Bill Text: MI SB0327 | 2019-2020 | 100th Legislature | Introduced

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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) 2019-05-16 - Referred To Committee On Health Policy And Human Services [SB0327 Detail]

Download: Michigan-2019-SB0327-Introduced.html

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SENATE BILL No. 327

 

 

May 16, 2019, Introduced by Senator THEIS and referred to the Committee on Health Policy and   Human Services.

 

 

 

     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

 

2018 PA 463 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. Subject to section 16221b, 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.

 

     (xiv) Conviction of a violation of section 136 or 136a of the

 

Michigan penal code, 1931 PA 328, MCL 750.136 and 750.136a. 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).

 

     (v) A violation of section 7303a(2).

 

     (w) A violation of section 7303a(4) or (5).

 

     (x) A violation of section 7303b.

 

     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

 

sapiens 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 ___ 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.