1     
ABORTION REVISIONS

2     
2024 GENERAL SESSION

3     
STATE OF UTAH

4     
Chief Sponsor: Brian S. King

5     
Senate Sponsor: ____________

6     

7     LONG TITLE
8     General Description:
9          This bill modifies provisions related to abortion.
10     Highlighted Provisions:
11          This bill:
12          ▸     allows for the licensing of abortion clinics and allows an abortion to be performed
13     in an abortion clinic;
14          ▸     removes the 72-hour waiting period before an abortion may be performed;
15          ▸     modifies the material that must be included in an information module and website
16     concerning abortion; and
17          ▸     makes technical and conforming changes.
18     Money Appropriated in this Bill:
19          None
20     Other Special Clauses:
21          None
22     Utah Code Sections Affected:
23     AMENDS:
24          26B-2-201, as last amended by Laws of Utah 2023, Chapter 301 and renumbered and
25     amended by Laws of Utah 2023, Chapter 305
26          26B-2-204, as last amended by Laws of Utah 2023, Chapter 301 and renumbered and
27     amended by Laws of Utah 2023, Chapter 305
28          26B-2-205, as last amended by Laws of Utah 2023, Chapter 301 and renumbered and
29     amended by Laws of Utah 2023, Chapter 305
30          26B-2-206, as last amended by Laws of Utah 2023, Chapter 301 and renumbered and
31     amended by Laws of Utah 2023, Chapter 305
32          26B-2-224, as last amended by Laws of Utah 2023, Chapter 301 and renumbered and
33     amended by Laws of Utah 2023, Chapter 305
34          26B-2-232, as renumbered and amended by Laws of Utah 2023, Chapter 305
35          76-7-301, as last amended by Laws of Utah 2023, Chapters 301, 330
36          76-7-302, as last amended by Laws of Utah 2023, Chapters 158, 301
37          76-7-305, as last amended by Laws of Utah 2023, Chapters 301, 330
38          76-7-305.5, as last amended by Laws of Utah 2023, Chapters 301, 330
39          76-7a-101, as last amended by Laws of Utah 2023, Chapters 158, 301
40          76-7a-201, as last amended by Laws of Utah 2023, Chapters 158, 301
41     

42     Be it enacted by the Legislature of the state of Utah:
43          Section 1. Section 26B-2-201 is amended to read:
44          26B-2-201. Definitions.
45          As used in this part:
46          (1) [(a)] "Abortion clinic" means a type I abortion clinic or a type II abortion clinic.
47          [(b) "Abortion clinic" does not mean a clinic that meets the definition of hospital under
48     Section 76-7-301 or Section 76-71-101.]
49          (2) "Activities of daily living" means essential activities including:
50          (a) dressing;
51          (b) eating;
52          (c) grooming;
53          (d) bathing;
54          (e) toileting;
55          (f) ambulation;
56          (g) transferring; and
57          (h) self-administration of medication.
58          (3) "Ambulatory surgical facility" means a freestanding facility, which provides
59     surgical services to patients not requiring hospitalization.
60          (4) "Assistance with activities of daily living" means providing of or arranging for the
61     provision of assistance with activities of daily living.
62          (5) (a) "Assisted living facility" means:
63          (i) a type I assisted living facility, which is a residential facility that provides assistance
64     with activities of daily living and social care to two or more residents who:
65          (A) require protected living arrangements; and
66          (B) are capable of achieving mobility sufficient to exit the facility without the
67     assistance of another person; and
68          (ii) a type II assisted living facility, which is a residential facility with a home-like
69     setting that provides an array of coordinated supportive personal and health care services
70     available 24 hours per day to residents who have been assessed under department rule to need
71     any of these services.
72          (b) Each resident in a type I or type II assisted living facility shall have a service plan
73     based on the assessment, which may include:
74          (i) specified services of intermittent nursing care;
75          (ii) administration of medication; and
76          (iii) support services promoting residents' independence and self-sufficiency.
77          (6) "Birthing center" means a facility that:
78          (a) receives maternal clients and provides care during pregnancy, delivery, and
79     immediately after delivery; and
80          (b) (i) is freestanding; or
81          (ii) is not freestanding, but meets the requirements for an alongside midwifery unit
82     described in Subsection 26B-2-228(7).
83          (7) "Committee" means the Health Facility Committee created in Section 26B-1-204.
84          (8) "Consumer" means any person not primarily engaged in the provision of health care
85     to individuals or in the administration of facilities or institutions in which such care is provided
86     and who does not hold a fiduciary position, or have a fiduciary interest in any entity involved in
87     the provision of health care, and does not receive, either directly or through his spouse, more
88     than 1/10 of his gross income from any entity or activity relating to health care.
89          (9) "End stage renal disease facility" means a facility which furnishes staff-assisted
90     kidney dialysis services, self-dialysis services, or home-dialysis services on an outpatient basis.
91          (10) "Freestanding" means existing independently or physically separated from another
92     health care facility by fire walls and doors and administrated by separate staff with separate
93     records.
94          (11) "General acute hospital" means a facility which provides diagnostic, therapeutic,
95     and rehabilitative services to both inpatients and outpatients by or under the supervision of
96     physicians.
97          (12) "Governmental unit" means the state, or any county, municipality, or other
98     political subdivision or any department, division, board, or agency of the state, a county,
99     municipality, or other political subdivision.
100          (13) (a) "Health care facility" means general acute hospitals, specialty hospitals, home
101     health agencies, hospices, nursing care facilities, residential-assisted living facilities, birthing
102     centers, ambulatory surgical facilities, small health care facilities, abortion clinics, [a clinic that
103     meets the definition of hospital under Section 76-7-301 or 76-71-201,] facilities owned or
104     operated by health maintenance organizations, end stage renal disease facilities, and any other
105     health care facility which the committee designates by rule.
106          (b) "Health care facility" does not include the offices of private physicians or dentists,
107     whether for individual or group practice, except that it does include an abortion clinic.
108          (14) "Health maintenance organization" means an organization, organized under the
109     laws of any state which:
110          (a) is a qualified health maintenance organization under 42 U.S.C. Sec. 300e-9; or
111          (b) (i) provides or otherwise makes available to enrolled participants at least the
112     following basic health care services: usual physician services, hospitalization, laboratory, x-ray,
113     emergency, and preventive services and out-of-area coverage;
114          (ii) is compensated, except for copayments, for the provision of the basic health
115     services listed in Subsection (14)(b)(i) to enrolled participants by a payment which is paid on a
116     periodic basis without regard to the date the health services are provided and which is fixed
117     without regard to the frequency, extent, or kind of health services actually provided; and
118          (iii) provides physicians' services primarily directly through physicians who are either
119     employees or partners of such organizations, or through arrangements with individual
120     physicians or one or more groups of physicians organized on a group practice or individual
121     practice basis.
122          (15) (a) "Home health agency" means an agency, organization, or facility or a
123     subdivision of an agency, organization, or facility which employs two or more direct care staff
124     persons who provide licensed nursing services, therapeutic services of physical therapy, speech
125     therapy, occupational therapy, medical social services, or home health aide services on a
126     visiting basis.
127          (b) "Home health agency" does not mean an individual who provides services under
128     the authority of a private license.
129          (16) "Hospice" means a program of care for the terminally ill and their families which
130     occurs in a home or in a health care facility and which provides medical, palliative,
131     psychological, spiritual, and supportive care and treatment.
132          (17) "Nursing care facility" means a health care facility, other than a general acute or
133     specialty hospital, constructed, licensed, and operated to provide patient living
134     accommodations, 24-hour staff availability, and at least two of the following patient services:
135          (a) a selection of patient care services, under the direction and supervision of a
136     registered nurse, ranging from continuous medical, skilled nursing, psychological, or other
137     professional therapies to intermittent health-related or paraprofessional personal care services;
138          (b) a structured, supportive social living environment based on a professionally
139     designed and supervised treatment plan, oriented to the individual's habilitation or
140     rehabilitation needs; or
141          (c) a supervised living environment that provides support, training, or assistance with
142     individual activities of daily living.
143          (18) "Person" means any individual, firm, partnership, corporation, company,
144     association, or joint stock association, and the legal successor thereof.
145          (19) "Resident" means a person 21 years old or older who:
146          (a) as a result of physical or mental limitations or age requires or requests services
147     provided in an assisted living facility; and
148          (b) does not require intensive medical or nursing services as provided in a hospital or
149     nursing care facility.
150          (20) "Small health care facility" means a four to 16 bed facility that provides licensed
151     health care programs and services to residents.
152          (21) "Specialty hospital" means a facility which provides specialized diagnostic,
153     therapeutic, or rehabilitative services in the recognized specialty or specialties for which the
154     hospital is licensed.
155          (22) "Substantial compliance" means in a department survey of a licensee, the
156     department determines there is an absence of deficiencies which would harm the physical
157     health, mental health, safety, or welfare of patients or residents of a licensee.
158          (23) "Type I abortion clinic" means a facility, including a physician's office, but not
159     including a general acute or specialty hospital, that:
160          (a) performs abortions, as defined in Section 76-7-301, during the first trimester of
161     pregnancy; and
162          (b) does not perform abortions, as defined in Section 76-7-301, after the first trimester
163     of pregnancy.
164          (24) "Type II abortion clinic" means a facility, including a physician's office, but not
165     including a general acute or specialty hospital, that:
166          (a) performs abortions, as defined in Section 76-7-301, after the first trimester of
167     pregnancy; or
168          (b) performs abortions, as defined in Section 76-7-301, during the first trimester of
169     pregnancy and after the first trimester of pregnancy.
170          Section 2. Section 26B-2-204 is amended to read:
171          26B-2-204. Licensing of an abortion clinic -- Rulemaking authority -- Fee --
172     Licensing of a clinic meeting the definition of hospital.
173          [(1) (a) No abortion clinic may operate in the state on or after January 1, 2024, or the
174     last valid date of an abortion clinic license issued under the requirements of this section,
175     whichever date is later.]
176          [(b) Notwithstanding Subsection (1)(a), a licensed abortion clinic may not perform an
177     abortion in violation of any provision of state law.]
178          [(2) The state may not issue a license for an abortion clinic after May 2, 2023.]
179          [(3) For any license for an abortion clinic that is issued under this section:]
180          [(a)] (1) A type I abortion clinic may not operate in the state without a license issued by
181     the department to operate a type I abortion clinic.
182          [(b)] (2) A type II abortion clinic may not operate in the state without a license issued
183     by the department to operate a type II abortion clinic.
184          [(c)] (3) The department shall make rules establishing minimum health, safety,
185     sanitary, and recordkeeping requirements for:
186          [(i)] (a) a type I abortion clinic; and
187          [(ii)] (b) a type II abortion clinic.
188          [(d)] (4) To receive and maintain a license described in this section, an abortion clinic
189     shall:
190          [(i)] (a) apply for a license on a form prescribed by the department;
191          [(ii)] (b) satisfy and maintain the minimum health, safety, sanitary, and recordkeeping
192     requirements established [unde7r] under Subsection (3) that relate to the type of abortion clinic
193     licensed;
194          [(iii)] (c) comply with the recordkeeping and reporting requirements of Section
195     76-7-313;
196          [(iv)] (d) comply with the requirements of Title 76, Chapter 7, Part 3, Abortion, and
197     Title 76, Chapter 7a, Abortion Prohibition;
198          [(v)] (e) pay the annual licensing fee; and
199          [(vi)] (f) cooperate with inspections conducted by the department.
200          [(e)] (5) The department shall, at least twice per year, inspect each abortion clinic in
201     the state to ensure that the abortion clinic is complying with all statutory and licensing
202     requirements relating to the abortion clinic. At least one of the inspections shall be made
203     without providing notice to the abortion clinic.
204          [(f)] (6) The department shall charge an annual license fee, set by the department in
205     accordance with the procedures described in Section 63J-1-504, to an abortion clinic in an
206     amount that will pay for the cost of the licensing requirements described in this section and the
207     cost of inspecting abortion clinics.
208          [(g)] (7) The department shall deposit the licensing fees described in this section in the
209     General Fund as a dedicated credit to be used solely to pay for the cost of the licensing
210     requirements described in this section and the cost of inspecting abortion clinics.
211          [(4) (a) Notwithstanding any other provision of this section, the department may
212     license a clinic that meets the definition of hospital under Section 76-7-301 or Section
213     76-7a-101.]
214          [(b) A clinic described in Subsection (4)(a) is not defined as an abortion clinic.]
215          Section 3. Section 26B-2-205 is amended to read:
216          26B-2-205. Exempt facilities.
217          This part does not apply to:
218          (1) a dispensary or first aid facility maintained by any commercial or industrial plant,
219     educational institution, or convent;
220          (2) a health care facility owned or operated by an agency of the United States;
221          (3) the office of a physician, physician assistant, or dentist whether it is an individual
222     or group practice, except that it does apply to an abortion clinic;
223          (4) a health care facility established or operated by any recognized church or
224     denomination for the practice of religious tenets administered by mental or spiritual means
225     without the use of drugs, whether gratuitously or for compensation, if it complies with statutes
226     and rules on environmental protection and life safety;
227          (5) any health care facility owned or operated by the Department of Corrections,
228     created in Section 64-13-2; and
229          (6) a residential facility providing 24-hour care:
230          (a) that does not employ direct care staff;
231          (b) in which the residents of the facility contract with a licensed hospice agency to
232     receive end-of-life medical care; and
233          (c) that meets other requirements for an exemption as designated by administrative
234     rule.
235          Section 4. Section 26B-2-206 is amended to read:
236          26B-2-206. License required -- Not assignable or transferable -- Posting --
237     Expiration and renewal -- Time for compliance by operating facilities.
238          (1) (a) A person or governmental unit acting severally or jointly with any other person
239     or governmental unit, may not establish, conduct, or maintain a health care facility in this state
240     without receiving a license from the department as provided by this part and the rules adopted
241     pursuant to this part.
242          (b) This Subsection (1) does not apply to facilities that are exempt under Section
243     26B-2-205.
244          (2) A license issued under this part is not assignable or transferable.
245          (3) The current license shall at all times be posted in each health care facility in a place
246     readily visible and accessible to the public.
247          (4) (a) The department may issue a license for a period of time not to exceed 12
248     months from the date of issuance for an abortion clinic and not to exceed 24 months from the
249     date of issuance for other health care facilities that meet the provisions of this part and
250     department rules adopted pursuant to this part.
251          (b) Each license expires at midnight on the day designated on the license as the
252     expiration date, unless previously revoked by the department.
253          (c) The license shall be renewed upon completion of the application requirements,
254     unless the department finds the health care facility has not complied with the provisions of this
255     part or the rules adopted pursuant to this part.
256          (5) A license may be issued under this section only for the operation of a specific
257     facility at a specific site by a specific person.
258          (6) Any health care facility in operation at the time of adoption of any applicable rules
259     as provided under this part shall be given a reasonable time for compliance as determined by
260     the committee.
261          Section 5. Section 26B-2-224 is amended to read:
262          26B-2-224. Patient identity protection.
263          (1) As used in this section:
264          (a) "EMTALA" means the federal Emergency Medical Treatment and Active Labor
265     Act.
266          (b) "Health professional office" means:
267          (i) a physician's office; or
268          (ii) a dental office.
269          (c) "Medical facility" means:
270          (i) a general acute hospital;
271          (ii) a specialty hospital;
272          (iii) a home health agency;
273          (iv) a hospice;
274          (v) a nursing care facility;
275          (vi) a residential-assisted living facility;
276          (vii) a birthing center;
277          (viii) an ambulatory surgical facility;
278          (ix) a small health care facility;
279          (x) an abortion clinic;
280          [(xi) a clinic that meets the definition of hospital under Section 76-7-301 or Section
281     76-7a-101;]
282          [(xii)] (xi) a facility owned or operated by a health maintenance organization;
283          [(xiii)] (xii) an end stage renal disease facility;
284          [(xiv)] (xiii) a health care clinic; or
285          [(xv)] (xiv) any other health care facility that the committee designates by rule.
286          (2) (a) In order to discourage identity theft and health insurance fraud, and to reduce
287     the risk of medical errors caused by incorrect medical records, a medical facility or a health
288     professional office shall request identification from an individual prior to providing in-patient
289     or out-patient services to the individual.
290          (b) If the individual who will receive services from the medical facility or a health
291     professional office lacks the legal capacity to consent to treatment, the medical facility or a
292     health professional office shall request identification:
293          (i) for the individual who lacks the legal capacity to consent to treatment; and
294          (ii) from the individual who consents to treatment on behalf of the individual described
295     in Subsection (2)(b)(i).
296          (3) A medical facility or a health professional office:
297          (a) that is subject to EMTALA:
298          (i) may not refuse services to an individual on the basis that the individual did not
299     provide identification when requested; and
300          (ii) shall post notice in its emergency department that informs a patient of the patient's
301     right to treatment for an emergency medical condition under EMTALA;
302          (b) may not be penalized for failing to ask for identification;
303          (c) is not subject to a private right of action for failing to ask for identification; and
304          (d) may document or confirm patient identity by:
305          (i) photograph;
306          (ii) fingerprinting;
307          (iii) palm scan; or
308          (iv) other reasonable means.
309          (4) The identification described in this section:
310          (a) is intended to be used for medical records purposes only; and
311          (b) shall be kept in accordance with the requirements of the Health Insurance
312     Portability and Accountability Act of 1996.
313          Section 6. Section 26B-2-232 is amended to read:
314          26B-2-232. Treatment of aborted remains.
315          (1) As used in this section, "aborted fetus" means a product of human conception,
316     regardless of gestational age, that has died from an abortion as that term is defined in Section
317     76-7-301.
318          (2) (a) A health care facility having possession of an aborted fetus shall provide for the
319     final disposition of the aborted fetus through:
320          (i) cremation as that term is defined in Section 58-9-102; or
321          (ii) interment.
322          (b) A health care facility may not conduct the final disposition of an aborted fetus less
323     than 72 hours after an abortion is performed unless:
324          (i) the pregnant woman authorizes the health care facility, in writing, to conduct the
325     final disposition of the aborted fetus less than 72 hours after the abortion is performed; or
326          (ii) immediate disposition is required under state or federal law.
327          (c) A health care facility may serve as an authorizing agent as defined in Section
328     58-9-102 with respect to the final disposition of an aborted fetus if:
329          (i) the pregnant woman provides written authorization for the health care facility to act
330     as the authorizing agent; or
331          (ii) (A) more than 72 hours have passed since the abortion was performed; and
332          (B) the pregnant woman did not exercise her right to control the final disposition of the
333     aborted fetus under Subsection (4)(a).
334          (d) Within 120 business days after the day on which an abortion is performed, a health
335     care facility possessing an aborted fetus shall:
336          (i) conduct the final disposition of the aborted fetus in accordance with this section; or
337          (ii) ensure that the aborted fetus is preserved until final disposition.
338          (e) A health care facility shall conduct the final disposition under this section in
339     accordance with applicable state and federal law.
340          (3) Before performing an abortion, a health care facility shall[:],
341          [(a) provide the pregnant woman with the information described in Subsection
342     76-7-305.5(2)(w) through:]
343          [(i) a form approved by the department;]
344          [(ii) an in-person consultation with a physician; or]
345          [(iii) an in-person consultation with a mental health therapist as defined in Section
346     58-60-102; and]
347          [(b)] if the pregnant woman makes a decision under Subsection (4)(b), document the
348     pregnant woman's decision under Subsection (4)(b) in the pregnant woman's medical record.
349          (4) A pregnant woman who has an abortion:
350          (a) except as provided in Subsection [(6)] (5), has the right to control the final
351     disposition of the aborted fetus;
352          (b) if the pregnant woman has a preference for disposition of the aborted fetus, shall
353     inform the health care facility of the pregnant woman's decision for final disposition of the
354     aborted fetus;
355          (c) is responsible for the costs related to the final disposition of the aborted fetus at the
356     chosen location if the pregnant woman chooses a method or location for the final disposition of
357     the aborted fetus that is different from the method or location that is usual and customary for
358     the health care facility; and
359          (d) for a medication-induced abortion, shall be permitted to return the aborted fetus to
360     the health care facility in a sealed container for disposition by the health care facility in
361     accordance with this section.
362          [(5) The form described in Subsection (3)(a)(i) shall include the following
363     information:]
364          ["You have the right to decide what you would like to do with the aborted fetus. You
365     may decide for the provider to be responsible for disposition of the fetus. If you are having a
366     medication-induced abortion, you also have the right to bring the aborted fetus back to this
367     provider for disposition after the fetus is expelled. The provider may dispose of the aborted
368     fetus by burial or cremation. You can ask the provider if you want to know the specific method
369     for disposition."]
370          [(6)] (5) If the pregnant woman is a minor, the health care facility shall obtain parental
371     consent for the disposition of the aborted fetus unless the minor is granted a court order under
372     Subsection 76-7-304.5(1)(b).
373          [(7)] (6) (a) A health care facility may not include fetal remains with other biological,
374     infectious, or pathological waste.
375          (b) Fetal tissue that is sent for permanently fixed pathology or used for genetic study is
376     not subject to the requirements of this section.
377          (c) (i) A health care facility is responsible for maintaining a record to demonstrate to
378     the department that the health care facility has complied with the provisions of this section.
379          (ii) The records described in Subsection [(7)(c)(i)] (6)(c)(i) shall be:
380          (A) maintained for at least two years; and
381          (B) made available to the department for inspection upon request by the department.
382          Section 7. Section 76-7-301 is amended to read:
383          76-7-301. Definitions.
384          As used in this part:
385          (1) (a) "Abortion" means the act, by a physician, of using an instrument, or prescribing
386     a drug, with the intent to cause the death of an unborn child of a woman known to be pregnant,
387     except as permitted under this part.
388          (b) "Abortion" does not include:
389          (i) removal of a dead unborn child;
390          (ii) removal of an ectopic pregnancy; or
391          (iii) the killing or attempted killing of an unborn child without the consent of the
392     pregnant woman, unless:
393          (A) the killing or attempted killing is done through a medical procedure carried out by
394     a physician or through a substance used under the direction of a physician; and
395          (B) the physician is unable to obtain the consent due to a medical emergency.
396          (2) "Abortion clinic" means the same as that term is defined in Section 26B-2-201.
397          (3) "Abuse" means the same as that term is defined in Section 80-1-102.
398          [(3)] (4) "Department" means the Department of Health and Human Services.
399          [(4)] (5) "Down syndrome" means a genetic condition associated with an extra
400     chromosome 21, in whole or in part, or an effective trisomy for chromosome 21.
401          [(5)] (6) "Gestational age" means the age of an unborn child as calculated from the first
402     day of the last menstrual period of the pregnant woman.
403          [(6)] (7) "Hospital" means:
404          (a) a general hospital licensed by the department according to Title 26B, Chapter 2,
405     Part 2, Health Care Facility Licensing and Inspection; and
406          (b) a clinic or other medical facility [that meets the following criteria:] to the extent
407     that such clinic or other medical facility is certified by the department as providing equipment
408     and personnel sufficient in quantity and quality to provide the same degree of safety to the
409     pregnant woman and the unborn child as would be provided for the particular medical
410     procedures undertaken by a general hospital licensed by the department.
411          [(i) a clinician who performs procedures at the clinic is required to be credentialed to
412     perform the same procedures at a general hospital licensed by the department; and]
413          [(ii) any procedures performed at the clinic are done with the same level of safety for
414     the pregnant woman and unborn child as would be available in a general hospital licensed by
415     the department.]
416          [(7)] (8) "Information module" means the pregnancy termination information module
417     prepared by the department.
418          [(8)] (9) "Medical emergency" means a life threatening physical condition aggravated
419     by, caused by, or arising from a pregnancy that places the pregnant woman at risk of death, or
420     poses a serious risk of substantial impairment of a major bodily function, unless the abortion is
421     performed or induced.
422          [(9)] (10) "Minor" means an individual who is:
423          (a) under 18 years old;
424          (b) unmarried; and
425          (c) not emancipated.
426          [(10)] (11) (a) "Partial birth abortion" means an abortion in which the person
427     performing the abortion:
428          (i) deliberately and intentionally vaginally delivers a living fetus until, in the case of a
429     head first presentation, the entire fetal head is outside the body of the mother, or, in the case of
430     breech presentation, any part of the fetal trunk past the navel is outside the body of the mother,
431     for the purpose of performing an overt act that the person knows will kill the partially delivered
432     living fetus; and
433          (ii) performs the overt act, other than completion of delivery, that kills the partially
434     living fetus.
435          (b) "Partial birth abortion" does not include the dilation and evacuation procedure
436     involving dismemberment prior to removal, the suction curettage procedure, or the suction
437     aspiration procedure for abortion.
438          [(11)] (12) "Perinatal hospice" means comprehensive support to the mother and her
439     family from the time of the diagnosis of a lethal fetal anomaly, through the time of the child's
440     birth, and through the postpartum period, that:
441          (a) focuses on alleviating fear and ensuring that the woman and her family experience
442     the life and death of a child in a comfortable and supportive environment; and
443          (b) may include counseling or medical care by:
444          (i) maternal-fetal medical specialists;
445          (ii) obstetricians;
446          (iii) neonatologists;
447          (iv) anesthesia specialists;
448          (v) psychiatrists, psychologists, or other mental health providers;
449          (vi) clergy;
450          (vii) social workers; or
451          (viii) specialty nurses.
452          [(12)] (13) "Physician" means:
453          (a) a medical doctor licensed to practice medicine and surgery under Title 58, Chapter
454     67, Utah Medical Practice Act;
455          (b) an osteopathic physician licensed to practice osteopathic medicine under Title 58,
456     Chapter 68, Utah Osteopathic Medical Practice Act; or
457          (c) a physician employed by the federal government who has qualifications similar to
458     an individual described in Subsection [(12)(a)] (13)(a) or (b).
459          [(13)] (14) (a) "Severe brain abnormality" means a malformation or defect that causes
460     an individual to live in a mentally vegetative state.
461          (b) "Severe brain abnormality" does not include:
462          (i) Down syndrome;
463          (ii) spina bifida;
464          (iii) cerebral palsy; or
465          (iv) any other malformation, defect, or condition that does not cause an individual to
466     live in a mentally vegetative state.
467          Section 8. Section 76-7-302 is amended to read:
468          76-7-302. Circumstances under which abortion authorized.
469          (1) An abortion may be performed in this state only by a physician.
470          (2) An abortion may be performed in this state only under the following circumstances:
471          (a) the unborn child has not reached 18 weeks gestational age;
472          (b) the unborn child has reached 18 weeks gestational age, and:
473          (i) the abortion is necessary to avert:
474          (A) the death of the woman on whom the abortion is performed; or
475          (B) a serious physical risk of substantial impairment of a major bodily function of the
476     woman on whom the abortion is performed; or
477          (ii) subject to Subsection (4), two physicians who practice maternal fetal medicine
478     concur, in writing, in the patient's medical record that the fetus has a fetal abnormality that in
479     the physicians' reasonable medical judgment is incompatible with life; or
480          (c) the unborn child has not reached 18 weeks gestational age and:
481          (i) (A) the woman is pregnant as a result of:
482          (I) rape, as described in Section 76-5-402;
483          (II) rape of a child, as described in Section 76-5-402.1; or
484          (III) incest, as described in Subsection 76-5-406(2)(j) or Section 76-7-102; or
485          (B) the pregnant child is under the age of 14; and
486          (ii) before the abortion is performed, the physician who performs the abortion:
487          (A) for an abortion authorized under Subsection (2)(c)(i)(A), verifies that the incident
488     described in Subsection (2)(c)(i)(A) has been reported to law enforcement; and
489          (B) if applicable, complies with the requirements of Section 80-2-602.
490          (3) An abortion may be performed only in an abortion clinic or a hospital, unless it is
491     necessary to perform the abortion in another location due to a medical emergency.
492          (4) If the unborn child has been diagnosed with a fetal abnormality that is incompatible
493     with life, at the time of the diagnosis, the physician shall inform the woman, both verbally and
494     in writing, that perinatal hospice and perinatal palliative care services are available and are an
495     alternative to abortion.
496          (5) A physician who performs an abortion under Subsection (2)(c) shall:
497          (a) maintain an accurate record as to the manner in which the physician conducted the
498     verification under Subsection (2)(c)(ii)(A); and
499          (b) report the information described in Subsection (5)(a) to the department in
500     accordance with Section 76-7-313.
501          Section 9. Section 76-7-305 is amended to read:
502          76-7-305. Informed consent requirements for abortion -- Exceptions.
503          (1) A person may not perform an abortion, unless, before performing the abortion, the
504     physician who will perform the abortion obtains from the woman on whom the abortion is to
505     be performed a voluntary and informed written consent that is consistent with:
506          (a) Section 8.08 of the American Medical Association's Code of Medical Ethics,
507     Current Opinions; and
508          (b) the provisions of this section.
509          (2) Except as provided in Subsection (8), consent to an abortion is voluntary and
510     informed only if[, at least 72 hours before the abortion]:
511          (a) a staff member of [a] an abortion clinic or hospital, physician, registered nurse,
512     nurse practitioner, advanced practice registered nurse, certified nurse midwife, genetic
513     counselor, or physician's assistant presents the information module to the pregnant woman;
514          (b) the pregnant woman views the entire information module and presents evidence to
515     the individual described in Subsection (2)(a) that the pregnant woman viewed the entire
516     information module;
517          (c) after receiving the evidence described in Subsection (2)(b), the individual described
518     in Subsection (2)(a):
519          (i) documents that the pregnant woman viewed the entire information module;
520          (ii) gives the pregnant woman, upon her request, a copy of the documentation
521     described in Subsection (2)(c)(i); and
522          (iii) provides a copy of the statement described in Subsection (2)(c)(i) to the physician
523     who is to perform the abortion, upon request of that physician or the pregnant woman;
524          (d) after the pregnant woman views the entire information module, the physician who
525     is to perform the abortion, the referring physician, a physician, a registered nurse, nurse
526     practitioner, advanced practice registered nurse, certified nurse midwife, genetic counselor, or
527     physician's assistant, in a face-to-face consultation in any location in the state, orally informs
528     the woman of:
529          (i) the nature of the proposed abortion procedure;
530          (ii) specifically how the procedure described in Subsection (2)(d)(i) will affect the
531     fetus;
532          (iii) the risks and alternatives to the abortion procedure or treatment;
533          (iv) the options and consequences of aborting a medication-induced abortion, if the
534     proposed abortion procedure is a medication-induced abortion;
535          (v) the probable gestational age and a description of the development of the unborn
536     child at the time the abortion would be performed;
537          (vi) the medical risks associated with carrying her child to term;
538          (vii) the right to view an ultrasound of the unborn child, at no expense to the pregnant
539     woman, upon her request; and
540          (viii) when the result of a prenatal screening or diagnostic test indicates that the unborn
541     child has or may have Down syndrome, the department's website, which contains the
542     information described in Section 26B-7-106, including the information on the informational
543     support sheet; and
544          (e) after the pregnant woman views the entire information module, a staff member of
545     the abortion clinic or hospital provides to the pregnant woman:
546          (i) on a document that the pregnant woman may take home:
547          (A) the address for the department's website described in Section 76-7-305.5; and
548          (B) a statement that the woman may request, from a staff member of the abortion clinic
549     or hospital where the woman viewed the information module, a printed copy of the material on
550     the department's website; and
551          (ii) a printed copy of the material on the department's website described in Section
552     76-7-305.5, if requested by the pregnant woman[; and].
553          [(iii) a copy of the form described in Subsection 26B-2-232(3)(a)(i) regarding the
554     disposition of the aborted fetus.]
555          (3) Before performing an abortion, the physician who is to perform the abortion shall:
556          (a) in a face-to-face consultation, provide the information described in Subsection
557     (2)(d), unless the attending physician or referring physician is the individual who provided the
558     information required under Subsection (2)(d); and
559          (b) (i) obtain from the pregnant woman a written certification that the information
560     required to be provided under Subsection (2) and this Subsection (3) was provided in
561     accordance with the requirements of Subsection (2) and this Subsection (3);
562          (ii) obtain a copy of the statement described in Subsection (2)(c)(i); and
563          (iii) ensure that[:]
564          [(A) the woman has received the information described in Subsections 26B-2-232(3)
565     and (4); and]
566          [(B)] if the woman has a preference for the disposition of the aborted fetus, the woman
567     has informed the health care facility of the woman's decision regarding the disposition of the
568     aborted fetus.
569          (4) When a medical emergency compels the performance of an abortion, the physician
570     shall inform the woman prior to the abortion, if possible, of the medical indications supporting
571     the physician's judgment that an abortion is necessary.
572          (5) If an ultrasound is performed on a woman before an abortion is performed, the
573     individual who performs the ultrasound, or another qualified individual, shall:
574          (a) inform the woman that the ultrasound images will be simultaneously displayed in a
575     manner to permit her to:
576          (i) view the images, if she chooses to view the images; or
577          (ii) not view the images, if she chooses not to view the images;
578          (b) simultaneously display the ultrasound images in order to permit the woman to:
579          (i) view the images, if she chooses to view the images; or
580          (ii) not view the images, if she chooses not to view the images;
581          (c) inform the woman that, if she desires, the person performing the ultrasound, or
582     another qualified person shall provide a detailed description of the ultrasound images,
583     including:
584          (i) the dimensions of the unborn child;
585          (ii) the presence of cardiac activity in the unborn child, if present and viewable; and
586          (iii) the presence of external body parts or internal organs, if present and viewable; and
587          (d) provide the detailed description described in Subsection (5)(c), if the woman
588     requests it.
589          (6) The information described in Subsections (2), (3), and (5) is not required to be
590     provided to a pregnant woman under this section if the abortion is performed for a reason
591     described in:
592          (a) Subsection 76-7-302(2)(b)(i), if the treating physician and one other physician
593     concur, in writing, that the abortion is necessary to avert:
594          (i) the death of the woman on whom the abortion is performed; or
595          (ii) a risk described in Subsection 76-7-302(2)(b)(i)(B); or
596          (b) Subsection 76-7-302(2)(b)(ii).
597          (7) In addition to the criminal penalties described in this part, a physician who violates
598     the provisions of this section:
599          (a) is guilty of unprofessional conduct as defined in Section 58-67-102 or 58-68-102;
600     and
601          (b) shall be subject to:
602          (i) suspension or revocation of the physician's license for the practice of medicine and
603     surgery in accordance with Section 58-67-401 or 58-68-401; and
604          (ii) administrative penalties in accordance with Section 58-67-402 or 58-68-402.
605          (8) A physician is not guilty of violating this section for failure to furnish any of the
606     information described in Subsection (2) or (3), or for failing to comply with Subsection (5), if:
607          (a) the physician can demonstrate by a preponderance of the evidence that the
608     physician reasonably believed that furnishing the information would have resulted in a severely
609     adverse effect on the physical or mental health of the pregnant woman;
610          (b) in the physician's professional judgment, the abortion was necessary to avert:
611          (i) the death of the woman on whom the abortion is performed; or
612          (ii) a risk described in Subsection 76-7-302(2)(b)(i)(B);
613          (c) the pregnancy was the result of rape or rape of a child, as described in Sections
614     76-5-402 and 76-5-402.1;
615          (d) the pregnancy was the result of incest, as defined in Subsection 76-5-406(2)(j) and
616     Section 76-7-102; or
617          (e) at the time of the abortion, the pregnant child was 14 years old or younger.
618          (9) A physician who complies with the provisions of this section and Section
619     76-7-304.5 may not be held civilly liable to the physician's patient for failure to obtain
620     informed consent under Section 78B-3-406.
621          (10) (a) The department shall provide an ultrasound, in accordance with the provisions
622     of Subsection (5)(b), at no expense to the pregnant woman.
623          (b) A local health department shall refer a pregnant woman who requests an ultrasound
624     described in Subsection (10)(a) to the department.
625          [(11) A physician is not guilty of violating this section if:]
626          [(a) the information described in Subsection (2) is provided less than 72 hours before
627     the physician performs the abortion; and]
628          [(b) in the physician's professional judgment, the abortion was necessary in a case
629     where:]
630          [(i) a ruptured membrane, documented by the attending or referring physician, will
631     cause a serious infection; or]
632          [(ii) a serious infection, documented by the attending or referring physician, will cause
633     a ruptured membrane.]
634          Section 10. Section 76-7-305.5 is amended to read:
635          76-7-305.5. Requirements for information module and website.
636          [(1)] In order to ensure that a woman's consent to an abortion is truly an informed
637     consent, the department shall, in accordance with the requirements of this section, develop an
638     information module and maintain a public website that is scientifically accurate,
639     comprehensible, and presented in a truthful, nonmisleading manner.
640          [(2) The information module and public website described in Subsection (1) shall:]
641          [(a) be scientifically accurate, comprehensible, and presented in a truthful,
642     nonmisleading manner;]
643          [(b) present adoption as a preferred and positive choice and alternative to abortion;]
644          [(c) be produced in a manner that conveys the state's preference for childbirth over
645     abortion;]
646          [(d) state that the state prefers childbirth over abortion;]
647          [(e) state that it is unlawful for any person to coerce a woman to undergo an abortion;]
648          [(f) state that any physician who performs an abortion without obtaining the woman's
649     informed consent or without providing her a private medical consultation in accordance with
650     the requirements of this section, may be liable to her for damages in a civil action at law;]
651          [(g) provide a geographically indexed list of resources and public and private services
652     available to assist, financially or otherwise, a pregnant woman during pregnancy, at childbirth,
653     and while the child is dependent, including:]
654          [(i) medical assistance benefits for prenatal care, childbirth, and neonatal care;]
655          [(ii) services and supports available under Section 35A-3-308;]
656          [(iii) other financial aid that may be available during an adoption;]
657          [(iv) services available from public adoption agencies, private adoption agencies, and
658     private attorneys whose practice includes adoption; and]
659          [(v) the names, addresses, and telephone numbers of each person listed under this
660     Subsection (2)(g);]
661          [(h) describe the adoption-related expenses that may be paid under Section 76-7-203;]
662          [(i) describe the persons who may pay the adoption related expenses described in
663     Subsection (2)(h);]
664          [(j) except as provided in Subsection (4), describe the legal responsibility of the father
665     of a child to assist in child support, even if the father has agreed to pay for an abortion;]
666          [(k) except as provided in Subsection (4), describe the services available through the
667     Office of Recovery Services, within the Department of Health and Human Services, to
668     establish and collect the support described in Subsection (2)(j);]
669          [(l) state that private adoption is legal;]
670          [(m) describe and depict, with pictures or video segments, the probable anatomical and
671     physiological characteristics of an unborn child at two-week gestational increments from
672     fertilization to full term, including:]
673          [(i) brain and heart function;]
674          [(ii) the presence and development of external members and internal organs; and]
675          [(iii) the dimensions of the fetus;]
676          [(n) show an ultrasound of the heartbeat of an unborn child at:]
677          [(i) four weeks from conception;]
678          [(ii) six to eight weeks from conception; and]
679          [(iii) each month after 10 weeks gestational age, up to 14 weeks gestational age;]
680          [(o) describe abortion procedures used in current medical practice at the various stages
681     of growth of the unborn child, including:]
682          [(i) the medical risks associated with each procedure;]
683          [(ii) the risk related to subsequent childbearing that are associated with each procedure;
684     and]
685          [(iii) the consequences of each procedure to the unborn child at various stages of fetal
686     development;]
687          [(p) describe the possible detrimental psychological effects of abortion;]
688          [(q) describe the medical risks associated with carrying a child to term;]
689          [(r) include relevant information on the possibility of an unborn child's survival at the
690     two-week gestational increments described in Subsection (2)(m);]
691          [(s) except as provided in Subsection (5), include:]
692          [(i) information regarding substantial medical evidence from studies concluding that an
693     unborn child who is at least 20 weeks gestational age may be capable of experiencing pain
694     during an abortion procedure; and]
695          [(ii) the measures that will be taken in accordance with Section 76-7-308.5;]
696          [(t) explain the options and consequences of aborting a medication-induced abortion;]
697          [(u) include the following statement regarding a medication-induced abortion,
698     "Research indicates that mifepristone alone is not always effective in ending a pregnancy. You
699     may still have a viable pregnancy after taking mifepristone. If you have taken mifepristone but
700     have not yet taken the second drug and have questions regarding the health of your fetus or are
701     questioning your decision to terminate your pregnancy, you should consult a physician
702     immediately.";]
703          [(v) inform a pregnant woman that she has the right to view an ultrasound of the
704     unborn child, at no expense to her, upon her request;]
705          [(w) inform a pregnant woman that she has the right to:]
706          [(i) determine the final disposition of the remains of the aborted fetus;]
707          [(ii) unless the woman waives this right in writing, wait up to 72 hours after the
708     abortion procedure is performed to make a determination regarding the disposition of the
709     aborted fetus before the health care facility may dispose of the fetal remains;]
710          [(iii) receive information about options for disposition of the aborted fetus, including
711     the method of disposition that is usual and customary for a health care facility; and]
712          [(iv) for a medication-induced abortion, return the aborted fetus to the health care
713     facility for disposition; and]
714          [(x) provide a digital copy of the form described in Subsection 26B-2-232(3)(a)(i);
715     and]
716          [(y) be in a typeface large enough to be clearly legible.]
717          [(3) The information module and website described in Subsection (1) may include a
718     toll-free 24-hour telephone number that may be called in order to obtain, orally, a list and
719     description of services, agencies, and adoption attorneys in the locality of the caller.]
720          [(4) The department may develop a version of the information module and website that
721     omits the information in Subsections (2)(j) and (k) for a viewer who is pregnant as the result of
722     rape.]
723          [(5) The department may develop a version of the information module and website that
724     omits the information described in Subsection (2)(s) for a viewer who will have an abortion
725     performed:]
726          [(a) on an unborn child who is less than 20 weeks gestational age at the time of the
727     abortion; or]
728          [(b) on an unborn child who is at least 20 weeks gestational age at the time of the
729     abortion, if:]
730          [(i) the abortion is being performed for a reason described in Subsection
731     76-7-302(2)(b)(i) or (ii); and]
732          [(ii) due to a serious medical emergency, time does not permit compliance with the
733     requirement to provide the information described in Subsection (2)(s).]
734          [(6) The department and each local health department shall make the information
735     module and the website described in Subsection (1) available at no cost to any person.]
736          [(7) The department shall make the website described in Subsection (1) available for
737     viewing on the department's website by clicking on a conspicuous link on the home page of the
738     website.]
739          [(8) The department shall ensure that the information module is:]
740          [(a) available to be viewed at all facilities where an abortion may be performed;]
741          [(b) interactive for the individual viewing the module, including the provision of
742     opportunities to answer questions and manually engage with the module before the module
743     transitions from one substantive section to the next;]
744          [(c) produced in English and may include subtitles in Spanish or another language;
745     and]
746          [(d) capable of being viewed on a tablet or other portable device.]
747          [(9) After the department releases the initial version of the information module, for the
748     use described in Section 76-7-305, the department shall:]
749          [(a) update the information module, as required by law; and]
750          [(b) present an updated version of the information module to the Health and Human
751     Services Interim Committee for the committee's review and recommendation before releasing
752     the updated version for the use described in Section 76-7-305.]
753          Section 11. Section 76-7a-101 is amended to read:
754          76-7a-101. Definitions.
755          As used in this chapter:
756          (1) (a) "Abortion" means the act, by a physician, of using an instrument, or prescribing
757     a drug, with the intent to cause the death of an unborn child of a woman known to be pregnant,
758     except as permitted under this chapter.
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 a type I abortion clinic licensed by the state or a type II
768     abortion clinic licensed by the state.
769          (3) "Department" means the Department of Health and Human Services.
770          [(3)] (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          [(4)] (5) "Hospital" means:
773          (a) a general hospital licensed by the department; [and] or
774          (b) a clinic or other medical facility [that meets the following criteria:] to the extent the
775     clinic or other medical facility is certified by the department as providing equipment and
776     personnel sufficient in quantity and quality to provide the same degree of safety to a pregnant
777     woman and an unborn child as would be provided for the particular medical procedure
778     undertaken by a general hospital licensed by the department.
779          [(i) a clinician who performs procedures at the clinic is required to be credentialed to
780     perform the same procedures at a general hospital licensed by the department; and]
781          [(ii) any procedures performed at the clinic are done with the same level of safety for
782     the pregnant woman and unborn child as would be available in a general hospital licensed by
783     the department.]
784          [(5)] (6) "Medical emergency" means a life threatening physical condition aggravated
785     by, caused by, or arising from a pregnancy that places the pregnant woman at risk of death, or
786     poses a serious risk of substantial impairment of a major bodily function, unless the abortion is
787     performed or induced.
788          [(6)] (7) "Perinatal hospice" means comprehensive support to the mother and her
789     family from the time of the diagnosis of a lethal fetal anomaly, through the time of the child's
790     birth, and through the postpartum period, that:
791          (a) focuses on alleviating fear and ensuring that the woman and her family experience
792     the life and death of a child in a comfortable and supportive environment; and
793          (b) may include counseling or medical care by:
794          (i) maternal-fetal medical specialists;
795          (ii) obstetricians;
796          (iii) neonatologists;
797          (iv) anesthesia specialists;
798          (v) psychiatrists, psychologists, or other mental health providers;
799          (vi) clergy;
800          (vii) social workers; or
801          (viii) specialty nurses.
802          [(7)] (8) "Physician" means:
803          (a) a medical doctor licensed to practice medicine and surgery in the state;
804          (b) an osteopathic physician licensed to practice osteopathic medicine in the state; or
805          (c) a physician employed by the federal government who has qualifications similar to
806     an individual described in Subsection [(7)(a)] (8)(a) or (b).
807          [(8)] (9) (a) "Severe brain abnormality" means a malformation or defect that causes an
808     individual to live in a mentally vegetative state.
809          (b) "Severe brain abnormality" does not include:
810          (i) Down syndrome;
811          (ii) spina bifida;
812          (iii) cerebral palsy; or
813          (iv) any other malformation, defect, or condition that does not cause an individual to
814     live in a mentally vegetative state.
815          Section 12. Section 76-7a-201 is amended to read:
816          76-7a-201. Abortion prohibition -- Exceptions -- Penalties.
817          (1) An abortion may be performed in this state only under the following circumstances:
818          (a) the abortion is necessary to avert:
819          (i) the death of the woman on whom the abortion is performed; or
820          (ii) a serious physical risk of substantial impairment of a major bodily function of the
821     woman on whom the abortion is performed;
822          (b) subject to Subsection (3), two physicians who practice maternal fetal medicine
823     concur, in writing, in the patient's medical record that the fetus has a fetal abnormality that in
824     the physicians' reasonable medical judgment is incompatible with life; or
825          (c) the unborn child has not reached 18 weeks gestational age and:
826          (i) (A) the woman is pregnant as a result of:
827          (I) rape, as described in Section 76-5-402;
828          (II) rape of a child, as described in Section 76-5-402.1; or
829          (III) incest, as described in Subsection 76-5-406(2)(j) or Section 76-7-102; or
830          (B) the pregnant child is under the age of 14; and
831          (ii) before the abortion is performed, the physician who performs the abortion:
832          (A) for an abortion authorized under Subsection (1)(c)(i)(A), verifies that the incident
833     described in Subsection (1)(c)(i)(A) has been reported to law enforcement; and
834          (B) if applicable, complies with requirements related to reporting suspicions of or
835     known child abuse.
836          (2) An abortion may be performed only:
837          (a) by a physician; and
838          (b) in an abortion clinic or a hospital, unless it is necessary to perform the abortion in
839     another location due to a medical emergency.
840          (3) If the unborn child has been diagnosed with a fetal abnormality that is incompatible
841     with life, at the time of the diagnosis, the physician shall inform the woman, both verbally and
842     in writing, that perinatal hospice services and perinatal palliative care are available and are an
843     alternative to abortion.
844          (4) A person who performs an abortion in violation of this section is guilty of a second
845     degree felony.
846          (5) In addition to the penalty described in Subsection (4), the department may take
847     appropriate corrective action against a health care facility, including revoking the health care
848     facility's license, if a violation of this chapter occurs at the health care facility.
849          (6) The department shall report a physician's violation of any provision of this section
850     to the state entity that regulates the licensing of a physician.
851          (7) A physician who performs an abortion under Subsection (1)(c) shall:
852          (a) maintain an accurate record as to the manner in which the physician conducted the
853     verification under Subsection (1)(c)(ii)(A); and
854          (b) report the information described in Subsection (7)(a) to the department in
855     accordance with Section 76-7-313.
856          Section 13. Effective date.
857          This bill takes effect on May 1, 2024.