Current through Register Vol. 49, No. 18, September 16, 2024
PURPOSE: This amendment updates definitions, establishes
contents of licensing applications, and incorporates application forms for
abortion facility licenses.
PURPOSE: This rule defines terminology used in
19
CSR 30-30.060 and
19
CSR 30-30.070, and establishes the procedures for
applying for an abortion facility license.
(1) The following definitions shall be used
in the interpretation and enforcement of
19
CSR 30-30.060 and
19
CSR 30-30.070:
(A)
Abortion-The act of using or prescribing any instrument, device, medicine,
drug, or any other means or substance with the intent to destroy the life of an
embryo or fetus in his or her mother's womb; or, the intentional termination of
the pregnancy of a mother by using or prescribing any instrument, device,
medicine, drug, or other means or substance with an intention other than to
increase the probability of a live birth or to remove a dead or dying unborn
child;
(B) Abortion facility- Any
clinic, physician's office, or any other place or facility in which abortions
are performed or induced other than a hospital;
(C) Administrator-A person who is designated
by an abortion facility to provide daily supervision over the abortion facility
and who is a physician licensed in Missouri, a registered nurse licensed in
Missouri, or an individual who has at least one (1) year of administrative
experience in health care;
(D)
Complication-Includes, but is not limited to, incomplete abortion, hemorrhage,
endometritis, parametritis, pyrexia, pelvic abscess, uterine perforation,
failed abortion, cervical lacerations, retained products, or diagnosable
psychiatric condition;
(E)
Department-The Missouri Department of Health and Senior Services;
(F) Discharge summary-A statement completed
by a physician or registered nurse regarding the condition of the patient at
the time of discharge;
(G) First
trimester-The first thirteen (13) weeks of gestation, based upon gestational
age;
(H) Gestational age-The length
of pregnancy measured from the onset of the last menstrual period, and except
in the case of a medical emergency as defined in section
188.015, RSMo,
determined by a physician in a manner consistent with accepted obstetrical and
neonatal practices and standards after performing or causing to be performed
such medical examinations, imaging studies, and tests as a reasonably prudent
physician, knowledgeable about the medical facts and conditions of both the
woman and the unborn child involved, would consider necessary to perform and
consider in making an accurate diagnosis;
(I) Health assessment-A determination of a
patient's physical and mental status;
(J) Licensed practical nurse (LPN)-A person
licensed to practice practical nursing pursuant to Chapter 335, RSMo;
(K) OB/GYN-A physician who is board-certified
or board-eligible by the American Board of Obstetrics and Gynecology or the
American Osteopathic Board of Obstetrics and Gynecology;
(L)
Person-Any individual, firm, partnership, corporation, association, or other
business entity;
(M) Physician-Any person licensed to practice medicine
pursuant to Chapter 334, RSMo;
(N) Registered
professional nurse-An individual who is a graduate of an approved school of
nursing and who is licensed to practice professional nursing under Chapter 335,
RSMo; and
(O) Surgical technologist-An individual who is
certified by the National Board of Surgical Technology and Surgical
Assisting.
(2)
Procedures for Licensing Abortion Facilities.
(A) No abortion shall be performed or induced
in any place or facility including a clinic or physician's office, without a
license issued by the department, except that abortions may be performed or
induced in hospitals without a separate abortion facility license issued by the
department.
(B) Application for an
abortion facility license shall be made in writing to the department on forms
provided by the department
by the person who will operate the facility. The forms shall
require at least the following information: date of application; name of
facility to appear on license; street address, city, county, zip code,
telephone number, and email address of facility; facility website address, if
any; name of person who will operate facility; organizational chart showing
ownership and control of facility; name of chief officer of governing body of
facility; name and qualifications of administrator; name and qualifications of
OB/GYN consultant; types of abortions that will be performed at the facility
(i.e., surgical and/or drug- or chemically-induced); estimated number of each
type of abortion that will be performed and/or induced annually at facility;
number of facility staff; number of physicians on staff; number of physicians
routinely performing or inducing abortions at facility; number of
anesthesiologists or CRNAs on staff, if any; usual days and hours of facility
operation; usual days and times that abortions are induced or performed at
facility; number of procedure rooms; and notarized certification by chief
officer of governing body and administrator that application is accurate and
facility will follow all applicable laws and regulations.
(C) Each application for an abortion facility
license shall be sent to the Missouri Department of Health and Senior Services,
Bureau of Ambulatory Care, PO Box 570, Jefferson City, MO 65102, and shall be
accompanied by an annual fee of two hundred dollars ($200).
(D) Each license, unless sooner suspended or
revoked, shall be issued for a period of one (1) year.
(E) Each license shall be issued only for the
persons and premises named in the application.
(F) The facility shall
notify the department in writing if the operator of the facility, name of the
facility, or premises of the facility changes. The facility shall provide the
notification at least thirty (30) days before the change.
(G)
Separate licenses are required for abortion facilities maintained on separate
sites even if operated by the same person.
(H) The abortion
facility license shall be conspicuously posted in a public area in the
facility.
(I) No license shall be issued or renewed by the
department until the department has inspected the facility and determined that
it is in compliance with all requirements of applicable regulations and
statutes.