CS/HB 1127

1	A bill to be entitled
2	An act relating to abortions; amending s. 390.0111, F.S.;
3	requiring that an ultrasound be performed on a woman
4	obtaining an abortion; specifying who must perform an
5	ultrasound; requiring that the ultrasound be reviewed with
6	the patient before the woman gives informed consent for
7	the abortion procedure; specifying who must review the
8	ultrasound with the patient; requiring that the woman
9	certify in writing that she declined to review the
10	ultrasound and did so of her own free will and without
11	undue influence; providing an exemption from the
12	requirement to view the ultrasound for women who are the
13	victims of rape, incest, domestic violence, or human
14	trafficking or for women who have a serious medical
15	condition necessitating the abortion; revising
16	requirements for written materials; providing that failure
17	to comply with the requirements of the section constitutes
18	grounds for disciplinary action; requiring rulemaking;
19	amending s. 390.012, F.S.; requiring an ultrasound for all
20	patients regardless of when the abortion is performed;
21	requiring the agency to adopt rules requiring clinics to
22	comply with s. 390.0111, F.S.; deleting provisions
23	relating to reviewing ultrasound evaluation results, to
24	conform to changes made by the act; providing for
25	severability; providing an effective date.
26
27	Be It Enacted by the Legislature of the State of Florida:
28
29	Section 1.  Subsection (3) of section 390.0111, Florida
30	Statutes, is amended, and subsections (12) and (13) are added to
31	that section, to read:
32	390.0111  Termination of pregnancies.-
33	(3)  CONSENTS REQUIRED.-A termination of pregnancy may not
34	be performed or induced except with the voluntary and informed
35	written consent of the pregnant woman or, in the case of a
36	mental incompetent, the voluntary and informed written consent
37	of her court-appointed guardian.
38	(a)  Except in the case of a medical emergency, consent to
39	a termination of pregnancy is voluntary and informed only if:
40	1.  The physician who is to perform the procedure, or the
41	referring physician, has, at a minimum, orally, in person,
42	informed the woman of:
43	a.  The nature and risks of undergoing or not undergoing
44	the proposed procedure that a reasonable patient would consider
45	material to making a knowing and willful decision of whether to
46	terminate a pregnancy.
47	b.  The probable gestational age of the fetus, verified by
48	an ultrasound, at the time the termination of pregnancy is to be
49	performed.
50	(I)  The ultrasound must be performed by the physician who
51	is to perform the abortion or by a person having documented
52	evidence that he or she has completed a course in the operation
53	of ultrasound equipment as prescribed by rule and who is working
54	in conjunction with the physician.
55	(II)  The person performing the ultrasound must offer the
56	woman the opportunity to view the live ultrasound images and
57	hear an explanation of them. If the woman accepts the
58	opportunity to view the images and hear the explanation, a
59	physician or a registered nurse, licensed practical nurse,
60	advanced registered nurse practitioner, or physician assistant
61	working in conjunction with the physician must contemporaneously
62	review and explain the images to the woman before the woman
63	gives informed consent to having an abortion procedure
64	performed.
65	(III)  The woman has a right to decline to view and hear
66	the explanation of the live ultrasound images after she is
67	informed of her right and offered an opportunity to view the
68	images and hear the explanation. If the woman declines, the
69	woman shall complete a form acknowledging that she was offered
70	an opportunity to view and hear the explanation of the images
71	but that she declined that opportunity. The form must also
72	indicate that the woman's decision was not based on any undue
73	influence from any person to discourage her from viewing the
74	images or hearing the explanation and that she declined of her
75	own free will.
76	(IV)  Unless requested by the woman, the person performing
77	the ultrasound may not offer the opportunity to view the images
78	and hear the explanation and the explanation may not be given
79	if, at the time the woman schedules or arrives for her
80	appointment to obtain an abortion, a copy of a restraining
81	order, police report, medical record, or other court order or
82	documentation is presented which provides evidence that the
83	woman is obtaining the abortion because the woman is a victim of
84	rape, incest, domestic violence, or human trafficking or that
85	the woman has been diagnosed as having a condition that, on the
86	basis of a physician's good faith clinical judgment, would
87	create a serious risk of substantial and irreversible impairment
88	of a major bodily function if the woman delayed terminating her
89	pregnancy.
90	c.  The medical risks to the woman and fetus of carrying
91	the pregnancy to term.
92	2.  Printed materials prepared and provided by the
93	department have been provided to the pregnant woman, if she
94	chooses to view these materials, including:
95	a.  A description of the fetus, including a description of
96	the various stages of development.
97	b.  A list of entities agencies that offer alternatives to
98	terminating the pregnancy.
99	c.  Detailed information on the availability of medical
100	assistance benefits for prenatal care, childbirth, and neonatal
101	care.
102	3.  The woman acknowledges in writing, before the
103	termination of pregnancy, that the information required to be
104	provided under this subsection has been provided.
105
106	Nothing in this paragraph is intended to prohibit a physician
107	from providing any additional information which the physician
108	deems material to the woman's informed decision to terminate her
109	pregnancy.
110	(b)  If In the event a medical emergency exists and a
111	physician cannot comply with the requirements for informed
112	consent, a physician may terminate a pregnancy if he or she has
113	obtained at least one corroborative medical opinion attesting to
114	the medical necessity for emergency medical procedures and to
115	the fact that to a reasonable degree of medical certainty the
116	continuation of the pregnancy would threaten the life of the
117	pregnant woman. If a In the event no second physician is not
118	available for a corroborating opinion, the physician may proceed
119	but shall document reasons for the medical necessity in the
120	patient's medical records.
121	(c)  Violation of this subsection by a physician
122	constitutes grounds for disciplinary action under s. 458.331 or
123	s. 459.015. Substantial compliance or reasonable belief that
124	complying with the requirements of informed consent would
125	threaten the life or health of the patient is a defense to any
126	action brought under this paragraph.
127	(12)  FAILURE TO COMPLY.-Failure to comply with the
128	requirements of this section constitutes grounds for
129	disciplinary action under each respective practice act and under
130	s. 456.072.
131	(13)  RULES.-The applicable boards, or the department if
132	there is no board, shall adopt rules necessary to implement the
133	provisions of this section.
134	Section 2.  Paragraph (d) of subsection (3) of section
135	390.012, Florida Statutes, is amended to read:
136	390.012  Powers of agency; rules; disposal of fetal
137	remains.-
138	(3)  For clinics that perform or claim to perform abortions
139	after the first trimester of pregnancy, the agency shall adopt
140	rules pursuant to ss. 120.536(1) and 120.54 to implement the
141	provisions of this chapter, including the following:
142	(d)  Rules relating to the medical screening and evaluation
143	of each abortion clinic patient. At a minimum, these rules shall
144	require:
145	1.  A medical history including reported allergies to
146	medications, antiseptic solutions, or latex; past surgeries; and
147	an obstetric and gynecological history.
148	2.  A physical examination, including a bimanual
149	examination estimating uterine size and palpation of the adnexa.
150	3.  The appropriate laboratory tests, including:
151	a.  For an abortion in which an ultrasound examination is
152	not performed before the abortion procedure, Urine or blood
153	tests for pregnancy performed before the abortion procedure.
154	b.  A test for anemia.
155	c.  Rh typing, unless reliable written documentation of
156	blood type is available.
157	d.  Other tests as indicated from the physical examination.
158	4.  An ultrasound evaluation for all patients who elect to
159	have an abortion after the first trimester. The rules shall
160	require that if a person who is not a physician performs an
161	ultrasound examination, that person shall have documented
162	evidence that he or she has completed a course in the operation
163	of ultrasound equipment as prescribed in rule. The rules shall
164	require clinics to be in compliance with s. 390.0111. The
165	physician, registered nurse, licensed practical nurse, advanced
166	registered nurse practitioner, or physician assistant shall
167	review, at the request of the patient, the ultrasound evaluation
168	results, including an estimate of the probable gestational age
169	of the fetus, with the patient before the abortion procedure is
170	performed.
171	5.  That the physician is responsible for estimating the
172	gestational age of the fetus based on the ultrasound examination
173	and obstetric standards in keeping with established standards of
174	care regarding the estimation of fetal age as defined in rule
175	and shall write the estimate in the patient's medical history.
176	The physician shall keep original prints of each ultrasound
177	examination of a patient in the patient's medical history file.
178	Section 3.  If any provision of this act or the application
179	thereof to any person or circumstance is held invalid, the
180	invalidity does not affect other provisions or applications of
181	the act which can be given effect without the invalid provision
182	or application, and to this end the provisions of this act are
183	severable.
184	Section 4.  This act shall take effect July 1, 2011.

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