Text of AL SB 457 (2010)

SB457 1 118838-1 2 By Senator Glover 3 RFD: Judiciary 4 First Read: 23-FEB-10 5 Page 0 118838-1:n:02/22/2010:CAJ/ll LRS2010-1246 1 2 3 4 5 6 7 SYNOPSIS: Under existing law, there is no provision 8 that gives health care providers, health care 9 institutions, or health care payers the right to 10 decline participation in a health care service that 11 violates his or her conscience. This bill would 12 provide health care providers, institutions, and 13 payers the right to decline participation in a 14 health care service that violates his or her 15 conscience, and to be immune from civil, criminal, 16 or administrative liability; and imposes legal 17 liability upon any public official, agency, 18 institution, or entity for the discrimination or 19 denial of financial assistance to any health care 20 provider, institution, or payer on account of his 21 or her refusal to participate in a health care 22 service that violates his or her conscience. 23 24 A BILL 25 TO BE ENTITLED 26 AN ACT 27 Page 1 1 To provide for health care providers, institutions, 2 and payers the right to decline participation in a health care 3 service that violates his or her conscience. 4 BE IT ENACTED BY THE LEGISLATURE OF ALABAMA: 5 Section 1. This act shall be known as the Alabama 6 Health Care Rights of Conscience Act. 7 Section 2. As used in this act, the following terms 8 shall have the following meanings: 9 (1) CONSCIENCE. The religious, moral, or ethical 10 principles held by a health care provider, the health care 11 institution, or health care payer. For purposes of this act, a 12 health care institution or health care payer's conscience 13 shall be determined by reference to its existing or proposed 14 religious, moral, or ethical guidelines, mission statement, 15 constitution, bylaws, articles of incorporation, regulations, 16 or other relevant documents. 17 (2) EMPLOYER. An individual or entity that pays for 18 or provides health benefits or health insurance coverage as a 19 benefit to its employees, whether through a third party, a 20 health maintenance organization, a program of self-insurance, 21 or some other means. 22 (3) HEALTH CARE INSTITUTION. A public or private 23 organization, corporation, partnership, sole proprietorship, 24 association, agency, network, joint venture, or other entity 25 that is involved in providing health care services, including, 26 but not limited to: Hospitals, clinics, medical centers, 27 Page 2 ambulatory surgical centers, private physician's offices, 1 pharmacies, nursing homes, university medical schools and 2 nursing schools, medical training facilities, or other 3 institutions or locations where health care procedures are 4 provided to any person. 5 (4) HEALTH CARE PAYER. An entity or employer that 6 contracts for, pays for, or arranges for the payment of, in 7 whole or in part, a health care service, including, but not 8 limited to, health maintenance organizations, health plans, 9 insurance companies, or management services organizations. 10 (5) HEALTH CARE PROVIDER. An individual who may be 11 asked to participate in any way in a health care service, 12 including, but not limited to: A physician, physician's 13 assistant, nurse, nurse's aide, medical assistant, hospital 14 employee, clinic employee, nursing home employee, pharmacist, 15 pharmacy employee, researcher, medical or nursing school 16 faculty, student or employee, counselor, social worker, or any 17 professional, paraprofessional, or any other person who 18 furnishes, or assists in the furnishing of, a health care 19 procedure. 20 (6) HEALTH CARE SERVICE. A phase of patient medical 21 care, treatment, or procedure, including, but not limited to, 22 the following: Patient referral, counseling, therapy, testing, 23 diagnosis or prognosis, research, instruction, prescribing, 24 dispensing, or administering any device, drug, or medication, 25 surgery, or any other care or treatment rendered by health 26 care providers or health care institutions. 27 Page 3 (7) PARTICIPATE IN A HEALTH CARE SERVICE. Counsel, 1 advise, provide, perform, assist in, refer for, admit for 2 purposes of providing, or participate in providing, any health 3 care service or any form of such service. 4 (8) PAY or PAYMENT. Pay, contract for, or otherwise 5 arrange for the payment of, in whole or in part. 6 Section 3. (a) A health care provider has the right 7 not to participate, and no health care provider shall be 8 required to participate in a health care service that violates 9 his or her conscience. This subsection does not allow a health 10 care provider to refuse to participate in a health care 11 service regarding a patient because of the patient's race, 12 color, national origin, ethnicity, sex, religion, creed, or 13 sexual orientation. 14 (b) No health care provider shall be civilly, 15 criminally, or administratively liable for declining to 16 participate in a health care service that violates his or her 17 conscience. This subsection does not exempt a health care 18 provider from liability for refusing to participate in a 19 health care service regarding a patient because of the 20 patient's race, color, national origin, ethnicity, sex, 21 religion, creed, or sexual orientation. 22 (c) It shall be unlawful for any person, health care 23 provider, health care institution, public or private 24 institution, public official, or any board which certifies 25 competency in medical specialties to discriminate against any 26 health care provider in any manner based on his or her 27 Page 4 declining to participate in a health care service that 1 violates his or her conscience. For purposes of this act, 2 discrimination includes, but is not limited to: Termination, 3 transfer, refusal of staff privileges, refusal of board 4 certification, adverse administrative action, demotion, loss 5 of career specialty, reassignment to a different shift, 6 reduction of wages or benefits, refusal to award any grant, 7 contract, or other program, refusal to provide residency 8 training opportunities, or any other penalty, disciplinary, or 9 retaliatory action. 10 Section 4. (a) A health care institution has the 11 right not to participate and no health care institution shall 12 be required to participate in a health care service that 13 violates its conscience. This subsection does not allow a 14 health care institution to refuse to participate in a health 15 care service regarding a patient because of the patient's 16 race, color, national origin, ethnicity, sex, religion, creed, 17 or sexual orientation. 18 (b) A health care institution that declines to 19 provide or participate in a health care service that violates 20 its conscience shall not be civilly, criminally, or 21 administratively liable if the institution provides a consent 22 form to be signed by a patient before admission to the 23 institution stating that it reserves the right to decline to 24 provide or participate in a health care service that violates 25 its conscience. This subsection does not exempt a health care 26 institution from liability for refusing to participate in a 27 Page 5 health care service regarding a patient because of the 1 patient's race, color, national origin, ethnicity, sex, 2 religion, creed, or sexual orientation. 3 (c) It shall be unlawful for any person, public or 4 private institution, or public official to discriminate 5 against any health care institution, or any person, 6 association, corporation, or other entity attempting to 7 establish a new health care institution or operating an 8 existing health care institution, in any manner, including, 9 but not limited to, any denial, deprivation, or 10 disqualification with respect to licensure, any aid 11 assistance, benefit, or privilege, including staff privileges, 12 or any authorization, including authorization to create, 13 expand, improve, acquire, affiliate, or merge with any health 14 care institution, because such health care institution or 15 person, association, or corporation planning, proposing, or 16 operating a health care institution, declines to participate 17 in a health care service which violates the health care 18 institution's conscience. 19 (d) It shall be unlawful for any public official, 20 agency, institution, or entity to deny any form of aid, 21 assistance, grants, or benefits, or in any other manner to 22 coerce, disqualify, or discriminate against any person, 23 association, corporation, or other entity attempting to 24 establish a new health care institution or operating an 25 existing health care institution because the existing or 26 proposed health care institution declines to participate in a 27 Page 6 health care service contrary to the health care institution's 1 conscience. 2 Section 5. (a) A health care payer has the right to 3 decline to pay, and no health care payer shall be required to 4 pay for, or arrange for, the payment of a health care service 5 that violates its conscience. This subsection does not allow a 6 health care payer to decline to pay or arrange for the payment 7 of a health care service regarding a patient because of the 8 patient's race, color, national origin, ethnicity, sex, 9 religion, creed, or sexual orientation. 10 (b) No health care payer and no person, association, 11 corporation, or other entity that owns, operates, supervises, 12 or manages a health care payer shall be civilly or criminally 13 liable by reason of the health care payer's declining to pay 14 for or arrange for the payment of a health care service that 15 violates its conscience. This subsection does not exempt from 16 liability a health care payer, or the owner, operator, 17 supervisor, or manager of a health care payer, for declining 18 to pay or arranging for the payment of a health care service 19 regarding a patient because of the patient's race, color, 20 national origin, ethnicity, sex, religion, creed, or sexual 21 orientation. 22 (c) It shall be unlawful for any person, public or 23 private institution, or public official to discriminate 24 against any health care payer, or any person, association, 25 corporation, or other entity (1) attempting to establish a new 26 health care payer, or (2) operating an existing health care 27 Page 7 payer, in any manner, including, but not limiting to, any 1 denial, deprivation, or disqualification with respect to 2 licensure, aid, assistance, benefit, privilege, or 3 authorization, including, but not limited to, any 4 authorization to create, expand, improve, acquire, affiliate, 5 or merge with any health care payer, because a health care 6 payer, or a person, association, corporation, or other entity 7 planning, proposing, or operating a health care payer declines 8 to pay for or arrange for the payment of any health care 9 service that violates its conscience. 10 (d) It shall be unlawful for any public official, 11 agency, institution, or entity to deny any form of aid, 12 assistance, grants, or benefits or in any other manner coerce, 13 disqualify, or discriminate against any health care payer, or 14 any person, association, corporation, or other entity 15 attempting to establish a new health care payer or operating 16 an existing health care payer because the existing or proposed 17 health care payer declines to pay for, or arrange for the 18 payment of, any health care service that is contrary to its 19 conscience. 20 Section 6. (a) A civil action for damages or 21 injunctive relief, or both, may be brought for the violation 22 of any provision of this act. It shall not be a defense to any 23 claim arising out of the violation of this act that such 24 violation was necessary to prevent additional burden or 25 expense on any other health care provider, health care 26 institution, individual, or patient. 27 Page 8 (b) Any individual, association, corporation, 1 entity, or health care institution injured by any public or 2 private individual, association, agency, entity, or 3 corporation by reason of any conduct prohibited by this act 4 may commence a civil action. Upon finding a violation of this 5 act, the aggrieved party shall be entitled to recover 6 threefold the actual damages, including pain and suffering, 7 sustained by such individual, association, corporation, 8 entity, or health care institution, the costs of the action, 9 and reasonable attorney's fees; but in no case shall recovery 10 be less than five thousand dollars ($5,000) for each violation 11 in addition to costs of the action and reasonable attorney's 12 fees. These damage remedies shall be cumulative, and not 13 exclusive of other remedies afforded under any other state or 14 federal law. 15 (c) The court in such civil action may award 16 injunctive relief, including, but not limited to, ordering 17 reinstatement of a health care provider to his or her prior 18 job position. 19 Section 7. The provisions of this act are severable. 20 If any part of this act is declared invalid or 21 unconstitutional, that declaration shall not affect the part 22 which remains. 23 Section 8. This act shall become effective on the 24 first day of the third month following its passage and 25 approval by the Governor, or its otherwise becoming law. 26 Page 9