Abortion Clinic Regulations

P.A. 206 of 1999
H.B. 4599 of 1999 – Rep. Terry Geiger
M.C.L. 333.20115

Current Status
Governor Engler signed a three bill package on 12/20/99, making H.B. 4599-4601, Public Acts 207-209 of 1999 respectively. The laws took effect on 3/9/00.

Description
This legislation requires abortion facilities that do a high-volume business be inspected for health conditions. Prior to passage of this law, abortion clinics were unregulated. This law aims to protect women’s health by requiring abortion clinics to provide safe and sanitary conditions.

Overview of Bills
CLINIC REGULATION ACT, H.B. 4599 sponsored by Representative Terry Geiger.

Brief Summary of H.B. 4599 As Introduced:

Current definitions allow abortionists to avoid various regulatory practices by labeling their facility as a private office. In addition, courts in the 1970’s and 1980’s used expansive interpretations of Roe v. Wade to strike down certain health regulations as they apply to abortion clinics only. This bill will require abortionists who operate in a private practice office to be subject to health department enforcement by:

  1. defining a freestanding surgical outpatient facility as a facility or private office that performs 50 or more abortions in a calendar year.
  2. directing the Department to re-promulgate health and safety rules regarding abortion clinics which have been struck down.

Changes Made in House-Passed H.B. 4599:

  1. to be defined as a Freestanding Surgical Outpatient Facility (FSOF), a facility must perform abortions on 50% or more of its patients, instead of the standard of performing 50 or more abortions per year.
  2. Rep. Kuipers’ amendment was adopted in committee so that existing facilities will not have to undergo major construction or remodeling to comply with the new rules. As long as health and safety can be maintained, the rules can be waived or modified by the department for existing facilities.
  3. The third change exempts abortion clinics from the requirement to obtain a Certificate of Need (CON) in order to become licensed as a Freestanding Surgical Outpatient Facility. A CON requires a minimum number of procedures to be performed in order for a facility to be licensed as a FSOF. This could exclude existing facilities from licensure based on volume, not health and safety. The intent of this legislation is to license and regulate, not create obstacles to licensing that could be vulnerable to another court challenge.

ABORTION REPORTING LAW, H.B. 4600 sponsored by Representative Clark Bisbee.

Abortionists are currently required to provide certain information to the Michigan Department of Community Health (MDCH) regarding each abortion. Amending Section 2835 of the Public Health Code, H.B. 4600 would update the definition for abortion and create a definition of “physical complication.” Currently only “immediate complications” must be reported, for which there is no definition in the law. That term will be replaced with “physical complication.” The bill also specifies that March’s annual abortion report provide a clear breakdown of abortions after 20 weeks. (Currently all abortions after 20 weeks are reported as one figure. This does not differentiate between second and third trimester abortions of viable children.); Finally the bill specifies that MDCH provide a clear breakdown in the report of abortions performed for minors (Currently 15 to 19 year olds are lumped together, complicating data on minors and the parental consent law.)

A provision in the bill requiring reporting of genetic tests done on the mother or unborn child prior to the abortion was removed in the Senate Committee because of potential conflicts with a recently-passed comprehensive law on genetic testing and patient privacy.

ABORTION INJURY REPORTING ACT, H.B. 4601 sponsored by Representative Bill O’Neil.

Brief Summary of H.B. 4601 As Introduced:

Many women with complications from abortion have those complications treated by a physician other than the abortionists. Because presently only abortionist must report complications they treat from the procedures they perform, many women’s injuries go unreported.

Adding Section 2837 to the Public Health Code would require ALL PHYSICIANS treating a woman with complications from an abortion to report those complications to MDCH. The bill also requires MDCH to amend the approved form for reporting sexually transmitted diseases (which all physicians must presently use) to include a section for reporting abortion complications.

Changes Made in House-Passed H.B. 4601:

  1. Eliminated directive for rules to be promulgated to implement reporting requirement. This makes reporting abortion complications a direct legal requirement.
  2. Eliminated the requirement for MDCH to alter the present form used to report sexually transmitted diseases to also allow for reporting abortion complications, and inserted language for MDCH to produce an appropriate form that will be sent directly to MDCH.

History
House Bills 4599 – 4601 were introduced by Reps. Terry Geiger, Clark Bisbee, and Bill O’Neil on 4/28/99. The package had a combined 67 co-sponsors! The bills were taken up in the House Regulatory Reform Committee on 5/25/99 and reported to the floor by a vote of 5-3.

The Michigan House of Representatives passed the Abortion Clinic Regulation and Reporting package on September 22 and 23, 1999 by votes of 72-37 and 69-34. The bills were referred to the Senate Families, Mental Health, and Human Services Committee. A hearing on the package was held on 10/20/99. The committee approved the bills on 12/1/99 by votes of 4-2.

The bills were reported from the Senate Families, Mental Health & Human Services Committee on 12/1/99, by votes of 4-2. The full Senate approved the package on 12/7/99 by votes of 27-11. Two minor amendments were made to H.B. 4600, requiring a vote in the House to concur in those amendments. The House concurred in the amendments to H.B. 4600 on 12/8/99.

These bills were in the House Health Policy Committee the previous two sessions, and didn’t make it to the House floor due to a lack of votes in the committee.