Missouri Senate

Perfected

TISSUE REPORTS (Section 188.047)

Under this act, tissue which was removed at the time of abortion and sent to a pathologist for examination shall be submitted within five business days for gross and, if indicated, histopathological examination. The pathologist shall provide a copy of the tissue report to the abortion facility or hospital within seventy-two hours. If the pathological examination does not reveal the presence of a completed abortion, the pathologist shall notify the abortion facility within twenty-four hours.

The Department shall reconcile each notice of abortion with its corresponding tissue report. If the Department does not receive either a notice or a report, the Department shall make an inquiry of the abortion facility or hospital. After such inquiry, if the hospital or abortion facility has not satisfactorily responded to said inquiry, and the Department finds that the abortion facility or hospital was not in compliance with this provision, the Department shall consider such noncompliance a deficiency requiring an unscheduled inspection of the facility to ensure the deficiency is remedied, subject to applicable licensure procedures.

Finally, this provision requires the Department, beginning January 1, 2018, to make an annual report to the General Assembly. The report shall include all reports and information received under this provision and the following for each abortion procedure reported to the Department the previous calendar year: (1) the abortion procedure used; (2) whether the Department received the tissue report for that abortion; and (3) the existence and nature, if any, of any inconsistencies or concerns between the physician's abortion report to the Department and the pathologist's submitted tissue report. The report shall not disclose any personal patient information prohibited by law and shall maintain the confidentiality of all personal information of patients, facility personnel, and facility physicians.

ATTORNEY GENERAL JURISDICTION (Section 188.075)

Under this act, the Attorney General shall have concurrent original jurisdiction throughout the state, along with each prosecuting or circuit attorney within their respective jurisdictions, to an action for any violation of the state's abortion laws, in which the prosecuting or circuit attorney has yet to commence such an action and the Attorney General shall first give the prosecuting or circuit attorney written notice, by certified mail, of his or her intent to commence an action. The Attorney General may not commence such action if, within ten business days following the prosecuting or circuit attorney's receipt of the written notice, the prosecuting or circuit attorney commences an action. The Attorney General, or each respective prosecuting or circuit attorney, may seek injunctive or any other relief as necessary. This provision shall only apply to violations occurring on or after the effective date of this act.

This provision is similar to SB 196 (2017) and similar to provisions of HCS/HB 1846 (2014).

PREEMPTION OF POLITICAL SUBDIVISION AUTHORITY REGARDING ABORTION (Section 188.125)

Under this act, the General Assembly acknowledges the rights of alternatives to abortion agencies to operate freely and engage in speech without government interference, as well as the right of a person not to be compelled by the government to participate in abortion, and that the constitution and laws of the United States and Missouri shall be interpreted, construed, applied, and enforced to fully protect these rights.

A political subdivision is preempted from enacting, adopting, maintaining, or enforcing any order, ordinance, rule, regulation, policy, or other similar measure that: (1) prohibits, restricts, limits, controls, directs, interferes with, or otherwise adversely affects an alternatives to abortion agency or its officers', agents', employees', or volunteers' operations or speech; (2) has the purpose or effect of requiring a person to directly or indirectly participate in abortion if such participation is contrary to their religious beliefs or moral convictions; (3) requires a real estate broker, real estate salesperson, real estate broker-salesperson, appraisal firm, appraiser, property owner, or any other person to buy, sell, exchange, purchase, rent, lease, advertise for, or otherwise conduct real estate transactions for, to, or with an abortion facility or for, to, or with a person for the purpose of performing or inducing an abortion not necessary to save the life of the mother if such requirement is contrary to their religious beliefs or moral convictions; and (4) requires an employer, employee, health care provider, health plan provider, health plan sponsor, or any other person to provide coverage for or to participate in a health plan that includes benefits that are not otherwise required by state law. However, nothing in this act shall be construed to prohibit any political subdivision from enacting, adopting, maintaining, or enforcing any order, ordinance, rule, regulation, policy, or other similar measure to assist pregnant women to carry their unborn children to term or to assist women in caring for their dependent children or placing them for adoption.

A court may order injunctive relief with specified damages for violations of this provision. Additionally, the Attorney General may bring a cause of action to defend the rights guaranteed under this act.

Nothing in this provision shall preclude or preempt a political subdivision from exercising its lawful authority to regulate zoning or land use or to enforce a building or fire code regulation, provided that the political subdivision treats an alternatives to abortion agency in the same manner as a similarly situated agency.

This provision is identical to SS/SB 41 (2017) and SCS/HCS/HB 174 (2017) and similar to provisions in HB 99 (2015), HB 919 (2015), HB 1103 (2014), SCS/HCS/HB 1192 (2014), SB 658 (2014), HB 31 (2013), HB 717 (2013), SB 50 (2013), HB 1357 (2012), and SB 745 (2012).

WHISTLEBLOWER PROTECTIONS (Section 188.160)

Every hospital, abortion facility, pathology laboratory, medical research entity, and any other facility involved in performing or inducing abortions shall establish and implement a written policy relating to protections for employees who disclose information concerning actual, potential, or alleged violations of applicable federal or state laws or administrative rules, regulations, or standards. The Department may adopt rules, regulations, or standards regarding the establishment and implementation of such policies.

DEFINITION OF AN ABORTION FACILITY (Sections 197.200 and 197.215)

This act modifies the definition of an ambulatory surgical to remove any reference to establishments operated for the purpose of performing or inducing an abortion and creates a new definition for such establishments.

This act adds a requirement for licensure of an abortion facility that each physician who is authorized to perform or induce an abortion be currently licensed to practice in Missouri. Additionally, this act limits the facility licensure requirement that physicians have surgical privileges at nearby hospitals to ambulatory surgical centers only and not abortion facilities.

This act modifies several other provisions of law to include references to or replace references to "ambulatory surgical centers" with the newly-defined "abortion facilities", including provisions relating to infection control, licensure standards, staff training, and whistleblower protections.

ABORTION FACILITY INSPECTIONS (Section 197.230)

This provision requires the Department to conduct annual, unannounced, on-site inspections and investigations of abortion facilities. These inspections shall, at a minimum, include the following areas: (1) compliance with all statutory and regulatory requirements for an abortion facility, including requirements that the facility maintain adequate staffing and equipment to respond to medical emergencies; (2) compliance with the provisions of Chapter 188; and (3) compliance with the requirement in state law that continuous physician or registered professional nursing services be provided whenever a patient is in the facility. Additionally, the inspection and investigation reports shall be available to the public, provided that information not subject to disclosure under the law be redacted.

Provisions of this act are identical to SS/SB 67 (2017) and similar to SCS/SB 644 (2016) and HCS/HBs 2069 & 2371 (2016).

SARAH HASKINS