HB-5711, As Passed House, December 14, 2012HB-5711, As Passed House, December 14, 2012

 

 

 

 

 

 

 

 

 

 

 

 

SENATE SUBSTITUTE FOR

 

HOUSE BILL NO. 5711

 

 

 

 

 

 

 

 

 

 

 

 

      A bill to amend 1978 PA 368, entitled

 

"Public health code,"

 

by amending sections 2803, 2804, 2834, 2835, 2848, 13807, 16221,

 

16226, 16299, 17015, 17515, 20115, and 22224 (MCL 333.2803,

 

333.2804, 333.2834, 333.2835, 333.2848, 333.13807, 333.16221,

 

333.16226, 333.16299, 333.17015, 333.17515, 333.20115, and

 

333.22224), sections 2803, 2834, and 2848 as amended by 2002 PA

 

562, section 2804 as amended by 1990 PA 149, section 2835 as

 

amended by 2010 PA 117, section 13807 as added by 1990 PA 21,

 

section 16221 as amended by 2011 PA 222, section 16226 as amended

 

by 2011 PA 224, section 16299 as amended by 2002 PA 685, section

 

17015 as amended by 2006 PA 77, section 17515 as added by 1993 PA

 

133, and section 20115 as amended and section 22224 as added by

 


1999 PA 206, and by adding sections 2836, 2854, 17015a, 17017,

 

and 17517.

 

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

 

 1        Sec. 2803. (1) "Abortion" means that term as defined in

 

 2  section 17015.

 

 3        (2) (1) "Dead body" means a human body or fetus, or a part

 

 4  of a dead human body or fetus, in a condition from which it may

 

 5  reasonably be concluded that death has occurred.

 

 6        (3) (2) "Fetal death" means the death of a fetus which that

 

 7  has completed at least 20 weeks of gestation or weighs at least

 

 8  400 grams. Fetal death includes a stillbirth. The definition

 

 9  shall conform in all other respects as closely as possible to the

 

10  definition recommended by the federal agency responsible for

 

11  vital statistics.

 

12        (4) "Fetal remains" means a dead fetus or part of a dead

 

13  fetus that has completed at least 10 weeks of gestation or has

 

14  reached the stage of development that, upon visual inspection of

 

15  the fetus or part of the fetus, the head, torso, or extremities

 

16  appear to be supported by skeletal or cartilaginous structures.

 

17  Fetal remains do not include the umbilical cord or placenta.

 

18        (5) (3) "File" means to present a certificate, report, or

 

19  other record to the local registrar provided for in this part for

 

20  registration by the state registrar.

 

21        (6) (4) "Final disposition" means the burial, cremation,

 

22  interment, or other legal disposition of a dead human body or

 

23  fetus fetal remains.

 

24        Sec. 2804. (1) "Institution" means a public or private

 


 1  establishment which that provides inpatient medical, surgical, or

 

 2  diagnostic care or treatment or nursing, custodial, or

 

 3  domiciliary care to 2 or more unrelated individuals, including an

 

 4  establishment to which individuals are committed by law.

 

 5        (2) "Law enforcement agency" means a police agency of a

 

 6  city, village, or township; a sheriff's department; the

 

 7  department of state police; and any other governmental law

 

 8  enforcement agency.

 

 9        (3) "Live birth" means a that term as defined by

 

10  departmental rule which shall conform as closely as possible to

 

11  the definition of live birth recommended by the federal agency

 

12  responsible for vital statistics.in section 1 of the born alive

 

13  infant protection act, 2002 PA 687, MCL 333.1071.

 

14        (4) "Local registrar" means the county clerk or the clerk's

 

15  deputy, or in the case of a city having a population of 40,000 or

 

16  more, the city clerk or city department designated by the

 

17  governing body of the city; or a registrar appointed pursuant to

 

18  section 2814. Population shall be determined according to the

 

19  latest federal decennial census.

 

20        (5) "Miscarriage" means the spontaneous expulsion of a

 

21  nonviable fetus that has completed less than 20 weeks of

 

22  gestation.

 

23        (6) (5) "Registration" means the acceptance by the state

 

24  registrar and the incorporation of certificates provided for in

 

25  this part into the official vital records.

 

26        Sec. 2834. (1) A fetal death occurring in this state , as

 

27  defined by section 2803, shall be reported to the state registrar

 


 1  within 5 days after delivery. The state registrar shall prescribe

 

 2  the form and manner for reporting fetal deaths.

 

 3        (2) The fetal death reporting form shall not contain the

 

 4  name of the biological parents, common identifiers such as social

 

 5  security or drivers license numbers, or other information

 

 6  identifiers that would make it possible to identify in any manner

 

 7  or in any circumstances the biological parents of the fetus. A

 

 8  state agency shall not compare data in an information system file

 

 9  with data in another computer system which that would result in

 

10  identifying in any way a woman or father involved in a fetal

 

11  death. Statistical information which that may reveal the identity

 

12  of the biological parents involved in a fetal death shall not be

 

13  maintained. This subsection does not apply after June 1, 2003.

 

14        (3) If a dead fetus that has completed at least 20 weeks of

 

15  gestation or weighs at least 400 grams is delivered in an

 

16  institution, the individual in charge of the institution or his

 

17  or her authorized representative shall prepare and file the fetal

 

18  death report and shall follow the protocols in place for the

 

19  institution in the event of a death that occurs after a live

 

20  birth but before being discharged from the institution.

 

21        (4) If a dead fetus that has completed at least 20 weeks of

 

22  gestation or weighs at least 400 grams is delivered outside an

 

23  institution, the physician in attendance shall prepare and file

 

24  the fetal death report.

 

25        (5) If a fetal death occurs without medical attendance at or

 

26  after the delivery or if inquiry is required by the medical

 

27  examiner, the attendant, mother, or other person having knowledge

 


 1  of the fetal death shall notify the medical examiner who shall

 

 2  investigate the cause and prepare and file the fetal death

 

 3  report.

 

 4        (6) The fetal death reports required under this section and

 

 5  filed before June 1, 2003 are confidential statistical reports to

 

 6  be used only for medical and health purposes and shall not be

 

 7  incorporated into the permanent official records of the system of

 

 8  vital statistics. A schedule for the disposition of these reports

 

 9  shall be provided for by the department. The department or any

 

10  employee of the department shall not disclose to any person

 

11  outside the department the reports or the contents of the reports

 

12  required by this section and filed before June 1, 2003 in any

 

13  manner or fashion so as to permit a way that permits the person

 

14  or entity to whom the report is disclosed to identify in any way

 

15  the biological parents.

 

16        (7) The fetal death reports required under this section and

 

17  filed on or after June 1, 2003 are permanent vital records

 

18  documents and shall be incorporated into the system of vital

 

19  statistics. as described in section 2805. Access to a fetal death

 

20  report or information contained on a fetal death report shall be

 

21  is the same as to a live birth record in accordance with under

 

22  sections 2882, 2883, and 2888.

 

23        (8) With information provided to the department under

 

24  subsection (7), the department shall create a certificate of

 

25  stillbirth which shall conform that conforms as nearly as

 

26  possible to recognized national standardized forms and shall

 

27  include, includes, but is not be limited to, the following

 


 1  information:

 

 2        (a) The name of the fetus, if it was given a name by the

 

 3  parent or parents.

 

 4        (b) The number of weeks of gestation completed.

 

 5        (c) The date of delivery and weight at the time of delivery.

 

 6        (d) The name of the parent or parents.

 

 7        (e) The name of the health facility institution in which the

 

 8  fetus was delivered or the name of the health professional in

 

 9  attendance if the delivery was outside a health facility.an

 

10  institution.

 

11        Sec. 2835. (1) As used in this section and section 2837, :

 

12        (a) "Abortion" means that term as defined in section 17015.

 

13        (b) "Physical "physical complication" means a physical

 

14  condition occurring during or after an abortion that, under

 

15  generally accepted standards of medical practice, requires

 

16  medical attention. Physical complication includes, but is not

 

17  limited to, infection, hemorrhage, cervical laceration, or

 

18  perforation of the uterus.

 

19        (2) A physician who performs an abortion shall report the

 

20  performance of that procedure to the department on forms

 

21  prescribed and provided by the department. A physician shall

 

22  transmit a report required under this subsection to the director

 

23  within 7 days after the performance of the abortion.

 

24        (3) Each report of an abortion required under subsection (2)

 

25  shall contain only the following information and no other

 

26  information:

 

27        (a) The age of the woman individual at the time of the

 


 1  abortion.

 

 2        (b) The marital status of the woman individual at the time

 

 3  of the abortion.

 

 4        (c) The race and, if applicable, Hispanic ethnicity of the

 

 5  woman.individual.

 

 6        (d) The city or township, county, and state in which the

 

 7  woman individual resided at the time of the abortion.

 

 8        (e) The location name and address of the facility and the

 

 9  type of facility in which the abortion was performed.

 

10        (f) The source of referral to the physician performing the

 

11  abortion.

 

12        (g) The number of previous pregnancies carried to term.

 

13        (h) The number of previous pregnancies ending in spontaneous

 

14  abortion.

 

15        (i) The number of previous pregnancies terminated by

 

16  abortion.

 

17        (j) The method used before the abortion to confirm the

 

18  pregnancy, the period of gestation in weeks of the present

 

19  pregnancy, and the first day of the last menstrual period.

 

20        (k) The method used to perform the abortion.

 

21        (l) The weight of the embryo or fetus, if determinable.

 

22        (m) Whether the fetus showed evidence of life when

 

23  separated, expelled, or removed from the woman.individual.

 

24        (n) The date of performance of the abortion.

 

25        (o) The method and source of payment for the abortion.

 

26        (p) A physical complication or death resulting from the

 

27  abortion and observed by the physician or reported to the

 


 1  physician or his or her agent before the report required under

 

 2  subsection (2) is transmitted to the director.

 

 3        (q) The physician's signature and his or her state license

 

 4  number.

 

 5        (4) The report required under subsection (2) shall not

 

 6  contain the name of the woman individual, common identifiers such

 

 7  as her social security number or motor vehicle operator's license

 

 8  number or other information or identifiers that would make it

 

 9  possible to identify in any manner or under any circumstances an

 

10  individual who has obtained or seeks to obtain an abortion. A

 

11  state agency shall not compare data in an electronic or other

 

12  information system file with data in another electronic or other

 

13  information system that would result in identifying in any manner

 

14  or under any circumstances an individual obtaining or seeking to

 

15  obtain an abortion. Statistical information that may reveal the

 

16  identity of a woman an individual obtaining or seeking to obtain

 

17  an abortion shall not be maintained.

 

18        (5) The department shall destroy each individual report

 

19  required by this section and each copy of the report after

 

20  retaining the report for 5 years after the date the report is

 

21  received.

 

22        (6) The department shall make available annually in

 

23  aggregate a statistical report summarizing the information

 

24  submitted in each individual report required by this section. The

 

25  department shall specifically summarize aggregate data regarding

 

26  all of the following in the annual statistical report:

 

27        (a) The period of gestation in 4-week intervals from 5 weeks

 


 1  through 28 weeks.

 

 2        (b) Abortions performed on women individuals aged 17 and

 

 3  under.

 

 4        (c) Physical complications reported under subsection (3)(p)

 

 5  and section 2837.

 

 6        (7) The reports required under this section are statistical

 

 7  reports to be used only for medical and health purposes and shall

 

 8  not be incorporated into the permanent official records of the

 

 9  system of vital statistics.

 

10        (8) The Except as otherwise provided in subsection (10), the

 

11  department or an employee of the department shall not disclose to

 

12  a person or entity outside the department the reports or the

 

13  contents of the reports required by this section in a manner or

 

14  fashion so as to permit the person or entity to whom the report

 

15  is disclosed to identify in any way the person individual who is

 

16  the subject of the report, the identity of the physician who

 

17  performed the abortion, or the name or address of a facility in

 

18  which an abortion was performed.

 

19        (9) A person who discloses confidential identifying

 

20  information in violation of this section, section 2834(6), or

 

21  section 2837 is guilty of a felony punishable by imprisonment for

 

22  not more than 3 years or a fine of not more than $5,000.00, or

 

23  both.

 

24        (10) The department may release the reports or the contents

 

25  of the reports required by this section to the department of

 

26  licensing and regulatory affairs for regulatory purposes only.

 

27  The department of licensing and regulatory affairs or an employee

 


 1  of the department of licensing or regulatory affairs shall not

 

 2  disclose to a person or entity outside of the department of

 

 3  licensing and regulatory affairs the reports or the contents of

 

 4  the reports required by this section in a manner or fashion so as

 

 5  to permit the person or entity to whom the report is disclosed to

 

 6  identify in any way the individual who is the subject of the

 

 7  report, the identity of the physician who performed the abortion,

 

 8  or the name or address of a facility in which an abortion was

 

 9  performed.

 

10        Sec. 2836. (1) All fetal remains resulting from abortions

 

11  shall be disposed of by interment or cremation as those terms are

 

12  defined in section 2 of the cemetery regulation act, 1968 PA 251,

 

13  MCL 456.522, or by incineration by a person other than a cemetery

 

14  registered under the cemetery regulation act, 1968 PA 251, MCL

 

15  456.521 to 456.543. Unless the mother has provided written

 

16  consent for research on the fetal remains under section 2688, a

 

17  physician who performs an abortion shall arrange for the final

 

18  disposition of the fetal remains resulting from the abortion.

 

19  Disposal of fetal remains resulting from an abortion may occur

 

20  without the supervision of a funeral director.

 

21        (2) This section does not require a physician to discuss the

 

22  final disposition of the fetal remains with the mother before

 

23  performing the abortion, nor does it require a physician to

 

24  obtain authorization from the mother for the final disposition of

 

25  the fetal remains upon completion of the abortion.

 

26        Sec. 2848. (1) Except as otherwise provided in sections 2844

 

27  and 2845, a funeral director or person acting as a funeral

 


 1  director, who first assumes custody of a dead body, not later

 

 2  than 72 hours after death or the finding of a dead body and

 

 3  before final disposition of the body, shall obtain authorization

 

 4  for the final disposition. The authorization for final

 

 5  disposition of a dead body shall be issued on a form prescribed

 

 6  by the state registrar and signed by the local registrar or the

 

 7  state registrar.

 

 8        (2) Before Except as otherwise provided in section 2836, or

 

 9  unless the mother has provided written consent for research on

 

10  the dead fetus under section 2688, before final disposition of a

 

11  dead fetus, irrespective of the duration of pregnancy, the

 

12  funeral director or person assuming responsibility for the final

 

13  disposition of the fetus or fetal remains shall obtain from the

 

14  parents, or parent in case of an if the mother is unmarried,

 

15  mother, an authorization for final disposition on a form

 

16  prescribed and furnished or approved by the state registrar. The

 

17  authorization may allow final disposition to be by a funeral

 

18  director, the individual in charge of the institution where the

 

19  fetus was delivered or miscarried, or an institution or agency

 

20  authorized to accept donated bodies, or fetuses, or fetal remains

 

21  under this code act. The parents, or parent if the mother is

 

22  unmarried, may direct the final disposition to be interment or

 

23  cremation as those terms are defined in section 2 of the cemetery

 

24  regulation act, 1968 PA 251, MCL 456.522, or incineration. After

 

25  final disposition, the funeral director, the individual in charge

 

26  of the institution, or other person making the final disposition

 

27  shall retain the permit for not less than 7 years. This section

 


 1  as amended by the amendatory act that added this sentence does

 

 2  not require a religious service or ceremony as part of the final

 

 3  disposition of fetal remains.

 

 4        (3) If final disposition is by cremation, the medical

 

 5  examiner of the county in which death occurred shall sign the

 

 6  authorization for final disposition.

 

 7        (4) A body may be moved from the place of death to be

 

 8  prepared for final disposition with the consent of the physician

 

 9  or county medical examiner who certifies the cause of death.

 

10        (5) A permit for disposition issued under the law of another

 

11  state that accompanies a dead body or dead fetus brought into

 

12  this state is authorization for final disposition of the dead

 

13  body or dead fetus in this state.

 

14        Sec. 2854. A person who violates this part by failing to

 

15  dispose of fetal remains resulting from an abortion as prescribed

 

16  in section 2836 or by failing to obtain the proper authorization

 

17  for final disposition of a dead body as provided under section

 

18  2848 is responsible for a state civil infraction as provided

 

19  under chapter 88 of the revised judicature act of 1961, 1961 PA

 

20  236, MCL 600.8801 to 600.8835, and may be ordered to pay a civil

 

21  fine of not more than $1,000.00 per violation.

 

22        Sec. 13807. (1) "Pathogen" means a microorganism that

 

23  produces disease.

 

24        (2) "Pathological waste" means human organs, tissues, body

 

25  parts other than teeth, products of conception, and fluids

 

26  removed by trauma or during surgery, or autopsy, or other medical

 

27  procedure, and not fixed in formaldehyde. Pathological waste does

 


 1  not include a fetus or fetal body parts.

 

 2        (3) "Point of generation" means the point at which medical

 

 3  waste leaves the producing facility site.

 

 4        (4) "Producing facility" means a facility that generates,

 

 5  stores, decontaminates, or incinerates medical waste.

 

 6        (5) "Products of conception" means any tissues or fluids,

 

 7  placenta, umbilical cord, or other uterine contents resulting

 

 8  from a pregnancy. Products of conception do not include a fetus

 

 9  or fetal body parts.

 

10        (6) (5) "Release" means any spilling, leaking, pumping,

 

11  pouring, emitting, emptying, discharging, injecting, escaping,

 

12  leaching, dumping, or disposing of medical waste into the

 

13  environment in violation of this part.

 

14        (7) (6) "Response activity" means an activity necessary to

 

15  protect the public health, safety, welfare, and the environment,

 

16  and includes, but is not limited to, evaluation, cleanup,

 

17  removal, containment, isolation, treatment, monitoring,

 

18  maintenance, replacement of water supplies, and temporary

 

19  relocation of people.

 

20        (8) (7) "Sharps" means needles, syringes, scalpels, and

 

21  intravenous tubing with needles attached.

 

22        (9) (8) "Storage" means the containment of medical waste in

 

23  a manner that does not constitute disposal of the medical waste.

 

24  (10) (9) "Transport" means the movement of medical waste

 

25  from the point of generation to any intermediate point and

 

26  finally to the point of treatment or disposal. Transport does not

 

27  include the movement of medical waste from a health facility or

 


    House Bill No. 5711 as amended December 12, 2012

 

 1  agency to another health facility or agency for the purposes of

 

 2  testing and research.

 

 3        <<Sec. 16221. The department may investigate activities related

 

 4  to the practice of a health profession by a licensee, a registrant,

 

 5  or an applicant for licensure or registration. The department may hold

 

 6  hearings, administer oaths, and order the taking of relevant testimony

 

 7  to be taken and shall report its findings to the appropriate disciplinary

 

 8  subcommittee. The disciplinary subcommittee shall proceed under

 

 9  section 16226 if it finds that 1 or more of the following grounds exist:

 

10        (a) A violation of general duty, consisting of negligence or

 

11  failure to exercise due care, including negligent delegation to or

 

12  supervision of employees or other individuals, whether or not injury

 

13  results, or any conduct, practice, or condition that impairs, or may

 

14  impair, the ability to safely and skillfully practice the health

 

15  profession.

 

16        (b) Personal disqualifications, consisting of 1 or more of the

 

17  following:

 

18        (i) Incompetence.

 

19        (ii) Subject to sections 16165 to 16170a, substance abuse use

 

20  disorder as defined in section 6107.100d of the mental health code,

 

21  1974 PA 258, MCL 330.1100d.

 

22        (iii) Mental or physical inability reasonably related to and

 

23  adversely affecting the licensee's ability to practice in a safe and

 

24  competent manner.

 

25        (iv) Declaration of mental incompetence by a court of

 

26  competent jurisdiction.

 

27        (v) Conviction of a misdemeanor punishable by imprisonment

 

 


    House Bill No. 5711 as amended December 12, 2012

 

 1  for a maximum term of 2 years; a misdemeanor involving the illegal

 

 2  delivery, possession, or use of a controlled substance; or a felony. A

 

 3  certified copy of the court record is conclusive evidence of the

 

 4  conviction.

 

       (vi) Lack of good moral character.

 

 6        (vii) Conviction of a criminal offense under section 520e

 

 7  or 520g of the Michigan penal code, 1931 PA 328, MCL 750.520e and

 

 8  750.520g. A certified copy of the court record is conclusive evidence

 

 9  of the conviction.

 

10        (viii) Conviction of a violation of section 492a of the Michigan

 

11  penal code, 1931 PA 328, MCL 750.492a. A certified copy of the court

 

12  record is conclusive evidence of the conviction.

 

13        (ix) Conviction of a misdemeanor or felony involving fraud in

 

14  obtaining or attempting to obtain fees related to the practice of a

 

15  health profession. A certified copy of the court record is conclusive

 

16  evidence of the conviction.

 

17        (x) Final adverse administrative action by a licensure,

 

18  registration, disciplinary, or certification board involving the

 

19  holder of, or an applicant for, a license or registration regulated by

 

20  another state or a territory of the United States, by the United States

 

21  military, by the federal government, or by another country. A certified

 

22  copy of the record of the board is conclusive evidence of the final

 

23  action.

 

24        (xi) Conviction of a misdemeanor that is reasonably related to or

 

25  that adversely affects the licensee's ability to practice in a safe and

 

26  competent manner. A certified copy of the court record is conclusive

 

27  evidence of the conviction.

 


    House Bill No. 5711 as amended December 12, 2012

 

 1        (xii) Conviction of a violation of section 430 of the Michigan

 

 2  penal code, 1931 PA 328, MCL 750.430. A certified copy of the court

 

 3  record is conclusive evidence of the conviction.

 

 4        (xiii) Conviction of a criminal offense under section 520b,

 

 5  520c, 520d, or 520f of the Michigan penal code, 1931 PA 328, MCL

 

 6  750.520b, 750.520c, 750.520d, and 750.520f. A certified copy of the court

 

 7  record is conclusive evidence of the conviction.

 

 8        (c) Prohibited acts, consisting of 1 or more of the following:

 

 9        (i) Fraud or deceit in obtaining or renewing a license or

 

10  registration.

 

11        (ii) Permitting the a license or registration to be used by an

 

12  unauthorized person.

 

13        (iii) Practice outside the scope of a license.

 

14        (iv) Obtaining, possessing, or attempting to obtain or possess

 

15  a controlled substance as defined in section 7104 or a drug as defined

 

16  in section 7105 without lawful authority; or selling, prescribing, giving

 

17  away, or administering drugs for other than lawful diagnostic or

 

18  therapeutic purposes.

 

19        (d) Unethical business practices, consisting of 1 or more of

 

20  the following:

 

21        (i) False or misleading advertising.

 

22        (ii) Dividing fees for referral of patients or accepting

 

23  kickbacks on medical or surgical services, appliances, or medications

 

24  purchased by or on behalf of patients.

 

25        (iii) Fraud or deceit in obtaining or attempting to obtain

 

26  third party reimbursement.

 

27        (e) Unprofessional conduct, consisting of 1 or more of the

 

 


    House Bill No. 5711 as amended December 12, 2012

 

 1  following:

 

 2        (i) Misrepresentation to a consumer or patient or in obtaining or

 

 3  attempting to obtain third party reimbursement in the course of

 

 4  professional practice.

 

 5        (ii) Betrayal of a professional confidence.

 

 6        (iii) Promotion for personal gain of an unnecessary drug, device,

 

 7  treatment, procedure, or service.

 

 8        (iv) Either of the following:

 

 9        (A) A requirement by a licensee other than a physician that an

 

10  individual purchase or secure a drug, device, treatment, procedure, or

 

11  service from another person, place, facility, or business in which the

 

12  licensee has a financial interest.

 

13        (B) A referral by a physician for a designated health service that

 

14  violates 42 USC 1395nn or a regulation promulgated under that section.

 

15  For purposes of this subparagraph, subdivision, 42 USC 1395nn and th e

 

16  regulations promulgated under that section as they exist on June 3, 2002

 

17  are incorporated by reference. A disciplinary subcommittee shall apply 42

 

18  USC 1395nn and the regulations promulgated under that section regardless

 

19  of the source of payment for the designated health service referred and

 

20  rendered. If 42 USC 1395nn or a regulation promulgated under that section

 

21  is revised after June 3, 2002, the department shall officially take

 

22  notice of the revision. Within 30 days after taking notice of the

 

23  revision, the department shall decide whether or not the revision

 

24  pertains to referral by physicians for designated health services and

 

25  continues to protect the public from inappropriate referrals by

 

26  physicians. If the department decides that the revision does both of

 

27  those things, the department may promulgate rules to incorporate the

 

 


    House Bill No. 5711 as amended December 12, 2012

 

 1  revision by reference. If the department does promulgate rules to

 

 2  incorporate the revision by reference, the department shall not make any

 

 3  changes to the revision. As used in this subparagraph, sub-subparagraph,

 

 4  "designated health service" means that term as defined in 42 USC 1395nn

 

 5  and the regulations promulgated under that section and "physician" means

 

 6  that term as defined in sections 17001 and 17501.

 

 7        (v) For a physician who makes referrals pursuant to 42 USC 1395nn

 

 8  or a regulation promulgated under that section, refusing to accept a

 

 9  reasonable proportion of patients eligible for medicaid and refusing

 

10  to accept payment from medicaid or medicare as payment in full for a

 

11  treatment, procedure, or service for which the physician refers the

 

12  individual and in which the physician has a financial interest. A

 

13  physician who owns all or part of a facility in which he or she

 

14  provides surgical services is not subject to this subparagraph if a

 

15  referred surgical procedure he or she performs in the facility is not

 

16  reimbursed at a minimum of the appropriate medicaid or medicare

 

17  outpatient fee schedule, including the combined technical and

 

18  professional components.

 

19        (f) Beginning June 3, 2003, the department of consumer and industry

 

20  services shall prepare the first of 3 annual reports on the effect of

 

21  2002 PA 402 on access to care for the uninsured and medicaid patients.

 

22  The department shall report on the number of referrals by licensees of

 

23  uninsured and medicaid patients to purchase or secure a drug, device,

 

24  treatment, procedure, or service from another person, place, facility, or

 

25  business in which the licensee has a financial interest.

 

26        (g) Failure to report a change of name or mailing address within 30

 

27  days after the change occurs.

 


    House Bill No. 5711 as amended December 12, 2012

 

 1        (h) A violation, or aiding or abetting in a violation, of this

 

 2  article or of a rule promulgated under this article.

 

 3        (i) Failure to comply with a subpoena issued pursuant to this

 

 4  part, failure to respond to a complaint issued under this article or

 

 5  article 7, failure to appear at a compliance conference or an

 

 6  administrative hearing, or failure to report under section 16222 or

 

 7  16223.

 

 8        (j) Failure to pay an installment of an assessment levied pursuant

 

 9  to under the insurance code of 1956, 1956 PA 218, MCL 500.100 to

 

10  500.8302, within 60 days after notice by the appropriate board.

 

11        (k) A violation of section 17013 or 17513.

 

12        (l) Failure to meet 1 or more of the requirements for licensure or

 

13  registration under section 16174.

 

14        (m) A violation of section 17015, or 17015a, 17017, 17515, or

 

15  17517.

 

16        (n) A violation of section 17016 or 17516.

 

17        (o) Failure to comply with section 9206(3).

 

18        (p) A violation of section 5654 or 5655.

 

19        (q) A violation of section 16274.

 

20        (r) A violation of section 17020 or 17520.

 

21        (s) A violation of the medical records access act, 2004 PA 47, MCL

 

22  333.26261 to 333.26271.

 

23        (t) A violation of section 17764(2).

 

24 

 

25 

 

26 

 

27 

 


    House Bill No. 5711 as amended December 12, 2012

 

 1 

 

 2 

 

 3                                              >>

 

 4        Sec. 16226. (1) After finding the existence of 1 or more of

 

 5  the grounds for disciplinary subcommittee action listed in

 

 6  section 16221, a disciplinary subcommittee shall impose 1 or more

 

 7  of the following sanctions for each violation:

 

 

 Violations of Section 16221                   Sanctions

Subdivision (a), (b)(ii),          Probation, limitation, denial,

10 (b)(iv), (b)(vi), or                suspension, revocation,

11 (b)(vii)                            restitution, community service,

12                                    or fine.

13                                   

14 Subdivision (b)(viii)               Revocation or denial.

15                                   

16 Subdivision (b)(i),                Limitation, suspension,

17 (b)(iii), (b)(v),                   revocation, denial,

18 (b)(ix), (b)(x),                   probation, restitution,

19 (b)(xi), or (b)(xii)                community service, or fine.

20                                   

21 Subdivision (b)(xiii)               Probation, limitation, denial,

22                                    suspension, revocation,

23                                    restitution, community service,

24                                    fine, or, subject to subsection

25                                    (5), permanent revocation.

26                                   

27                                   

28 Subdivision (c)(i)                 Denial, revocation, suspension,

29                                    probation, limitation, community


                                   service, or fine.

                                  

Subdivision (c)(ii)                Denial, suspension, revocation,

                                   restitution, community service,

                                   or fine.

                                  

Subdivision (c)(iii)                Probation, denial, suspension,

                                   revocation, restitution,

                                   community service, or fine.

10                                   

11 Subdivision (c)(iv)                Fine, probation, denial,

12 or (d)(iii)                         suspension, revocation, community

13                                    service, or restitution.

14                                   

15 Subdivision (d)(i)                 Reprimand, fine, probation,

16 or (d)(ii)                         community service, denial,

17                                    or restitution.

18                                   

19 Subdivision (e)(i)                 Reprimand, fine, probation,

20                                    limitation, suspension, community

21                                    service, denial, or restitution.

22                                   

23 Subdivision (e)(ii)                Reprimand, probation,

24 or (i)(i)                          suspension, restitution,

25                                    community service, denial, or

26                                    fine.

27                                   

28 Subdivision (e)(iii),               Reprimand, fine, probation,

29 (e)(iv), or (e)(v)                 suspension, revocation,

30                                    limitation, community service,

31                                    denial, or restitution.


                                  

Subdivision (g)                   Reprimand or fine.

                                  

Subdivision (h) or (s)            Reprimand, probation, denial,

                                   suspension, revocation,

                                   limitation, restitution,

                                   community service, or fine.

                                  

Subdivision (j)                   Suspension or fine.

10                                   

11 Subdivision (k), (p),             Reprimand or fine.

12 or (r)                           

13                                   

14 Subdivision (l)                    Reprimand, denial, or

15                                    limitation.

16                                   

17 Subdivision (m) or (o)            Denial, revocation, restitution,

18                                    probation, suspension,

19                                    limitation, reprimand, or fine.

20                                   

21 Subdivision (n)                   Revocation or denial.

22                                   

23 Subdivision (q)                   Revocation.

24                                   

25 Subdivision (t)                   Revocation, fine, and

26                                    restitution.

 

 

27        (2) Determination of sanctions for violations under this

 

28  section shall be made by a disciplinary subcommittee. If, during

 

29  judicial review, the court of appeals determines that a final

 

30  decision or order of a disciplinary subcommittee prejudices


 

 1  substantial rights of the petitioner for 1 or more of the grounds

 

 2  listed in section 106 of the administrative procedures act of

 

 3  1969, 1969 PA 306, MCL 24.306, and holds that the final decision

 

 4  or order is unlawful and is to be set aside, the court shall

 

 5  state on the record the reasons for the holding and may remand

 

 6  the case to the disciplinary subcommittee for further

 

 7  consideration.

 

 8        (3) A disciplinary subcommittee may impose a fine of up to,

 

 9  but not exceeding, $250,000.00 for a violation of section

 

10  16221(a) or (b).

 

11        (4) A disciplinary subcommittee may require a licensee or

 

12  registrant or an applicant for licensure or registration who has

 

13  violated this article or article 7 or a rule promulgated under

 

14  this article or article 7 to satisfactorily complete an

 

15  educational program, a training program, or a treatment program,

 

16  a mental, physical, or professional competence examination, or a

 

17  combination of those programs and examinations.

 

18        (5) A disciplinary subcommittee shall not impose the

 

19  sanction of permanent revocation for a violation of section

 

20  16221(b)(xiii) unless the violation occurred while the licensee or

 

21  registrant was acting within the health profession for which he

 

22  or she was licensed or registered.

 

23        Sec. 16299. (1) Except as otherwise provided in subsection

 

24  (2), a person who violates or aids or abets another in a

 

25  violation of this article, other than those matters described in

 

26  sections 16294 and 16296, is guilty of a misdemeanor punishable

 

27  as follows:


 

 1        (a) For the first offense, by imprisonment for not more than

 

 2  90 days, or a fine of not more than $100.00, or both.

 

 3        (b) For the second or subsequent offense, by imprisonment

 

 4  for not less than 90 days nor more than 6 months, or a fine of

 

 5  not less than $200.00 nor more than $500.00, or both.

 

 6        (2) Subsection (1) does not apply to a violation of section

 

 7  17015, or 17015a, 17017, 17515, or 17517.

 

 8        Sec. 17015. (1) Subject to subsection (10), a physician

 

 9  shall not perform an abortion otherwise permitted by law without

 

10  the patient's informed written consent, given freely and without

 

11  coercion to abort.

 

12        (2) For purposes of this section and section 17015a:

 

13        (a) "Abortion" means the intentional use of an instrument,

 

14  drug, or other substance or device to terminate a woman's

 

15  pregnancy for a purpose other than to increase the probability of

 

16  a live birth, to preserve the life or health of the child after

 

17  live birth, or to remove a dead fetus that has died as a result

 

18  of natural causes, accidental trauma, or a criminal assault on

 

19  the pregnant woman. Abortion does not include the use or

 

20  prescription of a drug or device intended as a contraceptive.

 

21        (b) "Coercion to abort" means an act committed with the

 

22  intent to coerce an individual to have an abortion, which act is

 

23  prohibited by section 213a of the Michigan penal code, 1931 PA

 

24  328, MCL 750.213a.

 

25        (c) "Domestic violence" means that term as defined in

 

26  section 1 of 1978 PA 389, MCL 400.1501.

 

27        (d) (b) "Fetus" means an individual organism of the species


 

 1  homo sapiens in utero.

 

 2        (e) (c) "Local health department representative" means a

 

 3  person , who meets 1 or more of the licensing requirements listed

 

 4  in subdivision (f) (h) and who is employed by, or under contract

 

 5  to provide services on behalf of, a local health department.

 

 6        (f) (d) "Medical emergency" means that condition which, on

 

 7  the basis of the physician's good faith clinical judgment, so

 

 8  complicates the medical condition of a pregnant woman as to

 

 9  necessitate the immediate abortion of her pregnancy to avert her

 

10  death or for which a delay will create serious risk of

 

11  substantial and irreversible impairment of a major bodily

 

12  function.

 

13        (g) (e) "Medical service" means the provision of a

 

14  treatment, procedure, medication, examination, diagnostic test,

 

15  assessment, or counseling, including, but not limited to, a

 

16  pregnancy test, ultrasound, pelvic examination, or an abortion.

 

17        (h) (f) "Qualified person assisting the physician" means

 

18  another physician or a physician's assistant licensed under this

 

19  part or part 175, a fully licensed or limited licensed

 

20  psychologist licensed under part 182, a professional counselor

 

21  licensed under part 181, a registered professional nurse or a

 

22  licensed practical nurse licensed under part 172, or a social

 

23  worker licensed under part 185.

 

24        (i) (g) "Probable gestational age of the fetus" means the

 

25  gestational age of the fetus at the time an abortion is planned

 

26  to be performed.

 

27        (j) (h) "Provide the patient with a physical copy" means


 

 1  confirming that the patient accessed the internet website

 

 2  described in subsection (5) and received a printed valid

 

 3  confirmation form from the website and including that form in the

 

 4  patient's medical record or giving a patient a copy of a required

 

 5  document by 1 or more of the following means:

 

 6        (i) In person.

 

 7        (ii) By registered mail, return receipt requested.

 

 8        (iii) By parcel delivery service that requires the recipient

 

 9  to provide a signature in order to receive delivery of a parcel.

 

10        (iv) By facsimile transmission.

 

11        (3) Subject to subsection (10), a physician or a qualified

 

12  person assisting the physician shall do all of the following not

 

13  less than 24 hours before that physician performs an abortion

 

14  upon a patient who is a pregnant woman:

 

15        (a) Confirm that, according to the best medical judgment of

 

16  a physician, the patient is pregnant, and determine the probable

 

17  gestational age of the fetus.

 

18        (b) Orally describe, in language designed to be understood

 

19  by the patient, taking into account her age, level of maturity,

 

20  and intellectual capability, each of the following:

 

21        (i) The probable gestational age of the fetus she is

 

22  carrying.

 

23        (ii) Information about what to do and whom to contact should

 

24  medical complications arise from the abortion.

 

25        (iii) Information about how to obtain pregnancy prevention

 

26  information through the department of community health.

 

27        (c) Provide the patient with a physical copy of the written


 

 1  standardized summary described in subsection (11)(b) that

 

 2  corresponds to the procedure the patient will undergo and is

 

 3  provided by the department of community health. If the procedure

 

 4  has not been recognized by the department, but is otherwise

 

 5  allowed under Michigan law, and the department has not provided a

 

 6  written standardized summary for that procedure, the physician

 

 7  shall develop and provide a written summary that describes the

 

 8  procedure, any known risks or complications of the procedure, and

 

 9  risks associated with live birth and meets the requirements of

 

10  subsection (11)(b)(iii) through (vii).

 

11        (d) Provide the patient with a physical copy of a medically

 

12  accurate depiction, illustration, or photograph and description

 

13  of a fetus supplied by the department of community health

 

14  pursuant to subsection (11)(a) at the gestational age nearest the

 

15  probable gestational age of the patient's fetus.

 

16        (e) Provide the patient with a physical copy of the prenatal

 

17  care and parenting information pamphlet distributed by the

 

18  department of community health under section 9161.

 

19        (f) Provide the patient with a physical copy of the

 

20  prescreening summary on prevention of coercion to abort described

 

21  in subsection (11)(i).

 

22        (4) The requirements of subsection (3) may be fulfilled by

 

23  the physician or a qualified person assisting the physician at a

 

24  location other than the health facility where the abortion is to

 

25  be performed. The requirement of subsection (3)(a) that a

 

26  patient's pregnancy be confirmed may be fulfilled by a local

 

27  health department under subsection (18). The requirements of


 

 1  subsection (3) cannot be fulfilled by the patient accessing an

 

 2  internet website other than the internet website described in

 

 3  subsection (5) that is maintained through and operated by the

 

 4  department under subsection (11)(g).

 

 5        (5) The requirements of subsection (3)(c) through (e) (f)

 

 6  may be fulfilled by a patient accessing the internet website that

 

 7  is maintained and operated through by the department under

 

 8  subsection (11)(g) and receiving a printed, valid confirmation

 

 9  form from the website that the patient has reviewed the

 

10  information required in subsection (3)(c) through (e) (f) at

 

11  least 24 hours before an abortion being performed on the patient.

 

12  The website shall not require any information be supplied by the

 

13  patient. The department shall not track, compile, or otherwise

 

14  keep a record of information that would identify a patient who

 

15  accesses this website. The patient shall supply the valid

 

16  confirmation form to the physician or qualified person assisting

 

17  the physician to be included in the patient's medical record to

 

18  comply with this subsection.

 

19        (6) Subject to subsection (10), before obtaining the

 

20  patient's signature on the acknowledgment and consent form, a

 

21  physician personally and in the presence of the patient shall do

 

22  all of the following:

 

23        (a) Provide the patient with the physician's name, confirm

 

24  with the patient that the coercion to abort screening required

 

25  under section 17015a was performed, and inform the patient of her

 

26  right to withhold or withdraw her consent to the abortion at any

 

27  time before performance of the abortion.


 

 1        (b) Orally describe, in language designed to be understood

 

 2  by the patient, taking into account her age, level of maturity,

 

 3  and intellectual capability, each of the following:

 

 4        (i) The specific risk, if any, to the patient of the

 

 5  complications that have been associated with the procedure the

 

 6  patient will undergo, based on the patient's particular medical

 

 7  condition and history as determined by the physician.

 

 8        (ii) The specific risk of complications, if any, to the

 

 9  patient if she chooses to continue the pregnancy based on the

 

10  patient's particular medical condition and history as determined

 

11  by a physician.

 

12        (7) To protect a patient's privacy, the information set

 

13  forth in subsection (3) and subsection (6) shall not be disclosed

 

14  to the patient in the presence of another patient.

 

15        (8) If at any time prior to before the performance of an

 

16  abortion, a patient undergoes an ultrasound examination, or a

 

17  physician determines that ultrasound imaging will be used during

 

18  the course of a patient's abortion, the physician or qualified

 

19  person assisting the physician shall provide the patient with the

 

20  opportunity to view or decline to view an active ultrasound image

 

21  of the fetus, and offer to provide the patient with a physical

 

22  picture of the ultrasound image of the fetus prior to before the

 

23  performance of the abortion. Before After the expiration of the

 

24  24-hour period prescribed under subsection (3) but before

 

25  performing an abortion on a patient who is a pregnant woman, a

 

26  physician or a qualified person assisting the physician shall do

 

27  all of the following:


 

 1        (a) Obtain the patient's signature on the acknowledgment and

 

 2  consent form described in subsection (11)(c) confirming that she

 

 3  has received the information required under subsection (3).

 

 4        (b) Provide the patient with a physical copy of the signed

 

 5  acknowledgment and consent form described in subsection (11)(c).

 

 6        (c) Retain a copy of the signed acknowledgment and consent

 

 7  form described in subsection (11)(c) and, if applicable, a copy

 

 8  of the pregnancy certification form completed under subsection

 

 9  (18)(b), in the patient's medical record.

 

10        (9) This subsection does not prohibit notifying the patient

 

11  that payment for medical services will be required or that

 

12  collection of payment in full for all medical services provided

 

13  or planned may be demanded after the 24-hour period described in

 

14  this subsection has expired. A physician or an agent of the

 

15  physician shall not collect payment, in whole or in part, for a

 

16  medical service provided to or planned for a patient before the

 

17  expiration of 24 hours from the time the patient has done either

 

18  or both of the following, except in the case of a physician or an

 

19  agent of a physician receiving capitated payments or under a

 

20  salary arrangement for providing those medical services:

 

21        (a) Inquired about obtaining an abortion after her pregnancy

 

22  is confirmed and she has received from that physician or a

 

23  qualified person assisting the physician the information required

 

24  under subsection (3)(c) and (d).

 

25        (b) Scheduled an abortion to be performed by that physician.

 

26        (10) If the attending physician, utilizing his or her

 

27  experience, judgment, and professional competence, determines


 

 1  that a medical emergency exists and necessitates performance of

 

 2  an abortion before the requirements of subsections (1), (3), and

 

 3  (6) can be met, the physician is exempt from the requirements of

 

 4  subsections (1), (3), and (6), may perform the abortion, and

 

 5  shall maintain a written record identifying with specificity the

 

 6  medical factors upon which the determination of the medical

 

 7  emergency is based.

 

 8        (11) The department of community health shall do each of the

 

 9  following:

 

10        (a) Produce medically accurate depictions, illustrations, or

 

11  photographs of the development of a human fetus that indicate by

 

12  scale the actual size of the fetus at 2-week intervals from the

 

13  fourth week through the twenty-eighth week of gestation. Each

 

14  depiction, illustration, or photograph shall be accompanied by a

 

15  printed description, in nontechnical English, Arabic, and

 

16  Spanish, of the probable anatomical and physiological

 

17  characteristics of the fetus at that particular state of

 

18  gestational development.

 

19        (b) Subject to subdivision (g), (e), develop, draft, and

 

20  print, in nontechnical English, Arabic, and Spanish, written

 

21  standardized summaries, based upon the various medical procedures

 

22  used to abort pregnancies, that do each of the following:

 

23        (i) Describe, individually and on separate documents, those

 

24  medical procedures used to perform abortions in this state that

 

25  are recognized by the department.

 

26        (ii) Identify the physical complications that have been

 

27  associated with each procedure described in subparagraph (i) and


 

 1  with live birth, as determined by the department. In identifying

 

 2  these complications, the department shall consider the annual

 

 3  statistical report required under section 2835(6) 2835, and shall

 

 4  consider studies concerning complications that have been

 

 5  published in a peer review medical journal, with particular

 

 6  attention paid to the design of the study, and shall consult with

 

 7  the federal centers for disease control and prevention, the

 

 8  American college congress of obstetricians and gynecologists, the

 

 9  Michigan state medical society, or any other source that the

 

10  department determines appropriate for the purpose.

 

11        (iii) State that as the result of an abortion, some women may

 

12  experience depression, feelings of guilt, sleep disturbance, loss

 

13  of interest in work or sex, or anger, and that if these symptoms

 

14  occur and are intense or persistent, professional help is

 

15  recommended.

 

16        (iv) State that not all of the complications listed in

 

17  subparagraph (ii) may pertain to that particular patient and refer

 

18  the patient to her physician for more personalized information.

 

19        (v) Identify services available through public agencies to

 

20  assist the patient during her pregnancy and after the birth of

 

21  her child, should she choose to give birth and maintain custody

 

22  of her child.

 

23        (vi) Identify services available through public agencies to

 

24  assist the patient in placing her child in an adoptive or foster

 

25  home, should she choose to give birth but not maintain custody of

 

26  her child.

 

27        (vii) Identify services available through public agencies to


 

 1  assist the patient and provide counseling should she experience

 

 2  subsequent adverse psychological effects from the abortion.

 

 3        (c) Develop, draft, and print, in nontechnical English,

 

 4  Arabic, and Spanish, an acknowledgment and consent form that

 

 5  includes only the following language above a signature line for

 

 6  the patient:

 

 7        "I, _____________________________ , voluntarily and

 

 8  willfully hereby authorize Dr. __________________ ("the

 

 9  physician") and any assistant designated by the physician to

 

10  perform upon me the following operation(s) or procedure(s):

 

11        __________________________________________________________

 

12        (Name of operation(s) or procedure(s))

 

13        __________________________________________________________

 

14        A. I understand that I am approximately _____ weeks

 

15  pregnant. I consent to an abortion procedure to terminate my

 

16  pregnancy. I understand that I have the right to withdraw my

 

17  consent to the abortion procedure at any time prior to before

 

18  performance of that procedure.

 

19        B. I understand that it is illegal for anyone to coerce me

 

20  into seeking an abortion.

 

21        C. I acknowledge that at least 24 hours before the scheduled

 

22  abortion I have received a physical copy of each of the

 

23  following:

 

24        1. (a) A medically accurate depiction, illustration, or

 

25  photograph of a fetus at the probable gestational age of the

 

26  fetus I am carrying.

 

27        2. (b) A written description of the medical procedure that


 

 1  will be used to perform the abortion.

 

 2        3. (c) A prenatal care and parenting information pamphlet.

 

 3        D. If any of the above listed documents listed in paragraph

 

 4  C were transmitted by facsimile, I certify that the documents

 

 5  were clear and legible.

 

 6        E. I acknowledge that the physician who will perform the

 

 7  abortion has orally described all of the following to me:

 

 8        1. (i) The specific risk to me, if any, of the complications

 

 9  that have been associated with the procedure I am scheduled to

 

10  undergo.

 

11        2. (ii) The specific risk to me, if any, of the complications

 

12  if I choose to continue the pregnancy.

 

13        F. I acknowledge that I have received all of the following

 

14  information:

 

15        1. (d) Information about what to do and whom to contact in

 

16  the event that complications arise from the abortion.

 

17        2. (e) Information pertaining to available pregnancy related

 

18  services.

 

19        G. I have been given an opportunity to ask questions about

 

20  the operation(s) or procedure(s).

 

21        H. I certify that I have not been required to make any

 

22  payments for an abortion or any medical service before the

 

23  expiration of 24 hours after I received the written materials

 

24  listed in paragraphs (a), (b), and (c) above, paragraph C, or 24

 

25  hours after the time and date listed on the confirmation form if

 

26  paragraphs (a), (b), and (c) were the information described in

 

27  paragraph C was viewed from the state of Michigan internet


 

 1  website.".

 

 2        (d) Make available to physicians through the Michigan board

 

 3  of medicine and the Michigan board of osteopathic medicine and

 

 4  surgery, and to any person upon request, the copies of medically

 

 5  accurate depictions, illustrations, or photographs described in

 

 6  subdivision (a), the written standardized written summaries

 

 7  described in subdivision (b), the acknowledgment and consent form

 

 8  described in subdivision (c), the prenatal care and parenting

 

 9  information pamphlet described in section 9161, and the pregnancy

 

10  certification form described in subdivision (f), and the

 

11  materials regarding coercion to abort described in subdivision

 

12  (i).

 

13        (e) The department shall not develop written standardized

 

14  summaries for abortion procedures under subdivision (b) that

 

15  utilize medication that has not been approved by the United

 

16  States food and drug administration for use in performing an

 

17  abortion.

 

18        (f) Develop, draft, and print a certification form to be

 

19  signed by a local health department representative at the time

 

20  and place a patient has a pregnancy confirmed, as requested by

 

21  the patient, verifying the date and time the pregnancy is

 

22  confirmed.

 

23        (g) Develop, operate, and maintain an internet website that

 

24  allows a patient considering an abortion to review the

 

25  information required in subsection (3)(c) through (e). (f). After

 

26  the patient reviews the required information, the department

 

27  shall assure that a confirmation form can be printed by the


 

 1  patient from the internet website that will verify the time and

 

 2  date the information was reviewed. A confirmation form printed

 

 3  under this subdivision becomes invalid 14 days after the date and

 

 4  time printed on the confirmation form.

 

 5        (h) Include on the informed consent internet website

 

 6  developed operated under subdivision (g) a list of health care

 

 7  providers, facilities, and clinics that offer to perform

 

 8  ultrasounds free of charge. The list shall be organized

 

 9  geographically and shall include the name, address, and telephone

 

10  number of each health care provider, facility, and clinic.

 

11        (i) After considering the standards and recommendations of

 

12  the joint commission on accreditation of healthcare

 

13  organizations, the Michigan domestic and sexual violence

 

14  prevention and treatment board, the Michigan coalition to end

 

15  domestic and sexual violence or successor organization, and the

 

16  American medical association, do all of the following:

 

17        (i) Develop, draft, and print or make available in printable

 

18  format, in nontechnical English, Arabic, and Spanish, a notice

 

19  that is required to be posted in facilities and clinics under

 

20  section 17015a. The notice shall be at least 8-1/2 inches by 14

 

21  inches, shall be printed in at least 44-point type, and shall

 

22  contain at a minimum all of the following:

 

23        (A) A statement that it is illegal under Michigan law to

 

24  coerce a woman to have an abortion.

 

25        (B) A statement that help is available if a woman is being

 

26  threatened or intimidated; is being physically, emotionally, or

 

27  sexually harmed; or feels afraid for any reason.


 

 1        (C) The telephone number of at least 1 domestic violence

 

 2  hotline and 1 sexual assault hotline.

 

 3        (ii) Develop, draft, and print or make available in printable

 

 4  format, in nontechnical English, Arabic, and Spanish, a

 

 5  prescreening summary on prevention of coercion to abort that, at

 

 6  a minimum, contains the information required under subparagraph

 

 7  (i) and notifies the patient that an oral screening for coercion

 

 8  to abort will be conducted before her giving written consent to

 

 9  obtain an abortion.

 

10        (iii) Develop, draft, and print screening and training tools

 

11  and accompanying training materials to be utilized by a physician

 

12  or qualified person assisting the physician while performing the

 

13  coercion to abort screening required under section 17015a. The

 

14  screening tools shall instruct the physician or qualified person

 

15  assisting the physician to orally communicate information to the

 

16  patient regarding coercion to abort and to document the findings

 

17  from the coercion to abort screening in the patient's medical

 

18  record.

 

19        (iv) Develop, draft, and print protocols and accompanying

 

20  training materials to be utilized by a physician or a qualified

 

21  person assisting the physician if a patient discloses coercion to

 

22  abort or that domestic violence is occurring, or both, during the

 

23  coercion to abort screening. The protocols shall instruct the

 

24  physician or qualified person assisting the physician to do, at a

 

25  minimum, all of the following:

 

26        (A) Follow the requirements of section 17015a as applicable.

 

27        (B) Assess the patient's current level of danger.


 

 1        (C) Explore safety options with the patient.

 

 2        (D) Provide referral information to the patient regarding

 

 3  law enforcement and domestic violence and sexual assault support

 

 4  organizations.

 

 5        (E) Document any referrals in the patient's medical record.

 

 6        (12) A physician's duty to inform the patient under this

 

 7  section does not require disclosure of information beyond what a

 

 8  reasonably well-qualified physician licensed under this article

 

 9  would possess.

 

10        (13) A written consent form meeting the requirements set

 

11  forth in this section and signed by the patient is presumed

 

12  valid. The presumption created by this subsection may be rebutted

 

13  by evidence that establishes, by a preponderance of the evidence,

 

14  that consent was obtained through fraud, negligence, deception,

 

15  misrepresentation, coercion, or duress.

 

16        (14) A completed certification form described in subsection

 

17  (11)(f) that is signed by a local health department

 

18  representative is presumed valid. The presumption created by this

 

19  subsection may be rebutted by evidence that establishes, by a

 

20  preponderance of the evidence, that the physician who relied upon

 

21  the certification had actual knowledge that the certificate

 

22  contained a false or misleading statement or signature.

 

23        (15) This section does not create a right to abortion.

 

24        (16) Notwithstanding any other provision of this section, a

 

25  person shall not perform an abortion that is prohibited by law.

 

26        (17) If any portion of this act or the application of this

 

27  act to any person or circumstances is found invalid by a court,


 

 1  that invalidity does not affect the remaining portions or

 

 2  applications of the act that can be given effect without the

 

 3  invalid portion or application, if those remaining portions are

 

 4  not determined by the court to be inoperable.

 

 5        (18) Upon a patient's request, each local health department

 

 6  shall:

 

 7        (a) Provide a pregnancy test for that patient to confirm the

 

 8  pregnancy as required under subsection (3)(a) and determine the

 

 9  probable gestational stage of the fetus. The local health

 

10  department need not comply with this subdivision if the

 

11  requirements of subsection (3)(a) have already been met.

 

12        (b) If a pregnancy is confirmed, ensure that the patient is

 

13  provided with a completed pregnancy certification form described

 

14  in subsection (11)(f) at the time the information is provided.

 

15        (19) The identity and address of a patient who is provided

 

16  information or who consents to an abortion pursuant to this

 

17  section is confidential and is subject to disclosure only with

 

18  the consent of the patient or by judicial process.

 

19        (20) A local health department with a file containing the

 

20  identity and address of a patient described in subsection (19)

 

21  who has been assisted by the local health department under this

 

22  section shall do both of the following:

 

23        (a) Only release the identity and address of the patient to

 

24  a physician or qualified person assisting the physician in order

 

25  to verify the receipt of the information required under this

 

26  section.

 

27        (b) Destroy the information containing the identity and


 

 1  address of the patient within 30 days after assisting the patient

 

 2  under this section.

 

 3        Sec. 17015a. (1) At the time a patient first presents at a

 

 4  private office, freestanding surgical outpatient facility, or

 

 5  other facility or clinic in which abortions are performed for the

 

 6  purpose of obtaining an abortion, whether before or after the

 

 7  expiration of the 24-hour period described in section 17015(3),

 

 8  the physician or qualified person assisting the physician shall

 

 9  orally screen the patient for coercion to abort using the

 

10  screening tools developed by the department under section

 

11  17015(11). The oral screening required under this subsection may

 

12  occur before the requirements of section 17015(3) have been met

 

13  with regard to that patient.

 

14        (2) If a patient discloses that she is the victim of

 

15  domestic violence that does not include coercion to abort, the

 

16  physician or qualified person assisting the physician shall

 

17  follow the protocols developed by the department under section

 

18  17015(11).

 

19        (3) If a patient discloses coercion to abort, the physician

 

20  or qualified person assisting the physician shall follow the

 

21  protocols developed by the department under section 17015(11).

 

22        (4) If a patient who is under the age of 18 discloses

 

23  domestic violence or coercion to abort by an individual

 

24  responsible for the health or welfare of the minor patient, the

 

25  physician or qualified person assisting the physician shall

 

26  report that fact to a local child protective services office.

 

27        (5) A private office, freestanding surgical outpatient


 

 1  facility, or other facility or clinic in which abortions are

 

 2  performed shall post in a conspicuous place in an area of its

 

 3  facility that is accessible to patients, employees, and visitors

 

 4  the notice described in section 17015(11)(i). A private office,

 

 5  freestanding surgical outpatient facility, or other facility or

 

 6  clinic in which abortions are performed shall make available in

 

 7  an area of its facility that is accessible to patients,

 

 8  employees, and visitors publications that contain information

 

 9  about violence against women.

 

10        (6) This section does not create a right to abortion.

 

11  Notwithstanding any other provision of this section, a person

 

12  shall not perform an abortion that is prohibited by law.

 

13        Sec. 17017. (1) This section and section 17517 do not apply

 

14  after December 31, 2018.

 

15        (2) Except as otherwise provided in this section, a

 

16  physician shall not diagnose and prescribe a medical abortion for

 

17  a patient who is or is presumed to be pregnant unless the

 

18  physician or an individual licensed and qualified by education

 

19  and training first personally performs a physical examination of

 

20  the patient. A physician shall not utilize other means including,

 

21  but not limited to, an internet web camera, to diagnose and

 

22  prescribe a medical abortion.

 

23        (3) A physician shall obtain the informed consent of a

 

24  patient in the manner prescribed under section 17015 to perform a

 

25  medical abortion. The physician shall be physically present at

 

26  the location of the medical abortion when the prescription drug

 

27  used to initiate the medical abortion is dispensed. An individual


 

 1  under the direct supervision of the prescribing physician who is

 

 2  qualified by education and training as provided in this act may

 

 3  dispense or administer the prescription drug used to initiate the

 

 4  medical abortion.

 

 5        (4) This section does not create a right to abortion.

 

 6  Notwithstanding any other provision of this section, a person

 

 7  shall not perform an abortion that is prohibited by law.

 

 8        (5) As used in this section:

 

 9        (a) "Abortion" means that term as defined in section 17015.

 

10        (b) "Medical abortion" means an abortion procedure that is

 

11  not a surgical procedure and that utilizes a prescription drug to

 

12  induce an abortion.

 

13        (c) "Prescription drug" means that term as defined in

 

14  section 17708.

 

15        Sec. 17515. A physician, before performing an abortion on a

 

16  patient, shall comply with section sections 17015 and 17015a.

 

17        Sec. 17517. A physician shall comply with section 17017.

 

18        Sec. 20115. (1) The department may promulgate rules to

 

19  further define the term "health facility or agency" and the

 

20  definition of a health facility or agency listed in section 20106

 

21  as required to implement this article. The department may define

 

22  a specific organization as a health facility or agency for the

 

23  sole purpose of certification authorized under this article. For

 

24  purpose of certification only, an organization defined in section

 

25  20106(5), 20108(1), or 20109(4) is considered a health facility

 

26  or agency. The term "health facility or agency" does not mean a

 

27  visiting nurse service or home aide service conducted by and for


 

 1  the adherents of a church or religious denomination for the

 

 2  purpose of providing service for those who depend upon spiritual

 

 3  means through prayer alone for healing.

 

 4        (2) The department shall promulgate rules to differentiate a

 

 5  freestanding surgical outpatient facility from a private office

 

 6  of a physician, dentist, podiatrist, or other health

 

 7  professional. The department shall specify in the rules that a

 

 8  facility including, but not limited to, a private practice office

 

 9  described in this subsection in which 50% or more of the patients

 

10  annually served at the facility undergo an abortion must be

 

11  licensed under this article as a freestanding surgical outpatient

 

12  facility if that facility performs 120 or more surgical abortions

 

13  per year and publicly advertises outpatient abortion services.

 

14        (3) The department shall promulgate rules that in effect

 

15  republish R 325.3826, R 325.3832, R 325.3835, R 325.3857, R

 

16  325.3866, R 325.3867, and R 325.3868 of the Michigan

 

17  administrative code, but shall include in the rules standards for

 

18  a freestanding surgical outpatient facility in which 50% or more

 

19  of the patients annually served in the freestanding surgical

 

20  outpatient facility undergo an abortion. or private practice

 

21  office that performs 120 or more surgical abortions per year and

 

22  that publicly advertises outpatient abortion services. The

 

23  department shall assure that the standards are consistent with

 

24  the most recent United States supreme court decisions regarding

 

25  state regulation of abortions.

 

26        (4) Subject to section 20145 and part 222, the department

 

27  may modify or waive 1 or more of the rules contained in R


    House Bill No. 5711 as amended December 12, 2012

 

 1  325.3801 to R 325.3877 of the Michigan administrative code

 

 2  regarding construction or equipment standards, or both, for a

 

 3  freestanding surgical outpatient facility in which 50% or more of

 

 4  the patients annually served in the freestanding surgical

 

 5  outpatient facility undergo an abortion that performs 120 or more

 

 6  surgical abortions per year and that publicly advertises

 

 7  outpatient abortion services, if both of the following conditions

 

 8  are met:

 

 9        (a) The freestanding surgical outpatient facility was in

 

10  existence and operating on the effective date of the amendatory

 

11  act that added this subsection.<<december 31, 2012>>.

 

12        (b) The department makes a determination that the existing

 

13  construction or equipment conditions, or both, within the

 

14  freestanding surgical outpatient facility are adequate to

 

15  preserve the health and safety of the patients and employees of

 

16  the freestanding surgical outpatient facility or that the

 

17  construction or equipment conditions, or both, can be modified to

 

18  adequately preserve the health and safety of the patients and

 

19  employees of the freestanding surgical outpatient facility

 

20  without meeting the specific requirements of the rules.

 

21        (5) By January 15 each year, the department of community

 

22  health shall provide the following information to the department

 

23  of licensing and regulatory affairs:

 

24        (a) From data received by the department of community health

 

25  through the abortion reporting requirements of section 2835, all

 

26  of the following:

 

27        (i) The name and location of each facility at which abortions


 

 1  were performed during the immediately preceding calendar year.

 

 2        (ii) The total number of abortions performed at that facility

 

 3  location during the immediately preceding calendar year.

 

 4        (iii) The total number of surgical abortions performed at that

 

 5  facility location during the immediately preceding calendar year.

 

 6        (b) Whether a facility at which surgical abortions were

 

 7  performed in the immediately preceding calendar year publicly

 

 8  advertises abortion services.

 

 9        (6) (5) As used in this subsection, "abortion" section:

 

10        (a) "Abortion" means that term as defined in section 17015.

 

11        (b) "Publicly advertises" means to advertise using directory

 

12  or internet advertising including yellow pages, white pages,

 

13  banner advertising, or electronic publishing.

 

14        (c) "Surgical abortion" means an abortion that is not a

 

15  medical abortion as that term is defined in section 17017.

 

16        Sec. 22224. (1) A health facility required to be licensed as

 

17  a freestanding surgical outpatient facility by rules promulgated

 

18  under section 20115(2) due to the performance of abortions at

 

19  that facility is not required to obtain a certificate of need in

 

20  order to be granted a license as a freestanding surgical

 

21  outpatient facility. However, a health facility described in this

 

22  subsection is subject to this part for the services performed at

 

23  that facility other than abortions.

 

24        (2) If a freestanding surgical outpatient facility is

 

25  applying for a certificate of need to initiate, replace, or

 

26  expand a covered clinical service consisting of surgical

 

27  services, the department shall not count abortion procedures in


    House Bill No. 5711 as amended December 12, 2012

                        as amended December 14, 2012

 

 1  determining if the freestanding surgical outpatient facility

 

 2  meets the annual minimum number of surgical procedures required

 

 3  in the certificate of need standards governing surgical services.

 

 4        (3) As used in this section, "abortion" means that term as

 

 5  defined in section 17015.

 

 6        Enacting section 1. This amendatory act takes effect March

 

 7  31, 2013.

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