Text of MO HB 489 (2023)

FIRST REGULAR SESSION HOUSE BILL NO. 489 102ND GENERAL ASSEMBLY INTRODUCED BY REPRESENTATIVE BAKER. 1261H.01I DANA RADEMAN MILLER, Chief Clerk AN ACT To amend chapter 191, RSMo, by adding thereto eleven new sections relating to health care, with penalty provisions. Be it enacted by the General Assembly of the state of Missouri, as follows: Section A. Chapter 191, RSMo, is amended by adding thereto eleven new sections, to 2 be known as sections 191.1770, 191.1775, 191.1780, 191.1785, 191.1790, 191.1795, 3 191.1800, 191.1802, 191.1805, 191.1807, and 191.1810, to read as follows: 191.1770. Sections 191.1770 to 191.1810 shall be known and may be cited as the 2 "Do No Harm Act". 191.1775. For purposes of sections 191.1770 to 191.1810, the following terms 2 mean: 3 (1) "Academic standards", the grade point average, standardized test score, or 4 other objective metric used to measure a student's achievements for the purpose of 5 admission into, advancement in, or graduation from a medical institution of higher 6 education; 7 (2) "Diversity-equity-inclusion" or "DEI": 8 (a) Any effort to promote racial diversity in any aspect of a health care-related 9 academic program; 10 (b) Any reference to group differences within a given setting with respect to 11 culture, ethnicity, gender, gender identity, national origin, race, religion, or sexual 12 orientation; and EXPLANATION — Matter enclosed in bold-faced brackets [thus] in the above bill is not enacted and is intended to be omitted from the law. Matter in bold-face type in the above bill is proposed language. 13 (c) The promulgation of policies, practices, and procedures designed or 14 implemented with reference to the group differences described in paragraph (b) of this 15 subdivision. 16 17 The term "diversity-equity-inclusion" or "DEI" shall not include equal opportunity or 18 equal employment opportunity materials designed to inform individuals about the 19 prohibition on discrimination based on protected status under state and federal law; 20 (3) "Health care provider", any public hospital or public health care provider 21 including, but not limited to, physicians' offices, outpatient clinics, medical testing sites, 22 medical laboratories, physical or occupational therapy or rehabilitation providers, 23 chiropractors, dentists, optometrists, mental health and clinical social workers, and 24 related providers; 25 (4) "Health care-related academic program", any health care-related area of 26 study designed to prepare students for employment as or with a health care provider by 27 conferring a degree or certification including, but not limited to, programs in nursing, 28 pre-medical studies, medical education, psychiatry, clinical social work, dentistry, dental 29 hygiene, physical or occupational therapy, chiropractic care, medical equipment 30 technician studies, and all related fields; 31 (5) "Health care-related professional licensing board", the board of podiatric 32 medicine, the state board of chiropractic examiners, the dental board, the state board of 33 registration for the healing arts, the state board of nursing, the state board of 34 optometry, the state committee of psychologists, the committee for professional 35 counselors, the state committee for social workers, the state committee for marital 36 and family therapists, the state board of pharmacy, the board of occupational therapy, 37 the state committee of dietitians, and the board of therapeutic massage; 38 (6) "Institution of higher education", any: 39 (a) State community college; 40 (b) State college or university offering bachelor's degrees, master's degrees, or 41 doctorate degrees; or 42 (c) Trade school; 43 (7) "Medical institution of higher education", any institution of higher education 44 that receives state funds and that offers health care-related degrees, health care-related 45 certifications, or health care-related training. 191.1780. 1. Each medical institution of higher education shall submit an annual 2 certification before December thirty-first to the state board of registration for the 3 healing arts and the coordinating board for higher education stating that the institution: HB 489 2 4 (1) Does not require applicants to subscribe to diversity-equity-inclusion (DEI) 5 ideologies and does not discriminate against applicants who do not subscribe to DEI 6 ideologies during the application process; and 7 (2) Does not require admitted students to study or subscribe to DEI ideologies 8 within the medical institution of higher education. 9 2. Each medical institution of higher education shall publish the titles and syllabi 10 for all mandatory courses, seminars, classes, workshops, and training sessions on its 11 website in an online database that is readily searchable by the public. 12 3. Medical institutions of higher education shall not conduct internal DEI audits 13 or otherwise engage DEI consultants. 191.1785. 1. All medical institutions of higher education in this state other than 2 open-enrollment institutions shall require applicants to complete a standardized 3 admissions test focused on knowledge and critical thinking with respect to science 4 and medical training in order to qualify for admission. 5 2. A medical institution of higher education shall not alter the academic 6 standards for the admission of new students to a health care-related course of study or 7 for the conferral of a health care-related degree or certificate unless the institution 8 submits to the general assembly and the coordinating board for higher education: 9 (1) A copy of the proposed academic standards; 10 (2) A concise general statement relating to the proposed standards; and 11 (3) The proposed effective date of the proposed standards. 12 3. The proposed standards described in subsection 2 of this section shall become 13 effective no earlier than sixty days from the date of the submission of the proposed 14 standards, excluding days either chamber of the general assembly is adjourned for more 15 than three days. 16 4. (1) The proposed standards described in subsection 2 of this section shall not 17 become effective if, before the earliest date on which the standards may become effective 18 as described in subsection 3 of this section, both chambers of the general assembly pass 19 and the governor approves a joint resolution of disapproval. 20 (2) For purposes of this subsection, the term "joint resolution of disapproval" 21 means a resolution introduced after the submission of the proposed standards described 22 in subsection 2 of this section that contains a statement in substantially the following 23 form: "The general assembly disapproves the standards submitted by ______________ 24 ____ (the medical institution of higher education) relating to __________________ (the 25 description of the standards), and such standards shall have no force or effect.". 191.1790. 1. Health care-related professional licensing boards shall not adopt or 2 impose, as a condition of obtaining or renewing any license, any incentives or HB 489 3 3 requirements for applicants for licensure or renewal of licensure to undergo, 4 demonstrate familiarity with, or support any diversity-equity-inclusion (DEI) 5 training, education, material, or program. 6 2. Organizations that issue state-required health care-related professional 7 certifications shall not use DEI material or require DEI training as part of the 8 certification process. 9 3. Health care-related professional licensing boards and organizations that issue 10 health care-related professional certifications shall not conduct internal DEI audits or 11 otherwise engage DEI consultants. 191.1795. 1. A health care provider or medical institution of higher education 2 shall not receive any state contract or grant unless the provider or institution has 3 certified before the award of the contract or grant that it does not and will not require 4 its employees, contractors, volunteers, vendors, or agents to subscribe to, study, or 5 receive instruction on diversity-equity-inclusion material in connection with the use of 6 state funds. 7 2. Each health care provider and medical institution of higher education shall 8 submit an annual certification before December thirty-first to the state board of 9 registration for the healing arts stating that the provider or institution does not and will 10 not require its employees, contractors, volunteers, vendors, or agents to subscribe to, 11 study, or receive instruction on diversity-equity-inclusion material in connection with 12 the use of state funds. 191.1800. Any state entity applying for a federal health care-related grant 2 related to diversity-equity-inclusion shall publish on its website all materials, 3 requirements, and instructions related to the federal grant application that are in the 4 entity's possession, submit a copy of the grant proposal to the state board of registration 5 for the healing arts for public posting, and submit a copy of the grant proposal to all 6 members of the house and senate committees on health policy. 191.1802. 1. An aggrieved person may commence an action against a health care 2 provider or medical institution of higher education for violations of sections 191.1770 to 3 191.1810. 4 2. If an aggrieved person proves that a health care provider or medical 5 institution of higher education violated sections 191.1770 to 191.1810, the person is 6 entitled to recover: 7 (1) Declaratory relief; 8 (2) Injunctive relief; HB 489 4 9 (3) Statutory damages of not less than one hundred thousand dollars assessed 10 against the health care provider or medical institution of higher education found by a 11 court to have violated sections 191.1770 to 191.1810; 12 (4) Compensatory damages; and 13 (5) Costs and attorney's fees. 14 3. Sovereign immunity to suit is waived and abolished to the extent of liability 15 created by sections 191.1770 to 191.1810. A person having a claim under sections 16 191.1770 to 191.1810 may sue a health care provider or medical institution of higher 17 education that would otherwise be entitled to such immunity for damages allowed by 18 sections 191.1770 to 191.1810. 19 4. An aggrieved person shall bring suit under sections 191.1770 to 191.1810 not 20 later than one year after the alleged violation occurred. 191.1805. 1. Any health care provider with more than fifty employees or medical 2 institution of higher education shall submit an annual certification to the state board of 3 registration for the healing arts and the attorney general signed by an officer of the 4 provider or institution under penalty of perjury stating that the provider or institution 5 is in compliance with the provisions of sections 191.1770 to 191.1810. 6 2. The attorney general shall have the authority to investigate allegations of 7 violations of sections 191.1770 to 191.1810. 8 3. In addition to any relief granted to aggrieved persons under a private right of 9 action, the attorney general may seek civil penalties of up to one million dollars against a 10 health care provider or medical institution of higher education for each violation of 11 sections 191.1770 to 191.1810. 12 4. The attorney general may file suit for a writ of mandamus compelling public 13 health care providers or public medical institutions of higher education to comply with 14 sections 191.1770 to 191.1810. 15 5. The attorney general shall have the authority to establish, by regulation, 16 procedures for investigating violations of sections 191.1770 to 191.1810. Any rule or 17 portion of a rule, as that term is defined in section 536.010, that is created under the 18 authority delegated in this section shall become effective only if it complies with and is 19 subject to all of the provisions of chapter 536 and, if applicable, section 536.028. This 20 section and chapter 536 are nonseverable and if any of the powers vested with the 21 general assembly pursuant to chapter 536 to review, to delay the effective date, or to 22 disapprove and annul a rule are subsequently held unconstitutional, then the grant of 23 rulemaking authority and any rule proposed or adopted after August 28, 2023, shall be 24 invalid and void. HB 489 5 191.1807. The state board of registration for the healing arts shall publish on its 2 website, on an annual basis before December thirty-first, a list of all the health care 3 providers and medical institutions of higher education that have provided DEI 4 certification as required under sections 191.1770 to 191.1810. 191.1810. If any provision of sections 191.1770 to 191.1810 or the application 2 thereof to any person or circumstance is held invalid, such determination shall not affect 3 the provisions or applications of sections 191.1770 to 191.1810 which may be given effect 4 without the invalid provision or application, and to that end the provisions of sections 5 191.1770 to 191.1810 are severable. ✔ HB 489 6