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HOUSE BILL NO. 6076
A bill to amend 1978 PA 368, entitled
"Public health code,"
by amending sections 20104, 20106, and 20161 (MCL 333.20104,
333.20106, and 333.20161), as amended by 2024 PA 252, and by adding
part 207A and section 22224d.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
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Sec. 20104. (1) Except as otherwise provided in part 221,
"certification" means the issuance of a document by the department
to a health facility or agency attesting to the fact that the
June 11, 2026, Introduced by Reps. Jenkins -Arno, Pavlov, Borton, Alexander, Wortz, Greene,
Slagh, Martin, Kelly and Neyer and referred to Committee on Health Policy.
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health facility or agency meets both of the following:
(a) It complies with applicable statutory and regulatory
requirements and standards.
(b) It is eligible to participate as a provider of care and
services in a specific federal or state health program.
(2) "Consumer" means a person who is not a health care
provider as that term is defined in 42 USC 300jj.
(3) "County medical care facility" means a nursing care
facility, other than a hospital long-term care unit, that provides
organized nursing care and medical treatment to 7 or more unrelated
individuals who are suffering or recovering from illness, injury,
or infirmity and that is owned by a county or counties.
(4) "Department" means the department of licensing and
regulatory affairs.
(5) "Direct access" means access to a patient or resident or
to a patient's or resident's property, financial information,
medical records, treatment information, or any other identifying
information.
(6) "Director" means the director of the department.
(7) "Freestanding abortion clinic" means that term as defined
in section 20751.
(8) (7) "Freestanding birth center" means that term as defined
in section 20701.
(9) (8) "Freestanding surgical outpatient facility" means a
facility, other than the office of a physician, dentist,
podiatrist, or other private practice office, offering a surgical
procedure and related care that in the opinion of the attending
physician can be safely performed without requiring overnight
inpatient hospital care. Freestanding surgical outpatient facility
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does not include a surgical outpatient facility owned by and
operated as part of a hospital.
(10) (9) "Good moral character" means that term as defined in,
and determined under, 1974 PA 381, MCL 338.41 to 338.47.
Sec. 20106. (1) "Health facility or agency", except as
provided in section 20115, means:
(a) An ambulance operation, aircraft transport operation,
nontransport prehospital life support operation, or medical first
response service.
(b) A county medical care facility.
(c) A freestanding surgical outpatient facility.
(d) A health maintenance organization.
(e) A home for the aged.
(f) A hospital.
(g) A nursing home.
(h) A hospice.
(i) A hospice residence.
(j) A facility or agency listed in subdivisions (a) to (g)
located in a university, college, or other educational institution.
(k) A freestanding birth center.
(l) A freestanding abortion clinic.
(2) "Health maintenance organization" means that term as
defined in section 3501 of the insurance code of 1956, 1956 PA 218,
MCL 500.3501.
(3) "Home for the aged" means a supervised personal care
facility at a single address, other than a hotel, adult foster care
facility, hospital, nursing home, or county medical care facility
that provides room, board, and supervised personal care to 21 or
more unrelated, nontransient individuals 55 years of age or older.
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Home for the aged includes a supervised personal care facility for
20 or fewer individuals 55 years of age or older if the facility is
operated in conjunction with and as a distinct part of a licensed
nursing home. Home for the aged does not include an area excluded
from this definition by section 17(3) of the continuing care
community disclosure act, 2014 PA 448, MCL 554.917.
(4) "Hospice" means a health care program that provides a
coordinated set of services rendered at home or in outpatient or
institutional settings for individuals suffering from a disease or
condition with a terminal prognosis.
(5) "Hospital" means a facility offering inpatient, overnight
care, and services for observation, diagnosis, and active treatment
of an individual with a medical, surgical, obstetric, chronic, or
rehabilitative condition requiring the daily direction or
supervision of a physician. Hospital does not include a mental
health hospital licensed or operated by the department of health
and human services or a hospital operated by the department of
corrections.
(6) "Hospital long-term care unit" means a nursing care
facility, owned and operated by and as part of a hospital,
providing organized nursing care and medical treatment to 7 or more
unrelated individuals suffering or recovering from illness, injury,
or infirmity.
Sec. 20161. (1) The department shall assess fees and other
assessments for health facility and agency licenses and
certificates of need on an annual basis as provided in this
article. Until October 1, 2027, except as otherwise provided in
this article, fees and assessments must be paid as provided in the
following schedule:
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(a) Freestanding surgical
outpatient facilities $500.00 per facility license.
(b) Hospitals $500.00 per facility license and
$10.00 per licensed bed.
(c) Nursing homes, county
medical care facilities, and
hospital long-term care units $500.00 per facility license and
$3.00 per licensed bed over 100
licensed beds.
(d) Homes for the aged $500.00 per facility license and
$6.27 per licensed bed.
(e) Hospice agencies $500.00 per agency license.
(f) Hospice residences $500.00 per facility license and
$5.00 per licensed bed.
(g) Freestanding birth center $500.00 per facility license.
(h) Freestanding abortion
clinic $500.00 per facility license.
(i) (h) Subject to subsection
(11), quality assurance assessment
for nursing homes and hospital
long-term care units an amount resulting in not more
than 6% of total industry
revenues.
(j) (i) Subject to subsection
(12), quality assurance assessment
for hospitals at a fixed or variable rate that
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generates funds not more than
the maximum allowable under the
federal matching requirements,
after consideration for the
amounts in subsection (12)(a)
and (i).
(k) (j) Initial licensure
application fee for subdivisions
(a), (b), (c), (d), (e), (f), and
(g), and (h) $2,000.00 per initial license.
(2) If a hospital requests the department to conduct a
certification survey for purposes of title XVIII or title XIX, the
hospital shall pay a license fee surcharge of $23.00 per bed. As
used in this subsection:
(a) "Title XVIII" means title XVIII of the social security
act, 42 USC 1395 to 1395lll.1395mmm.
(b) "Title XIX" means title XIX of the social security act, 42
USC 1396 to 1396w-8.1396w-9.
(3) All of the following apply to the assessment under this
section for certificates of need:
(a) The base fee for a certificate of need is $3,000.00 for
each application. For a project requiring a projected capital
expenditure of more than $500,000.00 but less than $4,000,000.00,
an additional fee of $5,000.00 is added to the base fee. For a
project requiring a projected capital expenditure of $4,000,000.00
or more but less than $10,000,000.00, an additional fee of
$8,000.00 is added to the base fee. For a project requiring a
projected capital expenditure of $10,000,000.00 or more, an
additional fee of $12,000.00 is added to the base fee.
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(b) In addition to the fees under subdivision (a), the
applicant shall pay $3,000.00 for any designated complex project
including a project scheduled for comparative review or for a
consolidated licensed health facility application for acquisition
or replacement.
(c) If required by the department, the applicant shall pay
$1,000.00 for a certificate of need application that receives
expedited processing at the request of the applicant.
(d) The department shall charge a fee of $500.00 to review any
letter of intent requesting or resulting in a waiver from
certificate of need review and any amendment request to an approved
certificate of need.
(e) A health facility or agency that offers certificate of
need covered clinical services shall pay $100.00 for each
certificate of need approved covered clinical service as part of
the certificate of need annual survey at the time of submission of
the survey data.
(f) Except as otherwise provided in this section, the
department shall use the fees collected under this subsection only
to fund the certificate of need program. Funds remaining in the
certificate of need program at the end of the fiscal year do not
lapse to the general fund but remain available to fund the
certificate of need program in subsequent years.
(4) A license issued under this part is effective for no
longer than 1 year after the date of issuance.
(5) Fees described in this section are payable to the
department at the time an application for a license, permit, or
certificate is submitted. If an application for a license, permit,
or certificate is denied or if a license, permit, or certificate is
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revoked before its expiration date, the department shall not refund
fees paid to the department.
(6) The fee for a provisional license or temporary permit is
the same as for a license. A license may be issued at the
expiration date of a temporary permit without an additional fee for
the balance of the period for which the fee was paid if the
requirements for licensure are met.
(7) The cost of licensure activities must be supported by
license fees.
(8) The application fee for a waiver under section 21564 is
$200.00 plus $40.00 per hour for the professional services and
travel expenses directly related to processing the application. The
travel expenses must be calculated in accordance with the state
standardized travel regulations of the department of technology,
management, and budget in effect at the time of the travel.
(9) An applicant for licensure or renewal of licensure under
part 209 shall pay the applicable fees set forth in part 209.
(10) Except as otherwise provided in this section, the fees
and assessments collected under this section must be deposited in
the state treasury, to the credit of the general fund. The
department may use the unreserved fund balance in fees and
assessments for the criminal history check program required under
this article.
(11) The quality assurance assessment collected under
subsection (1)(h) (1)(i) and all federal matching funds attributed
to that assessment must be used only for the following purposes and
under the following specific circumstances:
(a) The quality assurance assessment and all federal matching
funds attributed to that assessment must be used to finance
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Medicaid nursing home reimbursement payments. Only licensed nursing
homes and hospital long-term care units that are assessed the
quality assurance assessment and participate in the Medicaid
program are eligible for increased per diem Medicaid reimbursement
rates under this subdivision. A nursing home or long-term care unit
that is assessed the quality assurance assessment and that does not
pay the assessment required under subsection (1)(h) (1)(i) in
accordance with subdivision (c)(i) or in accordance with a written
payment agreement with this state shall not receive the increased
per diem Medicaid reimbursement rates under this subdivision until
all of its outstanding quality assurance assessments and any
penalties assessed under subdivision (f) have been paid in full.
This subdivision does not authorize or require the department to
overspend tax revenue in violation of the management and budget
act, 1984 PA 431, MCL 18.1101 to 18.1594.
(b) Except as otherwise provided under subdivision (c),
beginning October 1, 2005, the quality assurance assessment is
based on the total number of patient days of care each nursing home
and hospital long-term care unit provided to non-Medicare patients
within the immediately preceding year, must be assessed at a
uniform rate on October 1, 2005 and subsequently on October 1 of
each following year, and is payable on a quarterly basis, with the
first payment due 90 days after the date the assessment is
assessed.
(c) Within 30 days after September 30, 2005, the department
shall submit an application to the Centers for Medicare and
Medicaid Services to request a waiver according to 42 CFR 433.68(e)
to implement this subdivision as follows:
(i) If the waiver is approved, the quality assurance assessment
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rate for a nursing home or hospital long-term care unit with less
than 40 licensed beds or with the maximum number, or more than the
maximum number, of licensed beds necessary to secure federal
approval of the application is $2.00 per non-Medicare patient day
of care provided within the immediately preceding year or a rate as
otherwise altered on the application for the waiver to obtain
federal approval. If the waiver is approved, for all other nursing
homes and long-term care units the quality assurance assessment
rate is to be calculated by dividing the total statewide maximum
allowable assessment permitted under subsection (1)(h) (1)(i) less
the total amount to be paid by the nursing homes and long-term care
units with less than 40 licensed beds or with the maximum number,
or more than the maximum number, of licensed beds necessary to
secure federal approval of the application by the total number of
non-Medicare patient days of care provided within the immediately
preceding year by those nursing homes and long-term care units with
more than 39 licensed beds, but less than the maximum number of
licensed beds necessary to secure federal approval. The quality
assurance assessment, as provided under this subparagraph, must be
assessed in the first quarter after federal approval of the waiver
and must be subsequently assessed on October 1 of each following
year, and is payable on a quarterly basis, with the first payment
due 90 days after the date the assessment is assessed.
(ii) If the waiver is approved, continuing care retirement
centers are exempt from the quality assurance assessment if the
continuing care retirement center requires each center resident to
provide an initial life interest payment of $150,000.00, on
average, per resident to ensure payment for that resident's
residency and services and the continuing care retirement center
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utilizes all of the initial life interest payment before the
resident becomes eligible for medical assistance under the state's
Medicaid plan. As used in this subparagraph, "continuing care
retirement center" means a nursing care facility that provides
independent living services, assisted living services, and nursing
care and medical treatment services, in a campus-like setting that
has shared facilities or common areas, or both.
(d) Beginning May 10, 2002, the department shall increase the
per diem nursing home Medicaid reimbursement rates for the balance
of that year. For each subsequent year in which the quality
assurance assessment is assessed and collected, the department
shall maintain the Medicaid nursing home reimbursement payment
increase financed by the quality assurance assessment.
(e) The department shall implement this section in a manner
that complies with federal requirements necessary to ensure that
the quality assurance assessment qualifies for federal matching
funds.
(f) If a nursing home or a hospital long-term care unit fails
to pay the assessment required by subsection (1)(h), (1)(i), the
department may assess the nursing home or hospital long-term care
unit a penalty of 5% of the assessment for each month that the
assessment and penalty are not paid up to a maximum of 50% of the
assessment. The department may also refer for collection to the
department of treasury past due amounts consistent with section 13
of 1941 PA 122, MCL 205.13.
(g) The Medicaid nursing home quality assurance assessment
fund is established in the state treasury. The department shall
deposit the revenue raised through the quality assurance assessment
with the state treasurer for deposit in the Medicaid nursing home
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quality assurance assessment fund.
(h) The department shall not implement this subsection in a
manner that conflicts with 42 USC 1396b(w).
(i) The quality assurance assessment collected under
subsection (1)(h) (1)(i) must be prorated on a quarterly basis for
any licensed beds added to or subtracted from a nursing home or
hospital long-term care unit since the immediately preceding July
1. Any adjustments in payments are due on the next quarterly
installment due date.
(j) In each fiscal year governed by this subsection, Medicaid
reimbursement rates must not be reduced below the Medicaid
reimbursement rates in effect on April 1, 2002 as a direct result
of the quality assurance assessment collected under subsection
(1)(h).(1)(i).
(k) The state retention amount of the quality assurance
assessment collected under subsection (1)(h) (1)(i) must be equal
to 13.2% of the federal funds generated by the nursing homes and
hospital long-term care units quality assurance assessment,
including the state retention amount. The state retention amount
must be appropriated each fiscal year to the department to support
Medicaid expenditures for long-term care services. These funds must
offset an identical amount of general fund/general purpose revenue
originally appropriated for that purpose.
(l) Beginning October 1, 2027, the department shall not assess
or collect the quality assurance assessment or apply for federal
matching funds. The quality assurance assessment collected under
subsection (1)(h) (1)(i) must not be assessed or collected after
September 30, 2011 if the quality assurance assessment is not
eligible for federal matching funds. Any portion of the quality
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assurance assessment collected from a nursing home or hospital
long-term care unit that is not eligible for federal matching funds
must be returned to the nursing home or hospital long-term care
unit.
(12) The quality assurance dedication is an earmarked
assessment collected under subsection (1)(i). (1)(j). That
assessment and all federal matching funds attributed to that
assessment must be used only for the following purpose and under
the following specific circumstances:
(a) To maintain the increased Medicaid reimbursement rate
increases as provided for in subdivision (c).
(b) The quality assurance assessment must be assessed on all
net patient revenue, before deduction of expenses, less Medicare
net revenue, as reported in the most recently available Medicare
cost report and is payable on a quarterly basis, with the first
payment due 90 days after the date the assessment is assessed. As
used in this subdivision, "Medicare net revenue" includes Medicare
payments and amounts collected for coinsurance and deductibles.
(c) Beginning October 1, 2002, the department shall increase
the hospital Medicaid reimbursement rates for the balance of that
year. For each subsequent year in which the quality assurance
assessment is assessed and collected, the department shall maintain
the hospital Medicaid reimbursement rate increase financed by the
quality assurance assessments.
(d) The department shall implement this section in a manner
that complies with federal requirements necessary to ensure that
the quality assurance assessment qualifies for federal matching
funds.
(e) If a hospital fails to pay the assessment required by
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subsection (1)(i), (1)(j), the department may assess the hospital a
penalty of 5% of the assessment for each month that the assessment
and penalty are not paid up to a maximum of 50% of the assessment.
The department may also refer for collection to the department of
treasury past due amounts consistent with section 13 of 1941 PA
122, MCL 205.13.
(f) The hospital quality assurance assessment fund is
established in the state treasury. The department shall deposit the
revenue raised through the quality assurance assessment with the
state treasurer for deposit in the hospital quality assurance
assessment fund.
(g) In each fiscal year governed by this subsection, the
quality assurance assessment must only be collected and expended if
Medicaid hospital inpatient DRG and outpatient reimbursement rates
and graduate medical education payments are not below the level of
rates and payments in effect on April 1, 2002 as a direct result of
the quality assurance assessment collected under subsection (1)(i),
(1)(j), except as provided in subdivision (h).
(h) The quality assurance assessment collected under
subsection (1)(i) (1)(j) must not be assessed or collected after
September 30, 2011 if the quality assurance assessment is not
eligible for federal matching funds. Any portion of the quality
assurance assessment collected from a hospital that is not eligible
for federal matching funds must be returned to the hospital.
(i) The state retention amount of the quality assurance
assessment collected under subsection (1)(i) (1)(j) must be equal
to 13.2% of the federal funds generated by the hospital quality
assurance assessment, including the state retention amount. The
13.2% state retention amount described in this subdivision does not
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apply to the Healthy Michigan plan. Beginning in the fiscal year
ending September 30, 2018, and for each fiscal year thereafter,
there is a retention amount of at least $118,420,600.00 for each
fiscal year for the Healthy Michigan plan. By May 31 of each year,
the department, the state budget office, and the Michigan Health
and Hospital Association shall identify an appropriate retention
amount for the Healthy Michigan plan. The state retention
percentage must be applied proportionately to each hospital quality
assurance assessment program to determine the retention amount for
each program. The state retention amount must be appropriated each
fiscal year to the department to support Medicaid expenditures for
hospital services and therapy. These funds must offset an identical
amount of general fund/general purpose revenue originally
appropriated for that purpose.
(13) The department may establish a quality assurance
assessment to increase ambulance reimbursement as follows:
(a) The quality assurance assessment authorized under this
subsection must be used to provide reimbursement to Medicaid
ambulance providers. The department may promulgate rules to provide
the structure of the quality assurance assessment authorized under
this subsection and the level of the assessment.
(b) The department shall implement this subsection in a manner
that complies with federal requirements necessary to ensure that
the quality assurance assessment qualifies for federal matching
funds.
(c) The total annual collections by the department under this
subsection must not exceed $20,000,000.00.
(d) The quality assurance assessment authorized under this
subsection must not be collected after October 1, 2027. The quality
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assurance assessment authorized under this subsection must no
longer be collected or assessed if the quality assurance assessment
authorized under this subsection is not eligible for federal
matching funds.
(e) By November 1 of each year, the department shall send a
notification to each ambulance operation that will be assessed the
quality assurance assessment authorized under this subsection
during the year in which the notification is sent.
(14) The quality assurance assessment provided for under this
section is a tax that is levied on a health facility or agency.
(15) As used in this section:
(a) "Healthy Michigan plan" means the medical assistance
program described in section 105d of the social welfare act, 1939
PA 280, MCL 400.105d, that has a federal matching fund rate of not
less than 90%.
(b) "Medicaid" means that term as defined in section 22207.
PART 207A
FREESTANDING ABORTION CLINICS
Sec. 20751. (1) As used in this part:
(a) "Freestanding abortion clinic" means a facility, other
than a hospital or freestanding surgical outpatient facility, that
performs elective abortions.
(b) "Elective abortion" means the intentional use of suction,
a substance, or a medical instrument or other device to terminate a
woman's pregnancy for a purpose other than to increase the
probability of a live birth, to preserve the life or health of the
child after live birth, or to remove a fetus that has died as a
result of natural causes, accidental trauma, or a criminal assault
on the pregnant woman. Elective abortion does not include any of
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the following:
(i) The use or prescription of a drug or device intended as a
contraceptive.
(ii) The intentional use of an instrument, drug, or other
substance or device by a physician to terminate a woman's pregnancy
if the woman's physical condition, in the physician's reasonable
medical judgment, necessitates the termination of the woman's
pregnancy to avert her death.
(iii) Treatment on a pregnant woman who is experiencing a
miscarriage or has been diagnosed with an ectopic pregnancy.
(c) "Health care provider" means any of the following:
(i) A physician as that term is defined in section 17001 or
17501.
(ii) A physician's assistant licensed under part 170 or 175.
(iii) A certified nurse practitioner as that term is defined in
section 2701.
(2) In addition, article 1 contains general definitions and
principles of construction applicable to all articles in this code
and part 201 contains definitions applicable to this part.
Sec. 20761. (1) A freestanding abortion clinic must be
licensed under this article.
(2) "Freestanding abortion clinic" or a similar term or
abbreviation must not be used to describe or refer to a health
facility or agency unless it is licensed by the department under
this article.
Sec. 20763. The owner, operator, and governing body of a
freestanding abortion clinic licensed under this article:
(a) Are responsible for all phases of the operation of the
freestanding abortion clinic, selection of health care providers,
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and quality of care rendered in the freestanding abortion clinic.
(b) Shall cooperate with the department in the enforcement of
this article and require that the health care providers and other
personnel working in the freestanding abortion clinic and for whom
a state license or registration is required be currently licensed
or registered.
(c) Subject to sections 20769 and 20771, shall ensure that
health care providers are of a sufficient number to maintain safety
and quality of care and have the qualifications, training, and
skills necessary to meet operational needs and the needs of a
patient, considering the caseload and size of the freestanding
abortion clinic.
Sec. 20765. Subject to this part and any rules promulgated for
purposes of this part, a freestanding abortion clinic shall comply
with all of the following:
(a) Have a plan to identify needs caused by social
determinants of health and, with the consent of a patient, refer
the patient to a support service to address the patient's needs.
For purposes of this subdivision, "support service" includes, but
is not limited to, a food assistance program, a counseling service,
an early childhood development resource, a housing assistance
program, or an intimate partner violence support group.
(b) Develop, implement, and enforce written policies and
procedures for the freestanding abortion clinic's operations. The
policies and procedures must be made available to health care
providers and other personnel who are employed by or under contract
with the freestanding abortion clinic and must comply with all of
the following:
(i) Be administered in a manner that provides quality health
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care services in a safe environment.
(ii) Identify a process for hiring, credentialing, and training
staff.
(iii) Ensure that the right of a patient to informed consent and
to refuse treatment is upheld at every stage of care.
(iv) Include a process by which health care providers who are
employed by or under contract with the freestanding abortion clinic
comply with all of the following:
(A) Refer a patient to services that are not directly provided
by the freestanding abortion clinic, including, but not limited to,
outside laboratory testing services, sonogram services, and mental
health providers.
(B) Consult with another health care provider.
(C) Refer a patient to another health care provider.
(D) Transfer the care of a patient to another health care
provider with the informed consent of the patient.
(E) Initiate patient transport to a hospital described under
subdivision (e) when needed by calling 9-1-1 or an ambulance
operation or by arranging other means for patient transport.
(F) Notify a hospital described under subdivision (e) of the
freestanding abortion clinic's license.
(G) Include a process by which a patient's medical record is
provided to another health care provider on the patient's request
or if the patient is transferred as described in sub-subparagraph
(D) or (E).
(c) Ensure that any service is provided with adequate space
for any furnishings, equipment, supplies, and accommodations for a
patient and the family of the patient.
(d) Ensure that a patient is notified of each health care
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provider within the freestanding abortion clinic who maintains a
malpractice liability insurance policy and each health care
provider who does not.
(e) Identify a hospital to which a patient may be transferred
from the freestanding abortion clinic and that is in close
proximity to the freestanding abortion clinic.
Sec. 20767. (1) A freestanding abortion clinic shall not do
any of the following:
(a) Except as otherwise provided in this subdivision, use
general or regional anesthesia, including epidural anesthesia.
Local anesthesia, nitrous oxide, and other forms of pain relief may
be administered at the freestanding abortion clinic if all of the
following are met:
(i) It is determined to be clinically necessary by a health
care provider.
(ii) It is administered by a health care provider who is acting
within the scope of the health care provider's practice.
(iii) It is used according to the freestanding abortion clinic's
policies and procedures and according to the professionally
recognized standards of practice described in section 20777.
(b) Perform an elective abortion at the freestanding abortion
clinic if any of the following limiting factors apply:
(i) Fetal gestation is more than 22 weeks and 0 days.
(ii) Any other limiting factor established by rule under
section 20777 is present in the patient or the clinical needs of
the patient fall outside the scope of practice of a health care
provider at the freestanding abortion clinic.
(2) A freestanding abortion clinic shall develop policies and
procedures for assessing a patient seeking an elective abortion to
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determine whether it is appropriate for the patient to have the
elective abortion at the freestanding abortion clinic or if the
patient should be referred to a hospital.
Sec. 20769. (1) A freestanding abortion clinic shall provide
all of the following:
(a) Respectful, supportive care for which the patient provides
consent.
(b) Minimization of stress-inducing stimuli.
(c) Freedom of movement.
(d) Oral intake, as appropriate.
(e) Availability of nonpharmacologic pain relief methods.
(f) Regular and appropriate assessment of the patient and
throughout the elective abortion procedure and recovery.
(2) The freestanding abortion clinic shall provide a patient,
at the intake, with all of the following information:
(a) A written description of the training, philosophy of
practice, qualifications, and license or specialty certification of
a health care provider who is employed by or under contract with
the freestanding abortion clinic.
(b) A written description of the freestanding abortion
clinic's patient practice policies.
(c) The complaint process for state and national credentialing
organizations for a health care provider who is employed by or
under contract with the freestanding abortion clinic.
(3) The freestanding abortion clinic shall ensure that a
health care provider is present or available to the patient at all
times when a patient is at the freestanding abortion clinic and
until the patient has been determined to be clinically stable,
based on criteria established by the freestanding abortion clinic.
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(4) The freestanding abortion clinic shall ensure that a
health care provider monitors the progress of a patient's elective
abortion and the condition of the patient at intervals established
in the freestanding abortion clinic's policies and procedures.
(5) Subject to this subsection, the freestanding abortion
clinic shall have the personnel and equipment necessary to ensure
patient safety, meet the demands for services that are routinely
provided in the freestanding abortion clinic, provide coverage
during periods of high demand or in the case of an emergency, and
respond to patient health emergencies that may arise while a
patient is receiving services in the freestanding abortion clinic,
including, but not limited to, basic life support and the initial
management of complications. The freestanding abortion clinic shall
ensure that at least 2 individuals are on the premises and
immediately available during an elective abortion who are certified
in basic life support from the American Heart Association or an
equivalent organization as determined by the department.
Sec. 20771. (1) A freestanding abortion clinic shall not
discharge a patient from the freestanding abortion clinic until the
patient is clinically stable and has met discharge criteria
established by the freestanding abortion clinic.
(2) A freestanding abortion clinic shall ensure that a program
for follow-up care evaluation is planned for each patient.
(3) A freestanding abortion clinic shall ensure that both of
the following are available to a patient of the freestanding
abortion clinic 24 hours a day and 7 days a week:
(a) Consultation with a health care provider by telephone.
(b) A health care provider or other personnel who are
available on call to provide emergency follow-up care to the
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patient.
Sec. 20773. (1) The department shall not require a
freestanding abortion clinic to do any of the following:
(a) Maintain a collaborative agreement with another health
facility or agency or with a health care provider who is not
employed by or under contract with a freestanding abortion clinic.
(b) Provide care other than elective abortion services.
(2) Subsection (1) does not limit a freestanding abortion
clinic from maintaining a collaborative agreement or providing care
other than elective abortion services as described under subsection
(1).
Sec. 20775. (1) A freestanding abortion clinic shall recommend
that health care providers and other personnel who are employed by
or under contract with the freestanding abortion clinic receive an
annual vaccination against influenza and recommend that health care
providers and other personnel who are employed by or under contract
with the freestanding abortion clinic are fully vaccinated against
COVID-19.
(2) A freestanding abortion clinic shall provide evidence to
the department, on request, of immunization, positive titer result,
or documentation of refusal for health care providers and other
personnel who are employed by or under contract with the
freestanding abortion clinic, for each of the following:
(a) Rubella.
(b) Tdap.
(c) Hepatitis B.
(d) Varicella.
(e) Against any other disease required by the department by
rule.
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(3) A freestanding abortion clinic shall conduct tuberculosis
testing before employing or entering into a contract with an
individual who will work in the freestanding abortion clinic.
Sec. 20777. The department shall promulgate rules to implement
this part. The rules must include at least all of the following:
(a) Professionally recognized standards of practice based on
standards issued by the American Congress of Obstetrics and
Gynecology and The National Abortion Federation. If any of the
standards described in this subdivision are revised after the
effective date of the amendatory act that added this section, the
department shall take notice of the revision. The department, in
consultation with the persons described in this section, may
promulgate rules to incorporate any revision by reference.
(b) Limiting factors that, when present, would preclude a
patient from having an elective abortion at a freestanding abortion
clinic because the patient has comorbidities or is beyond the 22
weeks gestation. The rules must allow a freestanding abortion
clinic to develop policies that would include additional limiting
factors to preclude an elective abortion at the freestanding
abortion clinic.
Sec. 20779. Notwithstanding part 201, the department shall not
enforce this part or any rules promulgated for purposes of this
part, including, but not limited to, the requirement that a
freestanding abortion clinic be licensed under this article, until
1 year after the effective date of the amendatory act that added
this part.
Sec. 20781. This part does not require new or additional
third-party reimbursement or mandated worker's compensation
benefits for services rendered at a freestanding abortion clinic.
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Sec. 22224d. A freestanding abortion clinic as that term is
defined in section 20751 is not required to obtain a certificate of
need.