Missouri ‘Women’s Health and Clinic Safety Act’ (HB 456)

HB 456 would modify provisions relating to abortion, including donation of fetal organs or tissue, pathology fetal organs and tissue reports, abortion reports, employee disclosure policies, and inspections of abortion facilities.

Donation of Fetal Tissue

The bill would prohibit a person from knowingly donating or making 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.

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, would be guilty of a class C felony and subject to a fine of up to twice the amount of valuable consideration received.

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, or genetic condition of the fetus, the paternity of the fetus, or for law enforcement purposes would not be prohibited.

Fetal Organs and Tissue Reporting Requirements

The bill would require that all fetal organs and tissue removed at the time of an abortion be sent to a pathologist for gross and histopathological examination. All fetal organs and tissue reports issued by the pathologist would need to contain the following information:

• The estimated gestational age of the fetal organs and tissue;
• Whether all fetal organs and tissue were received that would be common for a specimen of such estimated gestational age;
• If the pathologist finds that all fetal organs and tissues were not received, what portion of the fetal organs and tissue were not received;
• A gross diagnosis and detailed gross findings of what was received including the percent blood clot and the percent tissue;
• The date the fetal organs and tissue were remitted to be disposed and the location of such disposal;
• A certification that all submitted fetal organs and tissue have been disposed in accordance with state laws and regulations; and
• The name and physical address of the entity conducting the examination of the specimen containing the fetal organs and tissue.

Each specimen would need to 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, would be required to send the Department of Health and Human Services a report documenting the date the specimen was collected, transported, received, and disposed.

TRAP

The department would need to 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 would be required to conduct an investigation and, if a deficiency is discovered, must perform an unscheduled inspection of the facility to ensure such deficiency is remedied. If the deficiency is not remedied, the department must suspend the abortion facility’s or hospital’s license for at least one year, subject to applicable licensure procedures.

The bill would require the department, beginning January 1, 2018, to make an annual report to the General Assembly. The report would need to include all reports and information received by the department under this law, the number of any deficiencies of each abortion facility in the year and whether such deficiencies were remedied, and the following for each abortion procedure reported:

• The termination procedure used with a clinical estimation of gestation;
• Whether the department received the fetal organs and tissue report for that abortion, along with a certification of the disposal of the fetal organs and tissue; and
• The existence and nature, if any, of any inconsistencies or concerns between the abortion report and the fetal organs and tissue report.

Physicians Reporting Requirements

Currently, an attending physician must submit an abortion report to the department. The bill would require the following additional information to be included in the report:

• The estimation of the gestational age of the fetal organs and tissue;
• Whether all fetal organs and tissue were removed that would be common for a specimen of such estimated gestational age; and
• If the attending physician finds that all fetal organs and tissue were not removed, what portion of the fetal organs and tissue were not removed.

Whistleblower Protections

The bill would require 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 bill goes on to describe what must be included in the policy. The department would need to have access to all information disclosed, collected, and maintained under this provision and complainants must 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 would be required to post a notice containing the disclosure policy.

TRAP

The bill would require the department to conduct annual, unannounced, on-site inspections and investigations of abortion facilities. These inspections must address certain areas of interest including:

• 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;
• Compliance with the requirement that all fetal organs or tissue removed at the time of abortion be submitted to a board certified or eligible pathologist and that the resultant tissue report be made a part of the patient’s permanent record;
• Review of patient records to ensure that no consent forms or other documentation authorizes any utilization of fetal organs or tissue in violation of this provision;
• Compliance with the provisions prohibiting the use of public funds, facilities, and employees to perform or to assist a prohibited abortion or to encourage or to counsel a woman to have a prohibited abortion; and
• Compliance with the requirement that continuous physician services or registered professional nursing services be provided whenever a patient is in the facility.

Inspection, investigation, and reports would need to be made available to the public.

Related Legislation

Companion bill to SB 67.

Similar to HB 602.

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