BILL ANALYSIS Ó
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|SENATE RULES COMMITTEE | AB 775|
|Office of Senate Floor Analyses | |
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THIRD READING
Bill No: AB 775
Author: Chiu (D) and Burke (D), et al.
Amended 5/4/15 in Assembly
Vote: 21
SENATE HEALTH COMMITTEE: 6-2, 6/24/15
AYES: Hernandez, Mitchell, Monning, Pan, Roth, Wolk
NOES: Nguyen, Nielsen
NO VOTE RECORDED: Hall
ASSEMBLY FLOOR: 49-26, 5/26/15 - See last page for vote
SUBJECT: Reproductive FACT Act
SOURCE: Attorney General Kamala Harris
Black Women for Wellness
NARAL Pro-Choice California
DIGEST: This bill enacts the Reproductive Freedom,
Accountability, Comprehensive Care, and Transparency Act and
requires clinics and other facilities that provide family
planning or pregnancy-related services to provide specified
notices to clients
ANALYSIS:
Existing law:
1) Requires the Department of Public Health (DPH) to inspect
and license health facilities, including but not limited to
clinics.
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2) Provides for exemptions from licensing requirements for
certain types of clinics, including federally operated
clinics, local government primary care clinics, clinics
affiliated with an institution of higher learning, clinics
conducted as outpatient departments of hospitals, and
community or free clinics. Provides for exemptions for
community or free clinics that are operated on separate
premises from the licensed clinic and are only open for
limited services of no more than 20 hours per week (also
known as intermittent clinics).
3) Authorizes DPH to take various types of enforcement
actions against a primary care clinic that has violated
state law or regulation, including imposing fines,
sanctions, civil or criminal penalties, and suspension or
revocation of the clinic's license.
4) Grants a specific right of privacy under the California
Constitution and provides that the right to have an abortion
may not be infringed upon without a compelling state
interest.
This bill:
1) Enacts the Reproductive Freedom, Accountability,
Comprehensive Care, and Transparency Act (Reproductive FACT
Act).
2) Defines a "licensed covered facility," for the purposes of
the Reproductive FACT Act, as a licensed clinic or an
intermittent clinic operating under a primary care clinic
whose primary purpose is providing family planning or
pregnancy-related services, and that satisfies two or more
of the following:
a) The facility offers obstetric ultrasounds, obstetric
sonograms, or prenatal care to pregnant women;
b) The facility provides, or offers counseling about,
contraception or contraceptive methods;
c) The facility offers pregnancy testing or pregnancy
diagnosis;
d) The facility advertises or solicits patrons with
offers to provide prenatal sonography, pregnancy tests,
or pregnancy options counseling;
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e) The facility offers abortion services; or,
f) The facility has staff or volunteers who collect
health information from clients.
3) Defines an "unlicensed covered facility," for the purposes
of the Reproductive FACT Act, as a facility that is not
licensed and does not have a licensed medical provider on
staff or under contract who provides or directly supervises
the provision of all of the services, whose primary purpose
is providing pregnancy-related services, and that satisfies
two or more of the following:
a) The facility offers obstetric ultrasounds, obstetric
sonograms, or prenatal care to pregnant women;
b) The facility offers pregnancy testing or pregnancy
diagnosis;
c) The facility advertises or solicits patrons with
offers to provide prenatal sonography, pregnancy tests,
or pregnancy options counseling; or,
d) The facility has staff or volunteers who collect
health information from clients.
4) Specifies this bill does not apply to a clinic directly
conducted, maintained, or operated by the United States or
any of its departments, officers, or agencies; or, a
licensed primary care clinic that is enrolled as a Medi-Cal
provider and a provider in the Family Planning, Access,
Care, and Treatment Program (FamilyPACT).
5) Requires a licensed covered facility to disseminate to
clients on site the following notice in English and in the
primary threshold languages for Medi-Cal beneficiaries as
determined by DHCS for the county in which the facility is
located:
"California has public programs that provide immediate free
or low-cost access to comprehensive family planning services
(including all FDA-approved methods of contraception),
prenatal care, and abortion for eligible women. To determine
whether you qualify, contact the county social services
office at [insert the telephone number]."
6) Permits the notice to be combined with other mandated
disclosures, but requires it be disclosed through one of the
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following methods:
a) A public notice posted in a conspicuous place where
individuals wait that may be easily read by those seeking
services from the facility. Requires the notice to be at
least 8.5 inches by 11 inches and written in no less than
22-point type;
b) A printed notice distributed to all clients in no
less than 14-point type; or,
c) A digital notice distributed to all clients that can
be read at the time of check-in or arrival, in the same
point type as other digital disclosures. Requires a
printed notice be available for all clients who cannot or
do not wish to receive the information in a digital
format.
7) Requires an unlicensed covered facility to disseminate to
clients on site and in any print and digital advertising
materials including Internet Web sites, the following notice
in English and in the primary threshold languages for
Medi-Cal beneficiaries as determined DHCS for the county in
which the facility is located:
"This facility is not licensed as a medical facility by the
State of California and has no licensed medical provider who
provides or directly supervises the provision of services."
8) Requires the onsite notice for unlicensed covered
facilities to be a sign at least 8.5 inches by 11 inches and
written in no less than 48-point type, and to be posted
conspicuously in the entrance of the facility and at least
one additional area where clients wait to receive services.
9) Requires the notice in the advertising material for
unlicensed covered facilities to be clear and conspicuous.
Defines "clear and conspicuous" to mean in larger point type
than the surrounding text, or in contrasting type, font, or
color to the surrounding text of the same size, or set off
from the surrounding text of the same size by symbols or
other marks that call attention to the language.
10) Makes covered facilities that fail to comply with the
Reproductive FACT Act liable for a civil penalty of $500 for
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a first offense and $1,000 for each subsequent offense.
Permits the Attorney General (AG), city attorney, or county
counsel to bring an action to impose a civil penalty after:
a) Providing the covered facility with reasonable
notice of noncompliance, which informs the facility that
it is subject to a civil penalty if it does not correct
the violation within 30 days from the date the notice is
sent to the facility; and,
b) Verifying that the violation was not corrected
within the 30-day period.
11) Requires any penalty resulting from an action brought by
the AG to be deposited into the General Fund. Requires the
penalty, if the action is brought by a city attorney, to be
paid to the treasurer of the city in which the judgment is
entered. Requires the penalty, if the action is brought by a
county counsel, to be paid to the treasurer of the county in
which the judgment is entered.
12) Makes the provisions of the Reproductive FACT Act
severable, and prohibits, if any provision of the Act or its
application is held invalid, that invalidity from affecting
other provisions or applications that can be given effect
without the invalid provision or application.
Comments
1)Author's statement. According to the author, California has a
proud legacy of respecting reproductive freedom and funding
forward-thinking programs to provide reproductive health
assistance to low income women. The power of the law is only
fully realized when California's women are fully informed of
the rights and services available to them. Because family
planning and pregnancy decisions are time sensitive,
California women should receive information that helps them
make decisions and access financial support at the sites where
they seek care. It is in the best interest of the state,
patients and providers that women are aware of available
assistance for preventing, continuing or terminating a
pregnancy. According to the Department of Health Care
Services, the Affordable Care Act expansion has made millions
of Californians, 53 percent of them women, newly eligible for
Medi-Cal. It is also critical that women know whether they are
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receiving care from licensed medical professionals when they
are making important reproductive health decisions. AB 775
ensures that women in California are fully informed of their
options and are able to make their own healthcare and
pregnancy-related decisions.
2)Unintended pregnancies. Almost half of all pregnancies in
California are unintended. According to a 2014 Guttmacher
Institute document titled "State Facts About Unintended
Pregnancy: California," an extensive body of research links
births resulting from unintended or closely spaced pregnancies
to adverse maternal and child health outcomes and myriad
social and economic challenges. Economically disadvantaged
women are disproportionately affected by unintended pregnancy
and its consequences. In 2008, the unintended pregnancy rate
among women with incomes lower than the federal poverty level,
at 137 per 1,000, was more than five times as high as the rate
among women with incomes greater than 200 percent of poverty
(26 per 1,000).
3)Crisis pregnancy centers (CPCs). According to a 2011 report
by the Public Law Research Institute of UC Hastings College of
the Law, CPCs are pro-life (largely Christian belief-based)
organizations that offer a limited range of free pregnancy
options, counseling, and other services to individuals that
visit a center. CPCs are local non-profit organizations,
generally receiving substantial funding and resources from at
least one large pro-life umbrella organizations such as: Care
Net, International Heart Beat, and the National Institute of
Family and Life Advocates. CPCs typically do not offer
services that conflict with pro-life pregnancy options, like
abortion referrals or procedures. In contrast, full-service
organizations that provide pregnancy-related services offer a
wider variety of services including administering medical
tests, performing medical procedures (including abortions),
and providing counseling in pregnancy options. At least 228
CPCs exist in California and approximately 2,500 exist
nationwide. CPC networks claim that centers collectively
extended pregnancy services to approximately 1.8 million women
between 2008 and 2013.
4)University of California, Hastings College of Law research
report. In the fall of 2009 the Assembly Business,
Professions and Consumer Protection Committee, concerned that
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CPCs throughout California were disseminating medically
inaccurate information about pregnancy options available in
the state, requested a report by the University of California,
Hastings College of Law regarding CPCs' practices and
potential legislative options for regulating them. Issued in
April 2011 and updated in June 2015, "Pregnancy Resource
Centers: Ensuring Access and Accuracy of Information,"
discusses several options for regulation of CPCs, ranging from
creating new regulations, leveraging existing regulations
aimed specifically at medical services, as well as creating a
new statute. Because approaches that have treated CPCs and
full-service pregnancy centers differently have been
challenged as violating the First Amendment, the report
concludes that the best approach to a statutory change would
regulate all pregnancy centers, not just CPCs, in a uniform
manner.
5)Policies in other locales. The City of New York enacted
regulations in 2011 and Montgomery County, Maryland adopted a
resolution in 2010 requiring CPCs without medical staff to
post signage indicating that they do not have a licensed
medical professional on staff and that pregnant women are
encouraged to consult with a licensed health care provider.
The City of New York's regulations also required CPCs to
disclose whether or not it provides referrals for abortions,
emergency contraception, and prenatal care. In 2014, an
appeals court overturned those provisions and the requirement
that CPCs tell clients that New York City health officials
recommend that pregnant women consult a licensed healthcare
provider, but upheld the medical staff notification piece. The
City and County of San Francisco passed a false advertising
ordinance aimed at CPCs, called the Pregnancy Information and
Protection Ordinance, which was challenged by CPC owner in
court as a violation of free speech. The ordinance was upheld
by a federal court earlier this year.
FISCAL EFFECT: Appropriation: No Fiscal
Com.:NoLocal: No
SUPPORT: (Verified6/29/15)
Attorney General Kamala Harris (co-source)
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Black Women for Wellness (co-source)
NARAL Pro-Choice California (co-source)
ACT for Women and Girls
Alameda County Board of Supervisors
Alameda County Public Health Department
American Congress of Obstetricians and Gynecologists District IX
American Nurses Association\California
Anti-Defamation League
California Association for Nurse Practitioners
California Church IMPACT
California Family Health Council
California Immigrant Policy Center
California Latinas for Reproductive Justice
California Nurses Association
California Pan-Ethnic Health Network
California Primary Care Association
California Religious Coalition for Reproductive Choice
California Women Lawyers
California Women's Law Center
Center on Reproductive Rights and Justice, University of
California, Berkeley School of Law
Citizens for Choice
City and County of San Francisco
City and County of San Francisco Department of Public Health
City of Berkeley
City of Los Angeles Mayor Eric Garcetti
City of West Hollywood
Feminist Majority
Forward Together
Fresno Barrios Unidos
League of Women Voters of California
Los Angeles County Supervisor Shelia Kuehl
Maternal and Child Health Access
National Center for Youth Law
National Council of Jewish Women California
National Health Law Program
Planned Parenthood Affiliates of California
San Francisco Women's Political Committee
Unite for Reproductive and Gender Equity
Western Methodist Justice Movement
Women's Community Clinic
OPPOSITION: (Verified6/29/15)
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Alliance for Defending Freedom
Alternatives Pregnancy Center
California Catholic Conference
California Right to Life Committee
California, Concerned Women for America
Capitol Resource Institute
Marin Pregnancy Clinic
National Institute of Family and Life Advocates
Open Arms Pregnancy Center
ASSEMBLY FLOOR: 49-26, 5/26/15
AYES: Alejo, Bonilla, Bonta, Brown, Burke, Calderon, Campos,
Chau, Chiu, Chu, Cooper, Dababneh, Daly, Dodd, Eggman,
Frazier, Cristina Garcia, Eduardo Garcia, Gatto, Gipson,
Gomez, Gonzalez, Gordon, Gray, Roger Hernández, Holden, Irwin,
Jones-Sawyer, Levine, Lopez, Low, McCarty, Medina, Mullin,
Nazarian, O'Donnell, Perea, Quirk, Rendon, Ridley-Thomas,
Rodriguez, Santiago, Mark Stone, Thurmond, Ting, Weber,
Williams, Wood, Atkins
NOES: Achadjian, Travis Allen, Baker, Bigelow, Brough, Chang,
Dahle, Beth Gaines, Gallagher, Grove, Hadley, Jones, Kim,
Lackey, Linder, Maienschein, Mayes, Melendez, Obernolte,
Olsen, Patterson, Salas, Steinorth, Wagner, Waldron, Wilk
NO VOTE RECORDED: Bloom, Chávez, Cooley, Harper, Mathis
Prepared by:Melanie Moreno / HEALTH /
7/2/15 13:48:10
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