The Commonwealth of Massachusetts

Executive Office of Health and Human Services
Department of Public Health
250 Washington Street, Boston, MA 02108-4619

DEVAL L. PATRICK
GOVERNOR
TIMOTHY P. MURRAY
LIEUTENANT GOVERNOR
JUDYANN BIGBY, MD
SECRETARY
John Auerbach
COMMISSIONER	
 Division of Health Care Quality
Hospital Affirmations 
Chapter 91 of the Acts of 2005
An Act Providing Timely Access to Emergency Contraception

The Hospital affirms that the Emergency Department is: 
1)	Providing the medically and factually accurate written information prepared by the Commissioner of Public Health about emergency contraception to all persons who provide care to victims of sexual assault; 
2)	Promptly providing the medically and factually accurate written information about emergency contraception prepared by the Commissioner of Public Health to every female rape victim of childbearing age who presents at a facility after a rape; and
3)	Promptly offering emergency contraception to each female rape victim of childbearing age and initiating emergency contraception upon her request.

The Hospital also affirms that:
1)	The Emergency Department offers emergency contraceptive pills rather than a prescription to the female rape victim of childbearing age.
2)	Neither the hospital nor its staff requires any female rape victim of childbearing age to complete any part of a sexual assault evidence collection kit as a condition of any of the following:
•	The provision of medically and factually accurate written information about emergency contraception; 
•	The prompt offering of emergency contraception; or
•	The initiation of emergency contraception.  

3)	If the Emergency Department does not initiate emergency contraception upon the request of the female rape victim of childbearing age, the contraindication(s) for non-initiation are documented in the patient’s medical record and are based on best clinical practice and information (such as American College of Obstetrics and Gynecology Practice Bulletin, 69, 2005; or World Health Organization Medical Eligibility Criteria for Contraceptive Use, Third edition, 2004).    

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Title									Hospital