BILL REQ. #:  S-3387.1 

Read first time 01/14/2004.   Referred to Committee on Children & Family Services & Corrections.

     AN ACT Relating to ensuring health care provider and insurer right of conscience; adding new sections to chapter 9.02 RCW; prescribing penalties; and declaring an emergency.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

NEW SECTION.  Sec. 1   The legislature finds and declares that people and organizations hold different beliefs about whether certain health care services are morally acceptable. It is the public policy of the state to respect and protect the right of conscience of all persons who refuse to obtain, receive, or accept, or who are engaged in, the delivery of, arrangement for, or payment of health care services and medical care whether acting individually, corporately, or in association with other persons; and to prohibit all forms of discrimination, disqualification, coercion, disability, or imposition of liability upon such persons or entities by reason of their refusing to act contrary to their conscience or conscientious convictions in refusing to obtain, receive, accept, deliver, pay for, or arrange for the payment of health care services and medical care.

NEW SECTION.  Sec. 2   The definitions in this section apply throughout this section and sections 3 through 18 of this act unless the context clearly requires otherwise.
     (1) "Health care" means any phase of patient care, including but not limited to: Testing; diagnosis; prognosis; ancillary research; instructions; family planning, counseling, referrals, or any other advice in connection with the use or procurement of contraceptives and sterilization or abortion procedures; medication; or surgery or other care or treatment rendered by a physician or physicians, nurses, paraprofessionals, or health care facility, intended for the physical, emotional, and mental well-being of persons.
     (2) "Physician" means any person who is licensed by the state of Washington under chapter 18.71 RCW.
     (3) "Health care personnel" means any nurse, nurses' aide, medical school student, professional, paraprofessional, or any other person who furnishes, or assists in the furnishing of, health care services.
     (4) "Health care facility" means any public or private hospital, clinic, center, medical school, medical training institution, laboratory or diagnostic facility, physician's office, infirmary, dispensary, ambulatory surgical treatment center, or other institution or location wherein health care services are provided to any person, including physician organizations and associations, networks, joint ventures, and all other combinations of those organizations.
     (5) "Conscience" means a sincerely held set of moral convictions arising from belief in and relation to God, or which, though not so derived, arises from a place in the life of its possessor parallel to that filled by God among adherents to religious faiths.
     (6) "Health care payer" means a health maintenance organization, insurance company, management services organization, or any other entity that pays for or arranges for the payment of any health care or medical care service, procedure, or product.

NEW SECTION.  Sec. 3   No physician or health care personnel shall be civilly or criminally liable to any person, estate, public or private entity, or public official by reason of his or her refusal to perform, assist, counsel, suggest, recommend, refer, or participate in any way in any particular form of health care service that is contrary to the conscience of such physician or health care personnel.

NEW SECTION.  Sec. 4   It is unlawful for any person, public or private institution, or public official to discriminate against any person in any manner, including but not limited to, licensing, hiring, promotion, transfer, staff appointment, hospital, managed care entity, or any other privileges, because of such person's conscientious refusal to receive, obtain, accept, perform, assist, counsel, suggest, recommend, refer, or participate in any way in any particular form of health care services contrary to his or her conscience.

NEW SECTION.  Sec. 5   (1) Nothing in this chapter relieves a physician from any duty, that may exist under any laws concerning current standards, normal medical practices, and procedures to inform his or her patient of the patient's condition, prognosis, and risks. However, such physician is under no duty to perform, assist, counsel, suggest, recommend, refer, or participate in any way in any form of medical practice or health care service that is contrary to his or her conscience.
     (2) Nothing in this chapter shall be construed so as to relieve a physician or other health care personnel from obligations under the law of providing emergency medical care.

NEW SECTION.  Sec. 6   It is unlawful for any public or private employer, entity, agency, institution, official, or person, including but not limited to, a medical, nursing, or other medical training institution, to deny admission because of, to place any reference in its application form concerning, to orally question about, to impose any burdens in terms or conditions of employment on, or to otherwise discriminate against, any applicant, in terms of employment, admission to, or participation in any programs for which the applicant is eligible, or to discriminate in relation thereto, in any other manner, on account of the applicant's refusal to receive, obtain, accept, perform, counsel, suggest, recommend, refer, assist, or participate in any way in any forms of health care services contrary to his or her conscience.

NEW SECTION.  Sec. 7   It is unlawful for any public official, guardian, agency, institution, or entity to deny any form of aid, assistance, or benefits, or to condition the reception in any way of any form of aid, assistance, or benefits, or in any other manner to coerce, disqualify, or discriminate against any person otherwise entitled to such aid, assistance, or benefits, because that person refuses to obtain, receive, accept, perform, assist, counsel, suggest, recommend, refer, or participate in any way in any form of health care services contrary to his or her conscience.

NEW SECTION.  Sec. 8   (1) No person, association, or corporation that owns, operates, supervises, or manages a health care facility shall be civilly or criminally liable to any person, estate, or public or private entity by reason of refusal of the health care facility to permit or provide any particular form of health care service that violates the facility's conscience as documented in its ethical guidelines, mission statement, constitution, bylaws, articles of incorporation, regulations, or other governing documents.
     (2) Nothing in this chapter shall be construed so as to relieve a physician or other health care personnel from obligations under the law of providing emergency medical care.

NEW SECTION.  Sec. 9   It is unlawful for any person, public or private institution, or public official to discriminate against any person, association, or corporation attempting to establish a new health care facility or operating an existing health care facility, in any manner, including but not limited to, denial, deprivation or disqualification in licensing, granting of authorizations, aids, assistance, benefits, medical staff, or any other privileges, and granting authorization to expand, improve, or create any health care facility, by reason of the refusal of such person, association, or corporation planning, proposing, or operating a health care facility, to permit or perform any particular form of health care service that violates the health care facility's conscience as documented in its existing or proposed ethical guidelines, mission statement, constitution, bylaws, articles of incorporation, regulations, or other governing documents.

NEW SECTION.  Sec. 10   It is unlawful for any public official, agency, institution, or entity to deny any form of aid, assistance, grants, or benefits; or in any other manner to coerce, disqualify, or discriminate against any person, association, or corporation attempting to establish a new health care facility or operating an existing health care facility that otherwise would be entitled to the aid, assistance, grant, or benefit because the existing or proposed health care facility refuses to perform, assist, counsel, suggest, recommend, refer, or participate in any way in any form of health care services contrary to the health care facility's conscience as documented in its existing or proposed ethical guidelines, mission statement, constitution, bylaws, articles of incorporation, regulations, or other governing documents.

NEW SECTION.  Sec. 11   No health care payer and no person, association, or corporation that owns, operates, supervises, or manages a health care payer shall be civilly or criminally liable to any person, estate, or public or private entity by reason of refusal of the health care payer to pay for or arrange for the payment of any particular form of health care services that violate the health care payer's conscience as documented in its ethical guidelines, mission statement, constitution, bylaws, articles of incorporation, regulations, or other governing documents.

NEW SECTION.  Sec. 12   It is unlawful for any person, public or private institution, or public official to discriminate against any person, association, or corporation: (1) Attempting to establish a new health care payer; or (2) operating an existing health care payer, in any manner, including but not limited to: Denial, deprivation, or disqualification in licensing; granting of authorizations, aids, assistance, benefits, or any other privileges; and granting authorization to expand, improve, or create any health care payer, because the person, association, or corporation planning, proposing, or operating a health care payer refuses to pay for or arrange for the payment of any particular form of health care services that violates the health care payer's conscience as documented in the existing or proposed ethical guidelines, mission statement, constitution, bylaws, articles of incorporation, regulations, or other governing documents.

NEW SECTION.  Sec. 13   It is unlawful for any public official, agency, institution, or entity to deny any form of aid, assistance, grants, or benefits; or in any other manner to coerce, disqualify, or discriminate against any person, association, or corporation attempting to establish a new health care payer or operating an existing health care payer that otherwise would be entitled to the aid, assistance, grant, or benefit because the existing or proposed health care payer refuses to pay for, arrange for the payment of, or participate in any way in any form of health care services contrary to the health care payer's conscience as documented in its existing or proposed ethical guidelines, mission statement, constitution, bylaws, articles of incorporation, regulations, or other governing documents.

NEW SECTION.  Sec. 14   Any person, association, corporation, entity, or health care facility injured by any public or private person, association, agency, entity, or corporation by reason of any action prohibited by this chapter may commence a suit therefor, and shall recover treble damages, including pain and suffering, sustained by such person, association, corporation, entity, or health care facility, the costs of the suit, and reasonable attorneys' fees; but in no case shall recovery be less than two thousand five hundred dollars for each violation in addition to costs of the suit and reasonable attorneys' fees. These damage remedies shall be cumulative, and not exclusive of other remedies afforded under any other state or federal law.

NEW SECTION.  Sec. 15   If an insurer provides any insurance coverage, services, or benefits to any employer or individual, the insurer may elect but may not be required to provide the employer or individual contraception or abortion related coverage, services, or benefits.

NEW SECTION.  Sec. 16   If an employer provides any insurance coverage, services, or benefits for any employee or any dependent of any employee by paying the costs or premiums in whole or in part for such coverage, services, or benefits or by participating in negotiating the terms of such coverage, services, or benefits, the employer may elect but may not be required to provide the employee contraception or abortion related coverage, services, or benefits.

NEW SECTION.  Sec. 17   If an employer provides disability coverage, services, or benefits, including sick leave plans or temporary disability benefit plans, for any employee by paying the costs or premiums in whole or in part for such coverage, services, or benefits or by participating in negotiating the terms of such coverage, services, or benefits, the employer may elect but may not be required to provide the employee such coverage, services, or benefits for any illness or disability caused or contributed to by any contraception or abortion related services.

NEW SECTION.  Sec. 18   Nothing in this chapter shall be construed as excusing any person, public or private institution, or public official from liability for refusal to permit or provide a particular form of health care service if:
     (1) The person, public or private institution, or public official has entered into a contract specifically to provide that particular form of health care service; or
     (2) The person, public or private institution, or public official has accepted federal or state funds for the sole purpose of, and specifically conditioned upon, permitting or providing that particular form of health care service.

NEW SECTION.  Sec. 19   Sections 1 through 18 of this act are each added to chapter 9.02 RCW.

NEW SECTION.  Sec. 20   If any provision of this act or its application to any person or circumstance is held invalid, the remainder of the act or the application of the provision to other persons or circumstances is not affected.

NEW SECTION.  Sec. 21   This act is necessary for the immediate preservation of the public peace, health, morals, or safety, or support of the state government and its existing public institutions, and takes effect immediately.