Report Title:

Sexual Assault; Emergency Contraceptives; Training; Enforcement

Description:

Requires hospitals to provide information on emergency contraception to sexual assault victims and provide emergency contraception when requested. Provides an exemption for religiously affiliated hospitals. Requires training on sexual assault and emergency contraceptives to those who treat survivors. Provides for enforcement and penalties. (HD1)

HOUSE OF REPRESENTATIVES

H.B. NO.

1240

TWENTY-THIRD LEGISLATURE, 2005

H.D. 1

STATE OF HAWAII

 


 

A BILL FOR AN ACT

 

RELATING TO EMERGENCY CONTRACEPTIVES FOR SEXUAL ASSAULT SURVIVORS IN EMERGENCY ROOMS.

 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

SECTION 1. The legislature finds that one out of every five women, or 302,100 women, are forcibly raped each year in the United States. Approximately every six minutes, a woman is sexually assaulted and reports the incident to law enforcement officials.

According to the Federal Bureau of Investigation's Uniform Crime Reports, there were three hundred four forcible rapes reported in Hawaii in 2002. However, the Department of Justice National Crime Victimization Surveys indicate that over half of all rapes are not reported to the police. After a woman is sexually assaulted, she may face the additional trauma of an unwanted pregnancy by the rapist. Each year, over thirty-two thousand women become pregnant as a result of a sexual assault, with approximately fifty per cent of these pregnancies ending in abortion.

Emergency contraceptives have been approved for use by the United States Food and Drug Administration to prevent pregnancy after unprotected sexual intercourse. The Ethical and Religious Directives for Catholic Health Care Services makes an exception for contraception for rape victims, stating that "a female who has been raped should be able to defend herself against a potential conception from the sexual assault." The exception was explained in an article in the September-October 2002 issue of Health Progress, the journal of the Catholic Health Association of the United States, by the Association's senior director of ethics, who noted that:

"Catholic teaching allows for the administration of emergency contraception within certain moral limits. Measures taken to prevent conception in such cases fall outside the general prohibition against contraception because the assailant's act is a violation of justice, and any semen within the woman's body is considered a continuation of the unjust aggression against which she may licitly defend herself."

Standards of emergency care, established by the American Medical Association, require that female victims of sexual assault be counseled about the risk of pregnancy and offered emergency contraception. One statewide study found inconsistent treatment protocols of sexual assault patients in Hawaii's emergency rooms and a lack of written policies. According to a 1997 Kaiser Family Foundation report, most women of reproductive age do not know enough about emergency contraception to ask for it--only eleven per cent have heard of it, are aware of its availability, and know that treatment must be initiated within seventy-two hours after sexual intercourse.

The purpose of this Act is to require all hospitals that provide emergency care to sexual assault survivors to provide information on emergency contraceptives to sexual assault victims to enable these women to make an informed choice regarding whether or not to obtain emergency contraception.

SECTION 2. Chapter 321, Hawaii Revised Statutes, is amended by adding a new part to be appropriately designated and to read as follows:

"PART    . EMERGENCY CONTRACEPTIVES

FOR SEXUAL ASSAULT SURVIVORS

§321-   Definitions. For purposes of this part:

"Department" means the department of health.

"Emergency care" means medical examinations, procedures, and services provided by a hospital to a victim of sexual assault after an alleged sexual assault.

"Emergency contraception" means any drug or device approved by the United States Food and Drug Administration that prevents pregnancy after sexual intercourse.

"Sexual assault" means any act of sexual penetration prohibited in chapter 707.

"Sexual assault survivor" means a female who alleges or is alleged to have been sexually assaulted and who presents herself as a patient to a hospital.

§321-   Emergency care for sexual assault survivors. (a) All hospitals, except as provided in subsection (b), that provide emergency care to sexual assault survivors shall:

(1) Provide each sexual assault survivor with medically and factually accurate written and oral information about emergency contraception;

(2) Orally inform each sexual assault survivor of her option to receive emergency contraception at the hospital; and

(3) Provide emergency contraception immediately at the hospital to each sexual assault survivor who requests it. The provision of emergency contraception shall include the initial dose, which the sexual assault survivor can take at the hospital, as well as any appropriate subsequent dosage as is medically prescribed, necessary, or required.

The cost of the emergency contraception dispensed shall be paid by the department.

(b) A religiously affiliated hospital with a religious objection to participation in the requirements of subsection (a) shall be exempt therefrom but shall provide emergency care to a sexual assault survivor by providing medically appropriate transportation in a timely manner to another health care facility or provider of the survivor's choice. The religiously affiliated hospital shall be responsible for the costs associated with transportation to the health care facility or provider of the survivor's choice. A hospital that is exempt under this subsection shall inform the sexual assault survivor that she will not be held responsible for the costs associated with transportation to the health care facility or provider of the survivor's choice.

§321-   Training. Hospitals that provide emergency care to sexual assault survivors shall ensure that each person who provides care to sexual assault survivors is provided with medically and factually accurate information about emergency contraception and sexual assault treatment.

§321-   Enforcement. (a) Complaints of failure to provide services required by this part may be filed with the department. In addition to any remedies at common law, the department shall have the power to accept, investigate, prosecute, and hear complaints regarding any hospital that is not providing the services required by this part. The department shall periodically determine hospital compliance with this part. Hospitals determined not to be in compliance will be provided with written notice of the department's determination of noncompliance and an opportunity for corrective action. If the department determines that noncompliance continues after the offending hospital receives written notice of the department's determination of noncompliance and an opportunity for correction, the department shall:

(1) Impose fines of up to $1,000 for every sexual assault survivor who is denied medically and factually accurate information about emergency contraception or who is not offered or provided emergency contraception; and

(2) After two violations, provide only statistical information relating to times and dates of the violations by the facility to the body or agency that determines issuance of state funding to the facility for the termination of all state funds to that facility.

(b) In any proceeding under this section, the hospital subject to the proceeding shall be given notice and the opportunity for a hearing in conformity with chapter 91.

(c) The director of health may adopt rules pursuant to chapter 91 necessary to carry out the purposes of this part."

SECTION 3. This Act shall take effect on July 1, 2005.