Virgina Late Term Abortion bill full text

2019 SESSION INTRODUCED 19103112D 1 HOUSEBILLNO.2491 2 OfferedJanuary 9,2019 3 PrefiledJanuary9,2019 4 ABILL toamend andreenact §§16.1-77, 18.2-73,18.2-74,18.2-76,and32.1-127 ofthe Code of 5 Virginia, relatingtoabortions; eliminatecertainrequirements. 6 ±±±±±±±±±± Patrons±±Tran, Adams,D.M.,Ayala, Carroll Foy,Carter, Gooditis, Guzman,Hope,Jones, J.C.,Kory, Krizek, Levine, Lopez,McQuinn, Rasoul,Reid,Rodman, Simon,Turpin, TylerandVanValkenburg; Senators: BoyskoandMcClellan 7 ±±±±±±±±±± 8 ReferredtoCommittee forCourts ofJustice 9 ±±±±±±±±±± 10 Beitenacted bythe General Assembly ofVirginia: 11 1.That §§16.1-77, 18.2-73,18.2-74,18.2-76,and32.1-127 ofthe Code ofVirginia areamended 12 andreenacted asfollows: 13 §16.1-77. Civiljurisdiction ofgeneral districtcourts. 14 Exceptasprovided inArticle 5(§ 16.1-122.1 etseq.), eachgeneral districtcourtshallhave, within 15 thelimits ofthe territory itserves, civiljurisdiction asfollows: 16 (1)Exclusive originaljurisdiction ofany claim tospecific personal property ortoany debt, fineor 17 other money, ortodamages forbreach ofcontract orfor injury donetoproperty, realorpersonal, orfor 18 anyinjury tothe person thatwould berecoverable byaction atlaw orsuit inequity, whentheamount 19 ofsuch claim doesnotexceed $4,500exclusive ofinterest andanyattorney fees,andconcurrent 20 jurisdiction withthecircuit courts having jurisdiction insuch territory ofany such claim whenthe 21 amount thereofexceeds $4,500butdoes notexceed $25,000, exclusive ofinterest andanyattorney fees. 22 However, this$25,000 limitshallnotapply withrespect todistress warrants undertheprovisions of 23 §55-230, casesinvolving liquidated damagesforviolations ofvehicle weightlimitspursuant to 24 §46.2-1135, norcases involving forfeitureofabond pursuant to§19.2-143. 25 (2)Jurisdiction totry and decide attachment caseswhen theamount ofthe plaintiff©s claimdoesnot 26 exceed $25,000 exclusive ofinterest andanyattorney fees. 27 (3)Jurisdiction ofactions ofunlawful entryordetainer asprovided in Article 13(§8.01-124 etseq.) 28 ofChapter 3of Title 8.01, andinChapter 13(§55-217 etseq.) ofTitle 55,and themaximum 29 jurisdictional limitsprescribed insubdivision (1)shall notapply toany claim, counter-claim or 30 cross-claim inan unlawful detaineractionthatincludes aclaim fordamages sustained orrent against 31 anyperson obligated onthe lease orguarantee ofsuch lease. 32 (4)Except whereotherwise specifically provided,alljurisdiction, powerandauthority overanycivil 33 action orproceeding conferredupon any general districtcourtjudge ormagistrate underorby virtue of 34 anyprovisions ofthe Code. 35 (5)Jurisdiction totry and decide suitsininterpleader involvingpersonalorreal property wherethe 36 amount ofmoney orvalue ofthe property isnot more thanthemaximum jurisdictional limitsofthe 37 general districtcourt.However, themaximum jurisdictional limitsprescribed insubdivision (1)shall not 38 apply toany claim, counter-claim, orcross-claim inan interpleader actionthatislimited tothe 39 disposition ofan earnest moneydeposit pursuant toareal estate purchase contract.Theaction shallbe 40 brought inaccordance withtheprocedures forinterpleader asset forth in § 8.01-364. However, the 41 general districtcourtshallnothave anypower toissue injunctions. Actionsininterpleader maybe 42 brought byeither thestakeholder orany ofthe claimants. Theinitial pleading shallbeeither bymotion 43 forjudgment, bywarrant indebt, orby other uniform courtformestablished bythe Supreme Courtof 44 Virginia. Theinitial pleading shall briefly setforth thecircumstances ofthe claim andshall name as 45 defendant allparties ininterest whoarenot parties plaintiff. 46 (6)Jurisdiction totry and decide anycases pursuant to§ 2.2-3713 ofthe Virginia Freedom of 47 Information Act(§2.2-3700 etseq.) or§ 2.2-3809 ofthe Government DataCollection and 48 Dissemination PracticesAct(§2.2-3800 etseq.), forwrits ofmandamus orfor injunctions. 49 (7)Concurrent jurisdiction withthecircuit courtshaving jurisdiction insuch territory toadjudicate 50 habitual offenders pursuanttothe provisions ofArticle 9(§ 46.2-355.1 etseq.) ofChapter 3of Title 51 46.2. 52 (8) Jurisdiction totry and decide casesalleging acivil violation described in§18.2-76. 53 (9) Jurisdiction totry and decide anycases pursuant to§55-79.80:2 ofthe Condominium Act 54 (§55-79.39 etseq.) or§55-513 ofthe Property Owners©Association Act(§55-508 etseq.). 55 (10) (9)Concurrent jurisdiction withthecircuit courtstosubmit matters toarbitration pursuantto 56 Chapter 21(§8.01-577 etseq.) ofTitle 8.01where theamount incontroversy iswithin thejurisdictional INTRODUCED HB2491 1/30/19 13:43

HB2491 2of 7 57 limits ofthe general districtcourt.Anyparty thatdisagrees withanorder byageneral districtcourt 58 granting anapplication tocompel arbitration mayappeal suchdecision tothe circuit courtpursuant to 59 §8.01-581.016. 60 §18.2-73. Whenabortion lawfulduring secondtrimester ofpregnancy. 61 Notwithstanding anyofthe provisions of§18.2-71 andinaddition tothe provisions of§18.2-72, it 62 shall belawful forany physician licensedbythe Board ofMedicine topractice medicine andsurgery, to 63 terminate orattempt toterminate ahuman pregnancy oraid orassist inthe termination ofahuman 64 pregnancy byperforming anabortion or causing amiscarriage onany woman duringthesecond 65 trimester ofpregnancy andprior tothe third trimester ofpregnancy providedsuchprocedure is 66 performed inahospital licensed bythe State Department ofHealth oroperated bythe Department of 67 Behavioral HealthandDevelopmental Services. 68 §18.2-74. Whenabortion ortermination ofpregnancy lawfulaftersecond trimester of 69 pregnancy. 70 Notwithstanding anyofthe provisions of§18.2-71 andinaddition tothe provisions of§§ 18.2-72 71 and18.2-73, itshall belawful forany physician licensedbythe Board ofMedicine topractice medicine 72 andsurgery toterminate orattempt toterminate ahuman pregnancy oraid orassist inthe termination\ 73 ofahuman pregnancy byperforming anabortion orcausing amiscarriage onany woman inastage of 74 pregnancy subsequent tothe second trimester, providedthatthefollowing conditions aremet: 75 (a) 1.Said operation isperformed inahospital licensed bythe Virginia StateDepartment ofHealth 76 oroperated bythe Department ofBehavioral HealthandDevelopmental Services. 77 (b) 2.The physician andtwo consulting physicians certifycertifies andsoenter enters inthe hospital 78 record ofthe woman ,that intheir thephysician©s medicalopinion, basedupontheirthephysician©s best 79 clinical judgment, thecontinuation ofthe pregnancy islikely toresult inthe death ofthe woman or 80 substantially andirremediably impairthemental orphysical healthofthe woman. 81 (c) 3.Measures forlife support forthe product ofsuch abortion ormiscarriage mustshallbe 82 available andutilized ifthere isany clearly visibleevidence ofviability. 83 §18.2-76. Informed writtenconsent required. 84 A. Before performing anyabortion orinducing anymiscarriage orterminating apregnancy as 85 provided in§18.2-72, 18.2-73,or18.2-74, thephysician shallobtain theinformed writtenconsent ofthe 86 pregnant woman.However, ifthe woman hasbeen adjudicated incapacitated byany court ofcompetent 87 jurisdiction orifthe physician knowsorhas good reason tobelieve thatsuch woman isincapacitated as 88 adjudicated byacourt ofcompetent jurisdiction, thenonly after permission isgiven inwriting bya 89 parent, guardian, committee, orother person standing inloco parentis tothe woman, maythephysician 90 perform theabortion orotherwise terminatethepregnancy. 91 B. At least 24hours before theperformance ofan abortion, aqualified medicalprofessional trained 92 in sonography andworking underthesupervision ofaphysician licensedinthe Commonwealth shall 93 perform fetaltransabdominal ultrasoundimagingonthe patient undergoing the abortion forthe purpose 94 of determining gestationalage.Ifthe pregnant womanlivesatleast 100miles fromthefacility where 95 the abortion isto be performed, thefetal ultrasound imagingshallbeperformed atleast twohours 96 before theabortion. Theultrasound imageshallcontain thedimensions ofthe fetus andaccurately 97 portray thepresence ofexternal members andinternal organsofthe fetus, ifpresent orviewable. 98 Determination ofgestational ageshall bebased uponmeasurement ofthe fetus inamanner consistent 99 with standard medicalpracticeinthe community fordetermining gestationalage.When onlythe 100 gestational sacisvisible duringultrasound imaging,gestational agemay bebased uponmeasurement of 101 the gestational sac.Ifgestational agecannot bedetermined byatransabdominal ultrasound,thenthe 102 patient undergoing theabortion shallbeverbally offeredotherultrasound imagingtodetermine 103 gestational age,which shemay refuse. Aprint ofthe ultrasound imageshallbemade todocument the 104 measurements thathave beentaken todetermine thegestational ageofthe fetus. 105 The provisions ofthis subsection shallnotapply ifthe woman seeking anabortion isthe victim of 106 rape orincest, ifthe incident wasreported tolaw-enforcement authorities.Nothinghereinshallpreclude 107 the physician fromusing anyultrasound imagingthatheconsiders to be medically appropriate pursuant 108 to the standard medicalpracticeinthe community. 109 C. The qualified medicalprofessional performingfetalultrasound imagingpursuant tosubsection B 110 shall verbally offerthewoman anopportunity toview theultrasound image,receive aprinted copyof 111 the ultrasound imageandhear thefetal heart tones pursuant tostandard medicalpracticeinthe 112 community, andshall obtain fromthewoman writtencertification thatthisopportunity wasoffered and 113 whether ornot itwas accepted and,ifapplicable, verification thatthepregnant womanlivesatleast 100 114 miles fromthefacility where the abortion isto be performed. Aprinted copyofthe ultrasound image 115 shall bemaintained inthe woman©s medicalrecordatthe facility wheretheabortion isto be performed 116 for the longer of(i) seven yearsor(ii) theextent required byapplicable federalorstate law. 117 D. For purposes ofthis section: 118 "Informed writtenconsent" meanstheknowing andvoluntary writtenconsent to abortion bya

3 of 7 119 pregnant womanofany age, without undueinducement orany element offorce, fraud, deceit, duress, or 120 other formofconstraint orcoercion bythe physician whoisto perform theabortion orhis agent. The 121 basic information toeffect suchconsent, asrequired bythis subsection, shallbeprovided bytelephone 122 or inperson tothe woman atleast 24hours before theabortion bythe physician whoisto perform the 123 abortion, byareferring physician, orby alicensed professional or practical nurseworking underthe 124 direct supervision ofeither thephysician whoisto perform theabortion orthe referring physician; 125 however, theinformation insubdivision 5may beprovided insteadbyalicensed health-care 126 professional workingunderthedirect supervision ofeither thephysician whoisto perform theabortion 127 or the referring physician. Thisbasic information shallinclude: 128 1. Afull, reasonable andcomprehensible medicalexplanation ofthe nature, benefits, andrisks ofand 129 alternatives tothe proposed procedures orprotocols tobe followed inher particular case; 130 2. An instruction thatthewoman maywithdraw herconsent atany time prior tothe performance of 131 the procedure; 132 3. An offer forthe woman tospeak withthephysician whoisto perform theabortion sothat he 133 may answer anyquestions thatthewoman mayhave andprovide furtherinformation concerningthe 134 procedures andprotocols; 135 4. Astatement ofthe probable gestational ageofthe fetus atthe time theabortion isto be performed 136 and that fetal ultrasound imagingshallbeperformed priortothe abortion toconfirm thegestational age; 137 and 138 5. An offer toreview theprinted materials described insubsection F.Ifthe woman chooses to 139 review suchmaterials, theyshall beprovided toher inarespectful andunderstandable manner,without 140 prejudice andintended togive thewoman theopportunity tomake aninformed choiceandshall be 141 provided toher atleast 24hours before theabortion ormailed toher atleast 72hours before the 142 abortion byfirst-class mailor,ifthe woman requests, bycertified mail,restricted delivery.Thisoffer for 143 the woman toreview thematerial shalladvise herofthe following: (i)the Department ofHealth 144 publishes printedmaterials thatdescribe theunborn childandlistagencies thatoffer alternatives to 145 abortion; (ii)medical assistance benefitsmaybeavailable forprenatal care,childbirth andneonatal care, 146 and that more detailed information\ onthe availability ofsuch assistance iscontained inthe printed 147 materials published bythe Department; (iii)thefather ofthe unborn childisliable toassist inthe 148 support ofher child, evenininstances wherehehas offered topay forthe abortion, thatassistance in 149 the collection ofsuch support isavailable, andthat more detailed information onthe availability ofsuch 150 assistance iscontained inthe printed materials published bythe Department; (iv)shehastheright to 151 review thematerials printedbythe Department andthat copies willbeprovided toher free ofcharge if 152 she chooses toreview them;and(v)astatewide listofpublic andprivate agencies andservices that 153 provide ultrasound imagingandauscultation offetal heart toneservices freeofcharge. Wherethe 154 woman hasadvised thatthepregnancy isthe result ofarape, theinformation inclause (iii)may be 155 omitted. 156 The information requiredbythis subsection maybeprovided bytelephone orinperson. 157 E. The physician neednotobtain theinformed writtenconsent ofthe woman whentheabortion isto 158 be performed pursuanttoamedical emergency orspontaneous miscarriage."Medicalemergency" means 159 any condition which,onthe basis ofthe physician©s goodfaithclinical judgment, socomplicates the 160 medical condition ofapregnant womanastonecessitate theimmediate abortionofher pregnancy to 161 avert herdeath orfor which adelay willcreate aserious riskofsubstantial andirreversible impairment 162 of amajor bodily function. 163 F. On orbefore October 1,2001, theDepartment ofHealth shallpublish, inEnglish andineach 164 language whichisthe primary language oftwo percent ormore ofthe population ofthe 165 Commonwealth, thefollowing printedmaterials insuch away astoensure thattheinformation iseasily 166 comprehensible: 167 1. Geographically indexedmaterials designedtoinform thewoman ofpublic andprivate agencies 168 and services available toassist awoman through pregnancy, uponchildbirth andwhile thechild is 169 dependent, including,butnotlimited to,information onservices relatingto(i) adoption asapositive 170 alternative, (ii)information relativetocounseling services,benefits,financial assistance, medicalcare 171 and contact persons orgroups, (iii)paternity establishment andchild support enforcement, (iv)child 172 development, (v)child rearing andstress management, (vi)pediatric andmaternal healthcare,and(vii) 173 public andprivate agencies andservices thatprovide ultrasound imagingandauscultation offetal heart 174 tone services freeofcharge. The materials shallinclude acomprehensive listofthe names and 175 telephone numbersofthe agencies, or,atthe option ofthe Department ofHealth, printedmaterials 176 including atoll-free, 24-hour-a-day telephonenumberwhichmaybecalled toobtain, orally,suchalist 177 and description ofagencies inthe locality ofthe caller andofthe services theyoffer; 178 2. Materials designedtoinform thewoman ofthe probable anatomical\ andphysiological 179 characteristics ofthe human fetusattwo-week gestational increments fromthetime when awoman can INTRODUCED HB2491

HB2491 4of 7 180 be known tobe pregnant tofull term, including anyrelevant information onthe possibility ofthe fetus©s 181 survival andpictures ordrawings representing thedevelopment ofthe human fetusattwo-week 182 gestational increments. Suchpictures ordrawings shallcontain thedimensions ofthe fetus andshall be 183 realistic andappropriate forthe stage ofpregnancy depicted.Thematerials shallbeobjective, 184 nonjudgmental anddesigned toconvey onlyaccurate scientific information aboutthehuman fetusatthe 185 various gestational ages;and 186 3. Materials containing objectiveinformation describingthemethods ofabortion procedures 187 commonly employed,themedical riskscommonly associatedwitheach such procedure, thepossible 188 detrimental psychological effectsofabortion, andthemedical riskscommonly associated withcarrying a 189 child toterm. 190 The Department ofHealth shallmake thesematerials availableateach local health department and, 191 upon request, toany person orentity, inreasonable numbersandwithout costtothe requesting party. 192 G. Any physician whofailstocomply withtheprovisions ofthis section shallbesubject toa$2,500 193 civil penalty. 194 §32.1-127. Regulations. 195 A.The regulations promulgated bythe Board tocarry outtheprovisions ofthis article shallbein 196 substantial conformity tothe standards ofhealth, hygiene, sanitation, construction andsafety as 197 established andrecognized bymedical andhealth careprofessionals andbyspecialists inmatters of 198 public healthandsafety, including healthandsafety standards established underprovisions ofTitle 199 XVIII andTitle XIXofthe Social Security Act,andtothe provisions ofArticle 2(§ 32.1-138 etseq.). 200 B.Such regulations: 201 1.Shall include minimum standardsfor(i)the construction andmaintenance ofhospitals, nursing 202 homes andcertified nursingfacilities to ensure theenvironmental protectionandthelife safety ofits 203 patients, employees, andthepublic; (ii) theoperation, staffingandequipping ofhospitals, nursinghomes 204 andcertified nursingfacilities; (iii)qualifications andtraining ofstaff ofhospitals, nursinghomesand 205 certified nursingfacilities, exceptthoseprofessionals licensedorcertified bythe Department ofHealth 206 Professions; (iv)conditions underwhich ahospital ornursing homemayprovide medical andnursing 207 services topatients intheir places ofresidence; and(v)policies relatedtoinfection prevention, disaster 208 preparedness, andfacility security ofhospitals, nursinghomes,andcertified nursingfacilities. For 209 purposes ofthis paragraph, facilitiesinwhich fiveormore firsttrimester abortions permonth are 210 performed shallbeclassified asacategory of"hospital" ; 211 2.Shall provide thatatleast onephysician whoislicensed topractice medicine inthis 212 Commonwealth shallbeon call atall times, though notnecessarily physicallypresentonthe premises, 213 ateach hospital whichoperates orholds itselfoutasoperating anemergency service; 214 3.May classify hospitals andnursing homesbytype ofspecialty orservice andmay provide for 215 licensing hospitalsandnursing homes by bed capacity andbytype ofspecialty orservice; 216 4.Shall alsorequire thateach hospital establish aprotocol fororgan donation, incompliance with 217 federal lawand theregulations ofthe Centers forMedicare andMedicaid Services(CMS),particularly 218 42C.F.R. §482.45. Eachhospital shallhaveanagreement withanorgan procurement organization 219 designated inCMS regulations for routine contact, whereby theprovider©s designated organprocurement 220 organization certifiedbyCMS (i)isnotified inatimely manner ofall deaths orimminent deathsof 221 patients inthe hospital and(ii)isauthorized todetermine thesuitability ofthe decedent orpatient for 222 organ donation and,inthe absence ofasimilar arrangement withanyeyebank ortissue bankin 223 Virginia certifiedbythe Eye Bank Association ofAmerica orthe American Association ofTissue 224 Banks, thesuitability fortissue and eyedonation. Thehospital shall also have anagreement withatleast 225 onetissue bankandatleast oneeyebank tocooperate inthe retrieval, processing, preservation, storage, 226 anddistribution oftissues andeyes toensure thatallusable tissues andeyes areobtained frompotential 227 donors andtoavoid interference withorgan procurement. Theprotocol shallensure thatthehospital 228 collaborates withthedesignated organprocurement organizationtoinform thefamily ofeach potential 229 donor ofthe option todonate organs, tissues,oreyes ortodecline todonate. Theindividual making 230 contact withthefamily shallhavecompleted acourse inthe methodology forapproaching potential 231 donor families andrequesting organ or tissue donation that(a)isoffered orapproved bythe organ 232 procurement organizationanddesigned inconjunction withthetissue andeyebank community and(b) 233 encourages discretionandsensitivity accordingtothe specific circumstances, views,andbeliefs ofthe 234 relevant family.Inaddition, the hospital shallwork cooperatively withthedesignated organprocurement 235 organization ineducating thestaff responsible forcontacting theorgan procurement organization©s 236 personnel ondonation issues,the proper review ofdeath records toimprove identification ofpotential 237 donors, andtheproper procedures formaintaining potentialdonorswhilenecessary testingand 238 placement ofpotential donatedorgans,tissues,andeyes takes place. Thisprocess shallbefollowed, 239 without exception, unlessthefamily ofthe relevant decedent orpatient hasexpressed opposition to 240 organ donation, thechief administrative\ officerofthe hospital orhis designee knowsofsuch opposition, 241 andnodonor cardorother relevant document, suchasan advance directive, canbefound;

5 of 7 242 5.Shall require thateach hospital thatprovides obstetrical servicesestablish aprotocol foradmission 243 ortransfer ofany pregnant womanwhopresents herselfwhileinlabor; 244 6.Shall alsorequire thateach licensed hospitaldevelopandimplement aprotocol requiring written 245 discharge plansforidentified, substance-abusing, postpartumwomenandtheir infants. Theprotocol shall 246 require thatthedischarge planbediscussed withthepatient andthat appropriate referralsforthe mother 247 andtheinfant bemade anddocumented. Appropriatereferralsmayinclude, butneed notbelimited to, 248 treatment services,comprehensive earlyintervention servicesforinfants andtoddlers withdisabilities 249 andtheir families pursuant toPart Hof the Individuals withDisabilities EducationAct,20U.S.C. 250 §1471 etseq., andfamily-oriented preventionservices.Thedischarge planning processshallinvolve, to 251 theextent possible, thefather ofthe infant andanymembers ofthe patient©s extended familywhomay 252 participate inthe follow-up careforthe mother andtheinfant. Immediately uponidentification, pursuant 253 to§54.1-2403.1, ofany substance-abusing, postpartumwoman,thehospital shallnotify, subject to 254 federal lawrestrictions, thecommunity servicesboardofthe jurisdiction inwhich thewoman residesto 255 appoint adischarge planmanager. The community servicesboardshallimplement andmanage the 256 discharge plan; 257 7.Shall require thateach nursing homeandcertified nursingfacilityfullydisclose tothe applicant 258 foradmission thehome©s orfacility©s admissions policies,including anypreferences given; 259 8.Shall require thateach licensed hospitalestablish aprotocol relatingtothe rights and 260 responsibilities ofpatients whichshallinclude aprocess reasonably designedtoinform patients ofsuch 261 rights andresponsibilities. Suchrights andresponsibilities ofpatients, acopy ofwhich shallbegiven to 262 patients onadmission, shallbeconsistent withapplicable federallawand regulations ofthe Centers for 263 Medicare andMedicaid Services; 264 9.Shall establish standards andmaintain aprocess fordesignation oflevels orcategories ofcare in 265 neonatal servicesaccording toan applicable nationalorstate-developed evaluationsystem.Such 266 standards maybedifferentiated for various levelsorcategories ofcare andmay include, butneed notbe 267 limited to,requirements forstaffing credentials, staff/patient ratios,equipment, andmedical protocols; 268 10.Shall require thateach nursing homeandcertified nursingfacilitytrainallemployees whoare 269 mandated toreport adultabuse, neglect, orexploitation pursuantto§63.2-1606 onsuch reporting 270 procedures andtheconsequences for failing tomake arequired report; 271 11.Shall permit hospital personnel, asdesignated inmedical staffbylaws, rulesandregulations, or 272 hospital policiesandprocedures, toaccept emergency telephoneandother verbal ordersformedication 273 ortreatment forhospital patients from physicians, andother persons lawfully authorized bystate statute 274 togive patient orders, subject toarequirement thatsuch verbal orderbesigned, withinareasonable 275 period oftime nottoexceed 72hours asspecified inthe hospital©s medicalstaffbylaws, rulesand 276 regulations orhospital policiesandprocedures, bythe person givingtheorder, or,when suchperson is 277 notavailable withintheperiod oftime specified, co-signed byanother physician orother person 278 authorized togive theorder; 279 12.Shall require, unlessthevaccination ismedically contraindicated orthe resident declines theoffer 280 ofthe vaccination, thateach certified nursingfacilityandnursing homeprovide orarrange forthe 281 administration toits residents of(i) anannual vaccination againstinfluenza and(ii)apneumococcal 282 vaccination, inaccordance withthe most recent recommendations ofthe Advisory Committee on 283 Immunization Practicesofthe Centers forDisease ControlandPrevention; 284 13.Shall require thateach nursing homeandcertified nursingfacilityregister withtheDepartment of 285 StatePolice toreceive noticeofthe registration orreregistration ofany sexoffender withinthesame or 286 acontiguous zipcode areainwhich thehome orfacility islocated, pursuant to§9.1-914; 287 14.Shall require thateach nursing homeandcertified nursingfacilityascertain, priortoadmission, 288 whether apotential patientisaregistered sexoffender, ifthe home orfacility anticipates thepotential 289 patient willhave alength ofstay greater thanthree daysorinfact stays longer thanthree days; 290 15.Shall require thateach licensed hospitalincludeinits visitation policy aprovision allowingeach 291 adultpatient toreceive visitsfromanyindividual fromwhom thepatient desires toreceive visits, 292 subject toother restrictions containedinthe visitation policyincluding, butnotlimited to,those related 293 tothe patient©s medicalcondition andthenumber ofvisitors permitted inthe patient©s room 294 simultaneously; 295 16.Shall require thateach nursing homeandcertified nursingfacilityshall,upontherequest ofthe 296 facility©s familycouncil, sendnotices andinformation aboutthefamily council mutually developed by 297 thefamily council andtheadministration ofthe nursing homeorcertified nursingfacility, andprovided 298 tothe facility forsuch purpose, tothe listed responsible party or acontact personofthe resident©s 299 choice uptosix times peryear. Such notices maybeincluded togetherwithamonthly billingstatement 300 orother regular communication. Noticesandinformation shallalsobeposted inadesignated location 301 within thenursing homeorcertified nursingfacility. Nofamily member ofaresident orother resident 302 representative shallberestricted fromparticipating inmeetings inthe facility withthefamilies or INTRODUCED HB2491

HB2491 6of 7 303 resident representatives ofother residents inthe facility; 304 17.Shall require thateach nursing homeandcertified nursingfacilitymaintain liabilityinsurance 305 coverage inaminimum amountof$1 million, andprofessional liabilitycoverage inan amount atleast 306 equaltothe recovery limitsetforth in§8.01-581.15, tocompensate patientsorindividuals forinjuries 307 andlosses resulting fromthenegligent orcriminal actsofthe facility. Failuretomaintain such 308 minimum insuranceshallresult inrevocation ofthe facility©s license; 309 18.Shall require eachhospital thatprovides obstetrical servicestoestablish policiestofollow whena 310 stillbirth, asdefined in§ 32.1-69.1, occursthatmeet theguidelines pertainingtocounseling patientsand 311 theirfamilies andother aspects ofmanaging stillbirthsasmay bespecified bythe Board inits 312 regulations; 313 19.Shall require eachnursing hometoprovide afull refund ofany unexpended patientfundson 314 deposit withthefacility following thedischarge ordeath ofapatient, otherthanentrance-related fees 315 paidtoacontinuing careprovider asdefined in§38.2-4900, within30days ofawritten request for 316 suchfunds bythe discharged patientor,inthe case ofthe death ofapatient, theperson administering 317 theperson©s estateinaccordance withthe Virginia SmallEstates Act(§64.2-600 etseq.); 318 20.Shall require thateach hospital thatprovides inpatient psychiatric servicesestablish aprotocol 319 thatrequires, forany refusal toadmit (i)amedically stablepatient referred toits psychiatric unit, direct 320 verbal communication betweentheon-call physician inthe psychiatric unitandthereferring physician, 321 ifrequested bysuch referring physician, andprohibits on-callphysicians orother hospital stafffrom 322 refusing arequest forsuch direct verbal communication byareferring physician and(ii)apatient for 323 whom thereisaquestion regarding themedical stability ormedical appropriateness ofadmission for 324 inpatient psychiatric servicesduetoasituation involving resultsofatoxicology screening,theon-call 325 physician inthe psychiatric unit to which thepatient issought tobe transferred toparticipate indirect 326 verbal communication, eitherinperson orvia telephone, withaclinical toxicologist orother person who 327 isaCertified Specialist inPoison Information employedbyapoison control centerthatisaccredited by 328 theAmerican Association ofPoison Control Centerstoreview theresults ofthe toxicology screenand 329 determine whetheramedical reason for refusing admission tothe psychiatric unitrelated tothe results 330 ofthe toxicology screenexists,ifrequested bythe referring physician; 331 21.Shall require thateach hospital thatisequipped toprovide life-sustaining treatmentshalldevelop 332 apolicy governing determination ofthe medical andethical appropriateness ofproposed medicalcare, 333 which shallinclude (i)aprocess forobtaining asecond opinion regarding themedical andethical 334 appropriateness ofproposed medicalcareincases inwhich aphysician hasdetermined proposedcareto 335 bemedically orethically inappropriate;\ (ii)provisions forreview ofthe determination thatproposed 336 medical careismedically orethically inappropriate byaninterdisciplinary medicalreviewcommittee 337 andadetermination bythe interdisciplinary medicalreviewcommittee regardingthemedical andethical 338 appropriateness ofthe proposed healthcare;and(iii) requirements forawritten explanation ofthe 339 decision reachedbythe interdisciplinary medicalreviewcommittee, whichshallbeincluded inthe 340 patient©s medicalrecord.Suchpolicy shallensure thatthepatient, hisagent, orthe person authorized to 341 make medical decisions pursuantto§54.1-2986 (a)are informed ofthe patient©s righttoobtain his 342 medical recordandtoobtain anindependent medicalopinionand(b) afforded reasonable opportunity to 343 participate inthe medical review committee meeting.Nothinginsuch policy shallprevent thepatient, 344 hisagent, orthe person authorized tomake medical decisions pursuantto§54.1-2986 fromobtaining 345 legalcounsel torepresent thepatient orfrom seeking otherremedies availableatlaw, including seeking 346 courtreview, provided thatthepatient, hisagent, orthe person authorized tomake medical decisions 347 pursuant to§54.1-2986, orlegal counsel provides writtennoticetothe chief executive officerofthe 348 hospital within14days ofthe date onwhich thephysician©s determination thatproposed medical 349 treatment ismedically orethically inappropriate isdocumented inthe patient©s medicalrecord; 350 22.Shall require everyhospital withanemergency department toestablish protocols toensure that 351 security personnel ofthe emergency department, ifany, receive training appropriate tothe populations 352 served bythe emergency department, whichmayinclude training basedonatrauma-informed approach 353 inidentifying andsafely addressing situationsinvolving patientsorother persons whopose arisk of 354 harmtothemselves orothers duetomental illnessorsubstance abuseorwho areexperiencing amental 355 health crisis;and 356 23.(Effective March1,2019) Shallrequire thateach hospital establish aprotocol requiring that, 357 before ahealth careprovider arrangesforairmedical transportation servicesforapatient whodoes not 358 haveanemergency medicalcondition asdefined in42 U.S.C. §1395dd(e)(1), thehospital shallprovide 359 thepatient orhis authorized representative withwritten orelectronic noticethatthepatient (i)may have 360 achoice oftransportation byanair medical transportation providerormedically appropriate ground 361 transportation byanemergency medicalservices provider and(ii)will be responsible forcharges 362 incurred forsuch transportation inthe event thattheprovider isnot acontracted networkprovider ofthe 363 patient©s healthinsurance carrierorsuch charges arenot otherwise coveredinfull orinpart bythe 364 patient©s healthinsurance plan.

7 of 7 365 C.Upon obtaining theappropriate license,ifapplicable, licensedhospitals, nursinghomes,and 366 certified nursingfacilities mayoperate adultdaycare centers. 367 D.All facilities licensedbythe Board pursuant tothis article whichprovide treatment orcare for 368 hemophiliacs and,inthe course ofsuch treatment, stockclotting factors,shallmaintain recordsofall lot 369 numbers orother unique identifiers forsuch clotting factorsinorder that,inthe event thelotisfound to 370 becontaminated withaninfectious agent,thosehemophiliacs whohave received unitsofthis 371 contaminated clottingfactormaybeapprised ofthis contamination. Facilitieswhichhaveidentified alot 372 which isknown tobe contaminated shallnotify therecipient©s attendingphysician andrequest thathe 373 notify therecipient ofthe contamination. Ifthe physician isunavailable,\ thefacility shallnotify bymail, 374 return receipt requested, eachrecipient whoreceived treatment fromaknown contaminated lotatthe 375 individual©s lastknown address. INTRODUCED HB2491

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