Text of AL HB 609 (2006)

Page 0 HB609 1 80016-1 2 By Representatives McClurkin, Galliher, Hill, Ward, Wood, 3 Hubbard, Allen, Collier, McClendon, Williams (J), Carns, 4 Thomas (E), Gaston, Ison, Glover, McMillan, Albritton, Love, 5 Oden, Greeson, Bentley, Beason, Beck, Clouse, Vance, Martin, 6 Gipson, Barton, Boothe and Millican 7 RFD: Health 8 First Read: 09-FEB-06 9 Page 1 80016-1:n:01/19/2006:LCG/mfp LRS2006-401 1 2 3 4 5 6 7 SYNOPSIS: Under current law, health care authorities 8 are vested with the authority to make and to alter 9 appropriate rules and regulations for the conduct 10 of any health care facility and properties owned or 11 operated by it. 12 This bill would give health care providers, 13 health care institutions, and health care payers 14 the following: The authority to refuse to perform 15 or to participate in health care services that 16 violate their conscience; immunity from civil, 17 criminal, or administrative liability for refusing 18 to provide or participate in a health care service 19 that violates their conscience; immunity from 20 discrimination or disciplinary action including 21 termination, transfer, refusal of staff privileges, 22 shift reassignment, or wage or benefits reduction 23 for declining to participate in a health care 24 service that violates their conscience. Further, 25 the bill would provide for civil actions, damages, 26 remedies, and injunctive relief for violation. 27 Page 2 1 A BILL 2 TO BE ENTITLED 3 AN ACT 4 5 Relating to health care, allows health care 6 providers, institutions, and payers to decline to perform any 7 health care service that violates their conscience and provide 8 remedies for persons who exercise that right and suffer 9 damages as a result. 10 BE IT ENACTED BY THE LEGISLATURE OF ALABAMA: 11 Section 1. This act may be known and cited as the 12 "Health Care Rights of Conscience Act." 13 Section 2. The Legislature hereby finds and 14 declares: 15 (a) It is the public policy of the State of Alabama 16 to respect and protect the fundamental right of conscience of 17 all individuals who provide health care services. 18 (b) Without comprehensive protection, health care 19 rights of conscience may be violated in various ways, such as 20 harassment, demotion, salary reduction, transfer, termination, 21 loss of staffing privileges, denial of aid or benefits, and 22 refusal to license, or refusal to certify. 23 (c) It is the purpose of this act to protect as a 24 basic civil right the right of all health care providers, 25 institutions and payers to decline to counsel, advise, pay 26 for, provide, perform, assist, or participate in providing or 27 Page 3 performing health care services that violate their 1 consciences. Such health care services may include, but are 2 not limited to, abortion, artificial birth control, artificial 3 insemination, assisted reproduction, human cloning, 4 euthanasia, human embryonic stem cell research, fetal 5 experimentation, physician-assisted suicide, and 6 sterilization. 7 (d) Accordingly, it is the purpose of this act to 8 prohibit all forms of discrimination, disqualification, 9 coercion, disability, or liability upon such health care 10 providers, institutions, and payers that decline to perform 11 any health care service that violates their conscience. 12 Section 3. The following words and terms shall have 13 the meanings ascribed to them in this section, unless 14 otherwise required by their respective context: 15 (1) CONSCIENCE. The religious, moral, or ethical 16 principles held by a health care provider, the health care 17 institution, or health care payer. For purposes of this act, a 18 health care institution or health care payer's conscience 19 shall be determined by reference to its existing or proposed 20 religious, moral, or ethical guidelines, mission statement, 21 constitution, bylaws, articles of incorporation, regulations, 22 or other relevant documents. 23 (2) EMPLOYER. Any individual or entity that pays for 24 or provides health benefits or health insurance coverage as a 25 benefit to its employees, whether through a third party, a 26 Page 4 health maintenance organization, a program of self insurance, 1 or some other means. 2 (3) HEALTH CARE INSTITUTION. Any public or private 3 organization, corporation, partnership, sole proprietorship, 4 association, agency, network, joint venture, or other entity 5 that is involved in providing health care services, including, 6 but not limited to: Hospitals, clinics, medical centers, 7 ambulatory surgical centers, private physician's offices, 8 pharmacies, nursing homes, university medical schools and 9 nursing schools, medical training facilities, or other 10 institutions or locations wherein health care services are 11 provided to any person. 12 (4) HEALTH CARE PAYER. Any entity or employer that 13 contracts for, pays for, or arranges for the payment of, in 14 whole or in part, any health care service or product, 15 including, but not limited to: Health maintenance 16 organizations, health plans, insurance companies, or 17 management services organizations. 18 (5) HEALTH CARE PROVIDER. Any individual who may be 19 asked to participate in any way in a health care service, 20 including, but not limited to: A physician, physician's 21 assistant, nurse, nurse's aide, medical assistant, hospital 22 employee, clinic employee, nursing home employee, pharmacist, 23 pharmacy employee, researcher, medical or nursing school 24 faculty, student, or employee, counselor, social worker, or 25 any professional, paraprofessional, or any other person who 26 Page 5 furnishes, or assists in the furnishing of, health care 1 services. 2 (6) HEALTH CARE SERVICE. Any phase of patient 3 medical care, treatment or procedure, including, but not 4 limited to, the following: Patient referral, counseling, 5 therapy, testing, diagnosis or prognosis, research, 6 instruction, prescribing, dispensing or administering any 7 device, drug, or medication, surgery, or any other care or 8 treatment rendered by health care providers or health care 9 institutions. 10 (7) PARTICIPATE. To counsel, advise, provide, 11 perform, assist in, refer for, admit for purposes of 12 providing, or participate in providing, any health care 13 service or any form of such service. 14 (8) PAY or PAYMENT. To pay, contract for, or 15 otherwise arrange for the payment of, in whole or in part. 16 Section 4. (a) A health care provider has the right 17 not to participate, and no health care provider shall be 18 required to participate, in a health care service that 19 violates his or her conscience. 20 (b) No health care provider shall be civilly, 21 criminally, or administratively liable for declining to 22 participate in a health care service that violates his or her 23 conscience. 24 (c) It shall be unlawful for any person, health care 25 provider, health care institution, public or private 26 institution, public official, or any board which certifies 27 Page 6 competency in medical specialties to discriminate against any 1 health care provider in any manner based on his or her 2 declining to participate in a health care service that 3 violates his or her conscience. For purposes of this act, 4 discrimination includes, but is not limited to: Termination, 5 transfer, refusal of staff privileges, refusal of board 6 certification, adverse administrative action, demotion, loss 7 of career specialty, reassignment to a different shift, 8 reduction of wages or benefits, refusal to award any grant, 9 contract, or other program, refusal to provide residency 10 training opportunities, or any other penalty disciplinary or 11 retaliatory action. 12 Section 5. (a) A health care institution has the 13 right not to participate, and no health care institution shall 14 be required to participate, in a health care service that 15 violates its conscience. 16 (b) A health care institution that declines to 17 provide or participate in a health care service that violates 18 its conscience shall not be civilly, criminally, or 19 administratively liable if the institution provides a consent 20 form to be signed by a patient before admission to the 21 institution stating that it reserves the right to decline to 22 provide or participate in health care services that violate 23 its conscience. 24 (c) It shall be unlawful for any person, public or 25 private institution, or public official to discriminate 26 against any health care institution, or any person, 27 Page 7 association, corporation, or other entity attempting to 1 establish a new health care institution or operating an 2 existing health care institution, in any manner, including, 3 but not limited to, any denial, deprivation or 4 disqualification with respect to licensure; any aid 5 assistance, benefit, or privilege, including staff privileges; 6 or any authorization, including authorization to create, 7 expand, improve, acquire, or affiliate or merge with any 8 health care institution, because such health care institution, 9 or person, association, or corporation planning, proposing, or 10 operating a health care institution, declines to participate 11 in a health care service which violates the health care 12 institution's conscience. 13 (d) It shall be unlawful for any public official, 14 agency, institution, or entity to deny any form of aid, 15 assistance, grants, or benefits, or in any other manner to 16 coerce, disqualify, or discriminate against any person, 17 association, corporation, or other entity attempting to 18 establish a new health care institution or operating an 19 existing health care institution because the existing or 20 proposed health care institution declines to participate in a 21 health care service contrary to the health care institution's 22 conscience. 23 Section 6. (a) A health care payer has the right to 24 decline to pay, and no health care payer shall be required to 25 pay for or arrange for the payment of, any health care service 26 or product that violates its conscience. 27 Page 8 (b) No health care payer and no person, association, 1 corporation, or other entity that owns, operates, supervises, 2 or manages a health care payer shall be civilly or criminally 3 liable by reason of the health care payer's declining to pay 4 for or arrange for the payment of any health care service that 5 violates its conscience. 6 (c) It shall be unlawful for any person, public or 7 private institution, or public official to discriminate 8 against any health care payer, or any person, association, 9 corporation, or other entity: (i) attempting to establish a 10 new health care payer or (ii) operating an existing health 11 care payer, in any manner, including, but not limited to, any 12 denial, deprivation, or disqualification with respect to 13 licensure, aid, assistance, benefit, privilege, or 14 authorization, including, but not limited to, any 15 authorization to create, expand, improve, acquire, or 16 affiliate or merge with, any health care payer, because a 17 health care payer, or a person, association, corporation, or 18 other entity planning, proposing, or operating a health care 19 payer declines to pay for or arrange for the payment of any 20 health care service that violates its conscience. 21 (d) It shall be unlawful for any public official, 22 agency, institution, or entity to deny any form of aid, 23 assistance, grants, or benefits, or in any other manner to 24 coerce, disqualify, or discriminate against any health care 25 payer, or any person, association, corporation, or other 26 entity attempting to establish a new health care payer or 27 Page 9 operating an existing health care payer because the existing 1 or proposed health care payer declines to pay for, or arrange 2 for the payment of, any health care service that is contrary 3 to its conscience. 4 Section 7. (a) A civil action for damages or 5 injunctive relief, or both, may be brought for the violation 6 of any provision of this act. It shall not be a defense to any 7 claim arising out of the violation of this act that such 8 violation was necessary to prevent additional burden or 9 expense on any other health care provider, health care 10 institution, individual, or patient. 11 (b) Any individual, association, corporation, 12 entity, or health care institution injured by any public or 13 private individual, association, agency, entity, or 14 corporation by reason of any conduct prohibited by this act 15 may commence a civil action. Upon finding a violation of this 16 act, the aggrieved party shall be entitled to recover three 17 times the actual damages, including pain and suffering, 18 sustained by such individual, association, corporation, 19 entity, or health care institution, the costs of the action, 20 and reasonable attorney's fees; but in no case shall recovery 21 be less than five thousand dollars ($5,000) for each violation 22 in addition to costs of the action and reasonable attorney's 23 fees. These damage remedies shall be cumulative, and not 24 exclusive of other remedies afforded under any other state or 25 federal law. 26 Page 10 (c) The court in such civil action may award 1 injunctive relief, including, but not limited to, ordering 2 reinstatement of a health care provider to his or her prior 3 job position. 4 Section 8. This act shall become effective on the 5 first day of the third month following its passage and 6 approval by the Governor, or its otherwise becoming law. 7