Rep. Norm Thurston — Voting Record

Bill

Number

H.B. 560 (2024GS)

Sponsor

Rep. Lisonbee, K.

Final action

Governor Signed 3/14/2024

Outcome

Became law — signed by Gov. Spencer J. Cox

Summary

What it does

• This bill:
• modifies definitions;
• allows the licensing of abortion clinics;
• allows abortions to be performed in licensed abortion clinics; and
• makes technical and conforming changes.

Every vote on this bill

Bill text

LICENSING MODIFICATIONS
GENERAL SESSION
STATE OF UTAH
Chief Sponsor: Karianne Lisonbee
Senate Sponsor: 
 Daniel McCay
LONG TITLE
General Description:
This bill modifies licensing provisions related to abortion.
Highlighted Provisions:
This bill:
▸ modifies definitions;
▸ allows the licensing of abortion clinics;
▸ allows abortions to be performed in licensed abortion clinics; and
▸ makes technical and conforming changes.
Money Appropriated in this Bill:
None
Other Special Clauses:
This bill provides a special effective date.
Utah Code Sections Affected:
AMENDS:
26B-2-201
, as last amended by Laws of Utah 2023, Chapter 301 and renumbered and
amended by Laws of Utah 2023, Chapter 305
26B-2-204
, as last amended by Laws of Utah 2023, Chapter 301 and renumbered and
amended by Laws of Utah 2023, Chapter 305
26B-2-205
, as last amended by Laws of Utah 2023, Chapter 301 and renumbered and
amended by Laws of Utah 2023, Chapter 305
26B-2-206
, as last amended by Laws of Utah 2023, Chapter 301 and renumbered and
amended by Laws of Utah 2023, Chapter 305
26B-2-224
, as last amended by Laws of Utah 2023, Chapter 301 and renumbered and
amended by Laws of Utah 2023, Chapter 305
76-7-301
, as last amended by Laws of Utah 2023, Chapters 301, 330
76-7-302
, as last amended by Laws of Utah 2023, Chapters 158, 301
76-7-305
, as last amended by Laws of Utah 2023, Chapters 301, 330
76-7a-101
, as last amended by Laws of Utah 2023, Chapters 158, 301
76-7a-201
, as last amended by Laws of Utah 2023, Chapters 158, 301
Be it enacted by the Legislature of the state of Utah:
Section 1. Section 
26B-2-201
 is amended to read:
26B-2-201.
Definitions.
As used in this part:
(1) [
(a)
] "Abortion clinic" means a type I abortion clinic or a type II abortion clinic.
[
(b) "Abortion clinic" does not mean a clinic that meets the definition of hospital under
Section 
76-7-301
 or Section 
76-71-101
.
]
(2) "Activities of daily living" means essential activities including:
(a) dressing;
(b) eating;
(c) grooming;
(d) bathing;
(e) toileting;
(f) ambulation;
(g) transferring; and
(h) self-administration of medication.
(3) "Ambulatory surgical facility" means a freestanding facility, which provides
surgical services to patients not requiring hospitalization.
(4) "Assistance with activities of daily living" means providing of or arranging for the
provision of assistance with activities of daily living.
(5) (a) "Assisted living facility" means:
(i) a type I assisted living facility, which is a residential facility that provides assistance
with activities of daily living and social care to two or more residents who:
(A) require protected living arrangements; and
(B) are capable of achieving mobility sufficient to exit the facility without the
assistance of another person; and
(ii) a type II assisted living facility, which is a residential facility with a home-like
setting that provides an array of coordinated supportive personal and health care services
available 24 hours per day to residents who have been assessed under department rule to need
any of these services.
(b) Each resident in a type I or type II assisted living facility shall have a service plan
based on the assessment, which may include:
(i) specified services of intermittent nursing care;
(ii) administration of medication; and
(iii) support services promoting residents' independence and self-sufficiency.
(6) "Birthing center" means a facility that:
(a) receives maternal clients and provides care during pregnancy, delivery, and
immediately after delivery; and
(b) (i) is freestanding; or
(ii) is not freestanding, but meets the requirements for an alongside midwifery unit
described in Subsection 
26B-2-228
(7).
(7) "Committee" means the Health Facility Committee created in Section 
26B-1-204
.
(8) "Consumer" means any person not primarily engaged in the provision of health care
to individuals or in the administration of facilities or institutions in which such care is provided
and who does not hold a fiduciary position, or have a fiduciary interest in any entity involved in
the provision of health care, and does not receive, either directly or through his spouse, more
than 1/10 of his gross income from any entity or activity relating to health care.
(9) "End stage renal disease facility" means a facility which furnishes staff-assisted
kidney dialysis services, self-dialysis services, or home-dialysis services on an outpatient basis.
(10) "Freestanding" means existing independently or physically separated from another
health care facility by fire walls and doors and administrated by separate staff with separate
records.
(11) "General acute hospital" means a facility which provides diagnostic, therapeutic,
and rehabilitative services to both inpatients and outpatients by or under the supervision of
physicians.
(12) "Governmental unit" means the state, or any county, municipality, or other
political subdivision or any department, division, board, or agency of the state, a county,
municipality, or other political subdivision.
(13) (a) "Health care facility" means general acute hospitals, specialty hospitals, home
health agencies, hospices, nursing care facilities, residential-assisted living facilities, birthing
centers, ambulatory surgical facilities, small health care facilities, abortion clinics, [
a clinic that
meets the definition of hospital under Section 
76-7-301
 or 
76-71-201
,
] facilities owned or
operated by health maintenance organizations, end stage renal disease facilities, and any other
health care facility which the committee designates by rule.
(b) "Health care facility" does not include the offices of private physicians or dentists,
whether for individual or group practice, except that it does include an abortion clinic.
(14) "Health maintenance organization" means an organization, organized under the
laws of any state which:
(a) is a qualified health maintenance organization under 42 U.S.C. Sec. 300e-9; or
(b) (i) provides or otherwise makes available to enrolled participants at least the
following basic health care services: usual physician services, hospitalization, laboratory, x-ray,
emergency, and preventive services and out-of-area coverage;
(ii) is compensated, except for copayments, for the provision of the basic health
services listed in Subsection (14)(b)(i) to enrolled participants by a payment which is paid on a
periodic basis without regard to the date the health services are provided and which is fixed
without regard to the frequency, extent, or kind of health services actually provided; and
(iii) provides physicians' services primarily directly through physicians who are either
employees or partners of such organizations, or through arrangements with individual
physicians or one or more groups of physicians organized on a group practice or individual
practice basis.
(15) (a) "Home health agency" means an agency, organization, or facility or a
subdivision of an agency, organization, or facility which employs two or more direct care staff
persons who provide licensed nursing services, therapeutic services of physical therapy, speech
therapy, occupational therapy, medical social services, or home health aide services on a
visiting basis.
(b) "Home health agency" does not mean an individual who provides services under
the authority of a private license.
(16) "Hospice" means a program of care for the terminally ill and their families which
occurs in a home or in a health care facility and which provides medical, palliative,
psychological, spiritual, and supportive care and treatment.
(17) "Nursing care facility" means a health care facility, other than a general acute or
specialty hospital, constructed, licensed, and operated to provide patient living
accommodations, 24-hour staff availability, and at least two of the following patient services:
(a) a selection of patient care services, under the direction and supervision of a
registered nurse, ranging from continuous medical, skilled nursing, psychological, or other
professional therapies to intermittent health-related or paraprofessional personal care services;
(b) a structured, supportive social living environment based on a professionally
designed and supervised treatment plan, oriented to the individual's habilitation or
rehabilitation needs; or
(c) a supervised living environment that provides support, training, or assistance with
individual activities of daily living.
(18) "Person" means any individual, firm, partnership, corporation, company,
association, or joint stock association, and the legal successor thereof.
(19) "Resident" means a person 21 years old or older who:
(a) as a result of physical or mental limitations or age requires or requests services
provided in an assisted living facility; and
(b) does not require intensive medical or nursing services as provided in a hospital or
nursing care facility.
(20) "Small health care facility" means a four to 16 bed facility that provides licensed
health care programs and services to residents.
(21) "Specialty hospital" means a facility which provides specialized diagnostic,
therapeutic, or rehabilitative services in the recognized specialty or specialties for which the
hospital is licensed.
(22) "Substantial compliance" means in a department survey of a licensee, the
department determines there is an absence of deficiencies which would harm the physical
health, mental health, safety, or welfare of patients or residents of a licensee.
(23) "Type I abortion clinic" means a facility, including a physician's office, but not
including a general acute or specialty hospital, that:
(a) performs abortions, as defined in Section 
76-7-301
, during the first trimester of
pregnancy; and
(b) does not perform abortions, as defined in Section 
76-7-301
, after the first trimester
of pregnancy.
(24) "Type II abortion clinic" means a facility, including a physician's office, but not
including a general acute or specialty hospital, that:
(a) performs abortions, as defined in Section 
76-7-301
, after the first trimester of
pregnancy; or
(b) performs abortions, as defined in Section 
76-7-301
, during the first trimester of
pregnancy and after the first trimester of pregnancy.
Section 2. Section 
26B-2-204
 is amended to read:
26B-2-204.
Licensing of an abortion clinic -- Rulemaking authority -- Fee.
[
(1) (a) No abortion clinic may operate in the state on or after January 1, 2024, or the
last valid date of an abortion clinic license issued under the requirements of this section,
whichever date is later.
]
[
(b) Notwithstanding Subsection (1)(a), a licensed abortion clinic may not perform an
abortion in violation of any provision of state law.
]
[
(2) The state may not issue a license for an abortion clinic after May 2, 2023.
]
[
(3) For any license for an abortion clinic that is issued under this section:
]
[
(a)
] 
(1)
 A type I abortion clinic may not operate in the state without a license issued by
the department to operate a type I abortion clinic.
[
(b)
] 
(2)
 A type II abortion clinic may not operate in the state without a license issued
by the department to operate a type II abortion clinic.
[
(c)
] 
(3)
 The department shall make rules establishing minimum health, safety,
sanitary, and recordkeeping requirements for:
[
(i)
] 
(a)
 a type I abortion clinic; and
[
(ii)
] 
(b)
 a type II abortion clinic.
[
(d)
] 
(4)
 To receive and maintain a license described in this section, an abortion clinic
shall:
[
(i)
] 
(a)
 apply for a license on a form prescribed by the department;
[
(ii)
] 
(b)
 satisfy and maintain the minimum health, safety, sanitary, and recordkeeping
requirements established [
unde7r
] 
under
 Subsection (3) that relate to the type of abortion clinic
licensed;
[
(iii)
] 
(c)
 comply with the recordkeeping and reporting requirements of Section
76-7-313
;
[
(iv)
] 
(d)
 comply with the requirements of Title 76, Chapter 7, Part 3, Abortion, and
Title 76, Chapter 7a, Abortion Prohibition;
[
(v)
] 
(e)
 pay the annual licensing fee; and
[
(vi)
] 
(f)
 cooperate with inspections conducted by the department.
[
(e)
] 
(5)
 The department shall, at least twice per year, inspect each abortion clinic in
the state to ensure that the abortion clinic is complying with all statutory and licensing
requirements relating to the abortion clinic. At least one of the inspections shall be made
without providing notice to the abortion clinic.
[
(f)
] 
(6)
 The department shall charge an annual license fee, set by the department in
accordance with the procedures described in Section 
63J-1-504
, to an abortion clinic in an
amount that will pay for the cost of the licensing requirements described in this section and the
cost of inspecting abortion clinics.
[
(g)
] 
(7)
 The department shall deposit the licensing fees described in this section in the
General Fund as a dedicated credit to be used solely to pay for the cost of the licensing
requirements described in this section and the cost of inspecting abortion clinics.
[
(4) (a) Notwithstanding any other provision of this section, the department may
license a clinic that meets the definition of hospital under Section 
76-7-301
 or Section
76-7a-101
.
]
[
(b) A clinic described in Subsection (4)(a) is not defined as an abortion clinic.
]
Section 3. Section 
26B-2-205
 is amended to read:
26B-2-205.
Exempt facilities.
This part does not apply to:
(1) a dispensary or first aid facility maintained by any commercial or industrial plant,
educational institution, or convent;
(2) a health care facility owned or operated by an agency of the United States;
(3) the office of a physician, physician assistant, or dentist whether it is an individual
or group practice
, except that it does apply to an abortion clinic
;
(4) a health care facility established or operated by any recognized church or
denomination for the practice of religious tenets administered by mental or spiritual means
without the use of drugs, whether gratuitously or for compensation, if it complies with statutes
and rules on environmental protection and life safety;
(5) any health care facility owned or operated by the Department of Corrections,
created in Section 
64-13-2
; and
(6) a residential facility providing 24-hour care:
(a) that does not employ direct care staff;
(b) in which the residents of the facility contract with a licensed hospice agency to
receive end-of-life medical care; and
(c) that meets other requirements for an exemption as designated by administrative
rule.
Section 4. Section 
26B-2-206
 is amended to read:
26B-2-206.
License required -- Not assignable or transferable -- Posting --
Expiration and renewal -- Time for compliance by operating facilities.
(1) (a) A person or governmental unit acting severally or jointly with any other person
or governmental unit, may not establish, conduct, or maintain a health care facility in this state
without receiving a license from the department as provided by this part and the rules adopted
pursuant to this part .
(b) This Subsection (1) does not apply to facilities that are exempt under Section
26B-2-205
.
(2) A license issued under this part is not assignable or transferable.
(3) The current license shall at all times be posted in each health care facility in a place
readily visible and accessible to the public.
(4) (a) The department may issue a license for a period of time 
not to exceed 12
months from the date of issuance for an abortion clinic and
 not to exceed 24 months from the
date of issuance for 
other
 health care facilities that meet the provisions of this part and
department rules adopted pursuant to this part.
(b) Each license expires at midnight on the day designated on the license as the
expiration date, unless previously revoked by the department.
(c) The license shall be renewed upon completion of the application requirements,
unless the department finds the health care facility has not complied with the provisions of this
part or the rules adopted pursuant to this part.
(5) A license may be issued under this section only for the operation of a specific
facility at a specific site by a specific person.
(6) Any health care facility in operation at the time of adoption of any applicable rules
as provided under this part shall be given a reasonable time for compliance as determined by
the committee.
Section 5. Section 
26B-2-224
 is amended to read:
26B-2-224.
Patient identity protection.
(1) As used in this section:
(a) "EMTALA" means the federal Emergency Medical Treatment and Active Labor
Act.
(b) "Health professional office" means:
(i) a physician's office; or
(ii) a dental office.
(c) "Medical facility" means:
(i) a general acute hospital;
(ii) a specialty hospital;
(iii) a home health agency;
(iv) a hospice;
(v) a nursing care facility;
(vi) a residential-assisted living facility;
(vii) a birthing center;
(viii) an ambulatory surgical facility;
(ix) a small health care facility;
(x) an abortion clinic;
[
(xi) a clinic that meets the definition of hospital under Section 
76-7-301
 or Section
76-7a-101
;
]
[
(xii)
] 
(xi)
 a facility owned or operated by a health maintenance organization;
[
(xiii)
] 
(xii)
 an end stage renal disease facility;
[
(xiv)
] 
(xiii)
 a health care clinic; or
[
(xv)
] 
(xiv)
 any other health care facility that the committee designates by rule.
(2) (a) In order to discourage identity theft and health insurance fraud, and to reduce
the risk of medical errors caused by incorrect medical records, a medical facility or a health
professional office shall request identification from an individual prior to providing in-patient
or out-patient services to the individual.
(b) If the individual who will receive services from the medical facility or a health
professional office lacks the legal capacity to consent to treatment, the medical facility or a
health professional office shall request identification:
(i) for the individual who lacks the legal capacity to consent to treatment; and
(ii) from the individual who consents to treatment on behalf of the individual described
in Subsection (2)(b)(i).
(3) A medical facility or a health professional office:
(a) that is subject to EMTALA:
(i) may not refuse services to an individual on the basis that the individual did not
provide identification when requested; and
(ii) shall post notice in its emergency department that informs a patient of the patient's
right to treatment for an emergency medical condition under EMTALA;
(b) may not be penalized for failing to ask for identification;
(c) is not subject to a private right of action for failing to ask for identification; and
(d) may document or confirm patient identity by:
(i) photograph;
(ii) fingerprinting;
(iii) palm scan; or
(iv) other reasonable means.
(4) The identification described in this section:
(a) is intended to be used for medical records purposes only; and
(b) shall be kept in accordance with the requirements of the Health Insurance
Portability and Accountability Act of 1996.
Section 6. Section 
76-7-301
 is amended to read:
76-7-301.
Definitions.
As used in this part:
(1) (a) "Abortion" means the act, by a physician, of using an instrument, or prescribing
a drug, with the intent to cause the death of an unborn child of a woman known to be pregnant,
except as permitted under this part.
(b) "Abortion" does not include:
(i) removal of a dead unborn child;
(ii) removal of an ectopic pregnancy; or
(iii) the killing or attempted killing of an unborn child without the consent of the
pregnant woman, unless:
(A) the killing or attempted killing is done through a medical procedure carried out by
a physician or through a substance used under the direction of a physician; and
(B) the physician is unable to obtain the consent due to a medical emergency.
(2) "Abortion clinic" means the same as that term is defined in Section 
26B-2-201
.
[
(2)
] 
(3)
 "Abuse" means the same as that term is defined in Section 
80-1-102
.
[
(3)
] 
(4)
 "Department" means the Department of Health and Human Services.
[
(4)
] 
(5)
 "Down syndrome" means a genetic condition associated with an extra
chromosome 21, in whole or in part, or an effective trisomy for chromosome 21.
[
(5)
] 
(6)
 "Gestational age" means the age of an unborn child as calculated from the first
day of the last menstrual period of the pregnant woman.
[
(6)
] 
(7)
 "Hospital" means:
(a) a general hospital licensed by the department according to Title 26B, Chapter 2,
Part 2, Health Care Facility Licensing and Inspection; and
(b) a clinic or other medical facility [
that meets the following criteria:
] 
to the extent
that such clinic or other medical facility is certified by the department as providing equipment
and personnel sufficient in quantity and quality to provide the same degree of safety to the
pregnant woman and the unborn child as would be provided for the particular medical
procedures undertaken by a general hospital licensed by the department.
[
(i) a clinician who performs procedures at the clinic is required to be credentialed to
perform the same procedures at a general hospital licensed by the department; and
]
[
(ii) any procedures performed at the clinic are done with the same level of safety for
the pregnant woman and unborn child as would be available in a general hospital licensed by
the department.
]
[
(7)
] 
(8)
 "Information module" means the pregnancy termination information module
prepared by the department.
[
(8)
] 
(9)
 "Medical emergency" means a life threatening physical condition aggravated
by, caused by, or arising from a pregnancy that places the pregnant woman at risk of death, or
poses a serious risk of substantial impairment of a major bodily function, unless the abortion is
performed or induced.
[
(9)
] 
(10)
 "Minor" means an individual who is:
(a) under 18 years old;
(b) unmarried; and
(c) not emancipated.
[
(10)
] 
(11)
 (a) "Partial birth abortion" means an abortion in which the person
performing the abortion:
(i) deliberately and intentionally vaginally delivers a living fetus until, in the case of a
head first presentation, the entire fetal head is outside the body of the mother, or, in the case of
breech presentation, any part of the fetal trunk past the navel is outside the body of the mother,
for the purpose of performing an overt act that the person knows will kill the partially delivered
living fetus; and
(ii) performs the overt act, other than completion of delivery, that kills the partially
living fetus.
(b) "Partial birth abortion" does not include the dilation and evacuation procedure
involving dismemberment prior to removal, the suction curettage procedure, or the suction
aspiration procedure for abortion.
[
(11)
] 
(12)
 "Perinatal hospice" means comprehensive support to the mother and her
family from the time of the diagnosis of a lethal fetal anomaly, through the time of the child's
birth, and through the postpartum period, that:
(a) focuses on alleviating fear and ensuring that the woman and her family experience
the life and death of a child in a comfortable and supportive environment; and
(b) may include counseling or medical care by:
(i) maternal-fetal medical specialists;
(ii) obstetricians;
(iii) neonatologists;
(iv) anesthesia specialists;
(v) psychiatrists, psychologists, or other mental health providers;
(vi) clergy;
(vii) social workers; or
(viii) specialty nurses.
[
(12)
] 
(13)
 "Physician" means:
(a) a medical doctor licensed to practice medicine and surgery under Title 58, Chapter
67, Utah Medical Practice Act;
(b) an osteopathic physician licensed to practice osteopathic medicine under Title 58,
Chapter 68, Utah Osteopathic Medical Practice Act; or
(c) a physician employed by the federal government who has qualifications similar to
an individual described in Subsection [
(12)(a)
] 
(13)(a)
 or (b).
[
(13)
] 
(14)
 (a) "Severe brain abnormality" means a malformation or defect that causes
an individual to live in a mentally vegetative state.
(b) "Severe brain abnormality" does not include:
(i) Down syndrome;
(ii) spina bifida;
(iii) cerebral palsy; or
(iv) any other malformation, defect, or condition that does not cause an individual to
live in a mentally vegetative state.
Section 7. Section 
76-7-302
 is amended to read:
76-7-302.
Circumstances under which abortion authorized.
(1) An abortion may be performed in this state only by a physician.
(2) An abortion may be performed in this state only under the following circumstances:
(a) the unborn child has not reached 18 weeks gestational age;
(b) the unborn child has reached 18 weeks gestational age, and:
(i) the abortion is necessary to avert:
(A) the death of the woman on whom the abortion is performed; or
(B) a serious physical risk of substantial impairment of a major bodily function of the
woman on whom the abortion is performed; or
(ii) subject to Subsection (4), two physicians who practice maternal fetal medicine
concur, in writing, in the patient's medical record that the fetus has a fetal abnormality that in
the physicians' reasonable medical judgment is incompatible with life; or
(c) the unborn child has not reached 18 weeks gestational age and:
(i) (A) the woman is pregnant as a result of:
(I) rape, as described in Section 
76-5-402
;
(II) rape of a child, as described in Section 
76-5-402.1
; or
(III) incest, as described in Subsection 
76-5-406
(2)(j) or Section 
76-7-102
; or
(B) the pregnant child is under the age of 14; and
(ii) before the abortion is performed, the physician who performs the abortion:
(A) for an abortion authorized under Subsection (2)(c)(i)(A), verifies that the incident
described in Subsection (2)(c)(i)(A) has been reported to law enforcement; and
(B) if applicable, complies with the requirements of Section 
80-2-602
.
(3) An abortion may be performed only in 
an abortion clinic or
 a hospital, unless it is
necessary to perform the abortion in another location due to a medical emergency.
(4) If the unborn child has been diagnosed with a fetal abnormality that is incompatible
with life, at the time of the diagnosis, the physician shall inform the woman, both verbally and
in writing, that perinatal hospice and perinatal palliative care services are available and are an
alternative to abortion.
(5) A physician who performs an abortion under Subsection (2)(c) shall:
(a) maintain an accurate record as to the manner in which the physician conducted the
verification under Subsection (2)(c)(ii)(A); and
(b) report the information described in Subsection (5)(a) to the department in
accordance with Section 
76-7-313
.
Section 8. Section 
76-7-305
 is amended to read:
76-7-305.
Informed consent requirements for abortion -- 72-hour wait mandatory
-- Exceptions.
(1) A person may not perform an abortion, unless, before performing the abortion, the
physician who will perform the abortion obtains from the woman on whom the abortion is to
be performed a voluntary and informed written consent that is consistent with:
(a) Section 8.08 of the American Medical Association's Code of Medical Ethics,
Current Opinions; and
(b) the provisions of this section.
(2) Except as provided in Subsection (8), consent to an abortion is voluntary and
informed only if, at least 72 hours before the abortion:
(a) a staff member of 
an abortion clinic or
 a hospital, physician, registered nurse, nurse
practitioner, advanced practice registered nurse, certified nurse midwife, genetic counselor, or
physician's assistant presents the information module to the pregnant woman;
(b) the pregnant woman views the entire information module and presents evidence to
the individual described in Subsection (2)(a) that the pregnant woman viewed the entire
information module;
(c) after receiving the evidence described in Subsection (2)(b), the individual described
in Subsection (2)(a):
(i) documents that the pregnant woman viewed the entire information module;
(ii) gives the pregnant woman, upon her request, a copy of the documentation
described in Subsection (2)(c)(i); and
(iii) provides a copy of the statement described in Subsection (2)(c)(i) to the physician
who is to perform the abortion, upon request of that physician or the pregnant woman;
(d) after the pregnant woman views the entire information module, the physician who
is to perform the abortion, the referring physician, a physician, a registered nurse, nurse
practitioner, advanced practice registered nurse, certified nurse midwife, genetic counselor, or
physician's assistant, in a face-to-face consultation in any location in the state, orally informs
the woman of:
(i) the nature of the proposed abortion procedure;
(ii) specifically how the procedure described in Subsection (2)(d)(i) will affect the
fetus;
(iii) the risks and alternatives to the abortion procedure or treatment;
(iv) the options and consequences of aborting a medication-induced abortion, if the
proposed abortion procedure is a medication-induced abortion;
(v) the probable gestational age and a description of the development of the unborn
child at the time the abortion would be performed;
(vi) the medical risks associated with carrying her child to term;
(vii) the right to view an ultrasound of the unborn child, at no expense to the pregnant
woman, upon her request; and
(viii) when the result of a prenatal screening or diagnostic test indicates that the unborn
child has or may have Down syndrome, the department's website, which contains the
information described in Section 
26B-7-106
, including the information on the informational
support sheet; and
(e) after the pregnant woman views the entire information module, a staff member of
the 
abortion clinic or
 hospital provides to the pregnant woman:
(i) on a document that the pregnant woman may take home:
(A) the address for the department's website described in Section 
76-7-305.5
; and
(B) a statement that the woman may request, from a staff member of the 
abortion clinic
or
 hospital where the woman viewed the information module, a printed copy of the material on
the department's website;
(ii) a printed copy of the material on the department's website described in Section
76-7-305.5
, if requested by the pregnant woman; and
(iii) a copy of the form described in Subsection 
26B-2-232
(3)(a)(i) regarding the
disposition of the aborted fetus.
(3) Before performing an abortion, the physician who is to perform the abortion shall:
(a) in a face-to-face consultation, provide the information described in Subsection
(2)(d), unless the attending physician or referring physician is the individual who provided the
information required under Subsection (2)(d); and
(b) (i) obtain from the pregnant woman a written certification that the information
required to be provided under Subsection (2) and this Subsection (3) was provided in
accordance with the requirements of Subsection (2) and this Subsection (3);
(ii) obtain a copy of the statement described in Subsection (2)(c)(i); and
(iii) ensure that:
(A) the woman has received the information described in Subsections 
26B-2-232
(3)
and (4); and
(B) if the woman has a preference for the disposition of the aborted fetus, the woman
has informed the health care facility of the woman's decision regarding the disposition of the
aborted fetus.
(4) When a medical emergency compels the performance of an abortion, the physician
shall inform the woman prior to the abortion, if possible, of the medical indications supporting
the physician's judgment that an abortion is necessary.
(5) If an ultrasound is performed on a woman before an abortion is performed, the
individual who performs the ultrasound, or another qualified individual, shall:
(a) inform the woman that the ultrasound images will be simultaneously displayed in a
manner to permit her to:
(i) view the images, if she chooses to view the images; or
(ii) not view the images, if she chooses not to view the images;
(b) simultaneously display the ultrasound images in order to permit the woman to:
(i) view the images, if she chooses to view the images; or
(ii) not view the images, if she chooses not to view the images;
(c) inform the woman that, if she desires, the person performing the ultrasound, or
another qualified person shall provide a detailed description of the ultrasound images,
including:
(i) the dimensions of the unborn child;
(ii) the presence of cardiac activity in the unborn child, if present and viewable; and
(iii) the presence of external body parts or internal organs, if present and viewable; and
(d) provide the detailed description described in Subsection (5)(c), if the woman
requests it.
(6) The information described in Subsections (2), (3), and (5) is not required to be
provided to a pregnant woman under this section if the abortion is performed for a reason
described in:
(a) Subsection 
76-7-302
(2)(b)(i), if the treating physician and one other physician
concur, in writing, that the abortion is necessary to avert:
(i) the death of the woman on whom the abortion is performed; or
(ii) a risk described in Subsection 
76-7-302
(2)(b)(i)(B); or
(b) Subsection 
76-7-302
(2)(b)(ii).
(7) In addition to the criminal penalties described in this part, a physician who violates
the provisions of this section:
(a) is guilty of unprofessional conduct as defined in Section 
58-67-102
 or 
58-68-102
;
and
(b) shall be subject to:
(i) suspension or revocation of the physician's license for the practice of medicine and
surgery in accordance with Section 
58-67-401
 or 
58-68-401
; and
(ii) administrative penalties in accordance with Section 
58-67-402
 or 
58-68-402
.
(8) A physician is not guilty of violating this section for failure to furnish any of the
information described in Subsection (2) or (3), or for failing to comply with Subsection (5), if:
(a) the physician can demonstrate by a preponderance of the evidence that the
physician reasonably believed that furnishing the information would have resulted in a severely
adverse effect on the physical or mental health of the pregnant woman;
(b) in the physician's professional judgment, the abortion was necessary to avert:
(i) the death of the woman on whom the abortion is performed; or
(ii) a risk described in Subsection 
76-7-302
(2)(b)(i)(B);
(c) the pregnancy was the result of rape or rape of a child, as described in Sections
76-5-402
 and 
76-5-402.1
;
(d) the pregnancy was the result of incest, as defined in Subsection 
76-5-406
(2)(j) and
Section 
76-7-102
; or
(e) at the time of the abortion, the pregnant child was 14 years old or younger.
(9) A physician who complies with the provisions of this section and Section
76-7-304.5
 may not be held civilly liable to the physician's patient for failure to obtain
informed consent under Section 
78B-3-406
.
(10) (a) The department shall provide an ultrasound, in accordance with the provisions
of Subsection (5)(b), at no expense to the pregnant woman.
(b) A local health department shall refer a pregnant woman who requests an ultrasound
described in Subsection (10)(a) to the department.
(11) A physician is not guilty of violating this section if:
(a) the information described in Subsection (2) is provided less than 72 hours before
the physician performs the abortion; and
(b) in the physician's professional judgment, the abortion was necessary in a case
where:
(i) a ruptured membrane, documented by the attending or referring physician, will
cause a serious infection; or
(ii) a serious infection, documented by the attending or referring physician, will cause a
ruptured membrane.
Section 9. Section 
76-7a-101
 is amended to read:
76-7a-101.
Definitions.
As used in this chapter:
(1) (a) "Abortion" means the act, by a physician, of using an instrument, or prescribing
a drug, with the intent to cause the death of an unborn child of a woman known to be pregnant,
except as permitted under this chapter.
(b) "Abortion" does not include:
(i) removal of a dead unborn child;
(ii) removal of an ectopic pregnancy; or
(iii) the killing or attempted killing of an unborn child without the consent of the
pregnant woman, unless:
(A) the killing or attempted killing is done through a medical procedure carried out by
a physician or through a substance used under the direction of a physician; and
(B) the physician is unable to obtain the consent due to a medical emergency.
(2) 
"Abortion clinic" means a type I abortion clinic licensed by the state or a type II
abortion clinic licensed by the state.
(3)
 "Department" means the Department of Health and Human Services.
[
(3)
] 
(4)
 "Down syndrome" means a genetic condition associated with an extra
chromosome 21, in whole or in part, or an effective trisomy for chromosome 21.
[
(4)
] 
(5)
 "Hospital" means:
(a) a general hospital licensed by the department; [
and
] 
or
(b) a clinic or other medical facility [
that meets the following criteria:
] 
to the extent the
clinic or other medical facility is certified by the department as providing equipment and
personnel sufficient in quantity and quality to provide the same degree of safety to a pregnant
woman and an unborn child as would be provided for the particular medical procedure
undertaken by a general hospital licensed by the department.
[
(i) a clinician who performs procedures at the clinic is required to be credentialed to
perform the same procedures at a general hospital licensed by the department; and
]
[
(ii) any procedures performed at the clinic are done with the same level of safety for
the pregnant woman and unborn child as would be available in a general hospital licensed by
the department.
]
[
(5)
] 
(6)
 "Medical emergency" means a life threatening physical condition aggravated
by, caused by, or arising from a pregnancy that places the pregnant woman at risk of death, or
poses a serious risk of substantial impairment of a major bodily function, unless the abortion is
performed or induced.
[
(6)
] 
(7)
 "Perinatal hospice" means comprehensive support to the mother and her
family from the time of the diagnosis of a lethal fetal anomaly, through the time of the child's
birth, and through the postpartum period, that:
(a) focuses on alleviating fear and ensuring that the woman and her family experience
the life and death of a child in a comfortable and supportive environment; and
(b) may include counseling or medical care by:
(i) maternal-fetal medical specialists;
(ii) obstetricians;
(iii) neonatologists;
(iv) anesthesia specialists;
(v) psychiatrists, psychologists, or other mental health providers;
(vi) clergy;
(vii) social workers; or
(viii) specialty nurses.
[
(7)
] 
(8)
 "Physician" means:
(a) a medical doctor licensed to practice medicine and surgery in the state;
(b) an osteopathic physician licensed to practice osteopathic medicine in the state; or
(c) a physician employed by the federal government who has qualifications similar to
an individual described in Subsection (7)(a) or (b).
[
(8)
] 
(9)
 (a) "Severe brain abnormality" means a malformation or defect that causes an
individual to live in a mentally vegetative state.
(b) "Severe brain abnormality" does not include:
(i) Down syndrome;
(ii) spina bifida;
(iii) cerebral palsy; or
(iv) any other malformation, defect, or condition that does not cause an individual to
live in a mentally vegetative state.
Section 10. Section 
76-7a-201
 is amended to read:
76-7a-201.
Abortion prohibition -- Exceptions -- Penalties.
(1) An abortion may be performed in this state only under the following circumstances:
(a) the abortion is necessary to avert:
(i) the death of the woman on whom the abortion is performed; or
(ii) a serious physical risk of substantial impairment of a major bodily function of the
woman on whom the abortion is performed;
(b) subject to Subsection (3), two physicians who practice maternal fetal medicine
concur, in writing, in the patient's medical record that the fetus has a fetal abnormality that in
the physicians' reasonable medical judgment is incompatible with life; or
(c) the unborn child has not reached 18 weeks gestational age and:
(i) (A) the woman is pregnant as a result of:
(I) rape, as described in Section 
76-5-402
;
(II) rape of a child, as described in Section 
76-5-402.1
; or
(III) incest, as described in Subsection 
76-5-406
(2)(j) or Section 
76-7-102
; or
(B) the pregnant child is under the age of 14; and
(ii) before the abortion is performed, the physician who performs the abortion:
(A) for an abortion authorized under Subsection (1)(c)(i)(A), verifies that the incident
described in Subsection (1)(c)(i)(A) has been reported to law enforcement; and
(B) if applicable, complies with requirements related to reporting suspicions of or
known child abuse.
(2) An abortion may be performed only:
(a) by a physician; and
(b) in 
an abortion clinic or
 a hospital, unless it is necessary to perform the abortion in
another location due to a medical emergency.
(3) If the unborn child has been diagnosed with a fetal abnormality that is incompatible
with life, at the time of the diagnosis, the physician shall inform the woman, both verbally and
in writing, that perinatal hospice services and perinatal palliative care are available and are an
alternative to abortion.
(4) A person who performs an abortion in violation of this section is guilty of a second
degree felony.
(5) In addition to the penalty described in Subsection (4), the department may take
appropriate corrective action against a health care facility, including revoking the health care
facility's license, if a violation of this chapter occurs at the health care facility.
(6) The department shall report a physician's violation of any provision of this section
to the state entity that regulates the licensing of a physician.
(7) A physician who performs an abortion under Subsection (1)(c) shall:
(a) maintain an accurate record as to the manner in which the physician conducted the
verification under Subsection (1)(c)(ii)(A); and
(b) report the information described in Subsection (7)(a) to the department in
accordance with Section 
76-7-313
.
Section 11. 
Effective date.
(1) Except as provided in Subsection (2), if approved by two-thirds of all the members
elected to each house, this bill takes effect upon approval by the governor, or the day following
the constitutional time limit of Utah Constitution, Article VII, Section 8, without the governor's
signature, or in the case of a veto, the date of veto override.
(2) If this bill is not approved by two-thirds of all members elected to each house, this
bill takes effect May 1, 2024.