00 CS FOR SENATE BILL NO. 348(STA) 01 "An Act relating to certain rights of conscience protection for persons who 02 directly or indirectly provide or perform health services." 03 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 04 * Section 1. AS 18 is amended by adding a new chapter to read: 05 Chapter 17. Rights of Conscience Protection. 06  Sec. 18.17.010. Policy. It is the public policy of the state to respect and 07 protect the rights of conscience of all persons who are involved in providing health 08 services. It is the purpose of this chapter to protect as a basic civil right the right of 09 all persons to refuse to counsel, advise, pay for, provide, perform, assist, or participate 10 directly or indirectly in providing or performing certain health services that violate the 11 persons' religious or moral convictions and to prohibit all forms of discrimination, 12 disqualification, coercion, disability, or liability of the persons by reason of their 13 refusals. 14  Sec. 18.17.020. Civil rights of conscience. (a) Subject to AS 18.12.050, a 01 person has the right not to counsel, advise, pay for, provide, perform, assist, or 02 participate directly or indirectly in providing or performing a health service if the 03 service includes a procedure that violates the person's religious or moral convictions 04 and the procedure is intended to end the life of an individual or involves an abortion. 05  (b) Subject to AS 18.12.050, a person may not be required to counsel, advise, 06 pay for, provide, perform, assist, or participate directly or indirectly in providing or 07 performing a health service if the service includes a procedure that violates the 08 person's religious or moral convictions and the procedure is intended to end the life 09 of an individual or involves an abortion. 10  Sec. 18.17.030. Individual rights of conscience. (a) Subject to 11 AS 18.12.050, an individual may not be required to counsel, advise, pay for, provide, 12 perform, assist, or participate directly or indirectly in providing or performing a health 13 service if the service includes a procedure that violates the individual's religious or 14 moral convictions and the procedure is intended to end the life of an individual or 15 involves an abortion. 16  (b) An individual is not civilly, criminally, or administratively liable to a 17 person for refusing, upon request or assignment and except as provided under 18 AS 18.12.050, to counsel, advise, pay for, provide, perform, assist, or participate 19 directly or indirectly in providing or performing a health service if the service includes 20 a procedure that violates the individual's religious or moral convictions and the 21 procedure is intended to end the life of an individual or involves an abortion, and if 22  (1) before the request or assignment, the individual notified the person 23 making the request or assignment of the individual's refusal to provide or perform that 24 type of health service and, if requested to do so, the individual stated the refusal in 25 writing; or 26  (2) within 24 hours after being asked or assigned to provide or perform 27 the health service, the individual notified the person making the request or assignment 28 of the individual's refusal. 29  (c) A person may not discriminate against, penalize, discipline, or retaliate 30 against an individual in employment; privileges; benefits; remuneration; promotion; 31 termination of employment; eligibility for admission to, renewal or participation in, or 01 graduation from an educational, study, or training program; or a grant, contract, or 02 other program because of the individual's refusal or unwillingness to counsel, advise, 03 pay for, provide, perform, assist, or participate directly or indirectly in providing or 04 performing a health service if the service includes a procedure that violates the 05 individual's religious or moral convictions and the procedure is not required under 06 AS 18.12.050 and is intended to end the life of an individual or the procedure involves 07 an abortion. 08  Sec. 18.17.040. Institutional rights of conscience. (a) A health care 09 institution may not be required to counsel, advise, pay for, provide, perform, assist, or 10 participate in providing or performing a health service if the service includes a 11 procedure that violates the religious or moral convictions of a majority of the board 12 of directors or other administrative head of the institution or of a majority of its 13 owners or partners and the procedure is intended to end the life of an individual or 14 involves an abortion. A health care institution is not required to admit or keep a 15 patient for the purpose of providing to that patient a health service if the service 16 includes a procedure that violates the religious or moral convictions of a majority of 17 the board of directors or other administrative head of the institution or of a majority 18 of its owners or partners and the procedure is intended to end the life of an individual 19 or involves an abortion. 20  (b) A health care institution is not civilly, criminally, or administratively liable 21 to a person for refusing to participate directly or indirectly in providing or performing 22 a health service if the service includes a procedure that violates the religious or moral 23 convictions of a majority of the board of directors or other administrative head of the 24 institution or of a majority of its owners or partners and the procedure is intended to 25 end the life of an individual or involves an abortion, and if the institution 26  (1) posted notice of its refusal policy in plain sight in the admission 27 area of the institution before the health service is requested; or 28  (2) within 24 hours after receiving the request, notified the person 29 requesting the health service of its refusal and there has been no irreversible change 30 in the circumstances of the patient or person making the request during the time 31 between making the request and the institution's refusal that would make it unjust for 01 the institution to refuse the request. 02  (c) A person may not discriminate or retaliate against a health care institution 03 in a grant, contract, or program because of the institution's refusal to counsel, advise, 04 pay for, provide, perform, assist, or participate directly or indirectly in providing or 05 performing a health service if the service includes a procedure that violates the 06 religious or moral convictions of a majority of the board of directors or other 07 administrative head of the institution or of a majority of its owners or partners and the 08 procedure is intended to end the life of an individual or involves an abortion. 09  Sec. 18.17.050. Exceptions. (a) This chapter does do not apply to a health 10 service that 11  (1) is necessary to save the life of an individual in any stage or 12 condition of existence from imminent death; 13  (2) requires for its success the immediate assistance of a person 14 asserting religious or moral objections; and 15  (3) must be performed before a replacement for a person asserting 16 religious or moral objections can be obtained or reasonably could have been obtained. 17  (b) This chapter does not relieve a person from liability to pay for a health 18 service, for which the person freely and knowingly contracted to pay, that was 19 performed before a timely conscientious objection was asserted by the person. 20  (c) A health care institution or a department or division of the institution that 21 is established for the sole or primary purpose of providing specific types of health 22 services may exclude an individual who objects to a procedure from employment in 23 a position for which the performance of the services is a necessary and substantial 24 responsibility if the individual's moral or conscience rights cannot be reasonably 25 accommodated by diligent effort. In this paragraph, "procedure" means a medical 26 procedure intended to end the life of an individual or involving an abortion. 27  Sec. 18.17.060. Remedies. (a) Notwithstanding other provisions of law, a 28 person injured by an act or omission that violates a provision of this chapter may 29 obtain an injunction and is entitled to receive three times the actual damages sustained 30 by the person or $3,000 for each violation, whichever is greater. 31  (b) Remedies provided for under this section are in addition to other remedies 01 that may be available under federal or state law. 02  Sec. 18.17.070. Federal requirements not affected. Nothing in this chapter 03 changes, modifies, or otherwise affects requirements of 42 U.S.C. 1395cc, 42 U.S.C. 04 1395dd, or 42 U.S.C. 1396a (a)(57) or (58). 05  Sec. 18.17.080. Definitions. In this chapter, 06  (1) "abortion" has the meaning given in AS 18.16.090; 07  (2) "health care institution" means a public or private corporation, 08 partnership, association, organization, agency, or other entity that is involved in 09 providing health care; in this paragraph, "entity" includes a hospital, clinic, physician's 10 office, medical school, nursing school, other health care training institution, insurance 11 organization, or financing organization; 12  (3) "health service" means a phase or type of service performed at a 13 health care institution or by a health professional, paraprofessional, or pharmacist or 14 by an employee of a health professional, paraprofessional, or pharmacist; in this 15 paragraph, "service" includes testing, diagnosis, prognosis, research, counseling, 16 therapy, treatment, family planning, referral, prescription, medication, surgery, the 17 termination of or failure to perform a procedure, and any necessary support services. 18 * Sec. 2. Under AS 01.10.030, if any provision of AS 18.17.010 - 18.17.080 or the 19 application of AS 18.17.010 - 18.17.080 to any person or circumstance is held invalid, the 20 remainder of AS 18.17.010 - 18.17.080 or the application of those statutes to other persons 21 or circumstances is not affected.