Bill Summary – FastDemocracy

Enrolled Copy                                                                           H.B. 467
                                      ABORTION CHANGES
                                       2023 GENERAL SESSION
                                            STATE OF UTAH
                              Chief Sponsor: Karianne Lisonbee
                                  Senate Sponsor: Daniel McCay
 Cosponsors:                          Katy Hall Jefferson Moss
 Cheryl K. Acton Jon Hawkins Susan Pulsipher
 Carl R. Albrecht Colin W. Jack Mike Schultz
 Kera Birkeland Dan N. Johnson Mark A. Strong
 Brady Brammer Trevor Lee Jordan D. Teuscher
 Walt Brooks Steven J. Lund
 Jefferson S. Burton                  A. Cory Maloy Joseph Elison
13
 LONG TITLE
 General Description:
        This bill modifies provisions related to abortion.
 Highlighted Provisions:
        This bill:
        < modifies definitions;
        < requires abortions to be performed in a hospital, with some exceptions;
        < prohibits licensing of abortion clinics after May 2, 2023, but allows licensing of
 certain clinics for providing an abortion if the clinic meets certain standards;
        < removes certain references to abortion clinics;
        < provides that inducing or performing an abortion contrary to statutory requirements
 is unprofessional conduct for a physician, osteopathic physician, physician assistant,
 advanced practice registered nurse, certified nurse midwife, and direct-entry
 midwife;
       H.B. 467                                                                         Enrolled Copy
        < modifies provisions that govern what constitutes a medical emergency in relation to
 an abortion;
        < modifies the conditions under which an abortion may be performed to protect the
 life or health of the mother;
        < amends language related to medical defects of a fetus;
        < repeals the statute that established a prohibition on abortions after 18 weeks and
 incorporates its contents into existing statute, replacing language that established
 now-superseded viability standards;
        < standardizes language between various statutes that regulate abortion;
        < requires a physician, in the case of a diagnosis of a lethal fetal anomaly, to give
 notice of the availability of perinatal hospice and perinatal palliative care services as
 an alternative to abortion;
        < treats an individual who becomes pregnant at a certain age as having the same
 access to abortion services as rape or incest situations;
        < prohibits the ability to receive an abortion due to rape or incest if the unborn child
 has reached 18 weeks gestational age;
        < requires updates to abortion information modules to match current law;
        < modifies state of mind standards for criminal acts;
        < provides for severability;
        < provides for regulation of drugs that are known to be used in relation to an abortion;
        < creates a criminal offense for prescribing a drug for the purpose of causing an
 abortion, unless the prescriber is licensed as a physician under the laws of this state;
 and
        < makes technical changes.
 Money Appropriated in this Bill:
        None
 Other Special Clauses:
        None
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      Enrolled Copy                                                            H.B. 467
 Utah Code Sections Affected:
 AMENDS:
       26-21-2, as last amended by Laws of Utah 2022, Chapter 255
       26-21-6.5, as last amended by Laws of Utah 2018, Chapter 282
       26-21-7, as last amended by Laws of Utah 2019, Chapter 349
       26-21-8, as last amended by Laws of Utah 2016, Chapter 74
       26-21-11, as last amended by Laws of Utah 1997, Chapter 209
       26-21-25, as last amended by Laws of Utah 2010, Chapter 218
       58-31b-502, as last amended by Laws of Utah 2022, Chapter 290
       58-44a-502, as last amended by Laws of Utah 2020, Chapter 25
       58-67-304, as last amended by Laws of Utah 2020, Chapters 12, 339
       58-67-502, as last amended by Laws of Utah 2021, Chapter 337
       58-68-304, as last amended by Laws of Utah 2020, Chapters 12, 339
       58-68-502, as last amended by Laws of Utah 2021, Chapter 337
       58-70a-501, as last amended by Laws of Utah 2021, Chapter 312
       58-77-603, as enacted by Laws of Utah 2005, Chapter 299
       63I-2-276, as last amended by Laws of Utah 2022, Chapter 117
       76-7-301, as last amended by Laws of Utah 2021, Chapter 262
       76-7-302, as last amended by Laws of Utah 2022, Chapter 335
       76-7-302.4, as enacted by Laws of Utah 2019, Chapter 124
       76-7-304, as last amended by Laws of Utah 2018, Chapter 282
       76-7-304.5, as last amended by Laws of Utah 2022, Chapter 287
       76-7-305, as last amended by Laws of Utah 2022, Chapter 181
       76-7-305.5, as last amended by Laws of Utah 2020, Chapter 251
       76-7-313, as last amended by Laws of Utah 2019, Chapters 124, 208
       76-7-314, as last amended by Laws of Utah 2019, Chapter 208
       76-7-314.5, as last amended by Laws of Utah 2010, Chapter 13
       76-7-317, as enacted by Laws of Utah 1974, Chapter 33
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        H.B. 467                                                                        Enrolled Copy
        76-7a-101, as last amended by Laws of Utah 2021, Chapter 262
        76-7a-201, as enacted by Laws of Utah 2020, Chapter 279
 ENACTS:
        76-7-332, Utah Code Annotated 1953
 REPEALS:
        76-7-302.5, as enacted by Laws of Utah 2019, Chapter 208
 90
 Be it enacted by the Legislature of the state of Utah:
        Section 1. Section 26-21-2 is amended to read:
        26-21-2. Definitions.
        As used in this chapter:
        (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 76-7a-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
 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:
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        Enrolled Copy                                                                             H.B. 467
        (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 26-21-29(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
 kidney dialysis services, self-dialysis services, or home-dialysis services on an outpatient basis.
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        H.B. 467                                                                           Enrolled Copy
         (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 76-7a-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
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        Enrolled Copy                                                                           H.B. 467
 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
 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
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        H.B. 467                                                                          Enrolled Copy
 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.
         (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 26-21-6.5 is amended to read:
         26-21-6.5. 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,
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        Enrolled Copy                                                                              H.B. 467
 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) 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.
          [(2)] (b) A type II abortion clinic may not operate in the state without a license issued
 by the department to operate a type II abortion clinic.
          [(3)] (c) The department shall make rules establishing minimum health, safety,
 sanitary, and recordkeeping requirements for:
          [(a)] (i) a type I abortion clinic; and
          [(b)] (ii) a type II abortion clinic.
          [(4)] (d) To receive and maintain a license described in this section, an abortion clinic
 shall:
          [(a)] (i) apply for a license on a form prescribed by the department;
          [(b)] (ii) satisfy and maintain the minimum health, safety, sanitary, and recordkeeping
 requirements established under Subsection [(3)] (3)(c) that relate to the