Amendment ID: S2996-1-R1
Redraft Amendment 1
Requiring public universities to provide medication abortion
Mr. Lewis, Ms. Rausch, Ms. Comerford, Mr. Lesser, Ms. DiZoglio, Ms. Creem, Messrs. Hinds, Feeney and Eldridge, Ms. Jehlen and Ms. Edwards move that the proposed new text be amended by inserting after section 4 the following section:-
“SECTION 4A. Chapter 15A of the General Laws is hereby amended by adding the following 2 sections:-
Section 46. (a) As used in this section and section 47, the following words shall have the following meanings unless the context clearly requires otherwise:
“Institution”, a public institution of higher education listed in section 5.
“Medication abortion”, abortion provided by medication techniques.
“Medication abortion readiness”, each institution’s preparedness to provide medication abortions to students or assist students in obtaining medication abortions, including, but not limited to, having in place equipment, protocols, patient educational materials, informational websites and training for staff; provided, however, that “medication abortion readiness” may include the provision of medication abortions.
“Health center”, a clinic or health center providing primary health care services to students operated by an institution.
(b) (1) Each institution shall develop a medication abortion readiness plan for its students.
(2) The department of public health shall issue guidance to all institutions regarding the required contents of medication abortion readiness plans in accordance with the varied capabilities of institutions to provide services including, but not limited to, directly providing medication abortions to students in a health center, providing referrals for abortion care services not provided in the health center or providing information to students about obtaining a medication abortion. In developing the guidance, the department shall consider factors including, but not limited to, whether the institution has an operational health center on campus, the institution’s proximity to a hospital, clinic or other facility that provides medication abortion, availability, convenience and cost of public transportation between the institution and closest facility that provides medication abortion and whether the institution employs health care workers on campus.
(3) The department of public health shall review medication abortion readiness plans annually, taking into consideration any changes to the capacity of each institution to provide services to students since the preceding approval of the plan.
(c) Each institution shall annually submit any amendments or revisions to its medication abortion readiness plan to the department of public health.
(d) Annually, not later than January 31, the department of public health shall determine whether the plan is adequate in proportion to each institution’s capacity. The department shall provide further guidance to institutions with plans deemed inadequate that includes remedial measures for the institution to develop an adequate plan.
Section 47. (a) There shall be established and set up on the books of the commonwealth a separate fund to be known as the Public University Health Center Sexual and Reproductive Health Preparation Fund for the purpose of medication abortion readiness. The fund shall be administered by the department of public health, in consultation with the department of higher education. The fund shall be credited with: (i) revenue from appropriations or other money authorized by the general court and specifically designated to be credited to the fund; and (ii) funds from non-state entities, including, but not limited to, gifts, grants and donations from private entities and local and federal government agencies. Amounts credited to the fund shall not be subject to further appropriation and any money remaining in the fund at the end of a fiscal year shall not revert to the General Fund.
(b) The department of public health shall utilize money in the fund to:
(i) provide a grant to each health center to pay for the cost of direct and indirect medication abortion readiness; provided, however, that, the department shall prioritize applications from the University of Massachusetts and state university segments and create a simple application process for community colleges to apply for funding; and provided further, that allowable expenses under these grants shall include, but not be limited to: (A) the purchase of equipment used in the provision of medication abortions; (B) facility and security upgrades; (C) costs associated with enabling the health center to deliver telehealth services; (D) costs associated with training staff in the provision of medication abortions; (E) staff cost reimbursement and clinical revenue offset while staff are in trainings; and (F) billing specialist consultation;
(ii) pay the direct and indirect costs of the department of public health associated with administration of the fund, including the costs of hiring staff; and
(iii) maintain a system of financial reporting on all aspects of the fund.
(c) Each health center grantee shall, as a condition of receiving a grant award from the fund, participate in an evaluation of its medication abortion readiness and its provision of medication abortions.
(d) The department of public health, working with the health centers, shall assist and advise on potential pathways for health centers to access public and private payers to provide funding for ongoing costs of providing medication abortions.
(e)(1) Annually, not later than December 31, the department of public health shall submit a report to the clerks of the senate and house of representatives, including, but not limited to, all of the following information for each reporting period:
(i) an accounting of the medication abortion plans of all institutions, including, but not limited to, a list of institutions that have submitted plans deemed adequate by the department, a list of institutions that are actively developing a remedial plan and a list of institutions that have not submitted an adequate plan to the department;
(ii) the number of medication abortions provided at health centers, disaggregated, to the extent possible, by the health center;
(iii) the total amount of funds granted by the department of public health to each institution and its health center from the fund that is expended on medication abortion readiness and the total amount of any other funds expended on medication abortion readiness and the source of those funds, disaggregated by use and, to the extent possible, health center; and
(iv) the total amount of funds expended on the provision of medication abortions and the source of those funds, disaggregated by use and, to the extent possible, health center.
(2) The report required in paragraph (1) and any associated data collected shall comply with state and federal privacy laws, including, but not limited to, section 70E of chapter 111, the federal Family Educational Rights and Privacy Act of 1974, 20 U.S.C. 1232g and the federal Health Insurance Portability and Accountability Act of 1996, Public Law 104-191.”; and
by adding the following 3 sections:-
“SECTION 39. An institution, as defined in section 46 of chapter 15A of the General Laws, shall not be required to utilize money from its general fund or student fees for medication abortion readiness required under said section 46 of said chapter 15A until January 1, 2026.
SECTION 40. Each institution’s first medication abortion readiness plan as required under subsection (b) of section 46 of chapter 15A of the General Laws shall be submitted to the department of public health not later than November 30, 2023 and the department shall review such plans for suitability by January 31, 2024.
SECTION 41. Subsection (c) and (d) of section 46 of chapter 15A of the General Laws shall take effect on February 1, 2024.”.