Bill Summary – FastDemocracy

LEGISLATIVE GENERAL COUNSEL                                           H.B. 504
Approved for Filing: A. Houston 6
         6 02-07-24 11:01 AM 6
                                    ABORTION REVISIONS
                                      2024 GENERAL SESSION
                                          STATE OF UTAH
                                 Chief Sponsor: Brian S. King
                                Senate Sponsor: ____________
 6
 LONG TITLE
 General Description:
        This bill modifies provisions related to abortion.
 Highlighted Provisions:
        This bill:
        < allows for the licensing of abortion clinics and allows an abortion to be performed
 in an abortion clinic;
        < removes the 72-hour waiting period before an abortion may be performed;
        < modifies the material that must be included in an information module and website
 concerning abortion; and
        < makes technical and conforming changes.
 Money Appropriated in this Bill:
        None
 Other Special Clauses:
        None
 Utah Code Sections Affected:
 AMENDS:
        26B-2-201, as last amended by Laws of Utah 2023, Chapter 301 and renumbered and
 amended by Laws of Utah 2023, Chapter 305
                                                                                                    H.B. 504
        26B-2-204, as last amended by Laws of Utah 2023, Chapter 301 and renumbered and
 amended by Laws of Utah 2023, Chapter 305
     *HB0504*
       H.B. 504                                                                 02-07-24 11:01 AM
        26B-2-205, as last amended by Laws of Utah 2023, Chapter 301 and renumbered and
 amended by Laws of Utah 2023, Chapter 305
        26B-2-206, as last amended by Laws of Utah 2023, Chapter 301 and renumbered and
 amended by Laws of Utah 2023, Chapter 305
        26B-2-224, as last amended by Laws of Utah 2023, Chapter 301 and renumbered and
 amended by Laws of Utah 2023, Chapter 305
        26B-2-232, as renumbered and amended by Laws of Utah 2023, Chapter 305
        76-7-301, as last amended by Laws of Utah 2023, Chapters 301, 330
        76-7-302, as last amended by Laws of Utah 2023, Chapters 158, 301
        76-7-305, as last amended by Laws of Utah 2023, Chapters 301, 330
        76-7-305.5, as last amended by Laws of Utah 2023, Chapters 301, 330
        76-7a-101, as last amended by Laws of Utah 2023, Chapters 158, 301
        76-7a-201, as last amended by Laws of Utah 2023, Chapters 158, 301
41
 Be it enacted by the Legislature of the state of Utah:
        Section 1. Section 26B-2-201 is amended to read:
        26B-2-201. Definitions.
        As used in this part:
        (1) [(a)] "Abortion clinic" means a type I abortion clinic or a type II abortion clinic.
        [(b) "Abortion clinic" does not mean a clinic that meets the definition of hospital under
 Section 76-7-301 or Section 76-71-101.]
        (2) "Activities of daily living" means essential activities including:
        (a) dressing;
        (b) eating;
        (c) grooming;
        (d) bathing;
        (e) toileting;
        (f) ambulation;
        (g) transferring; and
        (h) self-administration of medication.
        (3) "Ambulatory surgical facility" means a freestanding facility, which provides
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       02-07-24 11:01 AM                                                                         H.B. 504
 surgical services to patients not requiring hospitalization.
        (4) "Assistance with activities of daily living" means providing of or arranging for the
 provision of assistance with activities of daily living.
        (5) (a) "Assisted living facility" means:
        (i) a type I assisted living facility, which is a residential facility that provides assistance
 with activities of daily living and social care to two or more residents who:
        (A) require protected living arrangements; and
        (B) are capable of achieving mobility sufficient to exit the facility without the
 assistance of another person; and
        (ii) a type II assisted living facility, which is a residential facility with a home-like
 setting that provides an array of coordinated supportive personal and health care services
 available 24 hours per day to residents who have been assessed under department rule to need
 any of these services.
        (b) Each resident in a type I or type II assisted living facility shall have a service plan
 based on the assessment, which may include:
        (i) specified services of intermittent nursing care;
        (ii) administration of medication; and
        (iii) support services promoting residents' independence and self-sufficiency.
        (6) "Birthing center" means a facility that:
        (a) receives maternal clients and provides care during pregnancy, delivery, and
 immediately after delivery; and
        (b) (i) is freestanding; or
        (ii) is not freestanding, but meets the requirements for an alongside midwifery unit
 described in Subsection 26B-2-228(7).
        (7) "Committee" means the Health Facility Committee created in Section 26B-1-204.
        (8) "Consumer" means any person not primarily engaged in the provision of health care
 to individuals or in the administration of facilities or institutions in which such care is provided
 and who does not hold a fiduciary position, or have a fiduciary interest in any entity involved in
 the provision of health care, and does not receive, either directly or through his spouse, more
 than 1/10 of his gross income from any entity or activity relating to health care.
        (9) "End stage renal disease facility" means a facility which furnishes staff-assisted
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        H.B. 504                                                                    02-07-24 11:01 AM
 kidney dialysis services, self-dialysis services, or home-dialysis services on an outpatient basis.
         (10) "Freestanding" means existing independently or physically separated from another
 health care facility by fire walls and doors and administrated by separate staff with separate
 records.
         (11) "General acute hospital" means a facility which provides diagnostic, therapeutic,
 and rehabilitative services to both inpatients and outpatients by or under the supervision of
 physicians.
         (12) "Governmental unit" means the state, or any county, municipality, or other
 political subdivision or any department, division, board, or agency of the state, a county,
 municipality, or other political subdivision.
         (13) (a) "Health care facility" means general acute hospitals, specialty hospitals, home
 health agencies, hospices, nursing care facilities, residential-assisted living facilities, birthing
 centers, ambulatory surgical facilities, small health care facilities, abortion clinics, [a clinic that
 meets the definition of hospital under Section 76-7-301 or 76-71-201,] facilities owned or
 operated by health maintenance organizations, end stage renal disease facilities, and any other
 health care facility which the committee designates by rule.
         (b) "Health care facility" does not include the offices of private physicians or dentists,
 whether for individual or group practice, except that it does include an abortion clinic.
         (14) "Health maintenance organization" means an organization, organized under the
 laws of any state which:
         (a) is a qualified health maintenance organization under 42 U.S.C. Sec. 300e-9; or
         (b) (i) provides or otherwise makes available to enrolled participants at least the
 following basic health care services: usual physician services, hospitalization, laboratory, x-ray,
 emergency, and preventive services and out-of-area coverage;
         (ii) is compensated, except for copayments, for the provision of the basic health
 services listed in Subsection (14)(b)(i) to enrolled participants by a payment which is paid on a
 periodic basis without regard to the date the health services are provided and which is fixed
 without regard to the frequency, extent, or kind of health services actually provided; and
         (iii) provides physicians' services primarily directly through physicians who are either
 employees or partners of such organizations, or through arrangements with individual
 physicians or one or more groups of physicians organized on a group practice or individual
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        02-07-24 11:01 AM                                                                       H.B. 504
 practice basis.
         (15) (a) "Home health agency" means an agency, organization, or facility or a
 subdivision of an agency, organization, or facility which employs two or more direct care staff
 persons who provide licensed nursing services, therapeutic services of physical therapy, speech
 therapy, occupational therapy, medical social services, or home health aide services on a
 visiting basis.
         (b) "Home health agency" does not mean an individual who provides services under
 the authority of a private license.
         (16) "Hospice" means a program of care for the terminally ill and their families which
 occurs in a home or in a health care facility and which provides medical, palliative,
 psychological, spiritual, and supportive care and treatment.
         (17) "Nursing care facility" means a health care facility, other than a general acute or
 specialty hospital, constructed, licensed, and operated to provide patient living
 accommodations, 24-hour staff availability, and at least two of the following patient services:
         (a) a selection of patient care services, under the direction and supervision of a
 registered nurse, ranging from continuous medical, skilled nursing, psychological, or other
 professional therapies to intermittent health-related or paraprofessional personal care services;
         (b) a structured, supportive social living environment based on a professionally
 designed and supervised treatment plan, oriented to the individual's habilitation or
 rehabilitation needs; or
         (c) a supervised living environment that provides support, training, or assistance with
 individual activities of daily living.
         (18) "Person" means any individual, firm, partnership, corporation, company,
 association, or joint stock association, and the legal successor thereof.
         (19) "Resident" means a person 21 years old or older who:
         (a) as a result of physical or mental limitations or age requires or requests services
 provided in an assisted living facility; and
         (b) does not require intensive medical or nursing services as provided in a hospital or
 nursing care facility.
         (20) "Small health care facility" means a four to 16 bed facility that provides licensed
 health care programs and services to residents.
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        H.B. 504                                                                   02-07-24 11:01 AM
         (21) "Specialty hospital" means a facility which provides specialized diagnostic,
 therapeutic, or rehabilitative services in the recognized specialty or specialties for which the
 hospital is licensed.
         (22) "Substantial compliance" means in a department survey of a licensee, the
 department determines there is an absence of deficiencies which would harm the physical
 health, mental health, safety, or welfare of patients or residents of a licensee.
         (23) "Type I abortion clinic" means a facility, including a physician's office, but not
 including a general acute or specialty hospital, that:
         (a) performs abortions, as defined in Section 76-7-301, during the first trimester of
 pregnancy; and
         (b) does not perform abortions, as defined in Section 76-7-301, after the first trimester
 of pregnancy.
         (24) "Type II abortion clinic" means a facility, including a physician's office, but not
 including a general acute or specialty hospital, that:
         (a) performs abortions, as defined in Section 76-7-301, after the first trimester of
 pregnancy; or
         (b) performs abortions, as defined in Section 76-7-301, during the first trimester of
 pregnancy and after the first trimester of pregnancy.
         Section 2. Section 26B-2-204 is amended to read:
         26B-2-204. Licensing of an abortion clinic -- Rulemaking authority -- Fee --
 Licensing of a clinic meeting the definition of hospital.
         [(1) (a) No abortion clinic may operate in the state on or after January 1, 2024, or the
 last valid date of an abortion clinic license issued under the requirements of this section,
 whichever date is later.]
         [(b) Notwithstanding Subsection (1)(a), a licensed abortion clinic may not perform an
 abortion in violation of any provision of state law.]
         [(2) The state may not issue a license for an abortion clinic after May 2, 2023.]
         [(3) For any license for an abortion clinic that is issued under this section:]
         [(a)] (1) A type I abortion clinic may not operate in the state without a license issued by
 the department to operate a type I abortion clinic.
         [(b)] (2) A type II abortion clinic may not operate in the state without a license issued
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        02-07-24 11:01 AM                                                                          H.B. 504
 by the department to operate a type II abortion clinic.
          [(c)] (3) The department shall make rules establishing minimum health, safety,
 sanitary, and recordkeeping requirements for:
          [(i)] (a) a type I abortion clinic; and
          [(ii)] (b) a type II abortion clinic.
          [(d)] (4) To receive and maintain a license described in this section, an abortion clinic
 shall:
          [(i)] (a) apply for a license on a form prescribed by the department;
          [(ii)] (b) satisfy and maintain the minimum health, safety, sanitary, and recordkeeping
 requirements established [unde7r] under Subsection (3) that relate to the type of abortion clinic
 licensed;
          [(iii)] (c) comply with the recordkeeping and reporting requirements of Section
 76-7-313;
          [(iv)] (d) comply with the requirements of Title 76, Chapter 7, Part 3, Abortion, and
 Title 76, Chapter 7a, Abortion Prohibition;
          [(v)] (e) pay the annual licensing fee; and
          [(vi)] (f) cooperate with inspections conducted by the department.
          [(e)] (5) The department shall, at least twice per year, inspect each abortion clinic in
 the state to ensure that the abortion clinic is complying with all statutory and licensing
 requirements relating to the abortion clinic. At least one of the inspections shall be made
 without providing notice to the abortion clinic.
          [(f)] (6) The department shall charge an annual license fee, set by the department in
 accordance with the procedures described in Section 63J-1-504, to an abortion clinic in an
 amount that will pay for the cost of the licensing requirements described in this section and the
 cost of inspecting abortion clinics.
          [(g)] (7) The department shall deposit the licensing fees described in this section in the
 General Fund as a dedicated credit to be used solely to pay for the cost of the licensing
 requirements described in this section and the cost of inspecting abortion clinics.
          [(4) (a) Notwithstanding any other provision of this section, the department may
 license a clinic that meets the definition of hospital under Section 76-7-301 or Section
 76-7a-101.]
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        H.B. 504                                                                  02-07-24 11:01 AM
         [(b) A clinic described in Subsection (4)(a) is not defined as an abortion clinic.]
         Section 3. Section 26B-2-205 is amended to read:
         26B-2-205. Exempt facilities.
         This part does not apply to:
         (1) a dispensary or first aid facility maintained by any commercial or industrial plant,
 educational institution, or convent;
         (2) a health care facility owned or operated by an agency of the United States;
         (3) the office of a physician, physician assistant, or dentist whether it is an individual
 or group practice, except that it does apply to an abortion clinic;
         (4) a health care facility established or operated by any recognized church or
 denomination for the practice of religious tenets administered by mental or spiritual means
 without the use of drugs, whether gratuitously or for compensation, if it complies with statutes
 and rules on environmental protection and life safety;
         (5) any health care facility owned or operated by the Department of Corrections,
 created in Section 64-13-2; and
         (6) a residential facility providing 24-hour care:
         (a) that does not employ direct care staff;
         (b) in which the residents of the facility contract with a licensed hospice agency to
 receive end-of-life medical care; and
         (c) that meets other requirements for an exemption as designated by administrative
 rule.
         Section 4. Section 26B-2-206 is amended to read:
236