February 16, 2012, Introduced by Senators MOOLENAAR, JANSEN, KAHN, COLBECK, GREEN, PROOS, SCHUITMAKER, WALKER, BOOHER, HILDENBRAND, MARLEAU, KOWALL, PAVLOV, BRANDENBURG, MEEKHOF, CASPERSON, EMMONS, HUNE, NOFS, ROBERTSON, ROCCA, PAPPAGEORGE and HANSEN and referred to the Committee on Health Policy.
A bill to protect religious liberty and rights of conscience
in the areas of health care and medical and scientific research as
it pertains to employment, education and training, and providing or
participating in health care services and to the purchasing of or
providing for the purchase of health insurance; to provide immunity
from liability; and to prescribe penalties and provide remedies.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
Sec. 1. This act shall be known and may be cited as the
"religious liberty and conscience protection act".
Sec. 3. As used in this act:
(a) "Conscience" means religious beliefs, moral convictions,
or ethical principles sincerely held by an individual or entity.
For purposes of this act, the conscience of an entity shall be
determined by reference to its existing or proposed religious,
moral, or ethical guidelines, mission statement, constitution,
bylaws, articles of incorporation, or regulations.
(b) "Health care payer" or "payer" means an individual,
entity, or employer that purchases, contracts for, pays for, or
arranges for the payment of, in whole or in part, any health care
service, including, but not limited to, health maintenance
organizations, health plans, insurance companies, or management
services organizations.
(c) "Health care service" or "service" means any of the
following:
(i) A phase of patient medical care, treatment, or procedure,
including, but not limited to, patient referral, therapy, testing,
diagnosis or prognosis, research instruction, prescribing, surgery,
dispensing or administering a device, drug, or medication, or other
medical care rendered by a health provider or health facility.
(ii) Medical or scientific research directed toward developing
a therapeutic means of treating an illness, disease, or health
condition.
(d) "Health facility" means any of the following:
(i) A clinical laboratory, as defined in section 20104 of the
public health code, 1978 PA 368, MCL 333.20104.
(ii) A county medical care facility, as defined in section
20104 of the public health code, 1978 PA 368, MCL 333.20104.
(iii) A freestanding surgical outpatient facility, as defined in
section 20104 of the public health code, 1978 PA 368, MCL
333.20104.
(iv) A home for the aged, as defined in section 20106 of the
public health code, 1978 PA 368, MCL 333.20106.
(v) A hospital, as defined in section 20106 of the public
health code, 1978 PA 368, MCL 333.20106.
(vi) A hospice, as defined in section 20106 of the public
health code, 1978 PA 368, MCL 333.20106.
(vii) A hospice residence, as defined in section 21401 of the
public health code, 1978 PA 368, MCL 333.21401.
(viii) A nursing home, as defined in section 20109 of the public
health code, 1978 PA 368, MCL 333.20109.
(ix) A facility or agency listed in subparagraphs (i) to (viii)
located in a university, college, or other educational institution.
(x) The private practice office of a physician. As used in
this subparagraph, "physician" means an individual licensed or
otherwise authorized to engage in the practice of medicine or
osteopathic medicine and surgery under article 15 of the public
health code, 1978 PA 368, MCL 333.16101 to 333.18838.
(xi) A medical clinic that provides health care services.
(xii) A public or private institution that provides health care
services.
(xiii) A teaching institution that provides health care
services.
(xiv) A pharmacy that provides health care services. As used in
this subparagraph, "pharmacy" means that term as defined in section
17707 of the public health code, 1978 PA 368, MCL 333.17707.
(xv) Any other person or legal entity that provides health care
services.
(e) "Health provider" means any of the following:
(i) An individual employed, contracted, or granted privileges
to provide or assist in the provision of a health care service.
(ii) A faculty or staff member or a student of a university,
college, or educational institution where a health care service is
provided or where education and training regarding the provision of
a health care service is conducted.
(f) "Participate in a health care service" means to instruct,
advise, provide, perform, assist in, refer to a particular provider
or institution for, admit for purposes of providing, conduct
medical or scientific research for, or facilitate payment for a
health care service.
Sec. 5. (1) A health facility may assert as a matter of
conscience an objection to providing a health care service and may
decline to provide a health care service that violates its
conscience pursuant to this section. If a health facility asserts
as a matter of conscience an objection to providing a health care
service under this section, the health facility shall apply that
objection equally to all patients that it serves, subject to this
act.
(2) A health facility shall not assert a matter of conscience
objection under subsection (1) under either of the following
circumstances:
(a) The objection is based on the patient's or a group of
patients' status, or a patient's insurance coverage, ability to
pay, or method of payment.
(b) The objection is based on a disagreement with a health
provider employed by, under contract to, or granted privileges by
the health facility regarding the medical appropriateness of a
health care service for a specific patient, the patient has
consented to the provision of the health care service, and the
health facility routinely allows that health care service to be
performed.
(3) A health facility shall provide notice of its assertion of
an objection to providing a health care service described in
subsection (1) through written public notice or personally in
writing at the time an individual seeks to obtain that health care
service from the health facility.
(4) A health facility's assertion of an objection as described
in subsection (1) to providing a health care service shall not be a
basis for any of the following:
(a) Civil, criminal, or administrative liability.
(b) Eligibility discrimination against the health facility in
a grant, contract, or program, where providing the health care
service is not expressly required as a condition of eligibility for
the grant, contract, or program.
Sec. 7. (1) A health care payer may decline to do any of the
following:
(a) Pay or arrange payment for, or offer a contract, policy,
or product that facilitates payment for, a health care service that
violates the conscience of the payer.
(b) Purchase or financially contribute toward the purchase of
a contract, policy, or product that includes coverage for a health
care service that violates the conscience of the payer.
(2) A health care payer and any person that owns, operates,
supervises, or manages a health care payer entity is not civilly,
criminally, or administratively liable because the health care
payer declines to pay for or arrange for payment of a health care
service or declines to purchase or offer a contract, policy, or
product that facilitates payment for a health care service, if the
health care service violates the conscience of the payer.
(3) A person, public or private institution, or public
official shall not discriminate against a health care payer or any
person, association, corporation, or other entity operating an
existing health care payer or attempt to establish a new health
care payer, in any manner, including, but not limited to, denial,
deprivation, or disqualification with respect to licensure, aid,
assistance, benefit, privilege, or authorization because the health
care payer is planning, proposing, or operating a health care payer
that declines to pay for or arrange payment of a health care
service that violates the conscience of the payer.
(4) A public official, agency, or other entity shall not deny
any form of aid, assistance, grants, or benefits to, or in any
other manner coerce, disqualify, or discriminate against, a health
care payer because the existing or proposed health care payer
declines to pay for or arrange for the payment of a health care
service that violates the conscience of the payer.
Sec. 9. (1) A health provider may request reasonable
accommodation to avoid providing or participating in a health care
service to which the health provider objects as a matter of
conscience.
(2) A health provider shall request reasonable accommodation
described in subsection (1) in writing. The health provider shall
give the written request directly to his or her supervisor. The
health provider shall include in the written statement an
explanation of his or her objection and the health care service or
services to which he or she specifically objects to providing or
participating in under this section.
(3) A health provider may request reasonable accommodation
under any of the following conditions:
(a) Upon being offered employment.
(b) At the time the health provider adopts an ethical, moral,
or religious belief system that conflicts with participation in a
health care service.
(c) Within 24 hours after he or she is asked or has received
notice that he or she is scheduled to participate in a health care
service to which he or she objects.
(4) An employer shall retain a health provider's written
request filed under subsection (2) for the duration of the health
provider's employment. The written request is valid for the
duration of the health provider's employment or until rescinded by
the health provider in writing.
(5) Within 7 days after receiving a written request under
subsection (2), an employer shall develop a plan for reasonable
accommodation with the health provider to ensure that the health
provider will not be scheduled or requested to participate in a
health care service to which he or she specifically objects.
(6) An employer shall not ask a prospective employee regarding
his or her objection or potential objection to a health care
service unless participation in that health care service is a
regular or substantial portion of the normal course of duties for
the position or staff privileges the prospective employee is
seeking.
(7) An employer shall not refuse employment or staff
privileges to a health provider because the health provider is
known by the employer to have previously requested or is currently
requesting reasonable accommodation under subsection (1) unless
participation in that health care service is a regular or
substantial portion of the normal course of duties for that
position or staff privileges.
(8) A medical school or other institution for the education or
training of a health provider shall not refuse admission to an
individual or penalize that individual because the individual has
filed in writing with the medical school or other institution a
request for reasonable accommodation under subsection (1).
(9) The protections afforded to a health provider under this
section do not apply to a health provider who has submitted to his
or her supervisor a written request regarding providing or
participating in a certain health care service under any of the
following circumstances:
(a) A patient's condition, in the reasonable medical judgment
of an attending physician or medical director, requires immediate
action and no other qualified health provider is available to
provide that health care service.
(b) There is a public health emergency.
(c) The health provider first submits a request
contemporaneously to a patient's requiring or requesting the
objectionable health care service and no other health provider is
available to provide the health care service.
(d) The request is based on a patient's or a group of
patients' status or insurance coverage, ability to pay, or method
of payment.
(e) The request is made in the presence of a patient seeking a
health care service to which the health provider objects.
(10) This section does not relieve a health provider from a
duty that exists under any other law pertaining to current
standards of acceptable health care practice and procedure to
inform a patient of the patient's condition, prognosis, or risk of
receiving or forgoing relevant health care services for the
condition, including the availability of a health care service to
which the health provider objects.
(11) Subject to a collective bargaining agreement, if a health
provider submits a request regarding a health care service that at
the time the request is submitted constitutes a regular or
substantial portion of the health provider's current and defined
position, the employer may give the health provider not less than
60 days' notice of the termination of his or her employment.
(12) A health provider's objection to providing or
participating in a health care service as described in subsection
(1) shall not be the basis for any of the following:
(a) Civil liability to another person.
(b) Criminal action.
(c) Administrative or licensure action.
(13) If a health provider is required by his or her employer
to participate in a health care service more than 7 days after the
health provider has submitted a written request regarding that
health care service, the health provider is immune from civil
liability in an action arising from his or her participation in
that health care service.
Sec. 11. A civil action for damages or reinstatement of
employment, or both, may be brought against a person, including,
but not limited to, a governmental agency, health facility, or
other employer, for penalizing or discriminating against a health
provider, including, but not limited to, penalizing or
discriminating in hiring, promotion, transfer, a term or condition
of employment, licensing, or granting of staff privileges or
appointments, solely because that health provider has submitted a
request for reasonable accommodation under section 9. Civil damages
may be awarded equal to the amount of proven damages and attorney
fees. A civil action filed under this section may include a
petition for injunctive relief against a person alleged to have
penalized or discriminated against a health provider as described
in this section.
Sec. 13. A person who violates this act is responsible for a
state civil infraction and may be ordered to pay a fine of not more
than $1,000.00 for each day the violation continues or a fine of
not more than $1,000.00 for each occurrence.