RHODE ISLAND. Rhode Island General Laws.

 

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TITLE 11
Criminal Offenses

 

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CHAPTER 11-3
Abortion

 

11-3-1   11-3-5. [Unconstitutional.].

 

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CHAPTER 11-9
Children

 

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    11-9-18  Care of babies born alive during attempted abortions. Any physician, nurse, or other licensed medical person who knowingly and intentionally fails to provide reasonable medical care and treatment to an infant born alive in the course of an abortion shall be guilty of a felony and upon conviction shall be fined not exceeding five thousand dollars ($5,000), or imprisoned not exceeding five (5) years, or both. Any physician, nurse, or other licensed medical person who knowingly and intentionally fails to provide reasonable medical care and treatment to an infant born alive in the course of an abortion, and, as a result of that failure, the infant dies, shall be guilty of the crime of manslaughter.

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CHAPTER 11-54
Experimentation on Human Fetuses

11-54-1  Experimentation on human fetuses. (a) No person shall use any live human fetus, whether before or after expulsion from its mother's womb, for scientific, laboratory research, or other kind of experimentation. This section shall not prohibit procedures incident to the study of a human fetus while it is in its mother's womb, provided that in the best medical judgment of the physician, made at the time of the study, the procedures do not substantially jeopardize the life or health of the fetus, and provided the fetus is not the subject of a planned abortion. In any criminal proceeding the fetus shall be conclusively presumed not to be the subject of a planned abortion if the mother signed a written statement at the time of the study that she was not planning an abortion.

   (b) This section shall not prohibit or regulate diagnostic or remedial procedures, the purpose of which is to determine or to preserve the life or health of the fetus involved or the mother involved.

   (c) A fetus is a live fetus for purposes of this section when, in the best medical judgment of a physician, it shows evidence of life as determined by the same medical standards as are used in determining evidence of life in a spontaneously aborted fetus at approximately the same stage of gestational development.

   (d) No experimentation may knowingly be performed upon a dead fetus unless the consent of its mother has first been obtained, provided, that such consent shall not be required in the case of a routine pathological study. In any criminal proceeding, consent shall be conclusively presumed to have been granted for the purposes of this section by a written statement, signed by the mother, who is at least eighteen (18) years of age, to the effect that she consents to the use of her fetus for scientific, laboratory, research, or other kind of experimentation or study; that written consent shall constitute lawful authorization for the transfer of the dead fetus.

   (e) No person shall perform or offer to perform an abortion where part or all of the consideration for the performance is that the fetal remains may be used for experimentation or other kinds of research or study.

   (f) No person shall knowingly sell, transfer, distribute, or give away any fetus for a use which is in violation of the provisions of this section. For purposes of this section, the word "fetus" includes an embryo or neonate.

  11-54-2  Penalties. Any person who performs any of the acts prohibited by this chapter shall be guilty of a felony and shall be punished by a fine of at least one thousand dollars ($1,000) or shall be imprisoned for a period of at least one year, or both.

 

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CHAPTER 11-23
Homicide

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  11-23-5  Willful killing of unborn quick child. (a) The willful killing of an unborn quick child by any injury to the mother of the child, which would be murder if it resulted in the death of the mother; the administration to any woman pregnant with a quick child of any medication, drug, or substance or the use of any instrument or device or other means, with intent to destroy the child, unless it is necessary to preserve the life of the mother; in the event of the death of the child; shall be deemed manslaughter.

   (b) In any prosecution under this section, it shall not be necessary for the prosecution to prove that any necessity existed.

   (c) For the purposes of this section, "quick child" means an unborn child whose heart is beating, who is experiencing electronically-measurable brain waves, who is discernibly moving, and who is so far developed and matured as to be capable of surviving the trauma of birth with the aid of usual medical care and facilities available in this state.

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TITLE 23
Health and Safety

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CHAPTER 23-4.7
Informed Consent for Abortion

  23-4.7-1  "Abortion" defined. "Abortion" for the purpose of this chapter means administering to a woman, known to be pregnant, any medicine, drug, substance, or thing whatever, or the employment upon her of any instrument or means whatever, with intent to terminate a pregnancy. The term shall not include the administering of any medicine, drug, substance, or thing or the employment of any instrument or means for the purpose of completing an incomplete, spontaneous miscarriage.

 

  23-4.7-2  Informed written consent required. In order to insure that a woman's consent to abortion is truly informed consent, an abortion shall be performed only after the woman has given her consent, in writing, in a form satisfying the provisions of 23-4.7-5.

  23-4.7-3  Required disclosures. (a) Either the physician who is to perform the abortion or his or her authorized agent or another physician or his or her authorized agent shall:

   (1) Inform the woman that she is pregnant and inform her of the estimated gestational age of the fetus at the time of the disclosure.

   (2) Explain to the woman the medical nature of an abortion, including the probable gestational age of the fetus at the time the abortion is to be performed.

   (3) Explain to the woman the medical or surgical procedure to be employed to perform the abortion.

   (4) Explain to the woman all known material medical risks associated with the particular abortion procedure to be employed. In the event a physician or his or her authorized agent determines that the disclosure of a known material risk should not be made, that risk need not be disclosed, provided the medical basis for the nondisclosure is certified in writing in the patient's medical record.

   (b) In addition, a physician or his or her authorized agent may inform the woman of any other material facts or opinions or otherwise state anything with respect to the disclosures required in this section which, in the exercise of his or her best medical judgment, is reasonably necessary to enable the woman to give her informed consent to the proposed abortion, with full knowledge of its nature and consequences.

   23-4.7-4  Emergency requiring immediate action. Where there is an emergency requiring immediate action, the requirements of this chapter may be waived. The woman's attending physician shall certify in writing in the patient's medical record that an emergency exists and the medical basis for his or her opinion.

23-4.7-5  Consent form. (a) The woman's written consent required by 23-4.7-2 shall be on a form provided by the physician or facility and containing:

   (1) The disclosures required by 23-4.7-3; and

   (2) The woman's acknowledgment that either the physician who is to perform the abortion or his or her authorized agent or another physician or his or her authorized agent has provided her with the information required by 23-4.7-3.

   (b) The form shall in addition include the following statement: "If you decide to carry your pregnancy to term but not to keep the child, you may be able to place the child with either a relative, or with another family through foster care or adoption."

   (2) The person making the disclosures required under 23-4.7-3 shall not be required to state anything with respect to the contents of subdivision (1) of this subsection.

   (c) In cases where the woman does not understand English, either the consent form shall be written in a language understood by her, or the person informing her shall certify on the consent form that in his or her opinion, the information required to be given by 23-4.7-3 has been given in a manner as to be understandable by her; if an interpreter is used, the interpreter shall be named and reference to that use shall be made on the consent form.

   (d) A copy of the form shall be made available to the woman upon her request.

23-4.7-6  Minors Parental consent Judicial proceedings. Except in the case of a minor who has been found by a court of competent jurisdiction to be emancipated, if a pregnant woman is less than eighteen (18) years of age and has not married, an abortion shall not be performed upon her unless both the consent of the pregnant woman and that of at least one of her parents is obtained, except as provided in this section. In deciding whether to grant consent, a pregnant woman's parents shall consider only their child's best interests. If both parents have died or are otherwise unavailable to the physician within a reasonable time and in a reasonable manner, consent of the pregnant woman's legal guardian or one of her guardians shall be sufficient. If a pregnant woman less than eighteen (18) years of age has not married and if neither of her parents or guardians agree to consent to the performance of an abortion, or if she elects not to seek the consent of either of her parents or guardians, a judge of the family court shall, upon petition, or motion, and after an appropriate hearing, authorize a physician to perform the abortion, if the judge determines that the pregnant woman is mature and capable of giving informed consent to the proposed abortion or if the judge determines that she is not mature, but that the performance of an abortion upon her would be in her best interests. A pregnant woman less than eighteen (18) years of age may participate in proceedings in the family court on her own behalf, and she shall be represented in her proceeding by a guardian ad litem. Proceedings in the family court under this section shall be confidential and shall be given such precedence over other pending matters that the court may reach a decision promptly and without delay so as to serve the best interests of the pregnant woman. A judge of the family court who conducts proceedings under this section shall make in writing specific factual findings and legal conclusions supporting his or her decision and shall order a record of the evidence to be maintained including his or her own findings and conclusions.

 

23-4.7-7  Liability of physician. Any physician who knowingly violates the requirements of this chapter shall be deemed to have engaged in "unprofessional conduct" for the purposes of 5-37-5.1. The willful failure to provide the woman with the substance of the information pursuant to the requirements of 23-4.7-3 shall be prima facie evidence of failure to obtain informed consent in an action at law or in equity.

 

  23-4.7-8  Severability. If any section or provision of this chapter or the application of any section or provision is held invalid, that invalidity shall not affect other sections, provisions, or applications, and to this end the sections and provisions of this chapter are declared severable.

 

CHAPTER 23-4.8
Spousal Notice for Abortion [These provisions have been held to be unconstitutional and unenforceable.]

 

23-4.8-1  Declaration of purpose. The purpose of this chapter is to promote the state's interest in furthering the integrity of the institutions of marriage and the family.

 

23-4.8-2  Spousal notice requirements. If a married woman consents to an abortion, as that consent is required by chapter 4.7 of this title, the physician who is to perform the abortion or his or her authorized agent shall, if reasonably possible, notify the husband of that woman of the proposed abortion before it is performed.

23-4.8-3  Exceptions. The requirements of 23-4.8-2 shall not apply if:

   (1) The woman having the abortion furnishes to the physician who is to perform the abortion or the physician's authorized agent prior to the abortion being performed a written statement that she has given notice to her husband of the proposed abortion or a written statement that the fetus was not fathered by her husband;

   (2) The woman or her husband are living separate and apart or either spouse has filed a petition or complaint for divorce in a court of competent jurisdiction;

  23-4.8-4  Penalties. In the event a physician performs an abortion, as defined by chapter 4.7 of this title, upon a woman who he or she knows is married and the physician knowingly and intentionally violates the requirements of this chapter, he or she shall be guilty of "unprofessional conduct" for the purposes of 5-37-5.1.

 

  23-4.8-5  Severability. If any section or provision of this chapter or the application of any section or provision is held invalid, that invalidity shall not affect other sections, provisions or applications, and to this end the sections and provisions of this chapter are declared severable.

 

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CHAPTER 23-4.12
Partial Birth Abortion [These provisions have been held to be unconstitutional and unenforceable.]

23-4.12-1  Definitions. (a) For purposes of this chapter, "partial birth abortion" means an abortion in which the person performing the abortion vaginally delivers a living human fetus before killing the infant and completing the delivery.

   (b) For purposes of this chapter, the terms "fetus" and "infant" are used interchangeably to refer to the biological offspring of human parents.

   (c) As used in this section, "vaginally delivers a living fetus before killing the infant" means deliberately and intentionally delivers into the vagina a living fetus, or a substantial portion of the fetus, for the purpose of performing a procedure the person performing the abortion knows will kill the infant, and kills the infant.

  23-4.12-2  Prohibition of partial birth abortions. No person shall knowingly perform a partial birth abortion.

 

  23-4.12-3  Life of the mother exception. Section 23-4.12-2 shall not apply to a partial birth abortion that is necessary to save the life of a mother because her life is endangered by a physical disorder, physical illness, or physical injury, including a life-endangering condition caused by or arising from the pregnancy itself; provided, that no other medical procedure would suffice for that purpose.

23-4.12-4  Civil remedies. (a) The woman upon whom a partial birth abortion has been performed in violation of 23-4.12-2, the father of the fetus or infant, and the maternal grandparents of the fetus or infant, and the maternal grandparents of the fetus or infant if the mother has not attained the age of eighteen (18) years at the time of the abortion, may obtain appropriate relief in a civil action, unless the pregnancy resulted from the plaintiff's criminal conduct or the plaintiff consented to the abortion.

   (b) The relief shall include:

   (1) Money damages for all injuries, psychological and physical, occasioned by the violation of this chapter; and

   (2) Statutory damages equal to three (3) times the cost of the partial birth abortion.

   (c) If judgment is rendered in favor of the plaintiff in an action described in this section, the court shall also render judgment for a reasonable attorney's fee in favor of the plaintiff against the defendant. If the judgment is rendered in favor of the defendant and the court finds that the plaintiff's suit was frivolous and brought in bad faith, the court shall also render judgment for a reasonable attorney's fee in favor of the defendant against the plaintiff.

  23-4.12-5  Penalty. (a) Performance of a partial birth abortion deliberately and intentionally is a violation of this chapter and shall be a felony.

   (b) A woman upon whom a partial birth abortion is performed may not be prosecuted under this chapter for violating this chapter or any provision this chapter, or for conspiracy to violate this chapter or any provision this chapter.

  23-4.12-6  Severability. (a) If any one or more provisions, clauses, phrases, or words of 23-4.12-3 or the application of that section to any person or circumstance is found to be unconstitutional, it is declared to be inseverable.

   (b) If any one or more provisions, sections, subsections, sentences, clauses, phrases or words of the remaining sections or the application of them to any person or circumstance is found to be unconstitutional, they are declared to be severable and the balance of the chapter shall remain effective notwithstanding the unconstitutionality. The legislature declares that it would have passed this chapter, and each provision, section, subsection, sentence, clause, phrase, or words, with the exception of 23-4.12-3, irrespective of the fact that any one or more provisions, sections, subsections, sentences, clauses, phrases, or words be declared unconstitutional.

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CHAPTER 23-13
Maternal and Child Health Services for Children with Special Health Care Needs

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  23-13-21  Comprehensive reproductive health services. (a) The director of health is authorized and directed to establish a payor of last resort program to cover the cost of outpatient family planning counseling and comprehensive reproductive health services for men and women who are ineligible for Medicaid, lack health insurance coverage for these services, and whose family's income is between one hundred percent (100%) and one hundred eighty-five percent (185%) of the federal poverty level. The director shall promulgate regulations to implement this program. These regulations shall include: specific eligibility criteria, scope and standards for services to be covered, mechanisms for administration, and service delivery.

   (b) It is the intent of the general assembly that the following services be provided through this program:

   (1) Patient education and counseling on options for timing and spacing pregnancy;

   (2) Comprehensive medical services to prevent and control the spread of sexually transmitted diseases;

   (3) Access to safe and effective methods of contraception.

   (c) Excluded services will include but not be limited to elective abortion, elective hysterectomy, infertility related services, and other non-family planning procedures. No funds shall be expended to support school-based clinics dispensing contraceptive methods.

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CHAPTER 23-17
Licensing of Health Care Facilities

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  23-17-11  Abortion and sterilization Protection for nonparticipation Procedure. A physician or any other person who is a member of or associated with the medical staff of a health care facility or any employee of a health care facility in which an abortion or any sterilization procedure is scheduled, and who shall state in writing an objection to the abortion or sterilization procedure on moral or religious grounds, shall not be required to participate in the medical procedures which result in the abortion or sterilization, and the refusal of the person to participate in the medical procedures shall not form the basis for any claim of damages on account of the refusal or for any disciplinary or recriminatory action against the person.

 

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TITLE 27
Insurance

 

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CHAPTER 27-18
Accident and Sickness Insurance Policies

 

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    27-18-28  Health insurance contracts Abortion. [These provisions have been held to be unconstitutional and unenforceable.] (a) No health insurance contract, plan, or policy, delivered or issued for delivery in the state, shall provide coverage for induced abortions, except where the life of the mother would be endangered if the fetus were carried to term or where the pregnancy resulted from rape or incest, and except by an optional rider for which there must be paid an additional premium. This section shall be applicable to all contracts, plans, or policies of:

   (1) All health insurers subject to this title;

   (2) All group and blanket health insurers subject to this title;

   (3) All nonprofit hospital, medical, surgical, dental, and health service corporations; and

   (4) All health maintenance organizations;

   (5) Any provision of medical, hospital, surgical, and funeral benefits, and of coverage against accidental death or injury, when the benefits or coverage are incidental to or part of other insurance authorized by the statutes of this state.

   (b) Nothing contained in this section shall be construed to pertain to insurance coverage for complications as the result of an abortion.

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TITLE 28
Labor and Labor Relations

 

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CHAPTER 28-41
Temporary Disability Insurance Benefits

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  28-41-8  Pregnancy benefits. An eligible individual who is unemployed due to sickness resulting from pregnancy, childbirth, miscarriage, or abortion shall be entitled to receive those benefits which are regularly provided for unemployment due to sickness in chapters 39 41 of this title.

 

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TITLE 36
Public Officers and Employees

 

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CHAPTER 36-12
Insurance Benefits

 

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36-12-2.1  Health insurance benefits Coverage for abortions excluded. [These provisions have been held to be unconstitutional and unenforceable as applied to municipal employees.] (a) The state of Rhode Island or any city or town shall not include in any health insurance contracts, plans, or policies covering employees, any provision which shall provide coverage for induced abortions (except where the life of the mother would be endangered if the fetus were carried to term, or where the pregnancy resulted from rape or incest). This section shall be applicable to all contracts, plans or policies of:

   (1) All health insurers subject to title 27;

   (2) All group and blanket health insurers subject to title 27;

   (3) All nonprofit hospital, medical, surgical, dental, and health service corporations;

   (4) All health maintenance organizations; and

   (5) Any provision of medical, hospital, surgical, and funeral benefits and of coverage against accidental death or injury when the benefits or coverage are incidental to or part of other insurance authorized by the statutes of this state.

   (b) Provided, however, that the provisions of this section shall not apply to benefits provided under existing collective bargaining agreements entered into prior to June 30, 1982.

   (c) Nothing contained herein shall be construed to pertain to insurance coverage for complications as the result of an abortion.

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TITLE 42
State Affairs and Government

 

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CHAPTER 42-12.3
Health Care for Children and Pregnant Women

 

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  42-12.3-3  Medical assistance expansion for pregnant women/RIte Start. (a) The director of the department of human services is authorized to amend its title XIX state plan pursuant to title XIX of the Social Security Act to provide Medicaid coverage through expanded family income disregards for pregnant women whose family income levels are between one hundred eighty-five percent (185%) and two hundred fifty percent (250%) of the federal poverty level. The department is further authorized to promulgate any regulations necessary and in accord with title XIX [42 U.S.C. 1396 et seq.] of the Social Security Act to implement said state plan amendment. The services shall be in accord with title XIX [42 U.S.C. 1396 et seq.] of the Social Security Act.

   (b) The director of the department of human services is authorized and directed to establish a payor of last resort program to cover prenatal, delivery and postpartum care. The program shall cover the cost of maternity care for any woman who lacks health insurance coverage for maternity care and who is not eligible for medical assistance under title XIX [42 U.S.C. 1396 et seq.] of the Social Security Act including but not limited to a non-citizen pregnant woman lawfully admitted for permanent residence on or after August 22, 1996, without regard to the availability of federal financial participation, provided such pregnant woman satisfies all other eligibility requirements. The director shall promulgate regulations to implement this program. Such regulations shall include specific eligibility criteria; the scope of services to be covered; procedures for administration and service delivery; referrals for non-covered services; outreach; and public education. Excluded services under this paragraph will include, but not be limited to, induced abortion except to prevent the death of the mother.

   (c) The department of human services may enter into cooperative agreements with the department of health and/or other state agencies to provide services to individuals eligible for services under paragraphs (a) and (b) above.

   (d) The following services shall be provided through the program:

   (1) Antepartum and postpartum care;

   (2) Delivery;

   (3) Cesarean section;

   (4) Newborn hospital care;

   (5) Inpatient transportation from one hospital to another when authorized by a medical provider;

   (6) Prescription medications and laboratory tests;

   (e) The department of human services shall provide enhanced services, as appropriate, to pregnant women as defined in paragraphs (a) and (b), as well as to other pregnant women eligible for medical assistance. These services shall include: care coordination, nutrition and social service counseling, high risk obstetrical care, childbirth and parenting preparation programs, smoking cessation programs, outpatient counseling for drug-alcohol use, interpreter services, mental health services, and home visitation. The provision of enhanced services is subject to available appropriations. In the event that appropriations are not adequate for the provision of these services, the department has the authority to limit the amount, scope and duration of these enhanced services.

   (f) The department of human services shall provide for extended family planning services for up to twenty-four (24) months postpartum. These services shall be available to women who have been determined eligible for RIte Start or for medical assistance under title XIX [42 U.S.C. 1396 et seq.] of the social security act.

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Department of Health. RULES AND REGULATIONS FOR THE TERMINATION OF PREGNANCY (R23-1-TOP)

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INTRODUCTION


The Rhode Island Department of Health has legal and professional responsibilities for the health,
welfare and safety of the citizens of Rhode Island.

These rules and regulations are promulgated pursuant to the authority set forth in section 23-1-1 of the
General Laws of Rhode Island, as amended. The purpose of these rules and regulations is to safeguard the
health, safety and welfare of women undergoing a termination of pregnancy. To assure quality care, the
regulations focus on major areas of public health concern and define the facilities required for acceptable
practice, consistent with the most recent Guidelines for Women's Health Care of the American College
of Obstetricians and Gynecologists.

These regulations do not predetermine the result of professional judgement as to the wisdom and
propriety of the service which must remain the province of the physician or other licensed health care
practitioner acting within his/her scope of practice. These regulations shall supersede all previous rules and
regulations pertaining to the termination of pregnancy promulgated by the Department of Health and filed with
the Secretary of State.

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PART I:
Definitions

Section 1.0 Definitions

Wherever used in these regulations, the following terms shall be construed as follows:

1.1
"Fetal death", as defined in subsection 23-3-1(3) of the General Laws of Rhode Island, as
amended, means death prior to the complete expulsion or extraction from its mother of a product
of human conception, irrespective of the duration of pregnancy; the death is indicated by the fact
that after such expulsion or extraction the fetus does not breathe or show any other evidence of life
such as beating of the heart, pulsation of the umbilical cord, or definite movement of the voluntary
muscles.

1.2
"Gestation" means the duration of the pregnancy computed from the first day of the last menstrual
period, or based upon clinical judgment of the examining physician (or other licensed health care
practitioner acting within his/her scope of practice) when that date is unreliable.

1.3
"Gestational age" means the estimated age of the fetus based upon anatomical characteristics of
the fetus.

1.4
"Physician" means a person authorized or licensed to practice medicine or osteopathy pursuant
to Chapter 37 of Title 5.

1.5
"Termination of a pregnancy" or "Termination" shall mean administering to a woman any
medicine, drug, substance, or thing whatever, or the employment upon her of any instrument or
other means whatever, with intent to procure or induce the miscarriage of such woman. (The term
" ABORTION quot; is not used in these regulations, since it applies to both spontaneous and induced fetal
loss).

PART II:
Requirements for Pregnancy Terminations

Section 2.0
General Provisions

2.1
Pursuant to the provisions of section 23-1-19 of the General Laws of Rhode Island, as amended,
the Director of Health is authorized to enter, examine or survey at any reasonable time such places
as he/she considers necessary, which perform the services of these rules and regulations.

2.2
Prior to the end of the fourteenth (14th) week of gestation (counted from the first day of the last
normal menses), termination of pregnancy may be performed outside the hospital or freestanding
ambulatory surgical center, when hospital emergency back-up services are available and other
provisions of these regulations are observed.

2.3
From the beginning of the fifteenth (15th) week of gestation through the end of the eighteenth (18th)
week of gestation (counted from the first day of the last normal menses), termination procedures
utilizing surgical techniques or methods shall be performed only in a licensed hospital, licensed
freestanding ambulatory surgical center, licensed physician office setting providing surgical
treatment ("office operatory"), and/or in an outpatient setting meeting the criteria required for a
freestanding surgical facility, and in accordance with other provisions of these rules and regulations.

2.4
After the beginning of the nineteenth (19th) week of gestation (counted from the first day of the last
normal menses), a procedure utilizing surgical techniques or methods shall be performed in a
hospital, and/or a licensed freestanding ambulatory surgical center. Provided, however, consistent
with the provisions of section 11-23-5 of the Rhode Island General Laws, as amended, the
procedure shall be performed in the final trimester only when necessary to preserve the life or
health of the mother.

2.5

A patient shall not be compelled to undergo, a physician or other licensed health care practitioner
acting within his/her scope of practice shall not be compelled to perform, or a person shall not be
compelled to assist at, termination of pregnancy.

2.6

The principles for a signed statement of "informed consent", including an operative permit as
required for other medical-surgical procedures, shall apply.

Section 3.0
Requirements for Facilities Utilizing Surgical Techniques or Methods

3.1
Where inhalation anesthesia is utilized, a licensed freestanding ambulatory surgical center or a
licensed physician office setting providing surgical treatment ("office operatory") shall comply with
the safety standards cited in the Rules and Regulations for Licensing of Freestanding
Ambulatory Surgical Centers (R23-17-FASC) of reference 1 herein; a hospital shall comply
with the safety standards cited in the Rules and Regulations for Licensing of Hospitals of
reference 2 herein.

3.2

Furthermore all facilities utilizing surgical techniques or methods shall provide the following:

3.2.1

Facilities for registration, interviewing, counseling, history taking, medical evaluation and
examination, equipped with suitable furnishings and accommodations, including waiting
and dressing rooms and other appurtenances for the privacy, physical comfort and
convenience of patients and personnel;


3.2.2

An adequately staffed and equipped procedure room(s) sufficient in number and size to

accommodate expected caseload, personnel and equipment including the following:

a. Dressing room and scrub-up facilities suitably located to procedure room(s);

b. Utility room with facilities for sterilization of supplies, except when sterile supplies
are received from a central supply service;

c. All necessary instruments and supplies for the performance of appropriate surgical
procedure;

d. All necessary equipment for resuscitation and emergency treatment of
complications (e.g., hemorrhage, cardiac arrest, shock, anaphylactic reactions and
respiratory complications);

e. An adequate supply of drugs, Rh immune globulin, electrolyte solutions and plasma
volume expanders, immediately available at all times for emergency use; and

f. Environmental controls for the protection of the health, safety and welfare of
patients and personnel.

3.2.3 A recovery room(s) adequate in size and appropriately equipped and staffed in which the
patient(s) will be observed until sufficiently recovered from the procedure and the
anesthesia and can be safety discharged by the physician or other licensed health care
practitioner acting within his/her scope of practice.

3.2.4 Provisions shall be made for the prompt and safe transfer of patients for the back-up
services referred to in sections 2.2 and 2.3 above.

3.2.5 Facilities not on the ground floor shall be served by an elevator capable of accommodating
a standard stretcher.

3.2.6 Space and equipment shall be provided to permit the production, storage, retrieval and
reproduction of records.

Section 4.0
Program Requirements

4.1
Provisions shall be made for the protection of the dignity, privacy and emotional concerns of the
patient in a safe, considerate atmosphere.

4.2
All indicated counseling services shall be made available to patients for the prevention and
management of personal problems before and after a termination procedure.

4.3
Verification of the diagnosis and duration of pregnancy and a medical history shall be obtained and
a complete physical examination performed, including pelvic examination, with consideration of any
medical, surgical or psychiatric conditions requiring special attention.

4.4
No less than the following laboratory procedures shall be conducted on each patient and reports
shall be available prior to the performance of termination of pregnancy procedure: (1) pregnancy
test; (2) hemoglobin or hematocrit; (3) blood and Rh typing; and (4) urinalysis.

4.4.1 Other laboratory procedures such as Papanicolaou smear, and tests for sexually transmitted diseases should be conducted in accordance with standard medical practice.

4.5
A medical record shall be established and maintained for each patient and shall contain no less than
the following items:

a. reports of observations cited above in section 4.3;

b. laboratory findings;

c. plan of management, including reasons for termination of pregnancy, and procedure to be
employed;

d. all observations of patient's condition during procedure and recovery; and

e. discharge, follow-up, and referral plans.

4.6
All tissue removed shall be considered as surgical specimens and shall be submitted for
pathological examination and the report included in the patient record. Furthermore, for any
termination after the eleventh (11th) week of gestation, the gestational age of the fetus shall be
determined in accordance with current standards of medical practice.

4.7
Provisions shall be made for patient access to family planning services, including referral to
specialized agencies.

4.8
Rh immune globulin shall be administered to every unsensitized Rh(d) negative woman who has a
termination of pregnancy.

Section 5.0
Personnel Requirements

5.1
All termination procedures shall be performed only by a physician licensed under the provisions of
Chapter 5-37 of the General Laws of Rhode Island, as amended, or other licensed health care
practitioner acting within his/her scope of practice, provided, however, surgical terminations shall
only be performed by a physician.

5.2
There shall be sufficient personnel to carry out all required functions including reception, counseling,
pre- and post-operative nursing care, clerical work, housekeeping and maintenance.

5.3
Anesthesia shall be administered in accordance with the Rules and Regulations for Licensing
of Freestanding Ambulatory Surgical Centers (R23-17-FASC) or the Rules and
Regulations for Licensing of Hospitals as appropriate to the category of facility where the
termination of pregnancy is performed.

PART III:
Reporting and Severability

Section 6.0 Reporting Requirements

6.1
All live births, and all fetal deaths after 20 weeks of gestation, shall be reported in accordance with
the current requirements of section 23-3-17 of the General Laws of Rhode Island, as amended,
entitled "Fetal Death Registration."

6.2
All fetal deaths, whether induced as consequence of a termination procedure or by spontaneous
ABORTION shall be reported in accordance with subsection (b) of the above-cited law, which reads,


"All other fetal deaths, irrespective of the number of weeks uterogestation, shall be reported
directly to the state Department of Health within seven (7) calendar days after delivery." Such
reporting shall be made on authorized forms provided by the Department of Health.
______________________________________________________________________________________________

Section 7.0
Severability

7.1
If any provision of these regulations or the application thereof to any facility or circumstance shall
be held invalid, such invalidity shall not affect the provisions or application of the regulations which
can be given effect, and to this end, the provisions of the regulations are declared to be severable.

* * *


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RHODE ISLAND DEPARTMENT OF HUMAN SERVICES MANUAL
MEDICAL ASSISTANCE
MEDICAL ASSISTANCE PROGRAM OVERVIEW SECTION 0300
MEDICAL ASSISTANCE PROGRAM PURPOSE 0300.05
REV:06/1994


The Rhode Island Medical Assistance (MA) Program is the
federal/state program to meet the medical needs of low income
persons who are age 65 or over, blind, disabled, or members of
families with dependent children, or qualified pregnant women and
children.

The Statutory foundations of the Rhode Island MA Program are Title
XIX of The Social Security Act and Rhode Island General Laws 40-8.

* * *

Abortions, Rape, or Incest 0300.20.05.15
REV:06/1994

The cost of ABORTION services is paid when the pregnancy is the
result of an act of rape or incest or it is necessary to preserve
the life of the woman.

The following policy and procedure is to be followed when the
pregnancy is a result of an act of rape or incest which will
qualify for reimbursement by the Rhode Island Medical Assistance
Program:

o The patient must provide a signed written statement
attesting to the fact that the pregnancy is the result of
an act of rape or incest. This requirement shall be
waived if the treating physician certifies that in his or
her professional opinion, the patient was unable for
physical or psychological reasons, to comply with this
requirement.

o The treating physician must provide a signed statement
that she/he performed the termination of the pregnancy
and that the pregnancy resulted from an act of rape or
incest.

o The statements must be kept in the medical record for a
period of three years to maintain an audit trail.

o The procedure must be performed by a licensed treating
physician in a hospital setting or licensed out-patient
facility.

0300.20.05.20 Abortions, To Save the Life of the Mother
REV:05/1995

Payment for an ABORTION will be rendered when a physician has
found, and certified in writing to the Department of Human
Services at the time payment for services is requested, that an
ABORTION was medically necessary to save the life of the mother.

To qualify for reimbursement by the Rhode Island Medical
Assistance Program for an ABORTION the following policy must be
followed in order to document medical necessity to save the life
of a mother. (See section 0300.20.05.15 relative to payment for
an ABORTION when the pregnancy is the result of an act of rape or
incest.)

To receive Medical Assistance payment for services, the physician
must:

o be a doctor of medicine or osteopathy who is licensed
to practice in the State of Rhode Island;

o determine and certify in writing that in his/her
professional judgement, the ABORTION was medically
necessary to save the life of the mother;

o retain a copy of the certification in the patient's
medical record for a period of three years for purposes
of audit;

o submit a copy of the certification, which must contain
the name and address of the patient, attached to the
request for payment for services.

* * *