An audit released Wednesday found state regulators were loose in their inspections of South Carolina’s three abortion clinics — not being able to provide substantive records of some annual visits, likely underreporting the actual numbers of abortions being performed, and having no standards in place to train inspectors.
The report by the Legislative Audit Council (LAC) warned the lack of follow-through by the Department of Health and Environmental Control (DHEC) could leave women’s health at risk.
“When you have a lot of different parts of the program that are not working the way they should, things can happen,” lead auditor Marcia Lindsay told South Carolina Radio Network. “So it is a concern. And it’s nothing that would be that difficult for DHEC to do.”
The audit was requested last year by eight state House GOP members led by State Rep. Tommy Stringer, R-Greer, who said they were concerned DHEC was not properly regulating South Carolina’s three existing abortion clinics under state law. Stringer has historically opposed abortions and favors limiting them where possible. Abortions can be legally performed in South Carolina clinics during the first trimester, and slightly into the second trimester provided the fetus is not “viable” outside the womb. 99 percent of all abortions occur at these clinics.
DHEC is required to inspect each facility at least once per year, but the audit noted the agency could not provide three years’ worth of required inspection results from the past 14 years. The agency could only provide 33 out of what would have been at least 42 inspection reports from 2001 to 2014, the LAC report said.
The audit also claims inspectors did not use a consistent method of inspecting each facility. In at least two visits, the inspector listed the start and end times as less than five minutes apart. In its response, DHEC said this was because the inspector would post the time they filled out the report, rather than the amount of time for the inspection. Other times, as few as three patient records were examined during a visit, less than a third of a percent of the nearly 2,000 procedures done at that clinic in the previous year. The audit recommends that inspectors take a cross-sample that would better represent the women who visit the clinic, particularly any minors who must get parental approval under state law.
The agency also likely underreported the number of abortions being performed in South Carolina, LAC officials said. “We found that over a five-year period… that there was a difference between the clinics’ total and DHEC’s data of 471 procedures that were not reported,” Lindsay said. She added auditors used DHEC’s own data to show the database was missing several hundred cases from 2009-2013.
The report also noted DHEC did not have any standards in place for training inspectors until after the audit began in October. In a response, DHEC said it was already in the process of improving its abortion oversight before auditors began looking into the agency.
“The LAC did not obtain a final product but only a snapshot of a work-in-progress,” the agency’s public health director Jamie Shuster said in a letter filed with the audit report. “DHEC continues to implement new processes as part of the plan originally proposed in June 2013 and intends to incorporate recommendations of the Audit report… into the plan.”
The audit showed the number of abortions had declined over the past five years, dropping from nearly 7,000 in 2009 to slightly more than 5,700 last year.