Florida Senate - 2011                        COMMITTEE AMENDMENT
       Bill No. SB 1744
                                Barcode 294860                          
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                  Comm: RCS            .                                
                  04/04/2011           .                                

       The Committee on Health Regulation (Fasano) recommended the
    1         Senate Amendment (with title amendment)
    3         Delete lines 47 - 173
    4  and insert:
    5         (I) The ultrasound must be performed by the physician who
    6  is to perform the abortion or by a person having documented
    7  evidence that he or she has completed a course in the operation
    8  of ultrasound equipment as prescribed by rule and who is working
    9  in conjunction with the physician.
   10         (II) The person performing the ultrasound must allow the
   11  woman to view the live ultrasound images, and a physician or a
   12  registered nurse, licensed practical nurse, advanced registered
   13  nurse practitioner, or physician assistant working in
   14  conjunction with the physician must contemporaneously review and
   15  explain the live ultrasound images to the woman before the woman
   16  gives informed consent to having an abortion procedure
   17  performed. However, this sub-sub-subparagraph does not apply if,
   18  at the time the woman schedules or arrives for her appointment
   19  to obtain an abortion, a copy of a restraining order, police
   20  report, medical record, or other court order or documentation is
   21  presented which provides evidence that the woman is obtaining
   22  the abortion because the woman is a victim of rape, incest,
   23  domestic violence, or human trafficking or that the woman has
   24  been diagnosed as having a condition that, on the basis of a
   25  physician’s good faith clinical judgment, would create a serious
   26  risk of substantial and irreversible impairment of a major
   27  bodily function if the woman delayed terminating her pregnancy.
   28         (III) The woman has a right to decline to view the
   29  ultrasound images after she is informed of her right and offered
   30  an opportunity to view them. If the woman declines to view the
   31  ultrasound images, the woman shall complete a form acknowledging
   32  that she was offered an opportunity to view her ultrasound but
   33  that she rejected that opportunity. The form must also indicate
   34  that the woman’s decision not to view the ultrasound was not
   35  based on any undue influence from any third party to discourage
   36  her from viewing the images and that she declined to view the
   37  images of her own free will.
   38         c. The medical risks to the woman and fetus of carrying the
   39  pregnancy to term.
   40         2. Printed materials prepared and provided by the
   41  department have been provided to the pregnant woman, if she
   42  chooses to view these materials, including:
   43         a. A description of the fetus, including a description of
   44  the various stages of development.
   45         b. A list of entities agencies that offer alternatives to
   46  terminating the pregnancy.
   47         c. Detailed information on the availability of medical
   48  assistance benefits for prenatal care, childbirth, and neonatal
   49  care.
   50         3. The woman acknowledges in writing, before the
   51  termination of pregnancy, that the information required to be
   52  provided under this subsection has been provided.
   54  Nothing in this paragraph is intended to prohibit a physician
   55  from providing any additional information which the physician
   56  deems material to the woman’s informed decision to terminate her
   57  pregnancy.
   58         (b) If In the event a medical emergency exists and a
   59  physician cannot comply with the requirements for informed
   60  consent, a physician may terminate a pregnancy if he or she has
   61  obtained at least one corroborative medical opinion attesting to
   62  the medical necessity for emergency medical procedures and to
   63  the fact that to a reasonable degree of medical certainty the
   64  continuation of the pregnancy would threaten the life of the
   65  pregnant woman. If a In the event no second physician is not
   66  available for a corroborating opinion, the physician may proceed
   67  but shall document reasons for the medical necessity in the
   68  patient’s medical records.
   69         (c) Violation of this subsection by a physician constitutes
   70  grounds for disciplinary action under s. 458.331 or s. 459.015.
   71  Substantial compliance or reasonable belief that complying with
   72  the requirements of informed consent would threaten the life or
   73  health of the patient is a defense to any action brought under
   74  this paragraph.
   75         Section 2. Paragraph (d) of subsection (3) of section
   76  390.012, Florida Statutes, is amended to read:
   77         390.012 Powers of agency; rules; disposal of fetal
   78  remains.—
   79         (3) For clinics that perform or claim to perform abortions
   80  after the first trimester of pregnancy, the agency shall adopt
   81  rules pursuant to ss. 120.536(1) and 120.54 to implement the
   82  provisions of this chapter, including the following:
   83         (d) Rules relating to the medical screening and evaluation
   84  of each abortion clinic patient. At a minimum, these rules shall
   85  require:
   86         1. A medical history including reported allergies to
   87  medications, antiseptic solutions, or latex; past surgeries; and
   88  an obstetric and gynecological history.
   89         2. A physical examination, including a bimanual examination
   90  estimating uterine size and palpation of the adnexa.
   91         3. The appropriate laboratory tests, including:
   92         a. For an abortion in which an ultrasound examination is
   93  not performed before the abortion procedure, Urine or blood
   94  tests for pregnancy performed before the abortion procedure.
   95         b. A test for anemia.
   96         c. Rh typing, unless reliable written documentation of
   97  blood type is available.
   98         d. Other tests as indicated from the physical examination.
   99         4. An ultrasound evaluation for all patients who elect to
  100  have an abortion after the first trimester. The rules shall
  101  require that if a person who is not a physician performs an
  102  ultrasound examination, that person shall have documented
  103  evidence that he or she has completed a course in the operation
  104  of ultrasound equipment as prescribed in rule. The physician,
  105  registered nurse, licensed practical nurse, advanced registered
  106  nurse practitioner, or physician assistant shall review and
  107  explain, at the request of the patient, the live ultrasound
  108  images evaluation results, including an estimate of the probable
  109  gestational age of the fetus, with the patient before the
  110  abortion procedure is performed, unless the patient declines
  111  pursuant to s. 390.0111. If the patient declines to view the
  112  live ultrasound images, the rules shall require that s. 390.0111
  113  be complied with in all other respects.
  114         5. That the physician is responsible for estimating the
  115  gestational age of the fetus based on the ultrasound examination
  116  and obstetric standards in keeping with established standards of
  117  care regarding the estimation of fetal age as defined in rule
  118  and shall write the estimate in the patient’s medical history.
  119  The physician shall keep original prints of each ultrasound
  120  examination of a patient in the patient’s medical history file.
  122  ================= T I T L E  A M E N D M E N T ================
  123         And the title is amended as follows:
  124         Delete lines 3 - 22
  125  and insert:
  126         F.S.; requiring that an ultrasound be performed on a
  127         woman obtaining an abortion; specifying who must
  128         perform an ultrasound; requiring that the ultrasound
  129         be reviewed with the patient before the woman gives
  130         informed consent for the abortion procedure;
  131         specifying who must review the ultrasound with the
  132         patient; requiring that the woman certify in writing
  133         that she declined to review the ultrasound and did so
  134         of her own free will and without undue influence;
  135         providing an exemption from the requirement to view
  136         the ultrasound for women who are the victims of rape,
  137         incest, domestic violence, or human trafficking or for
  138         women who have a serious medical condition
  139         necessitating the abortion; revising requirements for
  140         written materials; amending s. 390.012, F.S.;
  141         requiring an ultrasound for all patients regardless of
  142         when the abortion is performed; requiring that live
  143         ultrasound images be reviewed and explained to the
  144         patient; requiring that all other provisions in s.
  145         390.0111, F.S., be complied with if the patient
  146         declines to view her live ultrasound images; providing