103RD GENERAL ASSEMBLY
State of Illinois
2023 and 2024
HB4356

 

Introduced 1/16/2024, by Rep. William E Hauter

 

SYNOPSIS AS INTRODUCED:
 
New Act

    Creates the Women's Health Protection Act. Requires all abortion clinics to be licensed by the Department of Public Health. Sets forth provisions relating to application procedures, license issuance, denial, suspension, revocation, or refusal, administrative decisions, and the adoption of rules. Requires the Department to establish policies and procedures for conducting prelicensure and relicensure inspections of abortion clinics. Provides that the Director of the Department shall adopt rules relating to an abortion clinic's physical facilities, supply and equipment standards, and personnel. Provides for civil penalties, including a $5,000 civil penalty for operating an abortion clinic without a license, a $5,000 civil penalty for intentionally violating the Act, and a $1,000 civil penalty for a first violation of the Act and $5,000 for a subsequent violation. Allows both the Office of the Attorney General and the Office of the State's Attorney for the county in which the violation occurred to initiate a legal action to enforce collection of civil penalties. Allows the Director to apply to any court of competent jurisdiction for an order enjoining any acts or practices which constitute or will constitute a violation of the Act. Provides that nothing in the Act makes lawful an abortion that is currently unlawful. Defines terms. States legislative findings and purposes. Effective one year after becoming law.


LRB103 36196 LNS 66288 b

 

 

A BILL FOR

 

HB4356LRB103 36196 LNS 66288 b

1    AN ACT concerning health.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 1. Short title. This Act may be cited as the
5Women's Health Protection Act.
 
6    Section 5. Legislative findings and purposes.
7    (a) The General Assembly finds that:
8        (1) Most abortions in this State are performed in
9    clinics devoted primarily to providing abortions and
10    family planning services. Most women who seek abortions at
11    these facilities lack any physician-patient relationship
12    with the physician who performs the abortion either before
13    or after the procedure. The women ordinarily do not return
14    to the facility for post-surgical care. In most instances,
15    the woman's only actual contact with the abortion provider
16    occurs simultaneously with the abortion procedure, with
17    little opportunity to ask questions about the procedure,
18    potential complications, and proper follow-up care.
19        (2) The medical, emotional, and psychological
20    consequences of an abortion are serious and can be
21    lasting.
22        (3) Abortion can lead to both short-term and long-term
23    medical complications. Potential complications from

 

 

HB4356- 2 -LRB103 36196 LNS 66288 b

1    abortion include, among others, bleeding, hemorrhage,
2    infection, uterine perforation, uterine scarring, blood
3    clots, cervical tears, incomplete abortion (retained
4    tissue), failure to actually terminate the pregnancy, free
5    fluid in the abdomen, acute abdomen, organ damage, missed
6    ectopic pregnancies, cardiac arrest, sepsis, respiratory
7    arrest, reactions to anesthesia and other drugs, and even
8    death.
9        (4) The risks for second-trimester abortions are
10    greater than for first-trimester abortions. The risk of
11    hemorrhage, in particular, is greater, and the resultant
12    complications may require a hysterectomy, other reparative
13    surgery, or a blood transfusion.
14        (5) The State has legitimate interests from the outset
15    of pregnancy in protecting the health of women.
16        (6) More specifically, the State has a legitimate
17    concern with the health of women who undergo abortions.
18    (b) Based on the findings in subsection (a), the purposes
19of this Act are to:
20        (1) regulate abortion clinics consistent with standard
21    health and safety procedures of the Department of Public
22    Health; and
23        (2) provide for the protection of public health
24    through the development, establishment, and enforcement of
25    medically appropriate standards of care and safety in
26    abortion clinics.
 

 

 

HB4356- 3 -LRB103 36196 LNS 66288 b

1    Section 10. Definitions. As used in this Act:
2    "Abortion" has the meaning given to that term in Section
31-10 of the Reproductive Health Act.
4    "Abortion clinic" means a facility, other than an
5accredited hospital or health care professional's office, in
6which 5 or more first-trimester abortions, that are not
7chemical abortions, in any month or any second-trimester or
8third-trimester abortions are performed, and whose primary
9purpose is the performance of abortions.
10    "Advanced practice registered nurse" has the meaning given
11to that term in Section 50-10 of the Nurse Practice Act.
12    "Department" means the Department of Public Health.
13    "Director" means the Director of the Department of Public
14Health.
15    "Health care professional" means a person who is a
16licensed physician, advanced practice registered nurse, or
17physician assistant.
18    "Licensee" means an individual, a partnership, an
19association, a limited liability company, or a corporation
20authorized by the Department of Public Health to operate an
21abortion clinic.
22    "Physician" means a person licensed to practice medicine
23in all its branches under the Medical Practice Act of 1987.
24    "Physician assistant" has the meaning given to that term
25in Section 4 of the Physician Assistant Practice Act of 1987.
 

 

 

HB4356- 4 -LRB103 36196 LNS 66288 b

1    Section 15. Licensure requirements.
2    (a) Beginning one year after the effective date of this
3Act, all abortion clinics shall be licensed by the Department.
4Any existing abortion clinic shall apply for licensure within
5one year of the effective date of this Act.
6    (b) A licensure applicant shall apply to the Department
7with Department-provided forms. The Department shall include
8such information as the Department reasonably requires,
9including affirmative evidence of ability to comply with such
10reasonable standards and rules as are lawfully prescribed
11hereunder. The Department shall supply supplemental forms for
12additional information it requires as needed.
13    (c) The Department shall issue a license which is valid
14for a period of one year after the following procedures are
15fulfilled:
16        (1) the Department receives an application for
17    license;
18        (2) the applicant and the facility meet the
19    requirements established by this Act; and
20        (3) the minimum standards and administrative rules are
21    adopted in accordance with this Act.
22    (d) The Department may issue a temporary or provisional
23license to an abortion clinic for a period of 6 months in cases
24where:
25        (1) no other State or local agency who is authorized

 

 

HB4356- 5 -LRB103 36196 LNS 66288 b

1    to inspect abortion facilities has given a disapproval to
2    such abortion clinic;
3        (2) sufficient compliance with the Department's
4    minimum standards and rules require a time extension; and
5        (3) any failure to comply is not detrimental to the
6    public's health and safety.
7    (e) A license:
8        (1) only applies to the location and licensee stated
9    on the application;
10        (2) is nontransferable between other places or
11    licensees once issued;
12        (3) if the location of the facility is changed, the
13    license shall be automatically revoked;
14        (4) is valid for one year from the issuance date,
15    unless sooner revoked;
16        (5) is only granted from a Department-prescribed form;
17    and
18        (6) may be renewed yearly upon application and payment
19    of the license fee if the applicant procures the original
20    license.
21    (f) A licensee or licensee applicant shall:
22        (1) complete a renewal application form prior to all
23    license renewals; and
24        (2) enclose a fee of $2,500, which is levied as the
25    license fee for a one-year operation of an abortion clinic
26    and paid into the Department's fund.

 

 

HB4356- 6 -LRB103 36196 LNS 66288 b

1    (g) The Department may deny, suspend, revoke, or refuse to
2renew a license in any case in which it finds that the
3applicant or licensee has substantially failed to comply with
4this Act's requirements or the Department's minimum standards
5and administrative rules adopted by the Department in
6accordance with this Act. In such case, the Department shall
7furnish the person, applicant, or licensee 30 days' notice
8specifying the reason or reasons for the action, however, if
9in the discretion of the Department, the failure to comply
10presents a substantial present threat to patient health and
11safety, the denial, suspension, revocation, or refusal to
12renew may be effective immediately.
13    (h) All final administrative decisions of the Department
14are subject to judicial review pursuant to the Administrative
15Review Law and its rules. As used in this subsection,
16"administrative decisions" has the meaning given to that term
17in Section 3-101 of the Code of Civil Procedure.
18    (i) The Department shall adopt any rules necessary to
19implement this Section.
 
20    Section 20. Inspections and investigations.
21    (a) The Department shall establish policies and procedures
22for conducting prelicensure and relicensure inspections of
23abortion clinics. Prior to issuing or reissuing a license, the
24Department shall conduct an on-site inspection to ensure
25compliance with this Act.

 

 

HB4356- 7 -LRB103 36196 LNS 66288 b

1    (b) The Department shall:
2        (1) establish policies and procedures for conducting
3    inspections and investigations in accordance with
4    complaints received by the Department and made against any
5    abortion clinic; and
6        (2) receive, record, and dispose of complaints in
7    accordance with established policies and procedures.
8    (c) If the Director determines that there is probable
9cause to believe a licensee, licensed abortion clinic, or
10abortion clinic is not adhering to this Act's requirements,
11the minimum standards or administrative rules adopted by the
12Department under the authority of this Act, or with any other
13standards and administrative rules related to the provision of
14abortion, the Director may issue an order authorizing an
15appropriately qualified employee or agent of the Department to
16enter upon the business premises with due consideration for
17patient care of the abortion clinic so as to inspect the
18physical premises and equipment and furnishing therein. No
19such order shall include the right of inspection of business,
20medical, or personnel records located on the premises. Any
21such order shall expire and become void 5 business days after
22its issuance by the Illinois State Medical Board. The
23execution of any such order shall be valid only during the
24normal business hours of the abortion clinic.
25    (d) An application for a license pursuant to this Act and
26the minimum standards or administrative rules adopted by the

 

 

HB4356- 8 -LRB103 36196 LNS 66288 b

1Department under the authority of this Act constitutes
2permission for an entry or inspection of the premises during
3the pendency of the application and, if licensed, during the
4term of the license, consistent with subsection (c).
5    (e) The Director may deny, suspend, revoke, or refuse to
6renew a license to operate an abortion clinic, if an
7inspection or investigation conducted pursuant to subsection
8(a), (b), or (c) reveals that a licensee or licensed abortion
9clinic is not adhering to:
10        (1) this Act's requirements; or
11        (2) the minimum standards or administrative rules
12    adopted by the Department under this Act.
 
13    Section 25. Minimum standards and administrative rules for
14abortion clinics.
15    (a) The Director shall adopt rules for an abortion
16clinic's physical facilities. At a minimum, these rules shall
17prescribe standards for:
18        (1) adequate private space specifically designated for
19    interviewing, counseling, and performing medical
20    evaluations;
21        (2) dressing rooms for staff and patients;
22        (3) appropriate lavatory areas;
23        (4) areas for preprocedure hand washing;
24        (5) private procedure rooms;
25        (6) adequate lighting and ventilation for abortion

 

 

HB4356- 9 -LRB103 36196 LNS 66288 b

1    procedures;
2        (7) surgical or gynecologic examination tables and
3    other fixed equipment;
4        (8) post-procedure recovery rooms that are supervised,
5    staffed, and equipped to meet the patients' needs;
6        (9) emergency exits to accommodate a stretcher or
7    gurney;
8        (10) areas for cleaning and sterilizing instruments;
9        (11) adequate areas for the secure storage of medical
10    records and necessary equipment and supplies; and
11        (12) a display in the abortion clinic, in a place that
12    is conspicuous to patients, of the clinic's current
13    license issued by the Department.
14    (b) The Director shall adopt rules to prescribe abortion
15clinic supply and equipment standards, including supplies and
16equipment that are required to be immediately available for
17use in an emergency. At a minimum, these rules shall:
18        (1) prescribe required equipment and supplies,
19    including medications, required for:
20            (A) performing, in an appropriate fashion, any
21        abortion procedure; and
22            (B) monitoring each patient's progress throughout
23        the procedure and recovery period.
24        (2) require that the number or amount of equipment and
25    supplies at the abortion clinic is adequate at all times
26    to assure sufficient quantities of clean, sterilized,

 

 

HB4356- 10 -LRB103 36196 LNS 66288 b

1    durable equipment, and supplies to meet each patient's
2    needs;
3        (3) prescribe required equipment, supplies, and
4    medications that shall be available and ready for
5    immediate use in an emergency and requirements for written
6    protocols and procedures to be followed by staff in an
7    emergency, such as the loss of electrical power;
8        (4) prescribe required equipment and supplies for
9    laboratory tests and the requirements for protocols to
10    maintain laboratory equipment located in the abortion
11    clinic or any equipment operated by clinic staff;
12        (5) require ultrasound equipment in all abortion
13    clinics; and
14        (6) require that all equipment is safe for patients
15    and the staff, meets applicable federal standards, and is
16    checked annually.
17    (c) The Director shall adopt rules relating to abortion
18clinic personnel. At a minimum, the rules shall:
19        (1) require an abortion clinic designate a medical
20    director who is licensed to practice medicine and surgery
21    in this State as follows:
22            (A) health care professionals performing abortions
23        are:
24                (i) licensed in this State; and
25                (ii) trained and educated in the procedures
26            involved;

 

 

HB4356- 11 -LRB103 36196 LNS 66288 b

1            (B) registered nurses, licensed practical nurses,
2        or other personnel supervised by a health care
3        professional receive training in the specific
4        responsibilities of their services provided at an
5        abortion clinic; and
6            (C) volunteers, if any, receive training in the
7        specific responsibilities of the services that
8        volunteers provide at an abortion clinic, including
9        counseling and patient advocacy;
10        (2) provide procedures for medical screening and
11    evaluation of each abortion clinic patient;
12        (3) provide procedures for abortion;
13        (4) prescribe minimum recovery room standards for the
14    abortion clinic;
15        (5) prescribe standards for follow-up care for
16    abortion patients;
17        (6) prescribe minimum abortion clinic incident
18    reporting. At a minimum, these reporting rules shall
19    require that:
20            (A) the abortion clinic record each incident
21        resulting in a patient's serious injury occurring at
22        an abortion clinic, and report the incident in writing
23        to the Department within 10 days after the incident.
24        As used in this paragraph, "serious injury" means an
25        injury that occurs at an abortion clinic and that
26        creates a serious risk of substantial impairment of a

 

 

HB4356- 12 -LRB103 36196 LNS 66288 b

1        major body organ or function;
2            (B) if a patient's death occurs, the abortion
3        clinic report it to the Department no later than the
4        next Department work day.
5            (C) an incident report be filed with the
6        Department and other appropriate professional
7        regulatory boards; and
8        (7) prohibit the Department from releasing personally
9    identifiable patient or physician information.
10    (d) This Act's provisions and the rules adopted under the
11Act shall be in addition to any other laws and administrative
12or other rules which are applicable to abortion clinics.
 
13    Section 30. Civil penalties.
14    (a) Whoever operates an abortion clinic without a valid
15license issued by the Department is subject to a civil penalty
16of $5,000.
17    (b) Any person who intentionally violates this Act or any
18rules adopted under this Act is subject to a civil penalty of
19$5,000 for each violation.
20    (c) Any violation of this Act or any rules adopted under
21this Act may be subject to a civil penalty of $1,000 for a
22first violation and $5,000 for each subsequent violation
23imposed by the Department.
24    (d) Each day of violation constitutes a separate violation
25for purposes of assessing civil penalties.

 

 

HB4356- 13 -LRB103 36196 LNS 66288 b

1    (e) In deciding whether and to what extent to impose
2penalties, the Department shall consider the following
3factors:
4        (1) the gravity of the violation, including the
5    probability that death or serious physical harm to a
6    patient or individual will result or has resulted;
7        (2) the size of the population at risk due to the
8    violation;
9        (3) the severity and scope of the actual or potential
10    harm;
11        (4) the extent to which the provisions of the
12    applicable statutes and rules were violated;
13        (5) any indications of good faith exercised by the
14    licensee;
15        (6) the duration, frequency, and relevance of any
16    previous violations committed by the licensee; and
17        (7) the financial benefit to the licensee of
18    committing or continuing the violation.
19    (f) Both the Office of the Attorney General and the Office
20of the State's Attorney for the county in which the violation
21occurred may initiate a legal action to enforce collection of
22civil penalties.
 
23    Section 35. Injunctive remedies. In addition to any other
24penalty provided by law, whenever, in the Director's judgment,
25any person has engaged, or is about to engage, in any acts or

 

 

HB4356- 14 -LRB103 36196 LNS 66288 b

1practices which constitute, or will constitute, a violation of
2this Act, or any rule adopted under this Act, the Director
3shall apply to any court of competent jurisdiction for an
4order enjoining such acts and practices. Upon the Director's
5showing that such person has engaged, or is about to engage, in
6any such acts or practices, an injunction, restraining order,
7or such other order as may be appropriate shall be granted by
8such court without bond.
 
9    Section 40. Construction. Nothing in this Act makes lawful
10an abortion that is currently unlawful.
 
11    Section 97. Severability. Any provision of this Act held
12to be invalid or unenforceable by its terms, or as applied to
13any person or circumstance, shall be construed so as to give it
14the maximum effect permitted by law, unless such holding shall
15be one of utter invalidity or unenforceability, in which event
16such provision shall be deemed severable from this Act and
17shall not affect the remainder of this Act or the application
18of such provision to other persons not similarly situated or
19to other, dissimilar circumstances.
 
20    Section 99. Effective date. This Act takes effect one year
21after becoming law.