Amendments	Fiscal Memos
HA0406	Amendment 1-0 to HB0977
HA0426	Amendment 2-0 to HB0977
HA0427	Amendment 3-0 to HB0977
HA0428	Amendment 4-0 to HB0977
HA0451	Amendment 5-0 to HB0977
HA0463	Amendment 6-0 to HB0977
HA0464	Amendment 7-0 to HB0977

	Amendments	Fiscal Memos
SA0379	Amendment 1-1 to SB1222
SA0425	Amendment 2- to SB1222
SA0428	Amendment 3- to SB1222
SA0429	Amendment 4- to SB1222
SA0430	Amendment 5- to SB1222

NOTE: Each fiscal memorandum applies only to the amendment(s) identified in the memorandum. The fiscal memorandum must be matched to any amendments that have been adopted.

Fiscal Summary

NOT SIGNIFICANT

Bill Summary

ON APRIL 15, 2015, THE SENATE ADOPTED AMENDMENTS #1 AND #2 AND PASSED SENATE BILL 1222, AS AMENDED.

AMENDMENT #1 rewrites this bill and establishes certain requirements for abortions that are similar, but not identical, to those provisions that were in effect prior to the Tennessee supreme court decision of Planned Parenthood of Middle Tennessee v. Sundquist. In that case, the court ruled that the provisions were unconstitutional under the state constitution based on a strict scrutiny review. In 2014, the voters of this state elected to amend the state constitution to state that it does not protect the right to an abortion and, as a result, to require that any abortion-related statutes be reviewed under the standard of review utilized by federal law, which is currently the undue burden standard of review. This amendment also revises and deletes some existing provisions that were not at issue in the Planned Parenthood decision.

The requirements established in this bill are as follows:

(1) This amendment retains the present law provision, which was not at issue in the Planned Parenthood decision, that no abortion may be performed or induced without the informed written consent of the pregnant woman, given freely and without coercion. This amendment specifies that this requirement does not apply in a medical emergency;
(2) Similar to the pre-Planned Parenthood decision, this amendment requires that in order to ensure that a consent for an abortion is truly informed consent, except in a medical emergency that prevents compliance, no abortion may be performed or induced upon a pregnant woman unless she has first been informed orally and in person by the attending physician who is to perform the abortion, or by the referring physician, of the following facts and has signed a consent form acknowledging that she has been informed as follows:
(A) That according to the best judgment of her attending physician or referring physician she is pregnant;
(B) The probable gestational age of the unborn child at the time the abortion is to be performed, based upon the information provided by her as to the time of her last menstrual period or after a history, physical examination, and appropriate laboratory tests;
(C) That if 24 or more weeks have elapsed from the first day of her last menstrual period or 22 or more weeks have elapsed from the time of conception, her unborn child may be viable, that is, capable of sustained survival outside of the womb, with or without medical assistance, and that if a viable child is prematurely born alive in the course of an abortion, the physician performing the abortion has a legal obligation to take steps to preserve the life and health of the child;
(D) That numerous public and private agencies and services are available to assist her during her pregnancy and after the birth of her child, if she chooses not to have the abortion, whether she wishes to keep her child or place the child for adoption, and that her attending physician or referring physician will provide her with a list of the agencies and the services available if she so requests; and
(E) The normal and reasonably foreseeable medical benefits, risks, or both of undergoing an abortion or continuing the pregnancy to term;
(3) Similar to the law prior to the Planned Parenthood decision, this amendment requires, except in a medical emergency that prevents compliance, at the same time the attending physician or referring physician provides the information required by (2), that physician inform the pregnant woman of the particular risks associated with her pregnancy and continuing the pregnancy to term, based upon the information known to the physician, as well as the risks of undergoing an abortion, along with a general description of the method of abortion to be used and the medical instructions to be followed subsequent to the abortion;
(4) Similar to the law prior to the Planned Parenthood decision, this amendment provides that, except in a medical emergency that prevents compliance, no abortion will be performed until a waiting period of 48 hours has elapsed after the attending physician or referring physician has provided the information required by (2) and (3), including the day on which the information was provided. After the 48 hours have elapsed and prior to the performance of the abortion, the patient must sign the consent form. This amendment adds that if any court temporarily, preliminarily, or permanently enjoins enforcement of the 48-hour waiting period or declares it unconstitutional, then the waiting period will be 24 hours, subject to the same medical emergency exception. If the injunction or declaration is subsequently vacated or reversed, the waiting period will revert to 48 hours;
(5) Similar to present law, this amendment requires the physician performing or inducing the abortion to provide the pregnant woman with a duplicate copy of the consent form signed by her. This amendment provides an emergency medical exception for this requirement;
(6) This amendment specifies, for purposes of the requirements described above in (1)-(5), a medical emergency is a condition that, on the basis of the physician's good faith medical judgment, so complicates a medical condition of a pregnant woman as to necessitate an immediate abortion of her pregnancy to avert her death or for which a delay will create serious risk of substantial and irreversible impairment of major bodily function. When a medical emergency compels the performance of an abortion, the physician must inform the woman, prior to the abortion if possible, of the medical reasons supporting the physician's judgment that an abortion is necessary to avert her death or to avert substantial and irreversible impairment of major bodily function. In any case in which a physician has determined that a medical emergency exists that excuses compliance with (1)-(4), the physician must state in the pregnant woman's medical records the basis for such determination.;
(7) This amendment specifies that an intentional or knowing violation by a physician of (1), (2), (3), or (4) above, or the requirement in (6) to provide the woman with information regarding a medical emergency, will be a Class E felony. An intentional, knowing, or reckless violation by a physician of (5) above or the requirement in (6) regarding medical records in case of a medical emergency will be a Class A misdemeanor. In addition, any physician who intentionally, knowingly, or recklessly violates any of the provisions of this amendment will be guilty of unprofessional conduct and such physician's license for the practice of medicine and surgery or osteopathy will be subject to suspension or revocation;
(8) This amendment requires the attorney general and reporter to notify the secretary of state and the executive secretary of the Tennessee code commission upon the occurrence of any of the events described above regarding a court ruling on the 48-hour waiting period;
(9) This amendment removes the present law requirement that a private physician's office, ambulatory surgical treatment center or other facility or clinic in which abortions, other than abortions necessary to prevent the death of the pregnant female, are performed conspicuously post a sign regarding the law against coercion; and
(10) This amendment removes the present law requirement that a physician performing an abortion have admitting privileges at a hospital in the county in which the abortion is performed or in a county adjacent to the county in which the abortion is performed.

AMENDMENT #2 retains the provisions of present law concerning posting signage and admitting privileges that are described in (9) and (10) of the Summary for Senate Amendment #1.

ON APRIL 21, 2015, THE HOUSE SUBSTITUTED SENATE BILL 1222 FOR HOUSE BILL 977, ADOPTED AMENDMENT #5, AND PASSED SENATE BILL 1222, AS AMENDED.

AMENDMENT #5 adds a severability clause to this bill.