Legislative Analysis
Phone: (517) 373-8080
HOSPITAL POLICY ON PREGNANCY AND BIRTH
http://www.house.mi.gov/hfa
Senate Bill 820 (S-1) as passed by the Senate Analysis available at
Sponsor: Sen. Mary Cavanagh http://www.legislature.mi.gov
House Committee: Health Policy [Discharged]
Senate Committee: Housing and Human Services
Complete to 12-17-24
SUMMARY:
Senate Bill 820 would amend the Public Health Code to do all of the following:
• Require hospitals to demonstrate to the Department of Licensing and Regulatory
Affairs (LARA) that they have a policy related to pregnant patients that complies with
requirements in the bill.
• Require a health facility or agency to stabilize a patient who is pregnant and in labor
and refuses treatment before they terminate their relationship with that patient.
• Provide that provisions that prohibit a hospital’s owner, operator, or governing body
from discriminating in employment or in patient care on the basis of sex also apply to
discrimination on the basis of pregnancy or lactating status.
Hospital policy
Beginning January 1, 2026, a hospital would have to demonstrate to LARA, in a form and
manner LARA requires, that the hospital has a policy that complies with all of the following:
• Unless otherwise prohibited by law, allows a patient who is giving birth to have at least
the following individuals present with them from the time they are admitted to the
hospital through the duration of their stay:
o Their partner or spouse, if they have one, or, if they do not have a partner or
spouse, a companion.
o A doula.
• Provides the hospital’s policy on receiving informed consent from the patient who is
giving birth.
• Provides the hospital’s process for receiving a pregnant patient’s information from a
health professional who initiates the transfer of the patient’s care to the hospital. Both
of the following would apply to this process:
o If the health professional initiating the transfer is a licensed midwife, the
process would have to require the hospital to accept the standard form
described in Part 171 (Midwifery) of the code, if provided for the patient, or
accept any information the midwife is required to provide under rules issued
under Part 171. 1
o If the health professional initiating the transfer is a certified nurse midwife (a
registered professional nurse with a specialty certification in nurse midwifery),
the process would have to require the hospital to accept any information
provided by the certified nurse midwife.
1
Part 171: https://www.legislature.mi.gov/documents/mcl/pdf/mcl-368-1978-15-171..pdf
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 Doula would mean an individual who provides nonclinical physical, emotional, and
informational support to an individual who is pregnant before, during, and after the
individual’s pregnancy.
A hospital could limit or otherwise exclude an individual from being present with a patient as
described above under any of the following circumstances:
• If there is a declared public health emergency, public health risk, or infection control
risk that requires limiting or excluding the individual:
• If the individual assaults another individual on the hospital premises.
• If any other circumstance exists under which the hospital determines that limiting or
excluding the individual is necessary to protect the health or safety of the public or of
one or more individuals on the hospital premises.
A hospital that limits or otherwise excludes a doula from being present as described above
would have to document the reason for the doula’s exclusion and allow for an alternative
individual (who would not be limited or excluded as described above) to be present with the
patient.
LARA could develop and issue rules to implement the above provisions.
Termination upon refusal of care
The code now requires that a health facility or agency have a policy that provides that a patient
or resident is entitled to refuse treatment to the extent provided by law and to be informed of
the consequences of that refusal. If a refusal of treatment prevents a health facility or agency
or its staff from providing appropriate care according to ethical and professional standards, the
relationship with the patient or resident may be terminated upon reasonable notice.
The bill would require the policy to add that, if the patient or resident is pregnant and in labor
at the health facility or agency, the health facility or agency must stabilize the patient or resident
before terminating the relationship with the patient or resident under the above provisions.
Health facility or agency means any of the following: 2
• An ambulance operation, aircraft transport operation, nontransport prehospital
life support operation, or medical first response service.
• A county medical care facility.
• A freestanding surgical outpatient facility.
• A health maintenance organization.
• A home for the aged.
• A hospital.
• A nursing home.
• A facility or agency listed above that is located in a university, college, or other
educational institution.
• A hospice or hospice residence.
2
Section 20115 has additional provisions: https://www.legislature.mi.gov/Laws/MCL?objectName=MCL-333-20115
House Fiscal Agency SB 820 (S-1) as passed by the Senate Page 2 of 3
 Nondiscrimination
The code now prohibits the owner, operator, and governing body of a licensed hospital from
discriminating because of race, religion, color, national origin, age, or sex in the operation of
the hospital, including employment, patient admission and care, room assignment, and
professional or nonprofessional selection and training programs, and shall not discriminate in
the selection and appointment of individuals to the physician staff of the hospital or its training
programs on the basis of licensure or registration or professional education as doctors of
medicine, osteopathic medicine and surgery, or podiatry.
The bill would add that, for purposes of the above provisions, sex includes pregnancy or
lactating status.
MCL 333.20201 and 333.21513 and proposed MCL 333.21537
FISCAL IMPACT:
Senate Bill 820 would have an indeterminate fiscal impact on the Department of Licensing and
Regulatory Affairs. The bill would require hospitals to have policies that comply with the bill’s
requirements for admitting patients who are giving birth. This may create potential violations
that LARA may investigate and issue disciplinary actions for. To the extent that violations of
the new provisions occur, additional fine revenue may be realized and enforcement costs
incurred.
Legislative Analyst: Rick Yuille
Fiscal Analyst: Una Jakupovic
■ This analysis was prepared by nonpartisan House Fiscal Agency staff for use by House members in their
deliberations and does not constitute an official statement of legislative intent.
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Statutes affected:
Substitute (S-1): 333.20201, 333.21513
Senate Introduced Bill: 333.20201, 333.21513
As Passed by the Senate: 333.20201, 333.21513