HB-5276, As Passed House, April 21, 2004                                    












                              SUBSTITUTE FOR                                    


                           HOUSE BILL NO. 5276                                  










                                                                                 A bill to allow certain health facilities to object to                            


    providing or participating in certain procedures under certain              


    circumstances; and to provide for protection from certain                   




                THE PEOPLE OF THE STATE OF MICHIGAN ENACT:                      


1       Sec. 1.  As used in this act:                                               


2       (a) "Health care service" means the provision or withdrawal                 


3   of, or research or experimentation involving, a medical                     


4   diagnosis, treatment, procedure, diagnostic test, device,                   


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


6   physical or mental condition of an individual.                              


7       (b) "Health facility" means any of the following:                           


8                                                                                (i) A clinical laboratory.                                                          


9       (ii) A county medical care facility.                                         


10      (iii) A freestanding surgical outpatient facility.                           



1       (iv) A home for the aged.                                                    


2       (v) A hospital.                                                             


3       (vi) A nursing home.                                                         


4       (vii) A hospice.                                                             


5       (viii) A hospice residence.                                                   


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


7   located in a university, college, or other educational                      


8   institution.                                                                


9       (x) A private physician's office.                                           


10      (xi) A medical clinic.                                                       


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


12  care services to an individual.                                             


13      (xiii) A teaching institution that provides health care                       


14  services to an individual.                                                  


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


16  individual.                                                                 


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


18  liability company, or other legal entity that provides health               


19  care services to an individual.                                             


20      (c) "Health profession" means a vocation, calling,                          


21  occupation, or employment performed by individuals acting                   


22  pursuant to a license or registration issued under article 15 of            


23  the public health code, 1978 PA 368, MCL 333.16101 to 333.18838.            


24  However, health profession does not include a vocation, calling,            


25  occupation, or employment performed by an individual licensed or            


26  registered as a sanitarian or a veterinarian.                               


27      (d) "Participate" or "participating" means, at a minimum, to                

     House Bill 5276 (H-2) as amended April 21, 2004     (1 of 2)


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


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


3   prepare, or provide medical advice or material or physical                  


4   assistance in a health care service.                                        


5       (e) "Public health emergency" means a condition or situation                


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


7   or welfare and requires immediate action to preserve the public             


8   health, safety, or welfare.                                                 


9       Sec. 2.  (1) Notwithstanding any other provision of law, a                  


10  health facility may withdraw or withhold from providing a health            


11  care service, or may refuse to provide or participate in a health           


12  care service, on [             ] ethical, moral, or religious               


13  grounds as reflected in its organizational documents, charter,              


14  bylaws, or an adopted mission statement.                                    


15      (2) A health facility shall not assert an objection described               


16  in subsection (1) under any of the following circumstances:                 


17      (a) The objection is to a health care service the health                    


18  facility routinely provides or participates in and is based on a            


19  disagreement with a member of a health profession employed by,              


20  under contract to, or granted privileges by the health facility             


21  regarding the medical appropriateness of a health care service              


22  for a specific patient if the patient has consented to the                  


23  provision of the health care service.                                       


24      (b) In the event of a public health emergency.                              

         [(c) In the event of an emergency where a patient's condition, in the reasonable medical judgment of an attending physician or medical director, requires immediate action to avert serious injury, harm, impairment, or death or is such that a delay would create a serious risk of substantial and irreversible impairment of a major bodily function to that patient.

     (3) This act does not relieve a health care facility from a duty that exists under another statute or other law pertaining to medical standards of acceptable health care practice and procedures.                                            

25      (4)] A health facility's objection as described in subsection               


26  (1) to providing or participating in a health care service shall            


27  not be a basis for 1 or more of the following:                              


1       (a) Civil, criminal, or administrative liability.                           


2       (b) Eligibility discrimination against the health facility in               


3   a grant, contract, or program, unless providing or participating            


4   in the health care service is the exclusive purpose for the                 


5   grant, contract, or program.