Targeted Regulation of Abortion Providers (TRAP)
Tennessee imposes extra restrictions on abortion providers, despite the fact that all health-care providers already must comply with a variety of federal and state regulations governing health, safety, building and fire codes, and zoning requirements.
Restrictions on Where Abortion Services May Be Provided
Every abortion provider must have admitting privileges at a hospital in the same or an adjacent county. Nothing requires a hospital to grant such privileges, and no exception is made for rural areas. § 39-15-202 (h) (Enacted 2012).
Tennessee has an unconstitutional and unenforceable regulatory scheme that is uniquely imposed on abortion providers and needlessly requires them to convert their practices to mini-hospitals. These requirements included:
Any facility used to terminate a pregnancy at any stage is deemed an ambulatory surgical treatment center, and therefore, must comply with all requirements of ambulatory surgical treatment centers despite lack of medical necessity. The statute exempts only those physicians' offices that do not provide a "substantial number" of procedures. Tenn. Code Ann. § 68-11-201(3) (Enacted 1998).
Under this scheme, abortion facilities-including private physicians' offices-must comply with dozens of administrative, professional qualification, and physical-plant requirements. Tenn. Comp. R. & Regs. 1200-8-10-.01 to .14. For example, each facility must provide a mattress and pillow as well as a "at least one chair, a bedside table, [and] an over bed tray" despite the fact that there are no overnight patients. Tenn. Comp. R. & Regs. 1200-8-10-.04(20)(b)(3). Each facility must also have one or more surgical suites and the suites are required to meet the same standards as hospital operating rooms, including those using general anesthesia. Tenn. Comp. R. & Regs. 1200-8-10-.06(1)(t) - (v).
A federal court permanently enjoined enforcement of the statute against certain providers due to the vagueness of the phrase "a substantial number of abortions." Bristol Reg'l Women's Ctr., P.C. v. Tenn. Dep't of Health, No. 3:99-0465 (M.D. Tenn. Oct. 23, 2001) (order granting judgment in favor of providers in relation to vagueness of statute). Subsequently, a state court declared the statute to be unconstitutional and unenforceable in all circumstances. Tenn. Dep't of Health, v. Boyle, No. M2001-01738-COA-R3-CV, 2002 WL 31840685 (Tenn. Ct. App. Dec. 19, 2002).
Another statute imposed additional administrative requirements solely on ambulatory surgical treatment centers providing abortion care. Tenn. Code Ann. §68-11-223 (Enacted 1989). The Tennessee attorney general has concluded that certain administrative requirements imposed solely on abortion facilities were unconstitutional and unenforceable. Tenn. Op. Att'y Gen. No. 89-123 (Sept. 26, 1989).
Tennessee has an unconstitutional requirement that all second-trimester abortion services be provided in a hospital. Tenn. Code Ann. § 39-15-201(c)(2) (Enacted 1989).
The Tennessee Supreme Court struck down the second-trimester hospitalization requirement as unconstitutional under the Tennessee Constitution. Planned Parenthood of Middle Tenn. v. Sundquist, 38 S.W.3d 1 (Tenn. 2000). See also Akron v. Akron Ctr. for Reprod. Health, 462 U.S. 416 (1983) (holding second-trimester hospitalization requirement unconstitutionally burdens a woman's constitutional right to choose).
Restrictions on Who May Provide Abortion Services
Tennessee prohibits certain qualified health-care professionals from providing abortion services.
Only a physician licensed or certified by the state may provide abortion care. Tenn. Code Ann. § 39-15-201(c) (Enacted 1989).
An additional law states that no nurse practitioner or physician's assistant may write or sign a prescription for or dispense any medication or provide any procedure involving a medication whose sole purpose is to cause an abortion. Tenn. Code Ann. § 53-10-104(c) (Enacted 1994).