Alabama 2022 Regular Session

Alabama Senate Bill SB320 Compare Versions

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

Old	New	Differences
1	1	1 SB320
2	2	2 219002-3
3	3	3 By Senator Weaver
4	4	4 RFD: Healthcare
5	5	5 First Read: 17-MAR-22
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7	7	Page 0 1 219002-3:n:03/16/2022:AHP*/cmg LSA2022-1020R2
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13	13	7
14	14	8 SYNOPSIS: Existing law requires abortion providers, 48
15	15	9 hours before performing an abortion on a woman, to
16	16	10 provide the woman with a state-produced pamphlet of
17	17	11 pregnancy-related services in this state.
18	18	12 This bill would require a physician, before
19	19	13 performing an abortion on a woman, to confirm that
20	20	14 the woman has received a free resource access
21	21	15 assistance offer. This offer would be provided
22	22	16 through a phone call to a toll-free number that is
23	23	17 staffed by support professionals who would explain
24	24	18 available pregnancy-related services to the woman,
25	25	19 help her learn about and connect to those
26	26	20 resources, and make available additional direct
27	27	21 support related to her pregnancy.
28	28	22 This bill would make available substantive
29	29	23 services to help pregnant women and parents of
30	30	24 young children navigate existing private and public
31	31	25 resources to support their pregnancy and parenting,
32	32	26 and would establish a process to ensure every woman
33	33	Page 1 1 seeking to obtain an abortion in Alabama learns
34	34	2 about those services prior to an abortion.
35	35	3 This bill would also support follow-up
36	36	4 services for women after the birth of their
37	37	5 children, including referrals to resources in their
38	38	6 community and public assistance programs.
39	39	7
40	40	8 A BILL
41	41	9 TO BE ENTITLED
42	42	10 AN ACT
43	43	11
44	44	12 Relating to pregnancy, parenting, and abortion; to
45	45	13 create the Every Mother Matters Act; to support certain
46	46	14 services for women before and after childbirth; to require a
47	47	15 physician, prior to the performance of an abortion, to confirm
48	48	16 that a woman upon whom an abortion is to be performed has
49	49	17 received a free resource access assistance offer; and to
50	50	18 provide for the provision and contents of the offer.
51	51	19 BE IT ENACTED BY THE LEGISLATURE OF ALABAMA:
52	52	20 Section 1. This act shall be known and may be cited
53	53	21 as the Every Mother Matters Act.
54	54	22 Section 2. For the purposes of this act, the
55	55	23 following terms have the following meanings:
56	56	24 (1) ABORTION. The same meaning as in Section
57	57	25 26-23H-3, Code of Alabama 1975.
58	58	26 (2) ABORTION PROVIDER. Any individual or entity that
59	59	27 offers or advertises the provision of abortions or that
60	60	Page 2 1 operates a facility at which abortions are performed or
61	61	2 induced, excluding general and specialized hospitals as
62	62	3 described in Section 22-21-20, Code of Alabama 1975.
63	63	4 (3) ABUSE. The same meaning as in Section 30-5-2,
64	64	5 Code of Alabama 1975.
65	65	6 (4) ASSAULT. The acts or offenses described in
66	66	7 Sections 13A-6-20, 13A-6-21, and 13A-6-22, Code of Alabama
67	67	8 1975.
68	68	9 (5) CARE AGENT. An individual employed by an
69	69	10 organization to perform the services required by this act.
70	70	11 (6) COERCION. The acts or offenses described in
71	71	12 Section 13A-6-25, Code of Alabama 1975.
72	72	13 (7) DEPARTMENT. The Alabama Department of Public
73	73	14 Health.
74	74	15 (8) ECTOPIC PREGNANCY. The same meaning as in
75	75	16 Section 26-23H-3, Code of Alabama 1975.
76	76	17 (9) HUMAN TRAFFICKING. The acts or offenses
77	77	18 described in Sections 13A-6-152 and 13A-6-153, Code of Alabama
78	78	19 1975.
79	79	20 (10) MEDICAL EMERGENCY. A condition that, based on
80	80	21 the good faith clinical judgment of a physician, has
81	81	22 complicated the medical condition of a pregnant woman so as to
82	82	23 necessitate the immediate termination of the woman's pregnancy
83	83	24 to avert her death or for which a delay will create a serious
84	84	25 risk of substantial and irreversible impairment of a major
85	85	26 bodily function.
86	86	Page 3 1 (11) NEGLECT. The same meaning as in Section
87	87	2 26-16-2, Code of Alabama 1975.
88	88	3 (12) ORGANIZATION. A non-governmental entity
89	89	4 contracting with the department to provide health pregnancy
90	90	5 program services, care plan coordination, and resource access
91	91	6 assistance offers as required by this act.
92	92	7 (13) PARTICIPANT. An individual receiving Pregnancy
93	93	8 Launch Program Services as provided in this act.
94	94	9 (14) SEXUAL ABUSE. The acts or offenses described in
95	95	10 Sections 13A-6-66 and 13A-6-67, Code of Alabama 1975.
96	96	11 Section 3. The department shall establish the
97	97	12 Pregnancy Launch Program by contracting with one or more
98	98	13 organizations to provide direct services, support, social
99	99	14 services case management, and program referrals statewide to
100	100	15 biological parents of unborn children, biological or adoptive
101	101	16 parents of children under two years of age, and parents and
102	102	17 legal guardians of pregnant minors.
103	103	18 Section 4. The Pregnancy Launch Program shall do all
104	104	19 of the following:
105	105	20 (1) Encourage healthy childbirth.
106	106	21 (2) Support childbirth as an alternative to
107	107	22 abortion.
108	108	23 (3) Promote family formation.
109	109	24 (4) Aid successful parenting.
110	110	25 (5) Increase families' economic self-sufficiency.
111	111	26 (6) Improve maternal health, mortality, and
112	112	27 postpartum outcomes.
113	113	Page 4 1 Section 5. (a) The Pregnancy Launch Program shall
114	114	2 consist of at least the following components:
115	115	3 (1) The use of licensed nurses, community health
116	116	4 workers, or other individuals of equivalent expertise to offer
117	117	5 healthy pregnancy program services to participants in the
118	118	6 Pregnancy Launch Program, including all of the following:
119	119	7 a. Assistance assessing and evaluating needs related
120	120	8 to pregnancy or parenting.
121	121	9 b. Medically accurate pregnancy-related medical
122	122	10 information.
123	123	11 c. Assistance obtaining obstetric care, primary
124	124	12 care, mental health or behavioral health counseling, and
125	125	13 postpartum care.
126	126	14 d. Support for factors affecting a pregnant woman's
127	127	15 pregnancy, including her or her family's well-being and
128	128	16 available support services.
129	129	17 e. Information on adoption.
130	130	18 (2) The use of licensed social workers, certified
131	131	19 life coaches, nurses, community health workers, licensed
132	132	20 professional counselors, or other individuals of equivalent
133	133	21 experience to offer care plan coordination services to
134	134	22 participants in the Pregnancy Launch Program, including all of
135	135	23 the following:
136	136	24 a. Assistance in identifying needs related to the
137	137	25 pregnancy or parent's ability to care for his or her unborn
138	138	26 child.
139	139	Page 5 1 b. Development of a care plan of resources and
140	140	2 support to address the needs identified.
141	141	3 c. Referrals to appropriate local resources,
142	142	4 including state and federal benefits programs and local
143	143	5 charitable organizations.
144	144	6 d. Assistance in applying for state and federal
145	145	7 benefits programs.
146	146	8 e. Assistance in accomplishing elements of the care
147	147	9 plan.
148	148	10 f. Services related to postpartum depression and
149	149	11 related referrals.
150	150	12 g. Assistance obtaining pediatric care and
151	151	13 postpartum care.
152	152	14 h. Assistance obtaining substance abuse treatment
153	153	15 and alcohol abuse treatment.
154	154	16 i. Education on available public and private
155	155	17 resources to address the pregnant woman's or biological
156	156	18 father's socioeconomic needs.
157	157	19 j. Social services or assistance in obtaining social
158	158	20 services related to education, professional certification,
159	159	21 housing, employment, resume development, childcare, adoption
160	160	22 services, financial needs, substance abuse, and health
161	161	23 benefits plan coverage.
162	162	24 k. Assistance for abuse, assault, sexual assault,
163	163	25 neglect, coercion, and human trafficking.
164	164	26 l. Assistance obtaining mental health or behavioral
165	165	27 counseling.
166	166	Page 6 1 (3) Administrative support and other expenses
167	167	2 necessary for the development or ongoing provision of
168	168	3 services.
169	169	4 (b)(1) The Pregnancy Launch Program shall be
170	170	5 available to residents of all counties of the state, including
171	171	6 residents in rural areas that may currently lack access to
172	172	7 similar services.
173	173	8 (2) Notwithstanding any law to the contrary, healthy
174	174	9 pregnancy program services and care plan coordination services
175	175	10 of the Pregnancy Launch Program may be provided in person
176	176	11 through existing facilities or remotely through a telephonic
177	177	12 system or other comparable, synchronous direct audio or video
178	178	13 technologies.
179	179	14 (c) To be eligible to be a participant, an
180	180	15 individual shall, at the time of initial contact with the
181	181	16 Pregnancy Launch Program, be one of the following:
182	182	17 (1) A resident of this state who is the biological
183	183	18 parent of an unborn child or a biological or adoptive parent
184	184	19 of a child under two years of age.
185	185	20 (2) A pregnant woman seeking to obtain an abortion
186	186	21 in this state.
187	187	22 (3) A parent or legal guardian of a minor residing
188	188	23 in this state who is pregnant or has a child under the age of
189	189	24 two years.
190	190	25 (d) Existing participants of the Pregnancy Launch
191	191	26 Program whose pregnancies are terminated are eligible to
192	192	Page 7 1 continue to receive services for six months after the date of
193	193	2 termination.
194	194	3 Section 6. Each organization providing Pregnancy
195	195	4 Launch Program services shall record and report monthly to the
196	196	5 department the following information pertaining to care plan
197	197	6 coordination and healthy pregnancy services:
198	198	7 (1) The number of pregnant women, biological
199	199	8 fathers, or parents or guardians of a pregnant minor
200	200	9 requesting assistance in developing a personalized care plan.
201	201	10 (2) The number of unique pregnant women, biological
202	202	11 fathers, or parents or guardians of a pregnant minor receiving
203	203	12 support in the following categories:
204	204	13 a. Education.
205	205	14 b. Training for a professional certification.
206	206	15 c. Housing.
207	207	16 d. Employment.
208	208	17 e. Resume development.
209	209	18 f. Child care.
210	210	19 g. Adoption services.
211	211	20 h. Financial needs.
212	212	21 i. Substance abuse.
213	213	22 j. Health benefit coverage.
214	214	23 (3) The number of pregnant women needing assistance
215	215	24 for abuse, assault, sexual assault, neglect, coercion, and
216	216	25 human trafficking.
217	217	26 (4) The number of women needing assistance for
218	218	27 postpartum depression and related referrals.
219	219	Page 8 1 (5) The number of pregnant women needing assistance
220	220	2 obtaining obstetric care, pediatric care, postpartum care, or
221	221	3 mental health or behavioral counseling.
222	222	4 (6) The number of pregnant women receiving
223	223	5 assistance or education for issues related to their health,
224	224	6 unborn children's health, pregnancy, abortion, fetal
225	225	7 development, or birth.
226	226	8 Section 7. (a) An individual shall not perform or
227	227	9 induce an abortion unless the individual verifies, in
228	228	10 accordance with Section 12, that the woman upon whom the
229	229	11 abortion is to be performed or induced has received a resource
230	230	12 access assistance offer.
231	231	13 (b) A resource access assistance offer under
232	232	14 subsection (a) shall consist of a care agent doing all of the
233	233	15 following:
234	234	16 (1) Informing the pregnant woman of and making
235	235	17 available the following:
236	236	18 a. Free healthy pregnancy program services offered
237	237	19 under Section 5.
238	238	20 b. Free care plan coordination services offered
239	239	21 under Section 5.
240	240	22 (2) Providing education on other public and private
241	241	23 resources available to address the socioeconomic needs of the
242	242	24 pregnant woman or the biological father of the unborn child.
243	243	25 (3) Offering screening and assistance for abuse,
244	244	26 assault, sexual assault, neglect, coercion, and human
245	245	27 trafficking.
246	246	Page 9 1 (c)(1) The pregnant woman is not required to do
247	247	2 either of the following in order to obtain an abortion:
248	248	3 a. Provide any personally identifiable information
249	249	4 to the department, care agent, or contracting organization.
250	250	5 b. Initiate, accept, or complete any services
251	251	6 offered pursuant to this section in order to obtain an
252	252	7 abortion.
253	253	8 (2) The pregnant woman may decline services offered
254	254	9 pursuant to Section 5 at any time.
255	255	10 (d) The resource access assistance offer shall be
256	256	11 provided at the expense of the state at no cost to the woman.
257	257	12 (e) This section does not apply in the case of a
258	258	13 medical emergency necessitating the performance of an
259	259	14 abortion. An individual who performs or induces an abortion in
260	260	15 a medical emergency shall do both of the following:
261	261	16 (1) Include in the woman's medical records a
262	262	17 statement signed by the physician certifying the nature of the
263	263	18 medical emergency.
264	264	19 (2) Not later than the 30th day after the
265	265	20 performance of the abortion, certify to the department the
266	266	21 specific medical condition that constituted the emergency.
267	267	22 (f) This section shall become operative 20 months
268	268	23 following the effective date of this act.
269	269	24 Section 8. (a) The department shall, not later than
270	270	25 10 months following the effective date of this act, contract
271	271	26 with one or more organizations sufficient to ensure that every
272	272	27 woman seeking an abortion in Alabama receives a resource
273	273	Page 10 1 access assistance offer as well as the opportunity to receive
274	274	2 free care plan coordination and free healthy pregnancy program
275	275	3 services.
276	276	4 (b) The department shall only contract with
277	277	5 organizations that are capable of offering resource access
278	278	6 assistance offers, care plan coordination, and healthy
279	279	7 pregnancy program services by telephonic means or other
280	280	8 comparable, synchronous direct audio or video technologies.
281	281	9 Section 9. An organization and any of its
282	282	10 subcontractors or agents who provide services under Sections 3
283	283	11 through 8 shall not do any of the following:
284	284	12 (1) Be an abortion provider that directly or
285	285	13 indirectly promotes, refers for, or assists women in obtaining
286	286	14 an abortion.
287	287	15 (2) Own, operate, or be affiliated with an abortion
288	288	16 provider that directly or indirectly promotes, refers for, or
289	289	17 assists women in obtaining an abortion.
290	290	18 (3) Employ an individual who has performed or
291	291	19 induced an abortion in the last two years.
292	292	20 (4) Have as a director, board member, officer,
293	293	21 volunteer, or employee an individual who has performed or
294	294	22 induced an abortion in the last two years or who serves in any
295	295	23 of these roles for an entity described in subdivision (1).
296	296	24 (5) Refer women to an abortion provider, recommend
297	297	25 abortion, or take any other action that directly or indirectly
298	298	26 assists a woman in obtaining an abortion.
299	299	Page 11 1 Section 10. Each care agent providing services under
300	300	2 this act, and any individual providing program services
301	301	3 through a subcontract or through an organization on a
302	302	4 volunteer basis, shall:
303	303	5 (1) Meet the qualifications established by the
304	304	6 department.
305	305	7 (2) Have not performed or induced an abortion in the
306	306	8 last two years.
307	307	9 (3) Have not, within the last two years, served as a
308	308	10 director, board member, officer, volunteer, or employee for an
309	309	11 entity that is an abortion provider or an entity that directly
310	310	12 or indirectly promotes abortion or assists women in obtaining
311	311	13 an abortion.
312	312	14 (4) Maintain the confidentiality of information the
313	313	15 care agent obtains while performing services under this act.
314	314	16 (5) Complete a training program regarding
315	315	17 recognizing signs that an individual may have been a victim of
316	316	18 human trafficking and provide appropriate assistance to that
317	317	19 individual.
318	318	20 (6) Not refer women to an abortion provider,
319	319	21 recommend abortion, or take any other action that directly or
320	320	22 indirectly assists a woman in obtaining an abortion.
321	321	23 Section 11. The department shall do all of the
322	322	24 following:
323	323	25 (1) Annually designate the proportion of resource
324	324	26 access assistance offers to be provided by each organization
325	325	27 based on the organization's share of participants initiating
326	326	Page 12 1 care plan coordination services or healthy pregnancy program
327	327	2 services.
328	328	3 (2) Establish a single toll-free number by which all
329	329	4 pregnant women seeking an abortion in Alabama may immediately
330	330	5 receive resource access assistance offers by automatically
331	331	6 connecting the pregnant woman to an organization based on this
332	332	7 proportion.
333	333	8 (3)a. Develop and maintain a secure process for
334	334	9 completing the verification requirements of this section and
335	335	10 Section 12 and enforcing the auditing requirements of Section
336	336	11 13.
337	337	12 b. The process shall not transmit any information to
338	338	13 either of the following:
339	339	14 1. The organization or care agent concerning the
340	340	15 identity or location of the individual who may perform or
341	341	16 induce the abortion or the facility at which the abortion may
342	342	17 occur.
343	343	18 2. The individual performing or inducing the
344	344	19 abortion or the individual's agent regarding the identity of
345	345	20 the organization or care agent providing the resource access
346	346	21 assistance offer.
347	347	22 (4) Provide a monthly report to each organization
348	348	23 regarding the percentage of pregnant women who were provided
349	349	24 resource access assistance offers by the organization who
350	350	25 subsequently obtained an abortion in this state.
351	351	26 (5) Provide a monthly report to the chairs of the
352	352	27 House and Senate health committees regarding its plans for
353	353	Page 13 1 implementing this act, its progress towards that
354	354	2 implementation, and the anticipated timeline for the
355	355	3 completion of key milestones.
356	356	4 (6) Adopt rules for the implementation of this act.
357	357	5 Section 12. (a) The individual who is to perform or
358	358	6 induce an abortion, or the individual's agent, shall do each
359	359	7 of the following before accepting any payment for
360	360	8 abortion-related services, before an abortion is performed or
361	361	9 induced, and before any sedative or anesthesia is
362	362	10 administered:
363	363	11 (1) Verify through the department's secure
364	364	12 verification process that the woman received a resource access
365	365	13 assistance offer from an organization.
366	366	14 (2) Record the verification in the woman's medical
367	367	15 record.
368	368	16 (3) Take any other steps required by department rule
369	369	17 to complete the secure verification process.
370	370	18 (b) The individual who performs or induces an
371	371	19 abortion, or the individual's agent, shall, within two
372	372	20 business days of the completion of an abortion, report to the
373	373	21 department confirmation for each abortion performed or induced
374	374	22 and the date and time of the performance or induction of the
375	375	23 abortion.
376	376	24 (c) Care agents shall do both of the following:
377	377	25 (1) Provide the resource access assistance offer,
378	378	26 care coordination, and healthy pregnancy program services.
379	379	27 (2) Record the information required by Section 6.
380	380	Page 14 1 (d) An organization shall record and report at least
381	381	2 monthly to the department the following information pertaining
382	382	3 to resource access assistance offers:
383	383	4 (1) The number of pregnant women needing assistance
384	384	5 for violence, abuse, assault, sexual assault, coercion,
385	385	6 neglect, or human trafficking.
386	386	7 (2) The number of women receiving a resource access
387	387	8 assistance offer who initiate care plan coordination.
388	388	9 (3) The number of women receiving a resource access
389	389	10 assistance offer who initiate healthy pregnancy program
390	390	11 services.
391	391	12 (e) This section shall become operative 20 months
392	392	13 following the effective date of this act.
393	393	14 Section 13. (a) The department, in order to enforce
394	394	15 compliance with this act, shall audit the medical records kept
395	395	16 by every individual who performs or induces an abortion and
396	396	17 every abortion provider according to the following process:
397	397	18 (1) At least once a year, the department shall audit
398	398	19 10 percent of the abortion medical records at random,
399	399	20 unannounced, and reasonable times.
400	400	21 (2) The department shall determine for each audited
401	401	22 medical record whether the individual who performed or induced
402	402	23 the abortion fully complied with subsections (a) and (b) of
403	403	24 Section 12.
404	404	25 (3) If the department finds that for five percent or
405	405	26 more of the audited medical records, the individual who
406	406	27 performed or induced the abortion failed to comply with
407	407	Page 15 1 subsections (a) and (b) of Section 12, the department shall
408	408	2 audit all abortion medical records from that individual since
409	409	3 the last inspection performed pursuant to this section.
410	410	4 (b) The results of the department's audit shall be a
411	411	5 public writing for the purpose of the Alabama Open Records
412	412	6 Law, Section 36-12-40, Code of Alabama 1975, and the
413	413	7 department shall publicly post the results of each audit on
414	414	8 its website, provided that the audit results shall not contain
415	415	9 any personally identifying information on any woman who
416	416	10 obtained an abortion.
417	417	11 (c) Any individual performing or inducing an
418	418	12 abortion who fails to comply with subsections (a) and (b) of
419	419	13 Section 12 shall be subject to a civil penalty of five
420	420	14 thousand dollars ($5,000) for each abortion he or she performs
421	421	15 or induces in violation of subsections (a) and (b) of Section
422	422	16 12.
423	423	17 (d) An abortion provider shall be jointly and
424	424	18 severally liable for each fine associated with an abortion
425	425	19 performed or induced at that facility.
426	426	20 (e) The Attorney General or the district attorney of
427	427	21 the county in which the abortion was performed or induced may
428	428	22 file an action to recover the civil penalty assessed under
429	429	23 this section.
430	430	24 (f) The civil penalty imposed by this section is in
431	431	25 addition to the criminal liability established by the Woman's
432	432	26 Right to Know Act, Chapter 23A of Title 26, Code of Alabama
433	433	27 1975.
434	434	Page 16 1 (g)(1) The Board of Medical Examiners shall revoke
435	435	2 the license of an abortion provider if greater than five
436	436	3 percent of medical records audited at that facility do not
437	437	4 comply with subsections (a) and (b) of Section 12.
438	438	5 (2) The department shall revoke the health center
439	439	6 facility license of an abortion provider if greater than five
440	440	7 percent of medical records audited at that facility do not
441	441	8 comply with subsections (a) and (b) of Section 12.
442	442	9 (h) This section shall become operative 20 months
443	443	10 following the effective date of this act.
444	444	11 Section 14. Records that identify an individual care
445	445	12 agent, pregnant woman, or biological or adoptive parent held
446	446	13 by the department pursuant to this act are not open records
447	447	14 for the purposes of Article 3 of Chapter 12 of Title 36, Code
448	448	15 of Alabama 1975. Those records may be released or made public
449	449	16 as follows:
450	450	17 (1) For statistical purposes, but only if a care
451	451	18 agent, pregnant woman, or biological or adoptive parent is not
452	452	19 identified.
453	453	20 (2) With the consent of each individual identified
454	454	21 in the information released.
455	455	22 (3) To individuals performing or inducing abortions
456	456	23 and to organizations, to the extent necessary to fulfill their
457	457	24 obligations pursuant to this act.
458	458	25 (4) To appropriate state agencies or county and
459	459	26 district courts to enforce this chapter.
460	460	Page 17 1 (5) To appropriate state licensing boards to enforce
461	461	2 state licensing laws.
462	462	3 (6) To licensed medical or health care personnel
463	463	4 currently treating the pregnant woman.
464	464	5 (7) Pursuant to a subpoena issued by a court of
465	465	6 competent jurisdiction, provided the release is made subject
466	466	7 to a confidentiality requirement as determined by that court.
467	467	8 Section 15. This act does not:
468	468	9 (1) Create or recognize a right to abortion.
469	469	10 (2) Create or recognize a right to a particular
470	470	11 method of abortion.
471	471	12 (3) Make lawful an abortion that is currently
472	472	13 unlawful under any law of this state.
473	473	14 Section 16. Nothing in this act shall be interpreted
474	474	15 to violate any speech or conduct rights protected by the First
475	475	16 Amendment of the Constitution of the United States, as made
476	476	17 applicable to the states through interpretations by the
477	477	18 Supreme Court of the United States of the Fourteenth Amendment
478	478	19 of the Constitution of the United States, or by the
479	479	20 Constitution of Alabama of 1901, including the Alabama
480	480	21 Religious Freedom Amendment, Article 1, Section 3.01.
481	481	22 Section 17. The provisions of this act are
482	482	23 severable. If any part of this act is declared invalid or
483	483	24 unconstitutional, that declaration shall not affect the part
484	484	25 which remains.
485	485	Page 18 1 Section 18. This act shall become effective on the
486	486	2 first day of the first month following its passage and
487	487	3 approval by the Governor, or its otherwise becoming law.
488	488	Page 19