Alleging that they performed second-trimester abortions without proper licenses, Gov. Rick Scott's administration is moving to sanction two more Florida abortion providers --- in addition to Planned Parenthood clinics in Naples, St. Petersburg and Fort Myers already facing potential fines.
The two additional providers, Bread and Roses Well Women Care in Gainesville and Aastra Women's Center in Plantation, are not affiliated with Planned Parenthood. But both have received citations from the state on the same grounds as the three Planned Parenthood clinics.
The Florida Agency for Health Care Administration contends that all five clinics, which are licensed to perform only first-trimester abortions, performed some procedures in the second trimester.
Based on Aug. 5 monitoring visits at the Gainesville and Plantation locations, AHCA cited Bread and Roses on five counts at $500 apiece, for a total fine of $2,500, and Aastra on six counts for a total of $3,000.
Attorneys for Planned Parenthood and the two additional clinics said the allegations come down to a shifting definition of what constitutes the first trimester of pregnancy --- and that AHCA is using a new definition that measures weeks of gestation rather than weeks since the first day of a woman's last menstrual period.
In an Aug. 18 letter to Tallahassee attorney Julie Gallagher, who represents Aastra and the three Planned Parenthood clinics facing sanctions, AHCA General Counsel Stuart Williams defined the second trimester as "that portion of a pregnancy following the 12th week and extending through the 24th week of gestation."
But Gallagher, a former AHCA general counsel, said a 2006 agency rule defines the first trimester as "extending through the completion of 14 weeks of pregnancy as measured from the first day of the woman's last menstrual period," or LMP.
"The addition of the new term 'weeks of gestation' that is calculated somehow differently than 'weeks LMP' --- and is in fact some kind of different date --- is evidence that they're making it up as they go along," Gallagher said Friday.
Tallahassee attorney Bob Weiss, who represents Bread and Roses, agreed that AHCA had been conducting regular inspections based on the "14 weeks since LMP" definition for years.
"As I understand it from talking to our client, that's always the way that it's been interpreted and always the way that they maintained their records," he said. "This would appear to represent a change in position."
But Williams, in a follow-up letter to Gallagher on Aug. 19, said Planned Parenthood had "self-reported that they were performing unauthorized abortions during the second trimester" and that "AHCA has not changed its position."
In July, Scott ordered AHCA to investigate the 16 Planned Parenthood offices that perform abortions in Florida. His order followed the release of a series of undercover videos by the pro-life group Center for Medical Progress, including footage that showed a Planned Parenthood doctor discussing the disposition of fetal tissue.
The videos have touched off a political firestorm nationally, with Republican members of Congress and GOP presidential candidates threatening to cut off federal funding for Planned Parenthood facilities.
Of Florida's 16 Planned Parenthood affiliates, 13 perform first- and second-trimester abortions. The three that received citations from the state perform only first-trimester abortions.
Weiss said Bread and Roses, the Gainesville provider, will file a response to AHCA's administrative complaint next week, contesting the fines and a corrective action plan. Aastra has already done so, as have the three Planned Parenthood clinics.
Gallagher said Friday she has given AHCA notice that Planned Parenthood will challenge "this new definition, or this revolving definition" as an unadopted rule.
Gallagher also said she doesn't know why Aastra, a single clinic, "has been tagged for these similar allegations unless that's a way to refute claims that this is all political and that it's directed against Planned Parenthood."
Bread and Roses, meanwhile, had taken a key role in Florida's abortion debate before the Planned Parenthood videos surfaced in July.
In late June, the clinic joined a lawsuit challenging the constitutionality of a new state law that would require a 24-hour waiting period before women can have abortions. A Leon County circuit judge issued a temporary injunction to block the law from taking effect, and the state has appealed to the 1st District Court of Appeal.
But an AHCA spokeswoman said Friday the inspection of Bread and Roses was not in retaliation for the clinic's role in challenging the waiting-period law.
"Secretary (Liz) Dudek instructed the agency to investigate all clinics who self-reported they were performing procedures beyond the scope of their license," AHCA communications director Mallory Deason said. "After our investigation, in all instances where a facility performed abortions beyond the scope of their license, they were fined."
