1     
LICENSING MODIFICATIONS

2     
2024 GENERAL SESSION

3     
STATE OF UTAH

4     
Chief Sponsor: Karianne Lisonbee

5     
Senate Sponsor: Daniel McCay

6     

7     LONG TITLE
8     General Description:
9          This bill modifies licensing provisions related to abortion.
10     Highlighted Provisions:
11          This bill:
12          ▸     modifies definitions;
13          ▸     allows the licensing of abortion clinics;
14          ▸     allows abortions to be performed in licensed abortion clinics; and
15          ▸     makes technical and conforming changes.
16     Money Appropriated in this Bill:
17          None
18     Other Special Clauses:
19          This bill provides a special effective date.
20     Utah Code Sections Affected:
21     AMENDS:
22          26B-2-201, as last amended by Laws of Utah 2023, Chapter 301 and renumbered and
23     amended by Laws of Utah 2023, Chapter 305
24          26B-2-204, as last amended by Laws of Utah 2023, Chapter 301 and renumbered and
25     amended by Laws of Utah 2023, Chapter 305
26          26B-2-205, as last amended by Laws of Utah 2023, Chapter 301 and renumbered and
27     amended by Laws of Utah 2023, Chapter 305

28          26B-2-206, as last amended by Laws of Utah 2023, Chapter 301 and renumbered and
29     amended by Laws of Utah 2023, Chapter 305
30          26B-2-224, as last amended by Laws of Utah 2023, Chapter 301 and renumbered and
31     amended by Laws of Utah 2023, Chapter 305
32          76-7-301, as last amended by Laws of Utah 2023, Chapters 301, 330
33          76-7-302, as last amended by Laws of Utah 2023, Chapters 158, 301
34          76-7-305, as last amended by Laws of Utah 2023, Chapters 301, 330
35          76-7a-101, as last amended by Laws of Utah 2023, Chapters 158, 301
36          76-7a-201, as last amended by Laws of Utah 2023, Chapters 158, 301
37     

38     Be it enacted by the Legislature of the state of Utah:
39          Section 1. Section 26B-2-201 is amended to read:
40          26B-2-201. Definitions.
41          As used in this part:
42          (1) [(a)] "Abortion clinic" means a type I abortion clinic or a type II abortion clinic.
43          [(b) "Abortion clinic" does not mean a clinic that meets the definition of hospital under
44     Section 76-7-301 or Section 76-71-101.]
45          (2) "Activities of daily living" means essential activities including:
46          (a) dressing;
47          (b) eating;
48          (c) grooming;
49          (d) bathing;
50          (e) toileting;
51          (f) ambulation;
52          (g) transferring; and
53          (h) self-administration of medication.
54          (3) "Ambulatory surgical facility" means a freestanding facility, which provides
55     surgical services to patients not requiring hospitalization.
56          (4) "Assistance with activities of daily living" means providing of or arranging for the
57     provision of assistance with activities of daily living.
58          (5) (a) "Assisted living facility" means:

59          (i) a type I assisted living facility, which is a residential facility that provides assistance
60     with activities of daily living and social care to two or more residents who:
61          (A) require protected living arrangements; and
62          (B) are capable of achieving mobility sufficient to exit the facility without the
63     assistance of another person; and
64          (ii) a type II assisted living facility, which is a residential facility with a home-like
65     setting that provides an array of coordinated supportive personal and health care services
66     available 24 hours per day to residents who have been assessed under department rule to need
67     any of these services.
68          (b) Each resident in a type I or type II assisted living facility shall have a service plan
69     based on the assessment, which may include:
70          (i) specified services of intermittent nursing care;
71          (ii) administration of medication; and
72          (iii) support services promoting residents' independence and self-sufficiency.
73          (6) "Birthing center" means a facility that:
74          (a) receives maternal clients and provides care during pregnancy, delivery, and
75     immediately after delivery; and
76          (b) (i) is freestanding; or
77          (ii) is not freestanding, but meets the requirements for an alongside midwifery unit
78     described in Subsection 26B-2-228(7).
79          (7) "Committee" means the Health Facility Committee created in Section 26B-1-204.
80          (8) "Consumer" means any person not primarily engaged in the provision of health care
81     to individuals or in the administration of facilities or institutions in which such care is provided
82     and who does not hold a fiduciary position, or have a fiduciary interest in any entity involved in
83     the provision of health care, and does not receive, either directly or through his spouse, more
84     than 1/10 of his gross income from any entity or activity relating to health care.
85          (9) "End stage renal disease facility" means a facility which furnishes staff-assisted
86     kidney dialysis services, self-dialysis services, or home-dialysis services on an outpatient basis.
87          (10) "Freestanding" means existing independently or physically separated from another
88     health care facility by fire walls and doors and administrated by separate staff with separate
89     records.

90          (11) "General acute hospital" means a facility which provides diagnostic, therapeutic,
91     and rehabilitative services to both inpatients and outpatients by or under the supervision of
92     physicians.
93          (12) "Governmental unit" means the state, or any county, municipality, or other
94     political subdivision or any department, division, board, or agency of the state, a county,
95     municipality, or other political subdivision.
96          (13) (a) "Health care facility" means general acute hospitals, specialty hospitals, home
97     health agencies, hospices, nursing care facilities, residential-assisted living facilities, birthing
98     centers, ambulatory surgical facilities, small health care facilities, abortion clinics, [a clinic that
99     meets the definition of hospital under Section 76-7-301 or 76-71-201,] facilities owned or
100     operated by health maintenance organizations, end stage renal disease facilities, and any other
101     health care facility which the committee designates by rule.
102          (b) "Health care facility" does not include the offices of private physicians or dentists,
103     whether for individual or group practice, except that it does include an abortion clinic.
104          (14) "Health maintenance organization" means an organization, organized under the
105     laws of any state which:
106          (a) is a qualified health maintenance organization under 42 U.S.C. Sec. 300e-9; or
107          (b) (i) provides or otherwise makes available to enrolled participants at least the
108     following basic health care services: usual physician services, hospitalization, laboratory, x-ray,
109     emergency, and preventive services and out-of-area coverage;
110          (ii) is compensated, except for copayments, for the provision of the basic health
111     services listed in Subsection (14)(b)(i) to enrolled participants by a payment which is paid on a
112     periodic basis without regard to the date the health services are provided and which is fixed
113     without regard to the frequency, extent, or kind of health services actually provided; and
114          (iii) provides physicians' services primarily directly through physicians who are either
115     employees or partners of such organizations, or through arrangements with individual
116     physicians or one or more groups of physicians organized on a group practice or individual
117     practice basis.
118          (15) (a) "Home health agency" means an agency, organization, or facility or a
119     subdivision of an agency, organization, or facility which employs two or more direct care staff
120     persons who provide licensed nursing services, therapeutic services of physical therapy, speech

121     therapy, occupational therapy, medical social services, or home health aide services on a
122     visiting basis.
123          (b) "Home health agency" does not mean an individual who provides services under
124     the authority of a private license.
125          (16) "Hospice" means a program of care for the terminally ill and their families which
126     occurs in a home or in a health care facility and which provides medical, palliative,
127     psychological, spiritual, and supportive care and treatment.
128          (17) "Nursing care facility" means a health care facility, other than a general acute or
129     specialty hospital, constructed, licensed, and operated to provide patient living
130     accommodations, 24-hour staff availability, and at least two of the following patient services:
131          (a) a selection of patient care services, under the direction and supervision of a
132     registered nurse, ranging from continuous medical, skilled nursing, psychological, or other
133     professional therapies to intermittent health-related or paraprofessional personal care services;
134          (b) a structured, supportive social living environment based on a professionally
135     designed and supervised treatment plan, oriented to the individual's habilitation or
136     rehabilitation needs; or
137          (c) a supervised living environment that provides support, training, or assistance with
138     individual activities of daily living.
139          (18) "Person" means any individual, firm, partnership, corporation, company,
140     association, or joint stock association, and the legal successor thereof.
141          (19) "Resident" means a person 21 years old or older who:
142          (a) as a result of physical or mental limitations or age requires or requests services
143     provided in an assisted living facility; and
144          (b) does not require intensive medical or nursing services as provided in a hospital or
145     nursing care facility.
146          (20) "Small health care facility" means a four to 16 bed facility that provides licensed
147     health care programs and services to residents.
148          (21) "Specialty hospital" means a facility which provides specialized diagnostic,
149     therapeutic, or rehabilitative services in the recognized specialty or specialties for which the
150     hospital is licensed.
151          (22) "Substantial compliance" means in a department survey of a licensee, the

152     department determines there is an absence of deficiencies which would harm the physical
153     health, mental health, safety, or welfare of patients or residents of a licensee.
154          (23) "Type I abortion clinic" means a facility, including a physician's office, but not
155     including a general acute or specialty hospital, that:
156          (a) performs abortions, as defined in Section 76-7-301, during the first trimester of
157     pregnancy; and
158          (b) does not perform abortions, as defined in Section 76-7-301, after the first trimester
159     of pregnancy.
160          (24) "Type II abortion clinic" means a facility, including a physician's office, but not
161     including a general acute or specialty hospital, that:
162          (a) performs abortions, as defined in Section 76-7-301, after the first trimester of
163     pregnancy; or
164          (b) performs abortions, as defined in Section 76-7-301, during the first trimester of
165     pregnancy and after the first trimester of pregnancy.
166          Section 2. Section 26B-2-204 is amended to read:
167          26B-2-204. Licensing of an abortion clinic -- Rulemaking authority -- Fee.
168          [(1) (a) No abortion clinic may operate in the state on or after January 1, 2024, or the
169     last valid date of an abortion clinic license issued under the requirements of this section,
170     whichever date is later.]
171          [(b) Notwithstanding Subsection (1)(a), a licensed abortion clinic may not perform an
172     abortion in violation of any provision of state law.]
173          [(2) The state may not issue a license for an abortion clinic after May 2, 2023.]
174          [(3) For any license for an abortion clinic that is issued under this section:]
175          [(a)] (1) A type I abortion clinic may not operate in the state without a license issued by
176     the department to operate a type I abortion clinic.
177          [(b)] (2) A type II abortion clinic may not operate in the state without a license issued
178     by the department to operate a type II abortion clinic.
179          [(c)] (3) The department shall make rules establishing minimum health, safety,
180     sanitary, and recordkeeping requirements for:
181          [(i)] (a) a type I abortion clinic; and
182          [(ii)] (b) a type II abortion clinic.

183          [(d)] (4) To receive and maintain a license described in this section, an abortion clinic
184     shall:
185          [(i)] (a) apply for a license on a form prescribed by the department;
186          [(ii)] (b) satisfy and maintain the minimum health, safety, sanitary, and recordkeeping
187     requirements established [unde7r] under Subsection (3) that relate to the type of abortion clinic
188     licensed;
189          [(iii)] (c) comply with the recordkeeping and reporting requirements of Section
190     76-7-313;
191          [(iv)] (d) comply with the requirements of Title 76, Chapter 7, Part 3, Abortion, and
192     Title 76, Chapter 7a, Abortion Prohibition;
193          [(v)] (e) pay the annual licensing fee; and
194          [(vi)] (f) cooperate with inspections conducted by the department.
195          [(e)] (5) The department shall, at least twice per year, inspect each abortion clinic in
196     the state to ensure that the abortion clinic is complying with all statutory and licensing
197     requirements relating to the abortion clinic. At least one of the inspections shall be made
198     without providing notice to the abortion clinic.
199          [(f)] (6) The department shall charge an annual license fee, set by the department in
200     accordance with the procedures described in Section 63J-1-504, to an abortion clinic in an
201     amount that will pay for the cost of the licensing requirements described in this section and the
202     cost of inspecting abortion clinics.
203          [(g)] (7) The department shall deposit the licensing fees described in this section in the
204     General Fund as a dedicated credit to be used solely to pay for the cost of the licensing
205     requirements described in this section and the cost of inspecting abortion clinics.
206          [(4) (a) Notwithstanding any other provision of this section, the department may
207     license a clinic that meets the definition of hospital under Section 76-7-301 or Section
208     76-7a-101.]
209          [(b) A clinic described in Subsection (4)(a) is not defined as an abortion clinic.]
210          Section 3. Section 26B-2-205 is amended to read:
211          26B-2-205. Exempt facilities.
212          This part does not apply to:
213          (1) a dispensary or first aid facility maintained by any commercial or industrial plant,

214     educational institution, or convent;
215          (2) a health care facility owned or operated by an agency of the United States;
216          (3) the office of a physician, physician assistant, or dentist whether it is an individual
217     or group practice, except that it does apply to an abortion clinic;
218          (4) a health care facility established or operated by any recognized church or
219     denomination for the practice of religious tenets administered by mental or spiritual means
220     without the use of drugs, whether gratuitously or for compensation, if it complies with statutes
221     and rules on environmental protection and life safety;
222          (5) any health care facility owned or operated by the Department of Corrections,
223     created in Section 64-13-2; and
224          (6) a residential facility providing 24-hour care:
225          (a) that does not employ direct care staff;
226          (b) in which the residents of the facility contract with a licensed hospice agency to
227     receive end-of-life medical care; and
228          (c) that meets other requirements for an exemption as designated by administrative
229     rule.
230          Section 4. Section 26B-2-206 is amended to read:
231          26B-2-206. License required -- Not assignable or transferable -- Posting --
232     Expiration and renewal -- Time for compliance by operating facilities.
233          (1) (a) A person or governmental unit acting severally or jointly with any other person
234     or governmental unit, may not establish, conduct, or maintain a health care facility in this state
235     without receiving a license from the department as provided by this part and the rules adopted
236     pursuant to this part .
237          (b) This Subsection (1) does not apply to facilities that are exempt under Section
238     26B-2-205.
239          (2) A license issued under this part is not assignable or transferable.
240          (3) The current license shall at all times be posted in each health care facility in a place
241     readily visible and accessible to the public.
242          (4) (a) The department may issue a license for a period of time not to exceed 12
243     months from the date of issuance for an abortion clinic and not to exceed 24 months from the
244     date of issuance for other health care facilities that meet the provisions of this part and

245     department rules adopted pursuant to this part.
246          (b) Each license expires at midnight on the day designated on the license as the
247     expiration date, unless previously revoked by the department.
248          (c) The license shall be renewed upon completion of the application requirements,
249     unless the department finds the health care facility has not complied with the provisions of this
250     part or the rules adopted pursuant to this part.
251          (5) A license may be issued under this section only for the operation of a specific
252     facility at a specific site by a specific person.
253          (6) Any health care facility in operation at the time of adoption of any applicable rules
254     as provided under this part shall be given a reasonable time for compliance as determined by
255     the committee.
256          Section 5. Section 26B-2-224 is amended to read:
257          26B-2-224. Patient identity protection.
258          (1) As used in this section:
259          (a) "EMTALA" means the federal Emergency Medical Treatment and Active Labor
260     Act.
261          (b) "Health professional office" means:
262          (i) a physician's office; or
263          (ii) a dental office.
264          (c) "Medical facility" means:
265          (i) a general acute hospital;
266          (ii) a specialty hospital;
267          (iii) a home health agency;
268          (iv) a hospice;
269          (v) a nursing care facility;
270          (vi) a residential-assisted living facility;
271          (vii) a birthing center;
272          (viii) an ambulatory surgical facility;
273          (ix) a small health care facility;
274          (x) an abortion clinic;
275          [(xi) a clinic that meets the definition of hospital under Section 76-7-301 or Section

276     76-7a-101;]
277          [(xii)] (xi) a facility owned or operated by a health maintenance organization;
278          [(xiii)] (xii) an end stage renal disease facility;
279          [(xiv)] (xiii) a health care clinic; or
280          [(xv)] (xiv) any other health care facility that the committee designates by rule.
281          (2) (a) In order to discourage identity theft and health insurance fraud, and to reduce
282     the risk of medical errors caused by incorrect medical records, a medical facility or a health
283     professional office shall request identification from an individual prior to providing in-patient
284     or out-patient services to the individual.
285          (b) If the individual who will receive services from the medical facility or a health
286     professional office lacks the legal capacity to consent to treatment, the medical facility or a
287     health professional office shall request identification:
288          (i) for the individual who lacks the legal capacity to consent to treatment; and
289          (ii) from the individual who consents to treatment on behalf of the individual described
290     in Subsection (2)(b)(i).
291          (3) A medical facility or a health professional office:
292          (a) that is subject to EMTALA:
293          (i) may not refuse services to an individual on the basis that the individual did not
294     provide identification when requested; and
295          (ii) shall post notice in its emergency department that informs a patient of the patient's
296     right to treatment for an emergency medical condition under EMTALA;
297          (b) may not be penalized for failing to ask for identification;
298          (c) is not subject to a private right of action for failing to ask for identification; and
299          (d) may document or confirm patient identity by:
300          (i) photograph;
301          (ii) fingerprinting;
302          (iii) palm scan; or
303          (iv) other reasonable means.
304          (4) The identification described in this section:
305          (a) is intended to be used for medical records purposes only; and
306          (b) shall be kept in accordance with the requirements of the Health Insurance

307     Portability and Accountability Act of 1996.
308          Section 6. Section 76-7-301 is amended to read:
309          76-7-301. Definitions.
310          As used in this part:
311          (1) (a) "Abortion" means the act, by a physician, of using an instrument, or prescribing
312     a drug, with the intent to cause the death of an unborn child of a woman known to be pregnant,
313     except as permitted under this part.
314          (b) "Abortion" does not include:
315          (i) removal of a dead unborn child;
316          (ii) removal of an ectopic pregnancy; or
317          (iii) the killing or attempted killing of an unborn child without the consent of the
318     pregnant woman, unless:
319          (A) the killing or attempted killing is done through a medical procedure carried out by
320     a physician or through a substance used under the direction of a physician; and
321          (B) the physician is unable to obtain the consent due to a medical emergency.
322          (2) "Abortion clinic" means the same as that term is defined in Section 26B-2-201.
323          [(2)] (3) "Abuse" means the same as that term is defined in Section 80-1-102.
324          [(3)] (4) "Department" means the Department of Health and Human Services.
325          [(4)] (5) "Down syndrome" means a genetic condition associated with an extra
326     chromosome 21, in whole or in part, or an effective trisomy for chromosome 21.
327          [(5)] (6) "Gestational age" means the age of an unborn child as calculated from the first
328     day of the last menstrual period of the pregnant woman.
329          [(6)] (7) "Hospital" means:
330          (a) a general hospital licensed by the department according to Title 26B, Chapter 2,
331     Part 2, Health Care Facility Licensing and Inspection; and
332          (b) a clinic or other medical facility [that meets the following criteria:] to the extent
333     that such clinic or other medical facility is certified by the department as providing equipment
334     and personnel sufficient in quantity and quality to provide the same degree of safety to the
335     pregnant woman and the unborn child as would be provided for the particular medical
336     procedures undertaken by a general hospital licensed by the department.
337          [(i) a clinician who performs procedures at the clinic is required to be credentialed to

338     perform the same procedures at a general hospital licensed by the department; and]
339          [(ii) any procedures performed at the clinic are done with the same level of safety for
340     the pregnant woman and unborn child as would be available in a general hospital licensed by
341     the department.]
342          [(7)] (8) "Information module" means the pregnancy termination information module
343     prepared by the department.
344          [(8)] (9) "Medical emergency" means a life threatening physical condition aggravated
345     by, caused by, or arising from a pregnancy that places the pregnant woman at risk of death, or
346     poses a serious risk of substantial impairment of a major bodily function, unless the abortion is
347     performed or induced.
348          [(9)] (10) "Minor" means an individual who is:
349          (a) under 18 years old;
350          (b) unmarried; and
351          (c) not emancipated.
352          [(10)] (11) (a) "Partial birth abortion" means an abortion in which the person
353     performing the abortion:
354          (i) deliberately and intentionally vaginally delivers a living fetus until, in the case of a
355     head first presentation, the entire fetal head is outside the body of the mother, or, in the case of
356     breech presentation, any part of the fetal trunk past the navel is outside the body of the mother,
357     for the purpose of performing an overt act that the person knows will kill the partially delivered
358     living fetus; and
359          (ii) performs the overt act, other than completion of delivery, that kills the partially
360     living fetus.
361          (b) "Partial birth abortion" does not include the dilation and evacuation procedure
362     involving dismemberment prior to removal, the suction curettage procedure, or the suction
363     aspiration procedure for abortion.
364          [(11)] (12) "Perinatal hospice" means comprehensive support to the mother and her
365     family from the time of the diagnosis of a lethal fetal anomaly, through the time of the child's
366     birth, and through the postpartum period, that:
367          (a) focuses on alleviating fear and ensuring that the woman and her family experience
368     the life and death of a child in a comfortable and supportive environment; and

369          (b) may include counseling or medical care by:
370          (i) maternal-fetal medical specialists;
371          (ii) obstetricians;
372          (iii) neonatologists;
373          (iv) anesthesia specialists;
374          (v) psychiatrists, psychologists, or other mental health providers;
375          (vi) clergy;
376          (vii) social workers; or
377          (viii) specialty nurses.
378          [(12)] (13) "Physician" means:
379          (a) a medical doctor licensed to practice medicine and surgery under Title 58, Chapter
380     67, Utah Medical Practice Act;
381          (b) an osteopathic physician licensed to practice osteopathic medicine under Title 58,
382     Chapter 68, Utah Osteopathic Medical Practice Act; or
383          (c) a physician employed by the federal government who has qualifications similar to
384     an individual described in Subsection [(12)(a)] (13)(a) or (b).
385          [(13)] (14) (a) "Severe brain abnormality" means a malformation or defect that causes
386     an individual to live in a mentally vegetative state.
387          (b) "Severe brain abnormality" does not include:
388          (i) Down syndrome;
389          (ii) spina bifida;
390          (iii) cerebral palsy; or
391          (iv) any other malformation, defect, or condition that does not cause an individual to
392     live in a mentally vegetative state.
393          Section 7. Section 76-7-302 is amended to read:
394          76-7-302. Circumstances under which abortion authorized.
395          (1) An abortion may be performed in this state only by a physician.
396          (2) An abortion may be performed in this state only under the following circumstances:
397          (a) the unborn child has not reached 18 weeks gestational age;
398          (b) the unborn child has reached 18 weeks gestational age, and:
399          (i) the abortion is necessary to avert:

400          (A) the death of the woman on whom the abortion is performed; or
401          (B) a serious physical risk of substantial impairment of a major bodily function of the
402     woman on whom the abortion is performed; or
403          (ii) subject to Subsection (4), two physicians who practice maternal fetal medicine
404     concur, in writing, in the patient's medical record that the fetus has a fetal abnormality that in
405     the physicians' reasonable medical judgment is incompatible with life; or
406          (c) the unborn child has not reached 18 weeks gestational age and:
407          (i) (A) the woman is pregnant as a result of:
408          (I) rape, as described in Section 76-5-402;
409          (II) rape of a child, as described in Section 76-5-402.1; or
410          (III) incest, as described in Subsection 76-5-406(2)(j) or Section 76-7-102; or
411          (B) the pregnant child is under the age of 14; and
412          (ii) before the abortion is performed, the physician who performs the abortion:
413          (A) for an abortion authorized under Subsection (2)(c)(i)(A), verifies that the incident
414     described in Subsection (2)(c)(i)(A) has been reported to law enforcement; and
415          (B) if applicable, complies with the requirements of Section 80-2-602.
416          (3) An abortion may be performed only in an abortion clinic or a hospital, unless it is
417     necessary to perform the abortion in another location due to a medical emergency.
418          (4) If the unborn child has been diagnosed with a fetal abnormality that is incompatible
419     with life, at the time of the diagnosis, the physician shall inform the woman, both verbally and
420     in writing, that perinatal hospice and perinatal palliative care services are available and are an
421     alternative to abortion.
422          (5) A physician who performs an abortion under Subsection (2)(c) shall:
423          (a) maintain an accurate record as to the manner in which the physician conducted the
424     verification under Subsection (2)(c)(ii)(A); and
425          (b) report the information described in Subsection (5)(a) to the department in
426     accordance with Section 76-7-313.
427          Section 8. Section 76-7-305 is amended to read:
428          76-7-305. Informed consent requirements for abortion -- 72-hour wait mandatory
429     -- Exceptions.
430          (1) A person may not perform an abortion, unless, before performing the abortion, the

431     physician who will perform the abortion obtains from the woman on whom the abortion is to
432     be performed a voluntary and informed written consent that is consistent with:
433          (a) Section 8.08 of the American Medical Association's Code of Medical Ethics,
434     Current Opinions; and
435          (b) the provisions of this section.
436          (2) Except as provided in Subsection (8), consent to an abortion is voluntary and
437     informed only if, at least 72 hours before the abortion:
438          (a) a staff member of an abortion clinic or a hospital, physician, registered nurse, nurse
439     practitioner, advanced practice registered nurse, certified nurse midwife, genetic counselor, or
440     physician's assistant presents the information module to the pregnant woman;
441          (b) the pregnant woman views the entire information module and presents evidence to
442     the individual described in Subsection (2)(a) that the pregnant woman viewed the entire
443     information module;
444          (c) after receiving the evidence described in Subsection (2)(b), the individual described
445     in Subsection (2)(a):
446          (i) documents that the pregnant woman viewed the entire information module;
447          (ii) gives the pregnant woman, upon her request, a copy of the documentation
448     described in Subsection (2)(c)(i); and
449          (iii) provides a copy of the statement described in Subsection (2)(c)(i) to the physician
450     who is to perform the abortion, upon request of that physician or the pregnant woman;
451          (d) after the pregnant woman views the entire information module, the physician who
452     is to perform the abortion, the referring physician, a physician, a registered nurse, nurse
453     practitioner, advanced practice registered nurse, certified nurse midwife, genetic counselor, or
454     physician's assistant, in a face-to-face consultation in any location in the state, orally informs
455     the woman of:
456          (i) the nature of the proposed abortion procedure;
457          (ii) specifically how the procedure described in Subsection (2)(d)(i) will affect the
458     fetus;
459          (iii) the risks and alternatives to the abortion procedure or treatment;
460          (iv) the options and consequences of aborting a medication-induced abortion, if the
461     proposed abortion procedure is a medication-induced abortion;

462          (v) the probable gestational age and a description of the development of the unborn
463     child at the time the abortion would be performed;
464          (vi) the medical risks associated with carrying her child to term;
465          (vii) the right to view an ultrasound of the unborn child, at no expense to the pregnant
466     woman, upon her request; and
467          (viii) when the result of a prenatal screening or diagnostic test indicates that the unborn
468     child has or may have Down syndrome, the department's website, which contains the
469     information described in Section 26B-7-106, including the information on the informational
470     support sheet; and
471          (e) after the pregnant woman views the entire information module, a staff member of
472     the abortion clinic or hospital provides to the pregnant woman:
473          (i) on a document that the pregnant woman may take home:
474          (A) the address for the department's website described in Section 76-7-305.5; and
475          (B) a statement that the woman may request, from a staff member of the abortion clinic
476     or hospital where the woman viewed the information module, a printed copy of the material on
477     the department's website;
478          (ii) a printed copy of the material on the department's website described in Section
479     76-7-305.5, if requested by the pregnant woman; and
480          (iii) a copy of the form described in Subsection 26B-2-232(3)(a)(i) regarding the
481     disposition of the aborted fetus.
482          (3) Before performing an abortion, the physician who is to perform the abortion shall:
483          (a) in a face-to-face consultation, provide the information described in Subsection
484     (2)(d), unless the attending physician or referring physician is the individual who provided the
485     information required under Subsection (2)(d); and
486          (b) (i) obtain from the pregnant woman a written certification that the information
487     required to be provided under Subsection (2) and this Subsection (3) was provided in
488     accordance with the requirements of Subsection (2) and this Subsection (3);
489          (ii) obtain a copy of the statement described in Subsection (2)(c)(i); and
490          (iii) ensure that:
491          (A) the woman has received the information described in Subsections 26B-2-232(3)
492     and (4); and

493          (B) if the woman has a preference for the disposition of the aborted fetus, the woman
494     has informed the health care facility of the woman's decision regarding the disposition of the
495     aborted fetus.
496          (4) When a medical emergency compels the performance of an abortion, the physician
497     shall inform the woman prior to the abortion, if possible, of the medical indications supporting
498     the physician's judgment that an abortion is necessary.
499          (5) If an ultrasound is performed on a woman before an abortion is performed, the
500     individual who performs the ultrasound, or another qualified individual, shall:
501          (a) inform the woman that the ultrasound images will be simultaneously displayed in a
502     manner to permit her to:
503          (i) view the images, if she chooses to view the images; or
504          (ii) not view the images, if she chooses not to view the images;
505          (b) simultaneously display the ultrasound images in order to permit the woman to:
506          (i) view the images, if she chooses to view the images; or
507          (ii) not view the images, if she chooses not to view the images;
508          (c) inform the woman that, if she desires, the person performing the ultrasound, or
509     another qualified person shall provide a detailed description of the ultrasound images,
510     including:
511          (i) the dimensions of the unborn child;
512          (ii) the presence of cardiac activity in the unborn child, if present and viewable; and
513          (iii) the presence of external body parts or internal organs, if present and viewable; and
514          (d) provide the detailed description described in Subsection (5)(c), if the woman
515     requests it.
516          (6) The information described in Subsections (2), (3), and (5) is not required to be
517     provided to a pregnant woman under this section if the abortion is performed for a reason
518     described in:
519          (a) Subsection 76-7-302(2)(b)(i), if the treating physician and one other physician
520     concur, in writing, that the abortion is necessary to avert:
521          (i) the death of the woman on whom the abortion is performed; or
522          (ii) a risk described in Subsection 76-7-302(2)(b)(i)(B); or
523          (b) Subsection 76-7-302(2)(b)(ii).

524          (7) In addition to the criminal penalties described in this part, a physician who violates
525     the provisions of this section:
526          (a) is guilty of unprofessional conduct as defined in Section 58-67-102 or 58-68-102;
527     and
528          (b) shall be subject to:
529          (i) suspension or revocation of the physician's license for the practice of medicine and
530     surgery in accordance with Section 58-67-401 or 58-68-401; and
531          (ii) administrative penalties in accordance with Section 58-67-402 or 58-68-402.
532          (8) A physician is not guilty of violating this section for failure to furnish any of the
533     information described in Subsection (2) or (3), or for failing to comply with Subsection (5), if:
534          (a) the physician can demonstrate by a preponderance of the evidence that the
535     physician reasonably believed that furnishing the information would have resulted in a severely
536     adverse effect on the physical or mental health of the pregnant woman;
537          (b) in the physician's professional judgment, the abortion was necessary to avert:
538          (i) the death of the woman on whom the abortion is performed; or
539          (ii) a risk described in Subsection 76-7-302(2)(b)(i)(B);
540          (c) the pregnancy was the result of rape or rape of a child, as described in Sections
541     76-5-402 and 76-5-402.1;
542          (d) the pregnancy was the result of incest, as defined in Subsection 76-5-406(2)(j) and
543     Section 76-7-102; or
544          (e) at the time of the abortion, the pregnant child was 14 years old or younger.
545          (9) A physician who complies with the provisions of this section and Section
546     76-7-304.5 may not be held civilly liable to the physician's patient for failure to obtain
547     informed consent under Section 78B-3-406.
548          (10) (a) The department shall provide an ultrasound, in accordance with the provisions
549     of Subsection (5)(b), at no expense to the pregnant woman.
550          (b) A local health department shall refer a pregnant woman who requests an ultrasound
551     described in Subsection (10)(a) to the department.
552          (11) A physician is not guilty of violating this section if:
553          (a) the information described in Subsection (2) is provided less than 72 hours before
554     the physician performs the abortion; and

555          (b) in the physician's professional judgment, the abortion was necessary in a case
556     where:
557          (i) a ruptured membrane, documented by the attending or referring physician, will
558     cause a serious infection; or
559          (ii) a serious infection, documented by the attending or referring physician, will cause a
560     ruptured membrane.
561          Section 9. Section 76-7a-101 is amended to read:
562          76-7a-101. Definitions.
563          As used in this chapter:
564          (1) (a) "Abortion" means the act, by a physician, of using an instrument, or prescribing
565     a drug, with the intent to cause the death of an unborn child of a woman known to be pregnant,
566     except as permitted under this chapter.
567          (b) "Abortion" does not include:
568          (i) removal of a dead unborn child;
569          (ii) removal of an ectopic pregnancy; or
570          (iii) the killing or attempted killing of an unborn child without the consent of the
571     pregnant woman, unless:
572          (A) the killing or attempted killing is done through a medical procedure carried out by
573     a physician or through a substance used under the direction of a physician; and
574          (B) the physician is unable to obtain the consent due to a medical emergency.
575          (2) "Abortion clinic" means a type I abortion clinic licensed by the state or a type II
576     abortion clinic licensed by the state.
577          (3) "Department" means the Department of Health and Human Services.
578          [(3)] (4) "Down syndrome" means a genetic condition associated with an extra
579     chromosome 21, in whole or in part, or an effective trisomy for chromosome 21.
580          [(4)] (5) "Hospital" means:
581          (a) a general hospital licensed by the department; [and] or
582          (b) a clinic or other medical facility [that meets the following criteria:] to the extent the
583     clinic or other medical facility is certified by the department as providing equipment and
584     personnel sufficient in quantity and quality to provide the same degree of safety to a pregnant
585     woman and an unborn child as would be provided for the particular medical procedure

586     undertaken by a general hospital licensed by the department.
587          [(i) a clinician who performs procedures at the clinic is required to be credentialed to
588     perform the same procedures at a general hospital licensed by the department; and]
589          [(ii) any procedures performed at the clinic are done with the same level of safety for
590     the pregnant woman and unborn child as would be available in a general hospital licensed by
591     the department.]
592          [(5)] (6) "Medical emergency" means a life threatening physical condition aggravated
593     by, caused by, or arising from a pregnancy that places the pregnant woman at risk of death, or
594     poses a serious risk of substantial impairment of a major bodily function, unless the abortion is
595     performed or induced.
596          [(6)] (7) "Perinatal hospice" means comprehensive support to the mother and her
597     family from the time of the diagnosis of a lethal fetal anomaly, through the time of the child's
598     birth, and through the postpartum period, that:
599          (a) focuses on alleviating fear and ensuring that the woman and her family experience
600     the life and death of a child in a comfortable and supportive environment; and
601          (b) may include counseling or medical care by:
602          (i) maternal-fetal medical specialists;
603          (ii) obstetricians;
604          (iii) neonatologists;
605          (iv) anesthesia specialists;
606          (v) psychiatrists, psychologists, or other mental health providers;
607          (vi) clergy;
608          (vii) social workers; or
609          (viii) specialty nurses.
610          [(7)] (8) "Physician" means:
611          (a) a medical doctor licensed to practice medicine and surgery in the state;
612          (b) an osteopathic physician licensed to practice osteopathic medicine in the state; or
613          (c) a physician employed by the federal government who has qualifications similar to
614     an individual described in Subsection (7)(a) or (b).
615          [(8)] (9) (a) "Severe brain abnormality" means a malformation or defect that causes an
616     individual to live in a mentally vegetative state.

617          (b) "Severe brain abnormality" does not include:
618          (i) Down syndrome;
619          (ii) spina bifida;
620          (iii) cerebral palsy; or
621          (iv) any other malformation, defect, or condition that does not cause an individual to
622     live in a mentally vegetative state.
623          Section 10. Section 76-7a-201 is amended to read:
624          76-7a-201. Abortion prohibition -- Exceptions -- Penalties.
625          (1) An abortion may be performed in this state only under the following circumstances:
626          (a) the abortion is necessary to avert:
627          (i) the death of the woman on whom the abortion is performed; or
628          (ii) a serious physical risk of substantial impairment of a major bodily function of the
629     woman on whom the abortion is performed;
630          (b) subject to Subsection (3), two physicians who practice maternal fetal medicine
631     concur, in writing, in the patient's medical record that the fetus has a fetal abnormality that in
632     the physicians' reasonable medical judgment is incompatible with life; or
633          (c) the unborn child has not reached 18 weeks gestational age and:
634          (i) (A) the woman is pregnant as a result of:
635          (I) rape, as described in Section 76-5-402;
636          (II) rape of a child, as described in Section 76-5-402.1; or
637          (III) incest, as described in Subsection 76-5-406(2)(j) or Section 76-7-102; or
638          (B) the pregnant child is under the age of 14; and
639          (ii) before the abortion is performed, the physician who performs the abortion:
640          (A) for an abortion authorized under Subsection (1)(c)(i)(A), verifies that the incident
641     described in Subsection (1)(c)(i)(A) has been reported to law enforcement; and
642          (B) if applicable, complies with requirements related to reporting suspicions of or
643     known child abuse.
644          (2) An abortion may be performed only:
645          (a) by a physician; and
646          (b) in an abortion clinic or a hospital, unless it is necessary to perform the abortion in
647     another location due to a medical emergency.

648          (3) If the unborn child has been diagnosed with a fetal abnormality that is incompatible
649     with life, at the time of the diagnosis, the physician shall inform the woman, both verbally and
650     in writing, that perinatal hospice services and perinatal palliative care are available and are an
651     alternative to abortion.
652          (4) A person who performs an abortion in violation of this section is guilty of a second
653     degree felony.
654          (5) In addition to the penalty described in Subsection (4), the department may take
655     appropriate corrective action against a health care facility, including revoking the health care
656     facility's license, if a violation of this chapter occurs at the health care facility.
657          (6) The department shall report a physician's violation of any provision of this section
658     to the state entity that regulates the licensing of a physician.
659          (7) A physician who performs an abortion under Subsection (1)(c) shall:
660          (a) maintain an accurate record as to the manner in which the physician conducted the
661     verification under Subsection (1)(c)(ii)(A); and
662          (b) report the information described in Subsection (7)(a) to the department in
663     accordance with Section 76-7-313.
664          Section 11. Effective date.
665          (1) Except as provided in Subsection (2), if approved by two-thirds of all the members
666     elected to each house, this bill takes effect upon approval by the governor, or the day following
667     the constitutional time limit of Utah Constitution, Article VII, Section 8, without the governor's
668     signature, or in the case of a veto, the date of veto override.
669          (2) If this bill is not approved by two-thirds of all members elected to each house, this
670     bill takes effect May 1, 2024.