HOUSE BILL No. 5473

 

December 1, 2005, Introduced by Reps. Schuitmaker, Wojno, Mortimer, Gaffney and Hune and referred to the Committee on Health Policy.

 

      A bill to amend 1978 PA 368, entitled

 

"Public health code,"

 

by amending sections 16204, 16263, 16343, 16905, 16909, 17015,

 

18115, 18201, 18211, 18212, 18214, 18221, 18223, and 18233 (MCL

 

333.16204, 333.16263, 333.16343, 333.16905, 333.16909, 333.17015,

 

333.18115, 333.18201, 333.18211, 333.18212, 333.18214, 333.18221,

 

333.18223, and 333.18233), section 16204 as added and section

 

18233 as amended by 1994 PA 234, section 16263 as amended by 2004

 

PA 97, section 16343 as added and section 18221 as amended by

 

1993 PA 79, section 16905 as added by 1995 PA 126, section 16909

 

as amended by 1997 PA 188, section 17015 as amended by 2002 PA

 

685, section 18115 as added by 1988 PA 421, section 18212 as

 

amended by 1987 PA 20, and section 18223 as amended by 1986 PA

 


174.

 

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

 

 1        Sec. 16204. (1) Effective for the renewal of licenses or

 

 2  registrations issued under this article and expiring after

 

 3  January 1, 1997 if the completion of continuing education is a

 

 4  condition for renewal, the appropriate board shall by rule

 

 5  require an applicant for renewal to complete an appropriate

 

 6  number of hours or courses in pain and symptom management. Rules

 

 7  promulgated by a board under section 16205(2) for continuing

 

 8  education in pain and symptom management shall cover both course

 

 9  length and content and shall take into consideration the

 

10  recommendation for that health care profession by the

 

11  interdisciplinary advisory committee created in section 16204a. A

 

12  board shall submit the notice of public hearing for the rules as

 

13  required under section 42 of the administrative procedures act of

 

14  1969,  being section 24.242 of the Michigan Compiled Laws  1969

 

15  PA 306, MCL 24.242, not later than 90 days after the first

 

16  interdisciplinary advisory committee makes its initial

 

17  recommendations and shall promulgate the rules as expeditiously

 

18  as possible.

 

19        (2) If a board proposes rules under section 16205(2) to

 

20  institute a requirement that continuing education be a mandatory

 

21  condition for the renewal of a license or registration issued

 

22  under this article, the rules shall require, as part of the

 

23  continuing education requirements, completion of an appropriate

 

24  number of hours or courses in pain and symptom management, taking

 

25  into consideration the recommendation for that health care

 


 1  profession by the interdisciplinary advisory committee created in

 

 2  section 16204a.

 

 3        (3) This section does not apply to individuals licensed or

 

 4  registered under part 182, 184, or 188 or to an individual

 

 5  licensed to engage in the practice as a dental hygienist under

 

 6  part 166.

 

 7        Sec. 16263. (1) Except as provided in subsection (2), the

 

 8  following words, titles, or letters or a combination thereof,

 

 9  with or without qualifying words or phrases, are restricted in

 

10  use only to those persons authorized under this article to use

 

11  the terms and in a way prescribed in this article:

 

12        (a) "Chiropractic", "doctor of chiropractic",

 

13  "chiropractor", "d.c.", and "chiropractic physician".

 

14        (b) "Dentist", "doctor of dental surgery", "oral and

 

15  maxillofacial surgeon", "orthodontist", "prosthodontist",

 

16  "periodontist", "endodontist", "oral pathologist", "pediatric

 

17  dentist", "dental hygienist", "registered dental hygienist",

 

18  "dental assistant", "registered dental assistant", "r.d.a.",

 

19  "d.d.s.", "d.m.d.", and "r.d.h.".

 

20        (c) "Doctor of medicine" and "m.d.".

 

21        (d) "Physician's assistant" and "p.a.".

 

22        (e) "Registered professional nurse", "registered nurse",

 

23  "r.n.", "licensed practical nurse", "l.p.n.", "nurse midwife",

 

24  "nurse anesthetist", "nurse practitioner", "trained attendant",

 

25  and "t.a.".

 

26        (f) "Doctor of optometry", "optometrist", and "o.d.".

 

27        (g) "Osteopath", "osteopathy", "osteopathic practitioner",

 


 1  "doctor of osteopathy", "diplomate in osteopathy", and "d.o.".

 

 2        (h) "Pharmacy", "pharmacist", "apothecary", "drugstore",

 

 3  "druggist", "medicine store", "prescriptions", and "r.ph.".

 

 4        (i) "Physical therapy", "physical therapist",

 

 5  "physiotherapist", "registered physical therapist", "licensed

 

 6  physical therapist", "physical therapy technician", "p.t.",

 

 7  "r.p.t.", "l.p.t.", and "p.t.t.".

 

 8        (j) "Chiropodist", "chiropody", "chiropodical", "podiatry",

 

 9  "podiatrist", "podiatric", "doctor of podiatric medicine", "foot

 

10  specialist", "podiatric physician and surgeon", and "d.p.m.".

 

11        (k)  "Consulting  Until October 1, 2006, "consulting

 

12  psychologist", "psychologist", "psychological assistant",

 

13  "psychological examiner", "licensed psychologist", and "limited

 

14  licensed psychologist". Beginning October 1, 2006, "consulting

 

15  psychologist", "psychologist", "psychological assistant",

 

16  "psychological examiner", "licensed doctoral psychologist",

 

17  "licensed master's psychologist", "licensed associate

 

18  psychologist", "l.d.p.", "l.m.p.", and "l.a.p.".

 

19        (l) "Licensed professional counselor", "licensed counselor",

 

20  "professional counselor", and "l.p.c.".

 

21        (m) "Sanitarian", "registered sanitarian", and "r.s.".

 

22        (n) Until July 1, 2005, "social worker", "certified social

 

23  worker", "social work technician", "s.w.", "c.s.w.", and

 

24  "s.w.t.". Beginning July 1, 2005, "social worker", "licensed

 

25  master's social worker", "licensed bachelor's social worker",

 

26  "registered social service technician", "social service

 

27  technician", "l.m.s.w.", "l.b.s.w.", and "r.s.s.t.".

 


 1        (o) "Veterinary", "veterinarian", "veterinary doctor",

 

 2  "veterinary surgeon", "doctor of veterinary medicine", "v.m.d.",

 

 3  "d.v.m.", "animal technician", or "animal technologist".

 

 4        (p) "Occupational therapist", "occupational therapist

 

 5  registered", "certified occupational therapist", "o.t.",

 

 6  "o.t.r.", "c.o.t.", "certified occupational therapy assistant",

 

 7  "occupational therapy assistant", or "c.o.t.a.".

 

 8        (q) "Marriage advisor" or "marriage consultant"; "family

 

 9  counselor", "family advisor", "family therapist", or "family

 

10  consultant"; "family guidance counselor", "family guidance

 

11  advisor", or "family guidance consultant"; "marriage guidance

 

12  counselor", "marriage guidance advisor", or "marriage guidance

 

13  consultant"; "family relations counselor"; "marriage relations

 

14  counselor", "marriage relations advisor", or "marriage relations

 

15  consultant"; "marital counselor" or "marital therapist"; "limited

 

16  licensed marriage and family therapist" or "limited licensed

 

17  marriage counselor"; "licensed marriage and family therapist" or

 

18  "licensed marriage counselor"; and "l.m.f.t.".

 

19        (r) "Nursing home administrator".

 

20        (s) "Respiratory therapist", "respiratory care

 

21  practitioner", "licensed respiratory therapist", "licensed

 

22  respiratory care practitioner", "r.t.", "r.c.p.", "l.r.t.", and

 

23  "l.r.c.p.".

 

24        (t) "Audiometrist", "audiologist", "hearing therapist",

 

25  "hearing aid audiologist", "educational audiologist", "industrial

 

26  audiologist", and "clinical audiologist".

 

27        (2) Notwithstanding section 16261, a person who was

 


 1  specially trained at an institution of higher education in this

 

 2  state to assist a physician in the field of orthopedics and upon

 

 3  completion of training, received a 2-year associate of science

 

 4  degree as an orthopedic physician's assistant before January 1,

 

 5  1977, may use the title "orthopedic physician's assistant"

 

 6  whether or not the person is licensed under this article.

 

 7        Sec. 16343. Fees for a person licensed or seeking licensure

 

 8  to engage in the practice of psychology under part 182 are as

 

 9  follows:

 

 

10 (a) Application processing fee.....................         $  50.00

11 (b) License fee, per year:                                 

12 (i)  Full doctoral  Doctoral........................           90.00

13  (ii) Limited doctoral .............................            30.00

14 (ii)  (iii) Masters limited  Master's.................            60.00

15  (iv) Temporary limited .............................           15.00

16 (iii)  (c) Limited license, per year  Associates.....           40.00

17  (d) Temporary license .............................           15.00

18 (c)  (e)  Examination review fee...................            20.00

 

 

19        Sec. 16905. (1) This part does not apply to an individual

 

20  engaged in the practice of social work as defined in section  

 

21  1601 of the occupational code, Act No. 299 of the Public Acts of

 

22  1980, being section 339.1601 of the Michigan Compiled Laws,  

 

23  18501 in the course of employment with a governmental agency or a

 

24  reputable social service agency regularly providing social work

 

25  services as an agency.

 

26        (2) This part does not apply to an ordained cleric or other

 

27  religious practitioner who is employed by or working under the


 

 1  authority of an organization exempt from taxation under section

 

 2  501(c)(3) of the internal revenue code of 1986  , 26 U.S.C. 501,  

 

 3  if the advice or counsel given by the cleric or other religious

 

 4  practitioner is incidental to his or her duties as a cleric or

 

 5  other religious practitioner, and if the cleric or other

 

 6  religious practitioner does not hold himself or herself out to

 

 7  the public as a marriage and family therapist licensed under this

 

 8  article or use 1 or more of the titles listed in section  

 

 9  16263(1)(p)  16263(1)(q) and if no fee or donation is exacted for

 

10  the service.

 

11        (3) This part does not apply to a physician licensed under

 

12  this article who has completed an accredited psychiatric

 

13  residency program approved by the Michigan board of medicine or

 

14  to a psychologist  fully  licensed under this article, if both of

 

15  the following circumstances exist:

 

16        (a) The individual is practicing his or her profession in a

 

17  manner consistent with his or her education and training and is

 

18  practicing in a manner consistent with the code of ethics of that

 

19  profession.

 

20        (b) The individual does not hold himself or herself out to

 

21  the public as a marriage and family therapist licensed under this

 

22  article or use any of the titles listed in section  16263(1)(p)

 

23  16263(1)(q) for advertising purposes. However, this subdivision

 

24  does not prohibit the individual from advertising under a

 

25  telephone or other business directory listing that uses those

 

26  titles if the individual discloses in the listing, in an

 

27  unabbreviated fashion, the profession in which he or she is


 

 1  licensed.

 

 2        (4) This part does not limit an individual in, or prevent an

 

 3  individual from, the practice of a statutorily regulated

 

 4  profession or occupation if services to families, couples, or

 

 5  subsystems of families are part of the services provided by that

 

 6  profession or occupation, and if the individual does not hold

 

 7  himself or herself out to the public as a marriage and family

 

 8  therapist licensed under this article or use 1 or more of the

 

 9  titles listed in section 16263(1)(p)  16263(1)(q). As used in

 

10  this subsection, "statutorily regulated profession or occupation"

 

11  means an occupation or profession regulated by statute that

 

12  includes, but is not limited to, all of the following: a

 

13  physician, attorney, social worker,  certified  licensed social

 

14  worker, registered social  work  service technician,  fully  

 

15  licensed psychologist,  limited licensed psychologist, temporary

 

16  limited licensed psychologist,  licensed professional counselor,

 

17  limited licensed counselor, or school counselor.

 

18        Sec. 16909. (1) The board shall grant a license as a

 

19  marriage and family therapist to an individual who meets all of

 

20  the following requirements:

 

21        (a) Provides satisfactory evidence to the board of meeting

 

22  either of the following educational qualifications:

 

23        (i) Has a master's or higher graduate degree from an

 

24  accredited training program in marriage and family therapy

 

25  approved by the board.

 

26        (ii) Has a master's or higher graduate degree from an

 

27  accredited college or university approved by the board and has


 

 1  completed all of the following graduate-level courses at an

 

 2  accredited college or university approved by the board:

 

 3        (A) Three courses in family studies that total at least 6

 

 4  semester or 9 quarter hours.

 

 5        (B) Three courses in family therapy methodology that total

 

 6  at least 6 semester or 9 quarter hours.

 

 7        (C) Three courses in human development, personality theory,

 

 8  or psychopathology that total at least 6 semester or 9 quarter

 

 9  hours.

 

10        (D) At least 2 semester or 3 quarter hours in ethics, law,

 

11  and standards of professional practice.

 

12        (E) At least 2 semester or 3 quarter hours in research.

 

13        (b) Except as otherwise provided in subsection (2), provides

 

14  satisfactory evidence to the board of having completed supervised

 

15  clinical marriage and family therapy experience in conjunction

 

16  with the applicant's educational program. The clinical marriage

 

17  and family therapy experience described in this subdivision shall

 

18  meet all of the following requirements:

 

19        (i) Be obtained either in a clinical practicum during

 

20  graduate education or in a postgraduate marriage and family

 

21  institute training program acceptable to the board.

 

22        (ii) Be obtained over not less than 8 consecutive months.

 

23        (iii) Be verified by a supervisor who has a master's or higher

 

24  graduate degree from an accredited college or university approved

 

25  by the board and meets 1 of the following:

 

26        (A) Is a marriage and family therapist.

 

27        (B) Is a  certified  licensed social worker  or a social


 

 1  worker registered  under this article.  16 of the occupational

 

 2  code, 1980 PA 299, MCL 339.1601 to 339.1610.

 

 3        (C) Is a licensed professional counselor as defined in

 

 4  section 18101.

 

 5        (D) Is a physician as defined in section 17001 or 17501 and

 

 6  practicing in a mental health setting.

 

 7        (E) Is a  fully  licensed psychologist as defined in section

 

 8  18201.

 

 9        (F) Is an approved supervisor or supervisor-in-training

 

10  through a program conducted by the American association for

 

11  marriage and family therapy and approved by the board.

 

12        (iv) Include not less than 300 direct client contact hours in

 

13  supervised clinical marriage and family therapy experience, at

 

14  least 1/2 of which were completed in a setting in which families,

 

15  couples, or subsystems of families were physically present in the

 

16  therapy room.

 

17        (v) Be supervised in a ratio of at least 1 hour of

 

18  supervision for each 5 hours of direct client contact, for a

 

19  total of not less than 60 hours of supervision concurrent with

 

20  the 300 hours of supervised direct client contact.

 

21        (c) Except as otherwise provided in subsection (2), provides

 

22  satisfactory evidence to the board of having completed a minimum

 

23  of 1,000 direct client contact hours in supervised marriage and

 

24  family therapy experience, at least 1/2 of which was completed

 

25  with families, couples, or subsystems of families physically

 

26  present in the therapy room, that meets all of the following

 

27  conditions:


 

 1        (i) Is verified by the supervising licensed marriage and

 

 2  family therapist.

 

 3        (ii) Is obtained following the completion of the degree

 

 4  required by subdivision (a)(i), is obtained following the

 

 5  completion of the degree required by subdivision (a)(ii) and

 

 6  concurrent with or following the course work specified in

 

 7  subdivision (a)(ii)(A), (B), (C), (D), and (E), or is obtained as

 

 8  part of a doctoral program in marriage and family therapy from an

 

 9  accredited college or university approved by the board, which

 

10  experience may include experience obtained under subdivision

 

11  (b)(i).

 

12        (iii) Is supervised in a ratio of at least 1 hour of

 

13  supervision for each 5 hours of experience, for a total of not

 

14  less than 200 hours of supervision concurrent with the 1,000

 

15  hours of supervised experience. Not less than 100 hours of

 

16  supervision under this subparagraph shall be individual

 

17  supervision with no more than 1 other supervisee present. The

 

18  remaining supervision under this subparagraph may be group

 

19  supervision involving no more than 6 supervisees with 1

 

20  supervisor. The supervision shall be given in face-to-face

 

21  contact with the individual obtaining marriage and family therapy

 

22  experience.

 

23        (2) The board shall waive the requirements of subsection

 

24  (1)(b) and (c) for an applicant who provides satisfactory

 

25  evidence to the board of having obtained a doctoral degree from

 

26  an accredited doctoral training program in marriage and family

 

27  therapy approved by the board.


 

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

 

 2  shall not perform an abortion otherwise permitted by law without

 

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

 

 4  coercion.

 

 5        (2) For purposes of this section:

 

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

 

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

 

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

 

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

 

10  live birth, or to remove a dead fetus. Abortion does not include

 

11  the use or prescription of a drug or device intended as a

 

12  contraceptive.

 

13        (b) "Fetus" means an individual organism of the species homo

 

14  sapiens in utero.

 

15        (c) "Local health department representative" means a person

 

16  employed by, or under contract to provide services on behalf of,

 

17  a local health department who meets 1 or more of the licensing

 

18  requirements listed in subdivision (f).

 

19        (d) "Medical emergency" means that condition which, on the

 

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

 

21  complicates the medical condition of a pregnant woman as to

 

22  necessitate the immediate abortion of her pregnancy to avert her

 

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

 

24  substantial and irreversible impairment of a major bodily

 

25  function.

 

26        (e) "Medical service" means the provision of a treatment,

 

27  procedure, medication, examination, diagnostic test, assessment,


 

 1  or counseling, including, but not limited to, a pregnancy test,

 

 2  ultrasound, pelvic examination, or an abortion.

 

 3        (f) "Qualified person assisting the physician" means another

 

 4  physician or a physician's assistant licensed under this part or

 

 5  part 175, a  fully licensed or limited licensed  psychologist

 

 6  licensed under part 182, a professional counselor licensed under

 

 7  part 181, a registered professional nurse or a licensed practical

 

 8  nurse licensed under part 172, or a social worker  registered  

 

 9  licensed under part 185.

 

10        (g) "Probable gestational age of the fetus" means the

 

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

 

12  to be performed.

 

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

 

14  confirming that the patient accessed the internet website

 

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

 

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

 

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

 

18  document by 1 or more of the following means:

 

19        (i) In person.

 

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

 

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

 

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

 

23        (iv) By facsimile transmission.

 

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

 

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

 

26  less than 24 hours before that physician performs an abortion

 

27  upon a patient who is a pregnant woman:


 

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

 

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

 

 3  gestational age of the fetus.

 

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

 

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

 

 6  and intellectual capability, each of the following:

 

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

 

 8  carrying.

 

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

 

10  medical complications arise from the abortion.

 

11        (iii) Information about how to obtain pregnancy prevention

 

12  information through the department of community health.

 

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

 

14  summary described in subsection (11)(b) that corresponds to the

 

15  procedure the patient will undergo and is provided by the

 

16  department of community health. If the procedure has not been

 

17  recognized by the department, but is otherwise allowed under

 

18  Michigan law, and the department has not provided a written

 

19  summary for that procedure, the physician shall develop and

 

20  provide a written summary that describes the procedure, any known

 

21  risks or complications of the procedure, and risks associated

 

22  with live birth and meets the requirements of subsection

 

23  (11)(b)(iii) through (vii).

 

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

 

25  accurate depiction, illustration, or photograph and description

 

26  of a fetus supplied by the department of community health

 

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


 

 1  probable gestational age of the patient's fetus.

 

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

 

 3  care and parenting information pamphlet distributed by the

 

 4  department of community health under section 9161.

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

12  internet website other than the internet website described in

 

13  subsection (5) that is maintained through the department.

 

14        (5) The requirements of subsection (3)(c) through (e) may be

 

15  fulfilled by a patient accessing the internet website maintained

 

16  and operated through the department and receiving a printed,

 

17  valid confirmation form from the website that the patient has

 

18  reviewed the information required in subsection (3)(c) through

 

19  (e) at least 24 hours before an abortion being performed on the

 

20  patient. The website shall not require any information be

 

21  supplied by the patient. The department shall not track, compile,

 

22  or otherwise keep a record of information that would identify a

 

23  patient who accesses this website. The patient shall supply the

 

24  valid confirmation form to the physician or qualified person

 

25  assisting the physician to be included in the patient's medical

 

26  record to comply with this subsection.

 

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


 

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

 

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

 

 3  all of the following:

 

 4        (a) Provide the patient with the physician's name and inform

 

 5  the patient of her right to withhold or withdraw her consent to

 

 6  the abortion at any time before performance of the abortion.

 

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

 

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

 

 9  and intellectual capability, each of the following:

 

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

 

11  complications that have been associated with the procedure the

 

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

 

13  condition and history as determined by the physician.

 

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

 

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

 

16  patient's particular medical condition and history as determined

 

17  by a physician.

 

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

 

19  forth in subsection (3) and subsection  (6) shall not be

 

20  disclosed to the patient in the presence of another patient.

 

21        (8) Before performing an abortion on a patient who is a

 

22  pregnant woman, a physician or a qualified person assisting the

 

23  physician shall do all of the following:

 

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

 

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

 

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

 

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


 

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

 

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

 

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

 

 4  of the pregnancy certification form completed under subsection

 

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

 

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

 

 7  that payment for medical services will be required or that

 

 8  collection of payment in full for all medical services provided

 

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

 

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

 

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

 

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

 

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

 

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

 

15  agent of a physician receiving capitated payments or under a

 

16  salary arrangement for providing those medical services:

 

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

 

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

 

19  qualified person assisting the physician the information required

 

20  under subsection (3)(c) and (d).

 

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

 

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

 

23  experience, judgment, and professional competence, determines

 

24  that a medical emergency exists and necessitates performance of

 

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

 

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

 

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


 

 1  shall maintain a written record identifying with specificity the

 

 2  medical factors upon which the determination of the medical

 

 3  emergency is based.

 

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

 

 5  following:

 

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

 

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

 

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

 

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

 

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

 

11  printed description, in nontechnical English, Arabic, and

 

12  Spanish, of the probable anatomical and physiological

 

13  characteristics of the fetus at that particular state of

 

14  gestational development.

 

15        (b) Subject to subdivision (g), develop, draft, and print,

 

16  in nontechnical English, Arabic, and Spanish, written

 

17  standardized summaries, based upon the various medical procedures

 

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

 

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

 

20  medical procedures used to perform abortions in this state that

 

21  are recognized by the department.

 

22        (ii) Identify the physical complications that have been

 

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

 

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

 

25  these complications, the department shall consider the annual

 

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

 

27  consider studies concerning complications that have been


 

 1  published in a peer review medical journal, with particular

 

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

 

 3  the federal centers for disease control, the American college of

 

 4  obstetricians and gynecologists, the Michigan state medical

 

 5  society, or any other source that the department determines

 

 6  appropriate for the purpose.

 

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

 

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

 

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

 

10  occur and are intense or persistent, professional help is

 

11  recommended.

 

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

 

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

 

14  the patient to her physician for more personalized information.

 

15        (v) Identify services available through public agencies to

 

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

 

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

 

18  of her child.

 

19        (vi) Identify services available through public agencies to

 

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

 

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

 

22  her child.

 

23        (vii) Identify services available through public agencies to

 

24  assist the patient and provide counseling should she experience

 

25  subsequent adverse psychological effects from the abortion.

 

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

 

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


 

 1  includes only the following language above a signature line for

 

 2  the patient:

 

 3        "I, ____________________, hereby authorize Dr.

 

 4  _______________________ ("the physician") and any assistant

 

 5  designated by the physician to perform upon me the following

 

 6  operation(s) or procedure(s):

 

 7        ________________________________________

 

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

 

 9        _________________________________________

 

10        I understand that I am approximately _____ weeks pregnant. I

 

11  consent to an abortion procedure to terminate my pregnancy. I

 

12  understand that I have the right to withdraw my consent to the

 

13  abortion procedure at any time prior to performance of that

 

14  procedure. I acknowledge that at least 24 hours before the

 

15  scheduled abortion I have received a physical copy of each of the

 

16  following:

 

17        (a) A medically accurate depiction, illustration, or

 

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

 

19  fetus I am carrying.

 

20        (b) A written description of the medical procedure that will

 

21  be used to perform the abortion.

 

22        (c) A prenatal care and parenting information pamphlet. If

 

23  any of the above listed documents were transmitted by facsimile,

 

24  I certify that the documents were clear and legible. I

 

25  acknowledge that the physician who will perform the abortion has

 

26  orally described all of the following to me:

 

27        (i) The specific risk to me, if any, of the complications


 

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

 

 2  undergo.

 

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

 

 4  I choose to continue the pregnancy.

 

 5        I acknowledge that I have received all of the following

 

 6  information:

 

 7        (d) Information about what to do and whom to contact in the

 

 8  event that complications arise from the abortion.

 

 9        (e) Information pertaining to available pregnancy related

 

10  services.

 

11        I have been given an opportunity to ask questions about the

 

12  operation(s) or procedure(s). I certify that I have not been

 

13  required to make any payments for an abortion or any medical

 

14  service before the expiration of 24 hours after I received the

 

15  written materials listed in paragraphs (a), (b), and (c) above,

 

16  or 24 hours after the time and date listed on the confirmation

 

17  form if paragraphs (a), (b), and (c) were viewed from the state

 

18  of Michigan internet website.".

 

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

 

20  of medicine and the Michigan board of osteopathic medicine and

 

21  surgery, and any person upon request the copies of medically

 

22  accurate depictions, illustrations, or photographs described in

 

23  subdivision (a), the standardized written summaries described in

 

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

 

25  subdivision (c), the prenatal care and parenting information

 

26  pamphlet described in section 9161, and the pregnancy

 

27  certification form described in subdivision (f).


 

 1        (e) The department shall not develop written summaries for

 

 2  abortion procedures under subdivision (b) that utilize medication

 

 3  that has not been approved by the United States food and drug

 

 4  administration for use in performing an abortion.

 

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

 

 6  signed by a local health department representative at the time

 

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

 

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

 

 9  confirmed.

 

10        (g) Develop and maintain an internet website that allows a

 

11  patient considering an abortion to review the information

 

12  required in subsection (3)(c) through (e). After the patient

 

13  reviews the required information, the department shall assure

 

14  that a confirmation form can be printed by the patient from the

 

15  internet website that will verify the time and date the

 

16  information was reviewed. A confirmation form printed under this

 

17  subdivision becomes invalid 14 days after the date and time

 

18  printed on the confirmation form.

 

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

 

20  section does not require disclosure of information beyond what a

 

21  reasonably well-qualified physician licensed under this article

 

22  would possess.

 

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

 

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

 

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

 

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

 

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


 

 1  misrepresentation, coercion, or duress.

 

 2        (14) A completed certification form described in subsection

 

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

 

 4  representative is presumed valid. The presumption created by this

 

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

 

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

 

 7  the certification had actual knowledge that the certificate

 

 8  contained a false or misleading statement or signature.

 

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

 

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

 

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

 

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

 

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

 

14  that invalidity does not affect the remaining portions or

 

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

 

16  invalid portion or application, if those remaining portions are

 

17  not determined by the court to be inoperable.

 

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

 

19  shall:

 

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

 

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

 

22  probable gestational stage of the fetus. The local health

 

23  department need not comply with this subdivision if the

 

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

 

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

 

26  provided with a completed pregnancy certification form described

 

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


 

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

 

 2  information or who consents to an abortion pursuant to this

 

 3  section is confidential and is subject to disclosure only with

 

 4  the consent of the patient or by judicial process.

 

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

 

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

 

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

 

 8  section shall do both of the following:

 

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

 

10  a physician or qualified person assisting the physician in order

 

11  to verify the receipt of the information required under this

 

12  section.

 

13        (b) Destroy the information containing the identity and

 

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

 

15  under this section.

 

16        Sec. 18115. (1) This article does not limit an individual

 

17  in, nor prevent an individual from, the practice of a statutorily

 

18  regulated profession or occupation if counseling is part of the

 

19  services provided by that profession or occupation, and the

 

20  individual does not hold himself or herself out as a counselor

 

21  regulated under this article. As used in this subsection,

 

22  "statutorily regulated profession or occupation" includes, but is

 

23  not limited to, all of the following: a physician, attorney,

 

24  marriage counselor, debt management counselor, social worker,  

 

25  certified social worker,  social  work  service technician,

 

26  licensed psychologist,  limited licensed psychologist, temporary

 

27  limited licensed psychologist,  or school counselor.


 

 1        (2) This part does not apply to any of the following:

 

 2        (a) An ordained member of the clergy if counseling is

 

 3  incidental to his or her religious duties performed under the

 

 4  auspices or recognition of a church, denomination, religious

 

 5  association, or sect, that has tax exempt status pursuant to

 

 6  section 501(c)(3) of the internal revenue code of 1986  , 26

 

 7  U.S.C. 501,  if the member of the clergy does not hold himself or

 

 8  herself out as a counselor licensed under this article.

 

 9        (b) An individual who performs volunteer services for a

 

10  public or private nonprofit organization, church, or charity, if

 

11  the individual is approved by the organization or agency for

 

12  which the services are rendered.

 

13        (c) An individual who is employed by or who volunteers to

 

14  work in a program licensed by the office of substance abuse

 

15  services.

 

16        (d) A member of any other profession whose practice may

 

17  include counseling principles, methods, or procedures from

 

18  practicing his or her profession as long as he or she is trained

 

19  in that profession and does not hold himself or herself out as a

 

20  counselor providing counseling. As used in this subdivision,

 

21  "profession" includes, but is not limited to, the fields of human

 

22  resources development and organizational development.

 

23        (3) This part does not prohibit the use of the word

 

24  "counselor" without the qualifying words "licensed" or

 

25  "professional" used in conjunction with the word "counselor",

 

26  except as otherwise provided by law.

 

27        Sec. 18201. (1) As used in this part:


 

 1        (a) "Psychologist" means an individual licensed under this

 

 2  article to engage in the practice of psychology at a doctoral

 

 3  level, master's level, or associate's level.

 

 4        (b) "Practice of psychology" means the rendering to

 

 5  individuals, groups, organizations, or the public of services

 

 6  involving the application of principles, methods, and procedures

 

 7  of understanding, predicting, and influencing behavior for the

 

 8  purposes of the diagnosis, assessment related to diagnosis,

 

 9  prevention, amelioration, or treatment of mental or emotional

 

10  disorders, disabilities or behavioral adjustment problems by

 

11  means of psychotherapy, counseling, behavior modification,

 

12  hypnosis, biofeedback techniques, psychological tests, or other

 

13  verbal or behavioral means. The practice of psychology shall not

 

14  include the practice of medicine such as prescribing drugs,

 

15  performing surgery, or administering electro-convulsive therapy.

 

16        (2) In addition to the definitions in this part, article 1

 

17  contains general definitions and principles of construction

 

18  applicable to all articles in this code and part 161 contains

 

19  definitions applicable to this part.

 

20        Sec. 18211. (1) For a period of 6 months after the effective

 

21  date of this code, an individual may use the terms set forth in

 

22  section 16263(k) if the individual is authorized to use the terms

 

23  as of the effective date of this part under Act No. 257 of the

 

24  Public Acts of 1959, as amended, being sections 338.1001 to

 

25  338.1019 of the Michigan Compiled Laws, or if the individual is

 

26  authorized under this part to use the terms.

 

27        (2) After the period prescribed in subsection (1), a person


 

 1  shall not engage in the practice of psychology unless licensed or

 

 2  otherwise authorized by this article. An individual who is a

 

 3  fully licensed psychologist on October 1, 2006 is a licensed

 

 4  doctoral psychologist. An individual who is a limited licensed

 

 5  psychologist on October 1, 2006 is a licensed master's

 

 6  psychologist.

 

 7        Sec. 18212. (1) Except as otherwise provided in subsection  

 

 8  (3)  (2), an individual shall not engage in  postdoctoral  

 

 9  postgraduate training which includes the practice of psychology

 

10  at a doctoral or master's level without obtaining a  full or

 

11  limited  doctoral or master's license, respectively, to practice

 

12  under this part.

 

13        (2)  A limited  An associate's license for an individual in  

 

14  postdoctoral  postgraduate training shall require that the

 

15  individual be under supervision of a licensed doctoral or

 

16  master's psychologist and confine his or her practice and

 

17  training to a hospital, clinic, institution, or other arrangement

 

18  approved by the board for the training. The hospital, clinic, or

 

19  institution and designated licensed psychologist are responsible

 

20  for the training.  A limited  An associate's license for  a

 

21  postdoctoral  postgraduate training is renewable for not more

 

22  than  5  3 years.

 

23        (3) The Michigan board of psychology shall waive the

 

24  requirement of having a limited license in order to engage in the

 

25  postdoctoral experience necessary to obtain a full license if all

 

26  of the following occur:

 

27        (a) The individual has met all the other requirements of


 

 1  subsection (2).

 

 2        (b) The individual submits a request for the waiver in

 

 3  writing and pays a sum equal to the cost of a limited license.

 

 4        (c) The individual has applied for a license between July 1,

 

 5  1985 and July 1, 1986.

 

 6        Sec. 18214. (1) This part does not prohibit an individual

 

 7  who holds a doctoral or master's degree in psychology from a

 

 8  regionally accredited college or university from using a title

 

 9  including "psychologist" if the individual does not engage in the

 

10  practice of psychology.

 

11        (2) This part does not prohibit an individual approved by

 

12  the state department of education from using the title "school

 

13  psychologist" and engaging in those duties and activities

 

14  pertinent to employment by a public or private elementary or

 

15  secondary school.

 

16        (3) This part does not prohibit an individual employed by a

 

17  regionally accredited college or university and involved in

 

18  research or the teaching of psychology from performing those

 

19  duties for which he or she is employed by that institution.

 

20        (4) This part does not prohibit a certified, licensed,

 

21  registered, or otherwise statutorily recognized member of any

 

22  profession including a lawyer, social worker, school counselor or

 

23  marriage counselor from practicing his or her profession as

 

24  authorized by law.

 

25        (5) This part does not prohibit a clergyman, professional

 

26  educator, or professional counselor, including an alcoholism or

 

27  drug abuse counselor, whose practice may include preventive


 

 1  techniques, counseling techniques, or behavior modification

 

 2  techniques from practicing his or her profession consistent with

 

 3  his or her training and with a code of ethics for that respective

 

 4  profession.

 

 5        (6) This part shall not apply to a participant or employee

 

 6  in a program licensed under part 62 or self-help, peer

 

 7  counseling, or support services provided by a nonprofit

 

 8  organization.

 

 9        Sec. 18221. (1) The Michigan board of psychology is created

 

10  in the department and shall consist of the following 9 voting

 

11  members who shall meet the requirements of part 161:

 

12        (a) Until October 1, 2006, 5 psychologists, including at

 

13  least 1 nondoctoral psychologist, and 4 public members.

 

14        (b) Beginning on October 1, 2006, 5 psychologists, of which

 

15  the number of doctoral and master's level psychologists shall be

 

16  representative of the ratio of each licensed in this state, and 4

 

17  public members.

 

18        (2) Section 1212 does not apply to this board.

 

19        Sec. 18223. (1) The board shall  promulgate rules requiring

 

20  that an individual granted a  grant a doctoral license under this

 

21  part  , except as provided in subsection (2), shall have  to an

 

22  individual who has been granted a doctoral degree in psychology  

 

23  , or a doctoral degree in a closely related field,  from a

 

24  regionally accredited  or other  college, university, or

 

25  institution approved by the board, which included education,  and  

 

26  training, and experience appropriate to the practice of

 

27  psychology at the doctoral level, and shall have not less than  2  


 

 1  3 years  postdoctoral  of supervised post graduate experience in

 

 2  the practice of psychology at the doctoral level in an organized

 

 3  health care setting, clinic, institution, or other arrangement,

 

 4  as established by the board. The 3 years of supervised

 

 5  postgraduate experience shall be under the supervision of a

 

 6  licensed doctoral psychologist, and the supervision shall be on a

 

 7  regularly scheduled, face-to-face basis, either individually or

 

 8  as a group, except that in the case of extreme hardship the board

 

 9  may approve an alternate supervisory arrangement.

 

10        (2)  In addition to section 16182, the  The board shall

 

11  grant a  limited  master's license to an individual who has been

 

12  granted a master's degree in psychology from a regionally

 

13  accredited college,  or  university, or institution approved by

 

14  the board,  if the individual has  which included education,

 

15  training, and experience appropriate to the practice of

 

16  psychology at the master's level, and shall have not less than 3

 

17  years of supervised postgraduate experience in the practice of

 

18  psychology at the master's level in an organized health care

 

19  setting, clinic, institution, or other arrangement, as

 

20  established by the board.  Except for duties performed as an

 

21  employee of a governmental entity or of a nonprofit organization

 

22  serving benevolent and charitable purposes, 2 limitations shall

 

23  be placed on a license granted to an individual under this

 

24  subsection. The limitations shall require supervision by a

 

25  psychologist who has a license other than a limited license and

 

26  shall prohibit advertising or other representation to the public

 

27  which will lead the public to believe the individual is engaging


 

 1  in the practice of psychology. A limited license granted under

 

 2  this subsection shall be renewed pursuant to part 161. An

 

 3  individual applying for a limited license pursuant to this

 

 4  subsection shall have 1 year of supervised postgraduate

 

 5  experience in an organized health care setting or other

 

 6  arrangement, as established by the board. The individual shall be

 

 7  supervised by a psychologist who has a license other than a

 

 8  limited license, or if a psychologist who has a license other

 

 9  than a limited license is not available, by a psychologist who

 

10  has at least a master's degree in psychology and at least 3 years

 

11  of experience in the practice of psychology or by any other

 

12  individual approved by the board. The board shall issue a

 

13  temporary license to the individual for the purpose of obtaining

 

14  the 1 year of postgraduate experience.  The 3 years of supervised

 

15  postgraduate experience shall be under the supervision of a

 

16  licensed doctoral or master's psychologist, and the supervision

 

17  shall be on a regularly scheduled, face-to-face basis, either

 

18  individually or as a group, except that in the case of extreme

 

19  hardship the board may approve an alternate supervisory

 

20  arrangement.

 

21        (3) The board shall grant an associate's license to an

 

22  individual who has been granted a doctoral or master's degree in

 

23  psychology from a regionally accredited college, university, or

 

24  institution approved by the board and completed all other

 

25  requirements for licensure at the doctoral or master's level

 

26  except for the examination and supervised postgraduate

 

27  experience. The board shall issue the associate's license to the


 

 1  individual so that the individual can obtain the 3 years of

 

 2  supervised postgraduate experience.

 

 3        Sec. 18233.  (1)  In addition to the requirements of part

 

 4  161, the board may require a licensee seeking renewal of a

 

 5  license to furnish the board with satisfactory evidence that

 

 6  during the 2 years immediately preceding application for renewal

 

 7  the licensee has attended continuing education courses or

 

 8  programs approved by the board totaling not less than a number of

 

 9  hours established by rule of the board in subjects related to the

 

10  practice of psychology and designed to further educate licensees.

 

11        (2) As required under section 16204, the board shall

 

12  promulgate rules requiring each applicant for license renewal to

 

13  complete as part of the continuing education requirement of

 

14  subsection (1) an appropriate number of hours or courses in pain

 

15  and symptom management.

 

16        Enacting section 1. This amendatory act takes effect October

 

17  1, 2006.