SS#4 SS SS SCS HS HCS HB 1320, 981, 1042, 1109 & 1250 -- ABORTION
(Vetoed by the Governor)

The bill makes several changes regarding abortion. The bill:

(1) Requires abortions to be performed in a physician's office,
outpatient clinic, ambulatory surgical center, or hospital;

(2) Requires a physician to be present in the abortion facility
until the patient is discharged;

(3) Requires physicians performing abortions to have a medical
malpractice insurance policy covering damages of $500,000; and

(4) Prohibits a physician from performing an abortion unless the
physician has clinical privileges for obstetrical and
gynecological care at a Missouri hospital.

Anyone violating any of these provisions is guilty of a class A
misdemeanor.  A medical emergency requiring an immediate
abortion is a defense to these crimes.

The bill also requires any abortion facility that is not
currently licensed by the Department of Health to be inspected
at least annually by the department. The department is required
to promulgate rules concerning these facilities.  The rules must
be related to the physical health and safety of patients.
Provisions are included for facilities that fail to comply with
the rules.

The bill also requires the Department of Health to have a
computerized listing of services available to pregnant women and
a program connected with the Tel-Link program to refer women to
organizations that assist women before and after their pregnancy.

The bill has an effective date of January 1, 1997.

HS HCS HB 1320, 981, 1042, 1109 & 1250 -- ABORTION (O'Connor)

The substitute makes several changes concerning abortion. The
substitute:

(1) Requires abortions to be performed or induced in a
physician's office, outpatient clinic, ambulatory surgical
center, or hospital;

(2) Requires a physician to be present in the abortion facility
or hospital until the patient is discharged;

(3) Requires physicians performing or inducing abortions to have
a medical malpractice insurance policy covering damages of
$500,000 per occurrence and $1 million annually; and

(4) Prohibits a physician from performing or inducing an
abortion unless the physician has clinical privileges at a
hospital in the county or an adjoining county where the abortion
is to be performed.

Anyone knowingly violating any of these provisions is guilty of
a class A misdemeanor.  A medical emergency requiring an
immediate abortion is a defense to this crime.

The substitute also requires any abortion facility which is not
currently licensed by the Department of Health to be licensed.
The annual fee for licensure is $200. The Department is required
to promulgate regulations pertaining to: facility construction;
number, qualifications, and organization of personnel; equipment
essential to the welfare of patients; services to be provided in
caring for patients; procedures for peer review of complaints;
and procedures for receiving and investigating complaints. The
department is also required to inspect facilities and may
suspend or deny a license based on failure to comply with
statutory or regulatory requirements. In addition, operating an
abortion facility without a license is a class A misdemeanor.

The substitute also requires the Department of Health to
establish alternatives to abortion services. These alternatives
include: pamphlets describing services which are available to
pregnant women; educational programs for social workers and
similar professionals describing services to assist pregnant
women; and a program to refer women to organizations to assist
the women before and after their pregnancy. The cost of the
program is capped at $99,000 for each of the first 3 fiscal
years.

The substitute has an effective date of January 1, 1997.

FISCAL NOTE:  Estimated Net Cost to General Revenue Fund of
$49,500 in FY 97, $99,000 in FY 98 & FY 99.

HCS HB 1320, 981, 1042, 1109 & 1250 -- ABORTION

SPONSORS:  Dougherty (O'Connor)

COMMITTEE ACTION:  Voted "do pass" by the Committee on Children,
Youth and Families by a vote of 11 to 6.

This substitute makes several changes concerning abortion. The
substitute:

(1) Changes the gestational age at which an abortion must be
done in a hospital from 16 weeks to 18 weeks. In the period from
14 weeks to 18 weeks, abortions must be done in hospitals or
ambulatory surgical centers.  During the first 14 weeks,
abortions must be performed in hospitals, ambulatory surgical
centers, physicians' offices, or outpatient clinics;

(2) Requires a physician to be present in the abortion facility
until the patient is discharged;

(3)Requires physicians performing abortions to maintain proof of
financial responsibility of at least $1 million;

(4) Prohibits abortion facilities or hospitals from hiring a
physician to perform an abortion without proof of financial
responsibility of at least $1 million; and

(5) Prohibits a physician from performing an abortion unless the
abortion is performed in a facility that has a contract with a
hospital to accept emergency patients or the physician has
surgical privileges at a hospital which offers obstetrical and
gynecological care and is located in the county or an adjoining
county where the abortion is to be performed.

Anyone knowingly violating any of these provisions will be
guilty of a class A misdemeanor.  A medical emergency requiring
an immediate abortion is a defense to this crime.

In addition, the substitute requires the Department of Health to
establish alternatives to abortion services. These alternatives
include: pamphlets for pregnant women describing alternatives to
abortion; educational programs for social workers and similar
professionals describing services to assist pregnant women; and
a program to refer women to organizations to assist the women
before and after their pregnancy. The cost of the program is
capped at $65,000 for each of the first 3 fiscal years.

The substitute also requires certain regulations of the
Department of Health to be applied to any facility where at
least 24 abortions have been performed in the previous year that
states publicly that it provides abortion services. This part of
the substitute does not apply to hospitals.

The substitute has an effective date of January 1, 1997.

FISCAL NOTE:  Estimated Net Cost to General Revenue Fund of
$32,500 in FY 97, $65,000 in FY 98 & $65,000 in FY 99.
Estimated Net Cost to Insurance Dedicated Fund of $17,806 in FY
97, $13,502 in FY 98, and $13,847 in FY 99.

PROPONENTS:  Supporters of the originals bills say that the
bills are compromise bills designed to ensure that women can
make safe and informed choices. Supporters say that pro-choice
and pro-life forces should be able to agree that if abortions
are to remain legal, they should also be safe. Supporters say
that there have been numerous instances of women who have been
seriously injured by an improperly performed abortion.
Supporters say that the bills assure adequate protection of the
health and safety of all women choosing abortion. Supporters
also say that the bills are consistent with American College of
Obstetricians and Gynecologists standards for performing
abortions. Supporters say that the bills are constitutional.

Testifying for the original bills were Representatives
O'Connor,  Ridgeway,  Auer, Reynolds,  Luetkenhaus, and Edwards--
Pavia; Missouri Right to Life; Campaign Life Missouri; Missouri
Catholic Conference; Missouri Eagle Forum; Lighthouse of Kansas
City; Concord Baptist Church; Nurses for Newborns; Salvation
Army; Women Exploited by Abortion; Advice and Aid Pregnancy
Center of Overland Park, Kansas; Faye Lee Combs Furlow;
Constance Eller; Joan Berry; and Becky Whitworth.

OPPONENTS:  Those who oppose the original bills say that the
bills are a poorly disguised attempt to infringe on a woman's
right to choose. Opponents say that the bills do nothing to
improve the safety of abortions and even make abortions riskier
because the bills severely limit access to abortions. Opponents
say the vast majority of abortions are performed without any
health consequences to the woman and that abortions are far
safer than childbirth and other medical procedures. Opponents
also say that the bills are not consistent with the newest
standards of the American College of Obstetricians and
Gynecologists. Opponents say that the bills are unconstitutional.

Testifying against the original bills were Missouri Alliance for
Choice; Planned Parenthood; Missouri Women's Network; National
Abortion Rights Action League; American Civil Liberties Union;
and Ann Stapleton.

Ted Wedel, Research Analyst

HB 1320 -- Abortion

Sponsor:  O'Conner

This bill makes several changes concerning abortion. The bill
changes the gestational age at which an abortion must be done in
a licensed hospital from 16 weeks to 18 weeks. In the period
from 14 weeks to 18 weeks, abortions must be done in licensed
hospitals or licensed ambulatory surgical centers.  During the
first 14 weeks, abortions must be performed in licensed
hospitals, licensed ambulatory surgical centers, physicians'
offices, or outpatient clinics.

The bill also requires a physician to be present in the abortion
facility until the patient is discharged.

The bill requires physicians to furnish to the Department of
Insurance proof of financial responsibility of at least $1
million in the form of either malpractice insurance or a surety
bond. The bill makes it unlawful for an abortion facility or
hospital to hire a physician to perform an abortion without
proof of financial responsibility.  Physicians must annually
submit this proof to the Department of Insurance. Records of
proof of financial responsibility are only available to certain
persons.

The bill also makes it unlawful for a physician to perform an
abortion if the physician does not have surgical privileges at a
hospital which offers obstetrical and gynecological care and is
located in the county or an adjoining county where the abortion
is to be performed.

Anyone knowingly violating any of these provisions will be
guilty of a class A misdemeanor.  A medical emergency requiring
an immediate abortion is a defense to this crime.

The bill requires the Department of Health to establish
alternatives to abortion services. These alternatives include:
pamphlets for pregnant women describing alternatives to
abortion; educational programs for social workers and similar
professionals describing services to assist pregnant women; and
a program to refer women to organizations to assist the women
before and after their pregnancy. The cost of the program is
capped at $65,000 for each of the first three fiscal years.

The bill has an effective date of January 1, 1997.