Text of RI HB 6793 (2006)

2006 -- H 6793 ======= LC00294 ======= STATE OF RHODE ISLAND IN GENERAL ASSEMBLY JANUARY SESSION, A.D. 2006 ____________ A N A C T RELATING TO HEALTH AND SAFETY -- HEALTH CARE RIGHTS OF CONSCIENCE ACT Introduced By: Representatives Corvese, Schadone, San Bento, Savage, and Palumbo Date Introduced: January 17, 2006 Referred To: House Health, Education & Welfare It is enacted by the General Assembly as follows: 1-1 SECTION 1. Section 23-17-11 of the General Laws in Chapter 23-17 entitled "Licensing 1-2 of Health Care Facilities" is hereby repealed. 1-3 23-17-11. Abortion and sterilization -- Protection for nonparticipation -- Procedure. 1-4 -- A physician or any other person who is a member of or associated with the medical staff of a 1-5 health care facility or any employee of a health care facility in which an abortion or any 1-6 sterilization procedure is scheduled, and who shall state in writing an objection to the abortion or 1-7 sterilization procedure on moral or religious grounds, shall not be required to participate in the 1-8 medical procedures which result in the abortion or sterilization, and the refusal of the person to 1-9 participate in the medical procedures shall not form the basis for any claim of damages on 1-10 account of the refusal or for any disciplinary or recriminatory action against the person. 1-11 SECTION 2. Title 23 of the General Laws entitled "Health and Safety" is hereby 1-12 amended by adding thereto the following chapter: 1-13 CHAPTER 17.20 1-14 HEALTH CARE RIGHTS OF CONSCIENCE ACT 1-15 23-17.20-1. Title. – This act may be known and cited as the "Health Care Rights of 1-16 Conscience Act." 1-17 23-17.20-2. Legislative findings and purposes. – (a) It is the public policy of the state of 1-18 Rhode Island to respect and protect the fundamental right of conscience of all individuals who 2-1 provide health care services. 2-2 (b) Without comprehensive protection, health care rights of conscience may be violated 2-3 in various ways, such as harassment, demotion, salary reduction, transfer, termination, loss of 2-4 staffing privileges, denial of aid or benefits, and refusal to license, or refusal to certify. 2-5 (c) It is the purpose of this chapter to protect as a basic civil right, the right of all health 2-6 care providers, institutions and payers to decline to counsel, advise, pay for, provide, perform, 2-7 assist, or participate in providing or performing health care services that violate their consciences. 2-8 Such health care services may include, but are not limited to, abortion, artificial birth control, 2-9 artificial insemination, assisted reproduction, human cloning, euthanasia, human embryonic stem 2-10 cell research, fetal experimentation, physician-assisted suicide, and sterilization. 2-11 (d) Accordingly, it is the purpose of this chapter to prohibit all forms of discrimination, 2-12 disqualification, coercion, disability, or liability upon such health care providers, institutions and 2-13 payers that decline to perform any health care service that violates their conscience. 2-14 23-17.20-3. Definitions. -- As used in this chapter: 2-15 (a) "Health care service" means any phase of patient medical care, treatment or 2-16 procedure, including, but not limited to, the following: patient referral, counseling, therapy, 2-17 testing, diagnosis or prognosis, research, instruction, prescribing, dispensing or administering any 2-18 device, drug, or medication, surgery, or any other care or treatment rendered by health care 2-19 providers or health care institutions. 2-20 (b) "Health care provider" means any individual who may be asked to participate in any 2-21 way in a health care service, including, but not limited to: a physician, physician's assistant, 2-22 nurse, nurses' aide, medical assistant, hospital employee, clinic employee, nursing home 2-23 employee, pharmacist, pharmacy employee, researcher, medical or nursing school faculty, student 2-24 or employee, counselor, social worker, or any professional, paraprofessional, or any other person 2-25 who furnishes, or assists in the furnishing of health care services. 2-26 (c) "Health care institution" means any public or private organization, corporation, 2-27 partnership, sole proprietorship, association, agency, network, joint venture, or other entity that is 2-28 involved in providing health care services, including, but not limited to: hospitals, clinics, 2-29 medical centers, ambulatory surgical centers, private physician's offices, pharmacies, nursing 2-30 homes, university medical schools and nursing schools, medical training facilities, or other 2-31 institutions or locations wherein health care services are provided to any person. 2-32 (d) "Health care payer" means any entity or employer that contracts for, pays for, or 2-33 arranges for the payment of, in whole or in part, any health care service or product, including, but 2-34 not limited to, health maintenance organizations, health plans, insurance companies, or 3-1 management services organizations. 3-2 (e) "Employer" means any individual or entity that pays for or provides health benefits or 3-3 health insurance coverage as a benefit to its employees, whether through a third party, a health 3-4 maintenance organization, a program of self insurance, or some other means. 3-5 (f) "Participate" in a health care service means to counsel, advise, provide, perform, assist 3-6 in refer for, admit for purposes of providing, or participate in providing, any health care service, 3-7 or any form of such service. 3-8 (g) "Pay" or "payment" means to pay, contract for, or otherwise arrange for the payment 3-9 of, in whole or in part. 3-10 (h) "Conscience" means the religious, moral or ethical principles held by a health care 3-11 provider, the health care institution or health care payer. For purposes of this chapter, a health 3-12 care institution or health care payer's conscience shall be determined by reference to its existing 3-13 or proposed religious, moral or ethical guidelines, mission statement, constitution, bylaws, 3-14 articles of incorporation, regulations, or other relevant documents. 3-15 23-17.20-4. Rights of conscience of health care providers. – (a) Rights of conscience. 3-16 A health care provider has the right not to participate, and no health care provider shall be 3-17 required to participate, in a health care service that violates his or her conscience. 3-18 (b) Immunity from liability. No health care provider shall be civilly, criminally, or 3-19 administratively liable for declining to participate in a health care service that violates his or her 3-20 conscience. 3-21 (c) Discrimination. It shall be unlawful for any person, health care provider, health care 3-22 institution, public or private institution, public official, or any board which certifies competency 3-23 in medical specialties to discriminate against any health care provider in any manner based on his 3-24 or her declining to participate in a health care service that violates his or her conscience. For 3-25 purposes of this chapter, discrimination includes, but is not limited to, termination, transfer, 3-26 refusal of staff privileges, refusal of board certification, adverse administrative action, demotion, 3-27 loss of career specialty, reassignment to a different shift, reduction of wages or benefits, refusal to 3-28 award any grant, contract, or other program, refusal to provide residency training opportunities, 3-29 or any other penalty, disciplinary or retaliatory action. 3-30 23-17.20-5. Rights of conscience of health care institutions. – (a) Rights of conscience. 3-31 A health care institution has the right not to participate, and no health care institution shall be 3-32 required to participate, in a health care service that violates its conscience. 3-33 (b) Immunity from liability. A health care institution that declines to provide or 3-34 participate in a health care service that violates its conscience shall not be civilly, criminally, or 4-1 administratively liable if the institution provides a consent form to be signed by a patient before 4-2 admission to the institution stating that it reserves the right to decline to provide or participate in 4-3 health care services that violate its conscience. 4-4 (c) Discrimination. It shall be unlawful for any person, public or private institution, or 4-5 public official to discriminate against any health care institution, or any person, association, 4-6 corporation, or other entity attempting to establish a new health care institution or operating in 4-7 existing health care institution, in any manner, including, but not limited to: any denial 4-8 deprivation or disqualification with respect to licensure; any aid assistance, benefit or privilege, 4-9 including staff privileges; or any authorization including authorization to create, expand, improve, 4-10 acquire, or affiliate or merge with any health care institution, because such health care institution, 4-11 or person, association, or corporation planning, proposing, or operating a health care institution, 4-12 declines to participate in a health care service which violates the health care institution's 4-13 conscience. 4-14 (d) Denial of aid or benefit. It shall be unlawful for any public official, agency, 4-15 institution, or entity to deny any form of aid, assistance, grants, or benefits, or in any other 4-16 manner to coerce, disqualify, or discriminate against any person, association, corporation, or 4-17 other entity attempting to establish a new health care institution or operating an existing health 4-18 care institution because the existing or proposed health care institution declines to participate in a 4-19 health care service contrary to the health care institution's conscience. 4-20 23-17.20-6. Rights of conscience of health care payers. – (a) Rights of conscience. A 4-21 health care payer has the right to decline to pay, and no health care payer shall be required to pay 4-22 for or arrange for the payment of any health care service or product that violates its conscience. 4-23 (b) Immunity from liability. No health care payer and no person, association, corporation, 4-24 or other entity that owns, operates, supervises, or manages a health care payer shall be civilly or 4-25 criminally liable by reason of the health care payer's declining to pay for or arrange for the 4-26 payment of any health care service that violates its conscience. 4-27 (c) Discrimination. It shall be unlawful for any person, public or private institution, or 4-28 public official to discriminate against any health care payer; or any person, association, 4-29 corporation, or other entity: (i) attempting to establish a new health care payer; or (ii) operating 4-30 an existing health care payer, in any manner, including, but not limited to, any denial, 4-31 deprivation, or disqualification with respect to licensure, aid, assistance, benefit, privilege, or 4-32 authorization, including, but not limited to, any authorization to create, expand, improve, acquire 4-33 or affiliate or merge with any health care payer, because a health care payer, or person, 4-34 association, corporation, or other entity planning, proposing, or a operating a health care payer 5-1 declines to pay for or arrange for the payment of any health care service that violates its 5-2 conscience. 5-3 (d) Denial of aid or benefits. It shall be unlawful for any public official, agency, 5-4 institution, or entity to deny any form of aid, assistance, grants, or benefits, or in any other 5-5 manner to coerce disqualify, or discriminate against any health care payer, or any person, 5-6 association, corporation, or other entity attempting to establish a new health care payer or 5-7 operating an existing health care payer because the existing or proposed health care payer 5-8 declines to pay for, or arrange for the payment of, any health care service that is contrary to its 5-9 conscience. 5-10 23-17.20-7. Civil remedies. – (a) A civil action for damages or injunctive relief, or both, 5-11 may be brought for the violation of any provision of this chapter. It shall not be a defense to any 5-12 claim arising out of the violation of this act that such violation was necessary to prevent 5-13 additional burden or expense on any other health care provider, health care institution, individual, 5-14 or patient. 5-15 (b) Damage remedies. Any individual, association, corporation, entity, or health care 5-16 institution injured by any public or private individual, association, agency, entity, or corporation 5-17 by reason of any conduct prohibited by this act may commence a civil action. Upon finding a 5-18 violation of this act, the aggrieved party shall be entitled to recover threefold the actual damages, 5-19 including pain and suffering, sustained by such individual, association, corporation, entity or 5-20 health care institution, the costs of the action, and reasonable attorneys' fees; but in no case shall 5-21 recovery be less than five thousand dollars ($5,000) for each violation in addition to the cost of 5-22 the action and reasonable attorneys' fees. These damage remedies shall be cumulative, and not 5-23 exclusive of other remedies afforded under any other state or federal law. 5-24 (c) Injunctive remedies. The court in such civil action may award injunctive relief, 5-25 including, but not limited to, ordering reinstatement of a health care provider to his or her prior 5-26 job position. 5-27 23-17.20-8. Discrimination in provision of health services on basis of race or 5-28 disability. – Nothing in this act shall be construed to authorize or shield from liability the denial 5-29 of a health care service that a health care provider, a health care institution, or a health care payer 5-30 provides to others on the basis of a patient's race or present or predicted disability. For purposes 5-31 of this section, the term "disability" has the meaning given to it by section 12102(2)(a) of Title 42 5-32 of the United States Code. 5-33 23-17.20-9. Severability. – The provisions of the chapter are declared to be severable, 5-34 and if any provision, word, phrase, or clause of the chapter or the application thereof to any 6-1 person shall be held invalid, such invalidity shall not affect the validity of the remaining portions 6-2 of this chapter. 6-3 SECTION 3. This act shall take effect upon passage. ======= LC00294 ======== EXPLANATION BY THE LEGISLATIVE COUNCIL OF A N A C T RELATING TO HEALTH AND SAFETY -- HEALTH CARE RIGHTS OF CONSCIENCE ACT *** 7-1 This act would provide protection from discrimination to all health care providers who 7-2 chose not to participate in a health care service that violates the conscience of the health care 7-3 provider. The act would also provide a civil cause of action for damages in instances of 7-4 violations of this act. 7-5 This act would take effect upon passage. ======= LC00294 ======= H6793