After an emotional public hearing, and a debate about font size, the King County Board of Health imposed a new rule on crisis pregnancy centers, many of which are faith-based, requiring them to post signs saying they’re not health care facilities.

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Facilities commonly referred to as “crisis pregnancy centers,” many of which are faith-based, will be required to post a sign telling patients they are not health-care facilities, under a new rule approved Thursday by the King County Board of Health.

After emotional public testimony, mostly against the signs, nine of 10 board members voted for the rule saying their action was meant to bring transparency and accurate information to pregnant women. Only Metropolitan King County Councilmember Kathy Lambert dissented.

“I believe women who are pregnant deserve complete, accurate and timely information about their health care and options,” said board Chairman Rod Dembowski, a King County Council member. “These centers are unregulated and are often staffed by volunteers and employees who lack medical training or licensure.”

At least eight of the pregnancy centers operate in King County, according to the feminist group Legal Voice.

A report by Legal Voice, included in the Board of Health records for the regulation, said the centers give medically inaccurate information about abortion and some don’t tell patients that they don’t provide abortions or make referrals involving abortion and contraception. The group’s report was based on visits to the centers by trained volunteer college and law students.

Employees and supporters of the centers strongly disagreed.

“That report was an absolute lie,” said Kim Triller, executive director of Care Net of Puget Sound.

“They did tell me about all options available,” said Jessica Johnson of Seattle, who said when she was pregnant more than a year ago, Care Net provided her an ultrasound and parenting classes at no cost. “Everyone knows where you can go if you want an abortion,” Johnson said.

Lambert offered similar reasoning for her dissent, saying an internet search will provide options for contraception and abortions.

Jonny Nicoli, a supporter of the centers, scoffed at the idea that the rule just required signs. “That’s the same way a powerful government oppressed the Jewish population, by putting up signs,” he said.

Board members Deborah Juarez and M. Lorena González, both Seattle City Council members, said the new requirement wouldn’t close the facilities down.

“When a woman walks in she should know ‘I’m not in a clinic,’ or ‘I’m in a facility where wonderful people are offering faith-based services,’” Juarez said.

González said the rule aims to ensure that women are not deceived by health care information given by people who are not qualified to dispense it.

The new rule requires that the pregnancy centers, also known as limited-service pregnancy centers, post a sign saying, “This facility is not a health care facility.” That sentence must be posted in 10 languages, including English, with all of the languages in 48-point type size.

Board members said they intended for the sign to be posted in entry ways or waiting areas, so that it’s readable to people.

The exact size of the sign led to debate and votes on amendments. Lambert proposed that signs should be 8.5 by 11 inches. Only Sally Bagshaw, a Seattle City Councilmember supported that amendment. “We’re fooling ourselves to think we can do it on 8-and-half by eleven,” said Dr. Bill Daniell, a board member.

The board voted that the sign should be at least 11 by 17 inches.

Failure to post a sign could lead to fines of $100 per day. Violations would be complaint-based, Dembowski said. A staff report said enforcement would cost be roughly $40,000 a year.

Pro-choice groups have been pressing for more disclosure from the pregnancy centers for years. Legal Voice and Planned Parenthood Votes Washington published a report in 2011 based on volunteer visits to several local centers in 2008 and 2009. Legal Voice said it updated the report with visits in 2016 and this year.

Dembowski said the board has been dealing with the issue for more than year, mostly on the legal aspects about the government compelling speech by the centers.

He said the rule has been reviewed and refined with attorneys considering case law and similar regulations, including one in California upheld by the Ninth Circuit Court of Appeals.

“I’m comfortable we’ve narrowly tailored the regulation to achieve a legitimate public health interest,” he said.