Bill Text: NJ A4350 | 2022-2023 | Regular Session | Introduced
Bill Title: Stengthens access to reproductive health care; appropriates $20 million.
Spectrum: Partisan Bill (Democrat 11-0)
Status: (Introduced - Dead) 2022-06-20 - Introduced, Referred to Assembly Health Committee [A4350 Detail]
Download: New_Jersey-2022-A4350-Introduced.html
Sponsored by:
Assemblywoman MILA M. JASEY
District 27 (Essex and Morris)
Assemblywoman SHANIQUE SPEIGHT
District 29 (Essex)
SYNOPSIS
Strengthens access to reproductive health care; appropriates $20 million.
CURRENT VERSION OF TEXT
As introduced.
An Act concerning reproductive rights; supplementing, amending, and repealing various parts of the statutory law; and making an appropriation.
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. (New section) As used in P.L.2021, c.375 and P.L. , c. (C. ) (pending before the Legislature as this bill):
"Abortion" means any medical treatment intended to induce the termination of pregnancy except for the purpose of producing a live birth. Abortion includes, but is not limited to, "medication abortion" and "early aspiration abortion" as defined in this section.
"Advanced practice clinician" means an advanced practice nurse licensed pursuant to P.L.1991, c.377 (C.45:11-45 et seq.); a physician assistant licensed pursuant to P.L.1991, c.378 (C.45:9-27.10 et seq.); a certified nurse midwife; and a certified midwife licensed pursuant to R.S.45:10-1 et seq.
"Early aspiration abortion" means a procedure that terminates a pregnancy in the first trimester of pregnancy, utilizing manual or electric suction to empty the uterus.
"First trimester of pregnancy" means the period of up to 14 completed weeks as calculated by an estimate of gestational age that utilizes the last menstrual period, ultrasound, physical examination, or any combination thereof as appropriate to the standard of care.
"Health care professional" means a person who is licensed or otherwise authorized to provide health care services, pursuant to Title 45 of the Revised Statutes, including, but not limited to, a physician, advance practice nurse, physician assistant, certified midwife, or certified nurse midwife.
"Medical abortion" means the use, prescription, order, dispensing, administration, or any combination thereof as applicable, of a medication or a combination of medications to induce termination of pregnancy.
"Practical support" means direct assistance to enable a person to obtain services related to the termination of a pregnancy including, but not limited to, ground and air transportation, gas money, lodging, meals, child care, translation services, doula support, and assistance related to shipping and handling of medications related to abortion care.
"Pregnancy" means the period of the human reproductive process beginning with the implantation of a fertilized egg.
"Public entity" means the State and any county, municipality, district, public authority, public agency, or other political subdivision or public body in the State.
"Reproductive health care services" includes all medical, surgical,
counseling or referral services relating to the human reproductive
system, including, but not limited to, services relating to pregnancy,
contraception or the termination of a pregnancy.
"State" means the State and any office, department, branch, division, subdivision, bureau, board, commission, agency, instrumentality, or individual acting under color of law of the State, but shall not include any entity that is statutorily authorized to sue and be sued.
2. Section 2 of P.L.2021, c.375 (C.10:7-2) is amended to read as follows:
2. a. Every individual present in the State, including, but not limited to, an individual who is under State control or supervision, shall have the fundamental right to: choose or refuse contraception or sterilization; and choose whether to carry a pregnancy, to give birth, or to terminate a pregnancy. The New Jersey Constitution recognizes the fundamental nature of the right to reproductive choice, including the right to access contraception, to terminate a pregnancy, and to carry a pregnancy to term, shall not be abridged by any law, rule, regulation, ordinance, or order issued by any State, county, or local governmental authority. Any law, rule, regulation, ordinance, or order, in effect on or adopted after the effective date of this act, that is determined to have the effect of limiting the constitutional right to freedom of reproductive choice and that does not conform with the provisions and the express or implied purposes of this act, shall be deemed invalid and shall have no force or effect.
b. If the State provides, directly or by contract, hospital or medical benefits for pregnancy-related care through any program administered or funded in whole or in part by the State, the State also shall provide a pregnant individual otherwise eligible for the program with substantially equivalent benefits to permit the individual to voluntarily terminate the individual's pregnancy.
c. A physician or other health care professional, acting within the professional's lawful scope of practice and in compliance with all generally applicable regulations, shall be authorized to provide and assist in the provision of abortion care in this State.
d. Nothing in this act shall preclude an advanced practice clinician who is licensed, certified, or otherwise authorized by law to practice in this State from performing early aspiration abortion, providing medical abortion, or managing the spontaneous termination of pregnancy consistent with the advanced practice clinician's scope of practice and with any regulations promulgated by the applicable licensing board.
e. A public entity shall not, in regulating or providing benefits, facilities, services, or information, deny or interfere with an individual's fundamental reproductive rights pursuant to subsection a. of this section or discriminate against an individual on the basis of the individual's exercise of fundamental reproductive rights pursuant to subsection a. of this section.
f. The following rules and regulations shall be void, and be given no force or effect following the effective date of P.L. , c. (pending before the Legislature as this bill):
(1) all rules and regulations promulgated by the Department of Human Services as of the effective date of P.L. , c. (pending before the Legislature as this bill), or parts thereof, which limit coverage for abortion services based on the type of facility or health care professional that provides the services, or which are otherwise inconsistent or in conflict with the provisions or express or implied purposes of P.L.2021, c.375 (C.10:7-1 et seq.) including, but not limited to, relevant parts or subparts of N.J.A.C.10:54-5.43 and N.J.A.C.10:66-2.16; and
(2) any rules and regulations promulgated by any other State agency as of the effective date of P.L. , c (pending before the Legislature as this bill), or parts thereof, which are inconsistent or in conflict with the provisions or express or implied purposes of P.L.2021, c.375 (C.10:7-1 et seq.).
g. The provisions of this section shall be enforceable under the "New Jersey Civil Rights Act," P.L.2004, c.143 (C.10:6-1 et seq.) or in any other manner provided by law.
(cf: P.L.2021, c.375, s.2).
3. (New section) a. Each hospital service corporation contract that provides hospital or medical expense benefits and is delivered, issued, executed, or renewed in this State pursuant to P.L.1938, c.366 (C.17:48-1 et seq.) or is approved for issuance or renewal in this State by the Commissioner of Banking and Insurance, on or after the effective date of P.L. , c. (pending before the Legislature as this bill), shall provide coverage for abortion, as defined by section 1 of P.L. , c. (C. ) (pending before the Legislature as this bill).
b. A contract subject to this section shall not impose a deductible, coinsurance, copayment, or any other cost-sharing requirement on the coverage required under this section. For a qualifying high-deductible health plan for a health savings account, the hospital service corporation shall establish the plan's cost-sharing for the coverage provided pursuant to this section at the minimum level necessary to preserve the subscriber's ability to claim tax-exempt contributions and withdrawals from the subscriber's health savings account under 26 U.S.C. s.223.
c. A contract shall not impose any restrictions or delays on, and shall not require prior authorization for, the coverage required under this section.
d. Notwithstanding the provisions of subsections a. through c. of this section to the contrary, if the Commissioner of Banking and Insurance concludes that enforcement of this section may adversely affect the allocation of federal funds to this State, the commissioner may grant an exemption to the requirements of this section, but only to the minimum extent necessary to ensure the continued receipt of federal funds.
e. A religious employer may request, and a hospital service corporation shall grant, an exclusion under the contract for the coverage required by this section if the required coverage conflicts with the religious employer's bona fide religious beliefs and practices. A religious employer that obtains an exclusion shall provide written notice thereof to subscribers and prospective subscribers, and the hospital service corporation shall provide notice to the Commissioner of Banking and Insurance in such form and manner as may be determined by the commissioner. The provisions of this subsection shall not be construed as authorizing a hospital service corporation to exclude coverage for care that is necessary to preserve the life or health of a subscriber.
For the purposes of this subsection, "religious employer" means an organization that is organized and operates as a nonprofit entity and is referred to in section 6033(a)(3)(A)(i) or (iii) of the Internal Revenue Code of 1986 (26 U.S.C. s.6033), as amended.
4. (New section) a. Each medical service corporation contract that provides hospital or medical expense benefits and is delivered, issued, executed, or renewed in this State pursuant to P.L.1940, c.74 (C.17:48A-1 et seq.) or is approved for issuance or renewal in this State by the Commissioner of Banking and Insurance, on or after the effective date of P.L. , c. (pending before the Legislature as this bill), shall provide coverage for abortion, as defined by section 1 of P.L. , c. (C. ) (pending before the Legislature as this bill).
b. A contract subject to this section shall not impose a deductible, coinsurance, copayment, or any other cost-sharing requirement on the coverage required under this section. For a qualifying high-deductible health plan for a health savings account, the medical service corporation shall establish the plan's cost-sharing for the coverage provided pursuant to this section at the minimum level necessary to preserve the subscriber's ability to claim tax-exempt contributions and withdrawals from the subscriber's health savings account under 26 U.S.C. s.223.
c. A contract shall not impose any restrictions or delays on, and shall not require prior authorization for, the coverage required under this section.
d. Notwithstanding the provisions of subsections a. through c. of this section to the contrary, if the Commissioner of Banking and Insurance concludes that enforcement of this section may adversely affect the allocation of federal funds to this State, the commissioner may grant an exemption to the requirements, but only to the minimum extent necessary to ensure the continued receipt of federal funds.
e. A religious employer may request, and a medical service corporation shall grant, an exclusion under the contract for the coverage required by this section if the required coverage conflicts with the religious employer's bona fide religious beliefs and practices. A religious employer that obtains an exclusion shall provide written notice thereof to subscribers and prospective subscribers, and the medical service corporation shall provide notice to the Commissioner of Banking and Insurance in a form and manner as may be determined by the commissioner. The provisions of this subsection shall not be construed as authorizing a medical service corporation to exclude coverage for care that is necessary to preserve the life or health of a subscriber.
For the purposes of this subsection, "religious employer" means an organization that is organized and operates as a nonprofit entity and is referred to in section 6033(a)(3)(A)(i) or (iii) of the Internal Revenue Code of 1986 (26 U.S.C. s.6033), as amended.
5. (New section) a. Each health service corporation contract that provides hospital or medical expense benefits and is delivered, issued, executed, or renewed in this State pursuant to P.L.1985, c.236 (C.17:48E-1 et seq.) or is approved for issuance or renewal in this State by the Commissioner of Banking and Insurance, on or after the effective date of P.L. , c. (pending before the Legislature as this bill), shall provide coverage for abortion, as defined by section 1 of P.L. , c. (C. ) (pending before the Legislature as this bill).
b. A contract subject to this section shall not impose a deductible, coinsurance, copayment, or any other cost-sharing requirement on the coverage required under this section. For a qualifying high-deductible health plan for a health savings account, the health service corporation shall establish the plan's cost-sharing for the coverage provided pursuant to this section at the minimum level necessary to preserve the subscriber's ability to claim tax-exempt contributions and withdrawals from the subscriber's health savings account under 26 U.S.C. s.223.
c. A contract shall not impose any restrictions or delays on, and shall not require prior authorization for, the coverage required under this section.
d. Notwithstanding the provisions of subsections a. through c. of this section to the contrary, if the Commissioner of Banking and Insurance concludes that enforcement of this section may adversely affect the allocation of federal funds to this State, the commissioner may grant an exemption to the requirements, but only to the minimum extent necessary to ensure the continued receipt of federal funds.
e. A religious employer may request, and a health service corporation shall grant, an exclusion under the contract for the coverage required by this section if the required coverage conflicts with the religious employer's bona fide religious beliefs and practices. A religious employer that obtains an exclusion shall provide written notice thereof to subscribers and prospective subscribers, and the health service corporation shall provide notice to the Commissioner of Banking and Insurance in such form and manner as may be determined by the commissioner. The provisions of this subsection shall not be construed as authorizing a health service corporation to exclude coverage for care that is necessary to preserve the life or health of a subscriber.
For the purposes of this subsection, "religious employer" means an organization that is organized and operates as a nonprofit entity and is referred to in section 6033(a)(3)(A)(i) or (iii) of the Internal Revenue Code of 1986 (26 U.S.C. s.6033), as amended.
6. (New section) a. Each individual health insurance policy that provides hospital or medical expense benefits and is delivered, issued, executed, or renewed in this State pursuant to chapter 26 of Title 17B of the New Jersey Statutes or is approved for issuance or renewal in this State by the Commissioner of Banking and Insurance, on or after the effective date of P.L. , c. (pending before the Legislature as this bill), shall provide coverage for abortion, as defined by section 1 of P.L. , c. (C. ) (pending before the Legislature as this bill).
b. A policy subject to this section shall not impose a deductible, coinsurance, copayment, or any other cost-sharing requirement on the coverage required under this section. For a qualifying high-deductible health plan for a health savings account, the individual health insurer shall establish the plan's cost-sharing for the coverage provided pursuant to this section at the minimum level necessary to preserve the insured's ability to claim tax-exempt contributions and withdrawals from the insured's health savings account under 26 U.S.C. s.223.
c. A policy shall not impose any restrictions or delays on, and shall not require prior authorization for, the coverage required under this section.
d. Notwithstanding the provisions of subsections a. through c. of this section to the contrary, if the Commissioner of Banking and Insurance concludes that enforcement of this section may adversely affect the allocation of federal funds to this State, the commissioner may grant an exemption to the requirements, but only to the minimum extent necessary to ensure the continued receipt of federal funds.
e. A religious employer may request, and an individual health insurer shall grant, an exclusion under the policy for the coverage required by this section if the required coverage conflicts with the religious employer's bona fide religious beliefs and practices. A religious employer that obtains an exclusion shall provide written notice thereof to insureds and prospective insureds, and the individual health insurer shall provide notice to the Commissioner of Banking and Insurance in a form and manner as may be determined by the commissioner. The provisions of this subsection shall not be construed as authorizing an individual health insurer to exclude coverage for care that is necessary to preserve the life or health of an insured.
For the purposes of this subsection, "religious employer" means an organization that is organized and operates as a nonprofit entity and is referred to in section 6033(a)(3)(A)(i) or (iii) of the Internal Revenue Code of 1986 (26 U.S.C. s.6033), as amended.
7. (New section) a. Each group health insurance policy that provides hospital or medical expense benefits and is delivered, issued, executed, or renewed in this State pursuant to chapter 27 of Title 17B of the New Jersey Statutes or is approved for issuance or renewal in this State by the Commissioner of Banking and Insurance, on or after the effective date of P.L. , c. (pending before the Legislature as this bill), shall provide benefits for abortion, as defined by section 1 of P.L. , c. (C. ) (pending before the Legislature as this bill).
b. A policy subject to this section shall not impose a deductible, coinsurance, copayment, or any other cost-sharing requirement on the coverage required under this section. For a qualifying high-deductible health plan for a health savings account, the group health insurer shall establish the plan's cost-sharing for the coverage provided pursuant to this section at the minimum level necessary to preserve the insured's ability to claim tax-exempt contributions and withdrawals from the insured's health savings account under 26 U.S.C. s.223.
c. A policy shall not impose any restrictions or delays on, and shall not require prior authorization for, the coverage required under this section.
d. Notwithstanding the provisions of subsections a. through c. of this section to the contrary, if the Commissioner of Banking and Insurance concludes that enforcement of this section may adversely affect the allocation of federal funds to this State, the commissioner may grant an exemption to the requirements, but only to the minimum extent necessary to ensure the continued receipt of federal funds.
e. A religious employer may request, and a group health insurer shall grant, an exclusion under the policy for the coverage required by this section if the required coverage conflicts with the religious employer's bona fide religious beliefs and practices. A religious employer that obtains an exclusion shall provide written notice thereof to insureds and prospective insureds, and the group health insurer shall provide notice to the Commissioner of Banking and Insurance in a form and manner as may be determined by the commissioner. The provisions of this subsection shall not be construed as authorizing a group health insurer to exclude coverage for care that is necessary to preserve the life or health of an insured.
For the purposes of this subsection, "religious employer" means an organization that is organized and operates as a nonprofit entity and is referred to in section 6033(a)(3)(A)(i) or (iii) of the Internal Revenue Code of 1986 (26 U.S.C. s.6033), as amended.
8. (New section) a. Each individual health benefits plan that provides hospital or medical expense benefits and is delivered, issued, executed, or renewed in this State pursuant to P.L.1992, c.161 (C.17B:27A-2 et seq.) or is approved for issuance or renewal in this State by the Commissioner of Banking and Insurance, on or after the effective date of P.L. , c. (pending before the Legislature as this bill), shall provide benefits for abortion, as defined by section 1 of P.L. , c. (C. ) (pending before the Legislature as this bill).
b. A health benefits plan subject to this section shall not impose a deductible, coinsurance, copayment, or any other cost-sharing requirement on the coverage required under this section. For a qualifying high-deductible health plan for a health savings account, the carrier shall establish the plan's cost-sharing for the coverage provided pursuant to this section at the minimum level necessary to preserve the covered person's ability to claim tax-exempt contributions and withdrawals from the covered person's health savings account under 26 U.S.C. s.223.
c. A health benefits plan shall not impose any restrictions or delays on, and shall not require prior authorization for, the coverage required under this section.
d. Notwithstanding the provisions of subsections a. through c. of this section, if the Commissioner of Banking and Insurance concludes that enforcement of this section may adversely affect the allocation of federal funds to this State, the commissioner may grant an exemption to the requirements, but only to the minimum extent necessary to ensure the continued receipt of federal funds.
e. A religious employer may request, and a carrier shall grant, an exclusion under the health benefits plan for the coverage required by this section if the required coverage conflicts with the religious employer's bona fide religious beliefs and practices. A religious employer that obtains an exclusion shall provide written notice thereof to covered persons and prospective covered persons, and the carrier shall provide notice to the Commissioner of Banking and Insurance in a form and manner as may be determined by the commissioner. The provisions of this subsection shall not be construed as authorizing a carrier to exclude coverage for care that is necessary to preserve the life or health of a covered person.
For the purposes of this subsection, "religious employer" means an organization that is organized and operates as a nonprofit entity and is referred to in section 6033(a)(3)(A)(i) or (iii) of the Internal Revenue Code of 1986 (26 U.S.C. s.6033), as amended.
9. (New section) a. Each small employer health benefits plan that provides hospital or medical expense benefits and is delivered, issued, executed, or renewed in this State pursuant to P.L.1992, c.162 (C.17B:27A-17 et seq.) or is approved for issuance or renewal in this State by the Commissioner of Banking and Insurance, on or after the effective date of P.L. , c. (pending before the Legislature as this bill), shall provide benefits for abortion, as defined by section 1 of P.L. , c. (C. ) (pending before the Legislature as this bill).
b. A health benefits plan subject to this section shall not impose a deductible, coinsurance, copayment, or any other cost-sharing requirement on the coverage required under this section. For a qualifying high-deductible health plan for a health savings account, the carrier shall establish the plan's cost-sharing for the coverage provided pursuant to this section at the minimum level necessary to preserve the covered person's ability to claim tax-exempt contributions and withdrawals from the covered person's health savings account under 26 U.S.C. s.223.
c. A health benefits plan shall not impose any restrictions or delays on, and shall not require prior authorization for, the coverage required under this section.
d. Notwithstanding the provisions of subsections a. through c. of this section to the contrary, if the Commissioner of Banking and Insurance concludes that enforcement of this section may adversely affect the allocation of federal funds to this State, the commissioner may grant an exemption to the requirements, but only to the minimum extent necessary to ensure the continued receipt of federal funds.
e. A religious employer may request, and a carrier shall grant, an exclusion under the health benefits plan for the coverage required by this section if the required coverage conflicts with the religious employer's bona fide religious beliefs and practices. A religious employer that obtains an exclusion shall provide written notice thereof to covered persons and prospective covered persons, and the carrier shall provide notice to the Commissioner of Banking and Insurance in a form and manner as may be determined by the commissioner. The provisions of this subsection shall not be construed as authorizing a carrier to exclude coverage for care that is necessary to preserve the life or health of a covered person.
For the purposes of this subsection, "religious employer" means an organization that is organized and operates as a nonprofit entity and is referred to in section 6033(a)(3)(A)(i) or (iii) of the Internal Revenue Code of 1986 (26 U.S.C. s.6033), as amended.
10. (New section) a. Each health maintenance organization contract for health care services that is delivered, issued, executed, or renewed in this State pursuant to P.L.1973, c.337 (C.26:2J-1 et seq.) or is approved for issuance or renewal in this State by the Commissioner of Banking and Insurance, on or after the effective date of P.L. , c. (pending before the Legislature as this bill), shall provide health care services for abortion, as defined by section 1 of P.L. , c. (C. ) (pending before the Legislature as this bill).
b. A contract subject to this section shall not impose a deductible, coinsurance, copayment, or any other cost-sharing requirement on the coverage required under this section. For a qualifying high-deductible health plan for a health savings account, the health maintenance organization shall establish the plan's cost-sharing for the coverage provided pursuant to this section at the minimum level necessary to preserve the enrollee's ability to claim tax-exempt contributions and withdrawals from the enrollee's health savings account under 26 U.S.C. s.223.
c. A contract shall not impose any restrictions or delays on, and shall not require prior authorization for, the coverage required under this section.
d. Notwithstanding the provisions of subsections a. through c. of this section to the contrary, if the Department of Banking and Insurance concludes that enforcement of this section may adversely affect the allocation of federal funds to this State, the commissioner may grant an exemption to the requirements, but only to the minimum extent necessary to ensure the continued receipt of federal funds.
e. A religious employer may request, and a health maintenance organization shall grant, an exclusion under the contract for the coverage required by this section if the required coverage conflicts with the religious employer's bona fide religious beliefs and practices. A religious employer that obtains an exclusion shall provide written notice thereof to enrollees and prospective enrollees, and the health maintenance organization shall provide notice to the Commissioner of Banking and Insurance in a form and manner as may be determined by the commissioner. The provisions of this subsection shall not be construed as authorizing a health maintenance organization to exclude coverage for care that is necessary to preserve the life or health of an enrollee.
For the purposes of this subsection, "religious employer" means an organization that is organized and operates as a nonprofit entity and is referred to in section 6033(a)(3)(A)(i) or (iii) of the Internal Revenue Code of 1986 (26 U.S.C. s.6033), as amended.
11. (New section) a. The State Health Benefits Commission shall ensure that every contract providing hospital or medical expense benefits, which is purchased by the commission on or after the effective date of P.L. , c. (pending before the Legislature as this bill), provides coverage for abortion, as defined by section 1 of P.L. , c. (C. ) (pending before the Legislature as this bill).
b. A contract subject to this section shall not impose a deductible, coinsurance, copayment, or any other cost-sharing requirement on the coverage required under this section. For a qualifying high-deductible health plan for a health savings account, the commission shall establish the plan's cost-sharing for the coverage provided pursuant to this section at the minimum level necessary to preserve the covered person's ability to claim tax-exempt contributions and withdrawals from the covered person's health savings account under 26 U.S.C. s.223.
c. A contract shall not impose any restrictions or delays on, and shall not require prior authorization for, the coverage required under this section.
d. Notwithstanding the provisions of subsections a. through c. of this section, if the Department of Banking and Insurance concludes that enforcement of this section may adversely affect the allocation of federal funds to this State, the commissioner may grant an exemption to the requirements, but only to the minimum extent necessary to ensure the continued receipt of federal funds.
12. (New section) a. The School Employees' Health Benefits Commission shall ensure that every contract providing hospital or medical expense benefits, which is purchased by the commission on or after the effective date of P.L. , c. (pending before the Legislature as this bill), provides coverage for abortion, as defined by section 1 of P.L. , c. (C. ) (pending before the Legislature as this bill).
b. A contract subject to this section shall not impose a deductible, coinsurance, copayment, or any other cost-sharing requirement on the coverage required under this section. For a qualifying high-deductible health plan for a health savings account, the commission shall establish the plan's cost-sharing for the coverage provided pursuant to this section at the minimum level necessary to preserve the covered person's ability to claim tax-exempt contributions and withdrawals from the covered person's health savings account under 26 U.S.C. s.223.
c. A contract shall not impose any restrictions or delays on, and shall not require prior authorization for, the coverage required under this section.
d. Notwithstanding the provisions of subsections a. through c. of this section to the contrary, if the Department of Banking and Insurance concludes that enforcement of this section may adversely affect the allocation of federal funds to this State, the commissioner may grant an exemption to the requirements, but only to the minimum extent necessary to ensure the continued receipt of federal funds.
13. Section 1 of P.L.1965, c.217 (C.9:17A-1) is amended to read as follows:
1. The consent to the performance of medical or surgical care and [procedure] procedures by a hospital or by a [physician licensed to practice medicine and surgery] health care professional, as defined by section 1 of P.L. , c. (C. ) (pending before the Legislature as this bill), which consent is executed by a married person who is a minor, or by a pregnant [woman] person who is a minor, on [his or her] the minor's behalf or on behalf of any of [his or her] the minor's children, shall be valid and binding, and, for such purposes, a married person who is a minor or a pregnant [woman] person who is a minor shall be deemed to have the same legal capacity to act and shall have the same powers and obligations as [has] a person of legal age. Notwithstanding any other provision of the law, an unmarried, pregnant minor may give consent to the furnishing of hospital, medical, and surgical care related to [her] the minor's pregnancy or [her] the minor's child[, although prior notification of a parent may be required pursuant to P.L.1999, c.145 (C.9:17A-1.1 et al.)] and such consent shall not be subject to disaffirmance because of minority. The consent of the parent or parents of an unmarried, pregnant minor shall not be necessary in order to authorize hospital, medical, and surgical care related to [her] the minor's pregnancy or [her] the minor's child.
(cf: P.L.1999, c.145, s.1)
14. a. (New section) Except as provided in sections 3 through 7 of P.L.1968, c. 185 (C.2A:84A-22.3 through 2A:84A-22.7), section 1 of P.L.1970, c. 313 (C.2A:84A-22.8), section 29 of P.L.1968, c.401 (C.45:8B-29), and subsection b. of this section, in any civil action or any proceeding preliminary thereto or in any probate, legislative, or administrative proceeding, a covered entity, as defined in 45 C.F.R. s.160.103, shall not disclose, unless the patient or that patient's conservator, guardian, or other authorized legal representative explicitly consents in writing to the disclosure:
(1) any communication made to a covered entity, or any information obtained by a covered entity from, a patient or the conservator, guardian, or other authorized legal representative of a patient relating to reproductive health care services that are permitted under the laws of this State; or
(2) any information obtained by personal examination of a patient relating to reproductive health care services that are permitted under the laws of this State.
A covered entity shall inform the patient or the patient's conservator, guardian, or other authorized legal representative of the patient's right to withhold written consent at or before the time reproductive health care services are rendered or at such time as the patient discloses any information relating to reproductive health care services that have been previously rendered.
b. Written consent of the patient or the patient's conservator, guardian, or other authorized legal representative shall not be required for the disclosure of such communication or information:
(1) pursuant to the laws of this State or the Rules Governing the Courts of the State of New Jersey;
(2) by a covered entity against whom a claim has been made, or there is a reasonable belief will be made, in an action or proceeding, to the covered entity's attorney or professional liability insurer or an insurer's agent for use in the defense of the action or proceeding;
(3) to the Commissioners of Health, Human Services, Banking and Insurance, or the professional licensing boards operating under the authority of the Division of Consumer Affairs in the Department of Law and Public Safety for records of a patient of a covered entity in connection with an investigation of a complaint, if the records are related to the complaint; or
(4) if child abuse, abuse of an elderly individual, abuse of an individual who is physically disabled or incompetent or abuse of an individual with intellectual disability is known or in good faith suspected. For the purposes of this paragraph, the provision of or material support for reproductive health care services that are permitted under the laws of this State shall not constitute abuse.
Nothing in this subsection shall be construed to conflict with or displace any requirements or conditions for disclosure set forth under 45 C.F.R. §§ 160.203 and 164.514.
c. Nothing in this section shall be construed to impede the lawful sharing of medical records as permitted by State or federal law or the Rules of Court, except in the case of a subpoena commanding the production, copying, or inspection of medical records relating to reproductive health care services.
15. (New section) A public entity, or employee, appointee, officer or official or any other person acting on behalf of a public entity, shall not provide any information or expend or use time, money, facilities, property, equipment, personnel or other resources in furtherance of any interstate investigation or proceeding seeking to impose civil or criminal liability upon a person or entity for:
a. providing, seeking, receiving, or inquiring about reproductive health care services; or
b. assisting any person or entity providing, seeking, receiving, or responding to an inquiry about reproductive health care services that are legal in this State.
This section shall not apply to any investigation or proceeding where the conduct subject to potential liability under the investigation or proceeding would be subject to liability under the laws of this State if committed in this State. This section shall not apply if it is necessary for the agency or person to engage in conduct otherwise prohibited by subsection a. of this section in order to comply with a valid order issued by a court with jurisdiction over the agency or person, or to comply with applicable provisions of State or federal law.
16. (New section) Notwithstanding the provisions of N.J.S.2A:160-14, the Governor shall not surrender, on demand of the executive authority of any other state, any person who:
a. is found in this State;
b. was not in the state whose executive authority is making the demand at the time of the commission of the alleged crime and has not fled therefrom; and
c. is charged in the state whose executive authority is making the demand with providing, receiving, assisting in providing or receiving, providing material support for, or traveling to obtain reproductive health care services that are permitted under the laws of this State, including on any theory of vicarious, joint, several or conspiracy liability.
17. (New section) a. A law of another state that authorizes a person to bring a civil action against a person or entity for undertaking any of the following conduct is contrary to the public policy of this State:
(1) Receiving or seeking an abortion.
(2) Performing or inducing a termination of an abortion.
(3) Knowingly engaging in conduct that aids or abets the performance, receipt, or inducement of an abortion.
(4) Attempting or intending to engage in the conduct described in paragraphs (1) to (3) of this subsection, inclusive.
b. A law described in subsection a. of this section shall not be applied to any matter, case, or controversy heard in a State court or in an administrative tribunal of this State.
c. The provisions of this
section shall not apply to an action founded in tort, contract, or statute
under the laws of this State, or an action founded in tort, contract, or
statute under the laws of another state and for which a similar claim would
exist under the laws of this State including, but not limited to, an alleged
act of malpractice or negligence by a person in the person's profession or
occupation.
18. (New section) a. A person is guilty of interference with reproductive health services if the person purposely or knowingly:
(1) inflicts or attempts to inflict bodily injury on another person, with purpose to unlawfully restrict another's access to or receipt or provision of reproductive health services or to intimidate the person from becoming or remaining a reproductive health services patient, provider, volunteer, or assistant, if the conduct would cause a reasonable person to be intimidated;
(2) physically obstructs any person seeking to enter into or exit from a reproductive services facility or place of religious worship, with purpose to unlawfully restrict another's access to or receipt or provision of reproductive health services or to intimidate the person from becoming or remaining a reproductive health services patient, provider, volunteer, or assistant, if the conduct would cause a reasonable person to be intimidated;
(3) intimidates, threatens, or coerces, or attempts to intimidate, threaten or coerce, any person or entity because that person or entity is a reproductive health services patient, provider, volunteer, or assistant, or in order to intimidate a person or entity, or a class of persons or entities, from becoming or remaining a reproductive health services patient, provider, volunteer, or assistant;
(4) damages, defaces or destroys the property of a person, entity, or facility, or attempts to do so, because the person, entity, or facility is a reproductive health services patient, provider, assistant, volunteer, or facility;
(5) videotapes, films, photographs, or records by electronic means, within 100 feet of the entrance to, or within, a reproductive health services facility, a reproductive health services patient, provider, volunteer, or assistant without that person's consent, with purpose to intimidate the person from becoming or remaining a reproductive health services patient, provider, volunteer, or assistant, if the conduct would cause a reasonable person to be intimidated;
(6) Discloses or distributes, in any manner or forum including, but not limited to, internet websites and social media, a videotape, film, photograph, or recording the person knows or reasonably should know was obtained in violation of paragraph (5) of this subsection, with purpose to intimidate the person from becoming or remaining a reproductive health services patient, provider, volunteer, or assistant, if the conduct would cause a reasonable person to be intimidated.
b. Interference with reproductive health services is a crime of the fourth degree, except that interference with reproductive health services is a crime of the second degree if the victim suffers significant bodily injury or serious bodily injury, and a crime of the third degree if the victim suffers bodily injury.
c. For purposes of this section:
(1) "intimidate" means to place a person in reasonable apprehension of bodily harm to themselves or to another.
(2) "physical obstruction" means rendering ingress to or egress from a reproductive health services facility or a place of religious worship impassable to another person, or rendering passage to or from a reproductive health services facility or a place of religious worship unreasonably difficult or hazardous to another person;
(3) "Reproductive health services" means medical, surgical, counseling services relating to the human reproductive system, including services relating to contraception, pregnancy, or the termination of a pregnancy;
(4) "reproductive health services facility" includes a hospital, clinic, office, or other site that provides or seeks to provide reproductive health services and includes the building or structure in which the facility is located; and
(5) "social media" means an electronic service or account, or electronic content, including, but not limited to, videos or still photographs, blogs, video blogs, podcasts, instant and text messages, email, online services or accounts, or internet website profiles or locations.
d. Nothing in this section shall be construed to preclude, or limit in any way, prosecution and conviction for any other offense including, but not limited to, prosecution and conviction for assault, N.J.S.2C:12-1, terroristic threats, N.J.S.2C:12-3, stalking, section 1 of P.L.1992, c.209 (C.2C:12-10), criminal coercion, N.J.S.2C:13-5, or criminal trespass, N.J.S.2C:18-3.
19. (New section) a. The Attorney General or any law enforcement officer may order the immediate dispersal of a gathering that substantially impedes access to or departure from an entrance or driveway to a reproductive health care facility during the business hours of the facility.
(1) A dispersal order issued pursuant to this subsection shall include the following statements:
(a) the gathering has substantially impeded access to or departure from the facility;
(b) each member of the gathering shall, under the penalty of arrest and prosecution, immediately disperse and cease to stand or be located within at least 25 feet of an entrance or a driveway to the facility; and
(c) the order shall remain in place for eight hours or until the close of business of the facility on the day the order is issued, whichever is sooner.
(2) A dispersal order shall not issue under this subsection unless the 25-foot boundary identified in paragraph (1) of this subsection is clearly marked.
b. Failure to comply with a dispersal order issued pursuant to this section shall be a disorderly persons offense.
c. For purposes of this section:
(1) "driveway" means an entry from a public street to a public or private parking area used by a reproductive health care facility;
(2) "entrance" means a door to a reproductive health care facility that directly abuts the public sidewalk; provided, however, that if the door does not directly abut the public sidewalk, the "entrance" shall be the point at which the public sidewalk intersects with a pathway leading to the door;
(3) "gathering" means two or more individuals; and
(4) "impede" means to obstruct, block, detain or render passage impossible, unsafe or unreasonably difficult.
20. (New section) a. A person who, in violation of section 18 of P.L. , c. (C. ) (pending before the Legislature as this bill), commits an act of interference with another person's reproductive health services shall be liable to that aggrieved person, who may bring a civil action in the Superior Court.
b. The court may award:
(1) injunctive relief;
(2) compensatory damages, but in an amount not less than liquidated damages computed at the rate of $1,000 for each violation of P.L. , c. (C. ) (pending before the Legislature as this bill);
(3) punitive damages upon proof of willful or reckless disregard of the law;
(4) reasonable attorney's fees and other litigation costs reasonably incurred; and
(5) any other preliminary and equitable relief as the court determines to be appropriate.
c. A conviction of a violation of section 18 of P.L. , c. (C. ) (pending before the Legislature as this bill) shall not be a prerequisite for a civil action brought pursuant to this section.
d. A court may, in its discretion, permit a person aggrieved by a violation of section 18 of P.L. , c. (C. ) (pending before the Legislature as this act) to use a pseudonym in a civil action brought pursuant to the provisions of this section when reasonably required to safeguard the health, safety, or privacy of the person.
21. (New section) The Attorney General may bring a civil action to enjoin, on a temporary, preliminary, or permanent basis, a violation of section 18 or 19 of P.L. , c. (C. ) (pending before the Legislature as this bill); for compensatory damages to persons aggrieved by the violation; and for the assessment of a civil penalty against each actor who violates section 18 or 19 of P.L. , c. (C. ) (pending before the Legislature as this bill). The civil penalty imposed on each actor shall not exceed $10,000 for a first violation, and shall not exceed $25,000 for any other subsequent violation. In imposing civil penalties pursuant to this section, the court shall consider a prior violation of the federal Freedom of Access to Clinic Entrances Act of 1994, 18 U.S.C. s.248, or a prior violation of a statute of another jurisdiction that would constitute a violation of the federal Freedom of Access to Clinic Entrances Act of 1994, 18 U.S.C. s.248, to be a prior violation of section 18 of P.L. , c. (C. ) (pending before the Legislature as this bill).
22. a. (New section) There is established in the General Fund a separate, non-lapsing fund to be known as the "Reproductive Health Access Fund." The fund shall be credited with moneys made available from an appropriation of $20,000,000 made pursuant to section 38 of P.L. , c. (C. ) (pending before the Legislature as this bill), interest earnings, and any other money from any other source accepted for the benefit of the fund.
b. The fund shall be used for the following purposes:
(1) $5,000,000 shall be appropriated for the "Abortion Care Clinical Training Program" established pursuant to section 23 of P.L. , c. (C. ) (pending before the Legislature as this bill);
(2) $5,000,000 shall be appropriated for the "Reproductive Health Security Grant Program" established pursuant to section 24 of P.L. , c. (C. ) (pending before the Legislature as this bill); and
(3) $10,000,000 shall be appropriated for the "Reproductive Health Care Facility Grant Program" established pursuant to section 25 of P.L. , c. (C. ) (pending before the Legislature as this bill).
c. Notwithstanding the provisions of subsection b. of this section to the contrary, the State Treasurer, in the State Treasurer's discretion, may transfer any portion of the amounts appropriated to the fund among the Division of Consumer Affairs in the Department of Law and Public Safety, the Office of Homeland Security and Preparedness, and the Health Care Facilities Financing Authority for the purposes set forth in paragraphs (1), (2), and (3) of subsection b. of this section.
23. a. (New section) There is established in the Division of Consumer Affairs in the Department of Law and Public Safety the "Abortion Care Clinical Training Program." The purpose of the program shall be to protect access to abortion by ensuring that there are a sufficient number of health professionals to provide abortion care. The division shall contract with a coordinating organization to administer the program. The coordinating organization shall:
(1) have demonstrated experience in coordinating health care training programs at community-based or hospital-based provider sites;
(2) be in good standing in any State or jurisdiction in which the organization is registered or incorporated;
(3) submit an annual report to the division on the performance of the program; and
(4) meet any other requirements established by the division.
b. The coordinating organization shall perform the following functions:
(1) administer grants to develop and sustain abortion care training programs at a minimum of two community-based provider sites;
(2) administer grants if funding is available to:
(a) other community-based sites;
(b) hospital-based provider sites;
(c) continuing education programs for health professionals through professional associations or other clinical education programs; and
(d) establish training program requirements that are consistent with evidence-based training standards, comply with applicable State law and regulations, and focus on providing culturally congruent care and include implicit bias training;
(3) support abortion care clinical training to health care professionals and to the clinical care teams of the health care professionals to:
(a) expand the number of health care professionals with abortion training; and
(b) increase the racial and ethnic diversity among health care professionals with abortion care training; and
(4) support the identification, screening, and placement of health care professionals at training sites.
c. The program shall be funded by the "Reproductive Health Access Fund" established pursuant to section 22 of P.L. , c. (C. ) (pending before the Legislature as this bill).
24. (New section) a. There is established the "Reproductive Health Security Grant Program" in the Office of Homeland Security and Preparedness, which shall provide grants to eligible reproductive health care facilities that provide reproductive health care services and which the Director of the Office of Homeland Security and Preparedness determines are at a high risk of being the target of unlawful activity, including but not limited to, acts of violence, property damage, vandalism, and harassment. Grants provided under the program shall be used by the grant recipient:
(1) to hire permanent or temporary security personnel limited to federal, State, county, or municipal law enforcement officers, special law enforcement officers appointed pursuant to P.L.1985, c.439 (C.40A:14-146.8 et seq.), or security officers registered pursuant to P.L.2004, c.134 (C.45:19A-1 et seq.); and
(2) for acquisition of target-hardening equipment for the purpose of preparedness against threats, attacks, and other violent acts.
b. The director shall administer the Reproductive Health Security Grant Program. There shall annually be distributed to approved eligible health care facilities a maximum grant of up to $10,000 per approved application for personnel and a maximum grant of up to $50,000 for target-hardening equipment. The director may adjust these amounts based upon the final availability of funds, analytical trends, and emerging threats.
c. An eligible health care facility shall apply to the office to receive a grant under the program, for either costs of security personnel or acquisition of target-hardening equipment, or both; however, an applicant only may be awarded funds for either personnel or for equipment in a fiscal year. The office first shall evaluate all applications as to whether the facilities are at high risk of terrorist attack, threats, domestic extremism, and other violent acts. The funds distributed under the program shall be utilized solely for security investments made within this State. Funds shall not be utilized to support security needs while traveling outside of this State.
Applicants may apply annually for a disbursement of funds for costs of security personnel and may be awarded grants in successive years. The office shall assign a preference for applicants who have not received a federal security grant that includes funding for hiring security personnel in the last two federal grant cycles.
Applicants may apply annually for grant funds for acquisition of target-hardening equipment. The office shall assign a preference for applicants who have not received either a federal or State security grant for target-hardening equipment in the last two grant cycles.
e. Of the amount appropriated to the program, five percent shall be allocated to the office to be used to administer the program.
f. For purposes of this section, "eligible reproductive health care facility" means a hospital, clinic, office, or other site that provides, refers, or seeks to provide reproductive health services.
25. (New section) There is established the "Reproductive Health Care Facility Grant Program" in the Health Care Facilities Financing Authority which shall award funding to eligible reproductive health care facilities that provide reproductive health care services. The authority, in consultation with the Commissioner of Health, may award funding to a licensed health care facility or other health care facility where licensed health care providers deliver reproductive health care services if the commissioner determines that the grant is necessary to maintain access to reproductive health care services or referral sources, as appropriate. Grants awarded pursuant to this section shall be used to support establishing or renovating existing health care facilities, investments in technology to facilitate care, the recruitment and retention of staff, and other operational needs that increase abortion care. In determining whether to award a grant to a licensed health care facility, the authority, in consultation with the Commissioner of Health, shall consider whether, at a minimum, the following factors are present:
(1) extraordinary circumstances threaten access to reproductive health care services in a community;
(2) persons in a community will be without ready access to reproductive health care services in the absence of the award of a grant;
(3) funding is unavailable from other sources to preserve or provide reproductive health care services;
(4) a grant is likely to stabilize access to the reproductive health care services; or
(5) there is a reasonable likelihood that the reproductive health care services will be sustainable upon the termination of the grant.
b. A licensed health care facility or other health care facility where licensed health care providers deliver reproductive health care services may apply for the funding made available pursuant to this section by applying to the authority in a form and manner determined by the authority. Applications shall include, at a minimum, the prior two years of financial statements and utilization statistics along with a two-year projection of utilization.
c. Notwithstanding the provisions of the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), to the contrary, the authority, in consultation with the Commissioner of Health, may adopt, immediately upon filing with the Office of Administrative Law, regulations that the authority, in consultation with the Commissioner of Health, deem necessary to effectuate the purposes of this section, which regulations shall be effective for a period not to exceed 18 months from the date of the filing. The authority may thereafter amend, adopt, or readopt the regulations in accordance with the requirements of P.L.1968, c.410 (C.52:14B-1 et seq.).
d. The program shall be funded by the "Reproductive Health Access Fund" established pursuant to section 22 of P.L. , c. (C. ) (pending before the Legislature as this bill).
e. Of the amount appropriated to the program, five percent shall be allocated to the authority to be used to administer the program.
f. For purposes of this section, "eligible reproductive health care facility" means a hospital, clinic, office, or other site that provides, refers or seeks to provide reproductive health services.
26. (New section) a. To ensure the affordability of, and access to reproductive health care for, anyone who seeks care in the State, regardless of their ability to pay for such care, the Department of Health shall administer a program to award grants to health care providers and non-profit entities to support the uncompensated costs relating to the termination of a pregnancy for individuals who lack insurance coverage, are underinsured, or whose insurance is deemed unusable by the rendering provider. The department also shall provide grants through the program established by this section to non-profit entities providing practical support to individuals traveling to New Jersey to access reproductive health services.
b. The program established pursuant to subsection a. of this section shall incorporate any existing programs and funding streams that provide coverage or reimbursement for family planning services.
c. The State Legislature shall annually appropriate the amount necessary to pay the reasonable and necessary expenses associated with the operation of the program established pursuant to this section, which expenses shall be determined by the department.
27. (New section) The Department of Health shall conduct a Statewide needs assessment to examine the gaps in delivery of reproductive health services in the State, including the impact that out-of-state restrictions have had on the need for reproductive health services and the provider network in the State. The department may contract with any consultant or one or more public or private entities to conduct the needs assessment required by this section.
28. Section 7 of P.L.1991, c.378 (C.45:9-27.16) is amended to read as follows:
7. a. A physician assistant may perform the following procedures:
(1) Approaching a patient to elicit a detailed and accurate history, perform an appropriate physical examination, identify problems, record information, and interpret and present information to the supervising physician;
(2) Suturing and caring for wounds including removing sutures and clips and changing dressings, except for facial wounds, traumatic wounds requiring suturing in layers, and infected wounds;
(3) Providing patient counseling services and patient education consistent with directions of the supervising physician;
(4) Assisting a physician in an inpatient setting by conducting patient rounds, recording patient progress notes, determining and implementing therapeutic plans jointly with the supervising physician, and compiling and recording pertinent narrative case summaries;
(5) Assisting a physician in the delivery of services to patients requiring continuing care in a private home, nursing home, extended care facility, or other setting, including the review and monitoring of treatment and therapy plans; and
(6) Referring patients to, and promoting their awareness of, health care facilities and other appropriate agencies and resources in the community.
(7) (Deleted by amendment, P.L.2015, c.224)
b. A physician assistant may perform the following procedures only when directed, ordered, or prescribed by the supervising physician, or when performance of the procedure is delegated to the physician assistant by the supervising physician as authorized under subsection d. of this section:
(1) Performing non-invasive laboratory procedures and related studies or assisting duly licensed personnel in the performance of invasive laboratory procedures and related studies;
(2) Giving injections, administering medications, and requesting diagnostic studies;
(3) Suturing and caring for facial wounds, traumatic wounds requiring suturing in layers, and infected wounds;
(4) Writing prescriptions or ordering medications in an inpatient or outpatient setting in accordance with section 10 of P.L.1991, c.378 (C.45:9-27.19);
(5) Prescribing the use of patient restraints; [and]
(6) Authorizing qualifying patients for the medical use of cannabis and issuing written instructions for medical cannabis to registered qualifying patients pursuant to P.L.2009, c.307 (C.24:6I-1 et al.); and
(7) Performing early aspiration abortion.
c. A physician assistant may assist a supervising surgeon in the operating room when a qualified assistant physician is not required by the board and a second assistant is deemed necessary by the supervising surgeon.
d. A physician assistant may perform medical services beyond those explicitly authorized in this section, when such services are delegated by a supervising physician with whom the physician assistant has signed a delegation agreement pursuant to section 8 of P.L.1991, c.378 (C.45:9-27.17). The procedures delegated to a physician assistant shall be limited to those customary to the supervising physician's specialty and within the supervising physician's and the physician assistant's competence and training.
e. Notwithstanding subsection d. of this section, a physician assistant shall not be authorized to measure the powers or range of human vision, determine the accommodation and refractive states of the human eye, or fit, prescribe, or adapt lenses, prisms, or frames for the aid thereof. Nothing in this subsection shall be construed to prohibit a physician assistant from performing a routine visual screening.
(cf: P.L.2019, c.153, s.45)
29. Section 10 of P.L.1991, c.378 (C.45:9-27.19) is amended to read as follows:
10. A physician assistant may order, prescribe, dispense, and administer medications and medical devices and issue written instructions to registered qualifying patients for medical cannabis to the extent delegated by a supervising physician.
a. Controlled dangerous substances may only be ordered or prescribed if:
(1) a supervising physician has authorized a physician assistant to order or prescribe Schedule II, III, IV, or V controlled dangerous substances in order to:
(a) continue or reissue an order or prescription for a controlled dangerous substance issued by the supervising physician;
(b) otherwise adjust the dosage of an order or prescription for a controlled dangerous substance originally ordered or prescribed by the supervising physician, provided there is prior consultation with the supervising physician;
(c) initiate an order or prescription for a controlled dangerous substance for a patient, provided there is prior consultation with the supervising physician if the order or prescription is not pursuant to subparagraph (d) of this paragraph; or
(d) initiate an order or prescription for a controlled dangerous substance as part of a treatment plan for a patient with a terminal illness, which for the purposes of this subparagraph means a medical condition that results in a patient's life expectancy being 12 months or less as determined by the supervising physician;
(2) the physician assistant has registered with, and obtained authorization to order or prescribe controlled dangerous substances from, the federal Drug Enforcement Administration and any other appropriate State and federal agencies; and
(3) the physician assistant complies with all requirements which the board shall establish by regulation for the ordering, prescription, or administration of controlled dangerous substances, all applicable educational program requirements, and continuing professional education programs approved pursuant to section 16 of P.L.1991, c.378 (C.45:9-27.25).
b. (Deleted by amendment, P.L.2015, c.224)
c. (Deleted by amendment, P.L.2015, c.224)
d. In the case of an order or prescription for a controlled dangerous substance or written instructions for medical cannabis, the physician assistant shall print on the order or prescription or the written instructions the physician assistant's Drug Enforcement Administration registration number.
e. The dispensing of medication or a medical device by a physician assistant shall comply with relevant federal and State regulations, and shall occur only if: (1) pharmacy services are not reasonably available; (2) it is in the best interest of the patient; or (3) the physician assistant is rendering emergency medical assistance.
f. A physician assistant may request, receive, and sign for prescription drug samples and may distribute those samples to patients.
g. A physician assistant may issue written instructions to a registered qualifying patient for medical cannabis pursuant to section 10 of P.L.2009, c.307 (C.24:6I-10) only if:
(1) a supervising physician has authorized the physician assistant to issue written instructions to registered qualifying patients;
(2) the physician assistant verifies the patient's status as a registered qualifying patient; and
(3) the physician assistant complies with the requirements for issuing written instructions for medical cannabis established pursuant to P.L.2009, c.307 (C.24:6I-1 et al.).
h. A physician assistant may provide medical abortion.
(cf: P.L.2019, c.153, s.46)
30. (New section) a. Certified nurse midwives and certified midwives may perform early aspiration abortions, consistent with their scope of practice and consistent with regulations of the applicable licensing board.
b. A certified nurse midwife authorized to prescribe drugs pursuant to section 2 of P.L. 1991, c. 97 (C.45:10-18), may provide medical abortions.
31. (New section) a. Advanced practice nurses may perform early aspiration abortions consistent with their scope of practice and consistent with regulations of the applicable licensing board.
b. An advanced practice nurse may provide medical abortion.
32. (New section) a. Notwithstanding any State law or regulation to the contrary, the Department of Human Services shall ensure that expenses incurred for abortion services shall be provided with no cost-sharing to persons served under the Medicaid program, established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.).
b. Any copayment, coinsurance, or deductible that may be required pursuant to the contract for services covered pursuant to subsection a. of this section shall not apply.
c. The department may take any administrative action necessary to effectuate the provisions of this section, including modifying or amending any applicable contract or promulgating, amending, or repealing any guidance, guidelines, or rules, which rules or amendments thereto shall be effective immediately upon filing with the Office of Administrative Law for a period not to exceed 12 months, and may, thereafter, be amended, adopted or readopted in accordance with the provisions of the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.).
33. Section 17 of P.L.2004, c.17 (C.17:30D-22) is amended to read as follows:
17. a. Notwithstanding any other law or regulation to the contrary, an insurer authorized to transact medical malpractice liability insurance in this State shall not increase the premium of any medical malpractice liability insurance policy based on a claim of medical negligence or malpractice against the insured if the insured is dismissed from an action alleging medical malpractice within 180 days of the filing of the last responsive pleading.
b. An insurer authorized to transact medical malpractice liability insurance in this State shall not take any adverse action, including loss of coverage, sanctions, fines, penalties, or rate increases, against an insured for providing or facilitating an abortion or reproductive health care service based solely on the fact that the patient receiving the service is a resident of a state where providing or facilitating an abortion or reproductive health care service is illegal, or based on a revocation of an insured's license from another state or other disciplinary action by another state that resulted from an insured's providing, authorizing, participating in, referring, or assisting in an abortion or any other health care service for the purpose of the abortion, or any other reproductive health care service, if the revocation or disciplinary action was based solely on a violation of the other state's law prohibiting the provision of abortion or other reproductive health care service and related services in the state or for a resident of the state or in any other state.
(cf: P.L.2004, c.17, s.17)
34. Section 8 of P.L.1978, c.73 (C.45:1-21) is amended to read as follows:
8. A board may refuse to admit a person to an examination or may refuse to issue or may suspend or revoke any certificate, registration or license issued by the board upon proof that the applicant or holder of such certificate, registration or license:
a. Has obtained a certificate, registration, license or authorization to sit for an examination, as the case may be, through fraud, deception, or misrepresentation;
b. Has engaged in the use or employment of dishonesty, fraud, deception, misrepresentation, false promise or false pretense;
c. Has engaged in gross negligence, gross malpractice or gross incompetence which damaged or endangered the life, health, welfare, safety or property of any person;
d. Has engaged in repeated acts of negligence, malpractice or incompetence;
e. Has engaged in professional or occupational misconduct as may be determined by the board;
f. Has been convicted of, or engaged in acts constituting, any crime or offense that has a direct or substantial relationship to the activity regulated by the board or is of a nature such that certification, registration or licensure of the person would be inconsistent with the public's health, safety, or welfare, provided that the board shall make this determination in a manner consistent with section 2 of P.L.2021, c.81 (C.45:1-21.5). For the purposes of this subsection a judgment of conviction or a plea of guilty, non vult, nolo contendere or any other such disposition of alleged criminal activity shall be deemed a conviction;
g. Has had his authority to engage in the activity regulated by the board revoked or suspended by any other state, agency or authority for reasons consistent with this section;
h. Has violated or failed to comply with the provisions of any act or regulation administered by the board;
i. Is incapable, for medical or any other good cause, of discharging the functions of a licensee in a manner consistent with the public's health, safety and welfare;
j. Has repeatedly failed to submit completed applications, or parts of, or documentation submitted in conjunction with, such applications, required to be filed with the Department of Environmental Protection;
k. Has violated any provision of P.L.1983, c.320 (C.17:33A-1 et seq.) or any insurance fraud prevention law or act of another jurisdiction or has been adjudicated, in civil or administrative proceedings, of a violation of P.L.1983, c.320 (C.17:33A-1 et seq.) or has been subject to a final order, entered in civil or administrative proceedings, that imposed civil penalties under that act against the applicant or holder;
l. Is presently engaged in drug or alcohol use that is likely to impair the ability to practice the profession or occupation with reasonable skill and safety. For purposes of this subsection, the term "presently" means at this time or any time within the previous 365 days;
m. Has prescribed or dispensed controlled dangerous substances indiscriminately or without good cause, or where the applicant or holder knew or should have known that the substances were to be used for unauthorized consumption or distribution;
n. Has permitted an unlicensed person or entity to perform an act for which a license or certificate of registration or certification is required by the board, or aided and abetted an unlicensed person or entity in performing such an act;
o. Advertised fraudulently in any manner.
The division is authorized, for purposes of facilitating determinations concerning licensure eligibility, to require the fingerprinting of each applicant in accordance with applicable State and federal laws, rules and regulations. Each applicant shall submit the applicant's name, address, and written consent to the director for a criminal history record background check to be performed. The division is authorized to receive criminal history record information from the State Bureau of Identification in the Division of State Police and the Federal Bureau of Investigation. Upon receipt of such notification, the division shall forward the information to the appropriate board which shall make a determination regarding the issuance of licensure. The applicant shall bear the cost for the criminal history record background check, including all costs of administering and processing the check, unless otherwise provided for by an individual enabling act. The Division of State Police shall promptly notify the division in the event an applicant or licensee, who was the subject of a criminal history record background check pursuant to this section, is convicted of a crime or offense in this State after the date the background check was performed.
Notwithstanding the provisions of any law, rule, or regulation to the contrary, a board shall not refuse to admit a person to an examination and shall not suspend, revoke, or refuse to renew any certificate, registration, or license issued by the board based solely on the holder of the certificate, registration, or license providing, authorizing, participating, referring for, or assisting with any health care, medical service, or procedure related to an abortion for a person who resides in a jurisdiction where the provision, authorization, participation, referral, or assistance would not be a basis for refusing to admit a person to an examination or for suspending, revoking, or refusing to renew a certificate, registration, or license in this State.
For purposes of this act:
"Completed application" means the submission of all of the information designated on the checklist, adopted pursuant to section 1 of P.L.1991, c.421 (C.13:1D-101), for the class or category of permit for which application is made.
"Permit" has the same meaning as defined in section 1 of P.L.1991, c.421 (C.13:1D-101).
(cf: P.L.2021, c.81, s.1)
35. Section 9 of P.L.1978, c.73 (C.45:1-22) is amended to read as follows:
9. In addition or as an alternative, as the case may be, to revoking, suspending or refusing to renew any license, registration or certificate issued by it, a board may, after affording an opportunity to be heard:
a. Issue a letter of warning, reprimand, or censure with regard to any act, conduct or practice which in the judgment of the board upon consideration of all relevant facts and circumstances does not warrant the initiation of formal action;
b. Assess civil penalties in accordance with this act;
c. Order that any person violating any provision of an act or regulation administered by such board to cease and desist from future violations thereof or to take such affirmative corrective action as may be necessary with regard to any act or practice found unlawful by the board;
d. Order any person found to have violated any provision of an act or regulation administered by such board to restore to any person aggrieved by an unlawful act or practice, any moneys or property, real or personal, acquired by means of such act or practice; provided, however, no board shall order restoration in a dollar amount greater than those moneys received by a licensee or his agent or any other person violating the act or regulation administered by the board;
e. Order any person, as a condition for continued, reinstated or renewed licensure, to secure medical or such other professional treatment as may be necessary to properly discharge licensee functions;
f. Order any person, as a condition for continued, reinstated or renewed licensure, to submit to any medical or diagnostic testing and monitoring or psychological evaluation which may be required to evaluate whether continued practice may jeopardize the safety and welfare of the public;
g. Order any person, as a condition for continued, reinstated or renewed licensure, to submit to an assessment of skills to determine whether the licensee can continue to practice with reasonable skill and safety, and to take and successfully complete educational training determined by the board to be necessary;
h. Order any person, as a condition for continued, reinstated or renewed licensure, to submit to an assessment of skills to determine whether the licensee can continue to practice with reasonable skill and safety, and to submit to any supervision, monitoring or limitation on practice determined by the board to be necessary.
A board may, upon a duly verified application of the Attorney General that either provides proof of a conviction of a court of competent jurisdiction for a crime or offense involving moral turpitude or relating adversely to the regulated profession or occupation, or alleges an act or practice violating any provision of an act or regulation administered by such board, enter a temporary order suspending or limiting any license issued by the board pending plenary hearing on an administrative complaint; provided, however, no such temporary order shall be entered unless the application made to the board palpably demonstrates a clear and imminent danger to the public health, safety and welfare and notice of such application is given to the licensee affected by such order. If, upon review of the Attorney General's application, the board determines that, although no palpable demonstration of a clear and imminent danger has been made, the licensee's continued unrestricted practice pending plenary hearing may pose a risk to the public health, safety and welfare, the board may order the licensee to submit to medical or diagnostic testing and monitoring, or psychological evaluation, or an assessment of skills to determine whether the licensee can continue to practice with reasonable skill and safety.
In any administrative proceeding commenced on a complaint alleging a violation of an act or regulation administered by a board, such board may issue subpoenas to compel the attendance of witnesses or the production of books, records, or documents at the hearing on the complaint.
A board shall not impose any additional or alternative penalties pursuant to this section on the holder of a certificate, registration, or license based solely on the holder providing, authorizing, participating, referring for, or assisting with any health care, medical service, or procedure related to an abortion for a person who resides in a jurisdiction where the provision, authorization, participation, referral, or assistance is illegal, if it would not be a basis for additional or alternative penalties in this State.
(cf: P.L.2001, c.307, s.2)
36. The following sections are repealed:
Sections 1 through 3 of P.L.1997, c.262 (C.2A:65A-5 through C.2A:65A-7);
Sections 2 through 13 of P.L.1999, c.145 (C.9:17A-1.1 through C.9:17A-1.12);
Sections 3, 4, and 5 of P.L.2021, c.375 (C.26:2S-39, C.52:14-17.29hh, and C.52:14-17.46.6q); and
Section 1 of P.L.1975, c.26 (C.30:4D-6.1).
38. (New section) There is appropriated from the General Fund to the Reproductive Health Access Fund $20 million, subject to the approval of the Director of Budget and Accounting, to carry out the purposes and objectives of section 22 of P.L. , c. (C. ) (pending before the Legislature as this bill).
39. (New section) The provisions of P.L. , c. (C. ) (pending before the Legislature as this bill) shall be deemed severable. If any provision of P.L. , c. (C. ) (pending before the Legislature as this bill), or any application of any provision, is held invalid, the invalidity shall not affect other applications of the provision, or other provisions of P.L. , c. (C. ) (pending before the Legislature as this bill), that reasonably can be given effect despite the invalidity.
40. This act shall take effect immediately, except that sections 3 through 12 shall take effect on the first day of the third month next following the date of enactment and shall apply to all contracts, plans, and policies delivered, issued, executed, or renewed on or after that date and the amendments made by section 2 of this act to subsection b. of section 2 of P.L.2021, c.375 (C.10:7-2) shall take effect on the 366th day next following the date of enactment. The Department of Banking and Insurance may take anticipatory administrative action, in advance of the effective date specified for sections 3 through 12 of this act, as may be necessary to implement those provisions.
STATEMENT
This bill implements various measures to strengthen access to reproductive health care in the State. The bill establishes the "Reproductive Health Access Fund" and appropriates $20 million to the fund.
The bill provides that any State program that provides benefits for pregnancy-related care will also provide benefits for the termination of pregnancy.
Health insurance coverage also will include coverage for termination of pregnancy. Upon request of a religious employer, a health insurer will grant an exclusion if the coverage conflicts with the religious employer's bona fide religious beliefs and practices.
The bill provides that in any civil action or other proceeding, a medical provider is barred from disclosing any communication made by a patient or the patient's legal representative relating to reproductive health care services that are permitted under the laws of this State, or any information obtained by personal examination of a patient relating to reproductive health care services that are permitted under the laws of this State, unless the patient or the patient's representative consents in writing.
Under the bill, a public agency, or employee, appointee, officer, or official or any other person acting on behalf of a public agency, is barred from providing any information or using time, money, facilities, property, equipment, personnel, or other resources in furtherance of any interstate investigation or proceeding seeking to impose civil or criminal liability upon a person or entity for providing, seeking, receiving, or inquiring about reproductive health services, or assisting any person or entity providing, seeking, receiving, or responding to an inquiry about reproductive health care services that are legal in this State.
This provision of the bill does not apply to any investigation or proceeding where the conduct subject to potential liability would be subject to liability under the laws of this State if committed in this State.
The bill also prohibits the Governor from complying with an extradition demand from another state for a person who is in this State, was not in the state making the demand at the time of the commission of the alleged crime and has not fled therefrom, and is charged in that state with providing, receiving, assisting in providing or receiving, providing material support for, or traveling to obtain reproductive health care services that are permitted under the laws of this State.
The bill declares that a law of another state that authorizes a person to bring a civil action against a person or entity for undertaking any of the following conduct is contrary to the public policy of this State:
(1) Receiving or seeking an abortion;
(2) Performing or inducing an abortion;
(3) Knowingly engaging in conduct that aids or abets the performance, receipt, or inducement of an abortion; or
(4) Attempting or intending to engage in the conduct described above.
This provision of the bill will not apply to an action founded in tort, contract, or statute under the laws of this State, or an action founded in tort, contract, or statute under the laws of another state and for which a similar claim would exist under the laws of this State, including but not limited to an alleged act of malpractice or negligence by a person in the person's profession or occupation.
The bill creates the new crime of "interference with reproductive health services." Among other provisions, a person is guilty of the crime if the person purposely or knowingly, with purpose to unlawfully restrict another's access to or receipt or provision of reproductive health services or to intimidate the person from becoming or remaining a reproductive health services patient, provider, volunteer, or assistant: (1) inflicts or attempts to inflict bodily injury; (2) obstructs any person seeking to enter into or exit from a reproductive services facility or place of religious worship; (3) intimidates, threatens or coerces, or attempts to intimidate, threaten, or coerce, any person or entity because that person or entity is a reproductive health services patient, provider, volunteer, or assistant; (4) damages, defaces, or destroys the property of a person, entity, or facility, or attempts to do so, because the person, entity, or facility is a reproductive health services patient, provider, assistant, volunteer, or facility; (5) videotapes, films, photographs, or records by electronic means, within 100 feet of the entrance to a reproductive health services facility, a patient, provider, volunteer, or assistant without that person's consent, with purpose to intimidate the person from becoming or remaining a reproductive health services patient, provider, volunteer, or assistant, where such conduct would cause a reasonable person to be intimidated; or (6) discloses or distributes a videotape, film, photograph, or recording of the person with purpose to intimidate the person from becoming or remaining a reproductive health services patient, provider, volunteer, or assistant, where such conduct would cause a reasonable person to be intimidated.
Interference with reproductive health services is a crime of the fourth degree, except that it is a crime of the second degree if the victim suffers significant bodily injury or serious bodily injury.
The bill authorizes the Attorney General or any law enforcement officer to order the immediate dispersal of a gathering that substantially impedes access to or departure from an entrance or driveway to a reproductive health care facility during the business hours of the facility.
The bill also authorizes a person to bring a civil action against a person who unlawfully interferes with another person's reproductive health services. The court may award injunctive relief; compensatory damages in an amount not less than liquidated damages computed at the rate of $1,000 for each violation; punitive damages upon proof of willful or reckless disregard of the law; reasonable attorney's fees and other litigation costs; and other preliminary and equitable relief as the court determines to be appropriate.
Under the bill, the Attorney General may bring a civil action to enjoin a violation of the law, for compensatory damages, and for the assessment of a civil penalty against each person who violates the law. The civil penalty imposed will be up to, but not exceeding, $10,000 for a first violation, and $25,000 for any subsequent violation.
The bill creates the "Reproductive Health Access Fund," which will be credited with moneys from an appropriation of $20 million made pursuant to the bill; interest; and any money from any other source. The fund will be used for the following purposes:
(1) $5 million will be appropriated for the "Abortion Care Clinical Training Program" established pursuant to the bill; (2) $5 million for the "Reproductive Health Security Grant Program" established pursuant to the bill; and (3) $10 million for the "Reproductive Health Care Facility Grant Program" established pursuant to the bill.
The bill provides that the "Reproductive Health Security Grant Program" in the Office of Homeland Security and Preparedness will provide grants to eligible reproductive health care facilities which the Director of the Office of Homeland Security and Preparedness determines are at a high risk of being the target of unlawful activity, including acts of violence, property damage, vandalism, and harassment. Grants provided under the program will be used to hire security personnel and target-hardening equipment.
The bill requires the Department of Health to conduct a Statewide needs assessment to examine the gaps in delivery of reproductive health services in the State, including the impact that out-of-State restrictions have had on the need for reproductive health services and the provider network in the State.
The bill provides that abortions may be performed by physician assistants, certified nurse midwives, and certified midwives.
Under the bill, the Department of Human Services will ensure that expenses incurred for abortion services will be provided with no cost-sharing to persons served under the Medicaid program.
The bill bars medical malpractice insurers from taking any adverse action, including loss of coverage, sanctions, fines, penalties, or rate increases, against an insured for providing or facilitating an abortion or reproductive health care service based solely on the fact that the patient receiving the service is a resident of a state where providing or facilitating an abortion or reproductive health care service is illegal.
Finally, the bill provides that a licensing board cannot refuse to admit a person to an examination and cannot suspend, revoke, or refuse to renew any certificate, registration, or license based solely on grounds that the applicant or the holder of the certificate, registration, or license provided, authorized, participated in, referred for, or assisted with any health care, medical service, or procedure related to an abortion for a person who resides in a jurisdiction where these acts are illegal, if the acts would not be a basis for these sanctions in this State.
