HB-5006, As Passed House, April 21, 2004                                    












                              SUBSTITUTE FOR                                    


                           HOUSE BILL NO. 5006                                  


                      (As amended April 21, 2004)                               








                                                                                 A bill to provide standards for personnel policies to                             


    protect the right of conscience of health care providers who                


    conscientiously object to providing or participating in certain             


    health care services under certain circumstances; to provide for            


    protection from certain liability; and to provide for penalties             


    and remedies.                                                               


                THE PEOPLE OF THE STATE OF MICHIGAN ENACT:                      


1       Sec. 1.  This act shall be known and may be cited as the                    


2   "conscientious objector policy act".                                        


3       Sec. 3.  As used in this act:                                               


4       (a) "Contraceptive medication [         ]" means a medication               


5   [         ] approved for the prevention of pregnancy that is taken          


6   or used in advance of sexual intercourse.                                   


7       (b) "Health care provider" means a person licensed or                       


8   registered under article 15 of the public health code, 1978 PA              


     House Bill No. 5006 (H-3) as amended April 21, 2004


1   368, MCL 333.16101 to 333.18838, a student of a health facility,            


2   or another person who is employed by or under contract to a                 


3   health facility and directly participates in the provision of a             


4   health care service.  Health care provider does not include a               


5   sanitarian or a veterinarian.                                               


6       (c) "Health care service" means the provision or withdrawal                 


7   of, or research or experimentation involving, a medical                     


8   diagnosis, treatment, procedure, diagnostic test, device,                   


9   medication, drug, or other substance intended to affect the                 


10  physical or mental condition of an individual.  Health care                 


11  service does not include the provision of a contraceptive                   


12  medication [         ].                                                     


13      (d) "Health facility" means any of the following:                           


14                                                                               (i) A clinical laboratory.                                                          


15      (ii) A county medical care facility.                                         


16      (iii) A freestanding surgical outpatient facility.                           


17      (iv) A home for the aged.                                                    


18      (v) A hospital.                                                             


19      (vi) A nursing home.                                                         


20      (vii) A hospice.                                                             


21      (viii) A hospice residence.                                                   


22      (ix) A facility or agency listed in subparagraphs (i) to (vi)                 


23  located in a university, college, or other educational                      


24  institution.                                                                


25      (x) A private physician's office.                                           


26      (xi) A medical clinic.                                                       


27      (xii) A public or private institution that provides health                   

     House Bill No. 5006 (H-3) as amended April 21, 2004


1   care services to an individual.                                             


2       (xiii) A teaching institution that provides health care                       


3   services to an individual.                                                  


4       (xiv) A pharmacy that provides health care services to an                    


5   individual.                                                                 


6       (xv) A corporation, partnership, sole proprietorship, limited               


7   liability company, or other legal entity that provides health               


8   care services to an individual.                                             


9       (e) "Medical director" means that term as defined in section                


10  20906 of the public health code, 1978 PA 368, MCL 333.20906.                


11      (f) "Participate" or "participating" means, at a minimum, to                


12  counsel, refer, perform, administer, prescribe, dispense, treat,            


13  withhold, withdraw, diagnose, test, evaluate, train, research,              


14  prepare, or provide medical advice or material or physical                  


15  assistance in a health care service.                                        


16      (g) "Person" means a person as defined in section 1106 of the               


17  public health code, 1978 PA 368, MCL 333.1106, or a governmental            


18  entity.                                                                     


19      (h) "Public health emergency" means a condition or situation                


20  that presents an immediate threat to the public health, safety,             


21  or welfare and requires immediate action to preserve the public             


22  health, safety, or welfare.                                                 


23      Sec. 5.  (1) A health care provider may object as a matter                  


24  of conscience to providing or participating in a health care                


25  service on [             ] ethical, moral, or religious grounds.            


26      (2) A health care provider shall notify his or her employer                 


27  in writing of a conscientious objection described in subsection             

     House Bill No. 5006 (H-3) as amended April 21, 2004


1   (1).  The written notice shall be given directly to his or her              


2   supervisor and shall include a statement explaining his or her              


3   conscientious objection and the health care service or services             


4   to which he or she specifically objects to providing or                     


5   participating in under this act.                                            


6       (3) A health care provider may assert his or her                            


7   conscientious objection under any of the following conditions:              


8       (a) Upon being offered employment.                                          


9       (b) At the time the health care provider adopts [an]                        


10  [             ] ethical, moral, or religious belief system that             


11  conflicts with participation in a health care service.                      


12      (c) Within 24 hours after he or she is asked or has received                


13  notice that he or she is scheduled to participate in a health               


14  care service to which he or she conscientiously objects.                    


15      Sec. 7.  (1) An employer shall retain a health care                         


16  provider's written objection filed under section 5 for the                  


17  duration of the health care provider's employment.  The written             


18  objection is valid for the duration of the health care provider's           


19  employment or until rescinded by the health care provider in                


20  writing.                                                                    


21      (2) Except as otherwise provided under subsection (3), after                


22  receiving a written objection pursuant to section 5, an employer            


23  shall not require the objecting health care provider to provide             


24  or participate in the objectionable health care service.                    


25      (3) If a health care provider asserts an objection under                    


26  section 5 less than 24 hours prior to the scheduled health care             


27  service, the employer shall make a reasonable effort to exclude             


1   the health care provider from participating in the health care              


2   service or find a replacement for the health care provider.  If a           


3   replacement is unavailable and the health care provider cannot be           


4   excluded, the employer may require the health care provider to              


5   provide or participate in that health care service.                         


6       (4) An employer shall not refuse employment or staff                        


7   privileges to a health care provider who has exercised his or her           


8   right to assert an objection to providing or participating in a             


9   health care service under section 5, unless participation in that           


10  health care service is indicated as a part of the normal course             


11  of duties in the posting of the availability of the position for            


12  employment or staff privileges.                                             


13      (5) A medical school or other institution for the education                 


14  or training of a health care provider shall not refuse admission            


15  to an individual or penalize that individual because the                    


16  individual has filed in writing with the medical school or other            


17  institution a conscientious objection to participating in a                 


18  health care service under this act.                                         


19      Sec. 9.  Except as provided in section 11, a health care                    


20  provider's objection to providing or participating in a health              


21  care service as described in section 5 shall not be the basis for           


22  1 or more of the following:                                                 


23      (a) Civil liability to another person.                                      


24      (b) Criminal action.                                                        


25      (c) Administrative or licensure action.                                     


26      (d) Termination of employment or refusal of staff privileges                


27  at a health facility.                                                       


1       Sec. 11.  (1) The protections afforded to a health care                     


2   provider under this act do not apply under any of the following             


3   circumstances:                                                              


4       (a) A health care provider shall not assert an objection to a               


5   health care service if a patient's condition, in the reasonable             


6   medical judgment of an attending physician or medical director,             


7   requires immediate action and no other qualified health care                


8   provider is available to provide that health care service.                  


9       (b) A health care provider shall not assert an objection to                 


10  providing or participating in a health care service in the event            


11  of a public health emergency.                                               


12      (c) A health care provider shall not assert an objection to                 


13  providing or participating in a health care service based on the            


14  classification of a patient or group of patients protected under            


15  the Elliot-Larsen civil rights act, 1976 PA 453, MCL 37.2101 to             


16  37.2804, or based on a disease or other medical condition.                  


17      (2) Subject to a collective bargaining agreement, if a health               


18  care provider asserts an objection to a health care service that            


19  at the time the objection is asserted constitutes a regular or              


20  substantial portion of the health care provider's current and               


21  defined position, the employer may give the health care provider            


22  not less than 60 days' notice of the termination of his or her              


23  employment.  As used in this section, "regular or substantial               


24  portion" means that 10% or more of the health care provider's               


25  daily or weekly hours of duty consist of providing or                       


26  participating in that health care service.                                  


27      (3) This act does not relieve a health care provider from a                 


1   duty that exists under another statute or other law pertaining to           


2   current standards of acceptable health care practice and                    


3   procedure to inform a patient of the patient's condition,                   


4   prognosis, and risks of receiving health care services for the              


5   condition.                                                                  


6       Sec. 13.  (1) A civil action for damages or reinstatement of                


7   employment, or both, may be brought against a person, including,            


8   but not limited to, a governmental agency, health facility, or              


9   other employer, for penalizing or discriminating against a health           


10  care provider, including, but not limited to, penalizing or                 


11  discriminating in hiring, promotion, transfer, a term or                    


12  condition of employment, licensing, or granting of staff                    


13  privileges or appointments, because that health care provider has           


14  asserted an objection to participating in a health care service             


15  under section 5.  Civil damages may be awarded equal to the                 


16  amount of proven damages and attorney fees.  A civil action filed           


17  under this subsection may include a petition for injunctive                 


18  relief against a person alleged to have penalized or                        


19  discriminated against a health care provider as described in this           


20  subsection.                                                                 


21      (2) A person who violates this act is responsible for a state               


22  civil infraction and may be ordered to pay a fine of not more               


23  than $1,000.00 for each day the violation continues or a fine of            


24  not more than $1,000.00 for each occurrence.