New Hampshire

House Bill 1209 (2001)

Health Care Providers Civil Rights Act

AN ACT relative to a civil rights act for health care providers.

Be it Enacted by the Senate and House of Representatives in General Court convened:

1 Statement of Purpose.

I. The general court of the state of New Hampshire finds that:

(a) Every individual has a fundamental right to exercise his or her religious beliefs and conscience.

(b) As a matter of religious belief and conscience, some individuals and religions object to certain health care procedures, including, but not limited to, abortion, artificial insemination, artificial contraception, cloning, human stem cell and fetal experimentation, withdrawal of nutrition and hydration, physician-assisted suicide and euthanasia under some or all circumstances. Individual and institutional health care providers have a right to object to participating in health care procedures for moral, religious, or philosophical reasons.

(c) If an institution chooses to perform legal but morally objectionable services, the institution shall do so in a manner that has no adverse effect on the right of an employee to exercise his or her conscience and to continue employment in his or her chosen career.

(d) Health care institutions that choose to perform legal health care services that may be morally objectionable have a duty to provide standard care to their patients but not at the cost of their employee's right of conscience.

(e) Without a comprehensive civil rights act for health care providers, religious beliefs and rights of conscience may be violated in various ways such as: harassment, demotion, salary reduction, transfer, termination, loss of staffing privileges, denial of aid or benefits, and refusal to license, or refusal to certify.

II. Therefore, based on the findings in paragraph I, it is the purpose of this act to:

(a) Ensure that all individuals' and health care institutions' religious beliefs or rights of conscience are protected.

(b) Allow all health care providers and health care institutions to refuse to participate in any manner with health care services to which they object based on their religious, philosophical, or moral convictions.

(c) Protect all health care providers and health care institutions that conscientiously object to participating in health care services from any adverse action taken against them as a result of their conscientious objection.

2 New Chapter; Health Care Providers Civil Rights Act.

Amend RSA by inserting after chapter 332-I the following new chapter:

CHAPTER 332-J
HEALTH CARE PROVIDERS CIVIL RIGHTS ACT

332-J:1 Definitions.

In this chapter:

I. "Conscientiously object or conscientious objection" means to object because of a religious belief, or a moral, ethical or philosophical conviction.

II. "Health care institution" means any public or private organization, corporation, partnership, sole proprietorship, association, agency, network, joint venture or other legal entity that is involved in providing health care services, including but not limited to: hospitals, clinics, medical centers, ambulatory surgical centers, private physician's offices, pharmacies, nursing homes, university medical schools and nursing schools, medical training facilities, or other institutions or locations wherein health care services are provided to any person.

III. "Health care payer" means a health maintenance organization, insurance company, management services organization, or any other entity that pays for or arranges for the payment of any health care service, procedure, or product.

IV. "Health care provider" means any individual who may be asked to participate in any way in a health care service, including but not limited to: physician, physician's assistant, nurse, nurses' aide, medical assistant, hospital employee, clinic employee, nursing home employee, pharmacist, pharmacy employee, medical school student, medical school employee, or any professional, paraprofessional, or any other person who furnishes, or assists in the furnishing of, health care services.

V. "Health care service" means the provision of any phase of patient medical care or treatment, including, but not limited to, the following: patient referrals, patient counseling, patient testing, patient diagnosis or prognosis, research, instruction, the prescription or administration of any device, drug or medication, or any combination of drugs or medications, performing surgery, or providing any other care or treatment rendered by health care providers or health care institutions, intended for the patient's physical, emotional, or mental well-being.

332-J:2 Health Care Provider's Right to Conscientiously Object.

I. A health care provider has the right to conscientiously object to participating in a health care service.

II. A health care provider who conscientiously objects to participating in any way in a health care service shall not be civilly or criminally liable to any person, estate, public or private entity, or public official.

III. It shall be unlawful for any person, health care provider, health care institution, public or private institution, public official, or national certifying board which certifies competency in medical specialties to discriminate against any health care provider in any manner based on his or her conscientious objection to participating in a health care service, including, but not limited to: termination, transfer, refusal of staff privileges at a health care institution, refusal of board certification, administrative action, refusal to provide standard residency training opportunities, or any other disciplinary action.

IV. A health care provider may express his or her conscientious objection verbally upon being asked to participate in a health care service that contravenes his or her religious belief, or moral, ethical or philosophical conviction. Within 10 business days of making a verbal conscientious objection, a health care provider shall send a letter by registered mail, return-receipt requested, to the chairperson of the department or equivalent supervising personnel, setting forth any conscientious objection which he or she has to participating in a health care service. The written conscientious objection shall be retained in the health care provider's personnel or other similar record, and shall serve as a valid continuing conscientious objection as long as that health care provider is employed by, or enrolled as a student in, the health care institution. Failure to send a written confirmation letter of a prior verbal conscientious objection shall not negate the right to conscientiously object; however, such failure shall limit the remedy available under RSA 332-J:5 to injunctive relief only.

V.(a) Within 30 days of the effective date of this chapter, all health care institutions shall post the following notice in a location that is conspicuous to health care providers.

Notice of Health Care Provider's Right to Conscientiously Object

State law permits any health care provider to refuse to participate in any type of health service based on his or her religious belief, or moral, ethical or philosophical conviction.

Any health care provider may express his or her conscientious objection verbally upon being asked to participate in a health care service that contravenes his or her religious belief, or moral, ethical or philosophical conviction. Within 10 business days of making a verbal conscientious objection, a health care provider shall send a letter by registered mail, return-receipt requested, to the chairperson of the department or equivalent supervising personnel setting forth any conscientious objection which he or she has to participating in a health care service.

It shall be unlawful for any health care institution to discriminate against, discipline, or take any other retaliatory action against any individual that exercises his or her right to conscientiously object, and state law provides specific civil remedies for the violation of the "Health Care Provider's Civil Rights Act", RSA 332-J.

"Health care provider" as defined in state law means any individual who may be asked to participate in any way in a health care service, including but not limited to: a physician, physician's assistant, nurse, nurses' aide, medical assistant, hospital employee, clinic employee, nursing home employee, pharmacist, pharmacy employee, medical school student, medical school employee, or any professional, paraprofessional, or any other person who furnishes, or assists in the furnishing of, health care services.

b) Failure to post such notice shall be a violation.

332-J:3 Health Care Institution's Right to Conscientiously Object.

I. A health care institution has the right to conscientiously object to providing a health care service.

II. It shall be unlawful for any person, public or private institution, or public official to discriminate against any person, association, or corporation attempting to establish a new health care institution or operating an existing health care institution, in any manner, including but not limited to, denial, deprivation or disqualification in licensing, granting of authorizations, aids, assistance, benefits, medical staff or any other privileges, and granting authorization to expand, improve, or create any health care institution, by reason of the refusal of such person, association, or corporation planning, proposing or operating a health care institution, to permit or perform any particular form of health care service which violates the health care institution's conscience as documented in its existing or proposed ethical guidelines, mission statement, constitution, bylaws, articles of incorporation, regulations, or other governing documents.

III. It shall be unlawful for any public official, agency, institution, or entity to deny any form of aid, assistance, grants or benefits, or in any other manner to coerce, disqualify, or discriminate against any person, association, or corporation attempting to establish a new health care institution or operating an existing health care institution which otherwise would be entitled to the aid, assistance, grant, or benefit because the existing or proposed health care institution refuses to perform, assist, counsel, suggest, recommend, refer, or participate in any way in any form of health care services contrary to the health care institution's conscience as documented in its existing or proposed ethical guidelines, mission statement, constitution, bylaws, articles of incorporation, regulations, or other governing documents.

IV. A health care institution may provide public notification of its conscientious objection to providing health care services by posting signs in the admissions area that indicate its conscientious objections.

V. A health care institution's conscientious objection to a health care service shall not be a basis for any civil, criminal, or administrative liability, nor for any retaliation against the health care institution in any grant, contract, or program.

332-J:4 Health Care Payer's Right to Conscientiously Object.

I. A health care payer has the right to conscientiously object to paying for or arranging for the payment of a health care service.

II. No health care payer and no person, association, or corporation that owns, operates, supervises, or manages a health care payer shall be civilly or criminally liable to any person, estate, or public or private entity by reason of refusal of the health care payer to pay for or arrange for the payment of any particular form of health care services that violate the health care payer's conscience as documented in its ethical guidelines, mission statement, constitution, bylaws, articles of incorporation, regulations, or other governing documents.

III. It shall be unlawful for any person, public or private institution, or public official to discriminate against any person, association, or corporation attempting to establish a new health care payer or operating an existing health care payer, in any manner, including but not limited to, denial, deprivation, or disqualification in licensing; granting of authorizations, aids, assistance, benefits, or any other privileges; and granting authorization to expand, improve, or create any health care payer, because the person, association, or corporation planning, proposing, or operating a health care payer refuses to pay for or arrange for the payment of any particular form of health care services that violates the health care payer's conscience as documented in the existing or proposed ethical guidelines, mission statement, constitution, bylaws, articles of incorporation, regulations, or other governing documents.

IV. It shall be unlawful for any public official, agency, institution, or entity to deny any form of aid, assistance, grants, or benefits, or in any other manner to coerce, disqualify, or discriminate against any person, association, or corporation attempting to establish a new health care payer or operating an existing health care payer that otherwise would be entitled to the aid, assistance, grant, or benefit, because the existing or proposed health care payer refuses to pay for, arrange for the payment of, or participate in any way in any form of health care services contrary to the health care payer's conscience as documented in its existing or proposed ethical guidelines, mission statement, constitution, bylaws, articles of incorporation, regulations, or other governing documents.

332-J:5 Civil Remedies.

I. A civil action for damages or injunctive relief, or both, may be brought for the violation of this chapter.

II. Any person, association, corporation, entity, or health care institution injured by any public or private person, association, agency, entity, or corporation by reason of any conduct prohibited by this chapter may commence a civil action therefor. Upon finding a violation of this chapter, the aggrieved party shall be entitled to recover threefold the actual damages, including pain and suffering, sustained by such person, association, corporation, entity or health care institution, the costs of the action and reasonable attorney's fees; but in no case shall recovery be less than $5,000 for each violation in addition to costs of the action and reasonable attorney's fees. These damage remedies shall be cumulative, and not exclusive of other remedies afforded under any other state or federal law.

III. The court in such civil action may award injunctive relief, including, but not limited to, ordering reinstatement of a health care provider to his or her position.

332-J:6 Severability.

If any provision of this chapter or the application thereof to any person or circumstance is held invalid, the invalidity does not affect other provisions or applications of the chapter which can be given effect without the invalid provisions or applications, and to this end the provisions of this chapter are severable.

3 Effective Date.

This act shall take effect January 1, 2003.