UTAH.  Utah Code.

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 [Title 26 -- Chapter 18 -- Medical Assistance Act]

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 26-18-4.   Department standards for eligibility under Medicaid -- Funds for abortions.

       (1)  The department may develop standards and administer policies relating to eligibility under the Medicaid program as long as they are consistent with Subsection 26-18-3(6).  An applicant receiving Medicaid assistance may be limited to particular types of care or services or to payment of part or all costs of care determined to be medically necessary.
       (2)  The department shall not provide any funds for medical, hospital, or other medical expenditures or medical services to otherwise eligible persons where the purpose of the assistance is to perform an abortion, unless the life of the mother would be endangered if an abortion were not performed. (This provision is unenforceable.)
       (3)  Any employee of the department who authorizes payment for an abortion contrary to the provisions of this section is guilty of a class B misdemeanor and subject to forfeiture of office.
       (4)  Any person or organization that, under the guise of other medical treatment, provides an abortion under auspices of the Medicaid program is guilty of a third degree felony and subject to forfeiture of license to practice medicine or authority to provide medical services and treatment.

 

 26-18-5.   Contracts for provision of medical services -- Federal provisions modifying department rules -- Compliance with Social Security Act.

       (1)  The department may contract with other public or private agencies to purchase or provide medical services in connection with the programs of the division.  Where these programs are used by other state agencies, contracts shall provide that other state agencies transfer the state matching funds to the department in amounts sufficient to satisfy needs of the specified program.
       (2)  All contracts for the provision or purchase of medical services shall be established on the basis of the state's fiscal year and shall remain uniform during the fiscal year insofar as possible.  Contract terms shall include provisions for maintenance, administration, and service costs.
       (3)  If a federal legislative or executive provision requires modifications or revisions in an eligibility factor established under this chapter as a condition for participation in medical assistance, the department may modify or change its rules as necessary to qualify for participation; providing, the provisions of this section shall not apply to department rules governing abortion.
       (4)  The department shall comply with all pertinent requirements of the Social Security Act and all orders, rules, and regulations adopted thereunder when required as a condition of participation in benefits under the Social Security Act.
 

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 26-18-10.   Utah Medical Assistance Program -- Policies and standards.

       (1)  The division shall develop a medical assistance program, which shall be known as the Utah Medical Assistance Program, for low income persons who are not eligible under the state plan for Medicaid under Title XIX of the Social Security Act or Medicare under Title XVIII of that act.
       (2)  Persons in the custody of prisons, jails, halfway houses, and other nonmedical government institutions are not eligible for services provided under this section.
       (3)  The department shall develop standards and administer policies relating to eligibility requirements, consistent with Subsection 26-18-3(6), for participation in the program, and for payment of medical claims for eligible persons.
       (4)  The program shall be a payor of last resort.  Before assistance is rendered the division shall investigate the availability of the resources of the spouse, father, mother, and adult children of the person making application.
       (5)  The department shall determine what medically necessary care or services are covered under the program, including duration of care, and method of payment, which may be partial or in full.
       (6)  The department shall not provide public assistance for medical, hospital, or other medical expenditures or medical services to otherwise eligible persons where the purpose of the assistance is for the performance of an abortion, unless the life of the mother would be endangered if an abortion were not performed. (This provision is unenforceable.)
       (7)  The department may establish rules to carry out the provisions of this section.
 

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[Title 26 -- Chapter 40 -- Utah Children's Health Insurance Act]

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26-40-107.   Limitation of benefits.
     Abortion is not a covered benefit, except as provided in 42 U.S.C. Sec. 1397ee.

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[Title 58 -- Chapter 77 -- Direct-entry Midwife Act]

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58-77-603.   Prohibited practices.
     A Direct-entry midwife may not:
     (1) administer a prescription drug to a client in a manner that violates this chapter;
     (2) effect any type of surgical delivery except for the cutting of an emergency episiotomy;
     (3) administer any type of epidural, spinal, or caudal anesthetic, or any type of narcotic analgesia;
     (4) use forceps or a vacuum extractor;
     (5) manually remove the placenta, except in an emergency that presents an immediate threat to the life of the client; or
     (6) induce abortion.

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[Title 76 -- Chapter 07 -- Offenses Against the Family]

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76-7-301.   Definitions.
     As used in this part:
     (1) "Abortion" means the intentional termination or attempted termination of human pregnancy after implantation of a fertilized ovum, and includes any and all procedures undertaken to kill a live unborn child and includes all procedures undertaken to produce a miscarriage. "Abortion" does not include removal of a dead unborn child.
     (2) "Medical emergency" means that condition which, on the basis of the physician's good faith clinical judgment, so threatens the life of a pregnant woman as to necessitate the immediate abortion of her pregnancy to avert her death, or for which a delay will create serious risk of substantial and irreversible impairment of major bodily function.
     (3) (a) "Partial birth abortion" means an abortion in which the person performing the abortion:
     (i) deliberately and intentionally vaginally delivers a living fetus until, in the case of a head first presentation, the entire fetal head is outside the body of the mother, or, in the case of breech presentation, any part of the fetal trunk past the navel is outside the body of the mother, for the purpose of performing an overt act that the person knows will kill the partially delivered living fetus; and
     (ii) performs the overt act, other than completion of delivery, that kills the partially living fetus.
     (b) "Partial birth abortion" does not include the dilation and evacuation procedure involving dismemberment prior to removal, the suction curettage procedure, or the suction aspiration procedure for abortion.
     (4) "Physician" means a medical doctor licensed to practice medicine and surgery under Title 58, Chapter 67, Utah Medical Practice Act, a physician in the employment of the government of the United States who is similarly qualified, or an osteopathic physician licensed to practice osteopathic medicine under Title 58, Chapter 68, Utah Osteopathic Medical Practice Act.
     (5) "Hospital" means a general hospital licensed by the Department of Health according to Title 26, Chapter 21, Health Care Facility Licensing and Inspection Act, and includes a clinic or other medical facility to the extent that such clinic or other medical facility provides equipment and personnel sufficient in quantity and quality to provide the same degree of safety to the pregnant woman and the unborn child as would be provided for the particular medical procedures undertaken by a general hospital licensed by the Department of Health. It shall be the responsibility of the Department of Health to determine if such clinic or other medical facility so qualifies and to so certify.

76-7-301.1.   Preamble -- Findings and policies of Legislature.
     (1) It is the finding and policy of the Legislature, reflecting and reasserting the provisions of Article I, Sections 1 and 7, Utah Constitution, which recognize that life founded on inherent and inalienable rights is entitled to protection of law and due process; and that unborn children have inherent and inalienable rights that are entitled to protection by the state of Utah pursuant to the provisions of the Utah Constitution.
     (2) The state of Utah has a compelling interest in the protection of the lives of unborn children.
     (3) It is the intent of the Legislature to protect and guarantee to unborn children their inherent and inalienable right to life as required by Article I, Sections 1 and 7, Utah Constitution.
     (4) It is also the policy of the Legislature and of the state that, in connection with abortion, a woman's liberty interest, in limited circumstances, may outweigh the unborn child's right to protection. These limited circumstances arise when the abortion is necessary to save the pregnant woman's life or prevent grave damage to her medical health, and when pregnancy occurs as a result of rape or incest. It is further the finding and policy of the Legislature and of the state that a woman may terminate the pregnancy if the unborn child would be born with grave defects.

76-7-302.   Circumstances under which abortion authorized. [These provisions are unconstitutional and unenforceable.]
     (1) An abortion may be performed in this state only by a physician licensed to practice medicine under Title 58, Chapter 67, Utah Medical Practice Act or an osteopathic physician licensed to practice medicine under Title 58, Chapter 68, Utah Osteopathic Medical Practice Act and, if performed 90 days or more after the commencement of the pregnancy as defined by competent medical practices, it shall be performed in a hospital. (The provision on hospital requirements is unconstitutional and unenforceable as applied to second trimester abortions._
     (2) An abortion may be performed in this state only under the following circumstances:
     (a) in the professional judgment of the pregnant woman's attending physician, the abortion is necessary to save the pregnant woman's life;
     (b) the pregnancy is the result of rape or rape of a child, as defined by Sections 76-5-402 and 76-5-402.1, that was reported to a law enforcement agency prior to the abortion;
     (c) the pregnancy is the result of incest, as defined by Subsection 76-5-406(10) or Section 76-7-102, and the incident was reported to a law enforcement agency prior to the abortion;
     (d) in the professional judgment of the pregnant woman's attending physician, to prevent grave damage to the pregnant woman's medical health; or
     (e) in the professional judgment of the pregnant woman's attending physician, to prevent the birth of a child that would be born with grave defects.
     (3) After 20 weeks gestational age, measured from the date of conception, an abortion may be performed only for those purposes and circumstances described in Subsections (2)(a), (d), and (e).
     (4) The name of a victim reported pursuant to Subsection (2)(b) or (c) is confidential and may not be revealed by law enforcement or any other party except upon approval of the victim. This subsection does not effect or supersede parental notification requirements otherwise provided by law.

76-7-303.   Concurrence of attending physician based on medical judgment.
     No abortion may be performed in this state without the concurrence of the attending physician, based on his best medical judgment.

76-7-304.   Considerations by physician -- Notice to minor's parents or guardian or married woman's husband. [The provisions relating to notification of the husband are unconstitutional and unenforceable. The provisions relating to parental notification are unconstitutional and unenforceable as applied to a specific emancipated and mature young woman who is capable of making an informed decision.]
     To enable the physician to exercise his best medical judgment, he shall:
     (1) Consider all factors relevant to the well-being of the woman upon whom the abortion is to be performed including, but not limited to,
     (a) her physical, emotional and psychological health and safety,
     (b) her age,
     (c) her familial situation.
     (2) Notify, if possible, the parents or guardian of the woman upon whom the abortion is to be performed, if she is a minor or the husband of the woman, if she is married.

76-7-305.   Informed consent requirements for abortion -- 24-hour wait mandatory -- Emergency exceptions.
     (1) No abortion may be performed unless a voluntary and informed written consent, consistent with Section 8.08 of the American Medical Association's Code of Medical Ethics, Current Opinions, is first obtained by the attending physician from the woman upon whom the abortion is to be performed. Except in the case of a medical emergency, consent to an abortion is voluntary and informed only if:
     (a) at least 24 hours prior to the abortion, the physician who is to perform the abortion, the referring physician, a registered nurse, nurse practitioner, advanced practice registered nurse, certified nurse midwife, or physician's assistant shall, in a face-to-face consultation, orally inform the woman of:
     (i) the nature of the proposed abortion procedure or treatment, specifically how that procedure will affect the fetus, and the risks and alternatives to an abortion procedure or treatment that any person would consider material to the decision of whether or not to undergo an abortion. The alternatives required to be provided under this subsection shall include a description of adoption services, including private and agency adoption methods, and a statement that it is legal for adoptive parents to financially assist in pregnancy and birth expenses;
     (ii) the probable gestational age and a description of the development of the unborn child at the time the abortion would be performed; and
     (iii) the medical risks associated with carrying her child to term;
     (b) at least 24 hours prior to the abortion the physician who is to perform the abortion, the referring physician, or, as specifically delegated by either of those physicians, a registered nurse, licensed practical nurse, certified nurse-midwife, advanced practice registered nurse, clinical laboratory technologist, psychologist, marriage and family therapist, clinical social worker, or certified social worker has orally, in a face-to-face consultation, informed the pregnant woman that:
     (i) the Department of Health, in accordance with Section 76-7-305.5, publishes printed material and an informational video that:
     (A) provides medically accurate information regarding all abortion procedures that may be used;
     (B) describes the gestational stages of an unborn child; and
     (C) includes information regarding public and private services and agencies available to assist her through pregnancy, at childbirth, and while the child is dependent, including private and agency adoption alternatives; and
     (ii) the printed material and a viewing of or a copy of the informational video shall be provided to her free of charge;
     (iii) medical assistance benefits may be available for prenatal care, childbirth, and neonatal care, and that more detailed information on the availability of that assistance is contained in the printed materials and the informational video published by the Department of Health;
     (iv) the father of the unborn child is legally required to assist in the support of her child, even in instances where he has offered to pay for the abortion, and that the Office of Recovery Services within the Department of Human Services will assist her in collecting child support. In the case of rape, this information may be omitted; and
     (v) she has the right to view an ultrasound of the unborn child, at no expense to her, upon her request;

     (c) the information required to be provided to the pregnant woman under Subsection (a) is also provided by the physician who is to perform the abortion, in a face-to-face consultation, prior to performance of the abortion, unless the attending or referring physician was the individual providing the information under Subsection (a);
     (d) a copy of the printed materials published by the Department of Health has been provided to the pregnant woman;
     (e) the informational video, published by the Department of Health, has been provided to the pregnant woman in accordance with Subsection (2); and
     (f) the pregnant woman has certified in writing, prior to the abortion, that the information required to be provided under Subsections (a), (b), (c), (d), and (e) was provided, in accordance with the requirements of those subsections.
     (2) When the informational video is provided to a pregnant woman, the person providing the information shall first request that the woman view the video at that time or at another specifically designated time and location. If the woman chooses not to do so, a copy of the video shall be provided to her.
     (3) When a serious medical emergency compels the performance of an abortion, the physician shall inform the woman prior to the abortion, if possible, of the medical indications supporting his judgment that an abortion is necessary.
     (4) Any physician who violates the provisions of this section is guilty of unprofessional conduct as defined in Section 58-67-102 or 58-68-102, and his license for the practice of medicine and surgery shall be subject to suspension or revocation in accordance with Sections 58-67-401 and 58-67-402, Utah Medical Practice Act, or Sections 58-68-401 and 58-68-402, Utah Osteopathic Medical Practice Act.
     (5) A physician is not guilty of violating this section for failure to furnish any of the information described in Subsection (1), if:
     (a) he can demonstrate by a preponderance of the evidence that he reasonably believed that furnishing the information would have resulted in a severely adverse effect on the physical or mental health of the pregnant woman;
     (b) in his professional judgment, the abortion was necessary to save the pregnant woman's life;
     (c) the pregnancy was the result of rape or rape of a child, as defined in Sections 76-5-402 and 76-5-402.1;
     (d) the pregnancy was the result of incest, as defined in Subsection 76-5-406(10) and Section 76-7-102;
     (e) in his professional judgment the abortion was to prevent the birth of a child who would have been born with grave defects; or
     (f) the pregnant woman was 14 years of age or younger.
     (6) A physician who complies with the provisions of this section may not be held civilly liable to his patient for failure to obtain informed consent under Section 78-14-5.

76-7-305.5.   Requirements for printed materials and informational video -- Annual report of Department of Health.
     (1) In order to insure that a woman's consent to an abortion is truly an informed consent, the Department of Health shall publish printed materials and produce an informational video in accordance with the requirements of this section. The department and each local health department shall make those materials and a viewing of the video available at no cost to any person. The printed material and the informational video shall be comprehensible and contain all of the following:
     (a) geographically indexed materials informing the woman of public and private services and agencies available to assist her, financially and otherwise, through pregnancy, at childbirth, and while the child is dependent, including services and supports available under Section 35A-3-308. Those materials shall contain a description of available adoption services, including a comprehensive list of the names, addresses, and telephone numbers of public and private agencies and private attorneys whose practice includes adoption, and explanations of possible available financial aid during the adoption process. The information regarding adoption services shall include the fact that private adoption is legal, and that the law permits adoptive parents to pay the costs of prenatacteristics of the unborn child at two-week gestational increments from fertilization to full term, accompanied by pictures or video segments representing the development of an unborn child at those gestational increments. The descriptions shall include information about brain and heart function and the presence of external members and internal organs during the applicable stages of development. Any pictures used shall contain the dimensions of the fetus and shall be realistic and appropriate for that woman's stage of pregnancy. The materials shall be designed to convey accurate scientific information about an unborn child at the various gestational ages, and to convey the state's preference for childbirth over abortion;
     (c) truthful, nonmisleading descriptions of abortion procedures used in current medical practice at the various stages of growth of the unborn child, the medical risks commonly associated with each procedure, including those related to subsequent childbearing, the consequences of each procedure to the fetus at various stages of fetal development, the possible detrimental psychological effects of abortion, and the medical risks associated with carrying a child to term;
     (d) any relevant information on the possibility of an unborn child's survival at the two-week gestational increments described in Subsection (1)(b);
     (e) information on the availability of medical assistance benefits for prenatal care, childbirth, and neonatal care;
     (f) a statement conveying that it is unlawful for any person to coerce a woman to undergo an abortion;
     (g) a statement conveying that any physician who performs an abortion without obtaining the woman's informed consent or without according her a private medical consultation in accordance with the requirements of this section, may be liable to her for damages in a civil action at law;
     (h) a statement conveying that the state of Utah prefers childbirth over abortion; and
     (i) information regarding the legal responsibility of the father to assist in child support, even in instances where he has agreed to pay for an abortion, including a description of the services available through the Office of Recovery Services, within the Department of Human Services, to establish and collect that support.
     (2) (a) The materials described in Subsection (1) shall be produced and printed in a way that conveys the state's preference for childbirth over abortion.
     (b) The printed material described in Subsection (1) shall be printed in a typeface large enough to be clearly legible.
     (3) Every facility in which abortions are performed shall immediately provide the printed informed consent materials and a viewing of or a copy of the informational video described in Subsection (1) to any patient or potential patient prior to the performance of an abortion, unless the patient's attending or referring physician certifies in writing that he reasonably believes that provision of the materials or video to that patient would result in a severely adverse effect on her physical or mental health.
     (4) The Department of Health shall produce a standardized videotape that may be used statewide, containing all of the information described in Subsection (1), in accordance with the requirements of that subsection and Subsection (2). In preparing the video, the department may summarize and make reference to the printed comprehensive list of geographically indexed names and services described in Subsection (1)(a). The videotape shall, in addition to the information described in Subsection (1), show an ultrasound of the heart beat of an unborn child at three weeks gestational age, at six to eight weeks gestational age, and each month thereafter, until 14 weeks gestational age. That information shall be presented in a truthful, nonmisleading manner designed to convey accurate scientific information, the state's preference for childbirth over abortion, and the positive aspects of adoption.
     (5) The Department of Health and local health departments shall provide ultrasounds in accordance with the provisions of Subsection 76-7-305(1)(b), at no expense to the pregnant woman.
     (6) The Department of Health shall compile and report the following information annually, preserving physician and patient anonymity:
     (a) the total amount of informed consent material described in Subsection (1) that was distributed;
     (b) the number of women who obtained abortions in this state without receiving those materials;
     (c) the number of statements signed by attending physicians certifying to his opinion regarding adverse effects on the patient under Subsection (3); and
     (d) any other information pertaining to protecting the informed consent of women seeking abortions.
     (7) The Department of Health shall annually report to the Health and Human Services Interim Committee regarding the information described in Subsection (6), and provide a copy of the printed materials and the videotape produced in accordance with this section to that committee.

76-7-306.   Physician, hospital employee, or hospital not required to participate in abortion.
     (1) A physician, or any other person who is a member of or associated with the staff of a hospital, or any employee of a hospital in which an abortion has been authorized, who states an objection to an abortion or the practice of abortion in general on moral or religious grounds shall not be required to participate in the medical procedures which will result in the abortion, and the refusal of any person to participate shall not form the basis of any claim for damages on account of the refusal or for any disciplinary or recriminatory action against such person, nor shall any moral or religious scruples or objections to abortions be the grounds for any discrimination in hiring in this state.
     (2) Nothing in this part shall require any private and/or denominational hospital to admit any patient for the purpose of performing an abortion.

76-7-307.   Medical procedure required to save life of unborn child.
     If an abortion is performed when the unborn child is sufficiently developed to have any reasonable possibility of survival outside its mother's womb, the medical procedure used must be that which, in the best medical judgment of the physician will give the unborn child the best chance of survival. No medical procedure designed to kill or injure that unborn child may be used unless necessary, in the opinion of the woman's physician, to prevent grave damage to her medical health.

76-7-308.   Medical skills required to preserve life of unborn child.
     Consistent with the purpose of saving the life of the woman or preventing grave damage to the woman's medical health, the physician performing the abortion must use all of his medical skills to attempt to promote, preserve and maintain the life of any unborn child sufficiently developed to have any reasonable possibility of survival outside of the mother's womb.

 

76-7-309.   Pathologist's report.
     Any human tissue removed during an abortion shall be submitted to a pathologist who shall make a report, including, but not limited to whether there was a pregnancy, and if possible, whether the pregnancy was aborted by evacuating the uterus.

 

76-7-310.   Experimentation with unborn children prohibited -- Testing for genetic defects.
     Live unborn children may not be used for experimentation, but when advisable, in the best medical judgment of the physician, may be tested for genetic defects.

76-7-310.5.   Prohibition of specified abortion procedures -- Viability defined.
     (1) As used in this section, "saline abortion procedure" means performance of amniocentesis and injection of saline into the amniotic sac within the uterine cavity.
     (2) (a) After viability has been determined in accordance with Subsection (2)(b), no person may knowingly perform a saline abortion procedure unless all other available abortion procedures would pose a risk to the life or the health of the pregnant woman.
     (b) For purposes of this section determination of viability shall be made by the physician, based upon his own best clinical judgment. The physician shall determine whether, based on the particular facts of a woman's pregnancy that are known to him, and in light of medical technology and information reasonably available to him, there is a realistic possibility of maintaining and nourishing a life outside of the womb, with or without temporary, artificial life-sustaining support.
     (3) Intentional, knowing, and willful violation of this section is a third degree felony.

76-7-311.   Selling and buying unborn children prohibited.
     Selling, buying, offering to sell and offering to buy unborn children is prohibited.

 

76-7-312.   Intimidation or coercion to obtain abortion prohibited.
     No person shall intimidate or coerce in any way any person to obtain an abortion.

 

76-7-313.   Physician's report to Department of Health.
     In order for the state Department of Health to maintain necessary statistical information and ensure enforcement of the provisions of this part, any physician performing an abortion must obtain and record in writing: the age of the pregnant woman; her marital status and county of residence; the number of previous abortions performed on her; the hospital or other facility where performed; the weight in grams of the unborn child aborted, if it is possible to ascertain; the pathological description of the unborn child; the given menstrual age of the unborn child; the measurements, if possible to ascertain; and the medical procedure used. This information, and a copy of the pathologist's report, as required in Section 76-7-309, together with an affidavit that the required consent was obtained pursuant to Section 76-7-305 and a certificate by the physician that the unborn child was or was not capable of survival outside of the mother's womb, must be filed by the physician with the state Department of Health within 10 days after the abortion. All information supplied to the state Department of Health shall be confidential and privileged pursuant to Title 26, Chapter 25.

76-7-314.   Violations of abortion laws -- Classifications.
     (1) (a) Any person who intentionally performs an abortion other than as authorized by this part is guilty of a felony of the third degree.
     (b) (i) Notwithstanding any other provision of law, a woman who seeks to have or obtains an abortion for herself is not criminally liable.
     (ii) A woman upon whom a partial birth abortion is performed may not be prosecuted under Section 76-7-326 or 76-7-329 for a conspiracy to violate Section 76-7-326 or 76-7-329.
     (2) A willful violation of Section 76-7-307, 76-7-308, 76-7-310, 76-7-310.5, 76-7-311, or 76-7-312 is a felony of the third degree.
     (3) A violation of Section 76-7-326 or 76-7-329 is a felony of the third degree.
     (4) A violation of any other provision of this part is a class A misdemeanor.

  76-7-315.   Exceptions to certain requirements in serious medical emergencies.
     When due to a serious medical emergency, time does not permit compliance with Section 76-7-302, 76-7-304, 76-7-305, 76-7-305.5, or 76-7-310.5 the provisions of those sections do not apply.

76-7-316.   Actions not precluded.
     Nothing in this part shall preclude any person believing himself aggrieved by another under this part, from bringing any other action at common law or other statutory provision.

76-7-317.   Separability clause.
     If any one or more provision, section, subsection, sentence, clause, phrase or word of this part or the application thereof to any person or circumstance is found to be unconstitutional, the same is hereby declared to be severable and the balance of this part shall remain effective notwithstanding such unconstitutionality. The legislature hereby declares that it would have passed this part, and each provision, section, subsection, sentence, clause, phrase or word thereof, irrespective of the fact.

 

76-7-317.1.   Creation of Abortion Litigation Trust Account.
     (1) (a) There is created in the General Fund a restricted account known as the Abortion Litigation Trust Account. All money received by the state from private sources for litigation expenses connected with the defense of Senate Bill 23, passed in the 1991 Annual General Session, shall be deposited in that account.
     (b) On behalf of the Abortion Litigation Trust Account, the Division of Finance may accept grants, gifts, bequests, or any money made available from any private sources to implement this section.
     (2) Money shall be appropriated by the Legislature from the account to the Office of the Attorney General under Title 63, Chapter 38, Budgetary Procedures Act.
     (3) The Abortion Litigation Trust Account may be used only for costs, expenses, and attorneys fees connected with the defense of the abortion law identified in Subsection (1).
     (4) Any funds remaining in the abortion litigation trust account after final appellate procedures shall revert to the General Fund, to be first used to offset the monies expended by the state in connection with litigation regarding Senate Bill 23.

76-7-317.2.   Finding of unconstitutionality -- Revival of old law.
     If Section 76-7-302 as amended by Senate Bill 23, 1991 Annual General Session, is ever held to be unconstitutional by the United States Supreme Court, Section 76-7-302, as enacted by Chapter 33, Laws of Utah 1974, is reenacted and immediately effective.

76-7-321.   Contraceptive and abortion services -- Funds -- Minor -- Definitions.
     As used in Sections 76-7-321 through 76-7-325:
     (1) "Abortion services" means any material, program, plan, or undertaking which seeks to promote abortion, encourages individuals to obtain an abortion, or provides abortions.
     (2) "Contraceptive services" means any material, program, plan, or undertaking that is used for instruction on the use of birth control devices and substances, encourages individuals to use birth control methods, or provides birth control devices.
     (3) "Funds" means any money, supply, material, building, or project provided by this state or its political subdivisions.
     (4) "Minor" means any person under the age of 18 who is not otherwise emancipated, married, or a member of the armed forces of the United States.

76-7-322.   Public funds for provision of contraceptive or abortion services restricted.
     No funds of the state or its political subdivisions shall be used to provide contraceptive or abortion services to an unmarried minor without the prior written consent of the minor's parent or guardian.

76-7-323.   Public funds for support entities providing contraceptive or abortion services restricted.
     No agency of the state or its political subdivisions shall approve any application for funds of the state or its political subdivisions to support, directly or indirectly, any organization or health care provider that provides contraceptive or abortion services to an unmarried minor without the prior written consent of the minor's parent or guardian. No institution shall be denied state or federal funds under relevant provisions of law on the ground that a person on its staff provides contraceptive or abortion services in that person's private practice outside of such institution.

76-7-324.   Violation of restrictions on public funds for contraceptive or abortion services as misdemeanor.
     Any agent of a state agency or political subdivision, acting alone or in concert with others, who violates Section 76-7-322, 76-7-323, or 76-7-331 is guilty of a class B misdemeanor.

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76-7-326.   Partial birth abortions prohibited. [These provisions are unconstitutional and unenforceable.]
     Any physician who knowingly performs a partial birth abortion and thereby kills a human fetus shall be fined or imprisoned, or both, as provided under this part. This section does not apply to a partial birth abortion that is necessary to save the life of a mother whose life is endangered by a physical disorder, physical illness, or physical injury, including a life endangering physical condition caused by or arising from the pregnancy itself.

76-7-327.   Remedies for father or maternal grandparents.
     (1) The father, if married to the mother at the time she receives a partial birth abortion, and if the mother has not attained the age of 18 years at the time of the abortion, the maternal grandparents of the fetus, may in a civil action obtain appropriate relief, unless the pregnancy resulted from the plaintiff's criminal conduct or the plaintiff consented to the abortion.
     (2) Such relief shall include:
     (a) money damages for all injuries, psychological and physical, occasioned by the violation of Section 76-7-326 or 76-7-329; and
     (b) statutory damages equal to three times the cost of the partial birth abortion.

76-7-328.   Hearing to determine necessity of physician's conduct.
     (1) A physician accused of an offense under Section 76-7-326 may seek a hearing before the Physicians Licensing Board created in Section 58-67-201, or the Osteopathic Physician and Surgeon's Licensing Board created in Section 58-68-201 on whether the physician's conduct was necessary to save the life of the mother whose life was endangered by a physical disorder, physical illness, or physical injury, including a life endangering physical condition caused by or arising from the pregnancy itself.
     (2) The findings on that issue are admissible on that issue at the trial of the physician. Upon a motion from the physician, the court shall delay the beginning of the trial for not more than 30 days to permit such a hearing to take place.

76-7-329.   Person unauthorized to perform abortions -- Penalties.
     A person who is not legally authorized by the state to perform abortions, but who nevertheless directly performs a partial birth abortion, is subject to Sections 76-7-301, 76-7-314, 76-7-326, and 76-7-327.

76-7-330.   Contingent continuance of prior law.
     (1) If the implementation of Section 76-7-326 enacted by this bill is stayed or otherwise ordered by a court of competent jurisdiction to not be implemented, beginning on the day on which the implementation of Section 76-7-326 is stayed or otherwise ordered not to be implemented the statutes listed in Subsection (2) shall:
     (a) be given effect as if this bill did not amend those statutes; and
     (b) remain in effect as if not amended by this bill until the day on which a court orders that Section 76-7-326 may be implemented.
     (2) Subsection (1) applies to:
     (a) Section 76-7-301;
     (b) Section 76-7-310.5; and
     (c) Section 76-7-314.
     (3) Nothing in this section prevents the Legislature from amending, repealing, or taking any other action regarding the sections listed in Subsection (2) in this or a subsequent session.

76-7-331.   Public funding of abortion forbidden.
     (1) As used in this section, "damage to a major bodily function" refers only to injury or impairment of a physical nature and may not be interpreted to mean mental, psychological, or emotional harm, illness, or distress.
     (2) Public funds of the state, its institutions, or its political subdivisions may not be used to pay or otherwise reimburse, either directly or indirectly, any person, agency, or facility for the performance of any induced abortion services unless:
     (a) in the professional judgment of the pregnant woman's attending physician, the abortion is necessary to save the pregnant woman's life;
     (b) the pregnancy is the result of rape or incest reported to law enforcement agencies, unless the woman was unable to report the crime for physical reasons or fear of retaliation; or
     (c) in the professional judgment of the pregnant woman's attending physician, the abortion is necessary to prevent permanent, irreparable, and grave damage to a major bodily function of the pregnant woman provided that a caesarian procedure or other medical procedure that could also save the life of the child is not a viable option.
     (3) Any officer or employee of the state who knowingly authorizes the use of funds prohibited by this section shall be dismissed from that person's office or position and the person's employment shall be immediately terminated.

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[Title 78 -- Chapter 11 -- Actions - Right to Sue and Be Sued]

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78-11-24.   Act or omission preventing abortion not actionable.
     A cause of action shall not arise, and damages shall not be awarded, on behalf of any person, based on the claim that but for the act or omission of another, a person would not have been permitted to have been born alive but would have been aborted.

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Utah Administrative Code.

 

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Title R414. Health, Health Care Financing, Coverage and Reimbursement Policy.

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Rule R414-1B. Prohibition of Payment for Certain Abortion Services.

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R414-1B-1. Introduction and Authority.

This rule is to assure compliance with the prohibition on using public funds for certain abortion services as provided in Utah Code Section 76-7-331. It is authorized by Utah Code Sections 26-1-5 and 26-18-3.

R414-1B-2. Definitions.

(1) "Abortion billing code" means the following codes:

(a) 59840, 59841, 59850, 59851, 59852, 59855, 59856 and 59857 as shown in the Current Procedural Terminology (CPT) manual of the American Medical Association, 2003 edition; and

(b) 69.01, 69.51, 74.91 and 75.0 as shown in the International Classification of Diseases, 9th Edition, Volumes 1 and 2, Clinical Modification, Volume 3 Procedures.

(2) "Certification" or "Certify" means submitting to the Division of Health Care Financing, Utah Department of Health, a Department-approved document signed by one authorized to act on behalf of a Medicaid provider.

(3) "Public funds" means money of the state, its institutions or its political subdivisions used to pay or otherwise reimburse a person, agency, or facility. "Public funds" does not include (i) clinical revenue generated from nongovernmental payors; or (ii) gift or donor funds from third party nongovernmental sources.

R414-1B-3. Certification.

(1) Each Medicaid provider that bills the Utah Department of Health for services related to an abortion billing code at any time after May 3, 2004 must certify that public funds it receives from the Department are not used to pay or otherwise reimburse, either directly or indirectly, any person, agency, or facility for the performance of any induced abortion services unless:

(a) in the professional judgment of the pregnant woman's attending physician, the abortion is necessary to save the pregnant woman's life;

(b) the pregnancy is the result of rape or incest reported to law enforcement agencies, unless the woman was unable to report the crime for physical reasons or fear of retaliation; or

(c) in the professional judgment of the pregnant woman's attending physician, the abortion is necessary to prevent permanent, irreparable and grave damage to a major bodily function of the pregnant women provided that a caesarian procedure or other medical procedure that could also save the life of the child is not a viable option.

(2) The certification shall be ongoing and apply to all future claims unless the provider notifies the Department in writing of a change in its certification status.

(3) Nothing in this rule shall increase Medicaid coverage for abortion services beyond what is required under federal law.

R414-1B-4. Standards for Certification.

(1) Each provider who submits a certification is responsible to be informed of the abortion funding restrictions found in Utah Code section 76-7-326 and to assess whether it receives public funds for any abortion that is not excepted in subsections (a), (b), or (c) of Utah Code subsection 76-7-326(2).

(2) A provider is not using public funds to directly or indirectly fund prohibited abortion services if it certifies that:

(a) it uses non-public funds to make up any difference between the reimbursement it receives from all payors for services identified by abortion billing codes, other than those services identified in R414-1B-3(1), and the costs incurred by the provider for those procedures; or

(b) it has adopted another method, based on generally accepted accounting principles, that provides a good faith basis for supporting the certification.

(3) Each provider that submits a certification meeting the requirements of this rule shall maintain records to support the certification and make those records available to the Department on request consistent with participation as a Medicaid provider.

* * *

Title R432. Health, Health Systems Improvement, Licensing.

 

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Rule R432-600. Abortion Clinic Rule.

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R432-600-1. Legal Authority.

This rule is adopted pursuant to Title 26, Chapter 21.

R432-600-2. Purpose.

The purpose of this rule is to promote the public health and welfare through the establishment and enforcement of licensure standards. This rule sets standards for the operation and maintenance of abortion clinics for providing safe and effective facilities and services.

R432-600-3. Time for Compliance.

All facilities governed by these rules shall be in full compliance at the time of licensure.

R432-600-4. Licensure.

A license is required to operate an abortion clinic. The licensee and facility shall maintain documentation that they are members in good standing with the National Abortion Federation which is required for licensure.

R432-600-5. Construction.

(1) See R432-4-1 through R432-4-24 General Construction Requirements.

(2) Each facility shall conform to the functional, space, and equipment specifications of U. S. Department of Health and Human Services, Guidelines for Construction and Equipment of Hospital and Medical Facilities, 1992- 93 edition, including Appendix A, specifically, Chapter 9, Outpatient Facilities, sections 9.1 and 9.2. Modifications or deletion of space and functional requirements may be made with Departmental written approval.

(3) Treatment rooms shall be a minimum of 110 square feet exclusive of vestibules or cabinets.

R432-600-6. Organization.

(1) Each clinic shall be operated by a licensee. If the licensee is other than a single individual, there shall be an organized functioning governing body to assure accountability.

(2) The licensee shall be responsible for the organization, management, operation, and control of the facility.

(3) Responsibilities shall include at least the following:

(a) Comply with all applicable federal, state and local laws, rules and requirements;

(b) Adopt and institute by-laws, protocols, policies and procedures relative to the operation of the clinic;

(c) Appoint, in writing, a qualified administrator to be responsible for the implementation of facility bylaws, policies and procedures, and for the overall management of the facility;

(d) Appoint, in writing, a qualified medical director to be responsible for clinical services;

(e) Establish a quality assurance committee in conjunction with the medical staff;

(f) Secure contracts for services not provided directly by the clinic;

(g) Receive and respond to the annual inspection report by the Department;

(h) Notify the Department in writing the name of a new administrator within five days of a change of administrator.

(i) Compile statistics on the distribution of the informed consent material as required in Section 76-7-313.

R432-600-7. Clinic Protocols, Policies, and Procedures.

Clear, explicit written protocols, criteria, policies and procedures in accordance with Section 76-7- 302, shall be established by the licensee with consultation of the medical director and the administrator in the following areas:

(1) Patient eligibility criteria;

(2) Physician competency criteria;

(3) Informed consent;

(4) Abortion procedure protocols to include;

(a) Clinic policy must indicate a limit on the number of weeks within the second trimester of pregnancy during which abortions can be safely performed in the clinic.

(b) If an abortion is performed when an unborn child is sufficiently developed to have any reasonable possibility of survival outside its mother's womb, the medical procedure used must be that which, in the best medical judgement of the physician, will give the unborn child the best chance of survival. (Refer to Section 76-7-307.)

(5) Pre and post counseling;

(6) Clinic operational functions;

(7) Patient care and patient rights policies;

(8) A quality assurance committee;

(9) Ongoing relevant training program for all clinic personnel;

(10) Emergency and disaster plans;

(11) Fire evacuation plans.

R432-600-8. Administrator.

(1) Each facility shall designate, in writing, an administrator who shall have sufficient freedom from other responsibilities to be on the premises of the clinic a sufficient number of hours in the business day to permit attention to the management and administration of the facility.

(2) The administrator shall designate a person to act as administrator in his absence. This person shall have sufficient power, authority, and freedom to act in the best interests of patient safety and well-being. It is not the intent to permit a de facto administrator to supplant or replace the designated facility administrator.

(3) The administrator shall be 21 years of age or older.

(4) The administrator shall be experienced in administration and supervision of personnel, and shall be knowledgeable about the medical aspects of abortions to interpret and be conversant in medical protocols.

(5) The administrator's responsibilities shall be included in a written job description.

(6) Responsibilities shall include at least the following:

(a) Develop and implement facility policies and procedures;

(b) Maintain an adequate number of qualified and competent staff to meet the needs of clinic patients;

(c) Develop clear and complete job descriptions for each position;

(d) Implement recommendations made by the quality assurance committee;

(e) Notify the Department promptly in the event of the death of a patient;

(f) Notify appropriate authorities when a serious communicable disease is diagnosed;

(g) File a fetal death certificate as required in Section 26-2-14, for each fetal death of 20 weeks gestation or more calculated from the date the last normal menstrual period began to date of delivery;

(h) Review all incident and accident reports and document what action was taken.

R432-600-9. Medical Director.

(1) The licensee of the abortion clinic shall retain, by formal agreement, a physician to serve as medical director.

(2) The medical director shall meet the following qualifications:

(a) Be currently licensed to practice medicine in Utah;

(b) Have sufficient training and expertise in abortion procedures to enable him to supervise the scope of service offered by the clinic;

(c) Be a diplomate of the American Board of Obstetrics and Gynecology or the American Board of Surgery; or submit evidence to the Department that other training and experience will qualify him for admission to an examination by either board; or

(d) Be certified by the American College of Osteopathic Obstetricians and Gynecologists or the American Board of Osteopathic Surgeons; or submit evidence to the Department that his training and experience qualifies him for admission to an examination by the College or Board;

(e) Be a member in good standing with the National Abortion Federation.

(3) The medical director shall have overall responsibility for the administration of medication and treatment delivered in the facility. Applicable laws relating to abortions, professional licensure acts and clinic protocols shall govern both medical staff and employee performance.

(4) The medical director shall be responsible for at least the following:

(a) To develop and review facility protocols;

(b) To establish competency criteria for staff physicians and personnel, including training in abortion procedures and abortion counseling;

(c) To supervise the performance of the medical staff;

(d) To serve as a member of the clinic's quality assurance committee;

(e) To act as consultant to the director of nursing;

(f) Ensure that a physician's report is filed as required in Section 76-7-313, for each abortion performed.

R432-600-10. Director of Nursing.

(1) Each clinic shall employ and designate in writing a director of nursing who will be responsible for the organization and functioning of the nursing staff and related service.

(2) The director of nursing shall be a registered nurse who has academic or post graduate training acceptable to the medical director.

(3) The director of nursing in consultation with the medical director shall plan and direct the delivery of nursing care by nursing staff.

R432-600-11. Health Surveillance.

(1) The Facility shall establish a personnel health program through written personnel health policies and procedures which shall protect the health and safety of personnel and clients commensurate with the service offered.

(2) An employee placement health evaluation to include at least a health inventory shall be completed when an employee is hired.

(3) The health inventory shall obtain at least the employee's history of the following:

(a) conditions that predispose the employee to acquiring or transmitting infectious diseases;

(b) Skin testing shall be exempted for all employees with known positive reaction to skin tests.

(6) All infections and communicable diseases reportable by law shall be reported by the facility to the local health department in accordance with R386-702-2.

R432-600-12. Personnel.

(1) The Administrator shall employ a sufficient number of professional and support staff who are competent to perform their respective duties, services and functions.

(a) All staff shall be licensed, certified or registered as required by the Utah Department of Commerce.

(b) Copies shall be maintained for Department review that all licenses, registration and certificates are current.

(c) Failure to ensure that all personnel are licensed, certified or registered may result in sanctions to the facility license.

(2) There shall be planned, documented, in-service training program held regularly for all facility personnel.

(3) The training program shall address all clinic protocols and policies.

(4) All clinic personnel shall have access to the facility's policies and procedures manuals and other information necessary to effectively perform assigned duties and carry out responsibilities.

R432-600-13. Contracts.

(1) The licensee shall make arrangements for professional and other required services not provided directly by the facility. If the facility contracts for services, there shall be a signed, dated agreement that details all services provided.

(2) The contract shall include:

(a) The effective and expiration dates;

(b) A description of goods or services to be provided;

(c) Copy of the professional license, if applicable.

R432-600-14. Emergency Transfer Agreements.

(1) The licensee shall maintain a written transfer agreement with one or more full-service JCAHO- accredited hospitals located within an overall travel time of 15 minutes or less from the clinic.

(2) The transfer agreement shall include provisions for:

(a) Hospital admitting privileges for the clinic medical director or the attending physician;

(b) Transfer of information needed for proper care and treatment of individual transferred;

(c) Security and accountability of the personal effects of the individual transferred.

R432-600-15. Quality Assurance.

(1) The administrator, in conjunction with the medical staff, shall establish a quality assurance committee and program. This committee shall review regularly clinic operations, protocols, policies and procedures, incident reports, infection control, patient care policies and safety.

(2) The committee shall include a representative from the clinic administration, a physician, and a nurse.

(3) The committee shall meet at least quarterly and keep minutes of the proceedings. The minutes shall be available for review by the Department.

(4) The committee shall initiate action to resolve identified quality assurance problems by filing a written report of findings and recommendations with the licensee.

R432-600-16. Emergency and Disaster.

(1) Each facility has the responsibility to assure the safety and well-being of patients in the event of an emergency or disaster. An emergency or disaster may include but is not limited interruption of public utilities, explosion, fire, earthquake, bomb threat, flood, windstorm, epidemic, and injury.

(2) The administrator shall be in charge of facility operations during any significant emergency. If not on the premises, he should make every reasonable effort to get to the facility to relieve subordinates and take charge during the emergency.

(3) The licensee and the administrator shall be responsible for the development of a plan, coordinated with state and local emergency or disaster authorities, to respond to emergencies and disasters.

(a) This plan shall be in writing and shall be distributed or made available to all facility staff to assure prompt and efficient implementation.

(b) The plan shall be reviewed and updated at least annually by the administrator and the licensee.

(4) The names and telephone numbers of clinic staff, emergency medical personnel, and emergency service systems shall be posted.

(5) The facility's emergency plan shall address the following:

(a) Evacuation of occupants to a safe place within the facility or to another location;

(b) Delivery of emergency care and services to facility occupants when staff is reduced by an emergency;

(c) The person or persons with decision-making authority for fiscal, medical, and personnel management;

(d) An inventory of available personnel, equipment, and supplies and instructions on how to acquire additional assistance;

(e) Assignment of personnel to specific tasks during an emergency;

(f) Names and telephone numbers of on-call physicians and staff at each nurses' station;

(g) Documentation of emergency events.

(6) The licensee and administrator shall develop a written fire emergency and evacuation plan in consultation with qualified fire safety personnel.

(a) The evacuation plan shall identify evacuation routes, location of fire alarm boxes, fire extinguishers, and emergency telephone numbers of the local fire department and shall be posted throughout the facility.

(b) The written fire emergency plan shall include fire-containment procedures and how to use the facility alarm systems and signals.

(c) Fire drills shall be held quarterly--one drill per shift per quarter. The actual evacuation of patients during a drill is optional.

R432-600-17. Patients' Rights.

(1) The clinic shall provide informed consent material (see Section 76-7-305.5) to any patient or potential patient.

(2) Written policies regarding the rights of patients shall be made available to the patient, public, and the Department upon request.

(3) Each patient admitted to the facility shall have the following rights:

(a) To be fully informed, prior to or at the time of admission and during stay, of these rights and of all facility rules that pertain to the patient;

(b) To be fully informed, prior to or at the time of admission and during stay, of services available in the facility and of any charges for which the patient may be liable;

(c) To refuse to participate in experimental research;

(d) To refuse treatment and to be informed of the medical consequences of such refusal;

(e) To be assured confidential treatment of personal and medical records and to approve or refuse release to any individual outside the facility, except in the case of transfer to another health facility, or as required by law or third party payment contract;

(f) To be treated with consideration, respect, and full recognition of personal dignity and individuality, including privacy in treatment and in care for personal needs.

R432-600-18. General Patient Care Policies.

(1) Each patient shall be treated as an individual with dignity and respect.

(2) Each clinic shall develop and implement patient care policies to be reviewed annually by the director of nursing.

(a) Patient care policies shall be developed and revised through patient-care conferences with all professionals involved in patient care.

(b) Admission and discharge policies shall be included in general patient care policies.

(3) The facility shall have a policy to notify next of kin in the event of serious injury to, or death of, the patient.

(4) Each patient shall be under the care of a physician who is a member of the clinic staff.

R432-600-19. Nursing Services.

(1) Each facility shall provide nursing services commensurate with the needs of the patients served.

(2) All non-medical patient services shall be under the general direction of the director of nursing, except as specifically exempted by facility policy.

(3) Nursing service personnel shall assist the physician, plan and deliver nursing care, treatments, and procedures commensurate with the patient's needs and clinic protocols.

(4) All nursing personnel shall maintain a current Utah nursing license.

(5) The facility shall provide adequate equipment in good working order to meet the needs of patients.

(a) Disposable and single-use items shall be properly disposed after use.

(b) The type and amount of equipment shall be identified in clinic policy and approved by the medical director.

R432-600-20. Medication and Treatments.

Documentation of medications and treatments shall comply with generally accepted professional practice and clinic policy.

R432-600-21. Pharmacy Service.

(1) There shall be written policies and procedures, approved by the medical director and administrator, to govern the acquisition, storage, and disposal of medications.

(2) There shall be provision for the supply of necessary drugs and biologicals on a prompt and timely basis.

(3) The clinic shall obtain reference material containing monographs on all drugs used in the facility. The drug monographs shall include generic and brand names, available strengths, dosage forms, indications and side effects, and other pharmacological data.

(4) All medications, solutions, and prescription items shall be kept in a secure controlled storage area, convenient to the nurses station and separate from non-medicine items.

(5) A accessible emergency drug supply shall be maintained in the facility.

(a) Specific drugs and dosages to be included in the emergency drug supply shall be approved by the medical director.

(b) Contents of the emergency drug supply shall be listed on the outside of the container.

(c) The use and regular inventory of the contents shall be documented by nursing staff.

(6) Medications stored at room temperature shall be maintained within 59 degrees - 80 degrees F (15 degrees to 30 degrees C). Refrigerated medications shall be maintained within 36 degrees - 46 degrees F (2 degrees to 8 degrees C).

(7) Medications and other items that require refrigeration shall be stored securely and segregated from food items.

R432-600-22. Laboratory and Radiology Services.

(1) The facility shall make provisions, as appropriate, for Laboratory and Radiology services.

(2) There shall be a valid order, documented in the patients medical record, from a physician or a person licensed to prescribe such services.

(3) Services shall be performed by a qualified licensed provider.

(4) If the facility provides its own laboratory service, these services shall comply with R432-100-22 in the General Hospital Facility Rules.

(5) If the facility provides its own radiology services, these shall comply with R432-100-21.

(6) If laboratory and radiology services are not provided directly, provision shall be made for such services. Reports or results shall be reported promptly to the attending physician and documented in the patient's medical record.

R432-600-23. Anesthesia Services.

Anesthesia services provided in the clinic shall comply with the General Hospital Rules R432-100- 15.

R432-600-24. Medical Records.

(1) Medical records shall be complete, accurately documented, and systematically organized to facilitate storage and retrieval. There shall be written policies and procedures to accomplish these purposes.

(2) A permanent individual medical record shall be maintained for each patient.

(3) All entries shall be permanent (typed or handwritten legibly in ink) and capable of being photocopied. Entries must be authenticated including date, name or identified initials, and title of the person making the entry.

(4) Records shall be kept for all patients admitted or accepted for treatment and care. Records shall be kept current and shall conform to good medical and professional practice based on the service provided to each patient.

(5) All records of discharged patients shall be completed and filed as soon as possible or within 30 days of discharge.

(6) Each patient's medical record shall include the following:

(a) An admission record (face sheet) including the patient's name; age; date of admission; name, address, and telephone number of physician and responsible person;

(b) Reports of physical examinations, laboratory tests and X-rays prescribed and completed, including ultrasound reports;

(c) Signed and dated physician orders for drugs and treatments;

(d) Signed and dated nurse's notes regarding the care of the patient. The notes shall include vital signs, medications, treatments and other pertinent information;

(e) Discharge summary which contains a brief narrative of conditions and diagnoses of the patient and final disposition;

(f) The pathologist's report of human tissue removed during an abortion;

(g) All information indicated in Section 76-7-313.

(7) Medical records shall be retained for at least seven years after the last date of patient care. Records of minors shall be retained until the minor reaches age 18 or the age of majority plus an additional two years. In no case shall the record be retained less than seven years.

(8) All patient records shall be retained within the clinic upon change of ownership.

(9) Provision shall be made for filing, safe storage, security, and easy accessibility of medical records.

(10) Medical record information shall be confidential. There shall be written procedures for the use and removal of medical records and the release of patient information.

(a) Information may be disclosed only to authorized persons in accordance with federal and state laws, and clinic policy.

(b) Requests for information which may identify the patient (including photographs) shall require the written consent of the patient.

R432-600-25. Housekeeping Services.

(1) There shall be adequate housekeeping services to maintain a clean, sanitary, and healthful environment in the facility.

(2) The housekeeping service shall meet all the requirements of this section.

(3) Written housekeeping policies and procedures shall be developed and implemented by each facility, and reviewed and updated as necessary.

(4) The facility shall employ housekeeping staff to maintain both the exterior and interior of the facility in a safe, clean, orderly manner.

(5) Housekeeping equipment shall be for institutional use and properly maintained.

(6) Cleaning solutions for floors shall be prepared in proper strengths according to the manufacturer's instructions and be checked to insure that the proper germicidal concentrations are maintained.

(7) There shall be sufficient number of noncombustible trash containers. Lids shall be provided where appropriate.

(8) Storage areas containing cleaning agents, bleaches, insecticides, or poisonous, dangerous, or flammable materials, shall be safeguarded. Toilet rooms shall not be used as storage places.

R432-600-26. Laundry Services.

(1) Each facility shall have provisions for storage and processing of clean and soiled linen as required for patient care.

(2) Processing may be done within the facility, in a separate building or in a commercial or shared laundry.

(3) Each facility shall develop and implement policies and procedures relevant to operation of the laundry which shall be reviewed and updated annually.

(4) Clean linen shall be stored, handled, and transported in a manner to prevent contamination.

(a) Clean linen shall be stored in clean ventilated closets, rooms, or alcoves used only for that purpose.

(b) Clean linen shall be covered if stored in alcoves and transported through the facility.

(c) Clean linen from a commercial laundry shall be delivered to a designated clean area in a manner that prevents contamination.

(d) Linens shall be maintained in good repair.

(e) A supply of clean washcloths and towels shall be provided and available to staff to meet the care needs of patients.

(5) Soiled linen shall be handled, stored and processed in a manner that will prevent the spread of infections.

(a) Soiled linen shall be sorted in a separate room by methods affording protection from contamination, according to facility policy and applicable rules.

(b) Soiled linen shall be stored and transported in a closed container which prevents airborne contamination of corridors, areas occupied by patients, and precludes cross contamination of clean linens.

(6) Laundry chutes shall be maintained in a clean sanitary state.

R432-600-27. Maintenance Services.

(1) There shall be adequate maintenance service to ensure that the facility, equipment, and grounds are maintained in a clean and sanitary condition and in good repair at all times for the safety and well-being of patients, staff, and visitors.

(2) The administrator shall employ a person qualified by experience and training to be in charge of facility maintenance.

(3) The facility shall develop and implement a written maintenance program, including preventive maintenance, to ensure continued operation and sanitary practices throughout the facility.

(4) All buildings, fixtures, equipment and spaces shall be maintained in operable conditions.

(5) A pest control program shall be conducted to ensure the facility is free from vermin and rodents by a licensed pest control contractor or an employee certified in pest control procedures.

(6) Equipment used in the clinic shall be approved by Underwriter's Laboratory and meet all applicable Utah Occupational Safety and Health Act requirements in effect at the time of purchase.

(7) Electrical systems including appliances, cords, equipment, call lights, and switches shall be maintained to guarantee safe functioning and compliance with the National Electrical Code.

(8) Heating and cooling systems shall be inspected annually to guarantee safe operation. Documentation of these inspection reports shall be maintained for Department review.

(9) There shall be regular inspections, to clean or replace all filters installed in heating, air conditioning, and ventilation systems, to maintain the systems in operating condition.

R432-600-28. Emergency Electric Service.

(1) The clinic shall make provision for emergency electrical power to provide lighting and power to critical areas essential for patient safety in the event of an interruption of normal electrical power service.

(2) The method utilized for emergency electrical power is subject to Departmental review and approval.

(3) There shall be provision for emergency exit lighting according to NFPA 101.

(4) Flashlights shall be available for emergency use by staff.

(5) All emergency electrical power systems shall be maintained in operating condition and tested as follows:

(a) Emergency generators shall be tested every 14-days, and run under load for 20 minutes every month.

(b) Transfer switches and battery operated equipment shall be tested every 14-days.

(6) A written record of inspection, performance, test period, and repair of the emergency electrical system shall be maintained on the premises for review.

R432-600-29. Storage and Disposal of Solid Wastes.

Facilities and equipment shall be provided for the sanitary storage and treatment or disposal of all categories of waste, including hazardous and infectious wastes if applicable, using techniques acceptable to the Department of Environmental Quality, and the local health department having jurisdiction.

R432-600-30. Oxygen.

If oxygen is utilized:

(1) Provision shall be made for safe handling and storage of oxygen according to the National Fire Protection Association 101 manual.

(2) Facility personnel shall not transfer gas from one cylinder to another.

(3) Piped oxygen system shall be tested in accordance with NFPA 56F and 56K.

(4) A written report shall be filed with the Utah Department of Health as follows:

(a) Upon completion of initial installation;

(b) Whenever changes are made to a system; and

(c) Whenever the integrity of the system has been breached.

R432-600-31. Lighting.

(1) Sodium and mercury vapor lights may not be used inside the facility, but may be utilized as a source of exterior lighting.

(2) At least 30 foot-candles of light shall illuminate reading, patient care (bed level) and working areas in patient treatment areas and not less than 20 foot-candles of light shall be provided in the rest of the room.

(3) All accessible storeroom, stairway, ramp, exit and entrance areas shall be illuminated by at least 20 foot-candles of light at floor level.

(4) All corridors shall be illuminated with a minimum of 20 foot-candles of light at floor level.

(5) Other areas shall be provided with the following minimum foot-candles of light at working surfaces:

(a) Operating rooms 50 Foot-candles

(b) Medication preparation areas 50 foot-candles

(c) Charting areas 50 foot-candles

(d) Reading rooms 50 foot-candles

(e) Laundry areas 20 foot-candles

(f) Bath and shower rooms 20 foot-candles

R432-600-32. Water Supply.

(1) Plumbing and drainage facilities shall be maintained in compliance with Utah Plumbing Code.

(2) Backflow prevention devices shall be maintained in operating condition and tested when required by the Utah Plumbing Code and Utah Public Drinking Water Regulations.

(3) Hot water temperature controls shall automatically regulate temperatures of hot water delivered to plumbing fixtures used by patients. The facility shall endeavor to maintain hot water delivered to patient care areas at temperature between 105 degrees and 115 degree F.

(4) There shall be grab bars at each toilet, bathtub, and shower used by patients.

(5) Toilet, hand washing facilities, shall be maintained in operating condition and in the number and types specified in construction requirements.

R432-600-33. Smoking Policy.

The smoking policy shall comply with the "Utah Clean Air Act", Title 26, Chapter 38, and Section 31- 4.4 of the Life Safety Code, 1991.

R432-600-33. Penalties.

Any person who violates any provision of this rule may be subject to the penalties enumerated in 26- 21-11 and R432-3-6 and be punished for violation of a class A misdemeanor as provided in 26-21-16.

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