First Regular Session 117th General Assembly (2011)
PRINTING CODE. Amendments: Whenever an existing statute (or a section of the Indiana
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HOUSE ENROLLED ACT No. 1210
AN ACT to amend the Indiana Code concerning health.
Be it enacted by the General Assembly of the State of Indiana:
SOURCE: IC 5-22-17-5.5; (11)HE1210.1.1. -->
SECTION 1. IC 5-22-17-5.5 IS ADDED TO THE INDIANA CODE
AS A
NEW SECTION TO READ AS FOLLOWS [EFFECTIVE
UPON PASSAGE]:
Sec. 5.5. (a) This section does not apply to
hospitals licensed under IC 16-21-2 or ambulatory surgical centers
licensed under IC 16-21-2.
(b) An agency of the state may not:
(1) enter into a contract with; or
(2) make a grant to;
any entity that performs abortions or maintains or operates a
facility where abortions are performed that involves the
expenditure of state funds or federal funds administered by the
state.
(c) Any appropriation by the state:
(1) in a budget bill;
(2) under IC 5-19-1-3.5; or
(3) in any other law of the state;
to pay for a contract with or grant made to any entity that
performs abortions or maintains or operates a facility where
abortions are performed is canceled, and the money appropriated
is not available for payment of any contract with or grant made to
the entity that performs abortions or maintains or operates a
facility where abortions are performed.
(d) For any contract with or grant made to an entity that
performs abortions or maintains or operates a facility where
abortions are performed covered under subsection (b), the budget
agency shall make a determination that funds are not available,
and the contract or grant shall be terminated under section 5 of
this chapter.
SOURCE: IC 16-18-2-128.3; (11)HE1210.1.2. -->
SECTION 2. IC 16-18-2-128.3 IS ADDED TO THE INDIANA
CODE AS A NEW SECTION TO READ AS FOLLOWS
[EFFECTIVE JULY 1, 2011]: Sec. 128.3. "Fertilization", for
purposes of IC 16-34, means the fusion of a human spermatozoon
with a human ovum.
SOURCE: IC 16-18-2-254.2; (11)HE1210.1.3. -->
SECTION 3. IC 16-18-2-254.2 IS ADDED TO THE INDIANA
CODE AS A NEW SECTION TO READ AS FOLLOWS
[EFFECTIVE JULY 1, 2011]: Sec. 254.2. "Objective scientific
information", for purposes of IC 16-34, means data that have been
reasonably derived from scientific literature and verified or
supported by research in compliance with scientific methods.
SOURCE: IC 16-18-2-287.5; (11)HE1210.1.4. -->
SECTION 4. IC 16-18-2-287.5 IS ADDED TO THE INDIANA
CODE AS A NEW SECTION TO READ AS FOLLOWS
[EFFECTIVE JULY 1, 2011]: Sec. 287.5. "Postfertilization age", for
purposes of IC 16-34, means the age of the fetus calculated from
the date of the fertilization of the ovum.
SOURCE: IC 16-34-1-8; (11)HE1210.1.5. -->
SECTION 5. IC 16-34-1-8 IS ADDED TO THE INDIANA CODE
AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
1, 2011]: Sec. 8. A qualified health plan (as defined in IC 27-8-33-3)
offered under Subtitle D of Title 1 of the federal Patient Protection
and Affordable Care Act (P.L. 111-148) may not provide coverage
for abortion, except in the following cases:
(1) The pregnant woman became pregnant through an act of
rape or incest.
(2) An abortion is necessary to avert the pregnant woman's
death or a substantial and irreversible impairment of a major
bodily function of the pregnant woman.
SOURCE: IC 16-34-1-9; (11)HE1210.1.6. -->
SECTION 6. IC 16-34-1-9 IS ADDED TO THE INDIANA CODE
AS A
NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
1, 2011]:
Sec. 9. (a) The general assembly finds the following:
(1) There is substantial medical evidence that a fetus at twenty
(20) weeks of postfertilization age has the physical structures
necessary to experience pain.
(2) There is substantial medical evidence that a fetus of at
least twenty (20) weeks of postfertilization age seeks to evade
certain stimuli in a manner similar to an infant's or adult's
response to pain.
(3) Anesthesia is routinely administered to a fetus of at least
twenty (20) weeks of postfertilization age when prenatal
surgery is performed.
(4) A fetus has been observed to exhibit hormonal stress
responses to painful stimuli earlier than at twenty (20) weeks
of postfertilization age.
(b) Indiana asserts a compelling state interest in protecting the
life of a fetus from the state at which substantial medical evidence
indicates that the fetus is capable of feeling pain.
SOURCE: IC 16-34-2-0.5; (11)HE1210.1.7. -->
SECTION 7. IC 16-34-2-0.5 IS ADDED TO THE INDIANA CODE
AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
1, 2011]: Sec 0.5. A medical emergency, for purposes of this
chapter, does not include a patient's claim or diagnosis that the
patient would engage in conduct that would result in the patient's
death or substantial physical impairment. Under the circumstances
described in this section and unless the following would pose a
great risk of death or substantial physical impairment of the
patient, the physician shall terminate the patient's pregnancy in a
manner that, in a physician's reasonable medical judgment, would
result in the best opportunity for the fetus to survive.
SOURCE: IC 16-34-2-1; (11)HE1210.1.8. -->
SECTION 8. IC 16-34-2-1 IS AMENDED TO READ AS
FOLLOWS [EFFECTIVE JULY 1, 2011]: Sec. 1. (a) Abortion shall in
all instances be a criminal act, except when performed under the
following circumstances:
(1) During the first trimester of pregnancy for reasons based upon
the professional, medical judgment of the pregnant woman's
physician if:
(A) the abortion is performed by the physician;
(B) the woman submitting to the abortion has filed her consent
with her physician. However, if in the judgment of the
physician the abortion is necessary to preserve the life of the
woman, her consent is not required; and
(C) the woman submitting to the abortion has filed with her
physician the written consent of her parent or legal guardian
if required under section 4 of this chapter.
(2) After the first trimester of pregnancy and before
the earlier of
viability
of the fetus or twenty (20) weeks of postfertilization
age, for reasons based upon the professional, medical judgment
of the pregnant woman's physician if:
(A) all the circumstances and provisions required for legal
abortion during the first trimester are present and adhered to;
and
(B) the abortion is performed in a hospital or ambulatory
outpatient surgical center (as defined in IC 16-18-2-14).
(3) Except as provided in subsection (b), at the earlier of
viability of the fetus or twenty (20) weeks of postfertilization
age and any time after, viability of the fetus, for reasons based
upon the professional, medical judgment of the pregnant woman's
physician if:
(A) all the circumstances and provisions required for legal
abortion before the earlier of viability of the fetus or twenty
(20) weeks of postfertilization age are present and adhered
to;
(B) the abortion is performed in compliance with section 3 of
this chapter; and
(C) before the abortion the attending physician shall certify in
writing to the hospital in which the abortion is to be
performed, that in the attending physician's professional,
medical judgment, after proper examination and review of the
woman's history, the abortion is necessary to prevent a
substantial permanent impairment of the life or physical health
of the pregnant woman. All facts and reasons supporting the
certification shall be set forth by the physician in writing and
attached to the certificate.
(b) A person may not knowingly or intentionally perform a partial
birth abortion unless a physician reasonably believes that:
(1) performing the partial birth abortion is necessary to save the
mother's life; and
(2) no other medical procedure is sufficient to save the mother's
life.
SOURCE: IC 16-34-2-1.1; (11)HE1210.1.9. -->
SECTION 9. IC 16-34-2-1.1, AS AMENDED BY P.L.44-2009,
SECTION 32, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
JULY 1, 2011]: Sec. 1.1. (a) An abortion shall not be performed except
with the voluntary and informed consent of the pregnant 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 the
following conditions are met:
(1) At least eighteen (18) hours before the abortion and in the
presence of the pregnant woman, the physician who is to perform
the abortion, the referring physician or a physician assistant (as
defined in IC 25-27.5-2-10), an advanced practice nurse (as
defined in IC 25-23-1-1(b)), or a midwife (as defined in
IC 34-18-2-19) to whom the responsibility has been delegated by
the physician who is to perform the abortion or the referring
physician has orally informed the pregnant woman orally and in
writing of the following:
(A) The name of the physician performing the abortion, the
physician's medical license number, and an emergency
telephone number where the physician or the physician's
designee may be contacted on a twenty-four (24) hour a
day, seven (7) day a week basis.
(B) That follow-up care by the physician or the physician's
designee (if the designee is licensed under IC 25-22.5) and
is available on an appropriate and timely basis when
clinically necessary.
(B) (C) The nature of the proposed procedure. or treatment.
(C) (D) The Objective scientific information of the risks of
and alternatives to the procedure, or treatment. including:
(i) the risk of infection and hemorrhage;
(ii) the potential danger to a subsequent pregnancy; and
(iii) the potential danger of infertility.
(E) That human physical life begins when a human ovum
is fertilized by a human sperm.
(D) (F) The probable gestational age of the fetus at the time
the abortion is to be performed, including: an offer to
provide:
(i) a picture or drawing of a fetus;
(ii) the dimensions of a fetus; and
(iii) relevant information on the potential survival of an
unborn fetus;
at this stage of development.
(G) That objective scientific information shows that a fetus
can feel pain at or before twenty (20) weeks of
postfertilization age.
(E) (H) The medical risks associated with carrying the fetus to
term.
(F) (I) The availability of fetal ultrasound imaging and
auscultation of fetal heart tone services to enable the pregnant
woman to view the image and hear the heartbeat of the fetus
and how to obtain access to these services.
(J) That the pregnancy of a child less than fifteen (15)
years of age may constitute child abuse under Indiana law
if the act included an adult and must be reported to the
department of child services or the local law enforcement
agency under IC 31-33-5.
(2) At least eighteen (18) hours before the abortion, the pregnant
woman will be orally informed orally and in writing of the
following:
(A) That medical assistance benefits may be available for
prenatal care, childbirth, and neonatal care from the county
office of the division of family resources.
(B) That the father of the unborn fetus is legally required to
assist in the support of the child. In the case of rape, the
information required under this clause may be omitted.
(C) That adoption alternatives are available and that adoptive
parents may legally pay the costs of prenatal care, childbirth,
and neonatal care.
(D) That there are physical risks to the pregnant woman in
having an abortion, both during the abortion procedure
and after.
(E) That Indiana has enacted the safe haven law under
IC 31-34-2.5.
(F) The:
(i) Internet web site address of the state department of
health's web site; and
(ii) description of the information that will be provided
on the web site and that are;
described in section 1.5 of this chapter.
(3) The pregnant woman certifies in writing, before the abortion
is performed, that:
(A) the information required by subdivisions (1) and (2) has
been provided to the pregnant woman;
(B) the pregnant woman has been offered the opportunity
to view the fetal ultrasound imaging and hear the
auscultation of the fetal heart tone if the fetal heart tone is
audible and that the woman has:
(i) viewed or refused to view the offered fetal ultrasound
imaging; and
(ii) listened to or refused to listen to the offered
auscultation of the fetal heart tone if the fetal heart tone
is audible; and
(C) the pregnant woman has been given a written copy of
the printed materials described in section 1.5 of this
chapter.
(b) Before an abortion is performed, the pregnant woman may, upon
the pregnant woman's request, shall view the fetal ultrasound imaging
and hear the auscultation of the fetal heart tone if the fetal heart tone is
audible unless the pregnant woman certifies in writing, before the
abortion is performed, that the pregnant woman does not want to
view the fetal ultrasound imaging.
SOURCE: IC 16-34-2-1.5; (11)HE1210.1.10. -->
SECTION 10. IC 16-34-2-1.5 IS ADDED TO THE INDIANA
CODE AS A NEW SECTION TO READ AS FOLLOWS
[EFFECTIVE JULY 1, 2011]: Sec. 1.5. (a) The state department
shall post Internet web site links concerning materials described in
this section on the state department's Internet web site.
(b) The state department shall post Internet web site links
relating to materials that include the following:
(1) Objective scientific information concerning the probable
anatomical and physiological characteristics of a fetus every
two (2) weeks of gestational age, including the following:
(A) Realistic pictures in color for each age of the fetus,
including the dimensions of the fetus.
(B) Whether there is any possibility of the fetus surviving
outside the womb.
(2) Objective scientific information concerning the medical
risks associated with each abortion procedure, including the
following:
(A) The risks of infection and hemorrhaging.
(B) The potential danger:
(i) to a subsequent pregnancy; or
(ii) of infertility.
(3) Information concerning the medical risks associated with
carrying the child to term.
(4) Information that medical assistance benefits may be
available for prenatal care, childbirth, and neonatal care.
(5) Information that the biological father is liable for
assistance in support of the child, regardless of whether the
biological father has offered to pay for an abortion.
(6) Information regarding telephone 211 dialing code services
for accessing human services as described in IC 8-1-19.5, and
the types of services that are available through this service.
(c) In complying with subsection (b)(6), the state department
shall consult with the recognized 211 service providers and the
Indiana utility regulatory commission as required by IC 8-1-19.5-9.
SOURCE: IC 16-34-2-2; (11)HE1210.1.11. -->
SECTION 11. IC 16-34-2-2 IS AMENDED TO READ AS
FOLLOWS [EFFECTIVE JULY 1, 2011]: Sec. 2.
(a) It shall be the
responsibility of the attending physician to do the following:
(1) Determine in accordance with accepted medical standards
the
postfertilization age of the fetus and which trimester the
pregnant woman receiving the abortion is in.
(2) Determine whether the fetus is viable.
(3) Certify that determination as part of any written reports
required of the attending physician by the state department or the
facility in which the abortion is performed.
(b) In making a determination under this section of the
postfertilization age of the fetus, the attending physician shall do
the following:
(1) Question the patient concerning the date of fertilization.
(2) Perform or cause to be performed medical examinations
and tests that a reasonably prudent physician would conduct
to accurately diagnose the postfertilization age of the fetus.
(c) Except in the case of a medical emergency (as described in
section 0.5 of this chapter), a physician that violates this section is
subject to disciplinary action under IC 25-1-9.
SOURCE: IC 16-34-2-3; (11)HE1210.1.12. -->
SECTION 12. IC 16-34-2-3, AS AMENDED BY P.L.146-2008,
SECTION 445, IS AMENDED TO READ AS FOLLOWS
[EFFECTIVE JULY 1, 2011]: Sec. 3. (a) All abortions performed
after
on and after the earlier of the time a fetus is viable
or the time the
postfertilization age of the fetus is at least twenty (20) weeks shall
be:
(1) governed by section 1(a)(3) and 1(b) of this chapter;
(2) performed in a hospital having premature birth intensive care
units, unless compliance with this requirement would result in an
increased risk to the life or health of the mother; and
(3) performed in the presence of a second physician as provided
in subsection (b).
(b) An abortion may be performed after
the earlier of the time a
fetus is viable
or the time the postfertilization age of the fetus is at
least twenty (20) weeks only if there is in attendance a physician,
other than the physician performing the abortion, who shall take control
of and provide immediate care for a child born alive as a result of the
abortion. During the performance of the abortion, the physician
performing the abortion, and after the abortion, the physician required
by this subsection to be in attendance, shall take all reasonable steps in
keeping with good medical practice, consistent with the procedure
used, to preserve the life and health of the viable unborn child.
However, this subsection does not apply if compliance would result in
an increased risk to the life or health of the mother.
(c) Any fetus born alive shall be treated as a person under the law,
and a birth certificate shall be issued certifying the child's birth even
though the child may subsequently die, in which event a death
certificate shall be issued. Failure to take all reasonable steps, in
keeping with good medical practice, to preserve the life and health of
the live born person shall subject the responsible persons to Indiana
laws governing homicide, manslaughter, and civil liability for wrongful
death and medical malpractice.
(d) If, before the abortion, the mother, and if married, her husband,
has or have stated in writing that she does or they do not wish to keep
the child in the event that the abortion results in a live birth, and this
writing is not retracted before the abortion, the child, if born alive, shall
immediately upon birth become a ward of the department of child
services.
SOURCE: IC 16-34-2-4; (11)HE1210.1.13. -->
SECTION 13. IC 16-34-2-4 IS AMENDED TO READ AS
FOLLOWS [EFFECTIVE JULY 1, 2011]: Sec. 4. (a) No physician
shall perform an abortion on an unemancipated pregnant woman less
than eighteen (18) years of age without first having obtained the written
consent of one (1) of the parents or the legal guardian of the minor
pregnant woman.
(b) A minor:
(1) who objects to having to obtain the written consent of her
parent or legal guardian under this section; or
(2) whose parent or legal guardian refuses to consent to an
abortion;
may petition, on her own behalf or by next friend, the juvenile court
in
the county in which the pregnant woman resides or in which the
abortion is to be performed, for a waiver of the parental consent
requirement under subsection (a).
A next friend may not be a
physician or provider of abortion services, representative of the
physician or provider, or other person that may receive a direct
financial benefit from the performance of an abortion.
(c) A physician who feels that compliance with the parental consent
requirement in subsection (a) would have an adverse effect on the
welfare of the pregnant minor or on her pregnancy may petition the
juvenile court within twenty-four (24) hours of the abortion request for
a waiver of the parental consent requirement under subsection (a).
(d) The juvenile court must rule on a petition filed by a pregnant
minor under subsection (b) or by her physician under subsection (c)
within forty-eight (48) hours of the filing of the petition. Before ruling
on the petition, the court shall consider the concerns expressed by the
pregnant minor and her physician. The requirement of parental consent
under this section shall be waived by the juvenile court if the court
finds that the minor is mature enough to make the abortion decision
independently or that an abortion would be in the minor's best interests.
(e) Unless the juvenile court finds that the pregnant minor is already
represented by an attorney, the juvenile court shall appoint an attorney
to represent the pregnant minor in a waiver proceeding brought by the
minor under subsection (b) and on any appeals. The cost of legal
representation appointed for the minor under this section shall be paid
by the county.
(f) A minor or her physician who desires to appeal an adverse
judgment of the juvenile court in a waiver proceeding under subsection
(b) or (c) is entitled to an expedited appeal, under rules to be adopted
by the supreme court.
(g) All records of the juvenile court and of the supreme court or the
court of appeals that are made as a result of proceedings conducted
under this section are confidential.
(h) A minor who initiates legal proceedings under this section is
exempt from the payment of filing fees.
(i) This section shall not apply where there is an emergency need for
a medical procedure to be performed such that continuation of the
pregnancy provides an immediate threat and grave risk to the life or
health of the pregnant woman and the attending physician so certifies
in writing.
SOURCE: IC 16-34-2-4.5; (11)HE1210.1.14. -->
SECTION 14. IC 16-34-2-4.5 IS ADDED TO THE INDIANA
CODE AS A NEW SECTION TO READ AS FOLLOWS
[EFFECTIVE JULY 1, 2011]: Sec. 4.5. (a) A physician may not
perform an abortion unless the physician:
(1) has admitting privileges at a hospital located in the county
where abortions are provided or a contiguous county; or
(2) has entered into an agreement with a physician who has
admitting privileges at a hospital in the county or contiguous
county concerning the management of possible complications
of the services provided.
(b) A physician who performs an abortion shall notify the
patient of the location of the hospital at which the physician or a
physician with whom the physician has entered into an agreement
under subsection (a)(2) has admitting privileges and where the
patient may receive follow-up care by the physician if
complications arise.
SOURCE: IC 16-34-2-5; (11)HE1210.1.15. -->
SECTION 15. IC 16-34-2-5 IS AMENDED TO READ AS
FOLLOWS [EFFECTIVE JULY 1, 2011]: Sec. 5. (a) Every medical
facility where abortions may be performed shall be supplied with forms
drafted by the state department, the purpose and function of which shall
be the improvement of maternal health and life through the compilation
of relevant maternal life and health factors and data, and a further
purpose and function shall be to monitor all abortions performed in
Indiana to assure the abortions are done only under the authorized
provisions of the law. Such forms shall include, among other things, the
following:
(1) The age of the woman who is aborted.
(2) The place where the abortion is performed.
(3) The full name and address of the physicians performing the
abortion.
(4) The name of the father if known.
(5) The postfertilization age of the fetus, the manner in which
the postfertilization age was determined, and if after the
earlier of the time the fetus obtains viability or the time the
postfertilization age of the fetus is at least twenty (20) weeks,
the medical reason for the abortion.
(6) The medical procedure employed to administer the abortion,
and if the medical procedure performed on a fetus who is
viable or has a postfertilization age of at least twenty (20)
weeks:
(A) whether the method of abortion used was a method,
that in the reasonable judgment of a physician, would
provide the best opportunity for the fetus to survive; and
(B) the basis for the determination that the pregnant
woman had a condition described in this chapter that
required the abortion to avert the death of or serious
impairment to the pregnant woman.
(7) The mother's obstetrical history, including dates of other
abortions, if any.
(8) The results of pathological examinations if performed.
(9) Information as to whether the fetus was delivered alive.
(10) Records of all maternal deaths occurring within the health
facility where the abortion was performed.
(b) The form provided for in subsection (a) shall be completed by
the physician performing the abortion and shall be transmitted to the
state department not later than July 30 for each abortion performed in
the first six (6) months of that year and not later than January 30 for
each abortion performed for the last six (6) months of the preceding
year. Each failure to file the form on time as required is a Class B
misdemeanor.
(c) Not later than June 30 of each year, the state department
shall compile a public report providing the following:
(1) Statistics for the previous calendar year from the
information submitted under this section.
(2) Statistics for previous calendar years compiled by the state
department under this subsection, with updated information
for the calendar year that was submitted to the state
department after the compilation of the statistics.
The state department shall ensure that no identifying information
of a pregnant woman is contained in the report.
SOURCE: IC 27-8-33; (11)HE1210.1.16. -->
SECTION 16. IC 27-8-33 IS ADDED TO THE INDIANA CODE
AS A NEW CHAPTER TO READ AS FOLLOWS [EFFECTIVE
JULY 1, 2011]:
Chapter 33. Health Care Exchanges and Abortion
Sec. 1. As used in this chapter, "abortion" means the
termination of human pregnancy with an intention other than to
produce a live birth or to remove a dead fetus.
Sec. 2. As used in this chapter, "federal Patient Protection and
Affordable Care Act" includes amendments made by the federal
Health Care and Education Reconciliation Act of 2010 (P.L.
111-152).
Sec. 3. As used in this chapter, "qualified health plan" has the
meaning set forth in Section 1301 of the federal Patient Protection
and Affordable Care Act (P.L. 111-148).
Sec. 4. A qualified health plan offered under Subtitle D of Title
1 of the federal Patient Protection and Affordable Care Act may
not provide coverage for abortion, except in the following cases:
(1) The pregnant woman became pregnant through an act of
rape or incest.
(2) An abortion is necessary to avert the pregnant woman's
death or a substantial and irreversible impairment of a major
bodily function of the pregnant woman.
SOURCE: ; (11)HE1210.1.17. -->
SECTION 17.
An emergency is declared for this act.
HEA 1210 _ Concur
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