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Senator Webster moved the following amendment to substitute

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amendment (856752):

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     Senate Amendment (with title amendment)

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     Delete lines 5 through 67

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and insert:

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     Delete lines 26 through 182

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and insert:

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     Section 1.  Subsection (3) of section 390.0111, Florida

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Statutes, is amended to read:

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     390.0111  Termination of pregnancies.--

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     (3)  CONSENTS REQUIRED.--A termination of pregnancy may not

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be performed or induced except with the voluntary and informed

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written consent of the pregnant woman or, in the case of a mental

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incompetent, the voluntary and informed written consent of her

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court-appointed guardian.

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

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termination of pregnancy is voluntary and informed only if:

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

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

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informed the woman of:

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     a.  The nature and risks of undergoing or not undergoing the

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proposed procedure that a reasonable patient would consider

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material to making a knowing and willful decision of whether to

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terminate a pregnancy.

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     b. The probable gestational age of the fetus, verified by

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an ultrasound, at the time the termination of pregnancy is to be

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performed.

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     (I) The ultrasound must be performed by the physician who

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is to perform the abortion or by a person having documented

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evidence that he or she has completed a course in the operation

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of ultrasound equipment as prescribed by rule and who is working

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in conjunction with the physician.

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     (II) The person performing the ultrasound must allow the

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woman to view the live ultrasound images, and a physician or a

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registered nurse, licensed practical nurse, advanced registered

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nurse practitioner, or physician assistant working in conjunction

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with the physician must contemporaneously review and explain the

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live ultrasound images to the woman prior to the woman giving

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informed consent to having an abortion procedure performed.

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However, this sub-sub-subparagraph does not apply if, at the time

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the woman schedules or arrives for her appointment to obtain an

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abortion, a copy of a restraining order, police report, medical

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record, or other court order or documentation is presented that

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evidences that the woman is obtaining the abortion because the

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woman is a victim of rape, incest, domestic violence, or human

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trafficking or that the woman has been diagnosed with a condition

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that, on the basis of a physician's good faith clinical judgment,

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would create a serious risk of substantial and irreversible

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impairment of a major bodily function if the woman delayed

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terminating her pregnancy.

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     (III) The woman has a right to decline to view the

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ultrasound images after she is informed of her right and offered

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an opportunity to view them. If the woman declines to view the

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ultrasound images, the woman shall complete a form acknowledging

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that she was offered an opportunity to view her ultrasound but

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that she rejected that opportunity. The form must also indicate

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that the woman's decision not to view the ultrasound was not

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based on any undue influence from any third party to discourage

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her from viewing the images and that she declined to view the

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images of her own free will.

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

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pregnancy to term.

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     2.  Printed materials prepared and provided by the

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department have been provided to the pregnant woman, if she

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chooses to view these materials, including:

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     a. A description of the fetus, including a description of

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the various stages of development.

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     b. A list of entities agencies that offer alternatives to

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terminating the pregnancy.

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     c.  Detailed information on the availability of medical

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assistance benefits for prenatal care, childbirth, and neonatal

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care.

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     3.  The woman acknowledges in writing, before the

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termination of pregnancy, that the information required to be

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provided under this subsection has been provided.

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Nothing in this paragraph is intended to prohibit a physician

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from providing any additional information which the physician

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

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pregnancy.

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

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cannot comply with the requirements for informed consent, a

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physician may terminate a pregnancy if he or she has obtained at

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least one corroborative medical opinion attesting to the medical

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necessity for emergency medical procedures and to the fact that

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to a reasonable degree of medical certainty the continuation of

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the pregnancy would threaten the life of the pregnant woman. In

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the event no second physician is available for a corroborating

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opinion, the physician may proceed but shall document reasons for

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the medical necessity in the patient's medical records.

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     (c)  Violation of this subsection by a physician constitutes

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grounds for disciplinary action under s. 458.331 or s. 459.015.

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Substantial compliance or reasonable belief that complying with

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the requirements of informed consent would threaten the life or

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health of the patient is a defense to any action brought under

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this paragraph.

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     Section 2.  Subsection (1) and paragraph (d) of subsection

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(3) of section 390.012, Florida Statutes, are amended to read:

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     390.012  Powers of agency; rules; disposal of fetal

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remains.--

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     (1)  The agency may develop and enforce rules pursuant to

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ss. 390.011-390.018 390.001-390.018 and part II of chapter 408

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for the health, care, and treatment of persons in abortion

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clinics and for the safe operation of such clinics.

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     (a)  The rules shall be reasonably related to the

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preservation of maternal health of the clients.

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     (b)  The rules shall be in accordance with s. 797.03 and may

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not impose an unconstitutional burden on a woman's freedom to

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decide whether to terminate her pregnancy.

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     (c)  The rules shall provide for:

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     1.  The performance of pregnancy termination procedures only

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by a licensed physician.

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     2.  The making, protection, and preservation of patient

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records, which shall be treated as medical records under chapter

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458.

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     (3)  For clinics that perform or claim to perform abortions

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after the first trimester of pregnancy, the agency shall adopt

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rules pursuant to ss. 120.536(1) and 120.54 to implement the

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provisions of this chapter, including the following:

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     (d)  Rules relating to the medical screening and evaluation

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of each abortion clinic patient. At a minimum, these rules shall

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require:

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     1.  A medical history including reported allergies to

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medications, antiseptic solutions, or latex; past surgeries; and

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an obstetric and gynecological history.

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     2.  A physical examination, including a bimanual examination

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estimating uterine size and palpation of the adnexa.

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     3.  The appropriate laboratory tests, including:

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     a. For an abortion in which an ultrasound examination is

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not performed before the abortion procedure, Urine or blood tests

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for pregnancy performed before the abortion procedure.

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     b.  A test for anemia.

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     c.  Rh typing, unless reliable written documentation of

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blood type is available.

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     d.  Other tests as indicated from the physical examination.

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     4. An ultrasound evaluation for all patients who elect to

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have an abortion after the first trimester. The rules shall

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require that if a person who is not a physician performs an

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ultrasound examination, that person shall have documented

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evidence that he or she has completed a course in the operation

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of ultrasound equipment as prescribed in rule. The physician,

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registered nurse, licensed practical nurse, advanced registered

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nurse practitioner, or physician assistant shall review and

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explain , at the request of the patient, the live ultrasound

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images evaluation results, including an estimate of the probable

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gestational age of the fetus, with the patient before the

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abortion procedure is performed, unless the patient declines

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pursuant to s. 390.0111. If the patient declines to view the live

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ultrasound images, the rules shall require that s. 390.0111 be

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complied with in all other respects.

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     5.  That the physician is responsible for estimating the

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gestational age of the fetus based on the ultrasound examination

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and obstetric standards in keeping with established standards of

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care regarding the estimation of fetal age as defined in rule and

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shall write the estimate in the patient's medical history. The

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physician shall keep original prints of each ultrasound

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examination of a patient in the patient's medical history file.

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     Section 3. If any provision of this act or the application

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thereof to any person or circumstance is held invalid, the

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invalidity does not affect other provisions or applications of

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the act which can be given effect without the invalid provision

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or application, and to this end the provisions of this act are

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severable.

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     Section 4.  This act shall take effect July 1, 2008.

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

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And the title is amended as follows:

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     Delete lines 72 through 80

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and insert:

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     Delete lines 2 through 22

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and insert:

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An act relating to abortion; amending s. 390.0111, F.S.;

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requiring that an ultrasound be performed on any woman

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obtaining an abortion; specifying who must perform an

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ultrasound; requiring that the ultrasound be reviewed with

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the patient prior to the woman giving informed consent;

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specifying who must review the ultrasound with the

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patient; requiring that the woman certify in writing that

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she declined to review the ultrasound and did so of her

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own free will and without undue influence; providing an

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exemption from the requirement to view the ultrasound for

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women who are the victims of rape, incest, domestic

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violence, or human trafficking or for women who have a

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serious medical condition necessitating the abortion;

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revising requirements for written materials; amending s.

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390.012, F.S.; conforming cross-references; requiring

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ultrasounds for all patients; requiring that live

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ultrasound images be reviewed and explained to the

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patient; requiring that all other provisions in s.

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390.0111, F.S., be complied with if the patient declines

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to view her live ultrasound images; providing for

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severability; providing an effective date.

4/24/2008  9:13:00 AM     9-08579-08