Bill Text: MI HB6076 | 2025-2026 | 103rd Legislature | Introduced
Bill Title: Health facilities: other; licensure of freestanding abortion clinics; require. Amends secs. 20104, 20106 & 20161 of 1978 PA 368 (MCL 333.20104 et seq.); adds pt 207A & sec. 22224d.
Sponsorship: Partisan Bill (Republican 10)
Status: (Introduced) 2026-06-16 - Bill Electronically Reproduced 06/11/2026 [HB6076 Detail]
Download: Michigan-2025-HB6076-Introduced.html
HOUSE BILL NO. 6076
A bill to amend 1978 PA 368, entitled
"Public health code,"
by amending sections 20104, 20106, and 20161 (MCL 333.20104, 333.20106, and 333.20161), as amended by 2024 PA 252, and by adding part 207A and section 22224d.
the people of the state of michigan enact:
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Sec. 20104. (1) Except as otherwise provided in part 221, "certification" means the issuance of a document by the department to a health facility or agency attesting to the fact that the
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health facility or agency meets both of the following:
(a) It complies with applicable statutory and regulatory requirements and standards.
(b) It is eligible to participate as a provider of care and services in a specific federal or state health program.
(2) "Consumer" means a person who is not a health care provider as that term is defined in 42 USC 300jj.
(3) "County medical care facility" means a nursing care facility, other than a hospital long-term care unit, that provides organized nursing care and medical treatment to 7 or more unrelated individuals who are suffering or recovering from illness, injury, or infirmity and that is owned by a county or counties.
(4) "Department" means the department of licensing and regulatory affairs.
(5) "Direct access" means access to a patient or resident or to a patient's or resident's property, financial information, medical records, treatment information, or any other identifying information.
(6) "Director" means the director of the department.
(7) "Freestanding abortion clinic" means that term as defined in section 20751.
(8) (7) "Freestanding birth center" means that term as defined in section 20701.
(9) (8) "Freestanding surgical outpatient facility" means a facility, other than the office of a physician, dentist, podiatrist, or other private practice office, offering a surgical procedure and related care that in the opinion of the attending physician can be safely performed without requiring overnight inpatient hospital care. Freestanding surgical outpatient facility
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does not include a surgical outpatient facility owned by and operated as part of a hospital.
(10) (9) "Good moral character" means that term as defined in, and determined under, 1974 PA 381, MCL 338.41 to 338.47.
Sec. 20106. (1) "Health facility or agency", except as provided in section 20115, means:
(a) An ambulance operation, aircraft transport operation, nontransport prehospital life support operation, or medical first response service.
(b) A county medical care facility.
(c) A freestanding surgical outpatient facility.
(d) A health maintenance organization.
(e) A home for the aged.
(f) A hospital.
(g) A nursing home.
(h) A hospice.
(i) A hospice residence.
(j) A facility or agency listed in subdivisions (a) to (g) located in a university, college, or other educational institution.
(k) A freestanding birth center.
(l) A freestanding abortion clinic.
(2) "Health maintenance organization" means that term as defined in section 3501 of the insurance code of 1956, 1956 PA 218, MCL 500.3501.
(3) "Home for the aged" means a supervised personal care facility at a single address, other than a hotel, adult foster care facility, hospital, nursing home, or county medical care facility that provides room, board, and supervised personal care to 21 or more unrelated, nontransient individuals 55 years of age or older.
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Home for the aged includes a supervised personal care facility for 20 or fewer individuals 55 years of age or older if the facility is operated in conjunction with and as a distinct part of a licensed nursing home. Home for the aged does not include an area excluded from this definition by section 17(3) of the continuing care community disclosure act, 2014 PA 448, MCL 554.917.
(4) "Hospice" means a health care program that provides a coordinated set of services rendered at home or in outpatient or institutional settings for individuals suffering from a disease or condition with a terminal prognosis.
(5) "Hospital" means a facility offering inpatient, overnight care, and services for observation, diagnosis, and active treatment of an individual with a medical, surgical, obstetric, chronic, or rehabilitative condition requiring the daily direction or supervision of a physician. Hospital does not include a mental health hospital licensed or operated by the department of health and human services or a hospital operated by the department of corrections.
(6) "Hospital long-term care unit" means a nursing care facility, owned and operated by and as part of a hospital, providing organized nursing care and medical treatment to 7 or more unrelated individuals suffering or recovering from illness, injury, or infirmity.
Sec. 20161. (1) The department shall assess fees and other assessments for health facility and agency licenses and certificates of need on an annual basis as provided in this article. Until October 1, 2027, except as otherwise provided in this article, fees and assessments must be paid as provided in the following schedule:
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$500.00 per facility license. |
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(b) Hospitals |
$500.00 per facility license and $10.00 per licensed bed. |
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(c) Nursing homes, county medical care facilities, and hospital long-term care units |
$500.00 per facility license and |
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$3.00 per licensed bed over 100 licensed beds. |
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(d) Homes for the aged |
$500.00 per facility license and $6.27 per licensed bed. |
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(e) Hospice agencies |
$500.00 per agency license. |
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(f) Hospice residences |
$500.00 per facility license and $5.00 per licensed bed. |
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(g) Freestanding birth center |
$500.00 per facility license. |
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(h) Freestanding abortion clinic |
$500.00 per facility license. |
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(i) (h) Subject to subsection (11), quality assurance assessment for nursing homes and hospital long-term care units |
an amount resulting in not more |
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than 6% of total industry revenues. |
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(j) (i) Subject to subsection (12), quality assurance assessment for hospitals |
at a fixed or variable rate that |
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generates funds not more than the maximum allowable under the federal matching requirements, after consideration for the amounts in subsection (12)(a) and (i). |
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(k) (j) Initial licensure application fee for subdivisions (a), (b), (c), (d), (e), (f), and (g), and (h) |
$2,000.00 per initial license. |
(2) If a hospital requests the department to conduct a certification survey for purposes of title XVIII or title XIX, the hospital shall pay a license fee surcharge of $23.00 per bed. As used in this subsection:
(a) "Title XVIII" means title XVIII of the social security act, 42 USC 1395 to 1395lll.1395mmm.
(b) "Title XIX" means title XIX of the social security act, 42 USC 1396 to 1396w-8.1396w-9.
(3) All of the following apply to the assessment under this section for certificates of need:
(a) The base fee for a certificate of need is $3,000.00 for each application. For a project requiring a projected capital expenditure of more than $500,000.00 but less than $4,000,000.00, an additional fee of $5,000.00 is added to the base fee. For a project requiring a projected capital expenditure of $4,000,000.00 or more but less than $10,000,000.00, an additional fee of $8,000.00 is added to the base fee. For a project requiring a projected capital expenditure of $10,000,000.00 or more, an additional fee of $12,000.00 is added to the base fee.
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(b) In addition to the fees under subdivision (a), the applicant shall pay $3,000.00 for any designated complex project including a project scheduled for comparative review or for a consolidated licensed health facility application for acquisition or replacement.
(c) If required by the department, the applicant shall pay $1,000.00 for a certificate of need application that receives expedited processing at the request of the applicant.
(d) The department shall charge a fee of $500.00 to review any letter of intent requesting or resulting in a waiver from certificate of need review and any amendment request to an approved certificate of need.
(e) A health facility or agency that offers certificate of need covered clinical services shall pay $100.00 for each certificate of need approved covered clinical service as part of the certificate of need annual survey at the time of submission of the survey data.
(f) Except as otherwise provided in this section, the department shall use the fees collected under this subsection only to fund the certificate of need program. Funds remaining in the certificate of need program at the end of the fiscal year do not lapse to the general fund but remain available to fund the certificate of need program in subsequent years.
(4) A license issued under this part is effective for no longer than 1 year after the date of issuance.
(5) Fees described in this section are payable to the department at the time an application for a license, permit, or certificate is submitted. If an application for a license, permit, or certificate is denied or if a license, permit, or certificate is
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revoked before its expiration date, the department shall not refund fees paid to the department.
(6) The fee for a provisional license or temporary permit is the same as for a license. A license may be issued at the expiration date of a temporary permit without an additional fee for the balance of the period for which the fee was paid if the requirements for licensure are met.
(7) The cost of licensure activities must be supported by license fees.
(8) The application fee for a waiver under section 21564 is $200.00 plus $40.00 per hour for the professional services and travel expenses directly related to processing the application. The travel expenses must be calculated in accordance with the state standardized travel regulations of the department of technology, management, and budget in effect at the time of the travel.
(9) An applicant for licensure or renewal of licensure under part 209 shall pay the applicable fees set forth in part 209.
(10) Except as otherwise provided in this section, the fees and assessments collected under this section must be deposited in the state treasury, to the credit of the general fund. The department may use the unreserved fund balance in fees and assessments for the criminal history check program required under this article.
(11) The quality assurance assessment collected under subsection (1)(h) (1)(i) and all federal matching funds attributed to that assessment must be used only for the following purposes and under the following specific circumstances:
(a) The quality assurance assessment and all federal matching funds attributed to that assessment must be used to finance
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Medicaid nursing home reimbursement payments. Only licensed nursing homes and hospital long-term care units that are assessed the quality assurance assessment and participate in the Medicaid program are eligible for increased per diem Medicaid reimbursement rates under this subdivision. A nursing home or long-term care unit that is assessed the quality assurance assessment and that does not pay the assessment required under subsection (1)(h) (1)(i) in accordance with subdivision (c)(i) or in accordance with a written payment agreement with this state shall not receive the increased per diem Medicaid reimbursement rates under this subdivision until all of its outstanding quality assurance assessments and any penalties assessed under subdivision (f) have been paid in full. This subdivision does not authorize or require the department to overspend tax revenue in violation of the management and budget act, 1984 PA 431, MCL 18.1101 to 18.1594.
(b) Except as otherwise provided under subdivision (c), beginning October 1, 2005, the quality assurance assessment is based on the total number of patient days of care each nursing home and hospital long-term care unit provided to non-Medicare patients within the immediately preceding year, must be assessed at a uniform rate on October 1, 2005 and subsequently on October 1 of each following year, and is payable on a quarterly basis, with the first payment due 90 days after the date the assessment is assessed.
(c) Within 30 days after September 30, 2005, the department shall submit an application to the Centers for Medicare and Medicaid Services to request a waiver according to 42 CFR 433.68(e) to implement this subdivision as follows:
(i) If the waiver is approved, the quality assurance assessment
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rate for a nursing home or hospital long-term care unit with less than 40 licensed beds or with the maximum number, or more than the maximum number, of licensed beds necessary to secure federal approval of the application is $2.00 per non-Medicare patient day of care provided within the immediately preceding year or a rate as otherwise altered on the application for the waiver to obtain federal approval. If the waiver is approved, for all other nursing homes and long-term care units the quality assurance assessment rate is to be calculated by dividing the total statewide maximum allowable assessment permitted under subsection (1)(h) (1)(i) less the total amount to be paid by the nursing homes and long-term care units with less than 40 licensed beds or with the maximum number, or more than the maximum number, of licensed beds necessary to secure federal approval of the application by the total number of non-Medicare patient days of care provided within the immediately preceding year by those nursing homes and long-term care units with more than 39 licensed beds, but less than the maximum number of licensed beds necessary to secure federal approval. The quality assurance assessment, as provided under this subparagraph, must be assessed in the first quarter after federal approval of the waiver and must be subsequently assessed on October 1 of each following year, and is payable on a quarterly basis, with the first payment due 90 days after the date the assessment is assessed.
(ii) If the waiver is approved, continuing care retirement centers are exempt from the quality assurance assessment if the continuing care retirement center requires each center resident to provide an initial life interest payment of $150,000.00, on average, per resident to ensure payment for that resident's residency and services and the continuing care retirement center
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utilizes all of the initial life interest payment before the resident becomes eligible for medical assistance under the state's Medicaid plan. As used in this subparagraph, "continuing care retirement center" means a nursing care facility that provides independent living services, assisted living services, and nursing care and medical treatment services, in a campus-like setting that has shared facilities or common areas, or both.
(d) Beginning May 10, 2002, the department shall increase the per diem nursing home Medicaid reimbursement rates for the balance of that year. For each subsequent year in which the quality assurance assessment is assessed and collected, the department shall maintain the Medicaid nursing home reimbursement payment increase financed by the quality assurance assessment.
(e) The department shall implement this section in a manner that complies with federal requirements necessary to ensure that the quality assurance assessment qualifies for federal matching funds.
(f) If a nursing home or a hospital long-term care unit fails to pay the assessment required by subsection (1)(h), (1)(i), the department may assess the nursing home or hospital long-term care unit a penalty of 5% of the assessment for each month that the assessment and penalty are not paid up to a maximum of 50% of the assessment. The department may also refer for collection to the department of treasury past due amounts consistent with section 13 of 1941 PA 122, MCL 205.13.
(g) The Medicaid nursing home quality assurance assessment fund is established in the state treasury. The department shall deposit the revenue raised through the quality assurance assessment with the state treasurer for deposit in the Medicaid nursing home
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quality assurance assessment fund.
(h) The department shall not implement this subsection in a manner that conflicts with 42 USC 1396b(w).
(i) The quality assurance assessment collected under subsection (1)(h) (1)(i) must be prorated on a quarterly basis for any licensed beds added to or subtracted from a nursing home or hospital long-term care unit since the immediately preceding July 1. Any adjustments in payments are due on the next quarterly installment due date.
(j) In each fiscal year governed by this subsection, Medicaid reimbursement rates must not be reduced below the Medicaid reimbursement rates in effect on April 1, 2002 as a direct result of the quality assurance assessment collected under subsection (1)(h).(1)(i).
(k) The state retention amount of the quality assurance assessment collected under subsection (1)(h) (1)(i) must be equal to 13.2% of the federal funds generated by the nursing homes and hospital long-term care units quality assurance assessment, including the state retention amount. The state retention amount must be appropriated each fiscal year to the department to support Medicaid expenditures for long-term care services. These funds must offset an identical amount of general fund/general purpose revenue originally appropriated for that purpose.
(l) Beginning October 1, 2027, the department shall not assess or collect the quality assurance assessment or apply for federal matching funds. The quality assurance assessment collected under subsection (1)(h) (1)(i) must not be assessed or collected after September 30, 2011 if the quality assurance assessment is not eligible for federal matching funds. Any portion of the quality
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assurance assessment collected from a nursing home or hospital long-term care unit that is not eligible for federal matching funds must be returned to the nursing home or hospital long-term care unit.
(12) The quality assurance dedication is an earmarked assessment collected under subsection (1)(i). (1)(j). That assessment and all federal matching funds attributed to that assessment must be used only for the following purpose and under the following specific circumstances:
(a) To maintain the increased Medicaid reimbursement rate increases as provided for in subdivision (c).
(b) The quality assurance assessment must be assessed on all net patient revenue, before deduction of expenses, less Medicare net revenue, as reported in the most recently available Medicare cost report and is payable on a quarterly basis, with the first payment due 90 days after the date the assessment is assessed. As used in this subdivision, "Medicare net revenue" includes Medicare payments and amounts collected for coinsurance and deductibles.
(c) Beginning October 1, 2002, the department shall increase the hospital Medicaid reimbursement rates for the balance of that year. For each subsequent year in which the quality assurance assessment is assessed and collected, the department shall maintain the hospital Medicaid reimbursement rate increase financed by the quality assurance assessments.
(d) The department shall implement this section in a manner that complies with federal requirements necessary to ensure that the quality assurance assessment qualifies for federal matching funds.
(e) If a hospital fails to pay the assessment required by
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subsection (1)(i), (1)(j), the department may assess the hospital a penalty of 5% of the assessment for each month that the assessment and penalty are not paid up to a maximum of 50% of the assessment. The department may also refer for collection to the department of treasury past due amounts consistent with section 13 of 1941 PA 122, MCL 205.13.
(f) The hospital quality assurance assessment fund is established in the state treasury. The department shall deposit the revenue raised through the quality assurance assessment with the state treasurer for deposit in the hospital quality assurance assessment fund.
(g) In each fiscal year governed by this subsection, the quality assurance assessment must only be collected and expended if Medicaid hospital inpatient DRG and outpatient reimbursement rates and graduate medical education payments are not below the level of rates and payments in effect on April 1, 2002 as a direct result of the quality assurance assessment collected under subsection (1)(i), (1)(j), except as provided in subdivision (h).
(h) The quality assurance assessment collected under subsection (1)(i) (1)(j) must not be assessed or collected after September 30, 2011 if the quality assurance assessment is not eligible for federal matching funds. Any portion of the quality assurance assessment collected from a hospital that is not eligible for federal matching funds must be returned to the hospital.
(i) The state retention amount of the quality assurance assessment collected under subsection (1)(i) (1)(j) must be equal to 13.2% of the federal funds generated by the hospital quality assurance assessment, including the state retention amount. The 13.2% state retention amount described in this subdivision does not
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apply to the Healthy Michigan plan. Beginning in the fiscal year ending September 30, 2018, and for each fiscal year thereafter, there is a retention amount of at least $118,420,600.00 for each fiscal year for the Healthy Michigan plan. By May 31 of each year, the department, the state budget office, and the Michigan Health and Hospital Association shall identify an appropriate retention amount for the Healthy Michigan plan. The state retention percentage must be applied proportionately to each hospital quality assurance assessment program to determine the retention amount for each program. The state retention amount must be appropriated each fiscal year to the department to support Medicaid expenditures for hospital services and therapy. These funds must offset an identical amount of general fund/general purpose revenue originally appropriated for that purpose.
(13) The department may establish a quality assurance assessment to increase ambulance reimbursement as follows:
(a) The quality assurance assessment authorized under this subsection must be used to provide reimbursement to Medicaid ambulance providers. The department may promulgate rules to provide the structure of the quality assurance assessment authorized under this subsection and the level of the assessment.
(b) The department shall implement this subsection in a manner that complies with federal requirements necessary to ensure that the quality assurance assessment qualifies for federal matching funds.
(c) The total annual collections by the department under this subsection must not exceed $20,000,000.00.
(d) The quality assurance assessment authorized under this subsection must not be collected after October 1, 2027. The quality
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assurance assessment authorized under this subsection must no longer be collected or assessed if the quality assurance assessment authorized under this subsection is not eligible for federal matching funds.
(e) By November 1 of each year, the department shall send a notification to each ambulance operation that will be assessed the quality assurance assessment authorized under this subsection during the year in which the notification is sent.
(14) The quality assurance assessment provided for under this section is a tax that is levied on a health facility or agency.
(15) As used in this section:
(a) "Healthy Michigan plan" means the medical assistance program described in section 105d of the social welfare act, 1939 PA 280, MCL 400.105d, that has a federal matching fund rate of not less than 90%.
(b) "Medicaid" means that term as defined in section 22207.
PART 207A
FREESTANDING ABORTION CLINICS
Sec. 20751. (1) As used in this part:
(a) "Freestanding abortion clinic" means a facility, other than a hospital or freestanding surgical outpatient facility, that performs elective abortions.
(b) "Elective abortion" means the intentional use of suction, a substance, or a medical instrument or other device to terminate a woman's pregnancy for a purpose other than to increase the probability of a live birth, to preserve the life or health of the child after live birth, or to remove a fetus that has died as a result of natural causes, accidental trauma, or a criminal assault on the pregnant woman. Elective abortion does not include any of
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the following:
(i) The use or prescription of a drug or device intended as a contraceptive.
(ii) The intentional use of an instrument, drug, or other substance or device by a physician to terminate a woman's pregnancy if the woman's physical condition, in the physician's reasonable medical judgment, necessitates the termination of the woman's pregnancy to avert her death.
(iii) Treatment on a pregnant woman who is experiencing a miscarriage or has been diagnosed with an ectopic pregnancy.
(c) "Health care provider" means any of the following:
(i) A physician as that term is defined in section 17001 or 17501.
(ii) A physician's assistant licensed under part 170 or 175.
(iii) A certified nurse practitioner as that term is defined in section 2701.
(2) In addition, article 1 contains general definitions and principles of construction applicable to all articles in this code and part 201 contains definitions applicable to this part.
Sec. 20761. (1) A freestanding abortion clinic must be licensed under this article.
(2) "Freestanding abortion clinic" or a similar term or abbreviation must not be used to describe or refer to a health facility or agency unless it is licensed by the department under this article.
Sec. 20763. The owner, operator, and governing body of a freestanding abortion clinic licensed under this article:
(a) Are responsible for all phases of the operation of the freestanding abortion clinic, selection of health care providers,
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and quality of care rendered in the freestanding abortion clinic.
(b) Shall cooperate with the department in the enforcement of this article and require that the health care providers and other personnel working in the freestanding abortion clinic and for whom a state license or registration is required be currently licensed or registered.
(c) Subject to sections 20769 and 20771, shall ensure that health care providers are of a sufficient number to maintain safety and quality of care and have the qualifications, training, and skills necessary to meet operational needs and the needs of a patient, considering the caseload and size of the freestanding abortion clinic.
Sec. 20765. Subject to this part and any rules promulgated for purposes of this part, a freestanding abortion clinic shall comply with all of the following:
(a) Have a plan to identify needs caused by social determinants of health and, with the consent of a patient, refer the patient to a support service to address the patient's needs. For purposes of this subdivision, "support service" includes, but is not limited to, a food assistance program, a counseling service, an early childhood development resource, a housing assistance program, or an intimate partner violence support group.
(b) Develop, implement, and enforce written policies and procedures for the freestanding abortion clinic's operations. The policies and procedures must be made available to health care providers and other personnel who are employed by or under contract with the freestanding abortion clinic and must comply with all of the following:
(i) Be administered in a manner that provides quality health
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care services in a safe environment.
(ii) Identify a process for hiring, credentialing, and training staff.
(iii) Ensure that the right of a patient to informed consent and to refuse treatment is upheld at every stage of care.
(iv) Include a process by which health care providers who are employed by or under contract with the freestanding abortion clinic comply with all of the following:
(A) Refer a patient to services that are not directly provided by the freestanding abortion clinic, including, but not limited to, outside laboratory testing services, sonogram services, and mental health providers.
(B) Consult with another health care provider.
(C) Refer a patient to another health care provider.
(D) Transfer the care of a patient to another health care provider with the informed consent of the patient.
(E) Initiate patient transport to a hospital described under subdivision (e) when needed by calling 9-1-1 or an ambulance operation or by arranging other means for patient transport.
(F) Notify a hospital described under subdivision (e) of the freestanding abortion clinic's license.
(G) Include a process by which a patient's medical record is provided to another health care provider on the patient's request or if the patient is transferred as described in sub-subparagraph (D) or (E).
(c) Ensure that any service is provided with adequate space for any furnishings, equipment, supplies, and accommodations for a patient and the family of the patient.
(d) Ensure that a patient is notified of each health care
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provider within the freestanding abortion clinic who maintains a malpractice liability insurance policy and each health care provider who does not.
(e) Identify a hospital to which a patient may be transferred from the freestanding abortion clinic and that is in close proximity to the freestanding abortion clinic.
Sec. 20767. (1) A freestanding abortion clinic shall not do any of the following:
(a) Except as otherwise provided in this subdivision, use general or regional anesthesia, including epidural anesthesia. Local anesthesia, nitrous oxide, and other forms of pain relief may be administered at the freestanding abortion clinic if all of the following are met:
(i) It is determined to be clinically necessary by a health care provider.
(ii) It is administered by a health care provider who is acting within the scope of the health care provider's practice.
(iii) It is used according to the freestanding abortion clinic's policies and procedures and according to the professionally recognized standards of practice described in section 20777.
(b) Perform an elective abortion at the freestanding abortion clinic if any of the following limiting factors apply:
(i) Fetal gestation is more than 22 weeks and 0 days.
(ii) Any other limiting factor established by rule under section 20777 is present in the patient or the clinical needs of the patient fall outside the scope of practice of a health care provider at the freestanding abortion clinic.
(2) A freestanding abortion clinic shall develop policies and procedures for assessing a patient seeking an elective abortion to
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determine whether it is appropriate for the patient to have the elective abortion at the freestanding abortion clinic or if the patient should be referred to a hospital.
Sec. 20769. (1) A freestanding abortion clinic shall provide all of the following:
(a) Respectful, supportive care for which the patient provides consent.
(b) Minimization of stress-inducing stimuli.
(c) Freedom of movement.
(d) Oral intake, as appropriate.
(e) Availability of nonpharmacologic pain relief methods.
(f) Regular and appropriate assessment of the patient and throughout the elective abortion procedure and recovery.
(2) The freestanding abortion clinic shall provide a patient, at the intake, with all of the following information:
(a) A written description of the training, philosophy of practice, qualifications, and license or specialty certification of a health care provider who is employed by or under contract with the freestanding abortion clinic.
(b) A written description of the freestanding abortion clinic's patient practice policies.
(c) The complaint process for state and national credentialing organizations for a health care provider who is employed by or under contract with the freestanding abortion clinic.
(3) The freestanding abortion clinic shall ensure that a health care provider is present or available to the patient at all times when a patient is at the freestanding abortion clinic and until the patient has been determined to be clinically stable, based on criteria established by the freestanding abortion clinic.
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(4) The freestanding abortion clinic shall ensure that a health care provider monitors the progress of a patient's elective abortion and the condition of the patient at intervals established in the freestanding abortion clinic's policies and procedures.
(5) Subject to this subsection, the freestanding abortion clinic shall have the personnel and equipment necessary to ensure patient safety, meet the demands for services that are routinely provided in the freestanding abortion clinic, provide coverage during periods of high demand or in the case of an emergency, and respond to patient health emergencies that may arise while a patient is receiving services in the freestanding abortion clinic, including, but not limited to, basic life support and the initial management of complications. The freestanding abortion clinic shall ensure that at least 2 individuals are on the premises and immediately available during an elective abortion who are certified in basic life support from the American Heart Association or an equivalent organization as determined by the department.
Sec. 20771. (1) A freestanding abortion clinic shall not discharge a patient from the freestanding abortion clinic until the patient is clinically stable and has met discharge criteria established by the freestanding abortion clinic.
(2) A freestanding abortion clinic shall ensure that a program for follow-up care evaluation is planned for each patient.
(3) A freestanding abortion clinic shall ensure that both of the following are available to a patient of the freestanding abortion clinic 24 hours a day and 7 days a week:
(a) Consultation with a health care provider by telephone.
(b) A health care provider or other personnel who are available on call to provide emergency follow-up care to the
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patient.
Sec. 20773. (1) The department shall not require a freestanding abortion clinic to do any of the following:
(a) Maintain a collaborative agreement with another health facility or agency or with a health care provider who is not employed by or under contract with a freestanding abortion clinic.
(b) Provide care other than elective abortion services.
(2) Subsection (1) does not limit a freestanding abortion clinic from maintaining a collaborative agreement or providing care other than elective abortion services as described under subsection (1).
Sec. 20775. (1) A freestanding abortion clinic shall recommend that health care providers and other personnel who are employed by or under contract with the freestanding abortion clinic receive an annual vaccination against influenza and recommend that health care providers and other personnel who are employed by or under contract with the freestanding abortion clinic are fully vaccinated against COVID-19.
(2) A freestanding abortion clinic shall provide evidence to the department, on request, of immunization, positive titer result, or documentation of refusal for health care providers and other personnel who are employed by or under contract with the freestanding abortion clinic, for each of the following:
(a) Rubella.
(b) Tdap.
(c) Hepatitis B.
(d) Varicella.
(e) Against any other disease required by the department by rule.
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(3) A freestanding abortion clinic shall conduct tuberculosis testing before employing or entering into a contract with an individual who will work in the freestanding abortion clinic.
Sec. 20777. The department shall promulgate rules to implement this part. The rules must include at least all of the following:
(a) Professionally recognized standards of practice based on standards issued by the American Congress of Obstetrics and Gynecology and The National Abortion Federation. If any of the standards described in this subdivision are revised after the effective date of the amendatory act that added this section, the department shall take notice of the revision. The department, in consultation with the persons described in this section, may promulgate rules to incorporate any revision by reference.
(b) Limiting factors that, when present, would preclude a patient from having an elective abortion at a freestanding abortion clinic because the patient has comorbidities or is beyond the 22 weeks gestation. The rules must allow a freestanding abortion clinic to develop policies that would include additional limiting factors to preclude an elective abortion at the freestanding abortion clinic.
Sec. 20779. Notwithstanding part 201, the department shall not enforce this part or any rules promulgated for purposes of this part, including, but not limited to, the requirement that a freestanding abortion clinic be licensed under this article, until 1 year after the effective date of the amendatory act that added this part.
Sec. 20781. This part does not require new or additional third-party reimbursement or mandated worker's compensation benefits for services rendered at a freestanding abortion clinic.
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Sec. 22224d. A freestanding abortion clinic as that term is defined in section 20751 is not required to obtain a certificate of need.
