* * *
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.
* * *
26-18-10.
(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.
* * *
* * *
26-40-107.
Limitation of benefits.
Abortion is not a covered benefit, except as provided
in 42 U.S.C. Sec. 1397ee.
* * *
* * *
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.
* * *
* * *
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
(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
(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
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.
* * *
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.
* * *
* * *
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.
* * *
--------------------------------------------
* * *
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
(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.
(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.
(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.
* * *
* * *
This rule is adopted pursuant to
Title 26, Chapter 21.
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.
All facilities governed by these
rules shall be in full compliance at the time of 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.
(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.
(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.
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.
(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.
(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
(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
(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.
(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.
(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.
(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.
(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.
(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.
(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.
(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.
(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.
(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.
(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
(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.
Documentation of medications and
treatments shall comply with generally accepted professional practice and
clinic policy.
(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.
(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.
Anesthesia services provided in the
clinic shall comply with the General Hospital Rules R432-100- 15.
(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.
(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.
(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.
(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.
(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.
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.
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.
(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)
(e) Laundry areas 20 foot-candles
(f)
(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.
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.
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.
* * *