Trial Engrossment of Amendment A00955 to House Bill 1058 P.N. 1609, Regular Session 2019-2020

A00955

THE GENERAL ASSEMBLY OF PENNSYLVANIA

HOUSE BILL

No.

1058

Session of

2019

INTRODUCED BY RAPP, CUTLER, KLUNK, PICKETT, ZIMMERMAN,

BERNSTINE, SAYLOR, KAUFFMAN, REESE, TOPPER, JOZWIAK, GROVE,

NEILSON, MURT, ECKER AND DIAMOND, APRIL 5, 2019

AS REPORTED FROM COMMITTEE ON HEALTH, HOUSE OF REPRESENTATIVES,

AS AMENDED, APRIL 29, 2019

AN ACT

Requiring that information on the option of perinatal hospice

care SUPPORT CARE PROGRAMS be given to a woman after

diagnosis of a life limiting condition; and imposing

penalties.

Providing for education about perinatal palliative care for

providers and information about perinatal palliative care for

patients that receive a diagnosis of a life limiting

condition; and imposing duties on the Department of Health.

The General Assembly of the Commonwealth of Pennsylvania

hereby enacts as follows:

Section 1. Short title.

This act shall be known and may be cited as the Perinatal

Hospice Information COMPASSION AND CARE FOR MEDICALLY

CHALLENGING PREGNANCIES Act.

Section 2. Definitions.

The following words and phrases when used in this act shall

have the meanings given to them in this section unless the

context clearly indicates otherwise:

"Abortion." The use of any means to terminate the clinically

diagnosable pregnancy of a woman with knowledge that the

termination will, with reasonable likelihood, cause the death of

the unborn child. The term does not include procedures with the

intent to:

(1) save the life or preserve the health of an unborn

child even if the unborn child does not survive;

(2) remove a dead unborn child caused by spontaneous

abortion; or

(3) remove an ectopic pregnancy.

"Department." The Department of Health of the Commonwealth.

"HEALTH CARE PRACTITIONER." AS DEFINED IN SECTION 103 OF THE

ACT OF JULY 19, 1979 (P.L.130, NO.48), KNOWN AS THE HEALTH CARE

FACILITIES ACT.

"Life limiting condition." A fetal condition diagnosed

before birth that will with reasonable certainty result in the

death of the unborn child within three months after birth.

"Medical emergency." A condition which, on the basis of the

physician's good faith clinical judgment, complicates the

medical condition of a pregnant woman and necessitates the

immediate termination of her pregnancy to avert her death or

serious risk of substantial and irreversible impairment of a

major bodily function.

"Perinatal hospice SUPPORT CARE." Comprehensive support to

the pregnant woman and her family that includes support from the

time of diagnosis through the time of birth and death of the

infant and through the postpartum period. Supportive care may

include, but is not limited to, counseling and medical care by

maternal-fetal medical specialists, obstetricians,

neonatologists, anesthesia specialists, clergy, social workers

and specialty nurses focused on alleviating fear and ensuring

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that the woman and her family experience the life and death of

their child in a comfortable and supportive environment.

"Physician." Any person licensed to practice medicine in

this Commonwealth. The term includes medical doctors and doctors

of osteopathy.

Section 3. Requirements.

(a) Information.--In the case of a pregnant woman who is

diagnosed as carrying an unborn child with a life limiting

condition, the physician OR HEALTH CARE PRACTITIONER who

diagnosed the woman shall provide her, orally and in person,

with information on perinatal hospice SUPPORT CARE, which shall

include a list of perinatal hospice SUPPORT CARE programs

available in this Commonwealth prepared by the department under

section 4.

(b) Waiting period.--After receiving the information, the

woman shall wait at least 24 hours before discussing her options

with the physician, including, but not limited to, perinatal

hospice. This waiting period shall run concurrent with the

waiting period under 18 Pa.C.S. § 3205 (relating to informed

consent).

shall be construed as a prohibition on an abortion performed due

to a medical emergency.

Section 4. Department duties.

The department shall:

(1) Publish, in a timely manner, NO LATER THAN 90 DAYS

AFTER THE EFFECTIVE DATE OF THIS ACT, PUBLISH a list of

perinatal hospice SUPPORT CARE programs available.

(2) Administer this act and promulgate regulations to

implement this act.

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(3) NO LATER THAN 90 DAYS AFTER THE EFFECTIVE DATE OF

THIS ACT, POST ALL OF THE FOLLOWING INFORMATION ON THE

DEPARTMENT'S PUBLICLY ACCESSIBLE INTERNET WEBSITE ON AN

INFORMATION SUPPORT SHEET THAT CAN BE PRINTED AND DELIVERED

BY A PHYSICIAN OR HEALTH CARE PRACTITIONER TO A PREGNANT

WOMAN FOR THE PURPOSE OF COMPLYING WITH SECTION 3(A):

(I) A STATEMENT INDICATING THAT PERINATAL SUPPORT

CARE PROGRAMS ARE AN INNOVATIVE AND COMPASSIONATE MODEL

OF SUPPORT FOR A PREGNANT WOMAN WHO FINDS OUT THAT HER

BABY HAS A LIFE LIMITING CONDITION AND WHO CHOOSES TO

CONTINUE HER PREGNANCY.

(II) A GENERAL DESCRIPTION OF THE HEALTH CARE

SERVICES AVAILABLE FROM PERINATAL SUPPORT CARE PROGRAMS.

(III) ANY APPLICABLE CONTACT INFORMATION, INCLUDING

ANY 24-HOUR PERINATAL SUPPORT CARE SERVICES AVAILABLE.

Section 5. Penalties.

(a) Violation.--A physician who violates this act is guilty

of unprofessional conduct and the physician's license for the

practice of medicine shall be subject to suspension or

revocation in accordance with procedures provided under the act

of October 5, 1978 (P.L.1109, No.261), known as the Osteopathic

Medical Practice Act, or the act of December 20, 1985 (P.L.457,

No.112), known as the Medical Practice Act of 1985.

(A) VIOLATION.--

(1) A PHYSICIAN WHO VIOLATES THIS ACT IS GUILTY OF

UNPROFESSIONAL CONDUCT AND THE PHYSICIAN'S LICENSE FOR THE

PRACTICE OF MEDICINE SHALL BE SUBJECT TO SUSPENSION OR

REVOCATION IN ACCORDANCE WITH PROCEDURES PROVIDED UNDER THE

ACT OF OCTOBER 5, 1978 (P.L.1109, NO.261), KNOWN AS THE

OSTEOPATHIC MEDICAL PRACTICE ACT, OR THE ACT OF DECEMBER 20,

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1985 (P.L.457, NO.112), KNOWN AS THE MEDICAL PRACTICE ACT OF

1985.

(2) A HEALTH CARE PRACTITIONER WHO VIOLATES THIS ACT

SHALL BE SUBJECT TO REVIEW AND DISCIPLINARY ACTION UNDER THE

LICENSURE, CERTIFICATION, REGISTRATION OR PERMIT PROVISIONS

OF LAW AND REGULATION GOVERNING THE RESPECTIVE HEALTH CARE

PRACTITIONER.

(b) Reasonable belief.--It is a defense to a violation for

failure to furnish the information required under section 3(a)

if the physician OR HEALTH CARE PRACTITIONER can demonstrate, by

a preponderance of the evidence, that the physician OR HEALTH

CARE PRACTITIONER reasonably believed that furnishing the

information would have a severely adverse effect on the physical

or mental health of the patient.

"Hospice." As defined in section 802.1 of the Health Care

Facilities Act.

"Life limiting condition." A health condition that carries a

high risk of mortality and either severely negatively impacts a

person's daily function or quality of life or excessively

strains the person's caregiver.

"Palliative care." Care that:

(1) focuses on expert assessment and management of pain

and other symptoms, assessment and support of caregiver needs

and coordination of care;

(2) attends to the physical, functional, psychological,

practical and spiritual consequences of a serious illness;

(3) is person-centered and family-centered, providing

people living with serious illness relief from the symptoms

and stress of an illness;

(4) through collaboration of an interdisciplinary care

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team, improves quality of life for the patient and the

family; and

(5) can be offered in all care settings and at any stage

of a serious illness, including through bereavement.

Section 3. Perinatal palliative care.

(a) Information for health care practitioners.--The

department shall provide information about services available

through pediatric palliative care programs, including services

for perinatal patients, to health care practitioners whose

practice includes prenatal diagnosis, counseling or management.

(b) Information for patients.--When a health care

practitioner, in the health care practitioner's best clinical

judgment, believes it is appropriate, the health care

practitioner shall provide to the health care practitioner's

patient information regarding pediatric palliative care

programs, including hospice programs, that are able to care for

perinatal patients diagnosed with a life limiting condition.

Section 4. Department duties.

The department shall:

(1) Establish a program to provide education about

pediatric palliative care, including services for perinatal

patients, for health care practitioners whose practice

includes prenatal diagnosis, counseling or management.

(2) Administer this act and promulgate regulations to

implement this act.

Section 6 5. Effective date.

This act shall take effect in 60 days.

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