Representative Karianne Lisonbee proposes the following substitute bill:


1     
ABORTION CHANGES

2     
2023 GENERAL SESSION

3     
STATE OF UTAH

4     
Chief Sponsor: Karianne Lisonbee

5     
Senate Sponsor: Daniel McCay

6     

7     LONG TITLE
8     General Description:
9          This bill modifies provisions related to abortion.
10     Highlighted Provisions:
11          This bill:
12          ▸     modifies definitions;
13          ▸     requires abortions to be performed in a hospital with limited exceptions;
14          ▸     prohibits licensing of abortion clinics after May 2, 2023;
15          ▸     removes certain references to abortion clinics;
16          ▸     provides that inducing or performing an abortion contrary to statutory requirements
17     is unprofessional conduct for a physician, osteopathic physician, physician assistant,
18     advanced practice registered nurse, certified nurse midwife, and direct-entry
19     midwife;
20          ▸     modifies provisions that govern what constitutes a medical emergency in relation to
21     an abortion;
22          ▸     modifies the conditions under which an abortion may be performed to protect the
23     life or health of the mother;
24          ▸     amends language related to medical defects of a fetus;
25          ▸     repeals the statute that established a prohibition on abortions after 18 weeks and
26     incorporates its contents into existing statute, replacing language that established
27     now-superseded viability standards;
28          ▸     standardizes language between various statutes that regulate abortion;
29          ▸     requires a physician, in the case of a diagnosis of a lethal fetal anomaly, to give
30     notice of the availability of perinatal hospice and perinatal palliative care services as
31     an alternative to abortion;
32          ▸     treats an individual who becomes pregnant at a certain age as having the same
33     access to abortion services as rape or incest situations;
34          ▸     restricts the ability to receive an abortion due to rape or incest to a pregnancy where
35     the unborn child has not reached 18 weeks gestational age;
36          ▸     modifies state of mind standards for criminal act;
37          ▸     provides for severability;
38          ▸     provides for regulation of drugs that are known to be used in relation to an abortion;
39          ▸     creates a criminal offense for prescribing a drug for the purpose of causing an
40     abortion, unless the prescriber is licensed as a physician under the laws of this state;
41     and
42          ▸     makes technical changes.
43     Money Appropriated in this Bill:
44          None
45     Other Special Clauses:
46          None
47     Utah Code Sections Affected:
48     AMENDS:
49          26-21-6.5, as last amended by Laws of Utah 2018, Chapter 282
50          26-21-7, as last amended by Laws of Utah 2019, Chapter 349
51          26-21-8, as last amended by Laws of Utah 2016, Chapter 74
52          26-21-11, as last amended by Laws of Utah 1997, Chapter 209
53          26-21-25, as last amended by Laws of Utah 2010, Chapter 218
54          58-31b-502, as last amended by Laws of Utah 2022, Chapter 290
55          58-44a-502, as last amended by Laws of Utah 2020, Chapter 25
56          58-67-304, as last amended by Laws of Utah 2020, Chapters 12, 339
57          58-67-502, as last amended by Laws of Utah 2021, Chapter 337
58          58-68-304, as last amended by Laws of Utah 2020, Chapters 12, 339
59          58-68-502, as last amended by Laws of Utah 2021, Chapter 337
60          58-70a-501, as last amended by Laws of Utah 2021, Chapter 312
61          58-77-603, as enacted by Laws of Utah 2005, Chapter 299
62          63I-2-276, as last amended by Laws of Utah 2022, Chapter 117
63          76-7-301, as last amended by Laws of Utah 2021, Chapter 262
64          76-7-302, as last amended by Laws of Utah 2022, Chapter 335
65          76-7-302.4, as enacted by Laws of Utah 2019, Chapter 124
66          76-7-304, as last amended by Laws of Utah 2018, Chapter 282
67          76-7-304.5, as last amended by Laws of Utah 2022, Chapter 287
68          76-7-305, as last amended by Laws of Utah 2022, Chapter 181
69          76-7-314, as last amended by Laws of Utah 2019, Chapter 208
70          76-7-314.5, as last amended by Laws of Utah 2010, Chapter 13
71          76-7-317, as enacted by Laws of Utah 1974, Chapter 33
72          76-7a-101, as last amended by Laws of Utah 2021, Chapter 262
73          76-7a-201, as enacted by Laws of Utah 2020, Chapter 279
74     ENACTS:
75          76-7-332, Utah Code Annotated 1953
76     REPEALS:
77          76-7-302.5, as enacted by Laws of Utah 2019, Chapter 208
78     

79     Be it enacted by the Legislature of the state of Utah:
80          Section 1. Section 26-21-6.5 is amended to read:
81          26-21-6.5. Licensing of an abortion clinic -- Rulemaking authority -- Fee.
82          (1) (a) No abortion clinic may operate in the state on or after January 1, 2024, or the
83     last valid date of an abortion clinic license issued under the requirements of this section,
84     whichever date is later.
85          (b) Notwithstanding Subsection (1)(a), a licensed abortion clinic may not perform an
86     abortion in violation of any provision of state law.
87          (2) The state may not issue a license for an abortion clinic after May 2, 2023.
88          (3) For any license that is issued under this section:
89          (a) A type I abortion clinic may not operate in the state without a license issued by the
90     department to operate a type I abortion clinic.
91          [(2)] (b) A type II abortion clinic may not operate in the state without a license issued
92     by the department to operate a type II abortion clinic.
93          [(3)] (c) The department shall make rules establishing minimum health, safety,
94     sanitary, and recordkeeping requirements for:
95          [(a)] (i) a type I abortion clinic; and
96          [(b)] (ii) a type II abortion clinic.
97          [(4)] (d) To receive and maintain a license described in this section, an abortion clinic
98     shall:
99          [(a)] (i) apply for a license on a form prescribed by the department;
100          [(b)] (ii) satisfy and maintain the minimum health, safety, sanitary, and recordkeeping
101     requirements established under Subsection [(3)] (3)(c) that relate to the type of abortion clinic
102     licensed;
103          [(c)] (iii) comply with the recordkeeping and reporting requirements of Section
104     76-7-313;
105          [(d)] (iv) comply with the requirements of Title 76, Chapter 7, Part 3, Abortion, and
106     Title 76, Chapter 7a, Abortion Prohibition;
107          [(e)] (v) pay the annual licensing fee; and
108          [(f)] (vi) cooperate with inspections conducted by the department.
109          [(5)] (e) The department shall, at least twice per year, inspect each abortion clinic in
110     the state to ensure that the abortion clinic is complying with all statutory and licensing
111     requirements relating to the abortion clinic. At least one of the inspections shall be made
112     without providing notice to the abortion clinic.
113          [(6)] (f) The department shall charge an annual license fee, set by the department in
114     accordance with the procedures described in Section 63J-1-504, to an abortion clinic in an
115     amount that will pay for the cost of the licensing requirements described in this section and the
116     cost of inspecting abortion clinics.
117          [(7)] (g) The department shall deposit the licensing fees described in this section in the
118     General Fund as a dedicated credit to be used solely to pay for the cost of the licensing
119     requirements described in this section and the cost of inspecting abortion clinics.
120          Section 2. Section 26-21-7 is amended to read:
121          26-21-7. Exempt facilities.
122          This chapter does not apply to:
123          (1) a dispensary or first aid facility maintained by any commercial or industrial plant,
124     educational institution, or convent;
125          (2) a health care facility owned or operated by an agency of the United States;
126          (3) the office of a physician, physician assistant, or dentist whether it is an individual
127     or group practice[, except that it does apply to an abortion clinic];
128          (4) a health care facility established or operated by any recognized church or
129     denomination for the practice of religious tenets administered by mental or spiritual means
130     without the use of drugs, whether gratuitously or for compensation, if it complies with statutes
131     and rules on environmental protection and life safety;
132          (5) any health care facility owned or operated by the Department of Corrections,
133     created in Section 64-13-2; and
134          (6) a residential facility providing 24-hour care:
135          (a) that does not employ direct care staff;
136          (b) in which the residents of the facility contract with a licensed hospice agency to
137     receive end-of-life medical care; and
138          (c) that meets other requirements for an exemption as designated by administrative
139     rule.
140          Section 3. Section 26-21-8 is amended to read:
141          26-21-8. License required -- Not assignable or transferable -- Posting --
142     Expiration and renewal -- Time for compliance by operating facilities.
143          (1) (a) A person or governmental unit acting severally or jointly with any other person
144     or governmental unit, may not establish, conduct, or maintain a health care facility in this state
145     without receiving a license from the department as provided by this chapter and the rules
146     adopted pursuant to this chapter.
147          (b) This Subsection (1) does not apply to facilities that are exempt under Section
148     26-21-7.
149          (2) A license issued under this chapter is not assignable or transferable.
150          (3) The current license shall at all times be posted in each health care facility in a place
151     readily visible and accessible to the public.
152          (4) (a) The department may issue a license for a period of time [not to exceed 12
153     months from the date of issuance for an abortion clinic and] not to exceed 24 months from the
154     date of issuance for [other] health care facilities that meet the provisions of this chapter and
155     department rules adopted pursuant to this chapter.
156          (b) Each license expires at midnight on the day designated on the license as the
157     expiration date, unless previously revoked by the department.
158          (c) The license shall be renewed upon completion of the application requirements,
159     unless the department finds the health care facility has not complied with the provisions of this
160     chapter or the rules adopted pursuant to this chapter.
161          (5) A license may be issued under this section only for the operation of a specific
162     facility at a specific site by a specific person.
163          (6) Any health care facility in operation at the time of adoption of any applicable rules
164     as provided under this chapter shall be given a reasonable time for compliance as determined
165     by the committee.
166          Section 4. Section 26-21-11 is amended to read:
167          26-21-11. Violations -- Denial or revocation of license -- Restricting or prohibiting
168     new admissions -- Monitor.
169          (1) If the department finds a violation of this chapter or any rules adopted pursuant to
170     this chapter the department may take one or more of the following actions:
171          [(1)] (a) serve a written statement of violation requiring corrective action, which shall
172     include time frames for correction of all violations;
173          [(2)] (b) subject to Subsection (2), deny or revoke a license if it finds:
174          [(a)] (i) there has been a failure to comply with the rules established pursuant to this
175     chapter;
176          [(b)] (ii) evidence of aiding, abetting, or permitting the commission of any illegal act;
177     or
178          [(c)] (iii) conduct adverse to the public health, morals, welfare, and safety of the people
179     of the state;
180          [(3)] (c) restrict or prohibit new admissions to a health care facility or revoke the
181     license of a health care facility for:
182          [(a)] (i) violation of any rule adopted under this chapter; or
183          [(b)] (ii) permitting, aiding, or abetting the commission of any illegal act in the health
184     care facility;
185          [(4)] (d) place a department representative as a monitor in the facility until corrective
186     action is completed;
187          [(5)] (e) assess to the facility the cost incurred by the department in placing a monitor;
188          [(6)] (f) assess an administrative penalty as allowed by Subsection 26-23-6(1)(a); or
189          [(7)] (g) issue a cease and desist order to the facility.
190          (2) If the department finds that an abortion has been performed in violation of Section
191     76-7-314 or 76-7a-201, the department shall deny or revoke the license.
192          Section 5. Section 26-21-25 is amended to read:
193          26-21-25. Patient identity protection.
194          (1) As used in this section:
195          (a) "EMTALA" means the federal Emergency Medical Treatment and Active Labor
196     Act.
197          (b) "Health professional office" means:
198          (i) a physician's office; or
199          (ii) a dental office.
200          (c) "Medical facility" means:
201          (i) a general acute hospital;
202          (ii) a specialty hospital;
203          (iii) a home health agency;
204          (iv) a hospice;
205          (v) a nursing care facility;
206          (vi) a residential-assisted living facility;
207          (vii) a birthing center;
208          (viii) an ambulatory surgical facility;
209          (ix) a small health care facility;
210          [(x) an abortion clinic;]
211          [(xi)] (x) a facility owned or operated by a health maintenance organization;
212          [(xii)] (xi) an end stage renal disease facility;
213          [(xiii)] (xii) a health care clinic; or
214          [(xiv)] (xiii) any other health care facility that the committee designates by rule.
215          (2) (a) In order to discourage identity theft and health insurance fraud, and to reduce
216     the risk of medical errors caused by incorrect medical records, a medical facility or a health
217     professional office shall request identification from an individual prior to providing in-patient
218     or out-patient services to the individual.
219          (b) If the individual who will receive services from the medical facility or a health
220     professional office lacks the legal capacity to consent to treatment, the medical facility or a
221     health professional office shall request identification:
222          (i) for the individual who lacks the legal capacity to consent to treatment; and
223          (ii) from the individual who consents to treatment on behalf of the individual described
224     in Subsection (2)(b)(i).
225          (3) A medical facility or a health professional office:
226          (a) that is subject to EMTALA:
227          (i) may not refuse services to an individual on the basis that the individual did not
228     provide identification when requested; and
229          (ii) shall post notice in its emergency department that informs a patient of the patient's
230     right to treatment for an emergency medical condition under EMTALA;
231          (b) may not be penalized for failing to ask for identification;
232          (c) is not subject to a private right of action for failing to ask for identification; and
233          (d) may document or confirm patient identity by:
234          (i) photograph;
235          (ii) fingerprinting;
236          (iii) palm scan; or
237          (iv) other reasonable means.
238          (4) The identification described in this section:
239          (a) is intended to be used for medical records purposes only; and
240          (b) shall be kept in accordance with the requirements of the Health Insurance
241     Portability and Accountability Act of 1996.
242          Section 6. Section 58-31b-502 is amended to read:
243          58-31b-502. Unprofessional conduct.
244          (1) "Unprofessional conduct" includes:
245          (a) failure to safeguard a patient's right to privacy as to the patient's person, condition,
246     diagnosis, personal effects, or any other matter about which the licensee is privileged to know
247     because of the licensee's or person with a certification's position or practice as a nurse or
248     practice as a medication aide certified;
249          (b) failure to provide nursing service or service as a medication aide certified in a
250     manner that demonstrates respect for the patient's human dignity and unique personal character
251     and needs without regard to the patient's race, religion, ethnic background, socioeconomic
252     status, age, sex, or the nature of the patient's health problem;
253          (c) engaging in sexual relations with a patient during any:
254          (i) period when a generally recognized professional relationship exists between the
255     person licensed or certified under this chapter and the patient; or
256          (ii) extended period when a patient has reasonable cause to believe a professional
257     relationship exists between the person licensed or certified under the provisions of this chapter
258     and the patient;
259          (d) (i) as a result of any circumstance under Subsection (1)(c), exploiting or using
260     information about a patient or exploiting the licensee's or the person with a certification's
261     professional relationship between the licensee or holder of a certification under this chapter and
262     the patient; or
263          (ii) exploiting the patient by use of the licensee's or person with a certification's
264     knowledge of the patient obtained while acting as a nurse or a medication aide certified;
265          (e) unlawfully obtaining, possessing, or using any prescription drug or illicit drug;
266          (f) unauthorized taking or personal use of nursing supplies from an employer;
267          (g) unauthorized taking or personal use of a patient's personal property;
268          (h) unlawful or inappropriate delegation of nursing care;
269          (i) failure to exercise appropriate supervision of persons providing patient care services
270     under supervision of the licensed nurse;
271          (j) employing or aiding and abetting the employment of an unqualified or unlicensed
272     person to practice as a nurse;
273          (k) failure to file or record any medical report as required by law, impeding or
274     obstructing the filing or recording of such a report, or inducing another to fail to file or record
275     such a report;
276          (l) breach of a statutory, common law, regulatory, or ethical requirement of
277     confidentiality with respect to a person who is a patient, unless ordered by a court;
278          (m) failure to pay a penalty imposed by the division;
279          (n) prescribing a Schedule II controlled substance without complying with the
280     requirements in Section 58-31b-803, if applicable;
281          (o) violating Section 58-31b-801;
282          (p) violating the dispensing requirements of Section 58-17b-309 or Chapter 17b, Part
283     8, Dispensing Medical Practitioner and Dispensing Medical Practitioner Clinic Pharmacy, if
284     applicable;
285          (q) performing or inducing an abortion in violation of the requirements of Section
286     76-7-302 or Section 76-7a-201, regardless of whether the person licensed or certified under the
287     provisions of this chapter is found guilty of a crime in connection with the violation;
288          [(q)] (r) falsely making an entry in, or altering, a medical record with the intent to
289     conceal:
290          (i) a wrongful or negligent act or omission of an individual licensed under this chapter
291     or an individual under the direction or control of an individual licensed under this chapter; or
292          (ii) conduct described in Subsections (1)(a) through (o) or Subsection 58-1-501(1); or
293          [(r)] (s) violating the requirements of Title 26, Chapter 61a, Utah Medical Cannabis
294     Act.
295          (2) "Unprofessional conduct" does not include, in accordance with Title 26, Chapter
296     61a, Utah Medical Cannabis Act, when registered as a qualified medical provider, or acting as
297     a limited medical provider, as those terms are defined in Section 26-61a-102, recommending
298     the use of medical cannabis.
299          (3) Notwithstanding Subsection (2), the division, in consultation with the board and in
300     accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, shall define
301     unprofessional conduct for an advanced practice registered nurse described in Subsection (2).
302          Section 7. Section 58-44a-502 is amended to read:
303          58-44a-502. Unprofessional conduct.
304          "Unprofessional conduct" includes:
305          (1) disregard for a patient's dignity or right to privacy as to the patient's person,
306     condition, possessions, or medical record;
307          (2) engaging in an act, practice, or omission which when considered with the duties
308     and responsibilities of a certified nurse midwife does or could jeopardize the health, safety, or
309     welfare of a patient or the public;
310          (3) failure to confine one's practice as a certified nurse midwife to those acts or
311     practices permitted by law;
312          (4) failure to file or record any medical report as required by law, impeding or
313     obstructing the filing or recording of such a report, or inducing another to fail to file or record
314     such a report;
315          (5) breach of a statutory, common law, regulatory, or ethical requirement of
316     confidentiality with respect to a person who is a patient, unless ordered by the court;
317          (6) failure to pay a penalty imposed by the division;
318          (7) prescribing a schedule II-III controlled substance without a consulting physician;
319          (8) performing or inducing an abortion in violation of the requirements of Section
320     76-7-302 or Section 76-7a-201, regardless of whether the individual licensed under this chapter
321     is found guilty of a crime in connection with the violation;
322          [(8)] (9) (a) failure to have and maintain a safe mechanism for obtaining medical
323     consultation, collaboration, and referral with a consulting physician, including failure to
324     identify one or more consulting physicians in the written documents required by Subsection
325     58-44a-102(9)(b)(iii); or
326          (b) representing that the certified nurse midwife is in compliance with Subsection
327     [(8)(a)] (9)(a) when the certified nurse midwife is not in compliance with Subsection [(8)(a)]
328     (9)(a); or
329          [(9)] (10) falsely making an entry in, or altering, a medical record with the intent to
330     conceal:
331          (a) a wrongful or negligent act or omission of an individual licensed under this chapter
332     or an individual under the direction or control of an individual licensed under this chapter; or
333          (b) conduct described in Subsections (1) through [(8)] (9) or Subsection 58-1-501(1).
334          Section 8. Section 58-67-304 is amended to read:
335          58-67-304. License renewal requirements.
336          (1) As a condition precedent for license renewal, each licensee shall, during each
337     two-year licensure cycle or other cycle defined by division rule:
338          (a) complete qualified continuing professional education requirements in accordance
339     with the number of hours and standards defined by division rule made in collaboration with the
340     board;
341          (b) appoint a contact person for access to medical records and an alternate contact
342     person for access to medical records in accordance with Subsection 58-67-302(1)(i);
343          (c) if the licensee practices medicine in a location with no other persons licensed under
344     this chapter, provide some method of notice to the licensee's patients of the identity and
345     location of the contact person and alternate contact person for the licensee; and
346          (d) if the licensee is an associate physician licensed under Section 58-67-302.8,
347     successfully complete the educational methods and programs described in Subsection
348     58-67-807(4).
349          (2) If a renewal period is extended or shortened under Section 58-67-303, the
350     continuing education hours required for license renewal under this section are increased or
351     decreased proportionally.
352          (3) (a) An application to renew a license under this chapter shall:
353          [(a)] (i) require a physician to answer the following question: "Do you perform elective
354     abortions in Utah in a location other than a hospital?"; and
355          [(b)] (ii) immediately following the question, contain the following statement: "For
356     purposes of the immediately preceding question, elective abortion means an abortion other than
357     one of the following: removal of a dead fetus, removal of an ectopic pregnancy, an abortion
358     that is necessary to avert the death of a woman, an abortion that is necessary to avert a serious
359     physical risk of substantial [and irreversible] impairment of a major bodily function of a
360     woman, an abortion of a fetus that has a defect that is uniformly diagnosable and uniformly
361     lethal, or an abortion where the woman is pregnant as a result of rape or incest."
362          (b) The statement in Subsection (3)(a)(ii) shall be modified, if necessary, to ensure
363     compliance with the definitions and requirements of Title 76, Chapter 7, Part 3, Abortion, and
364     Title 76, Chapter 7a, Abortion Prohibition.
365          (4) In order to assist the Department of Health and Human Services in fulfilling [its]
366     the department's responsibilities relating to the licensing of [an abortion clinic] a health care
367     facility and the enforcement of Title 76, Chapter 7, Part 3, Abortion, and Title 76, Chapter 7a,
368     Abortion Prohibition, if a physician responds positively to the question described in Subsection
369     [(3)(a),] (3)(a)(i) the division shall, within 30 days after the day on which [it] the division
370     renews the physician's license under this chapter, inform the Department of Health and Human
371     Services in writing:
372          (a) of the name and business address of the physician; and
373          (b) that the physician responded positively to the question described in Subsection
374     [(3)(a)] (3)(a)(i).
375          (5) The division shall accept and apply toward the hour requirement in Subsection
376     (1)(a) any continuing education that a physician completes in accordance with Sections
377     26-61a-106 and 26-61a-403.
378          Section 9. Section 58-67-502 is amended to read:
379          58-67-502. Unprofessional conduct.
380          (1) "Unprofessional conduct" includes, in addition to the definition in Section
381     58-1-501:
382          (a) using or employing the services of any individual to assist a licensee in any manner
383     not in accordance with the generally recognized practices, standards, or ethics of the
384     profession, state law, or division rule;
385          (b) making a material misrepresentation regarding the qualifications for licensure under
386     Section 58-67-302.7 or Section 58-67-302.8;
387          (c) violating the dispensing requirements of Chapter 17b, Part 8, Dispensing Medical
388     Practitioner and Dispensing Medical Practitioner Clinic Pharmacy, if applicable;
389          (d) violating the requirements of Title 26, Chapter 61a, Utah Medical Cannabis Act;
390     [or]
391          (e) performing or inducing an abortion in violation of the requirements of Section
392     76-7-302 or Section 76-7a-201, regardless of whether the individual licensed under this chapter
393     is found guilty of a crime in connection with the violation; or
394          [(e)] (f) falsely making an entry in, or altering, a medical record with the intent to
395     conceal:
396          (i) a wrongful or negligent act or omission of an individual licensed under this chapter
397     or an individual under the direction or control of an individual licensed under this chapter; or
398          (ii) conduct described in Subsections (1)(a) through (d) or Subsection 58-1-501(1).
399          (2) "Unprofessional conduct" does not include:
400          (a) in compliance with Section 58-85-103:
401          (i) obtaining an investigational drug or investigational device;
402          (ii) administering the investigational drug to an eligible patient; or
403          (iii) treating an eligible patient with the investigational drug or investigational device;
404     or
405          (b) in accordance with Title 26, Chapter 61a, Utah Medical Cannabis Act:
406          (i) when registered as a qualified medical provider or acting as a limited medical
407     provider, as those terms are defined in Section 26-61a-102, recommending the use of medical
408     cannabis;
409          (ii) when registered as a pharmacy medical provider, as that term is defined in Section
410     26-61a-102, providing pharmacy medical provider services in a medical cannabis pharmacy; or
411          (iii) when registered as a state central patient portal medical provider, as that term is
412     defined in Section 26-61a-102, providing state central patient portal medical provider services.
413          (3) Notwithstanding Subsection (2)(b), the division, in consultation with the board and
414     in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, shall define
415     unprofessional conduct for a physician described in Subsection (2)(b).
416          Section 10. Section 58-68-304 is amended to read:
417          58-68-304. License renewal requirements.
418          (1) As a condition precedent for license renewal, each licensee shall, during each
419     two-year licensure cycle or other cycle defined by division rule:
420          (a) complete qualified continuing professional education requirements in accordance
421     with the number of hours and standards defined by division rule in collaboration with the
422     board;
423          (b) appoint a contact person for access to medical records and an alternate contact
424     person for access to medical records in accordance with Subsection 58-68-302(1)(i);
425          (c) if the licensee practices osteopathic medicine in a location with no other persons
426     licensed under this chapter, provide some method of notice to the licensee's patients of the
427     identity and location of the contact person and alternate contact person for access to medical
428     records for the licensee in accordance with Subsection 58-68-302(1)(j); and
429          (d) if the licensee is an associate physician licensed under Section 58-68-302.5,
430     successfully complete the educational methods and programs described in Subsection
431     58-68-807(4).
432          (2) If a renewal period is extended or shortened under Section 58-68-303, the
433     continuing education hours required for license renewal under this section are increased or
434     decreased proportionally.
435          (3) (a) An application to renew a license under this chapter shall:
436          [(a)] (i) require a physician to answer the following question: "Do you perform elective
437     abortions in Utah in a location other than a hospital?"; and
438          [(b)] (ii) immediately following the question, contain the following statement: "For
439     purposes of the immediately preceding question, elective abortion means an abortion other than
440     one of the following: removal of a dead fetus, removal of an ectopic pregnancy, an abortion
441     that is necessary to avert the death of a woman, an abortion that is necessary to avert a serious
442     physical risk of substantial [and irreversible] impairment of a major bodily function of a
443     woman, an abortion of a fetus that has a defect that is uniformly diagnosable and uniformly
444     lethal, or an abortion where the woman is pregnant as a result of rape or incest."
445          (b) The statement in Subsection (3)(a)(ii) shall be modified, if necessary, to ensure
446     compliance with the definitions and requirements of Title 76, Chapter 7, Part 3, Abortion, and
447     Title 76, Chapter 7a, Abortion Prohibition.
448          (4) In order to assist the Department of Health and Human Services in fulfilling [its]
449     the department's responsibilities relating to the licensing of [an abortion clinic] a health care
450     facility and the enforcement of Title 76, Chapter 7, Part 3, Abortion, and Title 76, Chapter 7a,
451     Abortion Prohibition, if a physician responds positively to the question described in Subsection
452     [(3)(a)] (3)(a)(i), the division shall, within 30 days after the day on which it renews the
453     physician's license under this chapter, inform the Department of Health and Human Services in
454     writing:
455          (a) of the name and business address of the physician; and
456          (b) that the physician responded positively to the question described in Subsection
457     [(3)(a)] (3)(a)(i).
458          (5) The division shall accept and apply toward the hour requirement in Subsection
459     (1)(a) any continuing education that a physician completes in accordance with Sections
460     26-61a-106 and 26-61a-403.
461          Section 11. Section 58-68-502 is amended to read:
462          58-68-502. Unprofessional conduct.
463          (1) "Unprofessional conduct" includes, in addition to the definition in Section
464     58-1-501:
465          (a) using or employing the services of any individual to assist a licensee in any manner
466     not in accordance with the generally recognized practices, standards, or ethics of the
467     profession, state law, or division rule;
468          (b) violating the dispensing requirements of Chapter 17b, Part 8, Dispensing Medical
469     Practitioner and Dispensing Medical Practitioner Clinic Pharmacy, if applicable;
470          (c) making a material misrepresentation regarding the qualifications for licensure under
471     Section 58-68-302.5;
472          (d) violating the requirements of Title 26, Chapter 61a, Utah Medical Cannabis Act;
473     [or]
474          (e) performing or inducing an abortion in violation of the requirements of Section
475     76-7-302 or Section 76-7a-201, regardless of whether the individual licensed under this chapter
476     is found guilty of a crime in connection with the violation; or
477          [(e)] (f) falsely making an entry in, or altering, a medical record with the intent to
478     conceal:
479          (i) a wrongful or negligent act or omission of an individual licensed under this chapter
480     or an individual under the direction or control of an individual licensed under this chapter; or
481          (ii) conduct described in Subsections (1)(a) through (d) or Subsection 58-1-501(1).
482          (2) "Unprofessional conduct" does not include:
483          (a) in compliance with Section 58-85-103:
484          (i) obtaining an investigational drug or investigational device;
485          (ii) administering the investigational drug to an eligible patient; or
486          (iii) treating an eligible patient with the investigational drug or investigational device;
487     or
488          (b) in accordance with Title 26, Chapter 61a, Utah Medical Cannabis Act:
489          (i) when registered as a qualified medical provider or acting as a limited medical
490     provider, as those terms are defined in Section 26-61a-102, recommending the use of medical
491     cannabis;
492          (ii) when registered as a pharmacy medical provider, as that term is defined in Section
493     26-61a-102, providing pharmacy medical provider services in a medical cannabis pharmacy; or
494          (iii) when registered as a state central patient portal medical provider, as that term is
495     defined in Section 26-61a-102, providing state central patient portal medical provider services.
496          (3) Notwithstanding Subsection (2)(b), the division, in consultation with the board and
497     in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, shall define
498     unprofessional conduct for a physician described in Subsection (2)(b).
499          Section 12. Section 58-70a-501 is amended to read:
500          58-70a-501. Scope of practice.
501          (1) A physician assistant may provide any medical services that are not specifically
502     prohibited under this chapter or rules adopted under this chapter, and that are within the
503     physician assistant's skills and scope of competence.
504          (2) A physician assistant shall consult, collaborate with, and refer to appropriate
505     members of the health care team:
506          (a) as indicated by the patient's condition;
507          (b) based on the physician assistant's education, experience, and competencies;
508          (c) the applicable standard of care; and
509          (d) if applicable, in accordance with the requirements described in Section 58-70a-307.
510          (3) Subject to Section 58-70a-307, the degree of collaboration under Subsection (2):
511          (a) shall be determined at the physician assistant's practice, including decisions made
512     by the physician assistant's:
513          (i) employer;
514          (ii) group;
515          (iii) hospital service; or
516          (iv) health care facility credentialing and privileging system; and
517          (b) may also be determined by a managed care organization with whom the physician
518     assistant is a network provider.
519          (4) A physician assistant may only provide healthcare services:
520          (a) for which the physician assistant has been trained and credentialed, privileged, or
521     authorized to perform; and
522          (b) that are within the physician assistant's practice specialty.
523          (5) A physician assistant may authenticate through a signature, certification, stamp,
524     verification, affidavit, or endorsement any document that may be authenticated by a physician
525     and that is within the physician assistant's scope of practice.
526          (6) A physician assistant is responsible for the care that the physician assistant
527     provides.
528          (7) (a) As used in this Subsection (7):
529          (i) "ALS/ACLS certification" means a certification:
530          (A) in advanced life support by the American Red Cross;
531          (B) in advanced cardiac life support by the American Heart Association; or
532          (C) that is equivalent to a certification described in Subsection (7)(a)(i)(A) or (B).
533          (ii) "Minimal sedation anxiolysis" means creating a drug induced state:
534          (A) during which a patient responds normally to verbal commands;
535          (B) which may impair cognitive function and physical coordination; and
536          (C) which does not affect airway, reflexes, or ventilatory and cardiovascular function.
537          (b) Except as provided in Subsections (c) through (e), a physician assistant may not
538     administer general anesthetics.
539          (c) A physician assistant may perform minimal sedation anxiolysis if the procedure is
540     within the physician assistant's scope of practice.
541          (d) A physician assistant may perform rapid sequence induction for intubation of a
542     patient if:
543          (i) the procedure is within the physician assistant's scope of practice;
544          (ii) the physician assistant holds a valid ALS/ACLS certification and is credentialed
545     and privileged at the hospital where the procedure is performed; and
546          (iii) (A) a qualified physician is not available and able to perform the procedure; or
547          (B) the procedure is performed by the physician assistant under supervision of or
548     delegation by a physician.
549          (e) Subsection (7)(b) does not apply to anesthetics administered by a physician
550     assistant:
551          (i) in an intensive care unit of a hospital;
552          (ii) for the purpose of enabling a patient to tolerate ventilator support or intubation; and
553          (iii) under supervision of or delegation by a physician whose usual scope of practice
554     includes the procedure.
555          (8) (a) A physician assistant may prescribe or administer an appropriate controlled
556     substance that is within the physician assistant's scope of practice if the physician assistant
557     holds a Utah controlled substance license and a DEA registration.
558          (b) A physician assistant may prescribe, order, administer, and procure a drug or
559     medical device that is within the physician assistant's scope of practice.
560          (c) A physician assistant may dispense a drug if dispensing the drug:
561          (i) is permitted under Title 58, Chapter 17b, Pharmacy Practice Act; and
562          (ii) is within the physician assistant's scope of practice.
563          (9) A physician assistant may not perform or induce an abortion in violation of the
564     requirements of Section 76-7-302 or Section 76-7a-201, regardless of whether the physician
565     assistant is found guilty of a crime in connection with the violation.
566          [(9)] (10) A physician assistant practicing independently may only perform or provide
567     a health care service that:
568          (a) is appropriate to perform or provide outside of a health care facility; and
569          (b) the physician assistant has been trained and credentialed or authorized to provide or
570     perform independently without physician supervision.
571          [(10)] (11) A physician assistant, while practicing as a physician assistant:
572          (a) shall wear an identification badge showing the physician assistant's license
573     classification as a physician assistant;
574          (b) shall identify themselves to a patient as a physician assistant; and
575          (c) may not identify themselves to any person in connection with activities allowed
576     under this chapter other than as a physician assistant or PA.
577          Section 13. Section 58-77-603 is amended to read:
578          58-77-603. Prohibited practices.
579          A direct-entry midwife may not:
580          (1) administer a prescription drug to a client in a manner that violates this chapter;
581          (2) effect any type of surgical delivery except for the cutting of an emergency
582     episiotomy;
583          (3) administer any type of epidural, spinal, or caudal anesthetic, or any type of narcotic
584     analgesia;
585          (4) use forceps or a vacuum extractor;
586          (5) manually remove the placenta, except in an emergency that presents an immediate
587     threat to the life of the client; or
588          (6) [induce abortion] perform or induce an abortion in violation of the requirements of
589     Section 76-7-302 or Section 76-7a-201, regardless of whether the direct-entry midwife is found
590     guilty of a crime in connection with the violation.
591          Section 14. Section 63I-2-276 is amended to read:
592          63I-2-276. Repeal dates: Title 76.
593          (1) Subsection 76-5-102.7(2)(b), regarding assault or threat of violence against an
594     owner, employee, or contractor of a health facility, is repealed January 1, 2027.
595          [(2) If Section 76-7-302.4 is not in effect before January 1, 2029, Section 76-7-302.4 is
596     repealed January 1, 2029.]
597          [(3)] (2) Section 76-7-305.7 is repealed January 1, 2023.
598          Section 15. Section 76-7-301 is amended to read:
599          76-7-301. Definitions.
600          As used in this part:
601          (1) (a) "Abortion" means[:] the act, by a physician, of using an instrument, or
602     prescribing a drug, with the intent to cause the death of an unborn child of a woman known to
603     be pregnant, except as permitted under this part.
604          [(i) the intentional termination or attempted termination of human pregnancy after
605     implantation of a fertilized ovum through a medical procedure carried out by a physician or
606     through a substance used under the direction of a physician;]
607          [(ii) the intentional killing or attempted killing of a live unborn child through a medical
608     procedure carried out by a physician or through a substance used under the direction of a
609     physician; or]
610          [(iii) the intentional causing or attempted causing of a miscarriage through a medical
611     procedure carried out by a physician or through a substance used under the direction of a
612     physician.]
613          (b) "Abortion" does not include:
614          (i) removal of a dead unborn child;
615          (ii) removal of an ectopic pregnancy; or
616          (iii) the killing or attempted killing of an unborn child without the consent of the
617     pregnant woman, unless:
618          (A) the killing or attempted killing is done through a medical procedure carried out by
619     a physician or through a substance used under the direction of a physician; and
620          (B) the physician is unable to obtain the consent due to a medical emergency.
621          [(2) "Abortion clinic" means the same as that term is defined in Section 26-21-2.]
622          [(3)] (2) "Abuse" means the same as that term is defined in Section 80-1-102.
623          [(4)] (3) "Department" means the Department of Health and Human Services.
624          [(5)] (4) "Down syndrome" means a genetic condition associated with an extra
625     chromosome 21, in whole or in part, or an effective trisomy for chromosome 21.
626          [(6)] (5) "Gestational age" means the age of an unborn child as calculated from the first
627     day of the last menstrual period of the pregnant woman.
628          [(7)] (6) "Hospital" means:
629          (a) a general hospital licensed by the department according to Title 26, Chapter 21,
630     Health Care Facility Licensing and Inspection Act; and
631          (b) a clinic or other medical facility to the extent that such clinic or other medical
632     facility is certified by the department as providing equipment and personnel sufficient in
633     quantity and quality to provide the same degree of safety to the pregnant woman and the
634     unborn child as would be provided for the particular medical procedures undertaken by a
635     general hospital licensed by the department.
636          [(8)] (7) "Information module" means the pregnancy termination information module
637     prepared by the department.
638          [(9)] (8) "Medical emergency" means [that condition which, on the basis of the
639     physician's good faith clinical judgment, so threatens the life of a pregnant woman as to
640     necessitate the immediate abortion of her pregnancy to avert her death, or for which a delay
641     will create serious risk of substantial and irreversible impairment of major bodily function] a
642     life threatening physical condition aggravated by, caused by, or arising from a pregnancy that
643     places the pregnant woman at risk of death, or poses a serious risk of substantial impairment of
644     a major bodily function, unless the abortion is performed or induced.
645          [(10)] (9) "Minor" means an individual who is:
646          (a) under 18 years old;
647          (b) unmarried; and
648          (c) not emancipated.
649          [(11)] (10) (a) "Partial birth abortion" means an abortion in which the person
650     performing the abortion:
651          (i) deliberately and intentionally vaginally delivers a living fetus until, in the case of a
652     head first presentation, the entire fetal head is outside the body of the mother, or, in the case of
653     breech presentation, any part of the fetal trunk past the navel is outside the body of the mother,
654     for the purpose of performing an overt act that the person knows will kill the partially delivered
655     living fetus; and
656          (ii) performs the overt act, other than completion of delivery, that kills the partially
657     living fetus.
658          (b) "Partial birth abortion" does not include the dilation and evacuation procedure
659     involving dismemberment prior to removal, the suction curettage procedure, or the suction
660     aspiration procedure for abortion.
661          (11) "Perinatal hospice" means comprehensive support to the mother and her family
662     from the time of the diagnosis of a lethal fetal anomaly, through the time of the child's birth,
663     and through the postpartum period, that:
664          (a) focuses on alleviating fear and ensuring that the woman and her family experience
665     the life and death of a child in a comfortable and supportive environment; and
666          (b) may include counseling or medical care by:
667          (i) maternal-fetal medical specialists;
668          (ii) obstetricians;
669          (iii) neonatologists;
670          (iv) anesthesia specialists;
671          (v) psychiatrists, psychologists, or other mental health providers;
672          (vi) clergy;
673          (vii) social workers; or
674          (viii) specialty nurses.
675          (12) "Physician" means:
676          (a) a medical doctor licensed to practice medicine and surgery under Title 58, Chapter
677     67, Utah Medical Practice Act;
678          (b) an osteopathic physician licensed to practice osteopathic medicine under Title 58,
679     Chapter 68, Utah Osteopathic Medical Practice Act; or
680          (c) a physician employed by the federal government who has qualifications similar to
681     [a person] an individual described in Subsection [(12)(a)] (11)(a) or (b).
682          (13) (a) "Severe brain abnormality" means a malformation or defect that causes an
683     individual to live in a mentally vegetative state.
684          (b) "Severe brain abnormality" does not include:
685          (i) Down syndrome;
686          (ii) spina bifida;
687          (iii) cerebral palsy; or
688          (iv) any other malformation, defect, or condition that does not cause an individual to
689     live in a mentally vegetative state.
690          Section 16. Section 76-7-302 is amended to read:
691          76-7-302. Circumstances under which abortion authorized.
692          [(1) As used in this section, "viable" means that the unborn child has reached a stage of
693     fetal development when the unborn child is potentially able to live outside the womb, as
694     determined by the attending physician to a reasonable degree of medical certainty.]
695          [(2)] (1) An abortion may be performed in this state only by a physician.
696          [(3)] (2) An abortion may be performed in this state only under the following
697     circumstances:
698          (a) the unborn child [is not viable; or] has not reached 18 weeks gestational age;
699          (b) the unborn child [is viable, if:] has reached 18 weeks gestational age, and:
700          (i) the abortion is necessary to avert:
701          (A) the death of the woman on whom the abortion is performed; or
702          (B) a serious physical risk of substantial [and irreversible] impairment of a major
703     bodily function of the woman on whom the abortion is performed; or
704          (ii) subject to Subsection (4), two physicians who practice maternal fetal medicine
705     concur, in writing, in the patient's medical record that the fetus[:] has a fetal abnormality that in
706     the physicians' reasonable medical judgment is incompatible with life; or
707          [(A) has a defect that is uniformly diagnosable and uniformly lethal; or]
708          [(B) has a severe brain abnormality that is uniformly diagnosable; or]
709          [(iii) (A)]
710          (c) the unborn child has not reached 18 weeks gestational age; and
711          (i) (A) the woman is pregnant as a result of:
712          (I) rape, as described in Section 76-5-402;
713          (II) rape of a child, as described in Section 76-5-402.1; or
714          (III) incest, as described in Subsection 76-5-406(2)(j) or Section 76-7-102; [and] or
715          (B) the pregnant woman is under the age of 14; and
716          [(B)] (ii) before the abortion is performed, the physician who performs the abortion:
717          [(I)] (A) for an abortion authorized under Subsection (2)(c)(i)(A), verifies that the
718     incident described in Subsection [(3)(b)(iii)(A)] (2)(c)(i)(A) has been reported to law
719     enforcement; and
720          [(II)] (B) if applicable, complies with the requirements of Section 80-2-602.
721          [(4)] (3) An abortion may be performed only in [an abortion clinic or] a hospital, unless
722     it is necessary to perform the abortion in another location due to a medical emergency.
723          (4) If the unborn child has been diagnosed with a fetal abnormality that is incompatible
724     with life, at the time of the diagnosis, the physician shall inform the woman, both verbally and
725     in writing, that perinatal hospice and perinatal palliative care services are available and are an
726     alternative to abortion.
727          Section 17. Section 76-7-302.4 is amended to read:
728          76-7-302.4. Abortion restriction of an unborn child with Down syndrome.
729          Notwithstanding any other provision of this part, an abortion may not be performed if
730     the pregnant mother's sole reason for the abortion is that the unborn child has or may have
731     Down syndrome, unless the abortion is permissible for a reason described in [Subsection
732     76-7-302(3)(b)] Section 76-7-302.
733          Section 18. Section 76-7-304 is amended to read:
734          76-7-304. Considerations by physician -- Notice to a parent or guardian --
735     Exceptions.
736          (1) To enable the physician to exercise the physician's best medical judgment, the
737     physician shall consider all factors relevant to the well-being of a pregnant woman upon whom
738     an abortion is to be performed, including:
739          (a) her physical, emotional, and psychological health and safety;
740          (b) her age; and
741          (c) her familial situation.
742          (2) Subject to Subsection (3), at least 24 hours before a physician performs an abortion
743     on a minor, the physician shall notify a parent or guardian of the minor that the minor intends
744     to have an abortion.
745          (3) A physician is not required to comply with Subsection (2) if:
746          (a) subject to Subsection (4)(a):
747          (i) a medical condition exists that, on the basis of the physician's good faith clinical
748     judgment, so complicates the medical condition of a pregnant minor as to necessitate the
749     abortion of her pregnancy to avert:
750          (A) the minor's death; or
751          (B) a serious physical risk of substantial [and irreversible] impairment of a major
752     bodily function of the minor; and
753          (ii) there is not sufficient time to give the notice required under Subsection (2) before it
754     is necessary to terminate the minor's pregnancy in order to avert the minor's death or
755     impairment described in Subsection (3)(a)(i);
756          (b) subject to Subsection (4)(b):
757          (i) the physician complies with Subsection (5); and
758          (ii) (A) the minor is pregnant as a result of incest to which the parent or guardian was a
759     party; or
760          (B) the parent or guardian has abused the minor; or
761          (c) subject to Subsection (4)(b), the parent or guardian has not assumed responsibility
762     for the minor's care and upbringing.
763          (4) (a) If, for the reason described in Subsection (3)(a), a physician does not give the
764     24-hour notice described in Subsection (2), the physician shall give the required notice as early
765     as possible before the abortion, unless it is necessary to perform the abortion immediately in
766     order to avert the minor's death or impairment described in Subsection (3)(a)(i).
767          (b) If, for a reason described in Subsection (3)(b) or (c), a parent or guardian of a minor
768     is not notified that the minor intends to have an abortion, the physician shall notify another
769     parent or guardian of the minor, if the minor has another parent or guardian that is not exempt
770     from notification under Subsection (3)(b) or (c).
771          (5) If, for a reason described in Subsection (3)(b)(ii)(A) or (B), a physician does not
772     notify a parent or guardian of a minor that the minor intends to have an abortion, the physician
773     shall report the incest or abuse to the Division of Child and Family Services within the
774     Department of Health and Human Services.
775          Section 19. Section 76-7-304.5 is amended to read:
776          76-7-304.5. Consent required for abortions performed on minors -- Division of
777     Child and Family Services as guardian of a minor -- Hearing to allow a minor to
778     self-consent -- Appeals.
779          (1) In addition to the other requirements of this part, a physician may not perform an
780     abortion on a minor unless:
781          (a) the physician obtains the informed written consent of a parent or guardian of the
782     minor, in accordance with Sections 76-7-305 and 76-7-305.5;
783          (b) the minor is granted the right, by court order under Subsection (4)(b), to consent to
784     the abortion without obtaining consent from a parent or guardian; or
785          (c) (i) a medical condition exists that, on the basis of the physician's good faith clinical
786     judgment, so complicates the medical condition of a pregnant minor as to necessitate the
787     abortion of her pregnancy to avert:
788          (A) the minor's death; or
789          (B) a serious physical risk of substantial [and irreversible] impairment of a major
790     bodily function of the minor; and
791          (ii) there is not sufficient time to obtain the consent in the manner chosen by the minor
792     under Subsection (2) before it is necessary to terminate the minor's pregnancy in order to avert
793     the minor's death or impairment described in Subsection (1)(c)(i).
794          (2) (a) A minor who wants to have an abortion may choose:
795          (i) to seek consent from the minor's parent or guardian as described in Subsection (1);
796     or
797          (ii) to seek a court order as described in Subsection (1).
798          (b) Neither Subsection (1) nor this Subsection (2) require the minor to seek or obtain
799     consent from the minor's parent or guardian if the circumstances described in Subsection
800     76-7-304(3)(b)(ii) exist.
801          (3) If a minor does not obtain the consent of the minor's parent or guardian, the minor
802     may file a petition with the juvenile court to obtain a court order as described in Subsection (1).
803          (4) (a) The juvenile court shall close the hearing on a petition described in Subsection
804     (3) to the public.
805          (b) After considering the evidence presented at the hearing, the court shall order that
806     the minor may obtain an abortion without the consent of a parent or guardian of the minor if
807     the court finds by a preponderance of the evidence that:
808          (i) the minor:
809          (A) has given her informed consent to the abortion; and
810          (B) is mature and capable of giving informed consent to the abortion; or
811          (ii) an abortion would be in the minor's best interest.
812          (5) The Judicial Council shall make rules that:
813          (a) provide for the administration of the proceedings described in this section;
814          (b) provide for the appeal of a court's decision under this section;
815          (c) ensure the confidentiality of the proceedings described in this section and the
816     records related to the proceedings; and
817          (d) establish procedures to expedite the hearing and appeal proceedings described in
818     this section.
819          Section 20. Section 76-7-305 is amended to read:
820          76-7-305. Informed consent requirements for abortion -- 72-hour wait mandatory
821     -- Exceptions.
822          (1) A person may not perform an abortion, unless, before performing the abortion, the
823     physician who will perform the abortion obtains from the woman on whom the abortion is to
824     be performed a voluntary and informed written consent that is consistent with:
825          (a) Section 8.08 of the American Medical Association's Code of Medical Ethics,
826     Current Opinions; and
827          (b) the provisions of this section.
828          (2) Except as provided in Subsection (8), consent to an abortion is voluntary and
829     informed only if, at least 72 hours before the abortion:
830          (a) a staff member of [an abortion clinic or] a hospital, physician, registered nurse,
831     nurse practitioner, advanced practice registered nurse, certified nurse midwife, genetic
832     counselor, or physician's assistant presents the information module to the pregnant woman;
833          (b) the pregnant woman views the entire information module and presents evidence to
834     the individual described in Subsection (2)(a) that the pregnant woman viewed the entire
835     information module;
836          (c) after receiving the evidence described in Subsection (2)(b), the individual described
837     in Subsection (2)(a):
838          (i) documents that the pregnant woman viewed the entire information module;
839          (ii) gives the pregnant woman, upon her request, a copy of the documentation
840     described in Subsection (2)(c)(i); and
841          (iii) provides a copy of the statement described in Subsection (2)(c)(i) to the physician
842     who is to perform the abortion, upon request of that physician or the pregnant woman;
843          (d) after the pregnant woman views the entire information module, the physician who
844     is to perform the abortion, the referring physician, a physician, a registered nurse, nurse
845     practitioner, advanced practice registered nurse, certified nurse midwife, genetic counselor, or
846     physician's assistant, in a face-to-face consultation in any location in the state, orally informs
847     the woman of:
848          (i) the nature of the proposed abortion procedure;
849          (ii) specifically how the procedure described in Subsection (2)(d)(i) will affect the
850     fetus;
851          (iii) the risks and alternatives to the abortion procedure or treatment;
852          (iv) the options and consequences of aborting a medication-induced abortion, if the
853     proposed abortion procedure is a medication-induced abortion;
854          (v) the probable gestational age and a description of the development of the unborn
855     child at the time the abortion would be performed;
856          (vi) the medical risks associated with carrying her child to term;
857          (vii) the right to view an ultrasound of the unborn child, at no expense to the pregnant
858     woman, upon her request; and
859          (viii) when the result of a prenatal screening or diagnostic test indicates that the unborn
860     child has or may have Down syndrome, the [Department of Health website containing]
861     department's website, which contains the information described in Section 26-10-14, including
862     the information on the informational support sheet; and
863          (e) after the pregnant woman views the entire information module, a staff member of
864     the [abortion clinic or] hospital provides to the pregnant woman:
865          (i) on a document that the pregnant woman may take home:
866          (A) the address for the department's website described in Section 76-7-305.5; and
867          (B) a statement that the woman may request, from a staff member of the [abortion
868     clinic or] hospital where the woman viewed the information module, a printed copy of the
869     material on the department's website;
870          (ii) a printed copy of the material on the department's website described in Section
871     76-7-305.5, if requested by the pregnant woman; and
872          (iii) a copy of the form described in Subsection 26-21-33(3)(a)(i) regarding the
873     disposition of the aborted fetus.
874          (3) Before performing an abortion, the physician who is to perform the abortion shall:
875          (a) in a face-to-face consultation, provide the information described in Subsection
876     (2)(d), unless the attending physician or referring physician is the individual who provided the
877     information required under Subsection (2)(d); and
878          (b) (i) obtain from the pregnant woman a written certification that the information
879     required to be provided under Subsection (2) and this Subsection (3) was provided in
880     accordance with the requirements of Subsection (2) and this Subsection (3);
881          (ii) obtain a copy of the statement described in Subsection (2)(c)(i); and
882          (iii) ensure that:
883          (A) the woman has received the information described in Subsections 26-21-33(3) and
884     (4); and
885          (B) if the woman has a preference for the disposition of the aborted fetus, the woman
886     has informed the health care facility of the woman's decision regarding the disposition of the
887     aborted fetus.
888          (4) When a [serious] medical emergency compels the performance of an abortion, the
889     physician shall inform the woman prior to the abortion, if possible, of the medical indications
890     supporting the physician's judgment that an abortion is necessary.
891          (5) If an ultrasound is performed on a woman before an abortion is performed, the
892     individual who performs the ultrasound, or another qualified individual, shall:
893          (a) inform the woman that the ultrasound images will be simultaneously displayed in a
894     manner to permit her to:
895          (i) view the images, if she chooses to view the images; or
896          (ii) not view the images, if she chooses not to view the images;
897          (b) simultaneously display the ultrasound images in order to permit the woman to:
898          (i) view the images, if she chooses to view the images; or
899          (ii) not view the images, if she chooses not to view the images;
900          (c) inform the woman that, if she desires, the person performing the ultrasound, or
901     another qualified person shall provide a detailed description of the ultrasound images,
902     including:
903          (i) the dimensions of the unborn child;
904          (ii) the presence of cardiac activity in the unborn child, if present and viewable; and
905          (iii) the presence of external body parts or internal organs, if present and viewable; and
906          (d) provide the detailed description described in Subsection (5)(c), if the woman
907     requests it.
908          (6) The information described in Subsections (2), (3), and (5) is not required to be
909     provided to a pregnant woman under this section if the abortion is performed for a reason
910     described in:
911          (a) Subsection 76-7-302(3)(b)(i), if the treating physician and one other physician
912     concur, in writing, that the abortion is necessary to avert:
913          (i) the death of the woman on whom the abortion is performed; or
914          (ii) a serious physical risk of substantial [and irreversible] impairment of a major
915     bodily function of the woman on whom the abortion is performed; or
916          (b) Subsection 76-7-302(3)(b)(ii).
917          (7) In addition to the criminal penalties described in this part, a physician who violates
918     the provisions of this section:
919          (a) is guilty of unprofessional conduct as defined in Section 58-67-102 or 58-68-102;
920     and
921          (b) shall be subject to:
922          (i) suspension or revocation of the physician's license for the practice of medicine and
923     surgery in accordance with Section 58-67-401 or 58-68-401; and
924          (ii) administrative penalties in accordance with Section 58-67-402 or 58-68-402.
925          (8) A physician is not guilty of violating this section for failure to furnish any of the
926     information described in Subsection (2) or (3), or for failing to comply with Subsection (5), if:
927          (a) the physician can demonstrate by a preponderance of the evidence that the
928     physician reasonably believed that furnishing the information would have resulted in a severely
929     adverse effect on the physical or mental health of the pregnant woman;
930          (b) in the physician's professional judgment, the abortion was necessary to avert:
931          (i) the death of the woman on whom the abortion is performed; or
932          (ii) a serious physical risk of substantial [and irreversible] impairment of a major
933     bodily function of the woman on whom the abortion is performed;
934          (c) the pregnancy was the result of rape or rape of a child, as described in Sections
935     76-5-402 and 76-5-402.1;
936          (d) the pregnancy was the result of incest, as defined in Subsection 76-5-406(2)(j) and
937     Section 76-7-102; or
938          (e) at the time of the abortion, the pregnant woman was 14 years old or younger.
939          (9) A physician who complies with the provisions of this section and Section
940     76-7-304.5 may not be held civilly liable to the physician's patient for failure to obtain
941     informed consent under Section 78B-3-406.
942          (10) (a) The department shall provide an ultrasound, in accordance with the provisions
943     of Subsection (5)(b), at no expense to the pregnant woman.
944          (b) A local health department shall refer a pregnant woman who requests an ultrasound
945     described in Subsection (10)(a) to the department.
946          (11) A physician is not guilty of violating this section if:
947          (a) the information described in Subsection (2) is provided less than 72 hours before
948     the physician performs the abortion; and
949          (b) in the physician's professional judgment, the abortion was necessary in a case
950     where:
951          (i) a ruptured membrane, documented by the attending or referring physician, will
952     cause a serious infection; or
953          (ii) a serious infection, documented by the attending or referring physician, will cause a
954     ruptured membrane.
955          Section 21. Section 76-7-314 is amended to read:
956          76-7-314. Violations of abortion laws -- Classifications.
957          (1) [A willful] An intentional violation of Section 76-7-307, 76-7-308, 76-7-310,
958     76-7-310.5, 76-7-311, or 76-7-312 is a felony of the third degree.
959          (2) A violation of Section 76-7-326 is a felony of the third degree.
960          (3) A violation of Section [76-7-302.5 or] 76-7-314.5 is a felony of the second degree.
961          (4) A violation of any other provision of this part, including Subsections
962     76-7-305(2)(a) through (c), and (e), is a class A misdemeanor.
963          (5) The [Department of Health] department shall report a physician's violation of any
964     provision of this part to the Physicians Licensing Board, described in Section 58-67-201.
965          (6) Any person with knowledge of a physician's violation of any provision of this part
966     may report the violation to the Physicians Licensing Board, described in Section 58-67-201.
967          (7) In addition to the penalties described in this section, the department may take any
968     action described in Section 26-21-11 against [an abortion clinic] a health care facility if a
969     violation of this chapter occurs at the [abortion clinic] health care facility.
970          Section 22. Section 76-7-314.5 is amended to read:
971          76-7-314.5. Killing an unborn child.
972          (1) A person is guilty of killing an unborn child if the person intentionally causes the
973     death of an unborn child by performing an abortion of the unborn child in violation of the
974     provisions of Subsection [76-7-302(3)] 76-7-302(2).
975          (2) A woman is not criminally liable for:
976          (a) seeking to obtain, or obtaining, an abortion that is permitted by this part; or
977          (b) a physician's failure to comply with Subsection [76-7-302(3)(b)(ii)]
978     76-7-302(2)(b)(ii) or Section 76-7-305.
979          Section 23. Section 76-7-317 is amended to read:
980          76-7-317. Severability clause.
981          If any one or more provision, section, subsection, sentence, clause, phrase, or word of
982     this part or the application thereof to any person or circumstance is found to be
983     unconstitutional, the same is hereby declared to be severable and the balance of this part shall
984     remain effective notwithstanding such unconstitutionality. The legislature hereby declares that
985     it would have passed this part, and each provision, section, subsection, sentence, clause, phrase,
986     or word thereof, irrespective of the fact that any one or more provision, section, subsection,
987     sentence, clause, phrase, or word be declared unconstitutional. This section applies to any
988     provision, section, subsection, sentence, clause, phrase, or word of this part, regardless of the
989     time of enactment, amendment, or repeal.
990          Section 24. Section 76-7-332 is enacted to read:
991          76-7-332. Drugs known to be used for abortion -- Prescriber limitation --
992     Criminal penalties -- Pharmacy presumption for other use.
993          (1) As used in the section, "abortion-related drug" means a drug or medication that is
994     known to be used for the purpose of performing an abortion, and includes:
995          (a) methotrexate, or methotrexate with misoprostol;
996          (b) mifepristone, also known as mifeprex;
997          (c) misoprostol, also known as cytotec; and
998          (d) RU-486.
999          (2) An individual may not prescribe an abortion-related drug for the purpose of causing
1000     an abortion, unless the individual is licensed as a physician in this state under:
1001          (a) Title 58, Chapter 67, Utah Medical Practice Act; or
1002          (b) Title 58, Chapter 68, Utah Osteopathic Medical Practice Act.
1003          (3) A violation of Subsection (2) is a class B misdemeanor.
1004          (4) (a) Any prescription or medical order for a drug that is known to possibly cause an
1005     abortion shall be presumed by a pharmacy to be for an indication other than for the termination
1006     of a pregnancy.
1007          (b) A pharmacy dispensing a prescription or medical order for a drug that is known to
1008     possibly cause an abortion shall not be required to verify whether or not the prescription or
1009     medical order violates any provision of this chapter.
1010          Section 25. Section 76-7a-101 is amended to read:
1011          76-7a-101. Definitions.
1012          As used in this chapter:
1013          (1) (a) "Abortion" means[:] the act, by a physician, of using an instrument, or
1014     prescribing a drug, with the intent to cause the death of an unborn child of a woman known to
1015     be pregnant, except as permitted under this chapter.
1016          [(i) the intentional termination or attempted termination of human pregnancy after
1017     implantation of a fertilized ovum through a medical procedure carried out by a physician or
1018     through a substance used under the direction of a physician;]
1019          [(ii) the intentional killing or attempted killing of a live unborn child through a medical
1020     procedure carried out by a physician or through a substance used under the direction of a
1021     physician; or]
1022          [(iii) the intentional causing or attempted causing of a miscarriage through a medical
1023     procedure carried out by a physician or through a substance used under the direction of a
1024     physician.]
1025          (b) "Abortion" does not include:
1026          (i) removal of a dead unborn child;
1027          (ii) removal of an ectopic pregnancy; or
1028          (iii) the killing or attempted killing of an unborn child without the consent of the
1029     pregnant woman, unless:
1030          (A) the killing or attempted killing is done through a medical procedure carried out by
1031     a physician or through a substance used under the direction of a physician; and
1032          (B) the physician is unable to obtain the consent due to a medical emergency.
1033          [(2) "Abortion clinic" means a type I abortion clinic licensed by the state or a type II
1034     abortion clinic licensed by the state.]
1035          [(3)] (2) "Department" means the Department of Health and Human Services.
1036          [(4)] (3) "Down syndrome" means a genetic condition associated with an extra
1037     chromosome 21, in whole or in part, or an effective trisomy for chromosome 21.
1038          [(5)] (4) "Hospital" means:
1039          (a) a general hospital licensed by the department; or
1040          (b) a clinic or other medical facility to the extent the clinic or other medical facility is
1041     certified by the department as providing equipment and personnel sufficient in quantity and
1042     quality to provide the same degree of safety to a pregnant woman and an unborn child as would
1043     be provided for the particular medical procedure undertaken by a general hospital licensed by
1044     the department.
1045          [(6) "Incest" means the same as that term is defined in Section 80-1-102.]
1046          [(7)] (5) "Medical emergency" means a [condition which, on the basis of the
1047     physician's good faith clinical judgment, so threatens the life of a pregnant woman as to
1048     necessitate the immediate abortion of her pregnancy to avert her death, or for which a delay
1049     will create serious risk of substantial and irreversible impairment of major bodily function] life
1050     threatening physical condition aggravated by, caused by, or arising from a pregnancy that
1051     places the pregnant woman at risk of death, or poses a serious risk of substantial impairment of
1052     a major bodily function, unless the abortion is performed or induced.
1053          (6) "Perinatal hospice" means comprehensive support to the mother and her family
1054     from the time of the diagnosis of a lethal fetal anomaly, through the time of the child's birth,
1055     and through the postpartum period, that:
1056          (a) focuses on alleviating fear and ensuring that the woman and her family experience
1057     the life and death of a child in a comfortable and supportive environment; and
1058          (b) may include counseling or medical care by:
1059          (i) maternal-fetal medical specialists;
1060          (ii) obstetricians;
1061          (iii) neonatologists;
1062          (iv) anesthesia specialists;
1063          (v) psychiatrists, psychologists, or other mental health providers;
1064          (vi) clergy;
1065          (vii) social workers; or
1066          (viii) specialty nurses
1067          [(8)] (7) "Physician" means:
1068          (a) a medical doctor licensed to practice medicine and surgery in the state;
1069          (b) an osteopathic physician licensed to practice osteopathic medicine in the state; or
1070          (c) a physician employed by the federal government who has qualifications similar to
1071     an individual described in Subsection [(8)(a) or (b)] (6)(a) or (b).
1072          [(9) "Rape" means the same as that term is defined in Title 76, Utah Criminal Code.]
1073          [(10)] (8) (a) "Severe brain abnormality" means a malformation or defect that causes an
1074     individual to live in a mentally vegetative state.
1075          (b) "Severe brain abnormality" does not include:
1076          (i) Down syndrome;
1077          (ii) spina bifida;
1078          (iii) cerebral palsy; or
1079          (iv) any other malformation, defect, or condition that does not cause an individual to
1080     live in a mentally vegetative state.
1081          Section 26. Section 76-7a-201 is amended to read:
1082          76-7a-201. Abortion prohibition -- Exceptions -- Penalties.
1083          (1) An abortion may be performed in this state only under the following circumstances:
1084          (a) the abortion is necessary to avert:
1085          (i) the death of the woman on whom the abortion is performed; or
1086          (ii) a serious physical risk of substantial [and irreversible] impairment of a major
1087     bodily function of the woman on whom the abortion is performed;
1088          (b) subject to Subsection (3), two physicians who practice maternal fetal medicine
1089     concur, in writing, in the patient's medical record that the fetus[:] has a fetal abnormality that in
1090     the physicians' reasonable medical judgment is incompatible with life; or
1091          [(i) has a defect that is uniformly diagnosable and uniformly lethal; or]
1092          [(ii) has a severe brain abnormality that is uniformly diagnosable; or]
1093          (c) [(i)] the unborn child has not reached 18 weeks gestational age; and
1094          (i) (A) the woman is pregnant as a result of:
1095          [(A)] (I) rape, as described in Section 76-5-402;
1096          [(B)] (II) rape of a child, as described in Section 76-5-402.1; or
1097          [(C)] (III) incest[; and], as described in Subsection 76-5-406(2)(j) or Section 76-7-102;
1098     or
1099          (B) the pregnant woman is under the age of 14; and
1100          (ii) before the abortion is performed, the physician who performs the abortion:
1101          (A) for an abortion authorized under Subsection (1)(c)(i)(A), verifies that the incident
1102     described in Subsection [(1)(c)(i)] (1)(c)(i)(A) has been reported to law enforcement; and
1103          (B) if applicable, complies with requirements related to reporting suspicions of or
1104     known child abuse.
1105          (2) An abortion may be performed only:
1106          (a) by a physician; and
1107          (b) in [an abortion clinic or] a hospital, unless it is necessary to perform the abortion in
1108     another location due to a medical emergency.
1109          (3) If the unborn child has been diagnosed with a fetal abnormality that is incompatible
1110     with life, at the time of the diagnosis, the physician shall inform the woman, both verbally and
1111     in writing, that perinatal hospice services and perinatal palliative care are available and are an
1112     alternative to abortion.
1113          [(3)] (4) A person who performs an abortion in violation of this section is guilty of a
1114     second degree felony.
1115          [(4)] (5) In addition to the penalty described in Subsection [(3)] (4), the department
1116     may take appropriate corrective action against [an abortion clinic] a health care facility,
1117     including revoking the [abortion clinic's] health care facility's license, if a violation of this
1118     chapter occurs at the [abortion clinic] health care facility.
1119          [(5)] (6) The department shall report a physician's violation of any provision of this
1120     section to the state entity that regulates the licensing of a physician.
1121          Section 27. Repealer.
1122          This bill repeals:
1123          Section 76-7-302.5, Circumstances under which abortion prohibited.