CODING: Words stricken are deletions; words underlined are additions.





                                                   HOUSE AMENDMENT

                                                  Bill No. HB 3999

    Amendment No.     (for drafter's use only)

                            CHAMBER ACTION
              Senate                               House
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 4                                                                

 5                                           ORIGINAL STAMP BELOW

 6

 7

 8

 9

10                                                                

11  The Committee on Health Care Services offered the following:

12

13         Amendment (with title amendment) 

14  Remove from the bill:  Everything after the enacting clause

15

16  and insert in lieu thereof:

17         Section 1.  SHORT TITLE.--This act may be cited as the

18  "Parental Notice of Abortion Act."

19         Section 2.  Section 390.011, Florida Statutes, is

20  amended to read:

21         390.011  Definitions.--As used in this chapter, the

22  term:

23         (1)  "Abortion" means the termination of human

24  pregnancy with an intention other than to produce a live birth

25  or to remove a dead fetus.

26         (2)  "Abortion clinic" or "clinic" means any facility

27  in which abortions are performed.  The term does not include:

28         (a)  A hospital; or

29         (b)  A physician's office, provided that the office is

30  not used primarily for the performance of abortions.

31         (3) "Actual notice" means the giving of notice

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                                                   HOUSE AMENDMENT

                                                  Bill No. HB 3999

    Amendment No.     (for drafter's use only)





 1  directly, in person, or by telephone.

 2         (4)(3)  "Agency" means the Agency for Health Care

 3  Administration.

 4         (5)  "Child abuse and neglect" shall have the same

 5  meaning as defined in s. 415.503(3) and, as used in this

 6  chapter, shall refer to the commission of acts set forth in s.

 7  415.503(3) against a minor by a family member as defined in s.

 8  440.13(1)(b).

 9         (6)  "Constructive notice" means notice by certified

10  mail to the last known address of the parent or legal guardian

11  of a minor, with delivery deemed to have occurred 48 hours

12  after the certified notice is mailed.

13         (7)(4)  "Department" means the Department of Health.

14         (8)(5)  "Hospital" means a facility licensed under

15  chapter 395.

16         (9)  "Medical emergency" means a condition that, on the

17  basis of a physician's good faith clinical judgment, so

18  complicates the medical condition of a pregnant woman as to

19  necessitate the immediate termination of her pregnancy to

20  avert her death, or for which a delay in the termination of

21  her pregnancy will create serious risk of substantial and

22  irreversible impairment of a major bodily function.

23         (10)(6)  "Physician" means a physician licensed under

24  chapter 458 or chapter 459 or a physician practicing medicine

25  or osteopathic medicine in the employment of the United

26  States.

27         (11)  "Sexual abuse" shall have the same meaning as

28  defined in s. 415.503(15) and, as used in this chapter, shall

29  refer to the commission of acts set forth in s. 415.503(15)

30  against a minor by a family member as defined in s.

31  440.13(1)(b).

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                                                   HOUSE AMENDMENT

                                                  Bill No. HB 3999

    Amendment No.     (for drafter's use only)





 1         (13)(7)  "Third trimester" means the weeks of pregnancy

 2  after the 24th week of pregnancy.

 3         Section 3.  Section 390.0111, Florida Statutes, is

 4  amended to read:

 5         390.0111  Termination of pregnancies.--

 6         (1)  TERMINATION IN THIRD TRIMESTER; WHEN ALLOWED.--No

 7  termination of pregnancy shall be performed on any human being

 8  in the third trimester of pregnancy unless:

 9         (a)  Two physicians certify in writing to the fact

10  that, to a reasonable degree of medical probability, the

11  termination of pregnancy is necessary to save the life or

12  preserve the health of the pregnant woman; or

13         (b)  The physician certifies in writing to the medical

14  necessity for legitimate emergency medical procedures for

15  termination of pregnancy in the last trimester, and another

16  physician is not available for consultation.

17         (2)  PERFORMANCE BY PHYSICIAN REQUIRED.--No termination

18  of pregnancy shall be performed at any time except by a

19  physician.

20         (3)  CONSENTS REQUIRED.--A termination of pregnancy may

21  not be performed or induced except with the voluntary and

22  informed written consent of the pregnant woman or, in the case

23  of a mental incompetent person, the voluntary and informed

24  written consent of her court-appointed guardian.

25         (a)  Except in the case of a medical emergency, consent

26  to a termination of pregnancy is voluntary and informed only

27  if:

28         1.  The physician who is to perform the procedure, or

29  the referring physician, has, at a minimum, orally, in person,

30  informed the woman of:

31         a.  The nature and risks of undergoing or not

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                                                   HOUSE AMENDMENT

                                                  Bill No. HB 3999

    Amendment No.     (for drafter's use only)





 1  undergoing the proposed procedure that a reasonable patient

 2  would consider material to making a knowing and willful

 3  decision of whether to terminate a pregnancy.

 4         b.  The probable gestational age of the fetus at the

 5  time the termination of pregnancy is to be performed.

 6         c.  The medical risks to the woman and fetus of

 7  carrying the pregnancy to term.

 8         2.  Printed materials prepared and provided by the

 9  department have been provided to the pregnant woman, if she

10  chooses to view these materials, including:

11         a.  A description of the fetus.

12         b.  A list of agencies that offer alternatives to

13  terminating the pregnancy.

14         c.  Detailed information on the availability of medical

15  assistance benefits for prenatal care, childbirth, and

16  neonatal care.

17         3.  The woman acknowledges in writing, before the

18  termination of pregnancy, that the information required to be

19  provided under this subsection has been provided.

20

21  Nothing in this paragraph is intended to prohibit a physician

22  from providing any additional information which the physician

23  deems material to the woman's informed decision to terminate

24  her pregnancy.

25         (b)  In the event a medical emergency exists and a

26  physician cannot comply with the requirements for informed

27  consent, a physician may terminate a pregnancy if he or she

28  has obtained at least one corroborative medical opinion

29  attesting to the medical necessity for emergency medical

30  procedures and to the fact that to a reasonable degree of

31  medical certainty the continuation of the pregnancy would

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                                                   HOUSE AMENDMENT

                                                  Bill No. HB 3999

    Amendment No.     (for drafter's use only)





 1  threaten the life of the pregnant woman. In the event no

 2  second physician is available for a corroborating opinion, the

 3  physician may proceed but shall document reasons for the

 4  medical necessity in the patient's medical records.

 5         (c)  Violation of this subsection by a physician

 6  constitutes grounds for disciplinary action under s. 458.331

 7  or s. 459.015. Substantial compliance or reasonable belief

 8  that complying with the requirements of informed consent would

 9  threaten the life or health of the patient is a defense to any

10  action brought under this paragraph.

11         (4)  NOTIFICATION REQUIRED.--

12         (a)  A termination of pregnancy may not be performed or

13  induced upon a minor unless the person performing or inducing

14  the termination of pregnancy has given at least 48 hours

15  actual notice to one parent or to the legal guardian of the

16  pregnant minor of his or her intention to perform or induce

17  the termination of pregnancy. The notice may be given by a

18  referring physician. The person who performs the termination

19  of pregnancy must receive the written statement of the

20  referring physician certifying that the referring physician

21  has given notice. If actual notice is not possible after a

22  reasonable effort, the person or his or her agent must give 48

23  hours constructive notice.

24         (b)  Notice shall not be required if:

25         1.  A medical emergency exists and there is

26  insufficient time for the attending physician to comply with

27  the notification requirements. In the event a medical

28  emergency exists, the physician may terminate the pregnancy if

29  he or she has obtained at least one corroborative medical

30  opinion attesting to the medical necessity for emergency

31  medical procedures.  In the event no second physician is

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                                                   HOUSE AMENDMENT

                                                  Bill No. HB 3999

    Amendment No.     (for drafter's use only)





 1  available for a corroborating opinion, the physician may

 2  proceed but shall document reasons for the medical necessity

 3  in the patient's medical records;

 4         2.  Notice is waived in writing by the person who is

 5  entitled to notice;

 6         3.  Notice is waived if the minor is or has been

 7  married or has the disability of nonage removed pursuant to s.

 8  743.015, or similar statutes of other states; or

 9         4.  Notice is waived under the provisions of subsection

10  (5). 

11         (c)  Violation of this subsection by a physician

12  constitutes grounds for disciplinary action under s. 458.331

13  or s. 459.015.

14         (5)  PROCEDURE FOR JUDICIAL WAIVER OF NOTICE.--

15         (a)  A minor may petition any circuit court for a

16  waiver of the notice requirements of subsection (4) and may

17  participate in proceedings on her own behalf. The petition

18  shall include a statement that the complainant is pregnant and

19  notice has not been waived. The court may appoint a guardian

20  ad litem for her. Any guardian ad litem appointed under this

21  subsection shall act to maintain the confidentiality of the

22  proceedings. The circuit court shall advise the minor that she

23  has a right to court-appointed counsel and shall provide her

24  with counsel upon her request.

25         (b)  Court proceedings under this section shall be

26  confidential and shall ensure the anonymity of the minor. All

27  court proceedings under this section shall be sealed. The

28  minor shall have the right to file her petition in the circuit

29  court using a pseudonym or using solely her initials. All

30  documents related to this petition shall be confidential and

31  shall not be available to the public. Court proceedings under

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                                                   HOUSE AMENDMENT

                                                  Bill No. HB 3999

    Amendment No.     (for drafter's use only)





 1  this section shall be given precedence over other pending

 2  matters to the extent necessary to ensure that the court

 3  reaches a decision promptly. The court shall rule, and issue

 4  written findings of fact and conclusions of law, within 48

 5  hours of the time that the petition was filed, except that the

 6  48-hour limitation may be extended at the request of the

 7  minor. If the court fails to rule within the 48-hour period

 8  and an extension was not requested, then the petition shall be

 9  deemed to have been granted, and the notice requirement shall

10  be waived.

11         (c)  If the court finds, by clear and convincing

12  evidence, that the minor is sufficiently mature to decide

13  whether to terminate her pregnancy, the court shall issue an

14  order authorizing the minor to consent to the performance or

15  inducement of a termination of pregnancy without the

16  notification of a parent or guardian. If the court does not

17  make the finding specified in this paragraph or paragraph (d),

18  it shall dismiss the petition.

19         (d)  If the court finds, by clear and convincing

20  evidence, that there is evidence of child abuse or neglect, or

21  sexual abuse of the complainant by one or both of her parents,

22  her guardian, or her custodian, or that the notification of a

23  parent or guardian is not in the best interest of the

24  complainant, the court shall issue an order authorizing the

25  minor to consent to the performance or inducement of a

26  termination of pregnancy without the notification of a parent

27  or guardian. If the court does not make the finding specified

28  in this paragraph or paragraph (c), it shall dismiss the

29  petition.

30         (e)  A court that conducts proceedings under this

31  section shall issue written and specific factual findings and

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                                                   HOUSE AMENDMENT

                                                  Bill No. HB 3999

    Amendment No.     (for drafter's use only)





 1  legal conclusions supporting its decision and shall order that

 2  a confidential record of the evidence and the judge's findings

 3  and conclusions be maintained. At the hearing, the court shall

 4  hear evidence relating to the emotional development, maturity,

 5  intellect and understanding of the minor.

 6         (f)  An expedited confidential appeal shall be

 7  available, as the Supreme Court provides by rule, to any minor

 8  to whom the circuit court denies a waiver of notice. An order

 9  authorizing a termination of pregnancy without notice shall

10  not be subject to appeal.

11         (g)  No filing fees shall be required of any pregnant

12  minor who petitions a court for a waiver of parental

13  notification under this subsection at either the trial or the

14  appellate level.

15

16  The requirements and procedures under this subsection are

17  available to minors whether or not they are residents of this

18  state.

19         (6)(4)  STANDARD OF MEDICAL CARE TO BE USED DURING

20  VIABILITY.--If a termination of pregnancy is performed during

21  viability, no person who performs or induces the termination

22  of pregnancy shall fail to use that degree of professional

23  skill, care, and diligence to preserve the life and health of

24  the fetus which such person would be required to exercise in

25  order to preserve the life and health of any fetus intended to

26  be born and not aborted. "Viability" means that stage of fetal

27  development when the life of the unborn child may with a

28  reasonable degree of medical probability be continued

29  indefinitely outside the womb. Notwithstanding the provisions

30  of this subsection, the woman's life and health shall

31  constitute an overriding and superior consideration to the

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                                                   HOUSE AMENDMENT

                                                  Bill No. HB 3999

    Amendment No.     (for drafter's use only)





 1  concern for the life and health of the fetus when such

 2  concerns are in conflict.

 3         (7)(5)  EXPERIMENTATION ON FETUS PROHIBITED;

 4  EXCEPTION.--No person shall use any live fetus or live,

 5  premature infant for any type of scientific, research,

 6  laboratory, or other kind of experimentation either prior to

 7  or subsequent to any termination of pregnancy procedure except

 8  as necessary to protect or preserve the life and health of

 9  such fetus or premature infant.

10         (8)(6)  FETAL REMAINS.--Fetal remains shall be disposed

11  of in a sanitary and appropriate manner and in accordance with

12  standard health practices, as provided by rule of the

13  department.  Failure to dispose of fetal remains in accordance

14  with department rules is a misdemeanor of the second degree,

15  punishable as provided in s. 775.082 or s. 775.083.

16         (9)(7)  REFUSAL TO PARTICIPATE IN TERMINATION

17  PROCEDURE.--Nothing in this section shall require any hospital

18  or any person to participate in the termination of a

19  pregnancy, nor shall any hospital or any person be liable for

20  such refusal.  No person who is a member of, or associated

21  with, the staff of a hospital, nor any employee of a hospital

22  or physician in which or by whom the termination of a

23  pregnancy has been authorized or performed, who shall state an

24  objection to such procedure on moral or religious grounds

25  shall be required to participate in the procedure which will

26  result in the termination of pregnancy.  The refusal of any

27  such person or employee to participate shall not form the

28  basis for any disciplinary or other recriminatory action

29  against such person.

30         (10)(8)  EXCEPTION.--The provisions of this section

31  shall not apply to the performance of a procedure which

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                                                   HOUSE AMENDMENT

                                                  Bill No. HB 3999

    Amendment No.     (for drafter's use only)





 1  terminates a pregnancy in order to deliver a live child.

 2         (11)(9)  PENALTIES FOR VIOLATION.--Except as provided

 3  in subsections (3), (4), and (8) (6):

 4         (a)  Any person who willfully performs, or actively

 5  participates in, a termination of a pregnancy procedure in

 6  violation of the requirements of this section commits a felony

 7  of the third degree, punishable as provided in s. 775.082, s.

 8  775.083, or s. 775.084.

 9         (b)  Any person who performs, or actively participates

10  in, a termination of a pregnancy procedure in violation of the

11  provisions of this section which results in the death of the

12  woman commits a felony of the second degree, punishable as

13  provided in s. 775.082, s. 775.083, or s. 775.084.

14         (12)  PROCEEDINGS.--The Supreme Court is requested to

15  adopt rules to ensure that proceedings under this section are

16  handled in an expeditious and confidential manner and in a

17  manner which will satisfy the requirements of state and

18  federal courts.

19         Section 4.  If any provision of this act or the

20  application thereof to any person or circumstance is held

21  invalid, the invalidity shall not affect other provisions or

22  applications of the act which can be given effect without the

23  invalid provision or application, and to this end the

24  provisions of this act are declared severable.

25         Section 5.  This act shall take effect upon becoming a

26  law.

27

28

29  ================ T I T L E   A M E N D M E N T ===============

30  And the title is amended as follows:

31         On page 3, before the enacting clause

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                                                   HOUSE AMENDMENT

                                                  Bill No. HB 3999

    Amendment No.     (for drafter's use only)





 1  remove from the bill all lines:

 2

 3  and insert in lieu thereof:

 4                      A bill to be entitled

 5         An act relating to termination of pregnancies;

 6         providing a short title; amending s. 390.011,

 7         F.S.; defining additional terms; amending s.

 8         390.0111, F.S.; revising provisions relating to

 9         terminations of pregnancies; prohibiting the

10         performing or inducement of a termination of

11         pregnancy upon a minor without specified

12         notice; providing disciplinary action for

13         violation; providing notice requirements;

14         providing exceptions; providing procedure for

15         judicial waiver of notice; providing for

16         confidentiality of proceedings; providing for

17         issuance of a court order authorizing consent

18         to a termination of pregnancy without

19         notification; providing for dismissal of

20         petition; requiring the issuance of written

21         findings of fact and legal conclusions;

22         providing for expedited confidential appeal;

23         providing for waiver of filing fees; requesting

24         the Supreme Court to adopt rules; providing for

25         severability; providing an effective date.

26

27         WHEREAS, the Legislature finds that immature minors

28  often lack the ability to make fully informed choices that

29  take into account both immediate and long-range consequences,

30  and

31         WHEREAS, the medical, emotional, and psychological

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                                                   HOUSE AMENDMENT

                                                  Bill No. HB 3999

    Amendment No.     (for drafter's use only)





 1  consequences of abortion are sometimes serious and can be

 2  lasting, particularly when the patient is immature, and

 3         WHEREAS, the capacity to become pregnant and the

 4  capacity for mature judgment concerning the wisdom of an

 5  abortion are not necessarily related, and

 6         WHEREAS, parents ordinarily possess information

 7  essential to a physician's exercise of his or her best medical

 8  judgment concerning the child, and

 9         WHEREAS, parents who are aware that their minor

10  daughter has had an abortion may better ensure that she

11  receives adequate medical attention after her abortion, and

12         WHEREAS, parental consultation is usually desirable and

13  in the best interests of the minor, and

14         WHEREAS, the Legislature's purpose in enacting parental

15  notice legislation is to further the important and compelling

16  state interests of protecting minors against their own

17  immaturity, fostering family unity and preserving the family

18  as a viable social unit, protecting the constitutional rights

19  of parents to rear children who are members of their

20  household, and reducing teenage pregnancy and unnecessary

21  abortion, NOW, THEREFORE,

22

23

24

25

26

27

28

29

30

31

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