Report Title:

Emergency Contraceptives for Sexual Assault Survivors


Authorizes nonreligious hospitals to provide emergency contraception to sexual assault survivors. (SD1)



H.B. NO.



H.D. 2


S.D. 1







SECTION 1. The legislature finds that one out of every five women in the United States has been sexually assaulted. Each year, over three hundred thousand women are sexually assaulted in the United States. Every six minutes, somewhere in America, a woman is sexually assaulted and reports the incident to law enforcement officials.

In 2000, there were three hundred and forty-six forcible rapes reported in Hawaii. After a woman is sexually assaulted, she may face the additional trauma of an unwanted pregnancy as a result of the sexual assault. Each year in the United States, over thirty-two thousand women become pregnant as a result of the sexual assault and approximately fifty per cent of the pregnancies end in abortion.

Emergency contraceptives to prevent pregnancy after unprotected sexual intercourse have been approved for use by the United States Food and Drug Administration. Emergency contraception cannot and does not cause abortion. Emergency contraceptive pills are the most commonly used method of emergency contraception and are ordinary birth control pills. Emergency contraceptive pills reduce the risk of pregnancy following unprotected sexual intercourse by seventy-five to eighty-nine per cent. A twelve-hour delay of the first dose of emergency contraceptive pills increases the odds of pregnancy by almost fifty per cent.

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 that nearly one in three hospitals fail to offer emergency contraception to sexual assault victims. An additional twenty-three per cent have no clear policy on the issue. 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 purposes of this Act are to require hospitals to provide information on emergency contraceptives, and to require nonreligious hospitals to offer and provide emergency contraceptives to sexual assault survivors.

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



§321-    Definitions. As used in this part, unless the context otherwise requires:

"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.

"Religious hospital" means a hospital that meets the following criteria:

(1) The hospital policies and services are based on religious beliefs and are set down in moral and ethical directives consistent with those beliefs; and

(2) The hospital is exempt from taxation pursuant to section 501(c)(3) of the Internal Revenue code of 1986, as amended.

"Sexual assault" means sexual penetration as defined in sections 707-731(1)(a), (b), and (c); 707-732(1)(a); or 707-733(1)(a).

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

§321-    Emergency care for sexual assault survivors. Hospitals that provide emergency care to sexual assault survivors shall:

    1. Provide each sexual assault survivor with medically and factually accurate and unbiased 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 may take at the hospital, as well as the follow-up dose to be self-administered by the sexual assault survivor twelve hours later.
    4. The cost of the emergency contraception dispensed shall be paid by the department.

§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 and unbiased information about emergency contraception and sexual assault treatment.

§321-    Enforcement. In addition to any remedies at common law, the department shall respond to complaints and shall periodically determine whether hospitals are complying with this part. The department may use all investigative tools available to verify compliance with this part. If the department determines after a hearing conducted under chapter 91 that a hospital is not in compliance, the department shall:

    1. Impose an administrative fine of $5,000 per sexual assault survivor who is denied medically and factually accurate and unbiased information about emergency contraception or who is not offered or provided emergency contraception; and
    2. After two violations, suspend or revoke the hospital’s license.

§321-    Religious exemption. (a) Notwithstanding any other provision of this part, a religious hospital may request, and the department may issue, an exemption from the provision of emergency contraception to sexual assault survivors for religious reasons.

(b) Every religious hospital that invokes the exemption provided under this section shall provide to all sexual assault survivors:

(1) A list of other emergency care facilities in the vicinity that provide emergency contraceptives; and

(2) Written information on the use of emergency contraceptives and the risks of unintended pregnancy that is medically and factually accurate and unbiased.

(c) Any religious hospital that seeks to invoke the exemption provided under this section shall apply to the department in writing and provide specific and supporting documentation that meets the requirements of being a religious hospital. The department shall review each application and notify the religious hospital of acceptance or denial within thirty days of the submission of the completed application.

(d) The department shall maintain a separate file of all such applications and approvals and denials, and shall make them available to the public upon request."

SECTION 3. This Act shall take effect on July 1, 2003.