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     Cosponsors:
7     Cheryl K. Acton
8     Carl R. Albrecht
9     Kera Birkeland
10     Brady Brammer
11     Walt Brooks
12     Jefferson S. Burton
Joseph Elison
Katy Hall
Jon Hawkins
Colin W. Jack
Dan N. Johnson
Trevor Lee
Steven J. Lund
A. Cory Maloy
Jefferson Moss
Susan Pulsipher
Mike Schultz
Mark A. Strong
Jordan D. Teuscher
13     

14     LONG TITLE
15     General Description:
16          This bill modifies provisions related to abortion.
17     Highlighted Provisions:
18          This bill:
19          ▸     modifies definitions;
20          ▸     requires abortions to be performed in a hospital, with some exceptions;
21          ▸     prohibits licensing of abortion clinics after May 2, 2023, but allows licensing of
22     certain clinics for providing an abortion if the clinic meets certain standards;
23          ▸     removes certain references to abortion clinics;
24          ▸     provides that inducing or performing an abortion contrary to statutory requirements

25     is unprofessional conduct for a physician, osteopathic physician, physician assistant, advanced
26     practice registered nurse, certified nurse midwife, and direct-entry midwife;
27          ▸     modifies provisions that govern what constitutes a medical emergency in relation to
28     an abortion;
29          ▸     modifies the conditions under which an abortion may be performed to protect the
30     life or health of the mother;
31          ▸     amends language related to medical defects of a fetus;
32          ▸     repeals the statute that established a prohibition on abortions after 18 weeks and
33     incorporates its contents into existing statute, replacing language that established
34     now-superseded viability standards;
35          ▸     standardizes language between various statutes that regulate abortion;
36          ▸     requires a physician, in the case of a diagnosis of a lethal fetal anomaly, to give
37     notice of the availability of perinatal hospice and perinatal palliative care services as
38     an alternative to abortion;
39          ▸     treats an individual who becomes pregnant at a certain age as having the same
40     access to abortion services as rape or incest situations;
41          ▸     prohibits the ability to receive an abortion due to rape or incest if the unborn child
42     has reached 18 weeks gestational age;
43          ▸     requires updates to abortion information modules to match current law;
44          ▸     modifies state of mind standards for criminal act;
45          ▸     provides for severability;
46          ▸     provides for regulation of drugs that are known to be used in relation to an abortion;
47          ▸     creates a criminal offense for prescribing a drug for the purpose of causing an
48     abortion, unless the prescriber is licensed as a physician under the laws of this state;
49     and
50          ▸     makes technical changes.
51     Money Appropriated in this Bill:
52          None
53     Other Special Clauses:
54          None
55     Utah Code Sections Affected:

56     AMENDS:
57          26-21-2, as last amended by Laws of Utah 2022, Chapter 255
58          26-21-6.5, as last amended by Laws of Utah 2018, Chapter 282
59          26-21-7, as last amended by Laws of Utah 2019, Chapter 349
60          26-21-8, as last amended by Laws of Utah 2016, Chapter 74
61          26-21-11, as last amended by Laws of Utah 1997, Chapter 209
62          26-21-25, as last amended by Laws of Utah 2010, Chapter 218
63          58-31b-502, as last amended by Laws of Utah 2022, Chapter 290
64          58-44a-502, as last amended by Laws of Utah 2020, Chapter 25
65          58-67-304, as last amended by Laws of Utah 2020, Chapters 12, 339
66          58-67-502, as last amended by Laws of Utah 2021, Chapter 337
67          58-68-304, as last amended by Laws of Utah 2020, Chapters 12, 339
68          58-68-502, as last amended by Laws of Utah 2021, Chapter 337
69          58-70a-501, as last amended by Laws of Utah 2021, Chapter 312
70          58-77-603, as enacted by Laws of Utah 2005, Chapter 299
71          63I-2-276, as last amended by Laws of Utah 2022, Chapter 117
72          76-7-301, as last amended by Laws of Utah 2021, Chapter 262
73          76-7-302, as last amended by Laws of Utah 2022, Chapter 335
74          76-7-302.4, as enacted by Laws of Utah 2019, Chapter 124
75          76-7-304, as last amended by Laws of Utah 2018, Chapter 282
76          76-7-304.5, as last amended by Laws of Utah 2022, Chapter 287
77          76-7-305, as last amended by Laws of Utah 2022, Chapter 181
78          76-7-305.5, as last amended by Laws of Utah 2020, Chapter 251
79          76-7-313, as last amended by Laws of Utah 2019, Chapters 124, 208
80          76-7-314, as last amended by Laws of Utah 2019, Chapter 208
81          76-7-314.5, as last amended by Laws of Utah 2010, Chapter 13
82          76-7-317, as enacted by Laws of Utah 1974, Chapter 33
83          76-7a-101, as last amended by Laws of Utah 2021, Chapter 262
84          76-7a-201, as enacted by Laws of Utah 2020, Chapter 279
85     ENACTS:
86          76-7-332, Utah Code Annotated 1953

87     REPEALS:
88          76-7-302.5, as enacted by Laws of Utah 2019, Chapter 208
89     

90     Be it enacted by the Legislature of the state of Utah:
91          Section 1. Section 26-21-2 is amended to read:
92          26-21-2. Definitions.
93          As used in this chapter:
94          (1) (a) "Abortion clinic" means a type I abortion clinic or a type II abortion clinic.
95          (b) "Abortion clinic" does not mean a clinic that meets the definition of hospital under
96     Section 76-7-301 or Section 76-7a-101.
97          (2) "Activities of daily living" means essential activities including:
98          (a) dressing;
99          (b) eating;
100          (c) grooming;
101          (d) bathing;
102          (e) toileting;
103          (f) ambulation;
104          (g) transferring; and
105          (h) self-administration of medication.
106          (3) "Ambulatory surgical facility" means a freestanding facility, which provides
107     surgical services to patients not requiring hospitalization.
108          (4) "Assistance with activities of daily living" means providing of or arranging for the
109     provision of assistance with activities of daily living.
110          (5) (a) "Assisted living facility" means:
111          (i) a type I assisted living facility, which is a residential facility that provides assistance
112     with activities of daily living and social care to two or more residents who:
113          (A) require protected living arrangements; and
114          (B) are capable of achieving mobility sufficient to exit the facility without the
115     assistance of another person; and
116          (ii) a type II assisted living facility, which is a residential facility with a home-like
117     setting that provides an array of coordinated supportive personal and health care services

118     available 24 hours per day to residents who have been assessed under department rule to need
119     any of these services.
120          (b) Each resident in a type I or type II assisted living facility shall have a service plan
121     based on the assessment, which may include:
122          (i) specified services of intermittent nursing care;
123          (ii) administration of medication; and
124          (iii) support services promoting residents' independence and self sufficiency.
125          (6) "Birthing center" means a facility that:
126          (a) receives maternal clients and provides care during pregnancy, delivery, and
127     immediately after delivery; and
128          (b) (i) is freestanding; or
129          (ii) is not freestanding, but meets the requirements for an alongside midwifery unit
130     described in Subsection 26-21-29(7).
131          (7) "Committee" means the Health Facility Committee created in Section 26B-1-204.
132          (8) "Consumer" means any person not primarily engaged in the provision of health care
133     to individuals or in the administration of facilities or institutions in which such care is provided
134     and who does not hold a fiduciary position, or have a fiduciary interest in any entity involved in
135     the provision of health care, and does not receive, either directly or through his spouse, more
136     than 1/10 of his gross income from any entity or activity relating to health care.
137          (9) "End stage renal disease facility" means a facility which furnishes staff-assisted
138     kidney dialysis services, self-dialysis services, or home-dialysis services on an outpatient basis.
139          (10) "Freestanding" means existing independently or physically separated from another
140     health care facility by fire walls and doors and administrated by separate staff with separate
141     records.
142          (11) "General acute hospital" means a facility which provides diagnostic, therapeutic,
143     and rehabilitative services to both inpatients and outpatients by or under the supervision of
144     physicians.
145          (12) "Governmental unit" means the state, or any county, municipality, or other
146     political subdivision or any department, division, board, or agency of the state, a county,
147     municipality, or other political subdivision.
148          (13) (a) "Health care facility" means general acute hospitals, specialty hospitals, home

149     health agencies, hospices, nursing care facilities, residential-assisted living facilities, birthing
150     centers, ambulatory surgical facilities, small health care facilities, abortion clinics, a clinic that
151     meets the definition of hospital under Section 76-7-301 or 76-7a-201, facilities owned or
152     operated by health maintenance organizations, end stage renal disease facilities, and any other
153     health care facility which the committee designates by rule.
154          (b) "Health care facility" does not include the offices of private physicians or dentists,
155     whether for individual or group practice, except that it does include an abortion clinic.
156          (14) "Health maintenance organization" means an organization, organized under the
157     laws of any state which:
158          (a) is a qualified health maintenance organization under 42 U.S.C. Sec. 300e-9; or
159          (b) (i) provides or otherwise makes available to enrolled participants at least the
160     following basic health care services: usual physician services, hospitalization, laboratory, x-ray,
161     emergency, and preventive services and out-of-area coverage;
162          (ii) is compensated, except for copayments, for the provision of the basic health
163     services listed in Subsection (14)(b)(i) to enrolled participants by a payment which is paid on a
164     periodic basis without regard to the date the health services are provided and which is fixed
165     without regard to the frequency, extent, or kind of health services actually provided; and
166          (iii) provides physicians' services primarily directly through physicians who are either
167     employees or partners of such organizations, or through arrangements with individual
168     physicians or one or more groups of physicians organized on a group practice or individual
169     practice basis.
170          (15) (a) "Home health agency" means an agency, organization, or facility or a
171     subdivision of an agency, organization, or facility which employs two or more direct care staff
172     persons who provide licensed nursing services, therapeutic services of physical therapy, speech
173     therapy, occupational therapy, medical social services, or home health aide services on a
174     visiting basis.
175          (b) "Home health agency" does not mean an individual who provides services under
176     the authority of a private license.
177          (16) "Hospice" means a program of care for the terminally ill and their families which
178     occurs in a home or in a health care facility and which provides medical, palliative,
179     psychological, spiritual, and supportive care and treatment.

180          (17) "Nursing care facility" means a health care facility, other than a general acute or
181     specialty hospital, constructed, licensed, and operated to provide patient living
182     accommodations, 24-hour staff availability, and at least two of the following patient services:
183          (a) a selection of patient care services, under the direction and supervision of a
184     registered nurse, ranging from continuous medical, skilled nursing, psychological, or other
185     professional therapies to intermittent health-related or paraprofessional personal care services;
186          (b) a structured, supportive social living environment based on a professionally
187     designed and supervised treatment plan, oriented to the individual's habilitation or
188     rehabilitation needs; or
189          (c) a supervised living environment that provides support, training, or assistance with
190     individual activities of daily living.
191          (18) "Person" means any individual, firm, partnership, corporation, company,
192     association, or joint stock association, and the legal successor thereof.
193          (19) "Resident" means a person 21 years old or older who:
194          (a) as a result of physical or mental limitations or age requires or requests services
195     provided in an assisted living facility; and
196          (b) does not require intensive medical or nursing services as provided in a hospital or
197     nursing care facility.
198          (20) "Small health care facility" means a four to 16 bed facility that provides licensed
199     health care programs and services to residents.
200          (21) "Specialty hospital" means a facility which provides specialized diagnostic,
201     therapeutic, or rehabilitative services in the recognized specialty or specialties for which the
202     hospital is licensed.
203          (22) "Substantial compliance" means in a department survey of a licensee, the
204     department determines there is an absence of deficiencies which would harm the physical
205     health, mental health, safety, or welfare of patients or residents of a licensee.
206          (23) "Type I abortion clinic" means a facility, including a physician's office, but not
207     including a general acute or specialty hospital, that:
208          (a) performs abortions, as defined in Section 76-7-301, during the first trimester of
209     pregnancy; and
210          (b) does not perform abortions, as defined in Section 76-7-301, after the first trimester

211     of pregnancy.
212          (24) "Type II abortion clinic" means a facility, including a physician's office, but not
213     including a general acute or specialty hospital, that:
214          (a) performs abortions, as defined in Section 76-7-301, after the first trimester of
215     pregnancy; or
216          (b) performs abortions, as defined in Section 76-7-301, during the first trimester of
217     pregnancy and after the first trimester of pregnancy.
218          Section 2. Section 26-21-6.5 is amended to read:
219          26-21-6.5. Licensing of an abortion clinic -- Rulemaking authority -- Fee --
220     Licensing of a clinic meeting the definition of hospital.
221          (1) (a) No abortion clinic may operate in the state on or after January 1, 2024, or the
222     last valid date of an abortion clinic license issued under the requirements of this section,
223     whichever date is later.
224          (b) Notwithstanding Subsection (1)(a), a licensed abortion clinic may not perform an
225     abortion in violation of any provision of state law.
226          (2) The state may not issue a license for an abortion clinic after May 2, 2023.
227          (3) For any license for an abortion clinic that is issued under this section:
228          (a) A type I abortion clinic may not operate in the state without a license issued by the
229     department to operate a type I abortion clinic.
230          [(2)] (b) A type II abortion clinic may not operate in the state without a license issued
231     by the department to operate a type II abortion clinic.
232          [(3)] (c) The department shall make rules establishing minimum health, safety,
233     sanitary, and recordkeeping requirements for:
234          [(a)] (i) a type I abortion clinic; and
235          [(b)] (ii) a type II abortion clinic.
236          [(4)] (d) To receive and maintain a license described in this section, an abortion clinic
237     shall:
238          [(a)] (i) apply for a license on a form prescribed by the department;
239          [(b)] (ii) satisfy and maintain the minimum health, safety, sanitary, and recordkeeping
240     requirements established under Subsection [(3)] (3)(c) that relate to the type of abortion clinic
241     licensed;

242          [(c)] (iii) comply with the recordkeeping and reporting requirements of Section
243     76-7-313;
244          [(d)] (iv) comply with the requirements of Title 76, Chapter 7, Part 3, Abortion, and
245     Title 76, Chapter 7a, Abortion Prohibition;
246          [(e)] (v) pay the annual licensing fee; and
247          [(f)] (vi) cooperate with inspections conducted by the department.
248          [(5)] (e) The department shall, at least twice per year, inspect each abortion clinic in
249     the state to ensure that the abortion clinic is complying with all statutory and licensing
250     requirements relating to the abortion clinic. At least one of the inspections shall be made
251     without providing notice to the abortion clinic.
252          [(6)] (f) The department shall charge an annual license fee, set by the department in
253     accordance with the procedures described in Section 63J-1-504, to an abortion clinic in an
254     amount that will pay for the cost of the licensing requirements described in this section and the
255     cost of inspecting abortion clinics.
256          [(7)] (g) The department shall deposit the licensing fees described in this section in the
257     General Fund as a dedicated credit to be used solely to pay for the cost of the licensing
258     requirements described in this section and the cost of inspecting abortion clinics.
259          (4) (a) Notwithstanding any other provision of this section, the department may license
260     a clinic that meets the definition of hospital under Section 76-7-301 or Section 76-7a-101.
261          (b) A clinic described in Subsection (4)(a) is not defined as an abortion clinic.
262          Section 3. Section 26-21-7 is amended to read:
263          26-21-7. Exempt facilities.
264          This chapter does not apply to:
265          (1) a dispensary or first aid facility maintained by any commercial or industrial plant,
266     educational institution, or convent;
267          (2) a health care facility owned or operated by an agency of the United States;
268          (3) the office of a physician, physician assistant, or dentist whether it is an individual
269     or group practice[, except that it does apply to an abortion clinic];
270          (4) a health care facility established or operated by any recognized church or
271     denomination for the practice of religious tenets administered by mental or spiritual means
272     without the use of drugs, whether gratuitously or for compensation, if it complies with statutes

273     and rules on environmental protection and life safety;
274          (5) any health care facility owned or operated by the Department of Corrections,
275     created in Section 64-13-2; and
276          (6) a residential facility providing 24-hour care:
277          (a) that does not employ direct care staff;
278          (b) in which the residents of the facility contract with a licensed hospice agency to
279     receive end-of-life medical care; and
280          (c) that meets other requirements for an exemption as designated by administrative
281     rule.
282          Section 4. Section 26-21-8 is amended to read:
283          26-21-8. License required -- Not assignable or transferable -- Posting --
284     Expiration and renewal -- Time for compliance by operating facilities.
285          (1) (a) A person or governmental unit acting severally or jointly with any other person
286     or governmental unit, may not establish, conduct, or maintain a health care facility in this state
287     without receiving a license from the department as provided by this chapter and the rules
288     adopted pursuant to this chapter.
289          (b) This Subsection (1) does not apply to facilities that are exempt under Section
290     26-21-7.
291          (2) A license issued under this chapter is not assignable or transferable.
292          (3) The current license shall at all times be posted in each health care facility in a place
293     readily visible and accessible to the public.
294          (4) (a) The department may issue a license for a period of time [not to exceed 12
295     months from the date of issuance for an abortion clinic and] not to exceed 24 months from the
296     date of issuance for [other] health care facilities that meet the provisions of this chapter and
297     department rules adopted pursuant to this chapter.
298          (b) Each license expires at midnight on the day designated on the license as the
299     expiration date, unless previously revoked by the department.
300          (c) The license shall be renewed upon completion of the application requirements,
301     unless the department finds the health care facility has not complied with the provisions of this
302     chapter or the rules adopted pursuant to this chapter.
303          (5) A license may be issued under this section only for the operation of a specific

304     facility at a specific site by a specific person.
305          (6) Any health care facility in operation at the time of adoption of any applicable rules
306     as provided under this chapter shall be given a reasonable time for compliance as determined
307     by the committee.
308          Section 5. Section 26-21-11 is amended to read:
309          26-21-11. Violations -- Denial or revocation of license -- Restricting or prohibiting
310     new admissions -- Monitor.
311               (1) If the department finds a violation of this chapter or any rules adopted
312     pursuant to this chapter the department may take one or more of the following actions:
313          [(1)] (a) serve a written statement of violation requiring corrective action, which shall
314     include time frames for correction of all violations;
315          [(2)] (b) subject to Subsection (2), deny or revoke a license if it finds:
316          [(a)] (i) there has been a failure to comply with the rules established pursuant to this
317     chapter;
318          [(b)] (ii) evidence of aiding, abetting, or permitting the commission of any illegal act;
319     or
320          [(c)] (iii) conduct adverse to the public health, morals, welfare, and safety of the people
321     of the state;
322          [(3)] (c) restrict or prohibit new admissions to a health care facility or revoke the
323     license of a health care facility for:
324          [(a)] (i) violation of any rule adopted under this chapter; or
325          [(b)] (ii) permitting, aiding, or abetting the commission of any illegal act in the health
326     care facility;
327          [(4)] (d) place a department representative as a monitor in the facility until corrective
328     action is completed;
329          [(5)] (e) assess to the facility the cost incurred by the department in placing a monitor;
330          [(6)] (f) assess an administrative penalty as allowed by Subsection 26-23-6(1)(a); or
331          [(7)] (g) issue a cease and desist order to the facility.
332          (2) If the department finds that an abortion has been performed in violation of Section
333     76-7-314 or 76-7a-201, the department shall deny or revoke the license.
334          Section 6. Section 26-21-25 is amended to read:

335          26-21-25. Patient identity protection.
336          (1) As used in this section:
337          (a) "EMTALA" means the federal Emergency Medical Treatment and Active Labor
338     Act.
339          (b) "Health professional office" means:
340          (i) a physician's office; or
341          (ii) a dental office.
342          (c) "Medical facility" means:
343          (i) a general acute hospital;
344          (ii) a specialty hospital;
345          (iii) a home health agency;
346          (iv) a hospice;
347          (v) a nursing care facility;
348          (vi) a residential-assisted living facility;
349          (vii) a birthing center;
350          (viii) an ambulatory surgical facility;
351          (ix) a small health care facility;
352          (x) an abortion clinic;
353          (xi) a clinic that meets the definition of hospital under Section 76-7-301 or Section
354     76-7a-101;
355          [(xi)] (xii) a facility owned or operated by a health maintenance organization;
356          [(xii)] (xiii) an end stage renal disease facility;
357          [(xiii)] (xiv) a health care clinic; or
358          [(xiv)] (xv) any other health care facility that the committee designates by rule.
359          (2) (a) In order to discourage identity theft and health insurance fraud, and to reduce
360     the risk of medical errors caused by incorrect medical records, a medical facility or a health
361     professional office shall request identification from an individual prior to providing in-patient
362     or out-patient services to the individual.
363          (b) If the individual who will receive services from the medical facility or a health
364     professional office lacks the legal capacity to consent to treatment, the medical facility or a
365     health professional office shall request identification:

366          (i) for the individual who lacks the legal capacity to consent to treatment; and
367          (ii) from the individual who consents to treatment on behalf of the individual described
368     in Subsection (2)(b)(i).
369          (3) A medical facility or a health professional office:
370          (a) that is subject to EMTALA:
371          (i) may not refuse services to an individual on the basis that the individual did not
372     provide identification when requested; and
373          (ii) shall post notice in its emergency department that informs a patient of the patient's
374     right to treatment for an emergency medical condition under EMTALA;
375          (b) may not be penalized for failing to ask for identification;
376          (c) is not subject to a private right of action for failing to ask for identification; and
377          (d) may document or confirm patient identity by:
378          (i) photograph;
379          (ii) fingerprinting;
380          (iii) palm scan; or
381          (iv) other reasonable means.
382          (4) The identification described in this section:
383          (a) is intended to be used for medical records purposes only; and
384          (b) shall be kept in accordance with the requirements of the Health Insurance
385     Portability and Accountability Act of 1996.
386          Section 7. Section 58-31b-502 is amended to read:
387          58-31b-502. Unprofessional conduct.
388          (1) "Unprofessional conduct" includes:
389          (a) failure to safeguard a patient's right to privacy as to the patient's person, condition,
390     diagnosis, personal effects, or any other matter about which the licensee is privileged to know
391     because of the licensee's or person with a certification's position or practice as a nurse or
392     practice as a medication aide certified;
393          (b) failure to provide nursing service or service as a medication aide certified in a
394     manner that demonstrates respect for the patient's human dignity and unique personal character
395     and needs without regard to the patient's race, religion, ethnic background, socioeconomic
396     status, age, sex, or the nature of the patient's health problem;

397          (c) engaging in sexual relations with a patient during any:
398          (i) period when a generally recognized professional relationship exists between the
399     person licensed or certified under this chapter and the patient; or
400          (ii) extended period when a patient has reasonable cause to believe a professional
401     relationship exists between the person licensed or certified under the provisions of this chapter
402     and the patient;
403          (d) (i) as a result of any circumstance under Subsection (1)(c), exploiting or using
404     information about a patient or exploiting the licensee's or the person with a certification's
405     professional relationship between the licensee or holder of a certification under this chapter and
406     the patient; or
407          (ii) exploiting the patient by use of the licensee's or person with a certification's
408     knowledge of the patient obtained while acting as a nurse or a medication aide certified;
409          (e) unlawfully obtaining, possessing, or using any prescription drug or illicit drug;
410          (f) unauthorized taking or personal use of nursing supplies from an employer;
411          (g) unauthorized taking or personal use of a patient's personal property;
412          (h) unlawful or inappropriate delegation of nursing care;
413          (i) failure to exercise appropriate supervision of persons providing patient care services
414     under supervision of the licensed nurse;
415          (j) employing or aiding and abetting the employment of an unqualified or unlicensed
416     person to practice as a nurse;
417          (k) failure to file or record any medical report as required by law, impeding or
418     obstructing the filing or recording of such a report, or inducing another to fail to file or record
419     such a report;
420          (l) breach of a statutory, common law, regulatory, or ethical requirement of
421     confidentiality with respect to a person who is a patient, unless ordered by a court;
422          (m) failure to pay a penalty imposed by the division;
423          (n) prescribing a Schedule II controlled substance without complying with the
424     requirements in Section 58-31b-803, if applicable;
425          (o) violating Section 58-31b-801;
426          (p) violating the dispensing requirements of Section 58-17b-309 or Chapter 17b, Part
427     8, Dispensing Medical Practitioner and Dispensing Medical Practitioner Clinic Pharmacy, if

428     applicable;
429          (q) performing or inducing an abortion in violation of the requirements of Section
430     76-7-302 or Section 76-7a-201, regardless of whether the person licensed or certified under the
431     provisions of this chapter is found guilty of a crime in connection with the violation;
432          [(q)] (r) falsely making an entry in, or altering, a medical record with the intent to
433     conceal:
434          (i) a wrongful or negligent act or omission of an individual licensed under this chapter
435     or an individual under the direction or control of an individual licensed under this chapter; or
436          (ii) conduct described in Subsections (1)(a) through (o) or Subsection 58-1-501(1); or
437          [(r)] (s) violating the requirements of Title 26, Chapter 61a, Utah Medical Cannabis
438     Act.
439          (2) "Unprofessional conduct" does not include, in accordance with Title 26, Chapter
440     61a, Utah Medical Cannabis Act, when registered as a qualified medical provider, or acting as
441     a limited medical provider, as those terms are defined in Section 26-61a-102, recommending
442     the use of medical cannabis.
443          (3) Notwithstanding Subsection (2), the division, in consultation with the board and in
444     accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, shall define
445     unprofessional conduct for an advanced practice registered nurse described in Subsection (2).
446          Section 8. Section 58-44a-502 is amended to read:
447          58-44a-502. Unprofessional conduct.
448          "Unprofessional conduct" includes:
449          (1) disregard for a patient's dignity or right to privacy as to the patient's person,
450     condition, possessions, or medical record;
451          (2) engaging in an act, practice, or omission which when considered with the duties
452     and responsibilities of a certified nurse midwife does or could jeopardize the health, safety, or
453     welfare of a patient or the public;
454          (3) failure to confine one's practice as a certified nurse midwife to those acts or
455     practices permitted by law;
456          (4) failure to file or record any medical report as required by law, impeding or
457     obstructing the filing or recording of such a report, or inducing another to fail to file or record
458     such a report;

459          (5) breach of a statutory, common law, regulatory, or ethical requirement of
460     confidentiality with respect to a person who is a patient, unless ordered by the court;
461          (6) failure to pay a penalty imposed by the division;
462          (7) prescribing a schedule II-III controlled substance without a consulting physician;
463          (8) performing or inducing an abortion in violation of the requirements of Section
464     76-7-302 or Section 76-7a-201, regardless of whether the individual licensed under this chapter
465     is found guilty of a crime in connection with the violation;
466          [(8)] (9) (a) failure to have and maintain a safe mechanism for obtaining medical
467     consultation, collaboration, and referral with a consulting physician, including failure to
468     identify one or more consulting physicians in the written documents required by Subsection
469     58-44a-102(9)(b)(iii); or
470          (b) representing that the certified nurse midwife is in compliance with Subsection
471     [(8)(a)] (9)(a) when the certified nurse midwife is not in compliance with Subsection [(8)(a)]
472     (9)(a); or
473          [(9)] (10) falsely making an entry in, or altering, a medical record with the intent to
474     conceal:
475          (a) a wrongful or negligent act or omission of an individual licensed under this chapter
476     or an individual under the direction or control of an individual licensed under this chapter; or
477          (b) conduct described in Subsections (1) through [(8)] (9) or Subsection 58-1-501(1).
478          Section 9. Section 58-67-304 is amended to read:
479          58-67-304. License renewal requirements.
480          (1) As a condition precedent for license renewal, each licensee shall, during each
481     two-year licensure cycle or other cycle defined by division rule:
482          (a) complete qualified continuing professional education requirements in accordance
483     with the number of hours and standards defined by division rule made in collaboration with the
484     board;
485          (b) appoint a contact person for access to medical records and an alternate contact
486     person for access to medical records in accordance with Subsection 58-67-302(1)(i);
487          (c) if the licensee practices medicine in a location with no other persons licensed under
488     this chapter, provide some method of notice to the licensee's patients of the identity and
489     location of the contact person and alternate contact person for the licensee; and

490          (d) if the licensee is an associate physician licensed under Section 58-67-302.8,
491     successfully complete the educational methods and programs described in Subsection
492     58-67-807(4).
493          (2) If a renewal period is extended or shortened under Section 58-67-303, the
494     continuing education hours required for license renewal under this section are increased or
495     decreased proportionally.
496          (3) (a) An application to renew a license under this chapter shall:
497          [(a)] (i) require a physician to answer the following question: "Do you perform elective
498     abortions in Utah in a location other than a hospital?"; and
499          [(b)] (ii) immediately following the question, contain the following statement: "For
500     purposes of the immediately preceding question, elective abortion means an abortion other than
501     one of the following: removal of a dead fetus, removal of an ectopic pregnancy, an abortion
502     that is necessary to avert the death of a woman, an abortion that is necessary to avert a serious
503     physical risk of substantial [and irreversible] impairment of a major bodily function of a
504     woman, an abortion of a fetus that has a defect that is uniformly diagnosable and uniformly
505     lethal, or an abortion where the woman is pregnant as a result of rape or incest."
506          (b) The statement in Subsection (3)(a)(ii) shall be modified, if necessary, to ensure
507     compliance with the definitions and requirements of Title 76, Chapter 7, Part 3, Abortion, and
508     Title 76, Chapter 7a, Abortion Prohibition.
509          (4) In order to assist the Department of Health and Human Services in fulfilling [its]
510     the department's responsibilities relating to the licensing of [an abortion clinic] a health care
511     facility and the enforcement of Title 76, Chapter 7, Part 3, Abortion, and Title 76, Chapter 7a,
512     Abortion Prohibition, if a physician responds positively to the question described in Subsection
513     [(3)(a),] (3)(a)(i) the division shall, within 30 days after the day on which [it] the division
514     renews the physician's license under this chapter, inform the Department of Health and Human
515     Services in writing:
516          (a) of the name and business address of the physician; and
517          (b) that the physician responded positively to the question described in Subsection
518     [(3)(a)] (3)(a)(i).
519          (5) The division shall accept and apply toward the hour requirement in Subsection
520     (1)(a) any continuing education that a physician completes in accordance with Sections

521     26-61a-106 and 26-61a-403.
522          Section 10. Section 58-67-502 is amended to read:
523          58-67-502. Unprofessional conduct.
524          (1) "Unprofessional conduct" includes, in addition to the definition in Section
525     58-1-501:
526          (a) using or employing the services of any individual to assist a licensee in any manner
527     not in accordance with the generally recognized practices, standards, or ethics of the
528     profession, state law, or division rule;
529          (b) making a material misrepresentation regarding the qualifications for licensure under
530     Section 58-67-302.7 or Section 58-67-302.8;
531          (c) violating the dispensing requirements of Chapter 17b, Part 8, Dispensing Medical
532     Practitioner and Dispensing Medical Practitioner Clinic Pharmacy, if applicable;
533          (d) violating the requirements of Title 26, Chapter 61a, Utah Medical Cannabis Act;
534     [or]
535          (e) performing or inducing an abortion in violation of the requirements of Section
536     76-7-302 or Section 76-7a-201, regardless of whether the individual licensed under this chapter
537     is found guilty of a crime in connection with the violation; or
538          [(e)] (f) falsely making an entry in, or altering, a medical record with the intent to
539     conceal:
540          (i) a wrongful or negligent act or omission of an individual licensed under this chapter
541     or an individual under the direction or control of an individual licensed under this chapter; or
542          (ii) conduct described in Subsections (1)(a) through [(d)] (e) or Subsection
543     58-1-501(1).
544          (2) "Unprofessional conduct" does not include:
545          (a) in compliance with Section 58-85-103:
546          (i) obtaining an investigational drug or investigational device;
547          (ii) administering the investigational drug to an eligible patient; or
548          (iii) treating an eligible patient with the investigational drug or investigational device;
549     or
550          (b) in accordance with Title 26, Chapter 61a, Utah Medical Cannabis Act:
551          (i) when registered as a qualified medical provider or acting as a limited medical

552     provider, as those terms are defined in Section 26-61a-102, recommending the use of medical
553     cannabis;
554          (ii) when registered as a pharmacy medical provider, as that term is defined in Section
555     26-61a-102, providing pharmacy medical provider services in a medical cannabis pharmacy; or
556          (iii) when registered as a state central patient portal medical provider, as that term is
557     defined in Section 26-61a-102, providing state central patient portal medical provider services.
558          (3) Notwithstanding Subsection (2)(b), the division, in consultation with the board and
559     in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, shall define
560     unprofessional conduct for a physician described in Subsection (2)(b).
561          Section 11. Section 58-68-304 is amended to read:
562          58-68-304. License renewal requirements.
563          (1) As a condition precedent for license renewal, each licensee shall, during each
564     two-year licensure cycle or other cycle defined by division rule:
565          (a) complete qualified continuing professional education requirements in accordance
566     with the number of hours and standards defined by division rule in collaboration with the
567     board;
568          (b) appoint a contact person for access to medical records and an alternate contact
569     person for access to medical records in accordance with Subsection 58-68-302(1)(i);
570          (c) if the licensee practices osteopathic medicine in a location with no other persons
571     licensed under this chapter, provide some method of notice to the licensee's patients of the
572     identity and location of the contact person and alternate contact person for access to medical
573     records for the licensee in accordance with Subsection 58-68-302(1)(j); and
574          (d) if the licensee is an associate physician licensed under Section 58-68-302.5,
575     successfully complete the educational methods and programs described in Subsection
576     58-68-807(4).
577          (2) If a renewal period is extended or shortened under Section 58-68-303, the
578     continuing education hours required for license renewal under this section are increased or
579     decreased proportionally.
580          (3) (a) An application to renew a license under this chapter shall:
581          [(a)] (i) require a physician to answer the following question: "Do you perform elective
582     abortions in Utah in a location other than a hospital?"; and

583          [(b)] (ii) immediately following the question, contain the following statement: "For
584     purposes of the immediately preceding question, elective abortion means an abortion other than
585     one of the following: removal of a dead fetus, removal of an ectopic pregnancy, an abortion
586     that is necessary to avert the death of a woman, an abortion that is necessary to avert a serious
587     physical risk of substantial [and irreversible] impairment of a major bodily function of a
588     woman, an abortion of a fetus that has a defect that is uniformly diagnosable and uniformly
589     lethal, or an abortion where the woman is pregnant as a result of rape or incest."
590          (b) The statement in Subsection (3)(a)(ii) shall be modified, if necessary, to ensure
591     compliance with the definitions and requirements of Title 76, Chapter 7, Part 3, Abortion, and
592     Title 76, Chapter 7a, Abortion Prohibition.
593          (4) In order to assist the Department of Health and Human Services in fulfilling [its]
594     the department's responsibilities relating to the licensing of [an abortion clinic] a health care
595     facility and the enforcement of Title 76, Chapter 7, Part 3, Abortion, and Title 76, Chapter 7a,
596     Abortion Prohibition, if a physician responds positively to the question described in Subsection
597     [(3)(a)] (3)(a)(i), the division shall, within 30 days after the day on which it renews the
598     physician's license under this chapter, inform the Department of Health and Human Services in
599     writing:
600          (a) of the name and business address of the physician; and
601          (b) that the physician responded positively to the question described in Subsection
602     [(3)(a)] (3)(a)(i).
603          (5) The division shall accept and apply toward the hour requirement in Subsection
604     (1)(a) any continuing education that a physician completes in accordance with Sections
605     26-61a-106 and 26-61a-403.
606          Section 12. Section 58-68-502 is amended to read:
607          58-68-502. Unprofessional conduct.
608          (1) "Unprofessional conduct" includes, in addition to the definition in Section
609     58-1-501:
610          (a) using or employing the services of any individual to assist a licensee in any manner
611     not in accordance with the generally recognized practices, standards, or ethics of the
612     profession, state law, or division rule;
613          (b) violating the dispensing requirements of Chapter 17b, Part 8, Dispensing Medical

614     Practitioner and Dispensing Medical Practitioner Clinic Pharmacy, if applicable;
615          (c) making a material misrepresentation regarding the qualifications for licensure under
616     Section 58-68-302.5;
617          (d) violating the requirements of Title 26, Chapter 61a, Utah Medical Cannabis Act;
618     [or]
619          (e) performing or inducing an abortion in violation of the requirements of Section
620     76-7-302 or Section 76-7a-201, regardless of whether the individual licensed under this chapter
621     is found guilty of a crime in connection with the violation; or
622          [(e)] (f) falsely making an entry in, or altering, a medical record with the intent to
623     conceal:
624          (i) a wrongful or negligent act or omission of an individual licensed under this chapter
625     or an individual under the direction or control of an individual licensed under this chapter; or
626          (ii) conduct described in Subsections (1)(a) through [(d)] (e) or Subsection
627     58-1-501(1).
628          (2) "Unprofessional conduct" does not include:
629          (a) in compliance with Section 58-85-103:
630          (i) obtaining an investigational drug or investigational device;
631          (ii) administering the investigational drug to an eligible patient; or
632          (iii) treating an eligible patient with the investigational drug or investigational device;
633     or
634          (b) in accordance with Title 26, Chapter 61a, Utah Medical Cannabis Act:
635          (i) when registered as a qualified medical provider or acting as a limited medical
636     provider, as those terms are defined in Section 26-61a-102, recommending the use of medical
637     cannabis;
638          (ii) when registered as a pharmacy medical provider, as that term is defined in Section
639     26-61a-102, providing pharmacy medical provider services in a medical cannabis pharmacy; or
640          (iii) when registered as a state central patient portal medical provider, as that term is
641     defined in Section 26-61a-102, providing state central patient portal medical provider services.
642          (3) Notwithstanding Subsection (2)(b), the division, in consultation with the board and
643     in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, shall define
644     unprofessional conduct for a physician described in Subsection (2)(b).

645          Section 13. Section 58-70a-501 is amended to read:
646          58-70a-501. Scope of practice.
647          (1) A physician assistant may provide any medical services that are not specifically
648     prohibited under this chapter or rules adopted under this chapter, and that are within the
649     physician assistant's skills and scope of competence.
650          (2) A physician assistant shall consult, collaborate with, and refer to appropriate
651     members of the health care team:
652          (a) as indicated by the patient's condition;
653          (b) based on the physician assistant's education, experience, and competencies;
654          (c) the applicable standard of care; and
655          (d) if applicable, in accordance with the requirements described in Section 58-70a-307.
656          (3) Subject to Section 58-70a-307, the degree of collaboration under Subsection (2):
657          (a) shall be determined at the physician assistant's practice, including decisions made
658     by the physician assistant's:
659          (i) employer;
660          (ii) group;
661          (iii) hospital service; or
662          (iv) health care facility credentialing and privileging system; and
663          (b) may also be determined by a managed care organization with whom the physician
664     assistant is a network provider.
665          (4) A physician assistant may only provide healthcare services:
666          (a) for which the physician assistant has been trained and credentialed, privileged, or
667     authorized to perform; and
668          (b) that are within the physician assistant's practice specialty.
669          (5) A physician assistant may authenticate through a signature, certification, stamp,
670     verification, affidavit, or endorsement any document that may be authenticated by a physician
671     and that is within the physician assistant's scope of practice.
672          (6) A physician assistant is responsible for the care that the physician assistant
673     provides.
674          (7) (a) As used in this Subsection (7):
675          (i) "ALS/ACLS certification" means a certification:

676          (A) in advanced life support by the American Red Cross;
677          (B) in advanced cardiac life support by the American Heart Association; or
678          (C) that is equivalent to a certification described in Subsection (7)(a)(i)(A) or (B).
679          (ii) "Minimal sedation anxiolysis" means creating a drug induced state:
680          (A) during which a patient responds normally to verbal commands;
681          (B) which may impair cognitive function and physical coordination; and
682          (C) which does not affect airway, reflexes, or ventilatory and cardiovascular function.
683          (b) Except as provided in Subsections (c) through (e), a physician assistant may not
684     administer general anesthetics.
685          (c) A physician assistant may perform minimal sedation anxiolysis if the procedure is
686     within the physician assistant's scope of practice.
687          (d) A physician assistant may perform rapid sequence induction for intubation of a
688     patient if:
689          (i) the procedure is within the physician assistant's scope of practice;
690          (ii) the physician assistant holds a valid ALS/ACLS certification and is credentialed
691     and privileged at the hospital where the procedure is performed; and
692          (iii) (A) a qualified physician is not available and able to perform the procedure; or
693          (B) the procedure is performed by the physician assistant under supervision of or
694     delegation by a physician.
695          (e) Subsection (7)(b) does not apply to anesthetics administered by a physician
696     assistant:
697          (i) in an intensive care unit of a hospital;
698          (ii) for the purpose of enabling a patient to tolerate ventilator support or intubation; and
699          (iii) under supervision of or delegation by a physician whose usual scope of practice
700     includes the procedure.
701          (8) (a) A physician assistant may prescribe or administer an appropriate controlled
702     substance that is within the physician assistant's scope of practice if the physician assistant
703     holds a Utah controlled substance license and a DEA registration.
704          (b) A physician assistant may prescribe, order, administer, and procure a drug or
705     medical device that is within the physician assistant's scope of practice.
706          (c) A physician assistant may dispense a drug if dispensing the drug:

707          (i) is permitted under Title 58, Chapter 17b, Pharmacy Practice Act; and
708          (ii) is within the physician assistant's scope of practice.
709          (9) A physician assistant may not perform or induce an abortion in violation of the
710     requirements of Section 76-7-302 or Section 76-7a-201, regardless of whether the physician
711     assistant is found guilty of a crime in connection with the violation.
712          [(9)] (10) A physician assistant practicing independently may only perform or provide
713     a health care service that:
714          (a) is appropriate to perform or provide outside of a health care facility; and
715          (b) the physician assistant has been trained and credentialed or authorized to provide or
716     perform independently without physician supervision.
717          [(10)] (11) A physician assistant, while practicing as a physician assistant:
718          (a) shall wear an identification badge showing the physician assistant's license
719     classification as a physician assistant;
720          (b) shall identify themselves to a patient as a physician assistant; and
721          (c) may not identify themselves to any person in connection with activities allowed
722     under this chapter other than as a physician assistant or PA.
723          Section 14. Section 58-77-603 is amended to read:
724          58-77-603. Prohibited practices.
725          A direct-entry midwife may not:
726          (1) administer a prescription drug to a client in a manner that violates this chapter;
727          (2) effect any type of surgical delivery except for the cutting of an emergency
728     episiotomy;
729          (3) administer any type of epidural, spinal, or caudal anesthetic, or any type of narcotic
730     analgesia;
731          (4) use forceps or a vacuum extractor;
732          (5) manually remove the placenta, except in an emergency that presents an immediate
733     threat to the life of the client; or
734          (6) [induce abortion] perform or induce an abortion in violation of the requirements of
735     Section 76-7-302 or Section 76-7a-201, regardless of whether the direct-entry midwife is found
736     guilty of a crime in connection with the violation.
737          Section 15. Section 63I-2-276 is amended to read:

738          63I-2-276. Repeal dates: Title 76.
739          (1) Subsection 76-5-102.7(2)(b), regarding assault or threat of violence against an
740     owner, employee, or contractor of a health facility, is repealed January 1, 2027.
741          [(2) If Section 76-7-302.4 is not in effect before January 1, 2029, Section 76-7-302.4 is
742     repealed January 1, 2029.]
743          [(3)] (2) Section 76-7-305.7 is repealed January 1, 2023.
744          Section 16. Section 76-7-301 is amended to read:
745          76-7-301. Definitions.
746          As used in this part:
747          (1) (a) "Abortion" means[:] the act, by a physician, of using an instrument, or
748     prescribing a drug, with the intent to cause the death of an unborn child of a woman known to
749     be pregnant, except as permitted under this part.
750          [(i) the intentional termination or attempted termination of human pregnancy after
751     implantation of a fertilized ovum through a medical procedure carried out by a physician or
752     through a substance used under the direction of a physician;]
753          [(ii) the intentional killing or attempted killing of a live unborn child through a medical
754     procedure carried out by a physician or through a substance used under the direction of a
755     physician; or]
756          [(iii) the intentional causing or attempted causing of a miscarriage through a medical
757     procedure carried out by a physician or through a substance used under the direction of a
758     physician.]
759          (b) "Abortion" does not include:
760          (i) removal of a dead unborn child;
761          (ii) removal of an ectopic pregnancy; or
762          (iii) the killing or attempted killing of an unborn child without the consent of the
763     pregnant woman, unless:
764          (A) the killing or attempted killing is done through a medical procedure carried out by
765     a physician or through a substance used under the direction of a physician; and
766          (B) the physician is unable to obtain the consent due to a medical emergency.
767          [(2) "Abortion clinic" means the same as that term is defined in Section 26-21-2.]
768          [(3)] (2) "Abuse" means the same as that term is defined in Section 80-1-102.

769          [(4)] (3) "Department" means the Department of Health and Human Services.
770          [(5)] (4) "Down syndrome" means a genetic condition associated with an extra
771     chromosome 21, in whole or in part, or an effective trisomy for chromosome 21.
772          [(6)] (5) "Gestational age" means the age of an unborn child as calculated from the first
773     day of the last menstrual period of the pregnant woman.
774          [(7)] (6) "Hospital" means:
775          (a) a general hospital licensed by the department according to Title 26, Chapter 21,
776     Health Care Facility Licensing and Inspection Act; and
777          (b) a clinic or other medical facility [to the extent that such clinic or other medical
778     facility is certified by the department as providing equipment and personnel sufficient in
779     quantity and quality to provide the same degree of safety to the pregnant woman and the
780     unborn child as would be provided for the particular medical procedures undertaken by a
781     general hospital licensed by the department] that meets the following criteria:
782          (i) a clinician who performs procedures at the clinic is required to be credentialed to
783     perform the same procedures at a general hospital licensed by the department; and
784          (ii) any procedures performed at the clinic are done with the same level of safety for
785     the pregnant woman and unborn child as would be available in a general hospital licensed by
786     the department.
787          [(8)] (7) "Information module" means the pregnancy termination information module
788     prepared by the department.
789          [(9)] (8) "Medical emergency" means [that condition which, on the basis of the
790     physician's good faith clinical judgment, so threatens the life of a pregnant woman as to
791     necessitate the immediate abortion of her pregnancy to avert her death, or for which a delay
792     will create serious risk of substantial and irreversible impairment of major bodily function] a
793     life threatening physical condition aggravated by, caused by, or arising from a pregnancy that
794     places the pregnant woman at risk of death, or poses a serious risk of substantial impairment of
795     a major bodily function, unless the abortion is performed or induced.
796          [(10)] (9) "Minor" means an individual who is:
797          (a) under 18 years old;
798          (b) unmarried; and
799          (c) not emancipated.

800          [(11)] (10) (a) "Partial birth abortion" means an abortion in which the person
801     performing the abortion:
802          (i) deliberately and intentionally vaginally delivers a living fetus until, in the case of a
803     head first presentation, the entire fetal head is outside the body of the mother, or, in the case of
804     breech presentation, any part of the fetal trunk past the navel is outside the body of the mother,
805     for the purpose of performing an overt act that the person knows will kill the partially delivered
806     living fetus; and
807          (ii) performs the overt act, other than completion of delivery, that kills the partially
808     living fetus.
809          (b) "Partial birth abortion" does not include the dilation and evacuation procedure
810     involving dismemberment prior to removal, the suction curettage procedure, or the suction
811     aspiration procedure for abortion.
812          (11) "Perinatal hospice" means comprehensive support to the mother and her family
813     from the time of the diagnosis of a lethal fetal anomaly, through the time of the child's birth,
814     and through the postpartum period, that:
815          (a) focuses on alleviating fear and ensuring that the woman and her family experience
816     the life and death of a child in a comfortable and supportive environment; and
817          (b) may include counseling or medical care by:
818          (i) maternal-fetal medical specialists;
819          (ii) obstetricians;
820          (iii) neonatologists;
821          (iv) anesthesia specialists;
822          (v) psychiatrists, psychologists, or other mental health providers;
823          (vi) clergy;
824          (vii) social workers; or
825          (viii) specialty nurses.
826          (12) "Physician" means:
827          (a) a medical doctor licensed to practice medicine and surgery under Title 58, Chapter
828     67, Utah Medical Practice Act;
829          (b) an osteopathic physician licensed to practice osteopathic medicine under Title 58,
830     Chapter 68, Utah Osteopathic Medical Practice Act; or

831          (c) a physician employed by the federal government who has qualifications similar to
832     [a person] an individual described in Subsection (12)(a) or (b).
833          (13) (a) "Severe brain abnormality" means a malformation or defect that causes an
834     individual to live in a mentally vegetative state.
835          (b) "Severe brain abnormality" does not include:
836          (i) Down syndrome;
837          (ii) spina bifida;
838          (iii) cerebral palsy; or
839          (iv) any other malformation, defect, or condition that does not cause an individual to
840     live in a mentally vegetative state.
841          Section 17. Section 76-7-302 is amended to read:
842          76-7-302. Circumstances under which abortion authorized.
843          [(1) As used in this section, "viable" means that the unborn child has reached a stage of
844     fetal development when the unborn child is potentially able to live outside the womb, as
845     determined by the attending physician to a reasonable degree of medical certainty.]
846          [(2)] (1) An abortion may be performed in this state only by a physician.
847          [(3)] (2) An abortion may be performed in this state only under the following
848     circumstances:
849          (a) the unborn child [is not viable; or] has not reached 18 weeks gestational age;
850          (b) the unborn child [is viable, if:] has reached 18 weeks gestational age, and:
851          (i) the abortion is necessary to avert:
852          (A) the death of the woman on whom the abortion is performed; or
853          (B) a serious physical risk of substantial [and irreversible] impairment of a major
854     bodily function of the woman on whom the abortion is performed; or
855          (ii) subject to Subsection (4), two physicians who practice maternal fetal medicine
856     concur, in writing, in the patient's medical record that the fetus[:] has a fetal abnormality that in
857     the physicians' reasonable medical judgment is incompatible with life; or
858          [(A) has a defect that is uniformly diagnosable and uniformly lethal; or]
859          [(B) has a severe brain abnormality that is uniformly diagnosable; or]
860          [(iii) (A)]
861          (c) the unborn child has not reached 18 weeks gestational age and:

862          (i) (A) the woman is pregnant as a result of:
863          (I) rape, as described in Section 76-5-402;
864          (II) rape of a child, as described in Section 76-5-402.1; or
865          (III) incest, as described in Subsection 76-5-406(2)(j) or Section 76-7-102; [and] or
866          (B) the pregnant woman is under the age of 14; and
867          [(B)] (ii) before the abortion is performed, the physician who performs the abortion:
868          [(I)] (A) for an abortion authorized under Subsection (2)(c)(i)(A), verifies that the
869     incident described in Subsection [(3)(b)(iii)(A)] (2)(c)(i)(A) has been reported to law
870     enforcement; and
871          [(II)] (B) if applicable, complies with the requirements of Section 80-2-602.
872          [(4)] (3) An abortion may be performed only in [an abortion clinic or] a hospital, unless
873     it is necessary to perform the abortion in another location due to a medical emergency.
874          (4) If the unborn child has been diagnosed with a fetal abnormality that is incompatible
875     with life, at the time of the diagnosis, the physician shall inform the woman, both verbally and
876     in writing, that perinatal hospice and perinatal palliative care services are available and are an
877     alternative to abortion.
878          Section 18. Section 76-7-302.4 is amended to read:
879          76-7-302.4. Abortion restriction of an unborn child with Down syndrome.
880          Notwithstanding any other provision of this part, an abortion may not be performed if
881     the pregnant mother's sole reason for the abortion is that the unborn child has or may have
882     Down syndrome, unless the abortion is permissible for a reason described in [Subsection
883     76-7-302(3)(b)] Section 76-7-302.
884          Section 19. Section 76-7-304 is amended to read:
885          76-7-304. Considerations by physician -- Notice to a parent or guardian --
886     Exceptions.
887          (1) To enable the physician to exercise the physician's best medical judgment, the
888     physician shall consider all factors relevant to the well-being of a pregnant woman upon whom
889     an abortion is to be performed, including:
890          (a) her physical, emotional, and psychological health and safety;
891          (b) her age; and
892          (c) her familial situation.

893          (2) Subject to Subsection (3), at least 24 hours before a physician performs an abortion
894     on a minor, the physician shall notify a parent or guardian of the minor that the minor intends
895     to have an abortion.
896          (3) A physician is not required to comply with Subsection (2) if:
897          (a) subject to Subsection (4)(a):
898          (i) a medical condition exists that, on the basis of the physician's good faith clinical
899     judgment, so complicates the medical condition of a pregnant minor as to necessitate the
900     abortion of her pregnancy to avert:
901          (A) the minor's death; or
902          (B) a serious physical risk of substantial [and irreversible] impairment of a major
903     bodily function of the minor; and
904          (ii) there is not sufficient time to give the notice required under Subsection (2) before it
905     is necessary to terminate the minor's pregnancy in order to avert the minor's death or
906     impairment described in Subsection (3)(a)(i);
907          (b) subject to Subsection (4)(b):
908          (i) the physician complies with Subsection (5); and
909          (ii) (A) the minor is pregnant as a result of incest to which the parent or guardian was a
910     party; or
911          (B) the parent or guardian has abused the minor; or
912          (c) subject to Subsection (4)(b), the parent or guardian has not assumed responsibility
913     for the minor's care and upbringing.
914          (4) (a) If, for the reason described in Subsection (3)(a), a physician does not give the
915     24-hour notice described in Subsection (2), the physician shall give the required notice as early
916     as possible before the abortion, unless it is necessary to perform the abortion immediately in
917     order to avert the minor's death or impairment described in Subsection (3)(a)(i).
918          (b) If, for a reason described in Subsection (3)(b) or (c), a parent or guardian of a minor
919     is not notified that the minor intends to have an abortion, the physician shall notify another
920     parent or guardian of the minor, if the minor has another parent or guardian that is not exempt
921     from notification under Subsection (3)(b) or (c).
922          (5) If, for a reason described in Subsection (3)(b)(ii)(A) or (B), a physician does not
923     notify a parent or guardian of a minor that the minor intends to have an abortion, the physician

924     shall report the incest or abuse to the Division of Child and Family Services within the
925     Department of Health and Human Services.
926          Section 20. Section 76-7-304.5 is amended to read:
927          76-7-304.5. Consent required for abortions performed on minors -- Division of
928     Child and Family Services as guardian of a minor -- Hearing to allow a minor to
929     self-consent -- Appeals.
930          (1) In addition to the other requirements of this part, a physician may not perform an
931     abortion on a minor unless:
932          (a) the physician obtains the informed written consent of a parent or guardian of the
933     minor, in accordance with Sections 76-7-305 and 76-7-305.5;
934          (b) the minor is granted the right, by court order under Subsection (4)(b), to consent to
935     the abortion without obtaining consent from a parent or guardian; or
936          (c) (i) a medical condition exists that, on the basis of the physician's good faith clinical
937     judgment, so complicates the medical condition of a pregnant minor as to necessitate the
938     abortion of her pregnancy to avert:
939          (A) the minor's death; or
940          (B) a [serious risk of substantial and irreversible impairment of a major bodily function
941     of the minor] risk described in Subsection 76-7-302(2)(b)(i)(B); and
942          (ii) there is not sufficient time to obtain the consent in the manner chosen by the minor
943     under Subsection (2) before it is necessary to terminate the minor's pregnancy in order to avert
944     the minor's death or impairment described in Subsection (1)(c)(i).
945          (2) (a) A minor who wants to have an abortion may choose:
946          (i) to seek consent from the minor's parent or guardian as described in Subsection (1);
947     or
948          (ii) to seek a court order as described in Subsection (1).
949          (b) Neither Subsection (1) nor this Subsection (2) require the minor to seek or obtain
950     consent from the minor's parent or guardian if the circumstances described in Subsection
951     76-7-304(3)(b)(ii) exist.
952          (3) If a minor does not obtain the consent of the minor's parent or guardian, the minor
953     may file a petition with the juvenile court to obtain a court order as described in Subsection (1).
954          (4) (a) The juvenile court shall close the hearing on a petition described in Subsection

955     (3) to the public.
956          (b) After considering the evidence presented at the hearing, the court shall order that
957     the minor may obtain an abortion without the consent of a parent or guardian of the minor if
958     the court finds by a preponderance of the evidence that:
959          (i) the minor:
960          (A) has given her informed consent to the abortion; and
961          (B) is mature and capable of giving informed consent to the abortion; or
962          (ii) an abortion would be in the minor's best interest.
963          (5) The Judicial Council shall make rules that:
964          (a) provide for the administration of the proceedings described in this section;
965          (b) provide for the appeal of a court's decision under this section;
966          (c) ensure the confidentiality of the proceedings described in this section and the
967     records related to the proceedings; and
968          (d) establish procedures to expedite the hearing and appeal proceedings described in
969     this section.
970          Section 21. Section 76-7-305 is amended to read:
971          76-7-305. Informed consent requirements for abortion -- 72-hour wait mandatory
972     -- Exceptions.
973          (1) A person may not perform an abortion, unless, before performing the abortion, the
974     physician who will perform the abortion obtains from the woman on whom the abortion is to
975     be performed a voluntary and informed written consent that is consistent with:
976          (a) Section 8.08 of the American Medical Association's Code of Medical Ethics,
977     Current Opinions; and
978          (b) the provisions of this section.
979          (2) Except as provided in Subsection (8), consent to an abortion is voluntary and
980     informed only if, at least 72 hours before the abortion:
981          (a) a staff member of [an abortion clinic or] a hospital, physician, registered nurse,
982     nurse practitioner, advanced practice registered nurse, certified nurse midwife, genetic
983     counselor, or physician's assistant presents the information module to the pregnant woman;
984          (b) the pregnant woman views the entire information module and presents evidence to
985     the individual described in Subsection (2)(a) that the pregnant woman viewed the entire

986     information module;
987          (c) after receiving the evidence described in Subsection (2)(b), the individual described
988     in Subsection (2)(a):
989          (i) documents that the pregnant woman viewed the entire information module;
990          (ii) gives the pregnant woman, upon her request, a copy of the documentation
991     described in Subsection (2)(c)(i); and
992          (iii) provides a copy of the statement described in Subsection (2)(c)(i) to the physician
993     who is to perform the abortion, upon request of that physician or the pregnant woman;
994          (d) after the pregnant woman views the entire information module, the physician who
995     is to perform the abortion, the referring physician, a physician, a registered nurse, nurse
996     practitioner, advanced practice registered nurse, certified nurse midwife, genetic counselor, or
997     physician's assistant, in a face-to-face consultation in any location in the state, orally informs
998     the woman of:
999          (i) the nature of the proposed abortion procedure;
1000          (ii) specifically how the procedure described in Subsection (2)(d)(i) will affect the
1001     fetus;
1002          (iii) the risks and alternatives to the abortion procedure or treatment;
1003          (iv) the options and consequences of aborting a medication-induced abortion, if the
1004     proposed abortion procedure is a medication-induced abortion;
1005          (v) the probable gestational age and a description of the development of the unborn
1006     child at the time the abortion would be performed;
1007          (vi) the medical risks associated with carrying her child to term;
1008          (vii) the right to view an ultrasound of the unborn child, at no expense to the pregnant
1009     woman, upon her request; and
1010          (viii) when the result of a prenatal screening or diagnostic test indicates that the unborn
1011     child has or may have Down syndrome, the [Department of Health website containing]
1012     department's website, which contains the information described in Section 26-10-14, including
1013     the information on the informational support sheet; and
1014          (e) after the pregnant woman views the entire information module, a staff member of
1015     the [abortion clinic or] hospital provides to the pregnant woman:
1016          (i) on a document that the pregnant woman may take home:

1017          (A) the address for the department's website described in Section 76-7-305.5; and
1018          (B) a statement that the woman may request, from a staff member of the [abortion
1019     clinic or] hospital where the woman viewed the information module, a printed copy of the
1020     material on the department's website;
1021          (ii) a printed copy of the material on the department's website described in Section
1022     76-7-305.5, if requested by the pregnant woman; and
1023          (iii) a copy of the form described in Subsection 26-21-33(3)(a)(i) regarding the
1024     disposition of the aborted fetus.
1025          (3) Before performing an abortion, the physician who is to perform the abortion shall:
1026          (a) in a face-to-face consultation, provide the information described in Subsection
1027     (2)(d), unless the attending physician or referring physician is the individual who provided the
1028     information required under Subsection (2)(d); and
1029          (b) (i) obtain from the pregnant woman a written certification that the information
1030     required to be provided under Subsection (2) and this Subsection (3) was provided in
1031     accordance with the requirements of Subsection (2) and this Subsection (3);
1032          (ii) obtain a copy of the statement described in Subsection (2)(c)(i); and
1033          (iii) ensure that:
1034          (A) the woman has received the information described in Subsections 26-21-33(3) and
1035     (4); and
1036          (B) if the woman has a preference for the disposition of the aborted fetus, the woman
1037     has informed the health care facility of the woman's decision regarding the disposition of the
1038     aborted fetus.
1039          (4) When a [serious] medical emergency compels the performance of an abortion, the
1040     physician shall inform the woman prior to the abortion, if possible, of the medical indications
1041     supporting the physician's judgment that an abortion is necessary.
1042          (5) If an ultrasound is performed on a woman before an abortion is performed, the
1043     individual who performs the ultrasound, or another qualified individual, shall:
1044          (a) inform the woman that the ultrasound images will be simultaneously displayed in a
1045     manner to permit her to:
1046          (i) view the images, if she chooses to view the images; or
1047          (ii) not view the images, if she chooses not to view the images;

1048          (b) simultaneously display the ultrasound images in order to permit the woman to:
1049          (i) view the images, if she chooses to view the images; or
1050          (ii) not view the images, if she chooses not to view the images;
1051          (c) inform the woman that, if she desires, the person performing the ultrasound, or
1052     another qualified person shall provide a detailed description of the ultrasound images,
1053     including:
1054          (i) the dimensions of the unborn child;
1055          (ii) the presence of cardiac activity in the unborn child, if present and viewable; and
1056          (iii) the presence of external body parts or internal organs, if present and viewable; and
1057          (d) provide the detailed description described in Subsection (5)(c), if the woman
1058     requests it.
1059          (6) The information described in Subsections (2), (3), and (5) is not required to be
1060     provided to a pregnant woman under this section if the abortion is performed for a reason
1061     described in:
1062          (a) Subsection [76-7-302(3)(b)(i)] 76-7-302(2)(b)(i), if the treating physician and one
1063     other physician concur, in writing, that the abortion is necessary to avert:
1064          (i) the death of the woman on whom the abortion is performed; or
1065          (ii) a [serious risk of substantial and irreversible impairment of a major bodily function
1066     of the woman on whom the abortion is performed] risk described in Subsection
1067     76-7-302(2)(b)(i)(B); or
1068          (b) Subsection [76-7-302(3)(b)(ii)] 76-7-302(2)(b)(ii).
1069          (7) In addition to the criminal penalties described in this part, a physician who violates
1070     the provisions of this section:
1071          (a) is guilty of unprofessional conduct as defined in Section 58-67-102 or 58-68-102;
1072     and
1073          (b) shall be subject to:
1074          (i) suspension or revocation of the physician's license for the practice of medicine and
1075     surgery in accordance with Section 58-67-401 or 58-68-401; and
1076          (ii) administrative penalties in accordance with Section 58-67-402 or 58-68-402.
1077          (8) A physician is not guilty of violating this section for failure to furnish any of the
1078     information described in Subsection (2) or (3), or for failing to comply with Subsection (5), if:

1079          (a) the physician can demonstrate by a preponderance of the evidence that the
1080     physician reasonably believed that furnishing the information would have resulted in a severely
1081     adverse effect on the physical or mental health of the pregnant woman;
1082          (b) in the physician's professional judgment, the abortion was necessary to avert:
1083          (i) the death of the woman on whom the abortion is performed; or
1084          (ii) a [serious risk of substantial and irreversible impairment of a major bodily function
1085     of the woman on whom the abortion is performed] risk described in Subsection
1086     76-7-302(2)(b)(i)(B);
1087          (c) the pregnancy was the result of rape or rape of a child, as described in Sections
1088     76-5-402 and 76-5-402.1;
1089          (d) the pregnancy was the result of incest, as defined in Subsection 76-5-406(2)(j) and
1090     Section 76-7-102; or
1091          (e) at the time of the abortion, the pregnant woman was 14 years old or younger.
1092          (9) A physician who complies with the provisions of this section and Section
1093     76-7-304.5 may not be held civilly liable to the physician's patient for failure to obtain
1094     informed consent under Section 78B-3-406.
1095          (10) (a) The department shall provide an ultrasound, in accordance with the provisions
1096     of Subsection (5)(b), at no expense to the pregnant woman.
1097          (b) A local health department shall refer a pregnant woman who requests an ultrasound
1098     described in Subsection (10)(a) to the department.
1099          (11) A physician is not guilty of violating this section if:
1100          (a) the information described in Subsection (2) is provided less than 72 hours before
1101     the physician performs the abortion; and
1102          (b) in the physician's professional judgment, the abortion was necessary in a case
1103     where:
1104          (i) a ruptured membrane, documented by the attending or referring physician, will
1105     cause a serious infection; or
1106          (ii) a serious infection, documented by the attending or referring physician, will cause a
1107     ruptured membrane.
1108          Section 22. Section 76-7-305.5 is amended to read:
1109          76-7-305.5. Requirements for information module and website.

1110          (1) In order to ensure that a woman's consent to an abortion is truly an informed
1111     consent, the department shall, in accordance with the requirements of this section, develop an
1112     information module and maintain a public website.
1113          (2) The information module and public website described in Subsection (1) shall:
1114          (a) be scientifically accurate, comprehensible, and presented in a truthful,
1115     nonmisleading manner;
1116          (b) present adoption as a preferred and positive choice and alternative to abortion;
1117          (c) be produced in a manner that conveys the state's preference for childbirth over
1118     abortion;
1119          (d) state that the state prefers childbirth over abortion;
1120          (e) state that it is unlawful for any person to coerce a woman to undergo an abortion;
1121          (f) state that any physician who performs an abortion without obtaining the woman's
1122     informed consent or without providing her a private medical consultation in accordance with
1123     the requirements of this section, may be liable to her for damages in a civil action at law;
1124          (g) provide a geographically indexed list of resources and public and private services
1125     available to assist, financially or otherwise, a pregnant woman during pregnancy, at childbirth,
1126     and while the child is dependent, including:
1127          (i) medical assistance benefits for prenatal care, childbirth, and neonatal care;
1128          (ii) services and supports available under Section 35A-3-308;
1129          (iii) other financial aid that may be available during an adoption;
1130          (iv) services available from public adoption agencies, private adoption agencies, and
1131     private attorneys whose practice includes adoption; and
1132          (v) the names, addresses, and telephone numbers of each person listed under this
1133     Subsection (2)(g);
1134          (h) describe the adoption-related expenses that may be paid under Section 76-7-203;
1135          (i) describe the persons who may pay the adoption related expenses described in
1136     Subsection (2)(h);
1137          (j) except as provided in Subsection (4), describe the legal responsibility of the father
1138     of a child to assist in child support, even if the father has agreed to pay for an abortion;
1139          (k) except as provided in Subsection (4), describe the services available through the
1140     Office of Recovery Services, within the Department of Human Services, to establish and

1141     collect the support described in Subsection (2)(j);
1142          (l) state that private adoption is legal;
1143          (m) describe and depict, with pictures or video segments, the probable anatomical and
1144     physiological characteristics of an unborn child at two-week gestational increments from
1145     fertilization to full term, including:
1146          (i) brain and heart function;
1147          (ii) the presence and development of external members and internal organs; and
1148          (iii) the dimensions of the fetus;
1149          (n) show an ultrasound of the heartbeat of an unborn child at:
1150          (i) four weeks from conception;
1151          (ii) six to eight weeks from conception; and
1152          (iii) each month after 10 weeks gestational age, up to 14 weeks gestational age;
1153          (o) describe abortion procedures used in current medical practice at the various stages
1154     of growth of the unborn child, including:
1155          (i) the medical risks associated with each procedure;
1156          (ii) the risk related to subsequent childbearing that are associated with each procedure;
1157     and
1158          (iii) the consequences of each procedure to the unborn child at various stages of fetal
1159     development;
1160          (p) describe the possible detrimental psychological effects of abortion;
1161          (q) describe the medical risks associated with carrying a child to term;
1162          (r) include relevant information on the possibility of an unborn child's survival at the
1163     two-week gestational increments described in Subsection (2)(m);
1164          (s) except as provided in Subsection (5), include:
1165          (i) information regarding substantial medical evidence from studies concluding that an
1166     unborn child who is at least 20 weeks gestational age may be capable of experiencing pain
1167     during an abortion procedure; and
1168          (ii) the measures that will be taken in accordance with Section 76-7-308.5;
1169          (t) explain the options and consequences of aborting a medication-induced abortion;
1170          (u) include the following statement regarding a medication-induced abortion,
1171     "Research indicates that mifepristone alone is not always effective in ending a pregnancy. You

1172     may still have a viable pregnancy after taking mifepristone. If you have taken mifepristone but
1173     have not yet taken the second drug and have questions regarding the health of your fetus or are
1174     questioning your decision to terminate your pregnancy, you should consult a physician
1175     immediately.";
1176          (v) inform a pregnant woman that she has the right to view an ultrasound of the unborn
1177     child, at no expense to her, upon her request;
1178          (w) inform a pregnant woman that she has the right to:
1179          (i) determine the final disposition of the remains of the aborted fetus;
1180          (ii) unless the woman waives this right in writing, wait up to 72 hours after the
1181     abortion procedure is performed to make a determination regarding the disposition of the
1182     aborted fetus before the health care facility may dispose of the fetal remains;
1183          (iii) receive information about options for disposition of the aborted fetus, including
1184     the method of disposition that is usual and customary for a health care facility; and
1185          (iv) for a medication-induced abortion, return the aborted fetus to the health care
1186     facility for disposition; and
1187          (x) provide a digital copy of the form described in Subsection 26-21-33(3)(a)(i); and
1188          (y) be in a typeface large enough to be clearly legible.
1189          (3) The information module and website described in Subsection (1) may include a
1190     toll-free 24-hour telephone number that may be called in order to obtain, orally, a list and
1191     description of services, agencies, and adoption attorneys in the locality of the caller.
1192          (4) The department may develop a version of the information module and website that
1193     omits the information in Subsections (2)(j) and (k) for a viewer who is pregnant as the result of
1194     rape.
1195          (5) The department may develop a version of the information module and website that
1196     omits the information described in Subsection (2)(s) for a viewer who will have an abortion
1197     performed:
1198          (a) on an unborn child who is less than 20 weeks gestational age at the time of the
1199     abortion; or
1200          (b) on an unborn child who is at least 20 weeks gestational age at the time of the
1201     abortion, if:
1202          (i) the abortion is being performed for a reason described in Subsection

1203     [76-7-302(3)(b)(i)] 76-7-302(2)(b)(i) or (ii); and
1204          (ii) due to a serious medical emergency, time does not permit compliance with the
1205     requirement to provide the information described in Subsection (2)(s).
1206          (6) The department and each local health department shall make the information
1207     module and the website described in Subsection (1) available at no cost to any person.
1208          (7) The department shall make the website described in Subsection (1) available for
1209     viewing on the department's website by clicking on a conspicuous link on the home page of the
1210     website.
1211          (8) The department shall ensure that the information module is:
1212          (a) available to be viewed at all facilities where an abortion may be performed;
1213          (b) interactive for the individual viewing the module, including the provision of
1214     opportunities to answer questions and manually engage with the module before the module
1215     transitions from one substantive section to the next;
1216          (c) produced in English and may include subtitles in Spanish or another language; and
1217          (d) capable of being viewed on a tablet or other portable device.
1218          (9) After the department releases the initial version of the information module, for the
1219     use described in Section 76-7-305, the department shall:
1220          (a) update the information module, as required by law; and
1221          (b) present an updated version of the information module to the Health and Human
1222     Services Interim Committee for the committee's review and recommendation before releasing
1223     the updated version for the use described in Section 76-7-305.
1224          Section 23. Section 76-7-313 is amended to read:
1225          76-7-313. Department's enforcement responsibility -- Physician's report to
1226     department.
1227          (1) In order for the department to maintain necessary statistical information and ensure
1228     enforcement of the provisions of this part:
1229          (a) any physician performing an abortion must obtain and record in writing:
1230          (i) the age, marital status, and county of residence of the woman on whom the abortion
1231     was performed;
1232          (ii) the number of previous abortions performed on the woman described in Subsection
1233     (1)(a)(i);

1234          (iii) the hospital or other facility where the abortion was performed;
1235          (iv) the weight in grams of the unborn child aborted, if it is possible to ascertain;
1236          (v) the pathological description of the unborn child;
1237          (vi) the given gestational age of the unborn child;
1238          (vii) the date the abortion was performed;
1239          (viii) the measurements of the unborn child, if possible to ascertain; and
1240          (ix) the medical procedure used to abort the unborn child; and
1241          (b) the department shall make rules in accordance with Title 63G, Chapter 3, Utah
1242     Administrative Rulemaking Act.
1243          (2) Each physician who performs an abortion shall provide the following to the
1244     department within 30 days after the day on which the abortion is performed:
1245          (a) the information described in Subsection (1);
1246          (b) a copy of the pathologist's report described in Section 76-7-309;
1247          (c) an affidavit:
1248          (i) indicating whether the required consent was obtained pursuant to Sections 76-7-305
1249     and 76-7-305.5;
1250          (ii) described in Subsection (3), if applicable; and
1251          (iii) indicating whether at the time the physician performed the abortion, the physician
1252     had any knowledge that the pregnant woman sought the abortion solely because the unborn
1253     child had or may have had Down syndrome; and
1254          (d) a certificate indicating:
1255          [(i) whether the unborn child was or was not viable, as defined in Subsection
1256     76-7-302(1), at the time of the abortion;]
1257          [(ii)] (i) whether the unborn child was older or younger than 18 weeks gestational age
1258     at the time of the abortion; and
1259          [(iii)] (ii) [if the unborn child was viable, as defined in Subsection 76-7-302(1), or
1260     older than 18 weeks gestational age at the time of the abortion,] the reason for the abortion.
1261          (3) If the information module or the address to the website is not provided to a
1262     pregnant woman, the physician who performs the abortion on the woman shall, within 10 days
1263     after the day on which the abortion is performed, provide to the department an affidavit that:
1264          (a) specifies the information that was not provided to the woman; and

1265          (b) states the reason that the information was not provided to the woman.
1266          (4) All information supplied to the department shall be confidential and privileged
1267     pursuant to Title 26, Chapter 25, Confidential Information Release.
1268          (5) The department shall pursue all administrative and legal remedies when the
1269     department determines that a physician or a facility has not complied with the provisions of this
1270     part.
1271          Section 24. Section 76-7-314 is amended to read:
1272          76-7-314. Violations of abortion laws -- Classifications.
1273          (1) [A willful] An intentional violation of Section 76-7-307, 76-7-308, 76-7-310,
1274     76-7-310.5, 76-7-311, or 76-7-312 is a felony of the third degree.
1275          (2) A violation of Section 76-7-326 is a felony of the third degree.
1276          (3) A violation of Section [76-7-302.5 or] 76-7-314.5 is a felony of the second degree.
1277          (4) A violation of any other provision of this part, including Subsections
1278     76-7-305(2)(a) through (c), and (e), is a class A misdemeanor.
1279          (5) The [Department of Health] department shall report a physician's violation of any
1280     provision of this part to the Physicians Licensing Board, described in Section 58-67-201.
1281          (6) Any person with knowledge of a physician's violation of any provision of this part
1282     may report the violation to the Physicians Licensing Board, described in Section 58-67-201.
1283          (7) In addition to the penalties described in this section, the department may take any
1284     action described in Section 26-21-11 against [an abortion clinic] a health care facility if a
1285     violation of this chapter occurs at the [abortion clinic] health care facility.
1286          Section 25. Section 76-7-314.5 is amended to read:
1287          76-7-314.5. Killing an unborn child.
1288          (1) A person is guilty of killing an unborn child if the person intentionally causes the
1289     death of an unborn child by performing an abortion of the unborn child in violation of the
1290     provisions of Subsection [76-7-302(3)] 76-7-302(2).
1291          (2) A woman is not criminally liable for:
1292          (a) seeking to obtain, or obtaining, an abortion that is permitted by this part; or
1293          (b) a physician's failure to comply with Subsection [76-7-302(3)(b)(ii)]
1294     76-7-302(2)(b)(ii) or Section 76-7-305.
1295          Section 26. Section 76-7-317 is amended to read:

1296          76-7-317. Severability clause.
1297          If any one or more provision, section, subsection, sentence, clause, phrase, or word of
1298     this part or the application thereof to any person or circumstance is found to be
1299     unconstitutional, the same is hereby declared to be severable and the balance of this part shall
1300     remain effective notwithstanding such unconstitutionality. The legislature hereby declares that
1301     it would have passed this part, and each provision, section, subsection, sentence, clause, phrase,
1302     or word thereof, irrespective of the fact that any one or more provision, section, subsection,
1303     sentence, clause, phrase, or word be declared unconstitutional. This section applies to any
1304     provision, section, subsection, sentence, clause, phrase, or word of this part, regardless of the
1305     time of enactment, amendment, or repeal.
1306          Section 27. Section 76-7-332 is enacted to read:
1307          76-7-332. Drugs known to be used for abortion -- Prescriber limitation --
1308     Criminal penalties -- Pharmacy presumption for other use.
1309          (1) As used in the section, "abortion-related drug" means a drug or medication that is
1310     known to be used for the purpose of performing an abortion, and includes:
1311          (a) methotrexate, or methotrexate with misoprostol;
1312          (b) mifepristone, also known as mifeprex;
1313          (c) misoprostol, also known as cytotec; and
1314          (d) RU-486.
1315          (2) An individual may not prescribe an abortion-related drug for the purpose of causing
1316     an abortion, unless the individual is licensed as a physician in this state under:
1317          (a) Title 58, Chapter 67, Utah Medical Practice Act; or
1318          (b) Title 58, Chapter 68, Utah Osteopathic Medical Practice Act.
1319          (3) A violation of Subsection (2) is a class B misdemeanor.
1320          (4) (a) Any prescription or medical order for a drug that is known to possibly cause an
1321     abortion shall be presumed by a pharmacy to be for an indication other than for the termination
1322     of a pregnancy.
1323          (b) A pharmacy dispensing a prescription or medical order for a drug that is known to
1324     possibly cause an abortion shall not be required to verify whether the prescription or medical
1325     order violates any provision of this chapter.
1326          Section 28. Section 76-7a-101 is amended to read:

1327          76-7a-101. Definitions.
1328          As used in this chapter:
1329          (1) (a) "Abortion" means[:] the act, by a physician, of using an instrument, or
1330     prescribing a drug, with the intent to cause the death of an unborn child of a woman known to
1331     be pregnant, except as permitted under this chapter.
1332          [(i) the intentional termination or attempted termination of human pregnancy after
1333     implantation of a fertilized ovum through a medical procedure carried out by a physician or
1334     through a substance used under the direction of a physician;]
1335          [(ii) the intentional killing or attempted killing of a live unborn child through a medical
1336     procedure carried out by a physician or through a substance used under the direction of a
1337     physician; or]
1338          [(iii) the intentional causing or attempted causing of a miscarriage through a medical
1339     procedure carried out by a physician or through a substance used under the direction of a
1340     physician.]
1341          (b) "Abortion" does not include:
1342          (i) removal of a dead unborn child;
1343          (ii) removal of an ectopic pregnancy; or
1344          (iii) the killing or attempted killing of an unborn child without the consent of the
1345     pregnant woman, unless:
1346          (A) the killing or attempted killing is done through a medical procedure carried out by
1347     a physician or through a substance used under the direction of a physician; and
1348          (B) the physician is unable to obtain the consent due to a medical emergency.
1349          [(2) "Abortion clinic" means a type I abortion clinic licensed by the state or a type II
1350     abortion clinic licensed by the state.]
1351          [(3)] (2) "Department" means the Department of Health and Human Services.
1352          [(4)] (3) "Down syndrome" means a genetic condition associated with an extra
1353     chromosome 21, in whole or in part, or an effective trisomy for chromosome 21.
1354          [(5)] (4) "Hospital" means:
1355          (a) a general hospital licensed by the department; or
1356          (b) a clinic or other medical facility [to the extent the clinic or other medical facility is
1357     certified by the department as providing equipment and personnel sufficient in quantity and

1358     quality to provide the same degree of safety to a pregnant woman and an unborn child as would
1359     be provided for the particular medical procedure undertaken by a general hospital licensed by
1360     the department.] that meets the following criteria:
1361          (i) a clinician who performs procedures at the clinic is required to be credentialed to
1362     perform the same procedures at a general hospital licensed by the department; and
1363          (ii) any procedures performed at the clinic are done with the same level of safety for
1364     the pregnant woman and unborn child as would be available in a general hospital licensed by
1365     the department.
1366          [(6) "Incest" means the same as that term is defined in Section 80-1-102.]
1367          [(7)] (5) "Medical emergency" means a [condition which, on the basis of the
1368     physician's good faith clinical judgment, so threatens the life of a pregnant woman as to
1369     necessitate the immediate abortion of her pregnancy to avert her death, or for which a delay
1370     will create serious risk of substantial and irreversible impairment of major bodily function] life
1371     threatening physical condition aggravated by, caused by, or arising from a pregnancy that
1372     places the pregnant woman at risk of death, or poses a serious risk of substantial impairment of
1373     a major bodily function, unless the abortion is performed or induced.
1374          (6) "Perinatal hospice" means comprehensive support to the mother and her family
1375     from the time of the diagnosis of a lethal fetal anomaly, through the time of the child's birth,
1376     and through the postpartum period, that:
1377          (a) focuses on alleviating fear and ensuring that the woman and her family experience
1378     the life and death of a child in a comfortable and supportive environment; and
1379          (b) may include counseling or medical care by:
1380          (i) maternal-fetal medical specialists;
1381          (ii) obstetricians;
1382          (iii) neonatologists;
1383          (iv) anesthesia specialists;
1384          (v) psychiatrists, psychologists, or other mental health providers;
1385          (vi) clergy;
1386          (vii) social workers; or
1387          (viii) specialty nurses
1388          [(8)] (7) "Physician" means:

1389          (a) a medical doctor licensed to practice medicine and surgery in the state;
1390          (b) an osteopathic physician licensed to practice osteopathic medicine in the state; or
1391          (c) a physician employed by the federal government who has qualifications similar to
1392     an individual described in Subsection [(8)(a) or (b)] (7)(a) or (b).
1393          [(9) "Rape" means the same as that term is defined in Title 76, Utah Criminal Code.]
1394          [(10)] (8) (a) "Severe brain abnormality" means a malformation or defect that causes an
1395     individual to live in a mentally vegetative state.
1396          (b) "Severe brain abnormality" does not include:
1397          (i) Down syndrome;
1398          (ii) spina bifida;
1399          (iii) cerebral palsy; or
1400          (iv) any other malformation, defect, or condition that does not cause an individual to
1401     live in a mentally vegetative state.
1402          Section 29. Section 76-7a-201 is amended to read:
1403          76-7a-201. Abortion prohibition -- Exceptions -- Penalties.
1404          (1) An abortion may be performed in this state only under the following circumstances:
1405          (a) the abortion is necessary to avert:
1406          (i) the death of the woman on whom the abortion is performed; or
1407          (ii) a serious physical risk of substantial [and irreversible] impairment of a major
1408     bodily function of the woman on whom the abortion is performed;
1409          (b) subject to Subsection (3), two physicians who practice maternal fetal medicine
1410     concur, in writing, in the patient's medical record that the fetus[:] has a fetal abnormality that in
1411     the physicians' reasonable medical judgment is incompatible with life; or
1412          [(i) has a defect that is uniformly diagnosable and uniformly lethal; or]
1413          [(ii) has a severe brain abnormality that is uniformly diagnosable; or]
1414          (c) [(i)] the unborn child has not reached 18 weeks gestational age and:
1415          (i) (A) the woman is pregnant as a result of:
1416          [(A)] (I) rape, as described in Section 76-5-402;
1417          [(B)] (II) rape of a child, as described in Section 76-5-402.1; or
1418          [(C)] (III) incest[; and], as described in Subsection 76-5-406(2)(j) or Section 76-7-102;
1419     or

1420          (B) the pregnant woman is under the age of 14; and
1421          (ii) before the abortion is performed, the physician who performs the abortion:
1422          (A) for an abortion authorized under Subsection (1)(c)(i)(A), verifies that the incident
1423     described in Subsection [(1)(c)(i)] (1)(c)(i)(A) has been reported to law enforcement; and
1424          (B) if applicable, complies with requirements related to reporting suspicions of or
1425     known child abuse.
1426          (2) An abortion may be performed only:
1427          (a) by a physician; and
1428          (b) in [an abortion clinic or] a hospital, unless it is necessary to perform the abortion in
1429     another location due to a medical emergency.
1430          (3) If the unborn child has been diagnosed with a fetal abnormality that is incompatible
1431     with life, at the time of the diagnosis, the physician shall inform the woman, both verbally and
1432     in writing, that perinatal hospice services and perinatal palliative care are available and are an
1433     alternative to abortion.
1434          [(3)] (4) A person who performs an abortion in violation of this section is guilty of a
1435     second degree felony.
1436          [(4)] (5) In addition to the penalty described in Subsection [(3)] (4), the department
1437     may take appropriate corrective action against [an abortion clinic] a health care facility,
1438     including revoking the [abortion clinic's] health care facility's license, if a violation of this
1439     chapter occurs at the [abortion clinic] health care facility.
1440          [(5)] (6) The department shall report a physician's violation of any provision of this
1441     section to the state entity that regulates the licensing of a physician.
1442          Section 30. Repealer.
1443          This bill repeals:
1444          Section 76-7-302.5, Circumstances under which abortion prohibited.