Legislative Analysis
Phone: (517) 373-8080
MEDICAL TREATMENT OF MINORS AND
http://www.house.mi.gov/hfa
MEDICAL RECORDS RETENTION
Analysis available at
Senate Bill 69 as enacted http://www.legislature.mi.gov
Public Act 60 of 2023
Sponsor: Sen. Lana Theis
Senate Bill 70 as enacted
Public Act 61 of 2023
Sponsor: Sen. Ruth A. Johnson
Senate Bill 71 as enacted Senate Bill 72 as enacted
Public Act 62 of 2023 Public Act 63 of 2023
Sponsor: Sen. Roger Hauck Sponsor: Sen. Kristen McDonald Rivet
1st House Committee (SB 72): Criminal Justice
2nd House Committee (SB 72): Health Policy
House Committee (SBs 69, 70, and 71): Health Policy
Senate Committee: Civil Rights, Judiciary, and Public Safety
Complete to 7-13-23
SUMMARY:
Senate Bill 69 amends the Public Health Code to require written parental consent before
procedures involving vaginal or anal penetration can be performed on a minor; requires such
procedures to be within the treating health care professional’s scope of practice; requires
another health professional to be in the room during such procedures; provides exceptions;
establishes criminal penalties for violations; and requires the Department of Licensing and
Regulatory Affairs (LARA) to create a standardized consent form.
Senate Bill 71 requires performance of a medical service involving vaginal or anal penetration
to be included in a patient’s medical records; requires those records to be maintained for at
least 15 years; establishes administrative and criminal penalties for noncompliance; and allows
LARA to promulgate rules to provide guidance on standards of practice for services involving
vaginal or anal penetration in consultation with appropriate professional associations and other
interested parties.
Senate Bills 70 and 72 are identical bills that add the felonies established under Senate Bills 69
and 71 to the sentencing guidelines in the Code of Criminal Procedure.
Senate Bill 69 adds a new section to the Public Health Code to prohibit a licensee 1 or registrant
from performing a medical treatment, procedure, or examination on a patient who is a minor
1
Currently, the following health care professions are licensed under Article 15 of the Public Health Code: athletic
trainers, audiologists, acupuncturists, behavior analysts, chiropractors, counselors, dental assistants, dental hygienists,
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 (under 18 years of age) that involves the vaginal or anal penetration of the minor unless all of
the following conditions are met:
• The medical treatment, procedure, or examination is within the scope of practice of the
licensee’s or registrant’s health profession.
• A medical assistant or another licensee or registrant is in the room while the medical
treatment, procedure, or examination is performed.
• The licensee or registrant obtains the written consent of a parent, guardian, or person
in loco parentis of the minor (or the consent of any person authorized by law to provide
consent) on a form created as specified in the bill or on another form that includes the
same information. The written consent, which may be obtained electronically, must be
obtained before the medical treatment, procedure, or examination is performed. A new
consent form is not required if the same medical treatment, procedure, or examination
is required to be performed on a subsequent visit within six months from the date the
first written consent was obtained. The consent form must be maintained in a patient’s
medical record for at least 15 years after the date the medical treatment, procedure, or
examination was performed.
Exceptions
The conditions described above do not apply to a medical treatment, procedure, or examination
performed in the following circumstances:
• If necessary and associated with, or incident to, a medical emergency (a circumstance
that, in the licensee’s or registrant’s good-faith medical judgment, creates an immediate
threat of serious risk to the life or physical health of the patient).
• If primarily related to the patient’s urological, gastrointestinal, reproductive,
gynecological, or sexual health.
• If performed at a children’s advocacy center, as defined in the Child Protection Law.
• If performed for purposes of a sexual assault medical forensic examination under
section 21527 of the code.
• If performed for the purpose of measuring the patient’s temperature.
• If performed for the purpose of rectally administering a drug or medicine.
Penalties
A person who knowingly violates the bill’s requirements pertaining to a medical service
involving vaginal or anal penetration performed on a minor is guilty of a felony punishable by
imprisonment for up to two years or a fine of up to $5,000, or both, for a first offense, and by
imprisonment for up to five years or a fine of up to $10,000, or both, for a second or subsequent
offense.
The bill does not prohibit a person from being charged with, convicted of, or punished for any
other violation of law committed by that person while violating the bill’s provisions. A court
may order a term of imprisonment imposed for a violation to be served consecutively to a term
of imprisonment imposed for any other crime, including any other violation of law arising out
dentists, marriage and family therapists, massage therapists, midwives, nurses, nursing home administrators,
occupational therapists and occupational therapy assistants, optometrists, pharmacists, physical therapists and physical
therapy assistants, physician's assistants, physicians (M.D.s and D.O.s), podiatrists, psychologists, respiratory
therapists, social workers, speech-language pathologists, and veterinarians and veterinarian technicians. Registered
professions include sanitarians and registered social service technicians.
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 of the same transaction as the violation of the bill. (This means that multiple sentences may be
ordered to be served one at a time rather than all at the same time.)
Consent form
LARA must create and may periodically update, and make publicly available on its website, a
standardized consent form for use by a health care licensee or registrant who provides a medical
treatment, procedure, or examination to a minor involving vaginal or anal penetration.
Generally accepted standards of medical practice must be used in determining the information
to be included on the form. The form must include at least all of the following statements:
• That gloves are generally used for a medical treatment, procedure, or examination
involving vaginal or anal penetration.
• That the person providing consent may request that gloves be used during the
treatment, procedure, or examination.
• That the person providing consent has the right to request a clear explanation of the
nature of the treatment, procedure, or examination.
• That the person providing consent has the right to request information on whether there
is a reasonable alternative to the treatment, procedure, or examination that does not
consist of anal or vaginal penetration.
• That a licensee or registrant generally cannot be alone in the room with the patient
while the treatment, procedure, or examination is being performed.
Proposed MCL 333.16279 and 333.16279a
Senate Bill 71 amends Part 161 of Article 15 of the Public Health Code, which pertains to
licensed and registered occupations. If a medical service provided on or after the bill’s effective
date involves the vaginal or anal penetration of the patient, the bill requires a licensed health
care professional to expressly state in the patient’s medical record that vaginal or anal
penetration was performed unless the medical service meets any of the following:
• It relates primarily to the patient’s urological, gastrointestinal, reproductive,
gynecological, or sexual health.
• It is necessary and associated with or incident to a medical emergency.
• It is performed for the purpose of rectally administering a drug or medicine.
• It is performed to measure a patient’s temperature.
Medical emergency means a circumstance that, in the licensee’s good-faith medical
judgment, creates an immediate threat of serious risk to the life or physical health of
the patient.
Medical records retention and destruction
The Public Health Code establishes medical record retention and destruction procedures for
licensed persons. (Note that these requirements do not apply to persons registered, rather than
licensed, under the code, such as sanitarians or registered social service technicians.) In
general, a medical record must be retained for at least seven years from the date of the service
it pertains to. Under the bill, a health care licensee (or their personal representative if the
licensee were deceased) cannot destroy or otherwise dispose of records for a medical service
performed on or after the bill’s effective date that requires recording the vaginal or anal
penetration of a patient until they have been maintained for 15 years.
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 Guidance to licensees
The bill allows LARA to promulgate rules that provide guidance to licensees under Part 164
(Chiropractic), Part 170 (Medicine), Part 175 (Osteopathic Medicine and Surgery), Part 178
(Physical Therapy), and Part 179 (Athletic Training) on generally accepted standards of
practice for services involving vaginal or anal penetration (including internal pelvic floor
treatments). In doing so, LARA must consult with appropriate professional associations and
other interested stakeholders. The guidance for licensees under Part 170 or 175 does not have
to address medical services that primarily relate to a patient’s urological, gastrointestinal,
reproductive, gynecological, or sexual health; that are performed to measure a patient’s
temperature; or that are performed for the purpose of rectally administering a drug or medicine.
Health facilities and agencies: records documentation, retention, and destruction
If a medical service provided to a patient on or after the bill’s effective date involves the vaginal
or anal penetration of the patient, the bill requires a health facility or agency 2 to ensure that
the patient’s medical record expressly states that vaginal or anal penetration was performed
unless the medical service meets any of the following conditions:
• It relates primarily to the patient’s urological, gastrointestinal, reproductive,
gynecological, or sexual health.
• It is necessary and associated with or incident to a medical emergency.
• It is performed for the purpose of rectally administering a drug or medicine.
• It is performed to measure a patient’s temperature.
In general, the Public Health Code requires a health facility or agency to maintain records for
a minimum of seven years. The bill requires a minimum retention period of 15 years if the
service is performed on or after the bill’s effective date and either of the following applies:
• The record includes a medical service involving the vaginal or anal penetration of a
patient. This does not apply to a record for a medical service meeting any of the
exclusionary criteria for documentation described above.
• The patient files a complaint with the health facility or agency alleging sexual
misconduct by an individual employed by, under contract to, or granted privileges by
the health facility or agency.
Sexual misconduct means sexual penetration under the pretext of medical treatment;
female genital mutilation of a child; accosting, enticing, or soliciting a child for an
immoral purpose; child pornography; or criminal sexual conduct in the first, second,
third, or fourth degree or assault with intent to commit criminal sexual conduct in the
first, second, or third degree, regardless of whether the conduct results in a criminal
conviction.
Specifically, a health facility or agency may destroy or dispose of a medical record for a
medical service involving vaginal or anal penetration only after retaining it for 15 years.
2
Health facility or agency means an ambulance operation, aircraft transport operation, nontransport prehospital life
support operation, or medical first response service; county medical care facility; freestanding surgical outpatient
facility; health maintenance organization; home for the aged; hospital; nursing home; facility or agency previously
listed that is located in a university, college, or other educational institution; hospice; or hospice residence.
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 Penalties for noncompliance
The bill adds a new section authorizing the following administrative and criminal penalties for
a violation of the requirement to document a medical service involving vaginal or anal
penetration in a patient’s medical record:
Person (individual licensee):
• For a first violation: administrative fine of up to $1,000.
• For a second violation: administrative fine of up to $2,500.
• For a third or subsequent violation or if the violation is a result of gross negligence:
misdemeanor punishable by imprisonment for up to 180 days or a fine of up to
$5,000, or both.
• For an intentional violation: felony punishable by imprisonment for up to two years
or a fine of up to $7,500, or both.
Imposing these penalties does not limit any other sanction or additional action a
disciplinary subcommittee is authorized to impose or take.
Licensed health facility or agency:
• For a first violation: administrative fine of up to $2,500.
• For a second violation: administrative fine of up to $5,000.
• For a third or subsequent violation: misdemeanor punishable by imprisonment for
up to 180 days or a fine of up to $7,500, or both.
• For a violation that is the result of gross negligence: misdemeanor punishable by
imprisonment for up to 180 days or a fine of $10,000, or both.
• For an intentional violation: felony punishable by imprisonment for up to two years
or a fine of up to $10,000, or both.
The above penalties do not limit any other sanction LARA is authorized to impose on a
health facility or agency.
MCL 333.16213 et al.
Senate Bills 70 and 72, which are identical, place the felony penalties established by SBs 69
and 71 in the sentencing guidelines chapter of the Code of Criminal Procedure.
Performing certain medical treatments on a minor, first offense, is a Class G felony against a
person with a two-year maximum term of imprisonment and a subsequent offense is a Class E
felony with a five-year maximum term of imprisonment.
The intentional omission of a medical service involving vaginal or anal penetration from a
patient’s medical record is a Class G crime against the public trust with a statutory maximum
term of imprisonment of two years whether committed by a health professional or by a health
facility or agency.
MCL 777.13n
The bills take effect October 10, 2023.
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BACKGROUND:
The bills are part of a larger package of bills to address sexual assault that were originally
introduced following the revelation of hundreds of instances in which Larry Nassar, a
nationally known physician employed by Michigan State University who also provided
medical treatments to members of the USA Olympics women’s gymnastics team, was found
to have engaged in practices that constituted criminal sexual conduct.
Senate Bill 69 is a reintroduction of SB 226 of the 2021-22 legislative session, SB 217 of the
2019-20 legislative session, and HB 5793 of the 2017-18 legislative session. SB 226 was
passed by the Senate and HB 5793 was passed by the House of Representatives.
Senate Bill 71 is a reintroduction of HBs 4853 of the 2021-22 legislative session, HB 4370 of
the 2019-20 legislative session, and HB 5783 of the 2017-18 legislative session, all of which
were passed by the House of Representatives.
BRIEF DISCUSSION:
Senate Bill 69
Generally speaking, most people, and especially childr