HOUSE BILL No. 5711

 

May 31, 2012, Introduced by Rep. Rendon and referred to the Committee on Health Policy.

 

      A bill to amend 1978 PA 368, entitled

 

"Public health code,"

 

by amending sections 2803, 2804, 2834, 2848, 13807, 16221, 16226,

 

16299, 17015, 17515, and 20115 (MCL 333.2803, 333.2804, 333.2834,

 

333.2848, 333.13807, 333.16221, 333.16226, 333.16299, 333.17015,

 

333.17515, and 333.20115), sections 2803, 2834, and 2848 as

 

amended by 2002 PA 562, section 2804 as amended by 1990 PA 149,

 

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 by 1999 PA 206, and by adding sections 2836, 2854,

 

17015a, 17017, 17019, 17517, and 17519.

 

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

 

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


 

 1  section 17015.

 

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

 

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

 

 4  reasonably be concluded that death has occurred.

 

 5        (3) (2) "Fetal death" means the death of a fetus which that

 

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

 

 7  400 grams. Fetal death includes a stillbirth. The definition

 

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

 

 9  definition recommended by the federal agency responsible for

 

10  vital statistics.

 

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

 

12  fetus that has completed at least 8 weeks of gestation or has

 

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

 

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

 

15  appear to be supported by skeletal or cartilaginous structures.

 

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

 

17        (5) (3) "File" means to present a certificate, report, or

 

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

 

19  registration by the state registrar.

 

20        (6) (4) "Final disposition" means the burial, cremation,

 

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

 

22  fetus fetal remains.

 

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

 

24  establishment which that provides inpatient medical, surgical, or

 

25  diagnostic care or treatment or nursing, custodial, or

 

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

 

27  establishment to which individuals are committed by law.


 

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

 

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

 

 3  department of state police; and any other governmental law

 

 4  enforcement agency.

 

 5        (3) "Live birth" means a term defined by departmental rule

 

 6  which that shall conform as closely as possible to the definition

 

 7  of live birth recommended by the federal agency responsible for

 

 8  vital statistics.

 

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

 

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

 

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

 

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

 

13  section 2814. Population shall be determined according to the

 

14  latest federal decennial census.

 

15        (5) "Medical waste" means that term as defined in section

 

16  13805.

 

17        (6) "Miscarriage" means the spontaneous expulsion of a

 

18  nonviable fetus that has completed less than 20 weeks of

 

19  gestation.

 

20        (7) "Products of conception" means that term as defined in

 

21  section 13807.

 

22        (8) (5) "Registration" means the acceptance by the state

 

23  registrar and the incorporation of certificates provided for in

 

24  this part into the official vital records.

 

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

 

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

 

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


 

 1  the form and manner for reporting fetal deaths.

 

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

 

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

 

 4  security or drivers license numbers, or other information

 

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

 

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

 

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

 

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

 

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

 

10  death. Statistical information which that may reveal the identity

 

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

 

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

 

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

 

14  gestation is delivered in an institution, the individual in

 

15  charge of the institution or his or her authorized representative

 

16  shall prepare and file the fetal death report and make

 

17  arrangements for the final disposition of the dead fetus in

 

18  accordance with section 2848 taking into account the expressed

 

19  wishes of the parents, or parent in the case of an unmarried

 

20  mother, as long as those wishes do not conflict with any state or

 

21  federal law, rule, or regulation.

 

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

 

23  gestation is delivered outside an institution, the physician in

 

24  attendance shall prepare and file the fetal death report. If a

 

25  physician becomes aware of a fetal death or miscarriage that has

 

26  occurred outside an institution, the physician shall inform the

 

27  parents, or parent in case of an unmarried mother, that state law


 

 1  requires the parents or parent to authorize the final disposition

 

 2  of the dead fetus or fetal remains and that the parents or parent

 

 3  has a right to determine the final disposition of the dead fetus.

 

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

 

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

 

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

 

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

 

 8  investigate the cause and prepare and file the fetal death

 

 9  report. Except as otherwise specifically provided, this section

 

10  and section 2848 do not apply to a miscarriage that occurs

 

11  outside an institution.

 

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

 

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

 

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

 

15  incorporated into the permanent official records of the system of

 

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

 

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

 

18  employee of the department shall not disclose to any person

 

19  outside the department the reports or the contents of the reports

 

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

 

21  manner or fashion so as to permit the person or entity to whom

 

22  the report is disclosed to identify in any way the biological

 

23  parents.

 

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

 

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

 

26  documents and shall be incorporated into the system of vital

 

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


 

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

 

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

 

 3  sections 2882, 2883, and 2888.

 

 4        (8) With information provided to the department under

 

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

 

 6  stillbirth which that shall conform as nearly as possible to

 

 7  recognized national standardized forms and shall include, but not

 

 8  be limited to, the following information:

 

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

 

10  parent or parents.

 

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

 

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

 

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

 

14        (e) The name of the health facility in which the fetus was

 

15  delivered or the name of the health professional in attendance if

 

16  the delivery was outside a health facility.

 

17        (9) If a miscarriage occurs outside an institution and a

 

18  health professional is present or is immediately aware of the

 

19  miscarriage, then the health professional shall inform the

 

20  parents, or parent in the case of an unmarried mother, that state

 

21  law requires that authorization be obtained before the final

 

22  disposition of any fetal remains resulting from a miscarriage and

 

23  that the parents or parent has a right to determine the final

 

24  disposition of the fetal remains.

 

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

 

26  shall be disposed of by means lawful for other dead bodies,

 

27  including burial, cremation, or interment. Unless the mother has


 

 1  provided written consent for research on the fetal remains under

 

 2  section 2688, a physician who performs an abortion shall arrange

 

 3  for the final disposition of the fetal remains resulting from the

 

 4  abortion. If the fetal remains resulting from an abortion are

 

 5  disposed of by cremation, the fetal remains shall be incinerated

 

 6  separately from any other medical waste. However, this subsection

 

 7  does not prohibit the simultaneous cremation of fetal remains

 

 8  with products of conception or other fetal remains resulting from

 

 9  abortions.

 

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

 

11  final disposition of the fetal remains with the mother prior to

 

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

 

13  obtain authorization from the mother for the final disposition of

 

14  the fetal remains upon completion of the abortion.

 

15        (3) A person who violates this section is guilty of a felony

 

16  punishable by imprisonment for not more than 3 years or a fine of

 

17  not more than $5,000.00, or both.

 

18        Sec. 2848. (1) Except as provided in sections 2844 and 2845,

 

19  a funeral director or person acting as a funeral director, who

 

20  first assumes custody of a dead body, not later than 72 hours

 

21  after death or the finding of a dead body and before final

 

22  disposition of the body, shall obtain authorization for the final

 

23  disposition. The authorization for final disposition of a dead

 

24  body shall be issued on a form prescribed by the state registrar

 

25  and signed by the local registrar or the state registrar.

 

26        (2) Before Unless the mother has provided written consent

 

27  for research on the dead fetus under section 2688, before final


 

 1  disposition of a dead fetus, irrespective of the duration of

 

 2  pregnancy, or before final disposition of fetal remains resulting

 

 3  from a miscarriage, the funeral director or person assuming

 

 4  responsibility for the final disposition of the fetus or fetal

 

 5  remains shall obtain from the parents, or parent in case of an

 

 6  unmarried mother, an authorization for final disposition on a

 

 7  form prescribed and furnished or approved by the state registrar.

 

 8  The authorization may allow final disposition to be by a funeral

 

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

 

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

 

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

 

12  under this code act. The funeral director, individual in charge

 

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

 

14  shall take into account the express wishes of the parents, or

 

15  parent in case of an unmarried mother, as long as those wishes do

 

16  not conflict with any state or federal law, rule, or regulation.

 

17  After final disposition, the funeral director, the individual in

 

18  charge of the institution, or other person making the final

 

19  disposition shall retain the permit for not less than 7 years.

 

20  Nothing in this section as amended by the amendatory act that

 

21  added this sentence requires a religious service or ceremony as

 

22  part of the final disposition of fetal remains.

 

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

 

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

 

25  authorization for final disposition.

 

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

 

27  prepared for final disposition with the consent of the physician


 

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

 

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

 

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

 

 4  this state is authorization for final disposition of the dead

 

 5  body or dead fetus in this state.

 

 6        Sec. 2854. (1) A person who violates this part by failing to

 

 7  dispose of fetal remains resulting from an abortion as prescribed

 

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

 

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

 

10  2848 is responsible for a state civil infraction as provided

 

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

 

12  236, MCL 600.8801 to 600.8835, and may be ordered to pay a civil

 

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

 

14        (2) A person who suffers injury or damages as a result of a

 

15  person violating this part as described under subsection (1) may

 

16  bring a civil cause of action against that person to secure

 

17  actual damages, including damages for emotional distress, or

 

18  other appropriate relief.

 

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

 

20  produces disease.

 

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

 

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

 

23  removed by trauma or during surgery or autopsy or other medical

 

24  procedure, and not fixed in formaldehyde.

 

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

 

26  waste leaves the producing facility site.

 

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


 

 1  stores, decontaminates, or incinerates medical waste.

 

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

 

 3  placenta, umbilical cord, or other uterine contents resulting

 

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

 

 5  or fetal body parts.

 

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

 

 7  pouring, emitting, emptying, discharging, injecting, escaping,

 

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

 

 9  environment in violation of this part.

 

10        (7) (6) "Response activity" means an activity necessary to

 

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

 

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

 

13  removal, containment, isolation, treatment, monitoring,

 

14  maintenance, replacement of water supplies, and temporary

 

15  relocation of people.

 

16        (8) (7) "Sharps" means needles, syringes, scalpels, and

 

17  intravenous tubing with needles attached.

 

18        (9) (8) "Storage" means the containment of medical waste in

 

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

 

20  (10) (9) "Transport" means the movement of medical waste

 

21  from the point of generation to any intermediate point and

 

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

 

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

 

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

 

25  testing and research.

 

26        Sec. 16221. The department may investigate activities

 

27  related to the practice of a health profession by a licensee, a


 

 1  registrant, or an applicant for licensure or registration. The

 

 2  department may hold hearings, administer oaths, and order the

 

 3  taking of relevant testimony to be taken and shall report its

 

 4  findings to the appropriate disciplinary subcommittee. The

 

 5  disciplinary subcommittee shall proceed under section 16226 if it

 

 6  finds that 1 or more of the following grounds exist:

 

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

 

 8  failure to exercise due care, including negligent delegation to

 

 9  or supervision of employees or other individuals, whether or not

 

10  injury results, or any conduct, practice, or condition that

 

11  impairs, or may impair, the ability to safely and skillfully

 

12  practice the health profession.

 

13        (b) Personal disqualifications, consisting of 1 or more of

 

14  the following:

 

15        (i) Incompetence.

 

16        (ii) Subject to sections 16165 to 16170a, substance abuse as

 

17  defined in section 6107.

 

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

 

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

 

20  and competent manner.

 

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

 

22  competent jurisdiction.

 

23        (v) Conviction of a misdemeanor punishable by imprisonment

 

24  for a maximum term of 2 years; a misdemeanor involving the

 

25  illegal delivery, possession, or use of a controlled substance;

 

26  or a felony. A certified copy of the court record is conclusive

 

27  evidence of the conviction.


 

 1        (vi) Lack of good moral character.

 

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

 

 3  520g of the Michigan penal code, 1931 PA 328, MCL 750.520e and

 

 4  750.520g. A certified copy of the court record is conclusive

 

 5  evidence of the conviction.

 

 6        (viii) Conviction of a violation of section 492a of the

 

 7  Michigan penal code, 1931 PA 328, MCL 750.492a. A certified copy

 

 8  of the court record is conclusive evidence of the conviction.

 

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

 

10  obtaining or attempting to obtain fees related to the practice of

 

11  a health profession. A certified copy of the court record is

 

12  conclusive evidence of the conviction.

 

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

 

14  registration, disciplinary, or certification board involving the

 

15  holder of, or an applicant for, a license or registration

 

16  regulated by another state or a territory of the United States,

 

17  by the United States military, by the federal government, or by

 

18  another country. A certified copy of the record of the board is

 

19  conclusive evidence of the final action.

 

20        (xi) Conviction of a misdemeanor that is reasonably related

 

21  to or that adversely affects the licensee's ability to practice

 

22  in a safe and competent manner. A certified copy of the court

 

23  record is conclusive evidence of the conviction.

 

24        (xii) Conviction of a violation of section 430 of the

 

25  Michigan penal code, 1931 PA 328, MCL 750.430. A certified copy

 

26  of the court record is conclusive evidence of the conviction.

 

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


 

 1  520c, 520d, or 520f of the Michigan penal code, 1931 PA 328, MCL

 

 2  750.520b, 750.520c, 750.520d, and 750.520f. A certified copy of

 

 3  the court record is conclusive evidence of the conviction.

 

 4        (c) Prohibited acts, consisting of 1 or more of the

 

 5  following:

 

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

 

 7  registration.

 

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

 

 9  an unauthorized person.

 

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

 

11        (iv) Obtaining, possessing, or attempting to obtain or

 

12  possess a controlled substance as defined in section 7104 or a

 

13  drug as defined in section 7105 without lawful authority; or

 

14  selling, prescribing, giving away, or administering drugs for

 

15  other than lawful diagnostic or therapeutic purposes.

 

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

 

17  the following:

 

18        (i) False or misleading advertising.

 

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

 

20  kickbacks on medical or surgical services, appliances, or

 

21  medications purchased by or in behalf of patients.

 

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

 

23  third party reimbursement.

 

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

 

25  following:

 

26        (i) Misrepresentation to a consumer or patient or in

 

27  obtaining or attempting to obtain third party reimbursement in


 

 1  the course of professional practice.

 

 2        (ii) Betrayal of a professional confidence.

 

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

 

 4  device, treatment, procedure, or service.

 

 5        (iv) Either of the following:

 

 6        (A) A requirement by a licensee other than a physician that

 

 7  an individual purchase or secure a drug, device, treatment,

 

 8  procedure, or service from another person, place, facility, or

 

 9  business in which the licensee has a financial interest.

 

10        (B) A referral by a physician for a designated health

 

11  service that violates 42 USC 1395nn or a regulation promulgated

 

12  under that section. For purposes of this subparagraph, 42 USC

 

13  1395nn and the regulations promulgated under that section as they

 

14  exist on June 3, 2002 are incorporated by reference. A

 

15  disciplinary subcommittee shall apply 42 USC 1395nn and the

 

16  regulations promulgated under that section regardless of the

 

17  source of payment for the designated health service referred and

 

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

 

19  section is revised after June 3, 2002, the department shall

 

20  officially take notice of the revision. Within 30 days after

 

21  taking notice of the revision, the department shall decide

 

22  whether or not the revision pertains to referral by physicians

 

23  for designated health services and continues to protect the

 

24  public from inappropriate referrals by physicians. If the

 

25  department decides that the revision does both of those things,

 

26  the department may promulgate rules to incorporate the revision

 

27  by reference. If the department does promulgate rules to


 

 1  incorporate the revision by reference, the department shall not

 

 2  make any changes to the revision. As used in this subparagraph,

 

 3  "designated health service" means that term as defined in 42 USC

 

 4  1395nn and the regulations promulgated under that section and

 

 5  "physician" means that term as defined in sections 17001 and

 

 6  17501.

 

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

 

 8  1395nn or a regulation promulgated under that section, refusing

 

 9  to accept a reasonable proportion of patients eligible for

 

10  medicaid and refusing to accept payment from medicaid or medicare

 

11  as payment in full for a treatment, procedure, or service for

 

12  which the physician refers the individual and in which the

 

13  physician has a financial interest. A physician who owns all or

 

14  part of a facility in which he or she provides surgical services

 

15  is not subject to this subparagraph if a referred surgical

 

16  procedure he or she performs in the facility is not reimbursed at

 

17  a minimum of the appropriate medicaid or medicare outpatient fee

 

18  schedule, including the combined technical and professional

 

19  components.

 

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

 

21  industry services shall prepare the first of 3 annual reports on

 

22  the effect of 2002 PA 402 on access to care for the uninsured and

 

23  medicaid patients. The department shall report on the number of

 

24  referrals by licensees of uninsured and medicaid patients to

 

25  purchase or secure a drug, device, treatment, procedure, or

 

26  service from another person, place, facility, or business in

 

27  which the licensee has a financial interest.


 

 1        (g) Failure to report a change of name or mailing address

 

 2  within 30 days after the change occurs.

 

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

 

 4  this article or of a rule promulgated under this article.

 

 5        (i) Failure to comply with a subpoena issued pursuant to

 

 6  this part, failure to respond to a complaint issued under this

 

 7  article or article 7, failure to appear at a compliance

 

 8  conference or an administrative hearing, or failure to report

 

 9  under section 16222 or 16223.

 

10        (j) Failure to pay an installment of an assessment levied

 

11  pursuant to under the insurance code of 1956, 1956 PA 218, MCL

 

12  500.100 to 500.8302, within 60 days after notice by the

 

13  appropriate board.

 

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

 

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

 

16  licensure or registration under section 16174.

 

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

 

18  or 17517.

 

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

 

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

 

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

 

22        (q) A violation of section 16274.

 

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

 

24        (s) A violation of the medical records access act, 2004 PA

 

25  47, MCL 333.26261 to 333.26271.

 

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

 

27        (u) A violation of section 17019 or 17519.


 

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

 

 2  the grounds for disciplinary subcommittee action listed in

 

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

 

 4  of the following sanctions for each violation:

 

 

 Violations of Section 16221                   Sanctions

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

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

(b)(vii)                            restitution, community service,

                                   or fine.

10                                   

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

12                                   

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

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

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

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

17                                   

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

19                                    suspension, revocation,

20                                    restitution, community service,

21                                    fine, or, subject to subsection

22                                    (5), permanent revocation.

23                                   

24                                   

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

26                                    probation, limitation, community

27                                    service, or fine.

28                                   

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


                                   restitution, community service,

                                   or fine.

                                  

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

                                   revocation, restitution,

                                   community service, or fine.

                                  

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

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

10                                    service, or restitution.

11                                   

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

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

14                                    or restitution.

15                                   

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

17                                    limitation, suspension, community

18                                    service, denial, or restitution.

19                                   

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

21 or (i)(i)                          suspension, restitution,

22                                    community service, denial, or

23                                    fine.

24                                   

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

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

27                                    limitation, community service,

28                                    denial, or restitution.

29                                   

30 Subdivision (g)                   Reprimand or fine.

31                                   


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

                                   suspension, revocation,

                                   limitation, restitution,

                                   community service, or fine.

                                  

Subdivision (j)                   Suspension or fine.

                                  

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

or (r)                           

10                                   

11 Subdivision (l)                    Reprimand, denial, or

12                                    limitation.

13                                   

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

15                                    probation, suspension,

16                                    limitation, reprimand, or fine.

17                                   

18 Subdivision (n)                   Revocation or denial.

19                                   

20 Subdivision (q)                   Revocation.

21                                   

22 Subdivision (t)                   Revocation, fine, and

23                                    restitution.

24 Subdivision (u)                   Limitation described in section

25                                    17019 or 17519, as applicable

 

 

26        (2) Determination of sanctions for violations under this

 

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

 

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

 

29  decision or order of a disciplinary subcommittee prejudices

 

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


 

 1  listed in section 106 of the administrative procedures act of

 

 2  1969, 1969 PA 306, MCL 24.306, and holds that the final decision

 

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

 

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

 

 5  the case to the disciplinary subcommittee for further

 

 6  consideration.

 

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

 

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

 

 9  16221(a) or (b).

 

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

 

11  registrant or an applicant for licensure or registration who has

 

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

 

13  this article or article 7 to satisfactorily complete an

 

14  educational program, a training program, or a treatment program,

 

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

 

16  combination of those programs and examinations.

 

17        (5) A disciplinary subcommittee shall not impose the

 

18  sanction of permanent revocation for a violation of section

 

19  16221(b)(xiii) unless the violation occurred while the licensee or

 

20  registrant was acting within the health profession for which he

 

21  or she was licensed or registered.

 

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

 

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

 

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

 

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

 

26  as follows:

 

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


 

 1  90 days, or a fine of not more than $100.00, or both.

 

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

 

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

 

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

 

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

 

 6  17015, or 17017, 17019, 17515, 17517, or 17519.

 

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

 

 8  shall not perform an abortion otherwise permitted by law without

 

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

 

10  coercion to abort.

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

23  328, MCL 750.213a.

 

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

 

25  section 1 of 1978 PA 389, MCL 400.1501.

 

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

 

27  homo sapiens in utero.


 

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

 

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

 

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

 

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

 

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

 

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

 

 7  complicates the medical condition of a pregnant woman as to

 

 8  necessitate the immediate abortion of her pregnancy to avert her

 

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

 

10  substantial and irreversible impairment of a major bodily

 

11  function.

 

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

 

13  treatment, procedure, medication, examination, diagnostic test,

 

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

 

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

 

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

 

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

 

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

 

19  psychologist licensed under part 182, a professional counselor

 

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

 

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

 

22  worker licensed under part 185.

 

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

 

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

 

25  to be performed.

 

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

 

27  confirming that the patient accessed the internet website


 

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

 

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

 

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

 

 4  document by 1 or more of the following means:

 

 5        (i) In person.

 

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

 

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

 

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

 

 9        (iv) By facsimile transmission.

 

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

 

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

 

12  less than 24 hours before that physician performs an abortion

 

13  upon a patient who is a pregnant woman:

 

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

 

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

 

16  gestational age of the fetus.

 

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

 

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

 

19  and intellectual capability, each of the following:

 

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

 

21  carrying.

 

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

 

23  medical complications arise from the abortion.

 

24        (iii) Information about how to obtain pregnancy prevention

 

25  information through the department of community health.

 

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

 

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


 

 1  corresponds to the procedure the patient will undergo and is

 

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

 

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

 

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

 

 5  written standardized summary for that procedure, the physician

 

 6  shall develop and provide a written summary that describes the

 

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

 

 8  risks associated with live birth and meets the requirements of

 

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

 

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

 

11  accurate depiction, illustration, or photograph and description

 

12  of a fetus supplied by the department of community health

 

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

 

14  probable gestational age of the patient's fetus.

 

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

 

16  care and parenting information pamphlet distributed by the

 

17  department of community health under section 9161.

 

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

 

19  prescreening summary on prevention of coercion to abort described

 

20  in subsection (11)(i).

 

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

 

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

 

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

 

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

 

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

 

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

 

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


 

 1  internet website other than the internet website described in

 

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

 

 3  department under subsection (11)(g).

 

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

 

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

 

 6  is maintained and operated through by the department under

 

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

 

 8  form from the website that the patient has reviewed the

 

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

 

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

 

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

 

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

 

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

 

14  accesses this website. The patient shall supply the valid

 

15  confirmation form to the physician or qualified person assisting

 

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

 

17  comply with this subsection.

 

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

 

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

 

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

 

21  all of the following:

 

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

 

23  with the patient that the coercion to abort screening required

 

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

 

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

 

26  time before performance of the abortion.

 

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


 

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

 

 2  and intellectual capability, each of the following:

 

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

 

 4  complications that have been associated with the procedure the

 

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

 

 6  condition and history as determined by the physician.

 

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

 

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

 

 9  patient's particular medical condition and history as determined

 

10  by a physician.

 

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

 

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

 

13  to the patient in the presence of another patient.

 

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

 

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

 

16  physician determines that ultrasound imaging will be used during

 

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

 

18  person assisting the physician shall provide the patient with the

 

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

 

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

 

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

 

22  performance of the abortion. Before performing an abortion on a

 

23  patient who is a pregnant woman, a physician or a qualified

 

24  person assisting the physician shall do all of the following:

 

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

 

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

 

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


 

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

 

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

 

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

 

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

 

 5  of the pregnancy certification form completed under subsection

 

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

 

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

 

 8  that payment for medical services will be required or that

 

 9  collection of payment in full for all medical services provided

 

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

 

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

 

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

 

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

 

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

 

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

 

16  agent of a physician receiving capitated payments or under a

 

17  salary arrangement for providing those medical services:

 

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

 

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

 

20  qualified person assisting the physician the information required

 

21  under subsection (3)(c) and (d).

 

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

 

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

 

24  experience, judgment, and professional competence, determines

 

25  that a medical emergency exists and necessitates performance of

 

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

 

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


 

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

 

 2  shall maintain a written record identifying with specificity the

 

 3  medical factors upon which the determination of the medical

 

 4  emergency is based.

 

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

 

 6  following:

 

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

 

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

 

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

 

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

 

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

 

12  printed description, in nontechnical English, Arabic, and

 

13  Spanish, of the probable anatomical and physiological

 

14  characteristics of the fetus at that particular state of

 

15  gestational development.

 

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

 

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

 

18  standardized summaries, based upon the various medical procedures

 

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

 

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

 

21  medical procedures used to perform abortions in this state that

 

22  are recognized by the department.

 

23        (ii) Identify the physical complications that have been

 

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

 

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

 

26  these complications, the department shall consider the annual

 

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


 

 1  consider studies concerning complications that have been

 

 2  published in a peer review medical journal, with particular

 

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

 

 4  the federal centers for disease control and prevention, the

 

 5  American college congress of obstetricians and gynecologists, the

 

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

 

 7  department determines appropriate for the purpose.

 

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

 

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

 

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

 

11  occur and are intense or persistent, professional help is

 

12  recommended.

 

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

 

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

 

15  the patient to her physician for more personalized information.

 

16        (v) Identify services available through public agencies to

 

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

 

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

 

19  of her child.

 

20        (vi) Identify services available through public agencies to

 

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

 

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

 

23  her child.

 

24        (vii) Identify services available through public agencies to

 

25  assist the patient and provide counseling should she experience

 

26  subsequent adverse psychological effects from the abortion.

 

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


 

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

 

 2  includes only the following language above a signature line for

 

 3  the patient:

 

 4        "I, _____________________________ , voluntarily and

 

 5  willfully hereby authorize Dr. __________________ ("the

 

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

 

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

 

 8        ____________________________________________________________

 

 9  __

 

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

 

11        ____________________________________________________________

 

12  __

 

13        A. I understand that I am approximately _____ weeks

 

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

 

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

 

16  consent to the abortion procedure at any time prior to

 

17  performance of that procedure.

 

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

 

19  into seeking an abortion.

 

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

 

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

 

22  following:

 

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

 

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

 

25  fetus I am carrying.

 

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

 

27  will be used to perform the abortion.


 

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

 

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

 

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

 

 4  were clear and legible.

 

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

 

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

 

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

 

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

 

 9  undergo.

 

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

 

11  if I choose to continue the pregnancy.

 

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

 

13  information:

 

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

 

15  the event that complications arise from the abortion.

 

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

 

17  services.

 

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

 

19  the operation(s) or procedure(s).

 

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

 

21  payments for an abortion or any medical service before the

 

22  expiration of 24 hours after I received the written materials

 

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

 

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

 

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

 

26  paragraph C was viewed from the state of Michigan internet

 

27  website.".


 

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

 

 2  of medicine and the Michigan board of osteopathic medicine and

 

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

 

 4  accurate depictions, illustrations, or photographs described in

 

 5  subdivision (a), the written standardized written summaries

 

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

 

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

 

 8  information pamphlet described in section 9161, and the pregnancy

 

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

 

10  materials regarding coercion to abort described in subdivision

 

11  (i).

 

12        (e) The department shall not develop written standardized

 

13  summaries for abortion procedures under subdivision (b) that

 

14  utilize medication that has not been approved by the United

 

15  States food and drug administration for use in performing an

 

16  abortion.

 

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

 

18  signed by a local health department representative at the time

 

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

 

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

 

21  confirmed.

 

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

 

23  allows a patient considering an abortion to review the

 

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

 

25  the patient reviews the required information, the department

 

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

 

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


 

 1  date the information was reviewed. A confirmation form printed

 

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

 

 3  time printed on the confirmation form.

 

 4        (h) Include on the informed consent internet website

 

 5  developed under subdivision (g) a list of health care providers,

 

 6  facilities, and clinics that offer to perform ultrasounds free of

 

 7  charge. The list shall be organized geographically and shall

 

 8  include the name, address, and telephone number of each health

 

 9  care provider, facility, and clinic.

 

10        (i) After considering the standards and recommendations of

 

11  the joint commission on accreditation of healthcare

 

12  organizations, the Michigan domestic violence prevention and

 

13  treatment board, the Michigan coalition against domestic and

 

14  sexual violence or successor organization, and the American

 

15  medical association, do all of the following:

 

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

 

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

 

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

 

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

 

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

 

21  contain at a minimum all of the following:

 

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

 

23  coerce a woman to have an abortion.

 

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

 

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

 

26  sexually harmed; or feels afraid for any reason.

 

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


 

 1  hotline and 1 sexual assault hotline.

 

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

 

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

 

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

 

 5  a minimum, contains the information required under subparagraph

 

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

 

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

 

 8  obtain an abortion.

 

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

 

10  and accompanying training materials to be utilized by a physician

 

11  or qualified person assisting the physician while performing the

 

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

 

13  screening tools shall instruct the physician or qualified person

 

14  assisting the physician to do, at a minimum, all of the

 

15  following:

 

16        (A) Orally inform the patient that coercion to abort is

 

17  illegal and is grounds for a civil action, but clarifying that

 

18  discussions about pregnancy options, including personal or

 

19  intensely emotional expressions about those options, are not

 

20  necessarily coercion to abort and illegal.

 

21        (B) Orally ask the patient if her husband, parents,

 

22  siblings, relatives, or employer, the father or putative father

 

23  of the fetus, the parents of the father or putative father of the

 

24  fetus, or any other individual has engaged in coercion to abort

 

25  and coerced her into seeking an abortion.

 

26        (C) Orally ask the patient if an individual is taking

 

27  harmful actions against her, including, but not limited to,


 

 1  intimidating her, threatening her, physically hurting her, or

 

 2  forcing her to engage in sexual activities against her wishes.

 

 3        (D) Document the findings from the coercion to abort

 

 4  screening in the patient's medical record.

 

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

 

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

 

 7  person assisting the physician if a patient discloses coercion to

 

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

 

 9  coercion to abort screening. The protocols shall instruct the

 

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

 

11  minimum, all of the following:

 

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

 

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

 

14        (C) Explore safety options with the patient.

 

15        (D) Provide referral information to the patient regarding

 

16  law enforcement and domestic violence and sexual assault support

 

17  organizations.

 

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

 

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

 

17  private office, freestanding surgical outpatient facility, or

 

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

 

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

 

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

 

21  the physician or qualified person assisting the physician shall

 

22  orally screen the patient for coercion to abort using the

 

23  screening tools developed by the department under section

 

24  17015(11).

 

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

 

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

 

27  physician or qualified person assisting the physician shall


 

 1  follow the protocols developed by the department under section

 

 2  17015(11).

 

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

 

 4  or qualified person assisting the physician shall follow the

 

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

 

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

 

 7  domestic violence or coercion to abort by an individual

 

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

 

 9  physician or qualified person assisting the physician shall

 

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

 

11        (5) A private office, freestanding surgical outpatient

 

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

 

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

 

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

 

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

 

16  freestanding surgical outpatient facility, or other facility or

 

17  clinic in which abortions are performed shall make available in

 

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

 

19  employees, and visitors publications that contain information

 

20  about violence against women.

 

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

 

22  Notwithstanding any other provision of this section, a person

 

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

 

24        Sec. 17017. (1) A physician shall not diagnose and prescribe

 

25  a medical abortion for a patient who is or is presumed to be

 

26  pregnant without first personally performing a physical

 

27  examination of the patient. A physician shall not utilize other


 

 1  means including, but not limited to, an internet web camera, to

 

 2  diagnose and prescribe a medical abortion.

 

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

 

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

 

 5  medical abortion. The physician shall be physically present at

 

 6  the location of the medical abortion and at the time any

 

 7  prescription drug is dispensed or administered during a medical

 

 8  abortion. The prescribing physician shall provide direct

 

 9  supervision of the dispensing or administering of a prescription

 

10  drug during a medical abortion. An individual under the direct

 

11  supervision of the prescribing physician who is qualified by

 

12  education and training as provided in this act may dispense or

 

13  administer the prescription drug during a medical abortion.

 

14        (3) A physician shall not give, sell, dispense, administer,

 

15  otherwise provide, or prescribe a prescription drug to an

 

16  individual for the purpose of inducing an abortion in the

 

17  individual unless the physician satisfies all the criteria

 

18  established by federal law or guideline that a physician must

 

19  satisfy in order to give, sell, dispense, administer, otherwise

 

20  provide, or prescribe a prescription drug for inducing an

 

21  abortion.

 

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

 

23  Notwithstanding any other provision of this section, a person

 

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

 

25        (5) As used in this section:

 

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

 

27        (b) "Federal law or guideline" means any law, rule, or


 

 1  regulation of the United States or any drug approval letter,

 

 2  including the use of medication guides and patient agreements as

 

 3  described in a drug approval letter, of the United States food

 

 4  and drug administration, which law, rule, regulation, or letter

 

 5  governs or regulates the use of prescription drugs for the

 

 6  purpose of inducing abortions.

 

 7        (c) "Medical abortion" means an abortion procedure that

 

 8  utilizes a prescription drug or drugs including, but not limited

 

 9  to, mifepristone, misoprostol, or ulipristal acetate.

 

10        (d) "Prescription drug" means that term as defined in

 

11  section 17708.

 

12        Sec. 17019. (1) A physician who meets all of the following

 

13  shall maintain professional liability coverage of not less than

 

14  $1,000,000.00, or provide equivalent security as determined by

 

15  the department, for the purpose of compensating a woman suffering

 

16  from abortion complications caused by the gross negligence or

 

17  malpractice of the physician:

 

18        (a) He or she performs 5 or more abortions per month.

 

19        (b) Meets any of the following:

 

20        (i) He or she was the subject of 2 or more civil lawsuits in

 

21  the preceding 7 years related to harm caused by abortions

 

22  performed by him or her.

 

23        (ii) The disciplinary subcommittee has imposed 1 or more

 

24  sanctions against his or her license under this article for

 

25  unprofessional, unethical, or negligent conduct in the preceding

 

26  7 years.

 

27        (iii) He or she operates, or has supervisory authority over,


 

 1  an office or facility where abortions are performed and that

 

 2  office or facility was found during a follow-up inspection to be

 

 3  noncompliant with health and safety requirements after previous

 

 4  inspections had formally identified the compliance failures and

 

 5  needed corrective actions.

 

 6        (2) Subject to sections 16221 and 16226, if the disciplinary

 

 7  subcommittee finds that a physician is in violation of subsection

 

 8  (1), the disciplinary subcommittee shall immediately limit the

 

 9  physician's license to prohibit the physician from performing

 

10  abortions until he or she meets subsection (1).

 

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

 

12  defined in section 17015.

 

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

 

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

 

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

 

16        Sec. 17519. (1) A physician who meets all of the following

 

17  shall maintain professional liability coverage of not less than

 

18  $1,000,000.00, or provide equivalent security as determined by

 

19  the department, for the purpose of compensating a woman suffering

 

20  from abortion complications caused by the gross negligence or

 

21  malpractice of the physician:

 

22        (a) He or she performs 5 or more abortions per month.

 

23        (b) Meets any of the following:

 

24        (i) He or she was the subject of 2 or more civil lawsuits in

 

25  the preceding 7 years related to harm caused by abortions

 

26  performed by him or her.

 

27        (ii) The disciplinary subcommittee has imposed 1 or more


 

 1  sanctions against his or her license under this article for

 

 2  unprofessional, unethical, or negligent conduct in the preceding

 

 3  7 years.

 

 4        (iii) He or she operates, or has supervisory authority over,

 

 5  an office or facility where abortions are performed and that

 

 6  office or facility was found during a follow-up inspection to be

 

 7  noncompliant with health and safety requirements after previous

 

 8  inspections had formally identified the compliance failures and

 

 9  needed corrective actions.

 

10        (2) Subject to sections 16221 and 16226, if the disciplinary

 

11  subcommittee finds that a physician is in violation of subsection

 

12  (1), the disciplinary subcommittee shall immediately limit the

 

13  physician's license to prohibit the physician from performing

 

14  abortions until he or she meets subsection (1).

 

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

 

16  defined in section 17015.

 

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

 

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

 

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

 

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

 

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

 

22  sole purpose of certification authorized under this article. For

 

23  purpose of certification only, an organization defined in section

 

24  20106(5), 20108(1), or 20109(4) is considered a health facility

 

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

 

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

 

27  the adherents of a church or religious denomination for the


 

 1  purpose of providing service for those who depend upon spiritual

 

 2  means through prayer alone for healing.

 

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

 

 4  freestanding surgical outpatient facility from a private office

 

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

 

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

 

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

 

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

 

 9  annually served at the facility undergo an abortion must be

 

10  licensed under this article as a freestanding surgical outpatient

 

11  facility if that facility publicly advertises outpatient abortion

 

12  services and performs 6 or more abortions per month.

 

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

 

14  republish R 325.3826, R 325.3832, R 325.3835, R 325.3857, R

 

15  325.3866, R 325.3867, and R 325.3868 of the Michigan

 

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

 

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

 

18  of the patients annually served in the freestanding surgical

 

19  outpatient facility undergo an abortion. or private practice

 

20  office that publicly advertises outpatient abortion services and

 

21  performs 6 or more abortions per month. The department shall

 

22  assure that the standards are consistent with the most recent

 

23  United States supreme court decisions regarding state regulation

 

24  of abortions.

 

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

 

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

 

27  325.3801 to R 325.3877 of the Michigan administrative code


 

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

 

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

 

 3  the patients annually served in the freestanding surgical

 

 4  outpatient facility undergo an abortion, if both of the following

 

 5  conditions are met:

 

 6        (a) The freestanding surgical outpatient facility was in

 

 7  existence and operating on the effective date of the amendatory

 

 8  act that added this subsection.

 

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

 

10  construction or equipment conditions, or both, within the

 

11  freestanding surgical outpatient facility are adequate to

 

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

 

13  the freestanding surgical outpatient facility or that the

 

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

 

15  adequately preserve the health and safety of the patients and

 

16  employees of the freestanding surgical outpatient facility

 

17  without meeting the specific requirements of the rules.

 

18        (4) (5) As used in this subsection, "abortion" means that

 

19  term as defined in section 17015.

 

20        Enacting section 1. This amendatory act takes effect January

 

21  1, 2013.

 

22        Enacting section 2. This amendatory act does not take effect

 

23  unless all of the following bills of the 96th Legislature are

 

24  enacted into law:

 

25        (a) Senate Bill No. ____ or House Bill No. 5712(request no.

 

26  06059'12).

 

27        (b) Senate Bill No. ____ or House Bill No. 5713(request no.


 

 1  06060'12).

 

 2        (c) House Bill No. 5181.