Bill Summary – FastDemocracy

****
68th Legislature 2023                                                                                             HB 937.1
                                                  HOUSE BILL NO. 937
                           INTRODUCED BY L. SHELDON-GALLOWAY, S. GALLOWAY
  3
  A BILL FOR AN ACT ENTITLED: “AN ACT PROVIDING FOR THE LICENSURE AND REGULATION OF
  ABORTION CLINICS; PROVIDING DEFINITIONS; PROVIDING FOR ANNUAL LICENSURE FEES;
  PROVIDING RULEMAKING AUTHORITY; AND AMENDING SECTION 50-5-101, MCA.”
  7
  BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MONTANA:
  9
           NEW SECTION. Section 1.         Definitions. As used in [sections 1 through 4], the following definitions
  apply:
           (1)     (a) "Abortion clinic" means a facility that:
           (i)     performs surgical abortion procedures; or
           (ii)    provides an abortion-inducing drug.
           (b)     The term does not include:
           (i)     a hospital as defined in 50-5-101;
           (ii)    a critical access hospital as defined in 50-5-101;
           (iii)   an outpatient center for surgical services as defined in 50-5-101; or
           (iv)    a facility that provides, prescribes, administers, or dispenses an abortion-inducing drug to fewer
  than five patients each year.
           (2)     (a) "Abortion-inducing drug" means a medicine, drug, or other substance provided with the
  intent of terminating the clinically diagnosable pregnancy of a woman.
           (b)     The term includes the off-label use of drugs known to have abortion-inducing properties that
  are prescribed specifically with the intent of causing an abortion.
           (c)     The term does not include the use of drugs that may be known to cause an abortion if the
  drugs are prescribed for a medical indication other than abortion.
           (3)     "Affiliate" means an organization that directly or indirectly:
           (a)     owns or controls another organization;
                                                                 -1-                     Authorized Print Version – HB 937
****
68th Legislature 2023                                                                                                HB 937.1
           (b)       is owned or controlled, in whole or in part, by another organization;
           (c)       is related by shareholdings or other means of control to another organization;
           (d)       is a parent or subsidiary of another organization; or
           (e)       is under common control with another organization.
           (4)       "Medical practitioner" means a person authorized under 50-20-109 to perform an abortion in
  this state.
  7
           NEW SECTION. Section 2.          Licensure of abortion clinics -- application -- fee. (1) A person may
  not operate or advertise the operation of an abortion clinic unless the person is licensed by the department.
           (2)       An applicant for licensure as an abortion clinic shall apply on a form prescribed by the
  department containing information requested by the department pursuant to [section 3], including:
           (a)       an attestation that the applicant is of reputable and responsible character and is able to comply
  with rules adopted under [section 3];
           (b)       the name of the applicant;
           (c)       the location of the abortion clinic and the name of the person in charge of the abortion clinic;
           (d)       the qualifications of the applicant or of the medical practitioners employed by or to be employed
  by the abortion clinic to perform surgical abortion procedures or to prescribe, administer, or provide abortion-
  inducing drugs; and
           (e)       disclosures regarding:
           (i)       whether the applicant or an owner or affiliate of the applicant operated an abortion clinic that
  was closed as a direct result of patient health and safety;
           (ii)      whether an owner or clinic staff member has been convicted of a felony offense; and
           (iii)     whether an owner or clinic staff member was ever employed by a facility owned or operated by
  the applicant that closed because of administrative or legal action.
           (3)       An applicant for licensure shall include with the application copies of:
           (a)       administrative and legal documentation relating to information required under subsections
  (2)(e)(i) and (2)(e)(ii);
           (b)       inspection reports, if any; and
                                                                 -2-                      Authorized Print Version – HB 937
****
68th Legislature 2023                                                                                            HB 937.1
           (c)      violation remediation contracts, if any.
  2
           NEW SECTION. Section 3.          Department regulation of abortion clinics -- rulemaking. (1) In
  accordance with Title 50, chapter 5, the department shall license and regulate abortion clinics as provided in
  [sections 1 through 4] and shall enforce the provisions of [sections 1 through 4].
           (2)      The department shall adopt administrative rules for the licensure and operation of abortion
  clinics, including rules:
           (a)      establishing minimum license qualifications;
           (b)      establishing requirements for:
           (i)      sanitation standards;
           (ii)     staff qualifications;
           (iii)    necessary emergency equipment;
           (iv)     providing emergency care;
           (v)      monitoring patients after the administration of anesthesia;
           (vi)     providing follow-up care for patient complications;
           (vii)    quality assurance;
           (viii)   infection control;
           (ix)     the architecture or layout of an abortion clinic;
           (x)      providing to patients a hotline telephone number to assist women who are coerced into an
  abortion or who are victims of sex trafficking; and
           (xi)     obtaining annual training by law enforcement on identifying and assisting women who are
  coerced into an abortion or who are victims of sex trafficking;
           (c)      establishing operating policies for maintaining medical records, including the requirement that
  forms requiring a patient signature be stored in the patient's medical record;
           (d)      establishing procedures for the issuance, renewal, denial, and revocation of licenses, including:
           (i)      the form and content of the license; and
           (ii)     the collection of an annual license fee of $450, payable to the department for deposit in the
  general fund;
                                                                 -3-                    Authorized Print Version – HB 937
****
68th Legislature 2023                                                                                               HB 937.1
           (e)       establishing procedures and standards for inspections; and
           (f)       establishing procedures for addressing any violations of this section or rules adopted pursuant
  to this section.
  4
           NEW SECTION. Section 4.          Inspections. In accordance with Title 50, chapter 5, the department shall
  inspect an abortion clinic at least once each calendar year. If the department receives a complaint involving an
  abortion clinic, the department may conduct additional investigations as needed.
  8
           Section 5. Section 50-5-101, MCA, is amended to read:
           "50-5-101.    Definitions. As used in parts 1 through 3 of this chapter, unless the context clearly
  indicates otherwise, the following definitions apply:
           (1)       "Accreditation" means a designation of approval.
           (2)       "Accreditation association for ambulatory health care" means the organization nationally
  recognized by that name that surveys outpatient centers for surgical services upon their requests and grants
  accreditation status to the outpatient centers for surgical services that it finds meet its standards and
  requirements.
           (3)       "Activities of daily living" means tasks usually performed in the course of a normal day in a
  resident's life that include eating, walking, mobility, dressing, grooming, bathing, toileting, and transferring.
           (4)       "Adult day-care center" means a facility, freestanding or connected to another health care
  facility, that provides adults, on a regularly scheduled basis, with the care necessary to meet the needs of daily
  living but that does not provide overnight care.
           (5)       (a) "Adult foster care home" means a private home or other facility that offers, except as
  provided in 50-5-216, only light personal care or custodial care to four or fewer disabled adults or aged persons
  who are not related to the owner or manager of the home by blood, marriage, or adoption or who are not under
  the full guardianship of the owner or manager.
           (b)       As used in this subsection (5), the following definitions apply:
           (i)       "Aged person" means a person as defined by department rule as aged.
           (ii)      "Custodial care" means providing a sheltered, family-type setting for an aged person or
                                                                 -4-                         Authorized Print Version – HB 937
****
68th Legislature 2023                                                                                             HB 937.1
  disabled adult so as to provide for the person's basic needs of food and shelter and to ensure that a specific
  person is available to meet those basic needs.
          (iii)     "Disabled adult" means a person who is 18 years of age or older and who is defined by
  department rule as disabled.
          (iv)      (A) "Light personal care" means assisting the aged person or disabled adult in accomplishing
  such personal hygiene tasks as bathing, dressing, and hair grooming and supervision of prescriptive medicine
  administration.
          (B)       The term does not include the administration of prescriptive medications.
          (6)       "Affected person" means an applicant for a certificate of need, a long-term care facility located
  in the geographic area affected by the application, an agency that establishes rates for long-term care facilities,
  or a third-party payer who reimburses long-term care facilities in the area affected by the proposal.
          (7)       "Assisted living facility" means a congregate residential setting that provides or coordinates
  personal care, 24-hour supervision and assistance, both scheduled and unscheduled, and activities and health-
  related services.
          (8)       "Capital expenditure" means:
          (a)       an expenditure made by or on behalf of a long-term care facility that, under generally accepted
  accounting principles, is not properly chargeable as an expense of operation and maintenance; or
          (b)       a lease, donation, or comparable arrangement that would be a capital expenditure if money or
  any other property of value had changed hands.
          (9)       "Certificate of need" means a written authorization by the department for a person to proceed
  with a proposal subject to 50-5-301.
          (10)      "Chemical dependency facility" means a facility whose function is the treatment, rehabilitation,
  and prevention of the use of any chemical substance, including alcohol, that creates behavioral or health
  problems and endangers the health, interpersonal relationships, or economic function of an individual or the
  public health, welfare, or safety.
          (11)      "Clinical laboratory" means a facility for the microbiological, serological, chemical,
  hematological, radiobioassay, cytological, immunohematological, pathological, or other examination of
  materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or
                                                                -5-                      Authorized Print Version – HB 937
****
68th Legislature 2023                                                                                               HB 937.1
  treatment of a disease or assessment of a medical condition.
           (12)    "College of American pathologists" means the organization nationally recognized by that name
  that surveys clinical laboratories upon their requests and accredits clinical laboratories that it finds meet its
  standards and requirements.
           (13)    "Commission on accreditation of rehabilitation facilities" means the organization nationally
  recognized by that name that surveys rehabilitation facilities upon their requests and grants accreditation status
  to a rehabilitation facility that it finds meets its standards and requirements.
           (14)    "Comparative review" means a joint review of two or more certificate of need applications that
  are determined by the department to be competitive in that the granting of a certificate of need to one of the
  applicants would substantially prejudice the department's review of the other applications.
           (15)    "Congregate" means the provision of group services designed especially for elderly or disabled
  persons who require supportive services and housing.
           (16)    "Construction" means the physical erection of a new health care facility and any stage of the
  physical erection, including groundbreaking, or remodeling, replacement, or renovation of:
           (a)     an existing health care facility; or
           (b)     a long-term care facility as defined in 50-5-301.
           (17)    "Council on accreditation" means the organization nationally recognized by that name that
  surveys behavioral treatment programs, chemical dependency treatment programs, residential treatment
  facilities, and mental health centers upon their requests and grants accreditation status to programs and
  facilities that it finds meet its standards and requirements.
           (18)    "Critical access hospital" means a facility that is located in a rural area, as defined in 42 U.S.C.
  1395ww(d)(2)(D), and that has been designated by the department as a critical access hospital pursuant to 50-
  5-233.
           (19)    "Department" means the department of public health and human services provided for in 2-15-
  2201.
           (20)    "DNV healthcare, inc." means the company nationally recognized by that name that surveys
  hospitals upon their requests and grants accreditation status to a hospital that it finds meets its standards and
  requirements.
                                                                -6-                       Authorized Print Version – HB 937
****
68th Legislature 2023                                                                                                  HB 937.1
           (21)     "Eating disorder center" means a facility that specializes in the treatment of eating disorders.
           (22)     "End-stage renal dialysis facility" means a facility that specializes in the treatment of kidney
  diseases and includes freestanding hemodialysis units.
           (23)     "Federal acts" means federal statutes for the construction of health care facilities.
           (24)     "Governmental unit" means the state, a state agency, a county, municipality, or political
  subdivision of the state, or an agency of a political subdivision.
           (25)     "Healthcare facilities accreditation program" means the program nationally recognized by that
  name that surveys health care facilities upon their requests and grants accreditation status to a health care
  facility that it finds meets its standards and requirements.
           (26)     (a) "Health care facility" or "facility" means all or a portion of an institution, building, or agency,
  private or public, excluding federal facilities, whether organized for profit or not, that is used, operated, or
  designed to provide health services, medical treatment, or nursing, rehabilitative, or preventive care to any
  individual. The term includes abortion clinics as defined in [section 1], chemical dependency facilities, critical
  access hospitals, eating disorder centers, end-stage renal dialysis facilities, home health agencies, home
  infusion therapy agencies, hospices, hospitals, infirmaries, long-term care facilities, intermediate care facilities
  for the developmentally disabled, medical assistance facilities, mental health centers, outpatient centers for
  primary care, outpatient centers for surgical services, rehabilitation facilities, residential care facilities, and
  residential treatment facilities.
           (b)      The term does not include offices of private physicians, dentists, or other physical or mental
  health care workers regulated under Title 37, including licensed addiction counselors.
           (27)     "Home health agency" means a public agency or private organization or subdivision of the
  agency or organization that is engaged in providing home health services to individuals in the places where
  they live. Home health services must include the services of a licensed registered nurse and at least one other
  therapeutic service and may include additional support services.
           (28)     "Home infusion therapy agency" means a health care facility that provides home infusion
  therapy services.
           (29)     "Home infusion therapy services" means the preparation, administration, or furnishing of
  parenteral medications or parenteral or enteral