Amendments	Fiscal Memos
HA0280	Amendment 1-0 to HB1181
HA0283	Amendment 2-0 to HB1181

	Amendments	Fiscal Memos
SA0259	Amendment 1-1 to SB0828

NOTE: Each fiscal memorandum applies only to the amendment(s) identified in the memorandum. The fiscal memorandum must be matched to any amendments that have been adopted.

Fiscal Summary

NOT SIGNIFICANT

Bill Summary

Generally under present law, the method of disposition of an aborted fetus or aborted fetal tissue must be in conformity with the rules of the board for licensing healthcare facilities. This bill deletes that provision and instead requires that final disposition of fetal remains from a surgical abortion at an abortion facility be by cremation or interment. This bill provides that a pregnant woman who has a surgical abortion has the right to determine the following regarding the fetal remains:

(1) Whether the final disposition is by cremation or interment; and

(2) The location for the final disposition.

If a pregnant woman desires to exercise the rights under (1) and (2) above, the woman must make the determination in writing and the determination must clearly indicate whether the final disposition will be by cremation or interment and whether the final disposition will be at a location other than the location provided by the abortion facility. If the woman does not desire to make such determinations, then the abortion facility will determine whether final disposition is by cremation or interment.

This bill requires a pregnant woman who is under 18 years of age, unmarried, and unemancipated to obtain parental consent from one of the pregnant woman's parents, guardian, or custodian to the final disposition determination she makes. Such consent will not be required if an order authorizing the minor to consent, or the court to consent on behalf of the minor, to the abortion is issued by a court.

This bill requires an abortion facility to pay for and provide for the cremation or interment of the fetal remains from a surgical abortion performed at that facility. However, if the disposition determination identifies a location for final disposition other than a location provided by the abortion facility, then the pregnant woman will be responsible for the costs related to the final disposition of the fetal remains at the chosen location. This bill also requires an abortion facility to:

(1) Document in the pregnant woman's medical record the final disposition determination made;

(2) Maintain evidentiary documentation demonstrating the date and method of the disposition of fetal remains from surgical abortions performed or induced in the facility;

(3) Have written policies and procedures regarding cremation or interment of fetal remains from surgical abortions performed or induced in the facility; and

(4) Develop and maintain a written list of locations at which the facility provides or arranges for the final disposition of fetal remains from surgical abortions.

This bill provides that a person who buries or cremates fetal remains from a surgical abortion will not be liable for or subject to damages in a civil action, prosecution in a criminal proceeding, or professional disciplinary action related to the disposal of fetal remains, if that person complies with the law in good faith, receives a copy of a properly executed determination form, and acts in furtherance of the final disposition of the fetal remains. This bill also provides that a pregnant woman who has a surgical abortion, the fetal remains from which are not disposed of in compliance with this bill, will not be guilty of committing, attempting to commit, complicity in the commission of, or conspiracy in the commission of a violation of this bill. Other violations of the above-described requirements of this bill by an abortion facility will be a Class A misdemeanor.

This bill prohibits an operator of a crematory facility from:

(1) Cremating fetal remains without receiving a copy of a properly executed determination form;

(2) Disposing of cremated fetal remains by a means other than placing the cremated fetal remains in a grave, crypt, or niche; scattering the cremated fetal remains in a dignified manner, including in a memorial garden, at sea, by air, or at a lawful scattering ground; releasing the cremated fetal remains to the pregnant woman or a party designated by the pregnant woman; or any other lawful manner;

(3) Arranging for the disposal of cremated fetal remains by a means other than one described above; and

(4) Arranging for the transfer of the cremated fetal remains for disposal by a means other than the means described above.

This bill specifies that an operator of a crematory facility is not required to secure a death certificate, burial permit, transportation permit, or a cremation authorization form to cremate fetal remains.

ON APRIL 19, 2021, THE HOUSE ADOPTED AMENDMENTS #1 AND #2 AND PASSED HOUSE BILL 1181, AS AMENDED.

AMENDMENT #1 revises the bill as follows:

(1) Excludes a hospital from the definition of "abortion facility" for purposes of this bill if the hospital acts pursuant to hospital policies or regulations concerning the disposal of fetal remains that substantially comply with the requirements of this bill;

(2) Clarifies that this bill prohibits a person from making a final disposition of fetal remains from a surgical abortion that occurs at an abortion facility except by cremation or internment;

(3) Specifies that if a pregnant woman desires to exercise the right to make the determination regarding the fetal remains as described in this bill, then an abortion facility will be prohibited from releasing fetal remains from a surgical abortion, or arranging for the cremation or interment of the fetal remains, until the facility obtains a final disposition determination made, and if applicable, the consent made under this bill; and

(4) Adds that the commissioner of health may consider the following when promulgating rules to effectuate the purposes of the bill: the need to clearly state in rules that the only legal methods of disposition of fetal remains are by burial or cremation, and that fetal remains cannot be disposed of as infectious waste; appropriate time limitations within which abortion providers and facilities must satisfy the requirements of this bill; and the need to promulgate forms or establish other methods to ensure that the fetal remains of each unborn child are properly accounted for during transportation and delivery by and to persons and entities involved in the disposition of the fetal remains, and in a manner that does not disclose the protected healthcare information or identity of the pregnant woman on whom the abortion was performed.

AMENDMENT #2 revises various provisions of this bill as follows:

(1) Clarifies that the commissioner must develop the forms or modify existing forms (instead of promulgating rules that prescribe form) contemplated by this bill, such as the consent and notification forms, and adds a provision for "other forms that the commissioner determines to be necessary to ensure that the fetal remains of each unborn child are properly accounted for during transportation and delivery by and to persons and entities involved in the disposition of the fetal remains";

(2) Revises the provision regarding the promulgation of rules regarding the process to be followed for filing out the appropriate form when a medical emergency prevents a woman from initially completing the form to instead provide a list of factors that that the commissioner of health may consider when promulgating rules, including the need to establish procedures for the pregnant woman or the pregnant woman's authorized representative to complete the forms described in the bill, within a reasonable time following a medical emergency, in situations where a medical emergency prevents the pregnant woman from completing the forms; and

(3) Adds that:

(A) An abortion facility will not violate the bill if, upon the request of a law enforcement officer made prior to final disposition of fetal remains, the abortion facility retains the fetal remains and permits the law enforcement officer to collect a portion or all of the fetal remains as evidence in a criminal investigation, as long as the abortion facility subsequently makes final disposition of any remaining fetal remains in accordance with the bill;

(B) An abortion facility that retains fetal remains pursuant to the provisions described in this item (4) must retain all of the fetal remains of the unborn child that may remain following the collection of evidence by the law enforcement officer and, except for those portions of the fetal remains collected as evidence by the law enforcement officer, must not dispose of any portion of the fetal remains of that unborn child independently of other fetal remains of the same unborn child;

(C) A law enforcement officer that obtains fetal remains pursuant to this item (4) must provide to the abortion facility documentation describing the fetal remains collected as evidence, and the abortion facility must retain that documentation with the other documentation the abortion facility is required to retain under this provision; and

(D) A completed form as described in item (2) above is confidential and is not a public record open for inspection. The physician that performs the abortion must retain such completed forms in the pregnant woman's medical record as a record of the disposition of the fetal remains and must report the disposition of the fetal remains to the commissioner of health as required by present law when a physician performs an abortion.