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 15-11-29.

 

(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 15-11-38, 15-11-38.1, and 15-11-39, the unemancipated minor or next friend shall be notified of the date, time, and place of the hearing in such proceedings at the time of filing the petition. The hearing shall be held within three days of the date of filing, excluding Saturdays, Sundays, and holidays. The parents or guardian or person standing in loco parentis of the unemancipated minor shall not be served with the petition or with a summons or otherwise notified of the proceeding. If a hearing is not held within the time prescribed in this Code section, the petition shall be deemed granted.

 

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 Georgia

 

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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.

 

* * *

 

-----------------------------------------------------

 

Georgia Rules and Regulations.

 

* * *

 

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

31-7-1 of the Official Code of Georgia Annotated (Regulation of Hospitals and Related

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 31-7-1 of the

Official Code of Georgia Annotated. Such facilities do not admit patients for treatment

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 Georgia.

 

(i) "Commissioner" means the Commissioner of the Department of Human Resources of

the State of Georgia.

 

(j) "Board" means the Board of Human Resources of the State of Georgia.

 

 

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 Georgia Annotated.

 

(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 31-5-1

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 Georgia, under provisions of the Georgia Dentist and Dental Hygienists Act, Chapter

84-7, Georgia Laws, Ann.;

(p) "Podiatrist" (Chiropodist) means any person who is currently licensed to practice

podiatry (chiropody) in the State of Georgia, under provisions of the Georgia Podiatry

Act, Chapter 84-6, Georgia Laws, Ann.;

(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, Georgia Laws, Ann.;

(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 May 10, 1977, or as later revised. The permit for a single

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 Georgia without a valid permit

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 Department’s 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 Georgia. There shall be a sufficient

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 Georgia, and who shall be responsible for the direction and coordination of all

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 Georgia.

(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 Georgia Code Annotated, Chapter 88-3, and these rules and regulations.

(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, March 1, 1979, and subsequent revisions thereto.

(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

Georgia.

(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 Georgia law.

 

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 Georgia,

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 Georgia license number, as shown on the

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 March 1, 1980. This provision does not alter the

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, Ga. Dep't of Cmty. Health, Medicaid Provider Manuals, Part II: Policies and Procedures for Physician Services, ch. 900, § 904.2 (Rev. July 1, 2003) and Appendix H: Abortions, Certificate of Necessity for Abortion (DMA-311) (Feb. 24, 1998).  This information is taken from the NARAL Pro-Choice America website.]