H.B. NO.



H.D. 1
















     SECTION 1.  In the aftermath of rape, victims find themselves dealing with a host of reproductive and sexual health issues.  The physical and emotional trauma suffered by victims is compounded by the possibility of unwanted pregnancy as a result of the rape.  The average rate of pregnancy resulting from rape is between five and eight per cent with an estimated thirty-two thousand rape-related pregnancies occurring every year in the United States.

     Emergency contraception is a safe and effective means of preventing pregnancy after a sexual assault.  In fact, the provision of emergency contraception to victims of sexual assault is the most widely recognized and accepted standard of care for sexual assault patients.  The American Medical Association and the American College of Obstetricians and Gynecologists have stated that sexual assault victims should be informed about and provided emergency contraception.  However, a recent survey of emergency facilities in Hawaii revealed a lack of clear policy on the issue.

     The purpose of this Act is to ensure that victims of sexual assault are provided information about and access to emergency contraception when receiving emergency medical care at Hawaii's hospitals for sexual assaults.

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


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

     "Department" means the department of health.

     "Emergency contraception" means one or more prescription drugs used separately or in combination that is:

     (1)  Used postcoitally within a recommended amount of time;

     (2)  Used for the purpose of preventing pregnancy; and

     (3)  Approved by the United States Food and Drug Administration.

     "Emergency medical care" includes any medical examination or treatment provided by a hospital or provider to a sexual assault survivor following an alleged sexual assault.

     "Hospital" includes:

     (1)  An institution with an organized medical staff, regulated under section 321-11(10), that admits patients for inpatient care, diagnosis, observation, and treatment;

     (2)  A provider as defined in this part; and

     (3)  A health facility as defined in section 323F-1.

     "Medical care" means every type of care, treatment, surgery, hospitalization, attendance, service, and supplies as the nature of an injury or condition requires.  Medical care shall include outside consultation and referrals.

     "Provider" means any entity that provides sexual assault survivor services in a non-hospital setting.

     "Sexual assault" means sexual penetration as defined in section 707-700.

     "Sexual assault survivor" means a person who alleges or is alleged to have been sexually assaulted and as a result of the sexual assault presents as a patient at a hospital.

     §321-B  Compassionate care.  (a)  Any hospital that provides emergency medical care to a sexual assault survivor shall:

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

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

     (3)  When medically indicated, provide emergency contraception to each female sexual assault survivor who requests it, including the initial dose that can be taken at the hospital, and any further dosage as necessary; and

     (4)  Ensure that each person at the hospital who may provide emergency medical care shall be trained to provide a sexual assault survivor with medically and factually accurate and unbiased written and oral information about emergency contraception and sexual assault treatment options and access to emergency contraception.

     (b)  No hospital shall deny a sexual assault survivor emergency contraception based on a refusal to undergo a forensic or other medical examination or a refusal to report the alleged sexual assault to law enforcement.

     (c)  No hospital shall be required to provide emergency contraception to a sexual assault victim who has been determined to be pregnant through the administration by the hospital staff of a pregnancy test approved by the United States Food and Drug Administration.

     (d)  The cost of any emergency contraception dispensed pursuant to this part shall be paid by the department using moneys from the domestic violence and sexual assault special fund under section 321-1.3.

     (e)  Providers shall:

     (1)  Have medically trained personnel, including registered nurses, licensed social workers, and psychologists ready to respond within thirty minutes of admission of a sexual assault survivor;

     (2)  Provide medically accurate information;

     (3)  Provide transportation and the initial dose of medication, and counseling services to the patient at no cost to the provider; and

     (4)  Have staff available to provide services twenty-four hours per day, seven days a week.

     (f)  The department shall adopt rules under chapter 91 for the purposes of this part.

     §321-C  Enforcement; administrative penalties.  (a)  The department may set, charge, and collect administrative fines and recover administrative fees and costs, including attorney's fees and costs, resulting from a violation of this part or any rule adopted under this part.

     (b)  The department shall:

     (1)  Establish a policy and procedure to monitor compliance with this part, including a complaint process;

     (2)  Respond to any complaint received by the department concerning noncompliance by a hospital or provider with the requirements of section 321-B; and

     (3)  Provide written notice to any hospital or provider that the department determines is in violation of this part or any rule adopted under this part, including an opportunity to take corrective action.

     (c)  Any hospital or provider that violates this part or any rule adopted under this part after receiving written notice and an opportunity to take corrective action pursuant to subsection (b)(3) shall be fined not more than $1,000 for each separate offense.

     (d)  Sanctions under this section shall not be issued for violations occurring before July 1, 2012."

     SECTION 3.  In codifying the new sections added by section 2 of this Act, the revisor of statutes shall substitute appropriate section numbers for the letters used in designating the new sections in this Act.

     SECTION 4.  This Act shall take effect on July 1, 2050.





Report Title:

Compassionate Care; Emergency Contraception



Requires hospitals and providers to provide survivors of sexual assault with medically and factually accurate and unbiased information regarding emergency contraception, as well as access to emergency contraception.  Requires providers to provide certain additional services.  Effective July 1, 2050.  (HB127 HD1)




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