While those in public health have long known crisis pregnancy centers (CPCs) fail to offer medically sound care, a new rule in King County, Washington, aims to make that clear to the general public.

The rule, approved Thursday by the King County Board of Health, requires the anti-abortion facilities to prominently display, in ads and on site, a disclaimer saying: “This facility is not a health care facility.”

The rule comes as Hawaii this month became the latest state to require limited service pregnancy centers, commonly called CPCs or fake clinics, to display a notice describing state programs that offer comprehensive reproductive health care. California passed a similar law in 2015.

Fake clinics are typically religiously run nonprofits, and their staff are known to peddle mistruths and engage in emotional arm twisting to discourage people from ending their pregnancies, according to peer-reviewed research and both federal and independent investigations.

The King County rule was prompted by a two-year investigation of fake clinics by Legal Voice, a women’s rights advocacy group, and Planned Parenthood Votes Washington. Of the 20 CPCs volunteers called or visited, 19 provided false and misleading information about pregnancy, abortion care, and miscarriage, and dispensed medically inaccurate information about contraception and STI prevention. And while that investigation was conducted in 2008 and 2009, Legal Voice recently found that CPCs are continuing to masquerade as medical facilities. Legal Voice found that some collected women’s complete medical histories and all or part of their social security numbers.

Collecting social security numbers is troubling given a recent case in Hawaii, where a young woman had her attorney send a cease-and-desist letter to a CPC to stop the facility from sharing information she’d disclosed during her visit, as Rewire reported.

“When people think they’re going to health care facilities, and they’re not going to actual health care facilities, it’s a problem,” Sara Ainsworth, advocacy director with Legal Voice, told Rewire. Compounding the issue, she said, is that people believe the information they’re getting is medically accurate, when it’s not.

There are around 66 fake clinics in Washington and between seven and nine in King County, Ainsworth said. 

Board of Health Chair Rod Dembowski, the rule’s sponsor, said it was narrowly tailored to achieve a “legitimate public health interest.”

The notice must be translated into the county’s ten most common languages. Violators of the new regulation face fines of up to $100 a day.

Opponents called the Legal Voice report a “lie” and argued the facilities are an exercise of their faith and the signs are government-compelled speech. “That’s the same way a powerful government oppressed the Jewish population, by putting up signs,” said Jonny Nicoli, a supporter of the fake clinics, as the Seattle Times reported.

If history is a guide, a legal challenge is likely. A fake clinic and a prominent anti-choice organization sued last week to block Hawaii’s law, and anti-choice groups filed at least five lawsuits to stop California’s reproductive disclosure law, which they call a “bully bill.” The Ninth Circuit Court of Appeals upheld the constitutionality of the California law last year. Opponents are appealing the decision to the U.S. Supreme Court.

In Illinois, a federal court on Wednesday blocked a state law that requires fake clinics and doctors opposed to abortion rights to furnish a list of providers “they reasonably believe may offer” terminations if the patient requests it.