EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
[Brackets] indicate matter deleted from existing law.
*sb0891*
SENATE BILL 891
J1 2lr2818
By: Senators Carozza, Ready, and Eckardt
Introduced and read first time: February 7, 2022
Assigned to: Finance
A BILL ENTITLED
AN ACT concerning 1
Public Health – Medical Procedures – Parent or Guardian Notice 2
(Maryland Parental Involvement Enhancement Act) 3
FOR the purpose of altering the women on whom a physician is prohibited from performing 4
an abortion without first providing notice to a parent or guardian of the woman; 5
altering the circumstances under which a physician may perform certain medical 6
procedures without first providing notice to a parent or guardian; establishing a 7
process for a certain individual to seek a judicial waiver of the requirement that a 8
parent or guardian be notified of a medical procedure; and generally relating to 9
notice to a parent or guardian and medical procedures. 10
BY repealing and reenacting, with amendments, 11
Article – Health – General 12
Section 20–103 13
Annotated Code of Maryland 14
(2019 Replacement Volume and 2021 Supplement) 15
BY adding to 16
Article – Health – General 17
Section 20–111 18
Annotated Code of Maryland 19
(2019 Replacement Volume and 2021 Supplement) 20
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 21
That the Laws of Maryland read as follows: 22
Article – Health – General 23
20–103. 24
2 SENATE BILL 891
(A) THIS SECTION APPLIES ONLY WITH RESPECT TO A PREGNANT WOMAN 1
WHO IS: 2
(1) A MINOR; OR 3
(2) DISABLED AND HAS HAD A GUARDIAN APPOINTED FOR HER . 4
[(a)] (B) Except as provided in [subsections (b) and (c) of this section] § 20–111 5
OF THIS TITLE, a physician may not perform an abortion on [an unmarried minor] A 6
PREGNANT WOMAN unless the physician first gives notice to a parent or guardian of the 7
[minor] PREGNANT WOMAN . 8
[(b) The physician may perform the abortion without notice to a parent or 9
guardian if: 10
(1) The minor does not live with a parent or guardian; and 11
(2) A reasonable effort to give notice to a parent or guardian is 12
unsuccessful. 13
(c) (1) The physician may perform the abortion, without notice to a parent or 14
guardian of a minor if, in the professional judgment of the physician: 15
(i) Notice to the parent or guardian may lead to physical or 16
emotional abuse of the minor; 17
(ii) The minor is mature and capable of giving informed consent to 18
an abortion; or 19
(iii) Notification would not be in the best interest of the minor. 20
(2) The physician is not liable for civil damages or subject to a criminal 21
penalty for a decision under this subsection not to give notice. 22
(d) The postal receipt that shows an article of mail was sent by certified mail, 23
return receipt requested, bearing a postmark from the United States Postal Service, to the 24
last known address of a parent or guardian and that is attached to a copy of the notice letter 25
that was sent in that article of mail shall be conclusive evidence of notice or a reasonable 26
effort to give notice, as the case may be.] 27
[(e)] (C) A physician may not provide notice to a parent or guardian if the 28
[minor] PREGNANT WOMAN decides not have an abortion. 29
20–111. 30
SENATE BILL 891 3
(A) (1) IF A PHYSICIAN IS REQ UIRED TO PROVIDE NOT ICE TO A PARENT 1
OR GUARDIAN OF AN IN DIVIDUAL BEFORE PERF ORMING A MEDICAL PROCEDURE , 2
THE PHYSICIAN MAY PERFOR M THE MEDICAL PROCEDUR E ON THE INDIVIDUAL 3
WITHOUT NOTICE TO A PARENT OR GUARDIAN IF THE PHYSICIAN OBTAINS : 4
(I) A NOTARIZED WRITTEN ST ATEMENT FROM A PARENT OR 5
GUARDIAN OF THE INDIVIDUAL WAIVING THE PARENT O R GUARDIAN’S RIGHT TO 6
NOTICE OF THE MEDICAL PROCEDURE OF THE INDIVIDUAL, DATED NO MORE THAN 7
30 DAYS BEFORE THE DATE OF THE MEDICAL PROCEDURE ; OR 8
(II) 1. GOVERNMENT –ISSUED PROOF OF IDEN TITY OF THE 9
PARENT OR GUARDIAN OF THE INDIVIDUAL; 10
2. WRITTEN DOCUMENTATION STATING THAT THE 11
PARENT OR GUARDIAN I S THE LAWFUL PARENT OR GUARDIAN OF THE INDIVIDUAL; 12
AND 13
3. A SIGNED STATEMENT FRO M THE PARENT OR 14
GUARDIAN OF THE INDIVIDUAL STATING THAT THE PAR ENT OR GUARDIAN IS A WARE 15
THAT THE MEDICAL PROCEDURE IS TO BE PERFORMED O N THE INDIVIDUAL. 16
(2) THE PHYSICIAN SHALL K EEP A COPY OF ANY DOCUMENTS 17
PROVIDED BY THE INDIVIDUAL UNDER THIS SUBSECTIO N IN THE MEDICAL RECORD 18
OF THE INDIVIDUAL FOR AT LEAST 5 YEARS AFTER THE DATE ON WHICH THE 19
INDIVIDUAL REACHES THE AGE OF 18 YEARS OR 7 YEARS AFTER THE DATE OF THE 20
MEDICAL PROCEDURE , WHICHEVER IS LATER . 21
(3) A PHYSICIAN WHO RECEIV ES PARENTAL NOTICE U NDER 22
PARAGRAPH (1)(II) OF THIS SUBSECTION S HALL EXECUTE AND INC LUDE IN THE 23
MEDICAL RECORD OF TH E INDIVIDUAL AN AFFIDAVIT STATING : 24
“I, ______________, CERTIFY THAT ACCORDI NG TO MY BEST INFORM ATION AND 25
BELIEF, A REASONABLE PERSON UNDER SIMILAR CIRCUM STANCES WOULD RELY O N 26
THE INFORMATION PRES ENTED BY BOTH THE INDIVIDUAL AND THE INDIVIDUAL ’S 27
PARENT OR G UARDIAN AS SUFFICIEN T EVIDENCE OF IDENTI TY AND 28
RELATIONSHIP .”. 29
(B) (1) IF A PHYSICIAN IS REQ UIRED TO PROVIDE NOT ICE TO THE PARENT 30
OR GUARDIAN OF AN IN DIVIDUAL BEFORE PERF ORMING A MEDICAL PRO CEDURE, A 31
PHYSICIAN MAY PERFOR M THE MEDICAL PROCEDUR E ON THE INDIVIDUAL WITHOUT 32
PROVIDING PRIOR NOTI CE TO THE PARENT OR GUARDIAN OF THE INDIVIDUAL IF 33
THE PHYSICIAN CERTIF IES IN A DOCUMENT MA INTAINED IN THE MEDI CAL RECORD 34
OF THE INDIVIDUAL THAT A MEDICAL EMERGENCY EXISTS AND THERE IS 35 4 SENATE BILL 891
INSUFFICIENT TIME TO PROVIDE THE NOTICE. 1
(2) EXCEPT AS PROVIDED IN PARAGRAPH (3) OF THIS SUBSECTION, IF 2
THE PHYSICIAN PERFOR MS A MEDICAL PROCEDURE ON AN INDIVIDUAL UNDER 3
PARAGRAPH (1) OF THIS SUBSECTION , THE PHYSICIAN SHALL NOTIFY THE PARENT 4
OR GUARDIAN OF THE INDIVIDUAL WITHIN 24 HOURS AFTER THE PROCEDURE , 5
VERBALLY AND THROUGH CERTIFIED MAIL TO THE LAST KNOWN AD DRESS OF THE 6
PARENT OR GUARDIAN , SENT WITH RESTRICTED DELI VERY AND RETURN RECE IPT 7
REQUESTED : 8
(I) THAT A MEDICAL PROCEDURE WAS PERFORMED ON THE 9
INDIVIDUAL DUE TO A MEDICAL EMERGEN CY; 10
(II) OF THE NATURE OF THE MEDICAL PROCEDURE ; 11
(III) OF THE CIRCUMSTANCES OF THE MEDICAL EMERGENCY ; 12
AND 13
(IV) OF ANY ADDITIONAL RISKS TO THE INDIVIDUAL. 14
(3) (I) IF AN INDIVIDUAL GIVES NOTICE TO A PHYSICIAN OF THE 15
INDIVIDUAL’S INTENT TO SEEK A JUD ICIAL WAIVER UNDER S UBSECTION (C) OF THIS 16
SECTION FOLLOWING A MEDICAL PROCEDURE PERFORMED UNDER PARA GRAPH (1) 17
OF THIS SUBSECTION, THE PHYSICIAN: 18
1. MAY NOT NOTIFY THE PA RENT OR GUARDIAN OF THE 19
MEDICAL PROCEDURE BEFORE: 20
A. THE TIME FOR WHICH A N INDIVIDUAL MAY FILE A 21
PETITION EXPIRES ; OR 22
B. THE COURT MAKES A RULING REGARDING THE 23
JUDICIAL WAIVER ; AND 24
2. SHALL FILE A NOTICE W ITH THE CIRCUIT COUR T IN 25
THE JURISDICTION IN WHICH THE MEDICAL PROCEDURE WAS PERFORMED STATIN G: 26
A. THAT THE INDIVIDUAL HAS INDICATED THE 27
INDIVIDUAL’S INTENT TO SEEK A JUD ICIAL WAIVER UNDER SUBSECTION (C) OF THIS 28
SECTION; AND 29
B. THAT A MEDICAL PROCEDURE WAS PERFORMED ON 30
THE INDIVIDUAL DUE TO A MEDICAL EME RGENCY, THE NATURE OF THE 31 SENATE BILL 891 5
PROCEDURE , THE CIRCUMSTANCES OF THE EMERGENCY , AND ANY ADDITIONAL 1
RISKS TO THE INDIVIDUAL WITHIN 24 HOURS AFTER THE PROCEDURE . 2
(II) IF A COURT RECEIVES N OTICE UNDER SUBPARAG RAPH (I) 3
OF THIS PARAGRAPH , THE COURT SHALL PROM PTLY SCHEDULE A CONFIDENTIAL 4
CONFERENCE REGARDING THE NOTICE AND PROVIDE NOTICE O F THE CONFERENCE 5
TO THE PHYSICIAN AND THE INDIVIDUAL. 6
(III) IF THE INDIVIDUAL IS ABLE TO PARTICIPA TE IN THE 7
CONFERENCE , THE COURT SHALL : 8
1. ADVISE THE INDIVIDUAL THAT THE INDIVIDU AL HAS 9
THE RIGHT TO COURT –APPOINTED COUNSEL ; AND 10
2. ON THE INDIVIDUAL’S REQUEST , PROVIDE THE 11
INDIVIDUAL WITH COUNSEL . 12
(IV) IF THE INDIVIDUAL IS UNABLE TO PARTICI PATE IN THE 13
CONFERENCE , THE COURT SHALL APPO INT COUNSEL ON BEHAL F OF THE 14
INDIVIDUAL. 15
(V) AFTER THE CONFIDENTIA L CONFERENCE REGARDI NG THE 16
NOTICE AND TAKING IN TO ACCOUNT THE MEDIC AL CONDITION OF THE INDIVIDUAL, 17
THE COURT SHALL SET A DEADLINE BY WHICH THE INDIVIDUAL MUST FILE A 18
PETITION UNDER SUBSE CTION (C) OF THIS SECTION. 19
(VI) THE COURT MAY EXTEND THE DEA DLINE FOR FILING A 20
PETITION UNDER SUBSE CTION (C) OF THIS SECTION BASED ON THE MEDICAL 21
CONDITION OF THE INDIVIDUAL. 22
(VII) IF THE INDIVIDUAL DOES NOT FILE A PETI TION OR MOTION 23
BY THE DEADLINE SET BY THE COURT, THE COURT SHALL DIRE CT THAT THE COURT 24
CLERK PROVIDE THE NO TICE FILED UNDER SUB PARAGRAPH (I) OF THIS 25
PARAGRAPH TO THE PARENT OR GUARDIAN OF THE INDIVIDUAL. 26
(C) (1) AN INDIVIDUAL MAY FILE A PETITION WITH THE CIRCUIT COU RT 27
FOR THE COUNTY WHERE THE INDIVIDUAL RESIDES OR WHERE THE PHYSICIAN’S 28
OFFICE IS LOCATED TO SEEK AN ORDER WAIVIN G THE REQUIREMENT TO PROVIDE 29
NOTICE TO A PARENT OR GUARDIAN OF THE INDIVIDUAL. 30
(2) (I) A COURT SHALL ISSUE AN ORDER AUTHORIZING TH E 31
INDIVIDUAL TO CONSENT TO A MEDICAL PROCEDURE WITHOUT THE NOTIFICA TION 32
OF A PARENT OR GUARDIAN OF THE INDIVIDUAL IF THE COURT FINDS , BY CLEAR 33 6 SENATE BILL 891
AND CONVINCING EVIDE NCE, THAT: 1
1. THE INDIVIDUAL IS SUFFICIENTLY MATU RE AND 2
WELL–INFORMED ENOUGH TO D ECIDE WHETHER TO HAV E THE MEDICAL 3
PROCEDURE ; 4
2. THE INDIVIDUAL IS A VICTIM OF PHYSI CAL OR 5
SEXUAL ABUSE BY A PA RENT OR GUARDIAN ; OR 6
3. THAT PROVIDING NOTIFI CATION TO A PARENT O R 7
GUARDIAN WOULD NOT B E IN THE BEST INTERE ST OF THE INDIVIDUAL. 8
(II) IF THE INDIVIDUAL CLAIMS TO BE SUFFICI ENTLY MATURE 9
AND WELL–INFORMED TO DECIDE W HETHER TO HAVE THE MEDICAL PROCEDURE , 10
THE INDIVIDUAL SHALL PROVIDE CLEAR AND CONVINCING EVIDE NCE THAT THE 11
INDIVIDUAL IS SUFFICIENTLY MATU RE AND CAPABLE OF GI VING INFORMED 12
CONSENT WITHOUT GIVI NG NOTICE TO THE INDIVIDUAL ’S PARENT OR GUARDIAN 13
BASED ON THE INDIVIDUAL ’S EXPERIENCE LEVEL , PERSPECTIVE, AND JUDGMENT . 14
(III) IN DETERMINING WHETHE R AN INDIVIDUAL IS 15
SUFFICIENTLY MATURE AND WELL–INFORMED ENOUGH TO D ECIDE WHETHER TO 16
HAVE THE PROCEDURE , THE COURT MAY CONSIDER : 17
1. THE AGE OF THE INDIVIDUAL; 18
2. THE EXPERIENCES OF THE INDIVIDUAL WORKING, 19
LIVING OUTSIDE THE H OME, TRAVELING ON THE INDIVIDUAL ’S OWN, HANDLING 20
PERSONAL FINANCES , OR MAKING OTHER SIGN IFICANT DECISIONS ; AND 21
3. THE INTELLECTUAL ABIL ITY OF THE INDIVIDUAL TO 22
UNDERSTAND THE INDIVIDUAL ’S OPTIONS AND MAKE AN INFORMED DECISION . 23
(IV) IN DETERMINING WHETHE R PROVIDING NOTIFICA TION TO 24
A PARENT OR GUARDIAN OF THE INDIVIDUAL IS NOT IN THE BEST INTEREST OF THE 25
INDIVIDUAL, THE COURT MAY NOT CO NSIDER THE POTENTIAL FINANCIAL IMPACT 26
ON THE INDIVIDUAL OR THE FAMILY OF THE INDIVIDUAL IF THE INDIVIDUAL DOES 27
NOT HAVE THE MEDICAL PROCEDURE . 28
(3) (I) BEFORE ISSUING A RULING ON A PETITION FILED UND ER 29
THIS SUBSECTION, A COURT MAY ORDER THE INDIVIDUAL TO PARTICIPATE IN AN 30
EVALUATION AND COUNS ELING SESSION, WHICH SHALL BE PROMP TLY SCHEDULED 31
WITH A MENTAL HEALTH PROFESSIONAL FROM TH E DEPARTMENT OR THE 32
DEPARTMENT OF HUMAN SERVICES. 33 SENATE BILL 891 7
(II) THE PURPOSE OF AN EVA LUATION AND COUNSELI NG 1
SESSION IS TO DEVELOP AN EXPERT OPINION ON: 2
1. THE SUFFICIENCY OF KN OWLEDGE, INSIGHT, 3
JUDGMENT, AND MATURITY OF THE INDIVIDUAL WITH REGARD TO THE 4
INDIVIDUAL’S DECISION TO HAVE THE MEDICAL PROCEDURE ; AND 5
2. WHETHER THE INDIVIDUAL IS SEEKING THE MEDICAL 6
PROCEDURE OF THE INDIVIDUAL ’S OWN FREE WILL AND NO T ACTING UNDER 7
COERCION, INTIMIDATION, THREATS, ABUSE, UNDUE PRESSURE , OR EXTORTION . 8
(III) THE RESULTS OF AN EVA LUATION AND COUNSELI NG 9
SESSION UNDER THIS PARAGRAPH SHALL BE REPORTED TO THE COUR T 10
EXPEDITIOUSLY IN A C ONFIDENTIAL AND SECU RE MANNER TO ENSURE RECEIPT BY 11
THE COURT BEFORE A HEARING ON THE PET ITION. 12
(4) ANY PROCEEDINGS , EVALUATION, OR COUNSELING SESSION 13
HELD UNDER THIS SUBS ECTION SHALL BE CONF IDENTIAL. 14
(5) IF A COURT DOES NOT ISSUE AN ORDER UNDER PARAGRAPH (2)(I) 15
OF THIS SUBSECTION , THE COURT SHALL DISM ISS THE PETITION. 16
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect 17
October 1, 2022. 18