SS/SB 67 - This act, the "Women's Health and Clinic Safety Act", modifies provisions relating to abortion, including donation of fetal organs or tissue, pathology fetal organs and tissue reports, abortion reports, Attorney General jurisdiction, employee disclosure policies, and inspections of abortion facilities. DONATION OF FETAL TISSUE (Section 188.036) Under this provision, no person shall knowingly donate or make an anatomical gift of the fetal organs or tissue resulting from an abortion to any person or entity for medical, scientific, experimental, therapeutic, or any other use. Nothing in this act shall prohibit the utilization of fetal organs or tissue resulting from an abortion for medical or scientific purposes to determine the cause or causes of any anomaly, illness, death, genetic condition, paternity, or for law enforcement purposes. Any person who offers any inducement to a man or woman to conceive or abort a child for the use of fetal organs or tissue, or any person who receives valuable consideration for fetal organs or tissue resulting from an abortion, shall be guilty of a Class C felony and a fine of up to twice the amount of valuable consideration received. FETAL ORGANS AND TISSUE REPORTS (Section 188.047) Under current law, a representative sample of tissue removed at the time of abortion is sent to a pathologist for examination. This provision requires that all fetal organs and tissue removed at the time of abortion be sent to the pathologist for gross and histopathological examination. Additionally, all fetal organs and tissue reports issued by the pathologist shall contain the following: (1) the pathologist's estimation, to a reasonable degree of scientific certainty, of the gestational age of the fetal organs and tissue; (2) whether all organs and tissue received would be common for a specimen of such gestational age and the method of abortion; (3) what, if any, portion of the organs and tissue were not received; (4) a gross diagnosis and detailed gross findings of what was received, including the percent blood clot and the percent tissue; (5) the date the organs and tissue were remitted to be disposed and the location of such disposal; (6) a certification that all submitted organs and tissue have been disposed of in accordance with state and federal laws and regulations; and (7) the name and physical address of the entity conducting the examination of the specimen. Each specimen shall be given a unique identification number to allow the specimen to be tracked. Each facility that handles the specimen, including the abortion facility, the pathology lab, and the final disposition site, shall send the Department of Health and Human Services a report documenting the date the specimen was collected, transported, received, and disposed. This provision shall not apply to funeral establishments. The Department shall reconcile each notice of abortion with its corresponding fetal organs and tissue report. If the Department does not receive either a notice or a report, the Department shall conduct an investigation and, if a deficiency is discovered, shall perform an unscheduled inspection of the facility to ensure such deficiency is remedied. If the deficiency is not remedied, the Department shall suspend the abortion facility's or hospital's license for at least one year, 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 termination procedure used and a clinical estimation of gestation; (2) whether the Department received the fetal organs and tissue report for that abortion, along with a certification of the disposal of the remains; 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 fetal organs and 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. ABORTION REPORTS (Sections 188.052 and 188.055) Under current law, an attending physician must submit an abortion report to the Department. This act requires the abortion report to contain the following: (1) the attending physician's estimation, to a reasonable degree of scientific certainty, of the gestational age of the fetal organs and tissue; (2) whether all fetal organs and tissue were removed that would be common for a specimen of such estimated gestation age; and (3) what, if any, portion of the organs and tissue were not removed. Additionally, the Department shall, upon the request of the President Pro Tempore of the Senate, the Speaker of the House of Representatives, or the minority leaders of either body, prepare a summary of all consent and report forms within its possession, provided that such summary does not contain any personal information of patients, facility personnel, or 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 attorney and circuit attorney within their respective jurisdictions, to commence actions for any violation of the state's abortion laws. The Attorney General, or each respective prosecuting or circuit attorney, may seek injunctive or any other relief as necessary. This provision is identical to SB 196 (2017) and similar to provisions of HCS/HB 1846 (2014). EMPLOYEE DISCLOSURE POLICIES (Section 188.160) This act requires each hospital, ambulatory surgical center, pathology lab, medical research entity, and disposal facility involved in handling fetal organs or tissue from an elective abortion to establish and implement a written policy to protect employees who disclose information concerning alleged violations of applicable federal or state laws or administrative rules concerning the handling of fetal organs or tissue. The policy shall include a time frame for completion of investigations related to complaints, a method for notifying the complainant of the disposition of the investigation, and other specified provisions. The policy shall be submitted to the Department to verify implementation. The Department shall have access to all information disclosed, collected, and maintained under this provision and complainants shall be notified of their right to notify the Department of any information concerning alleged violations relating to abortions or handling of fetal organs or tissue. The act specifies the proper disclosure procedure internally and to the Department. Beginning December 1, 2017, each hospital, ambulatory surgical center, pathology lab, medical research entity, and disposal facility involved in handling fetal organs or tissue from an elective abortion shall post a notice containing the disclosure policy. 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 ambulatory surgical center, including requirements that the facility maintain adequate staffing and equipment to respond to medical emergencies; (2) compliance with the requirement that all tissue removed at the time of an abortion be submitted to a pathologist and that the resultant tissue report be made a part of the patient's permanent record; (3) review patient records to ensure that no consent forms or other documentation authorizes any utilization of fetal organs or tissue in violation of state law; (4) compliance with state law prohibiting the use of public funds, facilities, and employees to perform or assist a prohibited abortion or to encourage or counsel a women to have a prohibited abortion; and (5) 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 substantially similar to provisions in HCS/HB 194 (2017) and similar to SCS/SB 644 (2016) and HCS/HBs 2069 & 2371 (2016). SARAH HASKINS