HB 6076

HOUSE BILL NO. 6076
A bill to amend 1978 PA 368, entitled
"Public health code,"
by amending sections 20104, 20106, and 20161 (MCL
333.20104, 333.20106, and 333.20161), as amended by 2024 PA 252, and by adding
part 207A and section 22224d.
the people of the state of michigan enact:
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Sec. 20104. (1) Except as otherwise
provided in part 221, "certification" means the issuance of a
document by the department to a health facility or agency attesting to the fact
that the
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health
facility or agency meets both of the following:
(a) It complies
with applicable statutory and regulatory requirements and standards.
(b) It is eligible
to participate as a provider of care and services in a specific federal or
state health program.
(2)
"Consumer" means a person who is not a health care provider as that
term is defined in 42 USC 300jj.
(3) "County
medical care facility" means a nursing care facility, other than a
hospital long-term care unit, that provides organized nursing care and medical
treatment to 7 or more unrelated individuals who are suffering or recovering
from illness, injury, or infirmity and that is owned by a county or counties.
(4)
"Department" means the department of licensing and regulatory
affairs.
(5) "Direct
access" means access to a patient or resident or to a patient's or
resident's property, financial information, medical records, treatment
information, or any other identifying information.
(6)
"Director" means the director of the department.
(7) "Freestanding abortion clinic" means that term as defined
in section 20751.
(8) (7) "Freestanding
birth center" means that term as defined in section 20701.
(9) (8) "Freestanding
surgical outpatient facility" means a facility, other than the office of a
physician, dentist, podiatrist, or other private practice office, offering a
surgical procedure and related care that in the opinion of the attending physician
can be safely performed without requiring overnight inpatient hospital care.
Freestanding surgical outpatient facility
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does
not include a surgical outpatient facility owned by and operated as part of a
hospital.
(10) (9) "Good
moral character" means that term as defined in, and determined under, 1974
PA 381, MCL 338.41 to 338.47.
Sec. 20106. (1) "Health facility or
agency", except as provided in section 20115, means:
(a) An ambulance
operation, aircraft transport operation, nontransport prehospital life support
operation, or medical first response service.
(b) A county
medical care facility.
(c) A freestanding
surgical outpatient facility.
(d) A health
maintenance organization.
(e) A home for the
aged.
(f) A hospital.
(g) A nursing home.
(h) A hospice.
(i) A hospice
residence.
(j) A facility or
agency listed in subdivisions (a) to (g) located in a university, college, or
other educational institution.
(k) A freestanding
birth center.
(l) A freestanding
abortion clinic.
(2) "Health
maintenance organization" means that term as defined in section 3501 of
the insurance code of 1956, 1956 PA 218, MCL 500.3501.
(3) "Home for
the aged" means a supervised personal care facility at a single address,
other than a hotel, adult foster care facility, hospital, nursing home, or
county medical care facility that provides room, board, and supervised personal
care to 21 or more unrelated, nontransient individuals 55 years of age or
older.
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Home
for the aged includes a supervised personal care facility for 20 or fewer
individuals 55 years of age or older if the facility is operated in conjunction
with and as a distinct part of a licensed nursing home. Home for the aged does
not include an area excluded from this definition by section 17(3) of the
continuing care community disclosure act, 2014 PA 448, MCL 554.917.
(4)
"Hospice" means a health care program that provides a coordinated set
of services rendered at home or in outpatient or institutional settings for
individuals suffering from a disease or condition with a terminal prognosis.
(5)
"Hospital" means a facility offering inpatient, overnight care, and
services for observation, diagnosis, and active treatment of an individual with
a medical, surgical, obstetric, chronic, or rehabilitative condition requiring
the daily direction or supervision of a physician. Hospital does not include a
mental health hospital licensed or operated by the department of health and
human services or a hospital operated by the department of corrections.
(6) "Hospital
long-term care unit" means a nursing care facility, owned and operated by
and as part of a hospital, providing organized nursing care and medical
treatment to 7 or more unrelated individuals suffering or recovering from
illness, injury, or infirmity.
Sec. 20161. (1) The department shall
assess fees and other assessments for health facility and agency licenses and
certificates of need on an annual basis as provided in this article. Until
October 1, 2027, except as otherwise provided in this article, fees and
assessments must be paid as provided in the following schedule:
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(a) Freestanding surgical outpatient
facilities
$500.00
per facility license.
(b) Hospitals
$500.00
per facility license and $10.00 per licensed bed.
(c) Nursing homes, county medical care facilities, and
hospital long-term care units
$500.00
per facility license and
$3.00
per licensed bed over 100 licensed beds.
(d) Homes for the aged
$500.00
per facility license and $6.27 per licensed bed.
(e) Hospice agencies
$500.00
per agency license.
(f) Hospice residences
$500.00
per facility license and $5.00 per licensed bed.
(g) Freestanding birth center
$500.00
per facility license.
(h)
Freestanding abortion clinic
$500.00 per facility license.
(i) (h) Subject to subsection (11), quality
assurance assessment for nursing homes and hospital long-term care units
an
amount resulting in not more
than
6% of total industry revenues.
(j) (i) Subject to subsection (12), quality
assurance assessment for hospitals
at a
fixed or variable rate that
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generates
funds not more than the maximum allowable under the federal matching
requirements, after consideration for the amounts in subsection (12)(a) and
(i).
(k) (j) Initial licensure application fee for
subdivisions (a), (b), (c), (d), (e), (f), and (g), and (h)
$2,000.00
per initial license.
(2) If a hospital
requests the department to conduct a certification survey for purposes of title
XVIII or title XIX, the hospital shall pay a license fee surcharge of $23.00
per bed. As used in this subsection:
(a) "Title
XVIII" means title XVIII of the social security act, 42 USC 1395 to 1395lll.1395mmm.
(b) "Title
XIX" means title XIX of the social security act, 42 USC 1396 to 1396w-8.1396w-9.
(3) All of the
following apply to the assessment under this section for certificates of need:
(a) The base fee
for a certificate of need is $3,000.00 for each application. For a project
requiring a projected capital expenditure of more than $500,000.00 but less
than $4,000,000.00, an additional fee of $5,000.00 is added to the base fee.
For a project requiring a projected capital expenditure of $4,000,000.00 or
more but less than $10,000,000.00, an additional fee of $8,000.00 is added to
the base fee. For a project requiring a projected capital expenditure of
$10,000,000.00 or more, an additional fee of $12,000.00 is added to the base
fee.
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(b) In addition to
the fees under subdivision (a), the applicant shall pay $3,000.00 for any
designated complex project including a project scheduled for comparative review
or for a consolidated licensed health facility application for acquisition or
replacement.
(c) If required by
the department, the applicant shall pay $1,000.00 for a certificate of need
application that receives expedited processing at the request of the applicant.
(d) The department
shall charge a fee of $500.00 to review any letter of intent requesting or
resulting in a waiver from certificate of need review and any amendment request
to an approved certificate of need.
(e) A health
facility or agency that offers certificate of need covered clinical services
shall pay $100.00 for each certificate of need approved covered clinical
service as part of the certificate of need annual survey at the time of
submission of the survey data.
(f) Except as
otherwise provided in this section, the department shall use the fees collected
under this subsection only to fund the certificate of need program. Funds
remaining in the certificate of need program at the end of the fiscal year do
not lapse to the general fund but remain available to fund the certificate of
need program in subsequent years.
(4) A license
issued under this part is effective for no longer than 1 year after the date of
issuance.
(5) Fees described
in this section are payable to the department at the time an application for a
license, permit, or certificate is submitted. If an application for a license,
permit, or certificate is denied or if a license, permit, or certificate is
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revoked
before its expiration date, the department shall not refund fees paid to the
department.
(6) The fee for a
provisional license or temporary permit is the same as for a license. A license
may be issued at the expiration date of a temporary permit without an
additional fee for the balance of the period for which the fee was paid if the
requirements for licensure are met.
(7) The cost of
licensure activities must be supported by license fees.
(8) The application
fee for a waiver under section 21564 is $200.00 plus $40.00 per hour for the
professional services and travel expenses directly related to processing the
application. The travel expenses must be calculated in accordance with the
state standardized travel regulations of the department of technology,
management, and budget in effect at the time of the travel.
(9) An applicant
for licensure or renewal of licensure under part 209 shall pay the applicable
fees set forth in part 209.
(10) Except as
otherwise provided in this section, the fees and assessments collected under
this section must be deposited in the state treasury, to the credit of the
general fund. The department may use the unreserved fund balance in fees and
assessments for the criminal history check program required under this article.
(11) The quality
assurance assessment collected under subsection (1)(h)
(1)(i) and all federal matching funds
attributed to that assessment must be used only for the following purposes and
under the following specific circumstances:
(a) The quality
assurance assessment and all federal matching funds attributed to that
assessment must be used to finance
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Medicaid
nursing home reimbursement payments. Only licensed nursing homes and hospital
long-term care units that are assessed the quality assurance assessment and
participate in the Medicaid program are eligible for increased per diem
Medicaid reimbursement rates under this subdivision. A nursing home or
long-term care unit that is assessed the quality assurance assessment and that
does not pay the assessment required under subsection (1)(h) (1)(i) in
accordance with subdivision (c)(i) or in accordance with a written payment agreement with this state
shall not receive the increased per diem Medicaid reimbursement rates under
this subdivision until all of its outstanding quality assurance assessments and
any penalties assessed under subdivision (f) have been paid in full. This
subdivision does not authorize or require the department to overspend tax
revenue in violation of the management and budget act, 1984 PA 431, MCL 18.1101
to 18.1594.
(b) Except as
otherwise provided under subdivision (c), beginning October 1, 2005, the
quality assurance assessment is based on the total number of patient days of
care each nursing home and hospital long-term care unit provided to
non-Medicare patients within the immediately preceding year, must be assessed
at a uniform rate on October 1, 2005 and subsequently on October 1 of each
following year, and is payable on a quarterly basis, with the first payment due
90 days after the date the assessment is assessed.
(c) Within 30 days
after September 30, 2005, the department shall submit an application to the
Centers for Medicare and Medicaid Services to request a waiver according to 42
CFR 433.68(e) to implement this subdivision as follows:
(i) If the waiver is approved, the quality
assurance assessment
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rate
for a nursing home or hospital long-term care unit with less than 40 licensed
beds or with the maximum number, or more than the maximum number, of licensed
beds necessary to secure federal approval of the application is $2.00 per
non-Medicare patient day of care provided within the immediately preceding year
or a rate as otherwise altered on the application for the waiver to obtain
federal approval. If the waiver is approved, for all other nursing homes and
long-term care units the quality assurance assessment rate is to be calculated
by dividing the total statewide maximum allowable assessment permitted under
subsection (1)(h) (1)(i)
less the total amount to be paid by the nursing homes and long-term care
units with less than 40 licensed beds or with the maximum number, or more than
the maximum number, of licensed beds necessary to secure federal approval of
the application by the total number of non-Medicare patient days of care
provided within the immediately preceding year by those nursing homes and long-term
care units with more than 39 licensed beds, but less than the maximum number of
licensed beds necessary to secure federal approval. The quality assurance
assessment, as provided under this subparagraph, must be assessed in the first
quarter after federal approval of the waiver and must be subsequently assessed
on October 1 of each following year, and is payable on a quarterly basis, with
the first payment due 90 days after the date the assessment is assessed.
(ii) If the waiver is approved, continuing
care retirement centers are exempt from the quality assurance assessment if the
continuing care retirement center requires each center resident to provide an
initial life interest payment of $150,000.00, on average, per resident to
ensure payment for that resident's residency and services and the continuing
care retirement center
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utilizes
all of the initial life interest payment before the resident becomes eligible
for medical assistance under the state's Medicaid plan. As used in this
subparagraph, "continuing care retirement center" means a nursing
care facility that provides independent living services, assisted living
services, and nursing care and medical treatment services, in a campus-like
setting that has shared facilities or common areas, or both.
(d) Beginning May
10, 2002, the department shall increase the per diem nursing home Medicaid
reimbursement rates for the balance of that year. For each subsequent year in
which the quality assurance assessment is assessed and collected, the
department shall maintain the Medicaid nursing home reimbursement payment
increase financed by the quality assurance assessment.
(e) The department
shall implement this section in a manner that complies with federal
requirements necessary to ensure that the quality assurance assessment
qualifies for federal matching funds.
(f) If a nursing
home or a hospital long-term care unit fails to pay the assessment required by
subsection (1)(h), (1)(i),
the department may assess the nursing home or hospital long-term care
unit a penalty of 5% of the assessment for each month that the assessment and
penalty are not paid up to a maximum of 50% of the assessment. The department
may also refer for collection to the department of treasury past due amounts
consistent with section 13 of 1941 PA 122, MCL 205.13.
(g) The Medicaid
nursing home quality assurance assessment fund is established in the state
treasury. The department shall deposit the revenue raised through the quality
assurance assessment with the state treasurer for deposit in the Medicaid
nursing home
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quality
assurance assessment fund.
(h) The department
shall not implement this subsection in a manner that conflicts with 42 USC
1396b(w).
(i) The quality
assurance assessment collected under subsection (1)(h)
(1)(i) must be prorated on a quarterly
basis for any licensed beds added to or subtracted from a nursing home or
hospital long-term care unit since the immediately preceding July 1. Any
adjustments in payments are due on the next quarterly installment due date.
(j) In each fiscal
year governed by this subsection, Medicaid reimbursement rates must not be
reduced below the Medicaid reimbursement rates in effect on April 1, 2002 as a
direct result of the quality assurance assessment collected under subsection (1)(h).(1)(i).
(k) The state
retention amount of the quality assurance assessment collected under subsection
(1)(h) (1)(i) must
be equal to 13.2% of the federal funds generated by the nursing homes and
hospital long-term care units quality assurance assessment, including the state
retention amount. The state retention amount must be appropriated each fiscal
year to the department to support Medicaid expenditures for long-term care
services. These funds must offset an identical amount of general fund/general
purpose revenue originally appropriated for that purpose.
(l) Beginning October 1, 2027, the
department shall not assess or collect the quality assurance assessment or
apply for federal matching funds. The quality assurance assessment collected
under subsection (1)(h) (1)(i) must not be assessed or collected after
September 30, 2011 if the quality assurance assessment is not eligible for
federal matching funds. Any portion of the quality
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assurance
assessment collected from a nursing home or hospital long-term care unit that
is not eligible for federal matching funds must be returned to the nursing home
or hospital long-term care unit.
(12) The quality
assurance dedication is an earmarked assessment collected under subsection (1)(i). (1)(j). That
assessment and all federal matching funds attributed to that assessment must be
used only for the following purpose and under the following specific
circumstances:
(a) To maintain the
increased Medicaid reimbursement rate increases as provided for in subdivision
(c).
(b) The quality
assurance assessment must be assessed on all net patient revenue, before
deduction of expenses, less Medicare net revenue, as reported in the most
recently available Medicare cost report and is payable on a quarterly basis,
with the first payment due 90 days after the date the assessment is assessed.
As used in this subdivision, "Medicare net revenue" includes Medicare
payments and amounts collected for coinsurance and deductibles.
(c) Beginning
October 1, 2002, the department shall increase the hospital Medicaid
reimbursement rates for the balance of that year. For each subsequent year in
which the quality assurance assessment is assessed and collected, the
department shall maintain the hospital Medicaid reimbursement rate increase
financed by the quality assurance assessments.
(d) The department
shall implement this section in a manner that complies with federal
requirements necessary to ensure that the quality assurance assessment
qualifies for federal matching funds.
(e) If a hospital
fails to pay the assessment required by
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subsection
(1)(i), (1)(j), the
department may assess the hospital a penalty of 5% of the assessment for each
month that the assessment and penalty are not paid up to a maximum of 50% of
the assessment. The department may also refer for collection to the department
of treasury past due amounts consistent with section 13 of 1941 PA 122, MCL
205.13.
(f) The hospital
quality assurance assessment fund is established in the state treasury. The
department shall deposit the revenue raised through the quality assurance
assessment with the state treasurer for deposit in the hospital quality
assurance assessment fund.
(g) In each fiscal
year governed by this subsection, the quality assurance assessment must only be
collected and expended if Medicaid hospital inpatient DRG and outpatient
reimbursement rates and graduate medical education payments are not below the
level of rates and payments in effect on April 1, 2002 as a direct result of
the quality assurance assessment collected under subsection (1)(i), (1)(j), except as provided in subdivision (h).
(h) The quality
assurance assessment collected under subsection (1)(i)
(1)(j) must not be assessed or collected
after September 30, 2011 if the quality assurance assessment is not eligible
for federal matching funds. Any portion of the quality assurance assessment
collected from a hospital that is not eligible for federal matching funds must
be returned to the hospital.
(i) The state
retention amount of the quality assurance assessment collected under subsection
(1)(i) (1)(j) must
be equal to 13.2% of the federal funds generated by the hospital quality
assurance assessment, including the state retention amount. The 13.2% state
retention amount described in this subdivision does not
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apply
to the Healthy Michigan plan. Beginning in the fiscal year ending September 30,
2018, and for each fiscal year thereafter, there is a retention amount of at
least $118,420,600.00 for each fiscal year for the Healthy Michigan plan. By
May 31 of each year, the department, the state budget office, and the Michigan
Health and Hospital Association shall identify an appropriate retention amount
for the Healthy Michigan plan. The state retention percentage must be applied
proportionately to each hospital quality assurance assessment program to
determine the retention amount for each program. The state retention amount
must be appropriated each fiscal year to the department to support Medicaid
expenditures for hospital services and therapy. These funds must offset an
identical amount of general fund/general purpose revenue originally
appropriated for that purpose.
(13) The department
may establish a quality assurance assessment to increase ambulance
reimbursement as follows:
(a) The quality
assurance assessment authorized under this subsection must be used to provide
reimbursement to Medicaid ambulance providers. The department may promulgate
rules to provide the structure of the quality assurance assessment authorized
under this subsection and the level of the assessment.
(b) The department
shall implement this subsection in a manner that complies with federal
requirements necessary to ensure that the quality assurance assessment
qualifies for federal matching funds.
(c) The total
annual collections by the department under this subsection must not exceed
$20,000,000.00.
(d) The quality
assurance assessment authorized under this subsection must not be collected
after October 1, 2027. The quality
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assurance
assessment authorized under this subsection must no longer be collected or
assessed if the quality assurance assessment authorized under this subsection
is not eligible for federal matching funds.
(e) By November 1
of each year, the department shall send a notification to each ambulance
operation that will be assessed the quality assurance assessment authorized
under this subsection during the year in which the notification is sent.
(14) The quality
assurance assessment provided for under this section is a tax that is levied on
a health facility or agency.
(15) As used in
this section:
(a) "Healthy
Michigan plan" means the medical assistance program described in section
105d of the social welfare act, 1939 PA 280, MCL 400.105d, that has a federal
matching fund rate of not less than 90%.
(b)
"Medicaid" means that term as defined in section 22207.
PART 207A
FREESTANDING ABORTION CLINICS
Sec. 20751. (1) As used in this part:
(a)
"Freestanding abortion clinic" means a facility, other than a
hospital or freestanding surgical outpatient facility, that performs elective
abortions.
(b)
"Elective abortion" means the intentional use of suction, a
substance, or a medical instrument or other device to terminate a woman's
pregnancy for a purpose other than to increase the probability of a live birth,
to preserve the life or health of the child after live birth, or to remove a
fetus that has died as a result of natural causes, accidental trauma, or a
criminal assault on the pregnant woman. Elective abortion does not include any
of
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the following:
(i) The use or prescription of a drug or device intended as a
contraceptive.
(ii) The intentional use of an instrument, drug, or other
substance or device by a physician to terminate a woman's pregnancy if the
woman's physical condition, in the physician's reasonable medical judgment,
necessitates the termination of the woman's pregnancy to avert her death.
(iii) Treatment on a pregnant woman who is experiencing a
miscarriage or has been diagnosed with an ectopic pregnancy.
(c)
"Health care provider" means any of the following:
(i) A physician as that term is defined in section 17001 or
17501.
(ii) A physician's assistant licensed under part 170 or 175.
(iii) A certified nurse practitioner as that term is defined in
section 2701.
(2) In
addition, article 1 contains general definitions and principles of construction
applicable to all articles in this code and part 201 contains definitions
applicable to this part.
Sec. 20761. (1) A freestanding abortion
clinic must be licensed under this article.
(2)
"Freestanding abortion clinic" or a similar term or abbreviation must
not be used to describe or refer to a health facility or agency unless it is
licensed by the department under this article.
Sec. 20763. The owner, operator, and
governing body of a freestanding abortion clinic licensed under this article:
(a) Are
responsible for all phases of the operation of the freestanding abortion
clinic, selection of health care providers,
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and quality of care rendered in the freestanding abortion
clinic.
(b) Shall
cooperate with the department in the enforcement of this article and require
that the health care providers and other personnel working in the freestanding
abortion clinic and for whom a state license or registration is required be
currently licensed or registered.
(c) Subject
to sections 20769 and 20771, shall ensure that health care providers are of a
sufficient number to maintain safety and quality of care and have the
qualifications, training, and skills necessary to meet operational needs and
the needs of a patient, considering the caseload and size of the freestanding
abortion clinic.
Sec. 20765. Subject to this part and any
rules promulgated for purposes of this part, a freestanding abortion clinic
shall comply with all of the following:
(a) Have a
plan to identify needs caused by social determinants of health and, with the
consent of a patient, refer the patient to a support service to address the
patient's needs. For purposes of this subdivision, "support service"
includes, but is not limited to, a food assistance program, a counseling
service, an early childhood development resource, a housing assistance program,
or an intimate partner violence support group.
(b)
Develop, implement, and enforce written policies and procedures for the
freestanding abortion clinic's operations. The policies and procedures must be
made available to health care providers and other personnel who are employed by
or under contract with the freestanding abortion clinic and must comply with
all of the following:
(i) Be administered in a manner that provides quality health
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care services in a safe environment.
(ii) Identify a process for hiring, credentialing, and
training staff.
(iii) Ensure that the right of a patient to informed consent
and to refuse treatment is upheld at every stage of care.
(iv) Include a process by which health care providers who are
employed by or under contract with the freestanding abortion clinic comply with
all of the following:
(A) Refer a
patient to services that are not directly provided by the freestanding abortion
clinic, including, but not limited to, outside laboratory testing services,
sonogram services, and mental health providers.
(B) Consult
with another health care provider.
(C) Refer a
patient to another health care provider.
(D)
Transfer the care of a patient to another health care provider with the
informed consent of the patient.
(E)
Initiate patient transport to a hospital described under subdivision (e) when
needed by calling 9-1-1 or an ambulance operation or by arranging other means
for patient transport.
(F) Notify
a hospital described under subdivision (e) of the freestanding abortion
clinic's license.
(G) Include
a process by which a patient's medical record is provided to another health
care provider on the patient's request or if the patient is transferred as
described in sub-subparagraph (D) or (E).
(c) Ensure
that any service is provided with adequate space for any furnishings, equipment,
supplies, and accommodations for a patient and the family of the patient.
(d) Ensure
that a patient is notified of each health care
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provider within the freestanding abortion clinic who
maintains a malpractice liability insurance policy and each health care
provider who does not.
(e)
Identify a hospital to which a patient may be transferred from the freestanding
abortion clinic and that is in close proximity to the freestanding abortion
clinic.
Sec. 20767. (1) A freestanding abortion
clinic shall not do any of the following:
(a) Except
as otherwise provided in this subdivision, use general or regional anesthesia,
including epidural anesthesia. Local anesthesia, nitrous oxide, and other forms
of pain relief may be administered at the freestanding abortion clinic if all
of the following are met:
(i) It is determined to be clinically necessary by a health
care provider.
(ii) It is administered by a health care provider who is
acting within the scope of the health care provider's practice.
(iii) It is used according to the freestanding abortion
clinic's policies and procedures and according to the professionally recognized
standards of practice described in section 20777.
(b) Perform
an elective abortion at the freestanding abortion clinic if any of the
following limiting factors apply:
(i) Fetal gestation is more than 22 weeks and 0 days.
(ii) Any other limiting factor established by rule under
section 20777 is present in the patient or the clinical needs of the patient
fall outside the scope of practice of a health care provider at the
freestanding abortion clinic.
(2) A
freestanding abortion clinic shall develop policies and procedures for
assessing a patient seeking an elective abortion to
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determine whether it is appropriate for the patient to have
the elective abortion at the freestanding abortion clinic or if the patient
should be referred to a hospital.
Sec. 20769. (1) A freestanding abortion clinic
shall provide all of the following:
(a)
Respectful, supportive care for which the patient provides consent.
(b)
Minimization of stress-inducing stimuli.
(c) Freedom
of movement.
(d) Oral
intake, as appropriate.
(e)
Availability of nonpharmacologic pain relief methods.
(f) Regular
and appropriate assessment of the patient and throughout the elective abortion
procedure and recovery.
(2) The
freestanding abortion clinic shall provide a patient, at the intake, with all
of the following information:
(a) A
written description of the training, philosophy of practice, qualifications,
and license or specialty certification of a health care provider who is
employed by or under contract with the freestanding abortion clinic.
(b) A
written description of the freestanding abortion clinic's patient practice
policies.
(c) The
complaint process for state and national credentialing organizations for a
health care provider who is employed by or under contract with the freestanding
abortion clinic.
(3) The
freestanding abortion clinic shall ensure that a health care provider is
present or available to the patient at all times when a patient is at the
freestanding abortion clinic and until the patient has been determined to be
clinically stable, based on criteria established by the freestanding abortion clinic.
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(4) The
freestanding abortion clinic shall ensure that a health care provider monitors
the progress of a patient's elective abortion and the condition of the patient
at intervals established in the freestanding abortion clinic's policies and
procedures.
(5) Subject
to this subsection, the freestanding abortion clinic shall have the personnel
and equipment necessary to ensure patient safety, meet the demands for services
that are routinely provided in the freestanding abortion clinic, provide
coverage during periods of high demand or in the case of an emergency, and
respond to patient health emergencies that may arise while a patient is
receiving services in the freestanding abortion clinic, including, but not
limited to, basic life support and the initial management of complications. The
freestanding abortion clinic shall ensure that at least 2 individuals are on
the premises and immediately available during an elective abortion who are
certified in basic life support from the American Heart Association or an
equivalent organization as determined by the department.
Sec. 20771. (1) A freestanding abortion clinic
shall not discharge a patient from the freestanding abortion clinic until the
patient is clinically stable and has met discharge criteria established by the
freestanding abortion clinic.
(2) A
freestanding abortion clinic shall ensure that a program for follow-up care
evaluation is planned for each patient.
(3) A
freestanding abortion clinic shall ensure that both of the following are
available to a patient of the freestanding abortion clinic 24 hours a day and 7
days a week:
(a)
Consultation with a health care provider by telephone.
(b) A
health care provider or other personnel who are available on call to provide
emergency follow-up care to the
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patient.
Sec. 20773. (1) The department shall not
require a freestanding abortion clinic to do any of the following:
(a)
Maintain a collaborative agreement with another health facility or agency or
with a health care provider who is not employed by or under contract with a
freestanding abortion clinic.
(b) Provide
care other than elective abortion services.
(2)
Subsection (1) does not limit a freestanding abortion clinic from maintaining a
collaborative agreement or providing care other than elective abortion services
as described under subsection (1).
Sec. 20775. (1) A freestanding abortion clinic
shall recommend that health care providers and other personnel who are employed
by or under contract with the freestanding abortion clinic receive an annual
vaccination against influenza and recommend that health care providers and
other personnel who are employed by or under contract with the freestanding
abortion clinic are fully vaccinated against COVID-19.
(2) A
freestanding abortion clinic shall provide evidence to the department, on
request, of immunization, positive titer result, or documentation of refusal
for health care providers and other personnel who are employed by or under
contract with the freestanding abortion clinic, for each of the following:
(a)
Rubella.
(b) Tdap.
(c)
Hepatitis B.
(d)
Varicella.
(e) Against
any other disease required by the department by rule.
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(3) A
freestanding abortion clinic shall conduct tuberculosis testing before
employing or entering into a contract with an individual who will work in the
freestanding abortion clinic.
Sec. 20777. The department shall promulgate rules to implement this
part. The rules must include at least all of the following:
(a)
Professionally recognized standards of practice based on standards issued by
the American Congress of Obstetrics and Gynecology and The National Abortion
Federation. If any of the standards described in this subdivision are revised
after the effective date of the amendatory act that added this section, the
department shall take notice of the revision. The department, in consultation
with the persons described in this section, may promulgate rules to incorporate
any revision by reference.
(b)
Limiting factors that, when present, would preclude a patient from having an elective
abortion at a freestanding abortion clinic because the patient has
comorbidities or is beyond the 22 weeks gestation. The rules must allow a
freestanding abortion clinic to develop policies that would include additional
limiting factors to preclude an elective abortion at the freestanding abortion clinic.
Sec. 20779. Notwithstanding part 201, the
department shall not enforce this part or any rules promulgated for purposes of
this part, including, but not limited to, the requirement that a freestanding
abortion clinic be licensed under this article, until 1 year after the
effective date of the amendatory act that added this part.
Sec. 20781. This part does not require new or
additional third-party reimbursement or mandated worker's compensation benefits
for services rendered at a freestanding abortion clinic.
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Sec. 22224d. A freestanding abortion clinic as
that term is defined in section 20751 is not required to obtain a certificate
of need.