Amendments for HB23-1077
Senate Journal, March 31
After consideration on the merits, the Committee recommends that HB23-1077 be
amended as follows, and as so amended, be referred to the Committee on Appropriations
with favorable recommendation.
Amend reengrossed bill, page 3, line 8, strike "IS RECOGNIZED BY AND".
Page 3, line 9, strike "TEAM;" and substitute "TEAM, AND THE STUDENT'S OR
TRAINEE'S ROLE IN PERFORMING AN INTIMATE EXAMINATION FOR EDUCATIONAL
OR TRAINING PURPOSES HAS BEEN SHARED WITH THE PATIENT;".
Page 3, line 13, strike "(I) A LICENSEE MAY PERFORM" and substitute "THE
REQUIREMENTS OF SUBSECTION (1)(a) OF THIS SECTION DO NOT APPLY TO:
(I) A LICENSEE WHO PERFORMS".
Page 3, line 15, strike "ONLY".
Page 3, strike lines 17 through 19 and substitute "LIFE OR WELL-BEING OF THE
PATIENT, BUT THE LICENSEE MUST MAKE A RECORD OF".
Page 3, line 24, strike "UNCONSCIOUS." and substitute "UNCONSCIOUS; OR".
Page 3, strike lines 25 through 27.
Page 4, strike lines 1 through 3 and substitute:
"(II) A LICENSEE WHO HAS OBTAINED THE PATIENT'S CONSENT TO
PROVIDE HEALTH CARE THAT INCLUDES AN INTIMATE EXAMINATION IF THE
LICENSEE HAS INFORMED THE PATIENT OF THE INTIMATE EXAMINATION IN THE
COURSE OF OBTAINING THE PATIENT'S CONSENT TO THE HEALTH CARE.".
Page 4, lines 8 and 9, strike "THE LICENSEE DETERMINES THE NEED FOR THE
EXAMINATION:" and substitute "POSSIBLE BEFORE THE INTIMATE EXAMINATION
OCCURS:".
Page 5, strike lines 9 and 10 and substitute "ELECTRONIC DOCUMENT; AND".
Page 5, lines 19 and 20, strike "A REGULATOR FOR USE BY LICENSEES," and
substitute "THE DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT, IN
ACCORDANCE WITH SECTION 25-3-130 (3), FOR USE BY HEALTH-CARE
PROVIDERS,".
Page 5, strike lines 22 through 27.
Reletter succeeding paragraph accordingly.
Page 6, line 5, after "COMPLAINT" insert "REGARDING A VIOLATION OF THIS
SECTION".
Page 6, strike lines 25 and 26 and substitute:
"(b) (I) "INTIMATE EXAMINATION" MEANS PALPATION OF A BREAST OR
AN INTERNAL PELVIC, PROSTATE, OR RECTAL EXAMINATION.
(II) "INTIMATE EXAMINATION" DOES NOT INCLUDE A VISUAL
EXAMINATION OF A PART OF THE BODY SPECIFIED IN SUBSECTION (6)(b)(I) OF
THIS SECTION THAT OCCURS INCIDENTAL TO THE CARE BEING PROVIDED.".
Page 9, strike lines 3 through 27.
Strike page 10.
Page 11, strike lines 1 through 5 and substitute:
"25-3-130. Intimate examination of sedated or unconscious patient
- informed consent required - definitions. (1) (a) (I) EXCEPT AS PROVIDED IN
SUBSECTION (1)(b) OF THIS SECTION, A HEALTH-CARE FACILITY SHALL NOT
PERMIT A LICENSED HEALTH-CARE PROVIDER, OR A STUDENT OR TRAINEE UNDER
THE SUPERVISION OF A LICENSED HEALTH-CARE PROVIDER, TO PERFORM AN
INTIMATE EXAMINATION OF A SEDATED OR UNCONSCIOUS PATIENT AT THE
HEALTH-CARE FACILITY UNLESS THE PATIENT HAS PROVIDED SPECIFIC INFORMED
CONSENT TO THE EXAMINATION IN ACCORDANCE WITH SUBSECTION (2) OF THIS
SECTION.
(II) IN ADDITION TO THE REQUIREMENT TO OBTAIN A PATIENT'S SPECIFIC
INFORMED CONSENT, A HEALTH-CARE FACILITY MAY ALLOW A STUDENT OR
TRAINEE TO PERFORM AN INTIMATE EXAMINATION OF A SEDATED OR
UNCONSCIOUS PATIENT FOR EDUCATIONAL OR TRAINING PURPOSES ONLY IF:
(A) THE EXAMINATION IS RELATED TO THE PLANNED PROCEDURE TO BE
PERFORMED ON THE PATIENT AT THE HEALTH-CARE FACILITY;
(B) THE STUDENT OR TRAINEE HAS BEEN INTRODUCED TO THE PATIENT
AS PART OF THE PATIENT'S CARE TEAM, AND THE STUDENT'S OR TRAINEE'S ROLE
IN PERFORMING AN INTIMATE EXAMINATION FOR EDUCATIONAL OR TRAINING
PURPOSES HAS BEEN SHARED WITH THE PATIENT; AND
(C) THE STUDENT OR TRAINEE IS UNDER THE DIRECT SUPERVISION OF
THE LICENSED HEALTH-CARE PROVIDER RESPONSIBLE FOR SUPERVISING THE
STUDENT OR TRAINEE.
(b) THE REQUIREMENTS OF SUBSECTION (1)(a) OF THIS SECTION DO NOT
LIMIT THE ABILITY OF A HEALTH-CARE FACILITY TO ALLOW:
(I) A LICENSED HEALTH-CARE PROVIDER TO PERFORM AN INTIMATE
EXAMINATION OF A PATIENT WHO IS SEDATED OR UNCONSCIOUS WITHOUT
OBTAINING THE PATIENT'S SPECIFIC INFORMED CONSENT IN EMERGENCY
SITUATIONS WHEN THE INTIMATE EXAMINATION IS MEDICALLY NECESSARY FOR
THE LIFE OR WELL-BEING OF THE PATIENT, BUT THE LICENSED HEALTH-CARE
PROVIDER MUST MAKE A RECORD OF PERFORMING THE EXAMINATION WITHOUT
OBTAINING THE PATIENT'S SPECIFIC INFORMED CONSENT, INCLUDING AN
EXPLANATION OF THE REASON FOR NOT OBTAINING THE PATIENT'S CONSENT,
AND PROVIDE THE RECORD TO THE PATIENT ONCE THE PATIENT IS NO LONGER
UNDER SEDATION OR UNCONSCIOUS; OR
(II) A LICENSED HEALTH-CARE PROVIDER WHO HAS OBTAINED THE
PATIENT'S CONSENT TO PROVIDE HEALTH CARE THAT INCLUDES AN INTIMATE
EXAMINATION TO PERFORM THE INTIMATE EXAMINATION IF THE LICENSED
HEALTH-CARE PROVIDER HAS INFORMED THE PATIENT OF THE INTIMATE
EXAMINATION IN THE COURSE OF OBTAINING THE PATIENT'S CONSENT TO THE
HEALTH CARE.
(2) TO OBTAIN SPECIFIC INFORMED CONSENT TO PERFORM AN INTIMATE
EXAMINATION ON A SEDATED OR UNCONSCIOUS PATIENT, A HEALTH-CARE
FACILITY SHALL, DURING A PRE-OPERATIVE APPOINTMENT BEFORE THE
PROCEDURE AT WHICH THE EXAMINATION WILL BE PERFORMED OR, IN THE
ABSENCE OF A PRE-OPERATIVE APPOINTMENT, AS SOON AS POSSIBLE BEFORE THE
INTIMATE EXAMINATION OCCURS:
(a) PROVIDE A WRITTEN OR ELECTRONIC DOCUMENT TO THE PATIENT,
SEPARATE FROM ANY OTHER NOTICE OR AGREEMENT, THAT:
(I) INCLUDES THE FOLLOWING HEADING AT THE TOP OF THE DOCUMENT,
IN NO SMALLER THAN EIGHTEEN-POINT, BOLD-FACED TYPE: "CONSENT FOR
EXAMINATION OF BREASTS, PELVIC REGION, RECTUM, AND/OR
PROSTATE";
(II) SPECIFIES THE NATURE AND PURPOSE OF THE INTIMATE
EXAMINATION;
(III) NAMES ONE OR MORE LICENSED HEALTH-CARE PROVIDERS WHOM
THE PATIENT MAY AUTHORIZE TO PERFORM THE INTIMATE EXAMINATION;
(IV) STATES WHETHER THERE MAY BE ONE OR MORE STUDENTS OR
TRAINEES WHOM THE PATIENT MAY AUTHORIZE TO PERFORM AN INTIMATE
EXAMINATION FOR EDUCATIONAL OR TRAINING PURPOSES OR TO OBSERVE OR
OTHERWISE BE PRESENT AT THE EXAMINATION, EITHER IN PERSON OR THROUGH
ELECTRONIC MEANS, AND IDENTIFIES THE STUDENTS OR TRAINEES BY NAME;
AND
(V) PROVIDES THE PATIENT THE ABILITY TO CONSENT TO OR DECLINE
THE FOLLOWING:
(A) AN INTIMATE EXAMINATION FOR DIAGNOSIS OR TREATMENT, TO BE
PERFORMED BY A LICENSED HEALTH-CARE PROVIDER;
(B) AN INTIMATE EXAMINATION FOR EDUCATIONAL OR TRAINING
PURPOSES, TO BE PERFORMED BY A LICENSED HEALTH-CARE PROVIDER; AND
(C) ONE OR MORE, BUT NO MORE THAN THREE, ADDITIONAL INTIMATE
EXAMINATIONS FOR EDUCATIONAL OR TRAINING PURPOSES, TO BE PERFORMED
BY UP TO THREE DIFFERENT STUDENTS OR TRAINEES;
(b) OBTAIN THE SIGNATURE OF THE PATIENT ON THE WRITTEN OR
ELECTRONIC DOCUMENT; AND
(c) SIGN THE WRITTEN OR ELECTRONIC DOCUMENT.
(3) (a) FOR PURPOSES OF COMPLYING WITH SUBSECTION (2) OF THIS
SECTION, A HEALTH-CARE FACILITY MAY:
(I) DEVELOP AND USE ITS OWN WRITTEN OR ELECTRONIC DOCUMENT, SO
LONG AS THE DOCUMENT SATISFIES THE REQUIREMENTS OF SUBSECTION (2) OF
THIS SECTION; OR
(II) USE A WRITTEN OR ELECTRONIC DOCUMENT DEVELOPED BY THE
DEPARTMENT FOR USE BY HEALTH-CARE FACILITIES AND LICENSED
HEALTH-CARE PROVIDERS, SO LONG AS THE DOCUMENT SATISFIES THE
REQUIREMENTS OF SUBSECTION (2) OF THIS SECTION.
(b) IF THE DEPARTMENT DEVELOPS A WRITTEN OR ELECTRONIC
DOCUMENT FOR USE BY HEALTH-CARE FACILITIES, THE DEPARTMENT SHALL
DEVELOP A SINGLE, CONSISTENT DOCUMENT FOR USE BY ALL HEALTH-CARE
FACILITIES AND ALL LICENSED HEALTH-CARE PROVIDERS, REGARDLESS OF
PRACTICE AREA, THAT COMPLIES WITH THE REQUIREMENTS OF SUBSECTION (2)
OF THIS SECTION.
(c) THE HEALTH-CARE FACILITY SHALL MAKE THE COMPLETED, SIGNED
SPECIFIC INFORMED CONSENT DOCUMENT AVAILABLE TO THE PATIENT.".
Renumber succeeding subsections accordingly.
Page 11, line 8, after "COMPLAINT" insert "REGARDING A VIOLATION OF THIS
SECTION".
Page 12, strike lines 2 and 3 and substitute:
"(b) (I) "INTIMATE EXAMINATION" MEANS PALPATION OF A BREAST OR
AN INTERNAL PELVIC, PROSTATE, OR RECTAL EXAMINATION.
(II) "INTIMATE EXAMINATION" DOES NOT INCLUDE A VISUAL
EXAMINATION OF A PART OF THE BODY SPECIFIED IN SUBSECTION (6)(b)(I) OF
THIS SECTION THAT OCCURS INCIDENTAL TO THE CARE BEING PROVIDED.".
Page 13, line 6, strike "(5)(c)(I) AND (5)(c)(II)" and substitute "(6)(c)(I) AND
(6)(c)(II)".
Page 13, line 9, strike "(5)(c)(III)" and substitute "(6)(c)(III)".
Page 13, line 12, strike "(5)(c)(IV)" and substitute "(6)(c)(IV)".