Alabama 2022 Regular Session

Alabama House Bill HB401 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	1 HB401
2	2	2 217856-1
3	3	3 By Representatives Meadows, Collins, Stadthagen, Wilcox,
4	4	4 Shaver, Wood (D), Sorrell, Hanes, Whorton, Kiel, Mooney, Wingo
5	5	5 and Holmes
6	6	6 RFD: Health
7	7	7 First Read: 23-FEB-22
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9	9	Page 0 1 217856-1:n:02/17/2022:AHP*/cmg LSA2022-732
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15	15	7
16	16	8 SYNOPSIS: Existing law requires abortion providers, 48
17	17	9 hours before performing an abortion on a woman, to
18	18	10 provide the woman with a state-produced pamphlet of
19	19	11 pregnancy-related services in this state.
20	20	12 This bill would require a physician, before
21	21	13 performing an abortion on a woman, to confirm that
22	22	14 the woman has received a free resource access
23	23	15 assistance offer. This offer would be provided
24	24	16 through a phone call to a toll-free number that is
25	25	17 staffed by support professionals who would explain
26	26	18 available pregnancy-related services to the woman,
27	27	19 help her learn about and connect to those
28	28	20 resources, and make available additional direct
29	29	21 support related to her pregnancy.
30	30	22 This bill would make available substantive
31	31	23 services to help pregnant women and parents of
32	32	24 young children navigate existing private and public
33	33	25 resources to support their pregnancy and parenting,
34	34	26 and would establish a process to ensure every woman
35	35	Page 1 1 seeking to obtain an abortion in Alabama learns
36	36	2 about those services prior to an abortion.
37	37	3 This bill would also support follow-up
38	38	4 services for women after the birth of their
39	39	5 children, including referrals to resources in their
40	40	6 community and public assistance programs.
41	41	7
42	42	8 A BILL
43	43	9 TO BE ENTITLED
44	44	10 AN ACT
45	45	11
46	46	12 Relating to pregnancy, parenting, and abortion; to
47	47	13 create the Every Mother Matters Act; to support certain
48	48	14 services for women before and after childbirth; to require a
49	49	15 physician, prior to the performance of an abortion, to confirm
50	50	16 that a woman upon whom an abortion is to be performed has
51	51	17 received a free resource access assistance offer; and to
52	52	18 provide for the provision and contents of the offer.
53	53	19 BE IT ENACTED BY THE LEGISLATURE OF ALABAMA:
54	54	20 Section 1. This act shall be known and may be cited
55	55	21 as the Every Mother Matters Act.
56	56	22 Section 2. For the purposes of this act, the
57	57	23 following terms have the following meanings:
58	58	24 (1) ABORTION. The same meaning as in Section
59	59	25 26-23H-3, Code of Alabama 1975.
60	60	26 (2) ABORTION PROVIDER. Any individual or entity that
61	61	27 offers or advertises the provision of abortions or that
62	62	Page 2 1 operates a facility at which abortions are performed or
63	63	2 induced.
64	64	3 (3) ABUSE. The same meaning as in Section 30-5-2,
65	65	4 Code of Alabama 1975.
66	66	5 (4) AGENCY. An entity that contracts with the
67	67	6 department to provide the services required by this act.
68	68	7 (5) ASSAULT. The acts or offenses described in
69	69	8 Sections 13A-6-20, 13A-6-21, and 13A-6-22, Code of Alabama
70	70	9 1975.
71	71	10 (6) CARE AGENT. An individual employed by an agency
72	72	11 to perform the services required by this act.
73	73	12 (7) COERCION. The acts or offenses described in
74	74	13 Section 13A-6-25, Code of Alabama 1975.
75	75	14 (8) DEPARTMENT. The Alabama Department of Public
76	76	15 Health.
77	77	16 (9) ECTOPIC PREGNANCY. The same meaning as in
78	78	17 Section 26-23H-3, Code of Alabama 1975.
79	79	18 (10) HUMAN TRAFFICKING. The acts or offenses
80	80	19 described in Sections 13A-6-152 and 13A-6-153, Code of Alabama
81	81	20 1975.
82	82	21 (11) MEDICAL EMERGENCY. A condition that, based on
83	83	22 the good faith clinical judgment of a physician, has
84	84	23 complicated the medical condition of a pregnant woman so as to
85	85	24 necessitate the immediate termination of the woman's pregnancy
86	86	25 to avert her death or for which a delay will create a serious
87	87	26 risk of substantial and irreversible impairment of a major
88	88	27 bodily function.
89	89	Page 3 1 (12) NEGLECT. The same meaning as in Section
90	90	2 26-16-2, Code of Alabama 1975.
91	91	3 (13) PARTICIPANT. An individual receiving Pregnancy
92	92	4 Launch Program Services as provided in this act.
93	93	5 (14) SEXUAL ABUSE. The acts or offenses described in
94	94	6 Sections 13A-6-66 and 13A-6-67, Code of Alabama 1975.
95	95	7 Section 3. The department shall establish the
96	96	8 Pregnancy Launch Program by contracting with one or more
97	97	9 agencies to provide direct services, support, social services
98	98	10 case management, and program referrals statewide to biological
99	99	11 parents of unborn children, biological or adoptive parents of
100	100	12 children under two years of age, and parents and legal
101	101	13 guardians of pregnant minors.
102	102	14 Section 4. The Pregnancy Launch Program shall do all
103	103	15 of the following:
104	104	16 (1) Encourage healthy childbirth.
105	105	17 (2) Support childbirth as an alternative to
106	106	18 abortion.
107	107	19 (3) Promote family formation.
108	108	20 (4) Aid successful parenting.
109	109	21 (5) Increase families' economic self-sufficiency.
110	110	22 (6) Improve maternal health, mortality, and
111	111	23 postpartum outcomes.
112	112	24 Section 5. (a) The Pregnancy Launch Program shall
113	113	25 consist of at least the following components:
114	114	26 (1) The use of licensed nurses, community health
115	115	27 workers, or other individuals of equivalent expertise to offer
116	116	Page 4 1 healthy pregnancy program services to participants in the
117	117	2 Pregnancy Launch Program, including all of the following:
118	118	3 a. Assistance assessing and evaluating needs related
119	119	4 to pregnancy or parenting.
120	120	5 b. Medically accurate pregnancy-related medical
121	121	6 information.
122	122	7 c. Assistance obtaining obstetric care, primary
123	123	8 care, mental health or behavioral health counseling, and
124	124	9 postpartum care.
125	125	10 d. Support for factors affecting a pregnant woman's
126	126	11 pregnancy, including her or her family's well-being and
127	127	12 available support services.
128	128	13 e. Information on adoption.
129	129	14 (2) The use of licensed social workers, nurses,
130	130	15 community health workers, licensed professional counselors, or
131	131	16 other individuals of equivalent experience to offer care plan
132	132	17 coordination services to participants in the Pregnancy Launch
133	133	18 Program, including all of the following:
134	134	19 a. Assistance in identifying needs related to the
135	135	20 pregnancy or parent's ability to care for his or her unborn
136	136	21 child.
137	137	22 b. Development of a care plan of resources and
138	138	23 support to address the needs identified.
139	139	24 c. Referrals to appropriate local resources,
140	140	25 including state and federal benefits programs and local
141	141	26 charitable organizations.
142	142	Page 5 1 d. Assistance in applying for state and federal
143	143	2 benefits programs.
144	144	3 e. Assistance in accomplishing elements of the care
145	145	4 plan.
146	146	5 f. Services related to postpartum depression and
147	147	6 related referrals.
148	148	7 g. Assistance obtaining pediatric care and
149	149	8 postpartum care.
150	150	9 h. Assistance obtaining substance abuse treatment
151	151	10 and alcohol abuse treatment.
152	152	11 i. Education on available public and private
153	153	12 resources to address the pregnant woman's or biological
154	154	13 father's socioeconomic needs.
155	155	14 j. Social services or assistance in obtaining social
156	156	15 services related to education, professional certification,
157	157	16 housing, employment, resume development, childcare, adoption
158	158	17 services, financial needs, substance abuse, and health
159	159	18 benefits plan coverage.
160	160	19 k. Assistance for abuse, assault, sexual assault,
161	161	20 neglect, coercion, and human trafficking.
162	162	21 l. Assistance obtaining mental health or behavioral
163	163	22 counseling.
164	164	23 (3) Administrative support and other expenses
165	165	24 necessary for the development or ongoing provision of
166	166	25 services.
167	167	26 (b)(1) The Pregnancy Launch Program shall be
168	168	27 available to residents of all counties of the state, including
169	169	Page 6 1 residents in rural areas that may currently lack access to
170	170	2 similar services.
171	171	3 (2) Notwithstanding any law to the contrary, healthy
172	172	4 pregnancy program services and care plan coordination services
173	173	5 of the Pregnancy Launch Program may be provided in person
174	174	6 through existing facilities or remotely through a telephonic
175	175	7 system or other comparable, synchronous direct audio or video
176	176	8 technologies.
177	177	9 (c) To be eligible to be a participant, an
178	178	10 individual shall, at the time of initial contact with the
179	179	11 Pregnancy Launch Program, be one of the following:
180	180	12 (1) A resident of this state who is the biological
181	181	13 parent of an unborn child or a biological or adoptive parent
182	182	14 of a child under two years of age.
183	183	15 (2) A pregnant woman seeking to obtain an abortion
184	184	16 in this state.
185	185	17 (3) A parent or legal guardian of a minor residing
186	186	18 in this state who is pregnant or has a child under the age of
187	187	19 two years.
188	188	20 (d) Existing participants of the Pregnancy Launch
189	189	21 Program whose pregnancies are terminated are eligible to
190	190	22 continue to receive services for six months after the date of
191	191	23 termination.
192	192	24 Section 6. Each agency providing Pregnancy Launch
193	193	25 Program services shall record and report monthly to the
194	194	26 department the following information pertaining to care plan
195	195	27 coordination and healthy pregnancy services:
196	196	Page 7 1 (1) The number of pregnant women, biological
197	197	2 fathers, or parents or guardians of a pregnant minor
198	198	3 requesting assistance in developing a personalized care plan.
199	199	4 (2) The number of unique pregnant women, biological
200	200	5 fathers, or parents or guardians of a pregnant minor receiving
201	201	6 support in the following categories:
202	202	7 a. Education.
203	203	8 b. Training for a professional certification.
204	204	9 c. Housing.
205	205	10 d. Employment.
206	206	11 e. Resume development.
207	207	12 f. Child care.
208	208	13 g. Adoption services.
209	209	14 h. Financial needs.
210	210	15 i. Substance abuse.
211	211	16 j. Health benefit coverage.
212	212	17 (3) The number of pregnant women needing assistance
213	213	18 for abuse, assault, sexual assault, neglect, coercion, and
214	214	19 human trafficking.
215	215	20 (4) The number of women needing assistance for
216	216	21 postpartum depression and related referrals.
217	217	22 (5) The number of pregnant women needing assistance
218	218	23 obtaining obstetric care, pediatric care, postpartum care, or
219	219	24 mental health or behavioral counseling.
220	220	25 (6) The number of pregnant women receiving
221	221	26 assistance or education for issues related to their health,
222	222	Page 8 1 unborn children's health, pregnancy, abortion, fetal
223	223	2 development, or birth.
224	224	3 Section 7. (a) An individual shall not perform or
225	225	4 induce an abortion unless the individual verifies, in
226	226	5 accordance with Section 12, that the woman upon whom the
227	227	6 abortion is to be performed or induced has received a resource
228	228	7 access assistance offer.
229	229	8 (b) A resource access assistance offer under
230	230	9 subsection (a) shall consist of a care agent doing all of the
231	231	10 following:
232	232	11 (1) Informing the pregnant woman of and making
233	233	12 available the following:
234	234	13 a. Free healthy pregnancy program services offered
235	235	14 under Section 5.
236	236	15 b. Free care plan coordination services offered
237	237	16 under Section 5.
238	238	17 (2) Providing education on other public and private
239	239	18 resources available to address the socioeconomic needs of the
240	240	19 pregnant woman or the biological father of the unborn child.
241	241	20 (3) Offering screening and assistance for abuse,
242	242	21 assault, sexual assault, neglect, coercion, and human
243	243	22 trafficking.
244	244	23 (c)(1) The pregnant woman is not required to do
245	245	24 either of the following in order to obtain an abortion:
246	246	25 a. Provide any personally identifiable information
247	247	26 to the department, care agent, or contracting agency.
248	248	Page 9 1 b. Initiate, accept, or complete any services
249	249	2 offered pursuant to this section in order to obtain an
250	250	3 abortion.
251	251	4 (2) The pregnant woman may decline services offered
252	252	5 pursuant to Section 5 at any time.
253	253	6 (d) The resource access assistance offer shall be
254	254	7 provided at the expense of the state at no cost to the woman.
255	255	8 (e) This section does not apply in the case of a
256	256	9 medical emergency necessitating the performance of an
257	257	10 abortion. An individual who performs or induces an abortion in
258	258	11 a medical emergency shall do both of the following:
259	259	12 (1) Include in the woman's medical records a
260	260	13 statement signed by the physician certifying the nature of the
261	261	14 medical emergency.
262	262	15 (2) Not later than the 30th day after the
263	263	16 performance of the abortion, certify to the department the
264	264	17 specific medical condition that constituted the emergency.
265	265	18 (f) This section shall become operative 18 months
266	266	19 following the effective date of this act.
267	267	20 Section 8. (a) The department shall, not later than
268	268	21 nine months following the effective date of this act, contract
269	269	22 with one or more agencies sufficient to ensure that every
270	270	23 woman seeking an abortion in Alabama receives a resource
271	271	24 access assistance offer as well as the opportunity to receive
272	272	25 free care plan coordination and free healthy pregnancy program
273	273	26 services.
274	274	Page 10 1 (b) The department shall only contract with agencies
275	275	2 that are capable of offering resource access assistance
276	276	3 offers, care plan coordination, and healthy pregnancy program
277	277	4 services by telephonic means or other comparable, synchronous
278	278	5 direct audio or video technologies.
279	279	6 Section 9. An agency and any of its subcontractors
280	280	7 or agents who provide services under Sections 3 through 8
281	281	8 shall not do any of the following:
282	282	9 (1) Be an abortion provider that directly or
283	283	10 indirectly promotes, refers for, or assists women in obtaining
284	284	11 an abortion.
285	285	12 (2) Own, operate, or be affiliated with an abortion
286	286	13 provider that directly or indirectly promotes, refers for, or
287	287	14 assists women in obtaining an abortion.
288	288	15 (3) Employ an individual who has performed or
289	289	16 induced an abortion in the last two years.
290	290	17 (4) Have as a director, board member, officer,
291	291	18 volunteer, or employee an individual who has performed or
292	292	19 induced an abortion in the last two years or who serves in any
293	293	20 of these roles for an entity described in subdivision (1).
294	294	21 (5) Refer women to an abortion provider, recommend
295	295	22 abortion, or take any other action that directly or indirectly
296	296	23 assists a woman in obtaining an abortion.
297	297	24 Section 10. Each care agent providing services under
298	298	25 this act, and any individual providing program services
299	299	26 through a subcontract or through an agency on a volunteer
300	300	27 basis, shall:
301	301	Page 11 1 (1) Meet the qualifications established by the
302	302	2 department.
303	303	3 (2) Have not performed or induced an abortion in the
304	304	4 last two years.
305	305	5 (3) Have not, within the last two years, served as a
306	306	6 director, board member, officer, volunteer, or employee for an
307	307	7 entity that is an abortion provider or an entity that directly
308	308	8 or indirectly promotes abortion or assists women in obtaining
309	309	9 an abortion.
310	310	10 (4) Maintain the confidentiality of information the
311	311	11 care agent obtains while performing services under this act.
312	312	12 (5) Complete a training program regarding
313	313	13 recognizing signs that an individual may have been a victim of
314	314	14 human trafficking and provide appropriate assistance to that
315	315	15 individual.
316	316	16 (6) Not refer women to an abortion provider,
317	317	17 recommend abortion, or take any other action that directly or
318	318	18 indirectly assists a woman in obtaining an abortion.
319	319	19 Section 11. The department shall do all of the
320	320	20 following:
321	321	21 (1) Annually designate the proportion of resource
322	322	22 access assistance offers to be provided by each agency based
323	323	23 on the agency's share of participants initiating care plan
324	324	24 coordination services or healthy pregnancy program services.
325	325	25 (2) Establish a single toll-free number by which all
326	326	26 pregnant women seeking an abortion in Alabama may immediately
327	327	27 receive resource access assistance offers by automatically
328	328	Page 12 1 connecting the pregnant woman to an agency based on this
329	329	2 proportion.
330	330	3 (3)a. Develop and maintain a secure process for
331	331	4 completing the verification requirements of this section and
332	332	5 Section 12 and enforcing the auditing requirements of Section
333	333	6 13.
334	334	7 b. The process shall not transmit any information to
335	335	8 either of the following:
336	336	9 1. The agency or care agent concerning the identity
337	337	10 or location of the individual who may perform or induce the
338	338	11 abortion or the facility at which the abortion may occur.
339	339	12 2. The individual performing or inducing the
340	340	13 abortion or the individual's agent regarding the identity of
341	341	14 the agency or care agent providing the resource access
342	342	15 assistance offer.
343	343	16 (4) Provide a monthly report to each agency
344	344	17 regarding the percentage of pregnant women who were provided
345	345	18 resource access assistance offers by the agency who
346	346	19 subsequently obtained an abortion in this state.
347	347	20 (5) Adopt rules for the implementation of this act.
348	348	21 Section 12.
349	349	22 (a) The individual who is to perform or induce an
350	350	23 abortion, or the individual's agent, shall do each of the
351	351	24 following before accepting any payment for abortion-related
352	352	25 services, before an abortion is performed or induced, and
353	353	26 before any sedative or anesthesia is administered:
354	354	Page 13 1 (1) Verify through the department's secure
355	355	2 verification process that the woman received a resource access
356	356	3 assistance offer from an agency.
357	357	4 (2) Record the verification in the woman's medical
358	358	5 record.
359	359	6 (3) Take any other steps required by department rule
360	360	7 to complete the secure verification process.
361	361	8 (b) The individual who performs or induces an
362	362	9 abortion, or the individual's agent, shall, within two
363	363	10 business days of the completion of an abortion, report to the
364	364	11 department confirmation for each abortion performed or induced
365	365	12 and the date and time of the performance or induction of the
366	366	13 abortion.
367	367	14 (c) Care agents shall do both of the following:
368	368	15 (1) Provide the resource access assistance offer,
369	369	16 care coordination, and healthy pregnancy program services.
370	370	17 (2) Record the information required by Section 6.
371	371	18 (d) An agency shall record and report at least
372	372	19 monthly to the department the following information pertaining
373	373	20 to resource access assistance offers:
374	374	21 (1) The number of pregnant women needing assistance
375	375	22 for violence, abuse, assault, sexual assault, coercion,
376	376	23 neglect, or human trafficking.
377	377	24 (2) The number of women receiving a resource access
378	378	25 assistance offer who initiate care plan coordination.
379	379	Page 14 1 (3) The number of women receiving a resource access
380	380	2 assistance offer who initiate healthy pregnancy program
381	381	3 services.
382	382	4 (e) This section shall become operative 18 months
383	383	5 following the effective date of this act.
384	384	6 Section 13. (a) The department, in order to enforce
385	385	7 compliance with this act, shall audit the medical records kept
386	386	8 by every individual who performs or induces an abortion and
387	387	9 every abortion provider according to the following process:
388	388	10 (1) At least once a year, the department shall audit
389	389	11 10 percent of the abortion medical records at random,
390	390	12 unannounced, and reasonable times.
391	391	13 (2) The department shall determine for each audited
392	392	14 medical record whether the individual who performed or induced
393	393	15 the abortion fully complied with subsections (a) and (b) of
394	394	16 Section 12.
395	395	17 (3) If the department finds that for five percent or
396	396	18 more of the audited medical records, the individual who
397	397	19 performed or induced the abortion failed to comply with
398	398	20 subsections (a) and (b) of Section 12, the department shall
399	399	21 audit all abortion medical records from that individual since
400	400	22 the last inspection performed pursuant to this section.
401	401	23 (b) The results of the department's audit shall be a
402	402	24 public writing for the purpose of the Alabama Open Records
403	403	25 Law, Section 36-12-40, Code of Alabama 1975, and the
404	404	26 department shall publicly post the results of each audit on
405	405	27 its website, provided that the audit results shall not contain
406	406	Page 15 1 any personally identifying information on any woman who
407	407	2 obtained an abortion.
408	408	3 (c) Any individual performing or inducing an
409	409	4 abortion who fails to comply with subsections (a) and (b) of
410	410	5 Section 12 shall be subject to a civil penalty of five
411	411	6 thousand dollars ($5,000) for each abortion he or she performs
412	412	7 or induces in violation of subsections (a) and (b) of Section
413	413	8 12.
414	414	9 (d) An abortion provider shall be jointly and
415	415	10 severally liable for each fine associated with an abortion
416	416	11 performed or induced at that facility.
417	417	12 (e) The Attorney General or the district attorney of
418	418	13 the county in which the abortion was performed or induced may
419	419	14 file an action to recover the civil penalty assessed under
420	420	15 this section.
421	421	16 (f) The civil penalty imposed by this section is in
422	422	17 addition to the criminal liability established by the Woman's
423	423	18 Right to Know Act, Chapter 23A of Title 26, Code of Alabama
424	424	19 1975.
425	425	20 (g) The department shall revoke the license of an
426	426	21 abortion provider if greater than five percent of medical
427	427	22 records audited at that facility do not comply with
428	428	23 subsections (a) and (b) of Section 12.
429	429	24 (h) This section shall become operative 18 months
430	430	25 following the effective date of this act.
431	431	26 Section 14. Records that identify an individual care
432	432	27 agent, pregnant woman, or biological or adoptive parent held
433	433	Page 16 1 by the department pursuant to this act are not open records
434	434	2 for the purposes of Article 3 of Chapter 12 of Title 36, Code
435	435	3 of Alabama 1975. Those records may be released or made public
436	436	4 as follows:
437	437	5 (1) For statistical purposes, but only if a care
438	438	6 agent, pregnant woman, or biological or adoptive parent is not
439	439	7 identified.
440	440	8 (2) With the consent of each individual identified
441	441	9 in the information released.
442	442	10 (3) To individuals performing or inducing abortions
443	443	11 and to agencies, to the extent necessary to fulfill their
444	444	12 obligations pursuant to this act.
445	445	13 (4) To appropriate state agencies or county and
446	446	14 district courts to enforce this chapter.
447	447	15 (5) To appropriate state licensing boards to enforce
448	448	16 state licensing laws.
449	449	17 (6) To licensed medical or health care personnel
450	450	18 currently treating the pregnant woman.
451	451	19 (7) Pursuant to a subpoena issued by a court of
452	452	20 competent jurisdiction, provided the release is made subject
453	453	21 to a confidentiality requirement as determined by that court.
454	454	22 Section 15. This act does not:
455	455	23 (1) Create or recognize a right to abortion.
456	456	24 (2) Create or recognize a right to a particular
457	457	25 method of abortion.
458	458	26 (3) Make lawful an abortion that is currently
459	459	27 unlawful under any law of this state.
460	460	Page 17 1 Section 16. Nothing in this act shall be interpreted
461	461	2 to violate any speech or conduct rights protected by the First
462	462	3 Amendment of the Constitution of the United States, as made
463	463	4 applicable to the states through interpretations by the
464	464	5 Supreme Court of the United States of the Fourteenth Amendment
465	465	6 of the Constitution of the United States, or by the
466	466	7 Constitution of Alabama of 1901, including the Alabama
467	467	8 Religious Freedom Amendment, Article 1, Section 3.01.
468	468	9 Section 17. The provisions of this act are
469	469	10 severable. If any part of this act is declared invalid or
470	470	11 unconstitutional, that declaration shall not affect the part
471	471	12 which remains.
472	472	13 Section 18. This act shall become effective on the
473	473	14 first day of the first month following its passage and
474	474	15 approval by the Governor, or its otherwise becoming law.
475	475	Page 18