INFORMED CONSENT INFORMATION (Section 188.027)

This act requires information provided to a woman considering an abortion to include a description of the disposal process of the aborted fetus. Additionally, this act removes the requirement that the information consist of printed materials and instead requires that the information be provided in video format.

PARENTAL NOTIFICATION (Section 188.028)

Under current law, a person shall not knowingly perform an abortion on a minor under 18 until the attending physician has secured the written informed consent of the minor and one parent or guardian, unless a specified exception applies. This act adds the exception of a medical emergency and applies the law to persons knowingly inducing an abortion on a minor under 18.

Additionally, this act requires the consenting parent to notify any other custodial parent or guardian in writing prior to the securing of the informed written consent of the minor and one parent or guardian. Notice shall not be required for a parent or guardian: (1) who has been found guilty of specified crimes; (2) against whom an order of protection has been issued; (3) whose custodial, parental, or guardianship rights have been terminated by a court; or (4) whose whereabouts are unknown, who is a fugitive, who is habitually intoxicated or drugged, or who has been declared mentally incompetent or incapacitated.

This provisions is similar to SB 375 (2017), HB 326 (2017), and HB 1370 (2016).

DONATION OF FETAL TISSUE (Sections 188.036 and 194.375)

Under this provision, no person shall knowingly donate or make 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. Nothing in this section shall prohibit 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. 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 knowingly donates such organs or tissue in violation of this act, shall be guilty of a class C felony and a fine of up to twice the amount of valuable consideration received.

This act also modifies the definition of "remains of a human fetus" under the Disposition of Fetal Remains Act to include remains that have reached a stage of development so that there are cartilaginous structures or fetal or skeletal parts after an abortion or miscarriage.

TISSUE REPORTS (Section 188.047)

Under current law, a representative sample of tissue removed at the time of abortion is sent to a pathologist for examination. This provision requires that all tissue removed at the time of abortion be certified as nonhazardous in compliance with the Department of Natural Resources's regulations and be sent to the pathologist. Additionally, all tissue reports issued by the pathologist shall contain the following: (1) the pathologist's estimation, to a reasonable degree of scientific certainty, of the gestational age of the fetal remains; (2) whether all tissue and remains received would be common for a specimen of such gestational age; (3) what, if any, portion of the tissue and remains were not received; (4) a gross diagnosis and detailed gross findings of what was received, including the percent blood clot and the percent tissue; (5) the date the tissue and remains were remitted to be disposed and the location of such disposal; (6) a certification that all submitted tissue has been disposed of in accordance with state law; and (7) the name and physical address of the entity conducting the examination of the specimen.

Each facility that handles the specimen, including the abortion facility, the pathology lab, and the final disposition site, shall send the Department of Health and Human Services a report documenting the date the specimen was collected, transported, received, and disposed.

The Department shall reconcile each notice of abortion with its corresponding pathology report. If the Department does not receive either a notice or a report, the Department shall conduct an investigation and, if a deficiency is discovered, shall perform an unscheduled inspection of the facility to ensure such deficiency is remedied. If the deficiency is not remedied, the Department shall suspend the abortion facility's or hospital's license for at least one year.

Finally, this provision requires the Department, beginning January 1, 2018, to make an annual report to the General Assembly. The report shall include all reports and information received under this provision and the following for each abortion procedure reported to the Department the previous calendar year: (1) the location of the abortion facility; (2) the ages of the fetus aborted; (3) the termination procedure used and a clinical estimation of gestation; (4) whether the Department received the tissue report for that abortion, along with a certification of the disposal of the remains; and (5) the existence and nature, if any, of any inconsistencies or concerns between the physician's abortion report to the Department and the pathologist's submitted tissue report.

The mother of the aborted fetus shall be given the option to have the fetus returned to her for final disposition after the fetus has been released from the pathology lab.

ABORTION REPORTS (Section 188.052)

Under current law, an attending physician must submit an abortion report to the Department. This act requires the abortion report to contain the following: (1) the attending physician's estimation, to a reasonable degree of scientific certainty, of the gestational age of the fetal remains; (2) whether all tissue and remains of a human fetus were removed that would be common for a specimen of such estimated gestation age; and (3) what, if any, portion of the tissue and remains were not removed.

EMPLOYEE DISCLOSURE POLICIES (Section 188.160)

This act requires each hospital, ambulatory surgical center, pathology lab, medical research entity, and disposal facility involved in handling fetal remains 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 remains. The policy shall include a time frame for completion of investigations related to complaints, a method for notifying the complainant of the disposition of the investigation, and other specified provisions.

The policy shall be submitted to the Department to verify implementation. The Department shall have access to all information disclosed, collected, and maintained under this provision and complainants shall be notified of their right to notify the Department of any information concerning alleged violations relating to abortions or handling of fetal remains. 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 remains from an elective abortion shall post a notice containing the disclosure policy.

ABORTION FACILITY INSPECTIONS (Section 197.230)

This provision requires the Department to conduct annual, unannounced, on-site inspections and investigations of abortion facilities. These inspections shall, at a minimum, include the following areas: (1) 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; (2) compliance with the requirement that all tissue removed at the time of an abortion be submitted to a pathologist and that the resultant tissue report be made a part of the patient's permanent record; (3) review patient records to ensure that no consent forms or other documentation authorizes any utilization of fetal organs or tissue in violation of state law; (4) compliance with state law prohibiting the use of public funds, facilities, and employees to perform or assist a prohibited abortion or to encourage or counsel a women to have a prohibited abortion; and (5) compliance with the requirement in state law that continuous physician or registered professional nursing services be provided whenever a patient is in the facility. Additionally, the inspection and investigation reports shall be available to the public, provided that information not subject to disclosure under the law be redacted.

Provisions of this act are substantially similar to SB 67 (2017), SB 375 (2017), SCS/SB 644 (2016) and HCS/HBs 2069 & 2371 (2016).

SARAH HASKINS