House File 2316 - Introduced HOUSE FILE 2316 BY THORUP A BILL FOR An Act relating to medication abortions and providing 1 penalties. 2 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 3 TLSB 5473YH (3) 88 pf/rh
H.F. 2316 Section 1. NEW SECTION . 146E.1 Definitions. 1 As used in this section, unless the context otherwise 2 requires: 3 1. “Abortion” means the termination of a human pregnancy 4 with the intent other than to produce a live birth or to remove 5 a dead fetus. 6 2. “Abortion-inducing drug” means a drug, medicine, mixture, 7 or preparation, prescribed or administered with the intent 8 to terminate the pregnancy of a woman known to be pregnant. 9 “Abortion-inducing drug” includes mifepristone and misoprostol. 10 3. “Department” means the department of public health. 11 4. “Medication abortion” means an abortion induced by an 12 abortion-inducing drug. 13 5. “Medical emergency” means the same as defined in section 14 146B.1. 15 6. “Outpatient surgical facility” means the same as defined 16 in section 135.61. 17 7. “Stable” with reference to an internet website means 18 a website that, to the extent reasonably practicable, is 19 safeguarded from having its content altered other than by the 20 department. 21 Sec. 2. NEW SECTION . 146E.2 Facility where medication 22 abortions performed —— posting of signs. 23 1. A private office, freestanding outpatient surgical 24 facility, hospital, or other facility in which medication 25 abortions are performed shall conspicuously post a sign in 26 a location specified in this section, clearly visible to 27 patients, which reads as follows: 28 Recent developing research has indicated that mifepristone 29 alone is not always effective in ending a pregnancy. It may 30 be possible to avoid, cease, or even to reverse the intended 31 effects of a medication abortion utilizing an abortion-inducing 32 drug such as mifepristone if the second pill has not been 33 taken. Please consult with a health care professional 34 immediately. 35 -1- LSB 5473YH (3) 88 pf/rh 1/ 9
H.F. 2316 2. The sign required pursuant to subsection 1 shall be 1 printed with lettering that is legible and shall be at least 2 three-quarters of an inch in boldface type. 3 3. A facility in which medication abortions are performed 4 that is a private office or a freestanding outpatient surgical 5 facility shall post the required sign in each patient waiting 6 room and patient consultation room used by patients on whom 7 medication abortions are performed. A hospital or any other 8 facility in which medication abortions are performed that 9 is not a private office or freestanding outpatient surgical 10 facility shall post the required sign in each patient admission 11 area used by patients on whom medication abortions are 12 performed. 13 Sec. 3. NEW SECTION . 146E.3 Medication abortion —— informed 14 consent. 15 1. Except in the case of a medical emergency, in addition to 16 compliance with the prerequisites of chapter 146A, a physician 17 shall not perform or attempt to perform a medication abortion 18 involving the two-drug process of first dispensing mifepristone 19 followed by the dispensing of misoprostol unless the physician 20 who will perform the medication abortion, the referring 21 physician, or an agent of either physician obtains written 22 certification from the pregnant woman that the woman has been 23 informed, by telephone or in person, at least twenty-four hours 24 before the medication abortion of all of the following: 25 a. It may be possible to reverse the intended effects of a 26 medication abortion utilizing mifepristone if the woman changes 27 her mind but that time is of the essence. 28 b. Information on and assistance with reversing the effects 29 of a medication abortion utilizing mifepristone is available on 30 the department’s internet site. 31 2. Following the dispensing of mifepristone, the attending 32 physician or an agent of the attending physician shall provide 33 written medical discharge instructions to the woman which must 34 include the following statement: 35 -2- LSB 5473YH (3) 88 pf/rh 2/ 9
H.F. 2316 Recent developing research has indicated that mifepristone 1 alone is not always effective in ending a pregnancy. It may 2 be possible to avoid, cease, or even to reverse the intended 3 effects of a medication abortion utilizing an abortion-inducing 4 drug such as mifepristone if the second pill has not been 5 taken. Please consult with a health care professional 6 immediately. 7 3. The attending physician or an agent of the attending 8 physician shall maintain documentation verifying compliance 9 with this section in the woman’s medical record. 10 Sec. 4. NEW SECTION . 146E.4 Printed information and 11 internet site. 12 1. The department shall publish, in English and in each 13 language which is the primary language of two percent or 14 more of the state’s population, and shall make available 15 on the department’s internet site, materials designed to 16 inform a woman of the possibility of reversing the effects 17 of a medication abortion utilizing mifepristone if the woman 18 changes her mind, and information on and assistance with 19 resources that may be available to help reverse the effects 20 of a medication abortion. The materials shall be printed or 21 typed in an easy-to-read font, size, and style, and in a clear, 22 understandable manner calculated to ensure that the information 23 is easily comprehensible. 24 2. The department shall ensure that the department’s 25 internet site is stable and information regarding internet site 26 visits, views, or hits shall not be collected or maintained. 27 The department shall monitor the internet site on a daily basis 28 to prevent and correct tampering. 29 Sec. 5. NEW SECTION . 146E.5 Penalties. 30 1. A person who intentionally performs or attempts to 31 perform a medication abortion in violation of this chapter is 32 guilty of a class “D” felony. 33 2. A physician or physician’s agent shall not be civilly or 34 criminally liable for failure to comply with section 146E.3, 35 -3- LSB 5473YH (3) 88 pf/rh 3/ 9
H.F. 2316 subsection 1, paragraph “b” , regarding information to be 1 provided on the department’s internet site if the information 2 is not available on the department’s internet site at the time 3 the physician or physician’s agent is required to inform a 4 woman of the information. 5 3. A private office, freestanding outpatient surgical 6 facility, hospital, or other facility that intentionally 7 or recklessly fails to post a required sign in violation 8 of section 146E.2 shall be assessed a civil penalty of ten 9 thousand dollars. Each day on which a medication abortion is 10 performed, not including a medication abortion performed in a 11 medical emergency, during which the required sign is not posted 12 during business hours when patients or prospective patients are 13 present, constitutes a separate violation. 14 4. Failure of a physician to comply with this chapter is 15 grounds for licensee discipline under chapter 148. 16 Sec. 6. NEW SECTION . 146E.6 Civil remedies. 17 1. A woman upon whom a medication abortion has been 18 performed or attempted to be performed in violation of this 19 chapter may maintain an action against the physician who 20 performed or attempted to perform the medication abortion in 21 intentional or reckless violation of this chapter for actual 22 damages. 23 2. A parent or guardian of a woman who is less than eighteen 24 years of age at the time the medication abortion was performed 25 or was attempted to be performed upon the woman in violation of 26 this chapter may maintain an action against the physician who 27 performed or attempted to perform the medication abortion in 28 intentional or reckless violation of this chapter for actual 29 damages. 30 3. If the plaintiff prevails in an action brought under 31 this section, the plaintiff shall be entitled to an award of 32 reasonable attorney fees. 33 4. If the defendant prevails in an action brought under 34 this section and the court finds that the plaintiff’s suit was 35 -4- LSB 5473YH (3) 88 pf/rh 4/ 9
H.F. 2316 frivolous and brought in bad faith, the defendant shall be 1 entitled to an award of reasonable attorney fees. 2 5. Damages and attorney fees shall not be assessed against 3 the woman upon whom a medication abortion was performed or 4 attempted except as provided in subsection 4. 5 6. In a civil proceeding or action brought under this 6 chapter, the court shall rule whether the anonymity of any 7 woman upon whom a medication abortion has been performed or 8 attempted shall be preserved from public disclosure if the 9 woman does not provide consent to such disclosure. The court, 10 upon motion or on its own motion, shall make such a ruling 11 and, upon determining that the woman’s anonymity should be 12 preserved, shall issue orders to the parties, witnesses, 13 and counsel and shall direct the sealing of the record and 14 exclusion of individuals from courtrooms or hearing rooms to 15 the extent necessary to safeguard the woman’s identity from 16 public disclosure. Each such order shall be accompanied by 17 specific written findings explaining why the anonymity of the 18 woman should be preserved from public disclosure, why the order 19 is essential to that end, how the order is narrowly tailored 20 to serve that interest, and why no reasonable less restrictive 21 alternative exists. In the absence of written consent of the 22 woman upon whom a medication abortion has been performed or 23 attempted, anyone, other than a public official, who brings 24 an action under this section shall do so under a pseudonym. 25 This subsection shall not be construed to conceal the identity 26 of the plaintiff or of witnesses from the defendant or from 27 attorneys for the defendant. 28 7. This chapter shall not be construed to impose civil or 29 criminal liability on a woman upon whom a medication abortion 30 is performed or attempted. 31 EXPLANATION 32 The inclusion of this explanation does not constitute agreement with 33 the explanation’s substance by the members of the general assembly. 34 This bill relates to medication abortions. 35 -5- LSB 5473YH (3) 88 pf/rh 5/ 9
H.F. 2316 A medication abortion is defined in the bill as an abortion 1 induced by an abortion-inducing drug, defined as a drug, 2 medicine, mixture, or preparation, when it is prescribed or 3 administered with the intent to terminate the pregnancy of a 4 woman known to be pregnant. An abortion-inducing drug includes 5 mifepristone and misoprostol. 6 The bill requires a private office, freestanding outpatient 7 surgical facility, hospital, or other facility in which 8 medication abortions are performed to conspicuously post a sign 9 in a location as described in the bill. 10 The bill specifies that the sign shall be printed with 11 lettering that is legible and shall be at least three-quarters 12 of an inch in boldface type. A facility required to post 13 the sign that is a private office or freestanding outpatient 14 surgical facility must post the sign in each patient waiting 15 room and patient consultation room used by patients on whom 16 medication abortions are performed. A hospital or any other 17 facility in which medication abortions are performed that 18 is not a private office or freestanding outpatient surgical 19 facility shall post the required sign in each patient admission 20 area used by patients on whom medication abortions are 21 performed. 22 The bill requires that, except in the case of a medical 23 emergency, in addition to compliance with the abortion 24 prerequisites of Code chapter 146A, a physician shall not 25 perform or attempt to perform a medication abortion involving 26 the two-drug process of first dispensing mifepristone followed 27 by the dispensing of misoprostol, unless the physician who will 28 perform the medication abortion, the referring physician, or an 29 agent of either physician obtains written certification from 30 the pregnant woman. The written certification shall provide 31 that the woman has been informed, by telephone or in person, 32 at least 24 hours before the medication abortion, that it may 33 be possible to reverse the intended effects of a medication 34 abortion utilizing mifepristone if the woman changes her mind 35 -6- LSB 5473YH (3) 88 pf/rh 6/ 9
H.F. 2316 but that time is of the essence, and that information on and 1 assistance with reversing the effects of a medication abortion 2 utilizing mifepristone is available on the department of public 3 health’s (department) internet site. Following the dispensing 4 of mifepristone, the attending physician or an agent of the 5 attending physician shall provide written medical discharge 6 instructions to the woman which must include the statement 7 specified in the bill. 8 The bill requires the department to publish, in English and 9 in each language which is the primary language of 2 percent 10 or more of the state’s population, and to make available 11 on the department’s internet site, materials designed to 12 inform a woman of the possibility of reversing the effects 13 of a medication abortion utilizing mifepristone if the woman 14 changes her mind, and information on and assistance with the 15 resources that may be available to help reverse the effects 16 of a medication abortion. The materials shall be printed or 17 typed in an easy-to-read font, size, and style, and in a clear, 18 understandable manner calculated to ensure that the information 19 is easily comprehensible. The department shall ensure that the 20 department’s internet site is stable and information regarding 21 internet site visits, views, or hits shall not be collected or 22 maintained. The department shall monitor the internet site on 23 a daily basis to prevent and correct tampering. 24 The bill provides penalties for a violation of the bill. 25 The bill provides that a person who intentionally performs or 26 attempts to perform a medication abortion in violation of the 27 bill is guilty of a class “D” felony. A class “D” felony is 28 punishable by confinement for no more than five years and a 29 fine of at least $750 but not more than $7,500. 30 Under the bill, a physician or physician’s agent shall not 31 be civilly or criminally liable for failure to comply with 32 the provision regarding information to be provided on the 33 department’s internet site if the information is not available 34 on the internet site at the time the physician or physician’s 35 -7- LSB 5473YH (3) 88 pf/rh 7/ 9
H.F. 2316 agent is required to inform a woman of the information. A 1 private office, freestanding outpatient surgical facility, 2 hospital, or other facility that intentionally or recklessly 3 fails to post a required sign in violation of the bill shall 4 be assessed a civil penalty of $10,000. Each day on which a 5 medication abortion is performed, not including a medication 6 abortion performed in a medical emergency, during which the 7 required sign is not posted during business hours when patients 8 or prospective patients are present, constitutes a separate 9 violation. Failure of a physician to comply with the bill is 10 grounds for licensee discipline under Code chapter 148. 11 The bill provides civil remedies for violation of the 12 provisions of the bill. A woman upon whom a medication 13 abortion has been performed or attempted to be performed in 14 violation of the bill may maintain an action against the 15 physician who performed or attempted to perform the medication 16 abortion in intentional or reckless violation of the bill 17 for actual damages. A parent or guardian of a woman who is 18 less than 18 years of age at the time the medication abortion 19 was performed or attempted to be performed upon the woman 20 in violation of the bill may maintain an action against the 21 physician who performed or attempted to perform the medication 22 abortion in intentional or reckless violation of the bill for 23 actual damages. If the plaintiff prevails in an action brought 24 under the bill, the plaintiff shall be entitled to an award 25 of reasonable attorney fees. If the defendant prevails in an 26 action brought under the bill and the court finds that the 27 plaintiff’s suit was frivolous and brought in bad faith, the 28 defendant shall be entitled to an award of reasonable attorney 29 fees. Damages and attorney fees shall not be assessed against 30 the woman upon whom a medication abortion was performed or 31 attempted unless the defendant prevails and the court finds 32 that the plaintiff’s suit was frivolous and brought in bad 33 faith. 34 The bill also provides protections to guard the anonymity of 35 -8- LSB 5473YH (3) 88 pf/rh 8/ 9
H.F. 2316 the woman in a civil action under the bill. The bill is not to 1 be construed to impose civil or criminal liability on a woman 2 upon whom a medication abortion is performed or attempted. 3 -9- LSB 5473YH (3) 88 pf/rh 9/ 9