Bill Text: MI HB4467 | 2017-2018 | 99th Legislature | Introduced
Bill Title: Health; abortion; performing an abortion without first determining whether there is a detectable heartbeat; prohibit except in an emergency. Amends secs. 16221, 16299, 17015 & 17515 of 1978 PA 368 (MCL 333.16221 et seq.) & adds sec. 17015b.
Spectrum: Partisan Bill (Republican 1-0)
Status: (Introduced - Dead) 2017-04-19 - Bill Electronically Reproduced 03/30/2017 [HB4467 Detail]
Download: Michigan-2017-HB4467-Introduced.html
HOUSE BILL No. 4467
March 30, 2017, Introduced by Reps. Theis, Runestad, Crawford, Lucido, Hornberger, Griffin, Farrington, Hernandez, Allor, Hoitenga, Kahle, Rendon, Cox, Calley, LaSata, Miller, Brann, Glenn, Chatfield, Barrett, Reilly, Howrylak, Alexander, Noble, Kelly, Lower, Graves, Wentworth, Albert, Tedder, Lilly, VanderWall, Whiteford and Sheppard and referred to the Committee on Health Policy.
A bill to amend 1978 PA 368, entitled
"Public health code,"
by amending sections 16221, 16299, 17015, and 17515 (MCL 333.16221,
333.16299, 333.17015, and 333.17515), section 16221 as amended by
2016 PA 379 and sections 16299, 17015, and 17515 as amended by 2012
PA 499, and by adding section 17015b.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
Sec. 16221. The department shall investigate any allegation
that 1 or more of the grounds for disciplinary subcommittee action
under this section exist, and may investigate activities related to
the practice of a health profession by a licensee, a registrant, or
an applicant for licensure or registration. The department may hold
hearings, administer oaths, and order the taking of relevant
testimony. After its investigation, the department shall provide a
copy of the administrative complaint to the appropriate
disciplinary subcommittee. The disciplinary subcommittee shall
proceed under section 16226 if it finds that 1 or more of the
following grounds exist:
(a) Except as otherwise specifically provided in this section,
a violation of general duty, consisting of negligence or failure to
exercise due care, including negligent delegation to or supervision
of employees or other individuals, whether or not injury results,
or any conduct, practice, or condition that impairs, or may impair,
the ability to safely and skillfully engage in the practice of the
health profession.
(b) Personal disqualifications, consisting of 1 or more of the
following:
(i) Incompetence.
(ii) Subject to sections 16165 to 16170a, substance use
disorder as defined in section 100d of the mental health code, 1974
PA 258, MCL 330.1100d.
(iii) Mental or physical inability reasonably related to and
adversely affecting the licensee's or registrant's ability to
practice in a safe and competent manner.
(iv) Declaration of mental incompetence by a court of
competent jurisdiction.
(v) Conviction of a misdemeanor punishable by imprisonment for
a maximum term of 2 years; conviction of a misdemeanor involving
the illegal delivery, possession, or use of a controlled substance;
or conviction of any felony other than a felony listed or described
in another subparagraph of this subdivision. A certified copy of
the court record is conclusive evidence of the conviction.
(vi) Lack of good moral character.
(vii) Conviction of a criminal offense under section 520e or
520g of the Michigan penal code, 1931 PA 328, MCL 750.520e and
750.520g. A certified copy of the court record is conclusive
evidence of the conviction.
(viii) Conviction of a violation of section 492a of the
Michigan penal code, 1931 PA 328, MCL 750.492a. A certified copy of
the court record is conclusive evidence of the conviction.
(ix) Conviction of a misdemeanor or felony involving fraud in
obtaining or attempting to obtain fees related to the practice of a
health profession. A certified copy of the court record is
conclusive evidence of the conviction.
(x) Final adverse administrative action by a licensure,
registration, disciplinary, or certification board involving the
holder of, or an applicant for, a license or registration regulated
by another state or a territory of the United States, by the United
States military, by the federal government, or by another country.
A certified copy of the record of the board is conclusive evidence
of the final action.
(xi) Conviction of a misdemeanor that is reasonably related to
or that adversely affects the licensee's or registrant's ability to
practice in a safe and competent manner. A certified copy of the
court record is conclusive evidence of the conviction.
(xii) Conviction of a violation of section 430 of the Michigan
penal code, 1931 PA 328, MCL 750.430. A certified copy of the court
record is conclusive evidence of the conviction.
(xiii) Conviction of a criminal offense under section 83, 84,
316, 317, 321, 520b, 520c, 520d, or 520f of the Michigan penal
code, 1931 PA 328, MCL 750.83, 750.84, 750.316, 750.317, 750.321,
750.520b, 750.520c, 750.520d, and 750.520f. A certified copy of the
court record is conclusive evidence of the conviction.
(c) Prohibited acts, consisting of 1 or more of the following:
(i) Fraud or deceit in obtaining or renewing a license or
registration.
(ii) Permitting a license or registration to be used by an
unauthorized person.
(iii) Practice outside the scope of a license.
(iv) Obtaining, possessing, or attempting to obtain or possess
a controlled substance as defined in section 7104 or a drug as
defined in section 7105 without lawful authority; or selling,
prescribing, giving away, or administering drugs for other than
lawful diagnostic or therapeutic purposes.
(d) Except as otherwise specifically provided in this section,
unethical business practices, consisting of 1 or more of the
following:
(i) False or misleading advertising.
(ii) Dividing fees for referral of patients or accepting
kickbacks on medical or surgical services, appliances, or
medications purchased by or in behalf of patients.
(iii) Fraud or deceit in obtaining or attempting to obtain
third party reimbursement.
(e) Except as otherwise specifically provided in this section,
unprofessional conduct, consisting of 1 or more of the following:
(i) Misrepresentation to a consumer or patient or in obtaining
or attempting to obtain third party reimbursement in the course of
professional practice.
(ii) Betrayal of a professional confidence.
(iii) Promotion for personal gain of an unnecessary drug,
device, treatment, procedure, or service.
(iv) Either of the following:
(A) A requirement by a licensee other than a physician or a
registrant that an individual purchase or secure a drug, device,
treatment, procedure, or service from another person, place,
facility, or business in which the licensee or registrant has a
financial interest.
(B) A referral by a physician for a designated health service
that violates 42 USC 1395nn or a regulation promulgated under that
section. For purposes of this subdivision, 42 USC 1395nn and the
regulations promulgated under that section as they exist on June 3,
2002 are incorporated by reference. A disciplinary subcommittee
shall apply 42 USC 1395nn and the regulations promulgated under
that section regardless of the source of payment for the designated
health service referred and rendered. If 42 USC 1395nn or a
regulation promulgated under that section is revised after June 3,
2002, the department shall officially take notice of the revision.
Within 30 days after taking notice of the revision, the department
shall decide whether or not the revision pertains to referral by
physicians for designated health services and continues to protect
the public from inappropriate referrals by physicians. If the
department decides that the revision does both of those things, the
department may promulgate rules to incorporate the revision by
reference. If the department does promulgate rules to incorporate
the revision by reference, the department shall not make any
changes to the revision. As used in this sub-subparagraph,
"designated health service" means that term as defined in 42 USC
1395nn and the regulations promulgated under that section and
"physician" means that term as defined in sections 17001 and 17501.
(v) For a physician who makes referrals under 42 USC 1395nn or
a regulation promulgated under that section, refusing to accept a
reasonable proportion of patients eligible for Medicaid and
refusing to accept payment from Medicaid or Medicare as payment in
full for a treatment, procedure, or service for which the physician
refers the individual and in which the physician has a financial
interest. A physician who owns all or part of a facility in which
he or she provides surgical services is not subject to this
subparagraph if a referred surgical procedure he or she performs in
the facility is not reimbursed at a minimum of the appropriate
Medicaid or Medicare outpatient fee schedule, including the
combined technical and professional components.
(vi) Any conduct by a health professional with a patient while
he or she is acting within the health profession for which he or
she is licensed or registered, including conduct initiated by a
patient or to which the patient consents, that is sexual or may
reasonably be interpreted as sexual, including, but not limited to,
sexual intercourse, kissing in a sexual manner, or touching of a
body part for any purpose other than appropriate examination,
treatment, or comfort.
(vii) Offering to provide practice-related services, such as
drugs, in exchange for sexual favors.
(f) Failure to notify under section 16222(3) or (4).
(g) Failure to report a change of name or mailing address as
required in section 16192.
(h) A violation, or aiding or abetting in a violation, of this
article or of a rule promulgated under this article.
(i) Failure to comply with a subpoena issued pursuant to this
part, failure to respond to a complaint issued under this article,
article 7, or article 8, failure to appear at a compliance
conference or an administrative hearing, or failure to report under
section 16222(1) or 16223.
(j) Failure to pay an installment of an assessment levied
under the insurance code of 1956, 1956 PA 218, MCL 500.100 to
500.8302, within 60 days after notice by the appropriate board.
(k) A violation of section 17013 or 17513.
(l) Failure to meet 1 or more of the requirements for
licensure or registration under section 16174.
(m) A violation of section 17015, 17015a, 17015b, 17017,
17515, or 17517.
(n) A violation of section 17016 or 17516.
(o) Failure to comply with section 9206(3).
(p) A violation of section 5654 or 5655.
(q) A violation of section 16274.
(r) A violation of section 17020 or 17520.
(s) A violation of the medical records access act, 2004 PA 47,
MCL 333.26261 to 333.26271.
(t) A violation of section 17764(2).
(u) Failure to comply with the terms of a practice agreement
described in section 17047(2)(a) or (b), 17547(2)(a) or (b), or
18047(2)(a) or (b).
Sec. 16299. (1) Except as otherwise provided in subsection
(2), a person who violates or aids or abets another in a violation
of this article, other than those matters described in sections
16294 and 16296, is guilty of a misdemeanor punishable as follows:
(a) For the first offense, by imprisonment for not more than
90 days, or a fine of not more than $100.00, or both.
(b) For the second or subsequent offense, by imprisonment for
not less than 90 days nor more than 6 months, or a fine of not less
than $200.00 nor more than $500.00, or both.
(2) Subsection (1) does not apply to a violation of section
17015, 17015a, 17015b, 17017, 17515, or 17517.
Sec. 17015. (1) Subject to subsection (10), a physician shall
not perform an abortion otherwise permitted by law without the
patient's informed written consent, given freely and without
coercion to abort.
(2)
For purposes of this section and section sections 17015a
and 17015b:
(a) "Abortion" means the intentional use of an instrument,
drug, or other substance or device to terminate a woman's pregnancy
for a purpose other than to increase the probability of a live
birth, to preserve the life or health of the child after live
birth, or to remove a fetus that has died as a result of natural
causes, accidental trauma, or a criminal assault on the pregnant
woman. Abortion does not include the use or prescription of a drug
or device intended as a contraceptive or any medical treatment of a
woman who is experiencing a miscarriage or has been diagnosed with
an extrauterine pregnancy.
(b) "Coercion to abort" means an act committed with the intent
to
coerce an individual to have an abortion, which act is as
prohibited by section 213a of the Michigan penal code, 1931 PA 328,
MCL 750.213a.
(c) "Domestic violence" means that term as defined in section
1 of 1978 PA 389, MCL 400.1501.
(d)
"Fetus" means an individual organism of the species homo
Homo sapiens in utero.
(e) "Local health department representative" means a person
who meets 1 or more of the licensing requirements listed in
subdivision (h) and who is employed by, or under contract to
provide services on behalf of, a local health department.
(f)
"Medical emergency" means that a condition which, that, on
the
basis of the physician's good faith good-faith clinical
judgment, so complicates the medical condition of a pregnant woman
as to necessitate the immediate abortion of her pregnancy to avert
her death or for which a delay will create serious risk of
substantial and irreversible impairment of a major bodily function.
(g) "Medical service" means the provision of a treatment,
procedure, medication, examination, diagnostic test, assessment, or
counseling, including, but not limited to, a pregnancy test,
ultrasound, pelvic examination, or an abortion.
(h) "Qualified person assisting the physician" means another
physician or a physician's assistant licensed under this part or
part 175, a fully licensed or limited licensed psychologist
licensed under part 182, a professional counselor licensed under
part 181, a registered professional nurse or a licensed practical
nurse licensed under part 172, or a social worker licensed under
part 185.
(i) "Probable gestational age of the fetus" means the
gestational age of the fetus at the time an abortion is planned to
be performed.
(j) "Provide the patient with a physical copy" means
confirming that the patient accessed the internet website described
in subsection (5) and received a printed valid confirmation form
from the website and including that form in the patient's medical
record or giving a patient a copy of a required document by 1 or
more of the following means:
(i) In person.
(ii) By registered mail, return receipt requested.
(iii) By parcel delivery service that requires the recipient
to provide a signature in order to receive delivery of a parcel.
(iv) By facsimile transmission.
(3) Subject to subsection (10), a physician or a qualified
person
assisting the physician shall must
do all of the following
not less than 24 hours before that physician performs an abortion
upon a patient who is a pregnant woman:
(a) Confirm that, according to the best medical judgment of a
physician, the patient is pregnant, and determine the probable
gestational age of the fetus.
(b) Orally describe, in language designed to be understood by
the patient, taking into account her age, level of maturity, and
intellectual capability, each of the following:
(i) The probable gestational age of the fetus she is carrying.
(ii) Information about what to do and whom to contact should
medical complications arise from the abortion.
(iii) Information about how to obtain pregnancy prevention
information
through the department of community health and human
services.
(c) Provide the patient with a physical copy of the written
standardized summary described in subsection (11)(b) that
corresponds to the procedure the patient will undergo and is
provided
by the department of community health and human services.
If the procedure has not been recognized by the department of
health and human services, but is otherwise allowed under Michigan
law, and the department of health and human services has not
provided a written standardized summary for that procedure, the
physician shall develop and provide a written summary that
describes the procedure, any known risks or complications of the
procedure, and risks associated with live birth and meets the
requirements
of subsection (11)(b)(iii) through
to (vii).
(d) Provide the patient with a physical copy of a medically
accurate depiction, illustration, or photograph and description of
a
fetus supplied by the department of community health pursuant to
health and human services under subsection (11)(a) at the
gestational age nearest the probable gestational age of the
patient's fetus.
(e) Provide the patient with a physical copy of the prenatal
care and parenting information pamphlet distributed by the
department
of community health and
human services under section
9161.
(f) Provide the patient with a physical copy of the
prescreening summary on prevention of coercion to abort described
in subsection (11)(i).
(4) The requirements of subsection (3) may be fulfilled by the
physician or a qualified person assisting the physician at a
location other than the health facility where the abortion is to be
performed. The requirement of subsection (3)(a) that a patient's
pregnancy be confirmed may be fulfilled by a local health
department under subsection (18). The requirements of subsection
(3) cannot be fulfilled by the patient accessing an internet
website other than the internet website that is maintained and
operated by the department of health and human services under
subsection (11)(g).
(5)
The requirements of subsection (3)(c) through to (f)
may
be fulfilled by a patient accessing the internet website that is
maintained and operated by the department of health and human
services under subsection (11)(g) and receiving a printed, valid
confirmation form from the website that the patient has reviewed
the
information required in subsection (3)(c) through to (f)
at
least 24 hours before an abortion being performed on the patient.
The
website shall must not require any information be supplied by
the patient. The department of health and human services shall not
track, compile, or otherwise keep a record of information that
would identify a patient who accesses this website. The patient
shall supply the valid confirmation form to the physician or
qualified person assisting the physician to be included in the
patient's medical record to comply with this subsection.
(6) Subject to subsection (10), before obtaining the patient's
signature on the acknowledgment and consent form described in
subsection (11)(c), a physician personally and in the presence of
the
patient shall must do all of the following:
(a) Provide the patient with the physician's name, confirm
with the patient that the coercion to abort screening required
under section 17015a was performed, and inform the patient of her
right to withhold or withdraw her consent to the abortion at any
time before performance of the abortion.
(b) Orally describe, in language designed to be understood by
the patient, taking into account her age, level of maturity, and
intellectual capability, each of the following:
(i) The specific risk, if any, to the patient of the
complications that have been associated with the procedure the
patient will undergo, based on the patient's particular medical
condition and history as determined by the physician.
(ii) The specific risk of complications, if any, to the
patient if she chooses to continue the pregnancy based on the
patient's particular medical condition and history as determined by
a physician.
(7) To protect a patient's privacy, the information set forth
in
subsection (3) and subsection (6) shall must not be disclosed to
the patient in the presence of another patient.
(8) If at any time before the performance of an abortion, a
patient undergoes an ultrasound examination, or a physician
determines that ultrasound imaging will be used during the course
of a patient's abortion, the physician or qualified person
assisting the physician shall provide the patient with the
opportunity to view or decline to view an active ultrasound image
of the fetus, and offer to provide the patient with a physical
picture of the ultrasound image of the fetus before the performance
of the abortion. After the expiration of the 24-hour period
prescribed under subsection (3) but before performing an abortion
on a patient who is a pregnant woman, a physician or a qualified
person
assisting the physician shall must
do all of the following:
(a) Obtain the patient's signature on the acknowledgment and
consent form described in subsection (11)(c) confirming that she
has received the information required under subsection (3).
(b) Provide the patient with a physical copy of the signed
acknowledgment and consent form described in subsection (11)(c).
(c) Retain a copy of the signed acknowledgment and consent
form described in subsection (11)(c) and, if applicable, a copy of
the pregnancy certification form completed under subsection
(18)(b), in the patient's medical record.
(9) This subsection does not prohibit notifying the patient
that payment for medical services will be required or that
collection of payment in full for all medical services provided or
planned may be demanded after the 24-hour period described in this
subsection has expired. A physician or an agent of the physician
shall not collect payment, in whole or in part, for a medical
service provided to or planned for a patient before the expiration
of 24 hours from the time the patient has done either or both of
the following, except in the case of a physician or an agent of a
physician receiving capitated payments or under a salary
arrangement for providing those medical services:
(a) Inquired about obtaining an abortion after her pregnancy
is confirmed and she has received from that physician or a
qualified person assisting the physician the information required
under subsection (3)(c) and (d).
(b) Scheduled an abortion to be performed by that physician.
(10) If the attending physician, utilizing his or her
experience, judgment, and professional competence, determines that
a medical emergency exists and necessitates performance of an
abortion before the requirements of subsections (1), (3), and (6)
can be met, the physician is exempt from the requirements of
subsections (1), (3), and (6), may perform the abortion, and shall
maintain a written record identifying with specificity the medical
factors upon which the determination of the medical emergency is
based.
(11)
The department of community health and human services
shall do each of the following:
(a) Produce medically accurate depictions, illustrations, or
photographs of the development of a human fetus that indicate by
scale the actual size of the fetus at 2-week intervals from the
fourth week through the twenty-eighth week of gestation. Each
depiction,
illustration, or photograph shall must be accompanied by
a printed description, in nontechnical English, Arabic, and
Spanish, of the probable anatomical and physiological
characteristics of the fetus at that particular state of
gestational development.
(b) Subject to subdivision (e), develop, draft, and print, in
nontechnical English, Arabic, and Spanish, written standardized
summaries, based upon the various medical procedures used to abort
pregnancies, that do each of the following:
(i) Describe, individually and on separate documents, those
medical procedures used to perform abortions in this state that are
recognized by the department of health and human services.
(ii) Identify the physical complications that have been
associated with each procedure described in subparagraph (i) and
with live birth, as determined by the department of health and
human services. In identifying these complications, the department
of health and human services shall consider the annual statistical
report required under section 2835, and shall consider studies
concerning complications that have been published in a peer review
medical journal, with particular attention paid to the design of
the
study, and shall consult with the federal centers Centers for
disease
control Disease Control and prevention, Prevention, the
American
congress Congress of obstetricians Obstetricians and
gynecologists,
Gynecologists, the Michigan state medical society,
State Medical Society, or any other source that the department of
health and human services determines appropriate for the purpose.
(iii) State that as the result of an abortion, some women may
experience depression, feelings of guilt, sleep disturbance, loss
of interest in work or sex, or anger, and that if these symptoms
occur and are intense or persistent, professional help is
recommended.
(iv) State that not all of the complications listed in
subparagraph (ii) may pertain to that particular patient and refer
the patient to her physician for more personalized information.
(v) Identify services available through public agencies to
assist the patient during her pregnancy and after the birth of her
child, should she choose to give birth and maintain custody of her
child.
(vi) Identify services available through public agencies to
assist the patient in placing her child in an adoptive or foster
home, should she choose to give birth but not maintain custody of
her child.
(vii) Identify services available through public agencies to
assist the patient and provide counseling should she experience
subsequent adverse psychological effects from the abortion.
(c) Develop, draft, and print, in nontechnical English,
Arabic, and Spanish, an acknowledgment and consent form that
includes only the following language above a signature line for the
patient:
"I, _____________________________ , voluntarily and willfully
hereby authorize Dr. __________________ ("the physician") and any
assistant designated by the physician to perform upon me the
following operation(s) or procedure(s):
__________________________________________________________
(Name of operation(s) or procedure(s))
__________________________________________________________
A. I understand that I am approximately _____ weeks pregnant.
I consent to an abortion procedure to terminate my pregnancy. I
understand that I have the right to withdraw my consent to the
abortion procedure at any time before performance of that
procedure.
B. I understand that it is illegal for anyone to coerce me
into seeking an abortion.
C. I acknowledge that at least 24 hours before the scheduled
abortion I have received a physical copy of each of the following:
1. A medically accurate depiction, illustration, or photograph
of a fetus at the probable gestational age of the fetus I am
carrying.
2. A written description of the medical procedure that will be
used to perform the abortion.
3. A prenatal care and parenting information pamphlet.
D. If any of the documents listed in paragraph C were
transmitted by facsimile, I certify that the documents were clear
and legible.
E. I acknowledge that the physician who will perform the
abortion has orally described all of the following to me:
1. The specific risk to me, if any, of the complications that
have been associated with the procedure I am scheduled to undergo.
2. The specific risk to me, if any, of the complications if I
choose to continue the pregnancy.
F. I acknowledge that I have received all of the following
information:
1. Information about what to do and whom to contact in the
event that complications arise from the abortion.
2. Information pertaining to available pregnancy related
services.
G. I have been given an opportunity to ask questions about the
operation(s) or procedure(s).
H. I certify that I have not been required to make any
payments for an abortion or any medical service before the
expiration of 24 hours after I received the written materials
listed in paragraph C, or 24 hours after the time and date listed
on the confirmation form if the information described in paragraph
C
was viewed from the state of Michigan internet website.".website.
I. If an ultrasound procedure was performed upon me, I certify
that I was offered the opportunity to view, or decline to view, an
active ultrasound image of the fetus or receive a physical picture
of the ultrasound image of the fetus that I am carrying.
J. I certify that a fetal heartbeat (check 1) ___ has ___ has
not been detected. If a fetal heartbeat has not been detected, I
certify that I have been informed about the probability of
maintaining the pregnancy.".
(d) Make available to physicians through the Michigan board of
medicine and the Michigan board of osteopathic medicine and
surgery, and to any person upon request, the copies of medically
accurate depictions, illustrations, or photographs described in
subdivision (a), the written standardized summaries described in
subdivision (b), the acknowledgment and consent form described in
subdivision (c), the prenatal care and parenting information
pamphlet described in section 9161, the pregnancy certification
form described in subdivision (f), and the materials regarding
coercion to abort described in subdivision (i).
(e)
The department shall not develop In developing the written
standardized summaries for abortion procedures under subdivision
(b), that
utilize include in the
summaries only medication that has
not
been approved by the United States food
Food and drug
administration
Drug Administration for use in performing an
abortion.
(f) Develop, draft, and print a certification form to be
signed by a local health department representative at the time and
place a patient has a pregnancy confirmed, as requested by the
patient, verifying the date and time the pregnancy is confirmed.
(g) Develop, operate, and maintain an internet website that
allows a patient considering an abortion to review the information
required
in subsection (3)(c) through to
(f). After the patient
reviews
the required information, the department shall assure
ensure that a confirmation form can be printed by the patient from
the internet website that will verify the time and date the
information was reviewed. A confirmation form printed under this
subdivision becomes invalid 14 days after the date and time printed
on the confirmation form.
(h) Include on the informed consent internet website operated
under subdivision (g) a list of health care providers, facilities,
and clinics that offer to perform ultrasounds free of charge. The
list
shall must be organized geographically and shall must include
the name, address, and telephone number of each health care
provider, facility, and clinic.
(i) After considering the standards and recommendations of the
joint
commission Joint Commission on accreditation Accreditation of
healthcare
organizations, Healthcare
Organizations, the Michigan
domestic and sexual violence prevention and treatment board, the
Michigan
coalition Coalition to end domestic End Domestic and
sexual
violence Sexual Violence or successor organization, and the
American
medical association, Medical
Association, do all of the
following:
(i) Develop, draft, and print or make available in printable
format, in nontechnical English, Arabic, and Spanish, a notice that
is required to be posted in facilities and clinics under section
17015a.
The notice shall must be at least 8-1/2 inches by 14
inches,
shall must be printed in at least 44-point type, and shall
must contain at a minimum all of the following:
(A) A statement that it is illegal under Michigan law to
coerce a woman to have an abortion.
(B) A statement that help is available if a woman is being
threatened or intimidated; is being physically, emotionally, or
sexually harmed; or feels afraid for any reason.
(C) The telephone number of at least 1 domestic violence
hotline and 1 sexual assault hotline.
(ii) Develop, draft, and print or make available in printable
format, in nontechnical English, Arabic, and Spanish, a
prescreening summary on prevention of coercion to abort that, at a
minimum, contains the information required under subparagraph (i)
and notifies the patient that an oral screening for coercion to
abort will be conducted before her giving written consent to obtain
an abortion.
(iii) Develop, draft, and print screening and training tools
and accompanying training materials to be utilized by a physician
or qualified person assisting the physician while performing the
coercion to abort screening required under section 17015a. The
screening
tools shall must instruct the physician or qualified
person assisting the physician to orally communicate information to
the patient regarding coercion to abort and to document the
findings from the coercion to abort screening in the patient's
medical record.
(iv) Develop, draft, and print protocols and accompanying
training materials to be utilized by a physician or a qualified
person assisting the physician if a patient discloses coercion to
abort or that domestic violence is occurring, or both, during the
coercion
to abort screening. The protocols shall must instruct the
physician or qualified person assisting the physician to do, at a
minimum, all of the following:
(A) Follow the requirements of section 17015a as applicable.
(B) Assess the patient's current level of danger.
(C) Explore safety options with the patient.
(D) Provide referral information to the patient regarding law
enforcement and domestic violence and sexual assault support
organizations.
(E) Document any referrals in the patient's medical record.
(12) A physician's duty to inform the patient under this
section does not require disclosure of information beyond what a
reasonably well-qualified physician licensed under this article
would possess.
(13) A written consent form meeting the requirements set forth
in this section and signed by the patient is presumed valid. The
presumption created by this subsection may be rebutted by evidence
that establishes, by a preponderance of the evidence, that consent
was obtained through fraud, negligence, deception,
misrepresentation, coercion, or duress.
(14) A completed certification form described in subsection
(11)(f) that is signed by a local health department representative
is presumed valid. The presumption created by this subsection may
be rebutted by evidence that establishes, by a preponderance of the
evidence, that the physician who relied upon the certification had
actual knowledge that the certificate contained a false or
misleading statement or signature.
(15) This section does not create a right to abortion.
(16) Notwithstanding any other provision of this section, a
person shall not perform an abortion that is prohibited by law.
(17) If any portion of this act or the application of this act
to any person or circumstances is found invalid by a court, that
invalidity does not affect the remaining portions or applications
of the act that can be given effect without the invalid portion or
application, if those remaining portions are not determined by the
court to be inoperable.
(18)
Upon a patient's request, each a
local health department
shall comply with the following:
(a) Provide a pregnancy test for that patient to confirm the
pregnancy as required under subsection (3)(a) and determine the
probable gestational stage of the fetus. The local health
department need not comply with this subdivision if the
requirements of subsection (3)(a) have already been met.
(b) If a pregnancy is confirmed, ensure that the patient is
provided with a completed pregnancy certification form described in
subsection (11)(f) at the time the information is provided.
(19) The identity and address of a patient who is provided
information
or who consents to an abortion pursuant to under this
section is confidential and is subject to disclosure only with the
consent of the patient or by judicial process.
(20) A local health department with a file containing the
identity and address of a patient described in subsection (19) who
has been assisted by the local health department under this section
shall do both of the following:
(a) Only release the identity and address of the patient to a
physician or qualified person assisting the physician in order to
verify the receipt of the information required under this section.
(b) Destroy the information containing the identity and
address of the patient within 30 days after assisting the patient
under this section.
Sec. 17015b. (1) Except when a medical emergency exists that
prevents compliance with this section, a physician shall not
perform an abortion on a pregnant woman before determining, in
accordance with standard medical practice, whether a fetal
heartbeat is detectable in the fetus the pregnant woman is
carrying. An individual who performs an abortion in a medical
emergency without determining whether the fetus has a detectable
heartbeat shall note in the pregnant woman's medical record the
specific nature of the medical emergency that existed. Compliance
with this section does not require the use of an intravaginal
diagnostic procedure.
(2) If during the examination required under subsection (1) a
fetal heartbeat is detected, the physician or a qualified person
assisting the physician shall offer to the pregnant woman the
option of hearing or seeing evidence of the fetal heartbeat.
(3) If the examination required under subsection (1) does not
detect a fetal heartbeat, the physician or a qualified person
assisting the physician shall do all of the following that apply:
(a) Inform the pregnant woman of the probability of
maintaining the pregnancy versus experiencing a miscarriage, given
the absence of a detectable fetal heartbeat, the state of
pregnancy, and other factors known to affect the possibility of a
miscarriage.
(b) Inform the pregnant woman whether an additional option for
detecting the fetal heartbeat is available, including, but not
limited to, an additional diagnostic procedure that could be
performed immediately, or an additional diagnostic procedure that
could be delayed until a later date, to determine if the fetus is
physically developing.
(c) If the fetus has been visibly identified but is not
exhibiting a heartbeat or other signs of physical activity, advise
the pregnant woman that a procedure to remove a fetus that has died
is not considered an abortion under law and inform the pregnant
woman of the relative risks and benefits of different means of
terminating the pregnancy, including medical inducement, a surgical
procedure, or allowing a miscarriage to occur spontaneously.
Sec. 17515. A physician, before performing an abortion on a
patient,
shall comply with sections 17015 and 17015a.to 17015b.
Enacting section 1. This amendatory act takes effect 90 days
after the date it is enacted into law.
