) changes per hour. Storage enclosures for
combustion-supporting gases
of less than 1500 cubic feet cylinder capacity need not be
vented to the outside.
Flammable materials such as fabrics, rubber and wood shall not be
stored in these enclosures.
(v) Clothing generating large
amounts of static electricity shall be prohibited in the
procedure rooms.
9. Locations using flammable
anesthetic agents shall be identified by prominently posted
signs at all entrances to the
procedure room and within the location signifying the type of
anesthetics used.
(h) Toilet facilities shall
be accessible to patients from the treatment, examining and
recovery areas. Convenient
handwashing facilities shall be provided for both staff and
patients, and shall be
provided with soap, disposable towels and dispensers. The use of
common towels is prohibited.
(i) Emergency life support
equipment shall be available for immediate use, in patient
treatment areas. Such equipment
shall include, but not necessarily be limited to the
following: suction, IV
fluids, oxygen, needles, intracatheters, medications, and ventilatory
equipment such as ambu bags,
oral and nasal airways and endotracheal tubes. Facilities
providing general anesthesia
shall also have a defibrillator and tracheotomy equipment
and supplies.
(j) All medical gases shall
be stored in accordance with Bulletin 56A of the National Fire
Protection Association.
(k) All plumbing shall be
designed and installed in accordance with State laws and local
ordinances.
(l) The center shall be
arranged and organized in such a manner as to ensure the comfort,
safety, hygiene, privacy, and
dignity of patients treated therein.
(m) Equipment for sterilizing
instruments and supplies shall be conveniently located and
of adequate capacity for the
workload. Records shall be maintained to assure quality
control, including date, time
and temperature of each batch of sterilized supplies and
equipment.
(n) Medicines shall be stored
in a conveniently located cabinet with lock, and only
licensed persons shall have
access.
(o) Clean and soiled utility
rooms shall be arranged and provided with equipment
necessary for proper patient
care, including sterilizers, storage cabinets and work
counters.
(p) Each center shall provide
one or more recovery rooms or areas staffed by qualified
personnel. The recovery area
shall be adequate for the numbers of patients scheduled.
Separate recovery areas
and/or cubicle curtains shall be provided for patient privacy,
when appropriate.
290-5-33-.11 Personnel.
(1) The governing body Shall
appoint an administrator who is responsible for the
day-to-day management and
operation of the center.
(2) The administrator shall designate
an individual to act for him in his absence in order
to provide the center with
administrative direction at all times.
(3) All center personnel
shall be currently licensed to perform the services they render
when such services require
licensure or registration under the laws of the State of
(4) Each center shall require
that each employee receives a health examination upon
employment and a policy shall
provide for follow-up examinations. The examination
shall be in sufficient
detail, including pertinent laboratory and x-ray data, to assure that
the employee is physically
and mentally qualified to perform the job to which he is
assigned.
(5) There shall be a separate
personnel folder maintained for each employee. This file
shall contain all personnel
information concerning the employee, including the
application and
qualifications for employment, physical examination (including
laboratory and x-ray reports,
if applicable), job description and attendance record.
(6) Fire and internal
disaster drills shall be conducted at least quarterly and the results
documented. There shall be an
ongoing program of continuing education for all personnel
concerning aspects of fire
safety and the disaster plan for moving personnel and patients
to safety, and for handling
patient emergencies.
290-5-33-.12 Records.
(1) A full-time employee
shall be designated responsible for establishing and maintaining
medical records required to
be kept by these rules and regulations.
(2) Medical records
containing sufficient information to validate the diagnosis and to
establish the basis upon
which treatment is given shall be maintained on each patient.
Contents of individual
medical records shall normally contain the following at least:
(a) Admission and discharge
data:
1. Name, address, birth date,
sex, marital status, race, etc.
2. Date and time of
admission.
3. Date and time of
discharge.
4. Admitting diagnosis.
5. Final diagnosis.
6. Procedures or operations
performed.
7. Condition on discharge.
8. Attending practitioner's
signature.
(b) History and physical
examination data:
1. Personal medical history
(including all current medication that the patient is taking).
2. Family medical history.
3. Physical examination.
4. Psychiatric examination
(if applicable).
(c) Treatment data:
1. Practitioner's orders.
2. Progress notes.
3. Nurse notes.
4. Medication.
5.
Temperature-Pulse-Respiration (Graphic Chart; surgical purposes only).
6. Special examination(s) and
reports (include x-ray and lab reports).
7. Signed informed consent
form.
8. Operation record.
9. Anesthesia record (if
applicable).
10. Consultation record (if
applicable).
11. Tissue findings when
performed.
12. Where dental services are
rendered, a complete dental chart with dental diagnosis,
treatment, prescription and
progress notes shall be part of the clinical record.
(3) All orders on patients
shall be signed by the practitioner giving them; admitting
diagnosis (purpose of
admission) shall be recorded prior to or at the time of admission.
(4) Medical records shall be
preserved as original records, microfilms or other usable
forms and shall be such as to
afford a basis for complete audit of professional
information. Centers shall
retain all medical records, at least until the sixth anniversary of
the patient's discharge. In
the case of patients who have not attained majority at the time
of the discharge, centers
shall retain such records at least six (6) years after patient
reaches age of majority. In
the event a center shall cease operation, the Department shall
be advised of the disposition
and/or location of said records.
(5) The center shall collect,
retrieve and annually summarize data from the medical record
so that it may provide the
Department with the following medical statistical information
including:
(a) Number of visits by
patients.
(b) Number of patients seen.
(c) Basis of treatment
(clinical diagnosis and/or problem for which the patient was
treated).
(d) Types and number of
operative procedures performed.
(e) Age distribution of
patients.
(f) Complications and
emergencies.
(g) Number of times a patient
was transferred from the center to a hospital.
(h) Pathological diagnosis.
(6) Patient records shall be
current and shall be entitled to the same protection as
provided for any medical
records under
290-5-33-.13
Administrative Area and Waiting Rooms.
(1) Each center shall provide
administrative space and facilities for admitting patients and
other service, such as
telephone and information office files and supplies, patients'
personal belongings, medical
records and files.
(2) A waiting room area shall
be provided with a seating capacity to accommodate the
number of patients and others
of the public normally present in the facility at one time.
(3) The center shall have
adequate and conveniently located toilets and handwashing
facilities for its staff,
employees, out-patients and visiting personnel.
290-5-33-.14 Clinical
Laboratory Services.
(1) Laboratory services
utilized by an ambulatory surgical treatment center shall be
consistent with requirements
of the Clinical Laboratory Licensure Law of 1970, p. 531, et
seq., and applicable
amendments and regulations, which provide for clinical laboratory
services to be either
licensed under Rules and Regulations of the State of
Chapter 290-5-29, or to be
exempt from licensure as specified in the Clinical Laboratory
Licensure Law. If exemption
is claimed, the application shall state the name(s) of the
practitioner(s) responsible
for the operation of the clinical laboratory and there shall be an
affidavit by the physician
that he/she is responsible for the laboratory and claims the
exemption.
(2) All removed tissues shall
be examined immediately by the practitioner, whose
findings shall be recorded in
the patient's records, in addition to reports of pathologic
examinations which may be
obtained later.
(3) Laboratory services shall
be provided for each patient, consistent with accepted
medical practice and the
conditions and needs of the patient. Laboratory reports shall be
made a part of patient
records.
(4) A system shall be
established for the collection of information on all postoperative
surgical complications and
infections.
(5) The center shall report
to the Department all communicable diseases detected or
reported for patients.
290-5-33-.15
Housekeeping, Laundry, Maintenance and Sterile Supplies.
(1) Each center shall provide
sufficient space and equipment and ensure that
housekeeping and maintenance
is sufficient to keep the center and equipment in a clean
and tidy condition and state
of good repair. Proper maintenance shall be provided as
necessary to correct,
prevent, or adjust faulty equipment and/or correct other undesirable
conditions.
(2) Laundry service shall be provided.
Separate space and facilities shall be provided for
receiving, sorting, and
storing soiled laundry, and for the sorting, storing and issuing of
clean laundry, if reusable
items are utilized.
(3) There shall be adequate
space and facilities for receiving, packaging and proper
sterilizing and storage of
supplies and equipment, consistent with the services to be
provided.
(4) Special precaution shall
be taken to ensure that sterile instruments and supplies are
kept separate from nonsterile
instruments and supplies. Sterilization records shall be kept
and sterile items shall be
dated and utilized, based on established procedures.
(5) A recognized method of
checking sterilizer performance shall be adopted.
290-5-33-.16 Drug
Storage and Dispensing.
Each center shall provide
adequate space and equipment and staff to assure that drugs are
stored and administered in
compliance with State and Federal laws and regulations.
290-5-33-.17 Blood
Supply and Storage.
Each center which provides
service for which blood is needed, shall provide separate
refrigeration for the storage
of blood and shall have a written agreement with a source for
meeting its blood needs. If
blood is retained overnight, such refrigeration shall be
equipped with a temperature
alarm device, and shall be tied in on an automatic
emergency electrical power
system. In all cases, refrigeration equipment shall be provided
with a temperature recording
device or the temperature shall be checked and recorded
each day of use.
290-5-33-.18 X-Ray.
All x-ray facilities in the
center shall be registered with and meet the requirements of
rules and regulations
governing radiological health as promulgated by the Department.
X-rays and x-ray reports
shall be made a part of the patient's record.
290-5-33-.19 Electrical
Power.
(1) All electrical work and
equipment shall be designed and installed in accordance with
State and local laws and
ordinances.
(2) All areas of the center
shall have sufficient artificial lighting for designated purpose.
(3) Centers which utilize
general anesthesia shall provide an emergency electrical system
so controlled, that, after
interruption of the normal electric power supply, an acceptable
auxiliary power source is
available and capable of being brought into use within ten
seconds with sufficient
voltage and frequency to reestablish essential in-house services
and other emergency equipment
needed to effect a prompt and efficient transfer of
patients to an appropriate
licensed hospital, when needed.
290-5-33-.20 Sanitation
and Waste Disposal.
(1) All centers shall provide
facilities for maintaining sanitary standards throughout the
premises, as well as for
water Supply, sewerage, garbage and refuse, disposal systems.
Such facilities shall meet
local and State regulations.
(2) All garbage, trash and
waste shall be stored and disposed of in a manner, by approved
methods, that will not permit
the transmission of disease, create a nuisance, or provide a
breeding place for insects or
rodents.
(3) Arrangements shall be
made for proper disposal of all contaminated and/or infected
dressings and surgical and
obstetrical waste.
(4) Effective means shall be
provided at all outside doors, windows and other openings to
the center to prevent the
entrance and harborage of flies, other insects and rodents.
290-5-33-.21
Advertising.
Any advertising of the
services provided in or by ambulatory surgical treatment center
shall include the full name
of the center and its
face of the permit.
290-5-33-.22 Waiver of
Rule.
The Department may waive any
rule for a stated period of time when it is shown that the
specific rule is not
applicable or when a waiver is needed to permit experimentation and
demonstration of new and
innovative approaches to the delivery of services which will
not jeopardize the health and
safety of the patients, staff or others utilizing the center.
Results of such
experimentation and demonstration projects shall be submitted to the
Department as prescribed by
the plan under which the waiver is approved. The
Department shall maintain a
record of and make available to interested persons
information on all waivers
granted under this rule.
290-5-33-.23
Enforcement.
An ambulatory surgical
treatment center which fails to comply with these rules and
regulations shall be subject
to revocation of its permit or provisional permit and/or other
sanctions provided by law.
The enforcement and administration of these rules and
regulations shall be as
prescribed in Chapter 88-3, Enforcement and Administrative
Procedure, the "Georgia
Health Code," Acts 1964, pages 499, 518, which includes
provision for:
(a) the misdemeanor penalty
for violation of rules and regulations promulgated under this
Title;
(b) injunctive relief under
appropriate circumstances; and
(c) the due process
requirements of notice, hearing and appeals.
290-5-33-.24
Applicability of Regulations.
These regulations are
applicable only to ambulatory surgical treatment centers and the
services provided therein, and
expressly do not modify or revoke any of the provisions of
the published rules of the
Department of Human Resources, Chapter 290-5-6 (Rules and
Regulations for Hospitals),
or of Chapter 290-5-32 (Rules and Regulations for
Performance of Abortions
After the First Trimester of Pregnancy and Reporting
Requirements for all
Abortions), or of revisions which may be made to said regulations.
290-5-33-.25
Severability.
In the event that any rule,
sentence, clause or phrase of any of these rules and regulations
may be construed by any court
of competent jurisdiction to be invalid, illegal,
unconstitutional, or
otherwise unenforceable, such determination or adjudication shall in
no manner affect the
remaining rules or portions thereof and such remaining rules or
portions thereof shall remain
of full force and effect, as if such rule or portions thereof so
determined, declared or
adjudged invalid or unconstitutional were not originally a part
hereof. It is the intent of
the Board of Human Resources to establish rules and regulations
that are constitutional and
enforceable so as to safeguard the health and well-being of the
people of the State.
290-5-33-.26 Effective
Date of Rules.
The effective date of these
rules is
provision in 290-5-33-.05
which allows ninety (90) days from the effective date of these
regulations to file an
application for permit.
* * *
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[Georgia prohibits public funding
for abortion for women eligible for state medical assistance for general health
care unless the procedure is necessary to preserve the life of a woman
endangered by a physical disorder, physical injury, or physical illness,
including a life-endangering physical condition caused by or arising from the
pregnancy itself, or the pregnancy is the result of rape or incest. Div.
of Med. Assistance,