HCSHB489--DONOHARMACT
SPONSOR: Baker
COMMITTEEACTION:Voted"DoPasswithHCS"bytheSpecial
CommitteeonGovernmentAccountability byavoteof10to7.
ThefollowingisasummaryoftheHouseCommitteeSubstituteforHB
489.
Nopublicschooldistrictorpubliccharterschoolreceivingpublic
fundsshallrequireforastudent,asaconditionofenrollment,
attendanceofeventoractivity,oranyotherreason,to:
(1)ReceiveaCOVID-19vaccination;
(2)Receiveadoseofmessengerribonucleicacid;
(3)Receiveanytreatmentorprocedureintendedordesignedto
editoralterhumandeoxyribonucleic acidorthehumangenome;or
(4)Haveplacedunderthestudent'sskinanymechanicalor
electronicdevice.
Nopublicbody,politicalsubdivision,publicschooldistrict,
statedepartmentoragency,judgeorjudicialofficer,public
official,peaceofficer,orpersonappointedbytheGovernoracting
inanofficialcapacityshallrequireanypersonto:
(1)ReceiveaCOVID-19vaccination;
(2)Receiveadoseofmessengerribonucleicacid;
(3)Receiveanytreatmentorprocedureintendedordesignedto
editoralterhumandeoxyribonucleic acidorthehumangenome;or
(4)Haveplacedundertheperson'sskinanymechanicalor
electronicdevice;
Orimposeanyfine,tax,orcriminalorcivilpenaltybasedupona
person'sdecisiontoreceiveanyoftheabove.
TheprovisionsofthissectionrelatingtoCOVID-19vaccination
shallnotapplytoanystudenttraininginahealthcarefield
receivingclinicalhoursatafacilityasdescribedinthebilland
publiccollegesoruniversitiesthatrequireCOVID-19vaccination
foremployeesorselectstudentparticipantstoreceivefederal
funds.Additionally,theprovisionsofthissectionshallnot applytocertainfacilities,entities,andindividualsdescribedin
thebill(Section191.230,RSMo).
Studentsshallbeexemptfromapubliccollegeoruniversity
requirement,toreceivemedicaltreatment,asdefinedinthebill,
asaconditionofparticipationinasponsoredactivityifthe
studentsubmitsarequestinwritingthatstates:
(1)Thestudentholdsasincerelyheldreligiousbelief,whichmay
includeanydeeplyheldnontheisticmoralbelief,thatforbidsthe
employeefromreceivingthemedicaltreatmentandreasonable
accommodationwouldnotposeanunduehardship;or
(2)Thestudenthasreceivedwrittenrecommendation froma
physicianadvisingthestudentnottoreceivetherequiredmedical
treatment.
Acourtmaygrantanypersonwhoserightsareviolatedbythis
sectionrelief,includinginjunctiverelief,andreasonable
attorney'sfees(Section292.648).
Thisbillestablishesthe"DoNoHarmAct"andprovidestermsand
definitionsrelatingto"academicstandards","healthcarerelated
academicprograms","medicalinstitutionsofhighereducation"and
"Diversity-Equity-Inclusion"or"DEI"amongothers.
Thebillrequiresmedicalinstitutionsofhighereducationto
submitanannualcertificationbyDecember31sttotheStateBoard
ofRegistrationforHealingArts,withintheDepartmentofCommerce
andInsurance,andthecoordinatingBoardofHigherEducation,
withintheDepartmentofHigherEducation,thattheinstitution
doesnotrequireapplicantsorstudentstosubscribetoDEI
ideologies.
Thisbillrequiresmedicalinstitutionsofhighereducationto
publishtitlesandsyllabiforallmandatorycourses,seminars,
classesandtrainingsonanpubliconlinedatabase,andprohibits
institutionsfromconductingDEIauditsorhiringDEIconsultants.
Thebillrequiresmedicalinstitutionsofhighereducationto
requireapplicantstocompleteastandardizedadmissionstestand
outlinesacademicstandardsforhealthcarerelatedcoursesof
study,asspecifiedinthebill.Ifamedicalinstitutionof
highereducationwantstoalterthestandardsforadmissions,the
newstandardsmustbesubmittedtoeitherchamberoftheGeneral
Assemblyandshallnotbeeffectiveuntilatleast60dayshave
passedduringwhichajointresolutionofdisapprovalmaybe
passedbybothchambersandapprovedbytheGovernortoinvalidate
anysuchsubmittedstandards. Thebillrestrictshealthcare-relatedprofessionallicensing
boardsfromanyhavinganyrequirementsforobtainingorrenewing
licensesbeassociatedwithDEIrelatedmaterialsorprograms.
State-requiredhealthcare-relatedprofessionalcertifications
shallnotuseDEImaterialorrequireDEItrainingaspartofthe
certificationprocess. Suchboardsandorganizationsare
prohibitedfromconductingDEIauditsorhiringDEIconsultants.
Healthcareprovidersandmedicalinstitutionsofhighereducation
areprohibitedfromreceivingstatecontractsorgrantswithout
certifyingthattheproviderorinstitutionwillnotrequire
specifiedindividualsfromsubscribingto,studying,orreceiving
instructiononDEImaterial. Suchprovidersandinstitutionsmust
submitannualcertificationattestingtotheircompliance.
Allstateentitiesapplyingforanyfederalhealthcarerelated
grantrelatingtoDEIshallpublishonapublicwebsiteall
materials,requirements,andinstructionsrelatingtothegrant
applicationalongwithacopyofthegrantproposaltotheState
BoardofRegistrationfortheHealingArtsandtothemembersof
theHouseandSenateCommitteesonHealthPolicy.
Thebillprovidesanyaggrievedpersonacauseofactionforany
violationsofthesesectionstoincludedeclaratoryandinjunctive
relief,damagesofatleast$100,000againstthehealthcare
providerormedicalinstitutionofhighereducationforany
violations,compensatorydamages,andcostsandattorneyfees.
Furtherthebillwaivessovereignimmunityforsuchprovidersand
institutionsforuptoayearafteranyviolation.
Thebillrequireshealthcareproviderswithmorethan50employees
oranymedicalinstitutionofhighereducationtoannuallysubmit
certificationofcompliancetotheStateBoardofRegistrationfor
theHealingArtswithSections191.1770to191.1810,RSMo,and
authorizestheAttorneyGeneraltoinvestigateallegationsof
violations.
TheStateBoardofRegistrationfortheHealingArtsshallpublish
onitswebsiteannuallyalistofallthehealthcareprovidersand
medicalinstitutionsthathaveprovidedannualcertification
(Sections191.1771to191.1810,RSMo).
Thefollowingisasummaryofthepublictestimonyfromthe
committeehearing. Thetestimonywasbasedontheintroduced
versionofthebill.
PROPONENTS: Supporterssaythatdiversityinthemedicalfield
shouldnotbeachievedbysacrificingcompetenceorqualityofwork expectedofmedicalstudents. There'sapernicioustrendtoembed
diversityeducationwithincoreclassesinhealthcareeducationand
thisdistractsmedicalstudentsfromfoundationalsubjectsof
healthcareeducation. Medicalprofessionalsarepowerlessto
addressthemyriadsocialdeterminantsofnegativehealthcare
outcomesexperiencedbydiversegroupssoitmakeslittlesenseto
focusheavilyonthesesubjectsintheireducation. Past
discrimination shouldnotberemediedbypresentdiscrimination;
DEIgoalsinjectpoliticsintohealthcareeducationtothe
detrimentofpatients.
TestifyinginpersonforthebillwereRepresentative Baker;
StanleyGoldfarb,MD,DoNoHarm.
OPPONENTS: Thosewhoopposethebillsaythatitisincumbentupon
themedicalprofessiontoaddresspersistingdisparitiesin
healthcareoutcomesexperiencedbyminoritygroups.Health
professionalsdon'tfullyunderstandallthereasonscertaingroups
haveworseoutcomesthanothers;that'sthereasonit'simportant
tostudyandteachabouttheseproblems. Paritywillneverbe
achievediftheprofessionisunabletoexploretheseissues.
Preventingdiscussionsofthesetopicswillresultinmedical
professionalswhoareinadequatelytrainedtoservediverse
populations. ThereareconcernsthatifinstitutionsinMissouri
implementedthesechangestheywouldbeatriskoflosingfederal
funding.
TestifyinginpersonagainstthebillwereProfessional
CertificationCoalition(PCC);JayDevineni;NationalAssociation
ofSocialWorkers-MoChapter;BarbaraH.Miller,MD,Missouri
AcademyofFamilyPhysicians;UniversityHealth;ProChoice
Missouri;AmericanFederationofTeachers-Missouri;Reach
HealthcareFoundation;AdvocatesofPlannedParenthoodofTheSt.
LouisRegion&SouthwestMissouri;BJCHealthcare;National
AssociationofSocialWorkers-MissouriChapter;KatyErker-Lynch,
Promo;MissouriFamilyHealthCouncil;DanielJackson;Missouri
StateUniversity;MoStateConferenceNAACP;MoSpeechHearing
LanguageAssociation;BJCHealthSystem;UniversityofMissouri
System;ErinNischwitz;HealthForwardFoundation;MissouriCenter
ForPublicHealthExcellance;IndependentCollegesandUniversities
ofMissouri;CouncilonPublicHigherEd;MissouriHospital
Association;TeresaNichols;andJayDevineni,MizzouMedical
Society.
Writtentestimonyhasbeensubmittedforthisbill.Thefull
writtentestimonyandwitnessestestifyingonlinecanbefound
underTestimonyonthebillpageontheHousewebsite.