HB 277

1	A bill to be entitled
2	An act relating to abortions; amending s. 390.011,
3	F.S.; providing definitions; amending s. 390.0111,
4	F.S.; conforming terminology to changes made by the
5	act; restricting the circumstances in which an
6	abortion may be performed in the third trimester or
7	after viability; providing certain physician and
8	location requirements with regard to performing
9	abortions; requiring a physician who offers to perform
10	or who performs abortions to complete continuing
11	education related to ethics; prohibiting an abortion
12	from being performed in the third trimester in a
13	location other than a hospital; prohibiting any
14	abortion from being performed in a location other than
15	a hospital, abortion clinic, or physician's office;
16	requiring that certain requirements be completed 24
17	hours before an abortion is performed in order for
18	consent to an abortion to be considered voluntary and
19	informed; conforming terminology; providing that
20	substantial compliance or reasonable belief that
21	noncompliance with the requirements regarding consent
22	is necessary to prevent the death of the pregnant
23	woman or a substantial and irreversible impairment of
24	a major bodily function of the pregnant woman is a
25	defense to a disciplinary action under s. 458.331 or
26	s. 459.015, F.S.; deleting the definition of the term
27	"viability"; providing that the prevention of the
28	death or a substantial and irreversible impairment of
29	a major bodily function of the pregnant woman
30	constitutes an overriding and superior consideration
31	to the concern for the life and health of the fetus
32	under certain circumstances; prohibiting a physician
33	from knowingly performing a partial-birth abortion and
34	thereby killing a human fetus; providing exceptions
35	for when a partial-birth abortion is necessary;
36	increasing the penalty imposed for failing to properly
37	dispose of fetal remains; requiring the Department of
38	Health to permanently revoke the license of any health
39	care practitioner who is convicted or found guilty of,
40	or enters a plea of guilty or nolo contendere to,
41	regardless of adjudication, certain felony criminal
42	acts; providing that an infant born alive subsequent
43	to an attempted abortion is entitled to the same
44	rights, powers, and privileges as are granted by the
45	laws of this state; requiring a health care
46	practitioner to exercise the same degree of
47	professional skill, care, and diligence to preserve
48	the life and health of an infant as a reasonably
49	diligent and conscientious health care practitioner
50	would render to any infant born alive if the infant is
51	born alive subsequent to an attempted abortion;
52	requiring that another physician be present in order
53	to take control of any infant born alive; requiring
54	the physician who performs the abortion to take all
55	reasonable steps consistent with the abortion
56	procedure to preserve the life and health of the
57	unborn child; requiring a health care practitioner who
58	has knowledge of any violations to report the
59	violations to the department; providing that it is a
60	first-degree misdemeanor to unlawfully advertise how
61	to obtain an abortion; requiring an abortion clinic to
62	place a conspicuous notice on its premises and on any
63	form or medium of advertisement of the abortion clinic
64	which states that the abortion clinic is prohibited
65	from performing abortions in the third trimester or
66	after viability; providing a penalty; requiring the
67	Agency for Health Care Administration to submit to the
68	Governor and Legislature an annual report of aggregate
69	statistical data relating to abortions and provide
70	such data on its website; amending s. 390.01114, F.S.;
71	conforming terminology to changes made by the act;
72	deleting the definition of the term "medical
73	emergency"; amending s. 390.0112, F.S.; requiring the
74	director of a hospital, abortion clinic, or
75	physician's office to submit a monthly report to the
76	agency on a form developed by the agency which is
77	consistent with the U.S. Standard Report of Induced
78	Termination of Pregnancy from the Centers for Disease
79	Control and Prevention; requiring that the submitted
80	report not contain any personal identifying
81	information; requiring the agency to submit reported
82	data to the Division of Reproductive Health within the
83	Centers for Disease Control and Prevention; requiring
84	the physician performing the abortion procedure to
85	report such data if the abortion was performed in a
86	hospital, abortion clinic, or physician's office;
87	requiring the agency to adopt rules; amending s.
88	390.012, F.S.; conforming a cross-reference; requiring
89	the agency to adopt rules that prescribe standards for
90	placing conspicuous notice to be provided on the
91	premises and on any advertisement of an abortion
92	clinic which states that the abortion clinic is
93	prohibited from performing abortions in the third
94	trimester or after viability; conforming terminology
95	to changes made by the act; amending s. 390.014, F.S.;
96	prohibiting a person from establishing, conducting,
97	managing, or operating a clinic in this state without
98	a valid and current license issued by the agency;
99	requiring an abortion clinic to be owned and operated
100	by a physician who has received training during
101	residency in performing a dilation-and-curettage
102	procedure or a dilation-and-evacuation procedure or by
103	a corporation or limited liability company composed of
104	one or more such physicians; providing an exception;
105	providing a penalty; amending s. 390.018, F.S.;
106	revising the amount of the fine that the agency may
107	impose for a violation of ch. 390, F.S., relating to
108	abortion, or part II of ch. 408, F.S., relating to
109	licensure; amending s. 456.013, F.S.; requiring that
110	each applicable board require a physician who offers
111	to perform or performs abortions to annually complete
112	a course relating to ethics as part of the licensure
113	and renewal process; providing that the course counts
114	toward the total number of continuing education hours
115	required for the profession; requiring the applicable
116	board to approve the course; amending s. 765.113,
117	F.S.; conforming a cross-reference; repealing ss.
118	782.30, 782.32, 782.34, and 782.36, F.S., relating to
119	the Partial-Birth Abortion Act; repealing s. 797.02,
120	F.S., relating to the advertising of drugs for
121	abortions; repealing s. 797.03, F.S., relating to
122	prohibited acts related to abortions and their
123	penalties; providing for severability; providing an
124	effective date.
125
126	Be It Enacted by the Legislature of the State of Florida:
127
128	Section 1.  Section 390.011, Florida Statutes, is amended
129	to read:
130	390.011  Definitions.-As used in this chapter, the term:
131	(1)  "Abortion" means the termination of human pregnancy
132	with an intention other than to produce a live birth or to
133	remove a dead fetus.
134	(2)  "Abortion clinic" or "clinic" means any facility in
135	which abortions are performed. The term does not include:
136	(a)  A hospital; or
137	(b)  A physician's office, provided that the office is not
138	used primarily for the performance of abortions.
139	(3)  "Agency" means the Agency for Health Care
140	Administration.
141	(4)  "Born alive" means the complete expulsion or
142	extraction from the mother of a human infant, at any stage of
143	development, who, after such expulsion or extraction, breathes
144	or has a beating heart, pulsation of the umbilical cord, or
145	definite and voluntary movement of muscles, regardless of
146	whether the umbilical cord has been cut and regardless of
147	whether the expulsion or extraction occurs as a result of
148	natural or induced labor, cesarean section, induced abortion, or
149	other method.
150	(5)(4)  "Department" means the Department of Health.
151	(6)  "Health care practitioner" means any person licensed
152	under chapter 457; chapter 458; chapter 459; chapter 460;
153	chapter 461; chapter 462; chapter 463; chapter 464; chapter 465;
154	chapter 466; chapter 467; part I, part II, part III, part V,
155	part X, part XIII, or part XIV of chapter 468; chapter 478;
156	chapter 480; part III or part IV of chapter 483; chapter 484;
157	chapter 486; chapter 490; or chapter 491.
158	(7)(5)  "Hospital" means a facility as defined in s.
159	395.002(12) and licensed under chapter 395 and part II of
160	chapter 408.
161	(8)  "Medical emergency" means a condition that, on the
162	basis of a physician's good faith clinical judgment, so
163	complicates the medical condition of a pregnant woman as to
164	necessitate the immediate termination of her pregnancy to avert
165	her death, or for which a delay in the termination of her
166	pregnancy will create serious risk of substantial and
167	irreversible impairment of a major bodily function.
168	(9)(6)  "Partial-birth abortion" means an abortion a
169	termination of pregnancy in which the physician performing the
170	abortion: termination of pregnancy partially vaginally delivers
171	a living fetus before killing the fetus and completing the
172	delivery.
173	(a)  Deliberately and intentionally vaginally delivers a
174	living fetus until, in the case of a head-first presentation,
175	the entire fetal head is outside the body of the mother, or, in
176	the case of breech presentation, any part of the fetal trunk
177	past the navel is outside the body of the mother, for the
178	purpose of performing an overt act that the person knows will
179	kill the partially delivered living fetus; and
180	(b)  Performs the overt act, other than completion of
181	delivery, which kills the partially delivered living fetus.
182	(10)(7)  "Physician" means a physician licensed under
183	chapter 458 or chapter 459 or a physician practicing medicine or
184	osteopathic medicine in the employment of the United States.
185	(11)(8)  "Third trimester" means the weeks of pregnancy
186	after the 24th week of pregnancy.
187	(12)  "Viability" means that stage of fetal development
188	when the life of the unborn child may, with a reasonable degree
189	of medical probability, be continued indefinitely outside the
190	womb.
191	Section 2.  Section 390.0111, Florida Statutes, is amended
192	to read:
193	390.0111  Abortions Termination of pregnancies.-
194	(1)  ABORTION TERMINATION IN THIRD TRIMESTER OR AFTER
195	VIABILITY; WHEN ALLOWED.-An abortion may not No termination of
196	pregnancy shall be performed on any human being in the third
197	trimester or after the period at which, in the best medical
198	judgment of the physician, the fetus has attained viability of
199	pregnancy unless:
200	(a)  Two physicians certify in writing to the fact that, to
201	a reasonable degree of medical probability, the abortion
202	termination of pregnancy is necessary to prevent the death of
203	the pregnant woman or the substantial and irreversible
204	impairment of a major bodily function save the life or preserve
205	the health of the pregnant woman; or
206	(b)  The physician certifies in writing to the existence of
207	a medical emergency medical necessity for legitimate emergency
208	medical procedures for termination of pregnancy in the third
209	trimester, and another physician is not available for
210	consultation.
211	(2)  PHYSICIAN AND LOCATION REQUIREMENTS PERFORMANCE BY
212	PHYSICIAN REQUIRED.-
213	(a)  An abortion may not No termination of pregnancy shall
214	be performed at any time except by a physician as defined in s.
215	390.011.
216	(b)  A physician who offers to perform or who performs
217	abortions in an abortion clinic must annually complete a minimum
218	of 3 hours of continuing education related to ethics.
219	(c)  Except in the case of a medical emergency, an abortion
220	may not be performed:
221	1.  In the third trimester, or after the fetus has attained
222	viability, in a location other than in a hospital.
223	2.  In cases in which subparagraph 1. does not apply, in a
224	location other than a hospital, a validly licensed abortion
225	clinic, or a physician's office.
226	(3)  CONSENTS REQUIRED.-An abortion A termination of
227	pregnancy may not be performed or induced except with the
228	voluntary and informed written consent of the pregnant woman or,
229	in the case of a mental incompetent, the voluntary and informed
230	written consent of her court-appointed guardian.
231	(a)  Except in the case of a medical emergency, consent to
232	an abortion a termination of pregnancy is voluntary and informed
233	only if the following requirements are completed at least 24
234	hours before the abortion is performed:
235	1.  The physician who is to perform the procedure, or the
236	referring physician, has, at a minimum, orally, in person,
237	informed the woman of:
238	a.  The nature and risks of undergoing or not undergoing
239	the proposed procedure which that a reasonable patient would
240	consider material to making a knowing and willful decision of
241	whether to obtain an abortion terminate a pregnancy.
242	b.  The probable gestational age of the fetus, verified by
243	an ultrasound, at the time the abortion termination of pregnancy
244	is to be performed.
245	(I)  The ultrasound must be performed by the physician who
246	is to perform the abortion or by a person having documented
247	evidence that he or she has completed a course in the operation
248	of ultrasound equipment as prescribed by rule and who is working
249	in conjunction with the physician.
250	(II)  The person performing the ultrasound must offer the
251	woman the opportunity to view the live ultrasound images and
252	hear an explanation of them. If the woman accepts the
253	opportunity to view the images and hear the explanation, a
254	physician or a registered nurse, licensed practical nurse,
255	advanced registered nurse practitioner, or physician assistant
256	working in conjunction with the physician must contemporaneously
257	review and explain the images to the woman before the woman
258	gives informed consent to having an abortion procedure
259	performed.
260	(III)  The woman has a right to decline to view and hear
261	the explanation of the live ultrasound images after she is
262	informed of her right and offered an opportunity to view the
263	images and hear the explanation. If the woman declines, the
264	woman shall complete a form acknowledging that she was offered
265	an opportunity to view and hear the explanation of the images
266	but that she declined that opportunity. The form must also
267	indicate that the woman's decision was not based on any undue
268	influence from any person to discourage her from viewing the
269	images or hearing the explanation and that she declined of her
270	own free will.
271	(IV)  Unless requested by the woman, the person performing
272	the ultrasound may not offer the opportunity to view the images
273	and hear the explanation and the explanation may not be given
274	if, at the time the woman schedules or arrives for her
275	appointment to obtain an abortion, a copy of a restraining
276	order, police report, medical record, or other court order or
277	documentation is presented which provides evidence that the
278	woman is obtaining the abortion because the woman is a victim of
279	rape, incest, domestic violence, or human trafficking or that
280	the woman has been diagnosed as having a condition that, on the
281	basis of a physician's good faith clinical judgment, would
282	create a serious risk of substantial and irreversible impairment
283	of a major bodily function if the woman delayed terminating her
284	pregnancy.
285	c.  The medical risks to the woman and fetus of carrying
286	the pregnancy to term.
287	2.  Printed materials prepared and provided by the
288	department have been provided to the pregnant woman, if she
289	chooses to view these materials, including:
290	a.  A description of the fetus, including a description of
291	the various stages of development.
292	b.  A list of entities that offer alternatives to abortion
293	terminating the pregnancy.
294	c.  Detailed information on the availability of medical
295	assistance benefits for prenatal care, childbirth, and neonatal
296	care.
297	3.  The woman acknowledges in writing, before the
298	termination of pregnancy, that the information required to be
299	provided under this subsection has been provided.
300
301	Nothing in This paragraph does not is intended to prohibit a
302	physician from providing any additional information that which
303	the physician deems material to the woman's informed decision to
304	obtain an abortion terminate her pregnancy.
305	(b)  If a medical emergency exists and a physician cannot
306	comply with the requirements for informed consent, a physician
307	may perform an abortion terminate a pregnancy if he or she has
308	obtained at least one corroborative medical opinion attesting to
309	the medical necessity for emergency medical procedures and to
310	the fact that to a reasonable degree of medical certainty the
311	continuation of the pregnancy would threaten the life of the
312	pregnant woman. If a second physician is not available for a
313	corroborating opinion, the physician may proceed but shall
314	document reasons for the medical necessity in the patient's
315	medical records.
316	(c)  Violation of this subsection by a physician
317	constitutes grounds for disciplinary action under s. 458.331 or
318	s. 459.015. Substantial compliance or reasonable belief that
319	noncompliance complying with the requirements of this subsection
320	is necessary to prevent the death of the pregnant woman or a
321	substantial and irreversible impairment of a major bodily
322	function of the pregnant woman informed consent would threaten
323	the life or health of the patient is a defense to any action
324	brought under this paragraph.
325	(4)  STANDARD OF MEDICAL CARE TO BE USED DURING VIABILITY.-
326	If an abortion a termination of pregnancy is performed during
327	viability, a no person who performs or induces the abortion
328	termination of pregnancy shall fail to use that degree of
329	professional skill, care, and diligence to preserve the life and
330	health of the fetus which such person would be required to
331	exercise in order to preserve the life and health of any fetus
332	intended to be born and not aborted. "Viability" means that
333	stage of fetal development when the life of the unborn child may
334	with a reasonable degree of medical probability be continued
335	indefinitely outside the womb. Notwithstanding the provisions of
336	this subsection, the prevention of the death of the pregnant
337	woman or a substantial and irreversible impairment of a major
338	bodily function of the pregnant woman constitutes the woman's
339	life and health shall constitute an overriding and superior
340	consideration to the concern for the life and health of the
341	fetus when such concerns are in conflict.
342	(5)  PARTIAL-BIRTH ABORTION PROHIBITED; EXCEPTION.-
343	(a)  A No physician may not shall knowingly perform a
344	partial-birth abortion and thereby kill a human fetus.
345	(b)  A woman upon whom a partial-birth abortion is
346	performed may not be prosecuted under this section for a
347	conspiracy to violate the provisions of this section.
348	(c)  This subsection does shall not apply to a partial-
349	birth abortion that is necessary to save the life of a mother
350	whose life is endangered by a physical disorder, physical
351	illness, or physical injury, including a life-endangering
352	physical condition cause by or arising from the pregnancy
353	itself, if provided that no other medical procedure would
354	suffice for that purpose.
355	(6)  EXPERIMENTATION ON FETUS PROHIBITED; EXCEPTION.-A No
356	person may not shall use any live fetus or live, premature
357	infant for any type of scientific, research, laboratory, or
358	other kind of experimentation before either prior to or
359	subsequent to any abortion termination of pregnancy procedure
360	except as necessary to protect or preserve the life and health
361	of such fetus or premature infant.
362	(7)  FETAL REMAINS.-Fetal remains shall be disposed of in a
363	sanitary and appropriate manner and in accordance with standard
364	health practices, as provided by rule of the department of
365	Health. Failure to dispose of fetal remains in accordance with
366	department rules is a misdemeanor of the first second degree,
367	punishable as provided in s. 775.082 or s. 775.083.
368	(8)  REFUSAL TO PARTICIPATE IN ABORTION TERMINATION
369	PROCEDURE.-Nothing in This section does not shall require any
370	hospital or any person to participate in an abortion the
371	termination of a pregnancy, and a nor shall any hospital or any
372	person is not be liable for such refusal. A No person who is a
373	member of, or associated with, the staff of a hospital, or nor
374	any employee of a hospital or physician in which or by whom the
375	abortion termination of a pregnancy has been authorized or
376	performed, who states shall state an objection to such procedure
377	on moral or religious grounds is not shall be required to
378	participate in the procedure that which will result in the
379	abortion termination of pregnancy. The refusal of any such
380	person or employee to participate does shall not form the basis
381	for any disciplinary or other recriminatory action against such
382	person.
383	(9)  EXCEPTION.-The provisions of this section do shall not
384	apply to the performance of a procedure that which terminates a
385	pregnancy in order to deliver a live child.
386	(10)  PENALTIES FOR VIOLATION.-Except as provided in
387	subsections (3) and (7):
388	(a)  Any person who willfully performs, or actively
389	participates in, an abortion a termination of pregnancy
390	procedure in violation of the requirements of this section
391	commits a felony of the third degree, punishable as provided in
392	s. 775.082, s. 775.083, or s. 775.084.
393	(b)  Any person who performs, or actively participates in,
394	an abortion a termination of pregnancy procedure in violation of
395	the provisions of this section which results in the death of the
396	woman commits a felony of the second degree, punishable as
397	provided in s. 775.082, s. 775.083, or s. 775.084.
398	(c)  The department shall permanently revoke the license of
399	any licensed health care practitioner who has been convicted or
400	found guilty of, or entered a plea of guilty or nolo contendere
401	to, regardless of adjudication, a felony as provided in this
402	subsection.
403	(11)  CIVIL ACTION PURSUANT TO PARTIAL-BIRTH ABORTION;
404	RELIEF.-
405	(a)  The father, if married to the mother at the time she
406	receives a partial-birth abortion, and, if the mother has not
407	attained the age of 18 years at the time she receives a partial-
408	birth abortion, the maternal grandparents of the fetus may, in a
409	civil action, obtain appropriate relief, unless the pregnancy
410	resulted from the plaintiff's criminal conduct or the plaintiff
411	consented to the abortion.
412	(b)  In a civil action under this section, appropriate
413	relief includes:
414	1.  Monetary damages for all injuries, psychological and
415	physical, occasioned by the violation of subsection (5).
416	2.  Damages equal to three times the cost of the partial-
417	birth abortion.
418	(12)  INFANTS BORN ALIVE.-
419	(a)  An infant born alive subsequent to an attempted
420	abortion is entitled to the same rights, powers, and privileges
421	as are granted by the laws of this state to any other child born
422	alive in the course of birth that is not subsequent to an
423	attempted abortion.
424	(b)  If an infant is born alive subsequent to an attempted
425	abortion, any health care practitioner present at the time shall
426	humanely exercise the same degree of professional skill, care,
427	and diligence to preserve the life and health of the infant as a
428	reasonably diligent and conscientious health care practitioner
429	would render to an infant born alive in the course of birth that
430	is not subsequent to an attempted abortion.
431	(c)  An abortion may not be attempted pursuant to paragraph
432	(1)(a) unless a physician other than the physician performing
433	the abortion is in attendance to take control of any infant born
434	alive, to provide immediate medical care to the infant, and to
435	discharge the obligations imposed by paragraph (b). The
436	physician who performs the abortion shall take all reasonable
437	steps consistent with the abortion procedure to preserve the
438	life and health of the unborn child.
439	(d)  A health care practitioner who has knowledge of a
440	violation of this subsection shall report the violation to the
441	department.
442	(13)  PUBLIC NOTICES AND ADVERTISEMENTS.-
443	(a)  A person may not knowingly advertise, print, publish,
444	distribute, or circulate, or knowingly cause to be advertised,
445	printed, published, distributed, or circulated, any pamphlet,
446	printed paper, book, newspaper notice, advertisement, or
447	reference containing words or language giving or conveying any
448	notice, hint, or reference to any person, or the name of any
449	person, real or fictitious, from whom, or to any place, house,
450	shop, or office where any poison, drug, mixture, preparation,
451	medicine, or noxious thing, or any instrument or means whatever,
452	or any advice, direction, information, or knowledge that may be
453	obtained for the purpose of performing an abortion in violation
454	of this chapter.
455	(b)  An abortion clinic must provide conspicuous written
456	notice on its premises and on any advertisement that the
457	abortion clinic is prohibited, except in a medical emergency,
458	from performing abortions in the third trimester or after the
459	fetus has attained viability.
460	(c)  Any person who violates this subsection commits a
461	misdemeanor of the first degree, punishable as provided in s.
462	775.082 or s. 775.083.
463	(14)  RESPONSIBILITIES OF THE AGENCY.-Before each regular
464	legislative session, the agency shall report aggregate
465	statistical data relating to abortions, which has been reported
466	to the Division of Reproductive Health within the Centers for
467	Disease Control and Prevention, on its website and provide an
468	annual report to the Governor, the President of the Senate, and
469	the Speaker of the House of Representatives regarding such data.
470	Any information required to be reported under this subsection
471	must not include any personal identifying information.
472	(15)(12)  FAILURE TO COMPLY.-Failure to comply with the
473	requirements of this section constitutes grounds for
474	disciplinary action under each respective practice act and under
475	s. 456.072.
476	(16)(13)  RULES.-The applicable boards, or the department
477	if there is no board, shall adopt rules necessary to implement
478	the provisions of this section.
479	Section 3.  Section 390.01114, Florida Statutes, is amended
480	to read:
481	390.01114  Parental Notice of Abortion Act.-
482	(1)  SHORT TITLE.-This section may be cited as the
483	"Parental Notice of Abortion Act."
484	(2)  DEFINITIONS.-As used in this section, the term:
485	(a)  "Actual notice" means notice that is given directly,
486	in person or by telephone, to a parent or legal guardian of a
487	minor, by a physician, at least 48 hours before the inducement
488	or performance of an abortion a termination of pregnancy, and
489	documented in the minor's files.
490	(b)  "Child abuse" means abandonment, abuse, harm, mental
491	injury, neglect, physical injury, or sexual abuse of a child as
492	those terms are defined in ss. 39.01, 827.04, and 984.03.
493	(c)  "Constructive notice" means notice that is given in
494	writing, signed by the physician, and mailed at least 72 hours
495	before the inducement or performance of the abortion termination
496	of pregnancy, to the last known address of the parent or legal
497	guardian of the minor, by first-class mail and by certified
498	mail, return receipt requested, and delivery restricted to the
499	parent or legal guardian. After the 72 hours have passed,
500	delivery is deemed to have occurred.
501	(d)  "Medical emergency" means a condition that, on the
502	basis of a physician's good faith clinical judgment, so
503	complicates the medical condition of a pregnant woman as to
504	necessitate the immediate termination of her pregnancy to avert
505	her death, or for which a delay in the termination of her
506	pregnancy will create serious risk of substantial and
507	irreversible impairment of a major bodily function.
508	(d)(e)  "Sexual abuse" has the meaning ascribed in s.
509	39.01.
510	(e)(f)  "Minor" means a person under the age of 18 years.
511	(3)  NOTIFICATION REQUIRED.-
512	(a)  Actual notice shall be provided by the physician
513	performing or inducing an abortion with respect to the
514	termination of pregnancy before the performance or inducement of
515	the termination of the pregnancy of a minor. The notice may be
516	given by a referring physician. The physician who performs or
517	induces the abortion termination of pregnancy must receive the
518	written statement of the referring physician certifying that the
519	referring physician has given notice. If actual notice is not
520	possible after a reasonable effort has been made, the physician
521	performing or inducing the abortion termination of pregnancy or
522	the referring physician must give constructive notice. Notice
523	given under this subsection by the physician performing or
524	inducing the abortion termination of pregnancy must include the
525	name and address of the facility providing the abortion
526	termination of pregnancy and the name of the physician providing
527	notice. Notice given under this subsection by a referring
528	physician must include the name and address of the facility
529	where he or she is referring the minor and the name of the
530	physician providing notice. If actual notice is provided by
531	telephone, the physician must actually speak with the parent or
532	guardian, and must record in the minor's medical file the name
533	of the parent or guardian provided notice, the phone number
534	dialed, and the date and time of the call. If constructive
535	notice is given, the physician must document that notice by
536	placing copies of any document related to the constructive
537	notice, including, but not limited to, a copy of the letter and
538	the return receipt, in the minor's medical file. Actual notice
539	given by telephone shall be confirmed in writing, signed by the
540	physician, and mailed to the last known address of the parent or
541	legal guardian of the minor, by first-class mail and by
542	certified mail, return receipt requested, with delivery
543	restricted to the parent or legal guardian.
544	(b)  Notice is not required if:
545	1.  In the physician's good faith clinical judgment, a
546	medical emergency exists and there is insufficient time for the
547	attending physician to comply with the notification
548	requirements. If a medical emergency exists, the physician shall
549	make reasonable attempts, whenever possible, without endangering
550	the minor, to contact the parent or legal guardian, and may
551	proceed, but must document reasons for the medical necessity in
552	the patient's medical records. The physician shall provide
553	notice directly, in person or by telephone, to the parent or
554	legal guardian, including details of the medical emergency and
555	any additional risks to the minor. If the parent or legal
556	guardian has not been notified within 24 hours after the
557	abortion termination of the pregnancy, the physician shall
558	provide notice in writing, including details of the medical
559	emergency and any additional risks to the minor, signed by the
560	physician, to the last known address of the parent or legal
561	guardian of the minor, by first-class mail and by certified
562	mail, return receipt requested, with delivery restricted to the
563	parent or legal guardian;
564	2.  Notice is waived in writing by the person who is
565	entitled to notice and such waiver is notarized, dated not more
566	than 30 days before the abortion termination of pregnancy, and
567	contains a specific waiver of the right of the parent or legal
568	guardian to notice of the minor's abortion termination of
569	pregnancy;
570	3.  Notice is waived by the minor who is or has been
571	married or has had the disability of nonage removed under s.
572	743.015 or a similar statute of another state;
573	4.  Notice is waived by the patient because the patient has
574	a minor child dependent on her; or
575	5.  Notice is waived under subsection (4).
576	(c)  Violation of this subsection by a physician
577	constitutes grounds for disciplinary action under s. 458.331 or
578	s. 459.015.
579	(4)  PROCEDURE FOR JUDICIAL WAIVER OF NOTICE.-
580	(a)  A minor may petition any circuit court in which the
581	minor resides for a waiver of the notice requirements of
582	subsection (3) and may participate in proceedings on her own
583	behalf. The petition may be filed under a pseudonym or through
584	the use of initials, as provided by court rule. The petition
585	must include a statement that the petitioner is pregnant and
586	notice has not been waived. The court shall advise the minor
587	that she has a right to court-appointed counsel and shall
588	provide her with counsel upon her request at no cost to the
589	minor.
590	(b)1.  Court proceedings under this subsection must be
591	given precedence over other pending matters to the extent
592	necessary to ensure that the court reaches a decision promptly.
593	The court shall rule, and issue written findings of fact and
594	conclusions of law, within 3 business days after the petition is
595	filed, except that the 3-business-day limitation may be extended
596	at the request of the minor. If the court fails to rule within
597	the 3-business-day period and an extension has not been
598	requested, the minor may immediately petition for a hearing upon
599	the expiration of the 3-business-day period to the chief judge
600	of the circuit, who must ensure a hearing is held within 48
601	hours after receipt of the minor's petition and an order is
602	entered within 24 hours after the hearing.
603	2.  If the circuit court does not grant judicial waiver of
604	notice, the minor has the right to appeal. An appellate court
605	must rule within 7 days after receipt of appeal, but a ruling
606	may be remanded with further instruction for a ruling within 3
607	business days after the remand. The reason for overturning a
608	ruling on appeal must be based on abuse of discretion by the
609	court and may not be based on the weight of the evidence
610	presented to the circuit court since the proceeding is a
611	nonadversarial proceeding.
612	(c)  If the court finds, by clear and convincing evidence,
613	that the minor is sufficiently mature to decide whether to
614	obtain an abortion terminate her pregnancy, the court shall
615	issue an order authorizing the minor to consent to the
616	performance or inducement of an abortion a termination of
617	pregnancy without the notification of a parent or guardian. If
618	the court does not make the finding specified in this paragraph
619	or paragraph (d), it must dismiss the petition. Factors the
620	court shall consider include:
621	1.  The minor's:
622	a.  Age.
623	b.  Overall intelligence.
624	c.  Emotional development and stability.
625	d.  Credibility and demeanor as a witness.
626	e.  Ability to accept responsibility.
627	f.  Ability to assess both the immediate and long-range
628	consequences of the minor's choices.
629	g.  Ability to understand and explain the medical risks of
630	an abortion terminating her pregnancy and to apply that
631	understanding to her decision.
632	2.  Whether there may be any undue influence by another on
633	the minor's decision to have an abortion.
634	(d)  If the court finds, by a preponderance of the
635	evidence, that the petitioner is the victim of child abuse or
636	sexual abuse inflicted by one or both of her parents or her
637	guardian, or by clear and convincing evidence that the
638	notification of a parent or guardian is not in the best interest
639	of the petitioner, the court shall issue an order authorizing
640	the minor to consent to the performance or inducement of an
641	abortion a termination of pregnancy without the notification of
642	a parent or guardian. The best-interest standard does not
643	include financial best interest or financial considerations or
644	the potential financial impact on the minor or the minor's
645	family if the minor does not obtain the abortion terminate the
646	pregnancy. If the court finds evidence of child abuse or sexual
647	abuse of the minor petitioner by any person, the court shall
648	report the evidence of child abuse or sexual abuse of the
649	petitioner, as provided in s. 39.201. If the court does not make
650	the finding specified in this paragraph or paragraph (c), it
651	must dismiss the petition.
652	(e)  A court that conducts proceedings under this section
653	shall:
654	1.  Provide for a written transcript of all testimony and
655	proceedings;
656	2.  Issue a final written order containing factual findings
657	and legal conclusions supporting its decision, including factual
658	findings and legal conclusions relating to the maturity of the
659	minor as provided under paragraph (c); and
660	3.  Order that a confidential record be maintained, as
661	required under s. 390.01116.
662	(f)  All hearings under this section, including appeals,
663	shall remain confidential and closed to the public, as provided
664	by court rule.
665	(g)  An expedited appeal shall be made available, as the
666	Supreme Court provides by rule, to any minor to whom the circuit
667	court denies a waiver of notice. An order authorizing an
668	abortion a termination of pregnancy without notice is not
669	subject to appeal.
670	(h)  Filing fees or court costs may not be required of any
671	pregnant minor who petitions a court for a waiver of parental
672	notification under this subsection at either the trial or the
673	appellate level.
674	(i)  A county is not obligated to pay the salaries, costs,
675	or expenses of any counsel appointed by the court under this
676	subsection.
677	(5)  PROCEEDINGS.-The Supreme Court is requested to adopt
678	rules and forms for petitions to ensure that proceedings under
679	subsection (4) are handled expeditiously and in a manner
680	consistent with this act. The Supreme Court is also requested to
681	adopt rules to ensure that the hearings protect the minor's
682	confidentiality and the confidentiality of the proceedings.
683	(6)  REPORT.-The Supreme Court, through the Office of the
684	State Courts Administrator, shall report by February 1 of each
685	year to the Governor, the President of the Senate, and the
686	Speaker of the House of Representatives on the number of
687	petitions filed under subsection (4) for the preceding year, and
688	the timing and manner of disposal of such petitions by each
689	circuit court. For each petition resulting in a waiver of
690	notice, the reason for the waiver shall be included in the
691	report.
692	Section 4.  Section 390.0112, Florida Statutes, is amended
693	to read:
694	390.0112  Abortions Termination of pregnancies; reporting.-
695	(1)  The director of any hospital, validly licensed
696	abortion clinic, or physician's office medical facility in which
697	an abortion is performed any pregnancy is terminated shall
698	submit a monthly report each month to the agency on a form
699	developed by the agency which is consistent with the U.S.
700	Standard Report of Induced Termination of Pregnancy from the
701	Centers for Disease Control and Prevention. The report must not
702	contain any personal identifying information which contains the
703	number of procedures performed, the reason for same, and the
704	period of gestation at the time such procedures were performed
705	to the agency. The agency shall be responsible for keeping such
706	reports in a central place from which statistical data and
707	analysis can be made. The agency shall submit reported data to
708	the Division of Reproductive Health within the Centers for
709	Disease Control and Prevention.
710	(2)  If the abortion termination of pregnancy is not
711	performed in a hospital, validly licensed abortion clinic, or
712	physician's office medical facility, the physician performing
713	the procedure shall report be responsible for reporting such
714	information as required in subsection (1).
715	(3)  Reports submitted pursuant to this section shall be
716	confidential and exempt from the provisions of s. 119.07(1) and
717	shall not be revealed except upon the order of a court of
718	competent jurisdiction in a civil or criminal proceeding or as
719	required in subsection (1).
720	(4)  Any person required under this section to file a
721	report or keep any records who willfully fails to file such
722	report or keep such records may be subject to a $200 fine for
723	each violation. The agency shall be required to impose such
724	fines when reports or records required under this section have
725	not been timely received. For purposes of this section, timely
726	received is defined as 30 days following the preceding month.
727	(5)  The agency may adopt rules necessary to administer
728	this section.
729	Section 5.  Paragraphs (b) and (c) of subsection (1),
730	paragraph (a) of subsection (3), and subsection (6) of section
731	390.012, Florida Statutes, are amended to read:
732	390.012  Powers of agency; rules; disposal of fetal
733	remains.-
734	(1)  The agency may develop and enforce rules pursuant to
735	ss. 390.011-390.018 and part II of chapter 408 for the health,
736	care, and treatment of persons in abortion clinics and for the
737	safe operation of such clinics.
738	(b)  The rules shall be in accordance with s. 390.0111(2)
739	s. 797.03 and may not impose an unconstitutional burden on a
740	woman's freedom to decide whether to obtain an abortion
741	terminate her pregnancy.
742	(c)  The rules shall provide for:
743	1.  The performance of abortion pregnancy termination
744	procedures only by a licensed physician.
745	2.  The making, protection, and preservation of patient
746	records, which shall be treated as medical records under chapter
747	458.
748	(3)  For clinics that perform or claim to perform abortions
749	after the first trimester of pregnancy, the agency shall adopt
750	rules pursuant to ss. 120.536(1) and 120.54 to implement the
751	provisions of this chapter, including the following:
752	(a)  Rules for an abortion clinic's physical facilities. At
753	a minimum, these rules shall prescribe standards for:
754	1.  Adequate private space that is specifically designated
755	for interviewing, counseling, and medical evaluations.
756	2.  Dressing rooms for staff and patients.
757	3.  Appropriate lavatory areas.
758	4.  Areas for preprocedure hand washing.
759	5.  Private procedure rooms.
760	6.  Adequate lighting and ventilation for abortion
761	procedures.
762	7.  Surgical or gynecological examination tables and other
763	fixed equipment.
764	8.  Postprocedure recovery rooms that are equipped to meet
765	the patients' needs.
766	9.  Emergency exits to accommodate a stretcher or gurney.
767	10.  Areas for cleaning and sterilizing instruments.
768	11.  Adequate areas for the secure storage of medical
769	records and necessary equipment and supplies.
770	12.  The display in the abortion clinic, in a place that is
771	conspicuous to all patients, of the clinic's current license
772	issued by the agency.
773	13.  Conspicuous written notice to be provided on the
774	premises and on any advertisement of the abortion clinic, which
775	must state that the abortion clinic is prohibited, except in a
776	medical emergency, from performing abortions in the third
777	trimester or after the fetus has attained viability.
778	(6)  The agency may adopt and enforce rules, in the
779	interest of protecting the public health, to ensure the prompt
780	and proper disposal of fetal remains and tissue resulting from
781	an abortion pregnancy termination.
782	Section 6.  Subsection (1) of section 390.014, Florida
783	Statutes, is amended, and subsections (5), (6), and (7) are
784	added to that section to read:
785	390.014  Licenses; fees.-
786	(1)  The requirements of part II of chapter 408 shall apply
787	to the provision of services that require licensure pursuant to
788	ss. 390.011-390.018 and part II of chapter 408 and to entities
789	licensed by or applying for such licensure from the agency for
790	Health Care Administration pursuant to ss. 390.011-390.018. A
791	license issued by the agency is required in order to operate a
792	clinic in this state.
793	(5)  A person may not establish, conduct, manage, or
794	operate a clinic in this state without a valid and current
795	license issued by the agency.
796	(6)  A clinic must be wholly owned and operated by one or
797	more physicians who received residency training in performing
798	dilation-and-curettage and dilation-and-evacuation procedures or
799	by a professional corporation or limited liability company
800	composed solely of one or more such physicians. This subsection
801	does not apply to clinics licensed before July 1, 2012, or to
802	the renewal of licenses held by such clinics.
803	(7)  A person who willfully violates subsection (5) or
804	subsection (6) commits a misdemeanor of the first degree,
805	punishable as provided in s. 775.082 or s. 775.083.
806	Section 7.  Section 390.018, Florida Statutes, is amended
807	to read:
808	390.018  Administrative fine.-In addition to the
809	requirements of part II of chapter 408, the agency may impose a
810	fine upon the clinic in an amount not to exceed $5,000 $1,000
811	for each violation of any provision of this chapter, part II of
812	chapter 408, or applicable rules.
813	Section 8.  Subsection (7) of section 456.013, Florida
814	Statutes, is amended to read:
815	456.013  Department; general licensing provisions.-
816	(7)(a)  The boards, or the department when there is no
817	board, shall require the completion of a 2-hour course relating
818	to prevention of medical errors as part of the licensure and
819	renewal process. The 2-hour course shall count towards the total
820	number of continuing education hours required for the
821	profession. The course shall be approved by the board or
822	department, as appropriate, and shall include a study of root-
823	cause analysis, error reduction and prevention, and patient
824	safety. In addition, the course approved by the Board of
825	Medicine and the Board of Osteopathic Medicine shall include
826	information relating to the five most misdiagnosed conditions
827	during the previous biennium, as determined by the board. If the
828	course is being offered by a facility licensed pursuant to
829	chapter 395 for its employees, the board may approve up to 1
830	hour of the 2-hour course to be specifically related to error
831	reduction and prevention methods used in that facility.
832	(b)  In accordance with s. 390.0111, the board, or the
833	department if there is no board, shall require a physician who
834	offers to perform or performs abortions in an abortion clinic to
835	annually complete a 3-hour course related to ethics as part of
836	the licensure and renewal process. The 3-hour course shall count
837	toward the total number of continuing education hours required
838	for the profession. The applicable board, or the department if
839	there is no board, shall approve the course, as appropriate.
840	Section 9.  Section 765.113, Florida Statutes, is amended
841	to read:
842	765.113  Restrictions on providing consent.-Unless the
843	principal expressly delegates such authority to the surrogate in
844	writing, or a surrogate or proxy has sought and received court
845	approval pursuant to rule 5.900 of the Florida Probate Rules, a
846	surrogate or proxy may not provide consent for:
847	(1)  Abortion, sterilization, electroshock therapy,
848	psychosurgery, experimental treatments that have not been
849	approved by a federally approved institutional review board in
850	accordance with 45 C.F.R. part 46 or 21 C.F.R. part 56, or
851	voluntary admission to a mental health facility.
852	(2)  Withholding or withdrawing life-prolonging procedures
853	from a pregnant patient prior to viability as defined in s.
854	390.011 s. 390.0111(4).
855	Section 10.  Section 782.30, Florida Statutes, is repealed.
856	Section 11.  Section 782.32, Florida Statutes, is repealed.
857	Section 12.  Section 782.34, Florida Statutes, is repealed.
858	Section 13.  Section 782.36, Florida Statutes, is repealed.
859	Section 14.  Section 797.02, Florida Statutes, is repealed.
860	Section 15.  Section 797.03, Florida Statutes, is repealed.
861	Section 16.  If any provision of this act or its
862	application to any person or circumstance is held invalid, the
863	invalidity does not affect other provisions or applications of
864	the act which can be given effect without the invalid provision
865	or application, and to this end the provisions of this act are
866	severable.
867	Section 17.  This act shall take effect July 1, 2012.

CODING: Words stricken are deletions; words underlined are additions.