HAR §17-1737-48. Sterilization

(a) Sterilization means any medical procedure, treatment, or operation for the purpose of rendering an individual permanently incapable of reproducing. Sterilization shall be neither a necessary part of the treatment of an existing accompaniment of an operation. Sterilization under this program shall not be authorized for any individual who is: (1) Mentally incompetent; (2) Incompetent under applicable state law to give informed and binding consent because of mental incapacity; (3) Under twenty-one years; or (4) Institutionalized. (b) Informed consent shall be obtained prior to any sterilization procedure. For the purpose of this program, the informed consent shall be valid only if prior to obtaining the consent, the individual requesting the service was furnished with the following information: (1) A thorough explanation of the procedure to be performed; (2) A full description of the attendant discomforts and risks; (3) A description of the benefits to be expected; (4) Counseling concerning appropriate alternative methods, and the effect and impact of the proposed sterilization, including the fact that the procedure shall be considered irreversible; (5) An offer to answer any inquiries concerning the sterilization procedures; (6) Advice that the individual is free to withhold or withdraw the consent to the procedure without affecting the right to future medicaid benefits and without prejudice to future care; and (7) Advice that the sterilization will not be performed for at least thirty days except under conditions listed in subsection (e). (c) The provider shall use the appropriate departmental form to obtain written consent from a medicaid recipient who is requesting the service. No substitution of form shall be accepted. UNOFFICIAL 1737-67 (d) Sterilization shall not be performed sooner than thirty days but not more than one hundred eighty days following the giving of informed consent in writing, except as explained in subsection (e). (e) Exceptions to subsections (b)(7) and (d) may be made if more than seventy-two hours have passed since informed consent was given and where there is: (1) Premature delivery, when informed consent was given at least thirty days before expected date of delivery; or (2) Emergency abdominal surgery. (f) Consent for sterilization may not be obtained if the person requesting sterilization is: (1) In labor or childbirth; (2) Seeking to obtain or is obtaining an abortion; or (3) Under the influence of alcohol or other substances that affect the individual's state of awareness. (g) An operation for an ectopic pregnancy which results in sterilization due to removal of a woman's single remaining fallopian tube shall not be considered either a primary sterilization or an abortion and shall be a medically indicated procedure covered under the program. (h) A hysterectomy shall not be considered a sterilization procedure. The provisions of section 17-1737-47 shall apply. [Eff 08/01/94 ] (Auth: HRS §346-14) (Imp: 42 C.F.R. §§441.250 - 441.258)