By: Howard, et al. (Senate Sponsor - Nelson) H.B. No. 2706
         (In the Senate - Received from the House May 3, 2021;
  May 20, 2021, read first time and referred to Committee on
  Jurisprudence; May 22, 2021, reported favorably by the following
  vote:  Yeas 3, Nays 0; May 22, 2021, sent to printer.)
Click here to see the committee vote
 
 
A BILL TO BE ENTITLED
 
AN ACT
 
  relating to the emergency services and care provided to victims of
  sexual assault and other sex offenses and to the processes
  associated with preserving and analyzing the evidence of those
  offenses.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Chapter 38, Code of Criminal Procedure, is
  amended by adding Article 38.435 to read as follows:
         Art. 38.435.  PROHIBITED USE OF EVIDENCE FROM FORENSIC
  MEDICAL EXAMINATION PERFORMED ON VICTIM OF SEXUAL ASSAULT.
  Evidence collected during a forensic medical examination conducted
  under Subchapter F or G, Chapter 56A, may not be used to investigate
  or prosecute a misdemeanor offense, or an offense under Subchapter
  D, Chapter 481, Health and Safety Code, alleged to have been
  committed by the victim from whom the evidence was collected.
         SECTION 2.  Article 56A.252, Code of Criminal Procedure, is
  amended to conform to Sections 3 and 8, Chapter 1037 (H.B. 616),
  Acts of the 86th Legislature, Regular Session, 2019, and is further
  amended to read as follows:
         Art. 56A.252.  PAYMENT OF COSTS OF EXAMINATION.  (a) [A law
  enforcement agency that requests a forensic medical examination
  under Article 56A.251 shall pay all costs of the examination.]  On
  application to the attorney general, a health care provider that
  provides a forensic medical examination to a sexual assault
  survivor in accordance with this subchapter, or the [law
  enforcement agency is entitled to be reimbursed for the reasonable
  costs of the examination if the examination was performed by a
  physician or by a] sexual assault examiner or sexual assault nurse
  examiner who conducts the examination, as applicable, is entitled
  to be reimbursed in an amount set by attorney general rule for:
               (1)  the reasonable costs of the forensic portion of
  that examination; and
               (2)  the evidence collection kit [defined by Section
  420.003, Government Code].
         (b)  The application under Subsection (a) must be in the form
  and manner prescribed by the attorney general and must include:
               (1)  the documentation of the law enforcement agency's
  request for the forensic medical examination, as required under
  Article 56A.251(d); and
               (2)  a complete and itemized bill of the reasonable
  costs of the forensic portion of the examination.
         (c)  A health care provider or a sexual assault examiner or
  sexual assault nurse examiner, as applicable, who applies for
  reimbursement under Subsection (a) shall accept reimbursement from
  the attorney general as payment for the costs unless:
               (1)  the health care provider or sexual assault
  examiner or sexual assault nurse examiner, as applicable:
                     (A)  requests, in writing, additional
  reimbursement from the attorney general; and
                     (B)  provides documentation in support of the
  additional reimbursement, as reasonably requested by the attorney
  general; and
               (2)  the attorney general determines that there is a
  reasonable justification for additional reimbursement.
         (d)  A health care provider is not entitled to reimbursement
  under this article unless the forensic medical examination is
  conducted on the premises of the provider by a sexual assault
  examiner or sexual assault nurse examiner.
         (e)  On request, the attorney general may provide training to
  a health care provider regarding the process for applying for
  reimbursement under this article.
         SECTION 3.  Article 56A.254, Code of Criminal Procedure, is
  amended to read as follows:
         Art. 56A.254.  PAYMENT OF COSTS FOR CERTAIN MEDICAL CARE.
  The attorney general may make a payment to or on behalf of an
  individual for the reasonable costs incurred for medical care
  provided in accordance with Sections [Section] 323.004, 323.053,
  and 323.054, Health and Safety Code.
         SECTION 4.  Article 56A.302, Code of Criminal Procedure, is
  amended to read as follows:
         Art. 56A.302.  APPLICABILITY. This subchapter applies to
  the following health care providers [facilities] that provide
  diagnosis or treatment services to victims of sexual assault:
               (1)  a general or special hospital licensed under
  Chapter 241, Health and Safety Code;
               (2)  a general or special hospital owned by this state;
               (3)  an outpatient clinic; [and]
               (4)  a private physician's office; and
               (5)  a SAFE program as defined by Section 323.051,
  Health and Safety Code.
         SECTION 5.  Article 56A.303, Code of Criminal Procedure, is
  amended to conform to Section 4, Chapter 1037 (H.B. 616), Acts of
  the 86th Legislature, Regular Session, 2019, and is further amended
  to read as follows:
         Art. 56A.303.  FORENSIC MEDICAL EXAMINATION. (a)  In
  accordance with Subchapter B, Chapter 420, Government Code, and
  except as provided by Subsection (b), a health care provider 
  [facility] shall conduct a forensic medical examination of a victim
  of a [an alleged] sexual assault if:
               (1)  the victim arrives at the provider [facility]
  within 120 [96] hours after the assault occurred;
               (2)  the victim consents to the examination; and
               (3)  at the time of the examination the victim has not
  reported the assault to a law enforcement agency.
         (b)  If a health care provider [facility] does not provide
  diagnosis or treatment services to victims of sexual assault, the
  provider [facility] shall refer a victim of a [an alleged] sexual
  assault who seeks a forensic medical examination under Subsection
  (a) to a health care provider [facility] that provides services to
  those victims.
         (c)  A victim of a [an alleged] sexual assault may not be
  required to participate in the investigation or prosecution of an
  offense as a condition of receiving a forensic medical examination
  under this article.
         SECTION 6.  Article 56A.304, Code of Criminal Procedure, is
  amended to conform to Sections 4 and 8, Chapter 1037 (H.B. 616),
  Acts of the 86th Legislature, Regular Session, 2019, and is further
  amended to read as follows:
         Art. 56A.304.  PAYMENT OF FEES RELATED TO EXAMINATION. (a)  
  On application to the [The department shall pay the appropriate
  fees, as set by] attorney general [rule], a health care provider
  that provides [for the forensic portion of] a forensic medical
  examination to a sexual assault survivor in accordance with this
  subchapter, or the [conducted under Article 56A.303(a) and for the
  evidence collection kit if a physician,] sexual assault examiner
  [,] or sexual assault nurse examiner who conducts that [the
  forensic portion of the] examination, as applicable, within 120
  [96] hours after the [alleged] sexual assault occurred is entitled
  to be reimbursed in an amount set by attorney general rule for:
               (1)  the reasonable costs of the forensic portion of
  that examination; and
               (2)  the evidence collection kit.
         (b)  The application under Subsection (a) must be in the form
  and manner prescribed by the attorney general and must include:
               (1)  certification that the examination was conducted
  in accordance with the requirements of Article 56A.303(a); and
               (2)  a complete and itemized bill of the reasonable
  costs of the forensic portion of the examination [attorney general
  shall reimburse the department for fees paid under Subsection (a)].
         (c)  A health care provider or a sexual assault examiner or
  sexual assault nurse examiner, as applicable, who applies for
  reimbursement under Subsection (a) shall accept reimbursement from
  the attorney general as payment for the costs unless:
               (1)  the health care provider or sexual assault
  examiner or sexual assault nurse examiner, as applicable:
                     (A)  requests, in writing, additional
  reimbursement from the attorney general; and
                     (B)  provides documentation in support of the
  additional reimbursement, as reasonably requested by the attorney
  general; and
               (2)  the attorney general determines that there is a
  reasonable justification for additional reimbursement.
         (d)  A health care provider is not entitled to reimbursement
  under this article unless the forensic medical examination was
  conducted on the premises of the provider by a sexual assault
  examiner or sexual assault nurse examiner.
         (e)  On request, the attorney general may provide training to
  a health care provider regarding the process for applying for
  reimbursement under this article.
         (f)  A victim of a [an alleged] sexual assault may not be
  required to pay for:
               (1)  the forensic portion of the forensic medical
  examination; or
               (2)  the evidence collection kit.
         SECTION 7.  Article 56A.305, Code of Criminal Procedure, is
  amended to read as follows:
         Art. 56A.305.  PAYMENT OF COSTS FOR CERTAIN MEDICAL CARE.
  The attorney general may make a payment to or on behalf of an
  individual for the reasonable costs incurred for medical care
  provided in accordance with Sections [Section] 323.004, 323.053,
  and 323.054, Health and Safety Code.
         SECTION 8.  Section 420.003(1-a), Government Code, is
  amended to read as follows:
               (1-a)  "Active criminal case" means a case:
                     (A)  in which:
                           (i)  a sexual assault or other sex offense
  has been reported to a law enforcement agency; [and]
                           (ii)  physical evidence of the offense has
  been submitted to the agency or an accredited crime laboratory
  under this chapter for analysis; and
                           (iii)  the agency documents that an offense
  has been committed and reported; and
                     (B)  for which:
                           (i)  the statute of limitations has not run
  with respect to the prosecution of the offense; or
                           (ii)  a DNA profile was obtained that is
  eligible under Section 420.043 for comparison with DNA profiles in
  the state database or CODIS DNA database.
         SECTION 9.  The heading to Chapter 323, Health and Safety
  Code, is amended to read as follows:
  CHAPTER 323. EMERGENCY SERVICES AND FORENSIC EXAMINATION PROGRAMS
  FOR SURVIVORS OF SEXUAL ASSAULT
         SECTION 10.  Chapter 323, Health and Safety Code, is amended
  by designating Sections 323.001 through 323.008 as Subchapter A and
  adding a subchapter heading to read as follows:
 
  SUBCHAPTER A.  EMERGENCY SERVICES FOR SURVIVORS
  OF SEXUAL ASSAULT
         SECTION 11.  Section 323.001, Health and Safety Code, is
  amended to read as follows:
         Sec. 323.001.  DEFINITIONS. In this subchapter [chapter]:
               (1)  "Commission" means the Health and Human Services
  Commission.
               (2)  "Department" means the Department of State Health
  Services.
               (3)  "Health care facility" means a general or special
  hospital licensed under Chapter 241, a general or special hospital
  owned by this state, or a freestanding emergency medical care
  facility licensed under Chapter 254.
               (3-a)  "SAFE-ready facility" means a health care
  facility designated as a sexual assault forensic exam-ready
  facility under Section 323.0015.  The term includes a SAFE program
  designated as a SAFE-ready facility under Section 323.052.
               (3-b)  "SAFE program" has the meaning assigned by
  Section 323.051.
               (4)  "Sexual assault" means any act as described by
  Section 22.011 or 22.021, Penal Code.
               (4-a)  "Sexual assault forensic examiner" means a
  certified sexual assault nurse examiner or a physician with
  specialized training on conducting a forensic medical examination.
               (5)  "Sexual assault survivor" means an individual who
  is a victim of a sexual assault, regardless of whether a report is
  made or a conviction is obtained in the incident.
         SECTION 12.  Sections 323.004(a), (a-1), and (b), Health and
  Safety Code, are amended to read as follows:
         (a)  Except as otherwise provided by Subsection (a-2), after
  a sexual assault survivor arrives at a health care facility
  following a [an alleged] sexual assault, the facility shall
  provide care to the survivor in accordance with Subsection (b).
         (a-1)  A facility that is not a SAFE-ready facility shall
  inform the sexual assault survivor that:
               (1)  the facility is not a SAFE-ready facility and
  provide to the survivor the name and location of nearby [the
  closest] SAFE-ready facilities [facility] and the information form
  required by Section 323.0051; and
               (2)  the survivor is entitled, at the survivor's
  option:
                     (A)  to receive the care described by Subsection
  (b) at that facility, subject to Subsection (b-1); or
                     (B)  to be stabilized and to be referred or
  transferred to and receive the care described by Subsection (b) at a
  SAFE-ready facility.
         (b)  A health care facility providing care to a sexual
  assault survivor shall provide the survivor with:
               (1)  subject to Subsection (b-1), a forensic medical
  examination in accordance with Subchapter B, Chapter 420,
  Government Code, if the examination has been requested by a law
  enforcement agency under Subchapter F, Chapter 56A, Code of
  Criminal Procedure, or is conducted under Subchapter G, Chapter
  56A, Code of Criminal Procedure;
               (2)  a private area, if available, to wait or speak with
  the appropriate medical, legal, or sexual assault crisis center
  staff or volunteer until a physician, nurse, or physician assistant
  is able to treat the survivor;
               (3)  access to a sexual assault program advocate, if
  available, as provided by Subchapter H, Chapter 56A, Code of
  Criminal Procedure;
               (4)  the information form required by Section 323.005;
               (5)  a private treatment room, if available;
               (6)  if indicated by the history of contact, access to
  appropriate prophylaxis for exposure to sexually transmitted
  infections; [and]
               (7)  the name and telephone number of the nearest
  sexual assault crisis center; and
               (8)  if the health care facility has shower facilities,
  access to a shower at no cost to the survivor after the examination
  described by Subdivision (1).
         SECTION 13.  Section 323.005(a), Health and Safety Code, as
  amended by Chapters 408 (H.B. 8), 469 (H.B. 4173), and 1037 (H.B.
  616), Acts of the 86th Legislature, Regular Session, 2019, is
  reenacted and further amended to conform to Chapter 469 (H.B.
  4173), Acts of the 86th Legislature, Regular Session, 2019, to read
  as follows:
         (a)  The commission [department] shall develop a standard
  information form for sexual assault survivors that must include:
               (1)  a detailed explanation of the forensic medical
  examination required to be provided by law, including a statement
  that photographs may be taken of the genitalia;
               (2)  information regarding treatment of sexually
  transmitted infections and pregnancy, including:
                     (A)  generally accepted medical procedures;
                     (B)  appropriate medications; and
                     (C)  any contraindications of the medications
  prescribed for treating sexually transmitted infections and
  preventing pregnancy;
               (3)  information regarding drug-facilitated sexual
  assault, including the necessity for an immediate urine test for
  sexual assault survivors who may have been involuntarily drugged;
               (4)  information regarding crime victims compensation,
  including:
                     (A)  a statement that public agencies are
  responsible for paying for the forensic portion of an examination
  conducted under Subchapter F or G, Chapter 56A [Article 56.06 or
  56.065], Code of Criminal Procedure, and for the evidence
  collection kit used in connection with the examination and that the
  health care facility or provider, as applicable, is responsible for
  seeking reimbursement for those costs; and
                     (B)  information regarding the reimbursement of
  the survivor for the medical portion of the examination;
               (5)  an explanation that consent for the forensic
  medical examination may be withdrawn at any time during the
  examination;
               (6)  the name and telephone number of sexual assault
  crisis centers statewide; [and]
               (7)  information regarding postexposure prophylaxis
  for HIV infection;
               (8)  information regarding the period for which
  biological evidence collected from the forensic medical
  examination will be retained and preserved under Article 38.43,
  Code of Criminal Procedure; and
               (9)  a statement that the survivor has the right to
  access a shower for free after the forensic medical examination, if
  shower facilities are available at the health care facility.
         SECTION 14.  Section 323.0051(a), Health and Safety Code, is
  amended to read as follows:
         (a)  The commission [department] shall develop a standard
  information form for sexual assault survivors who arrive at a
  health care facility that is not a SAFE-ready facility.  The
  information form must include:
               (1)  information regarding the benefits of a forensic
  medical examination conducted by a sexual assault forensic
  examiner;
               (2)  the Internet website address to the commission's 
  [department's] list of SAFE-ready facilities that includes the
  facilities' physical addresses as required by Section 323.008;
               (3)  the following statements:
                     (A)  "As a survivor of sexual assault, you have
  the right to receive a forensic medical examination at this
  hospital emergency room if you are requesting the examination not
  later than 120 hours after the assault.";
                     (B)  "A report to law enforcement is not required,
  but if you make a report, law enforcement must first authorize the
  examination."; and
                     (C)  "Call 1-800-656-HOPE to be connected to a
  rape crisis center for free and confidential assistance."; and
               (4)  information on the procedure for submitting a
  complaint against the health care facility.
         SECTION 15.  Section 323.0052(a), Health and Safety Code, is
  amended to conform to Chapter 469 (H.B. 4173), Acts of the 86th
  Legislature, Regular Session, 2019, and further amended to read as
  follows:
         (a)  The commission [department] shall develop a standard
  information form that, as described by Subsection (b), is to be
  provided to sexual assault survivors who have not given signed,
  written consent to a health care facility to release the evidence as
  provided by Section 420.0735, Government Code. The form must
  include the following information:
               (1)  the Department of Public Safety's policy regarding
  storage of evidence of a sexual assault or other sex offense that is
  collected under Subchapter G, Chapter 56A [Article 56.065], Code of
  Criminal Procedure, including:
                     (A)  a statement that the evidence will be stored
  until the fifth anniversary of the date on which the evidence was
  collected before the evidence becomes eligible for destruction; and
                     (B)  the department's procedures regarding the
  notification of the survivor before a planned destruction of the
  evidence;
               (2)  a statement that the survivor may request the
  release of the evidence to a law enforcement agency and report a
  sexual assault or other sex offense to the agency at any time;
               (3)  the name, phone number, and e-mail address of the
  law enforcement agency with jurisdiction over the offense; and
               (4)  the name and phone number of a local rape crisis
  center.
         SECTION 16.  Section 323.008, Health and Safety Code, is
  amended to read as follows:
         Sec. 323.008.  DATA PUBLICATION. The commission
  [department] shall post on the commission's [department's] Internet
  website a list of all hospitals and other health facilities that are
  designated as SAFE-ready facilities under this chapter and the
  facilities' physical addresses.  The commission [department] shall
  update the list quarterly [annually]. To the extent possible, the
  commission [department] shall collect the data required by this
  section as part of a survey required by the commission [department]
  under other law.
         SECTION 17.  Chapter 323, Health and Safety Code, is amended
  by adding Subchapter B to read as follows:
  SUBCHAPTER B. SEXUAL ASSAULT FORENSIC EXAMINATION PROGRAMS
         Sec. 323.051.  DEFINITIONS. In this subchapter:
               (1)  "SAFE program" means a program that meets the
  requirements prescribed by Section 323.052.  The term does not
  include a program operated by a health care facility, as defined by
  Section 323.001.
               (2)  "Sexual assault examiner," "sexual assault nurse
  examiner," and "sexual assault program" have the meanings assigned
  by Section 420.003, Government Code.
               (3)  "Sexual assault forensic examiner" means a
  certified sexual assault nurse examiner or a physician licensed
  under Subtitle B, Title 3, Occupations Code, with specialized
  training on conducting a forensic medical examination.
         Sec. 323.052.  OPERATION OF SAFE PROGRAM; DESIGNATION OF
  SAFE PROGRAM AS SAFE-READY FACILITY.  (a)  A person may operate a
  SAFE program only if:
               (1)  the program meets the minimum standards
  established under Section 323.053; and
               (2)  the program provides forensic medical
  examinations to sexual assault survivors in accordance with Section
  323.054.
         (b)  The Health and Human Services Commission shall
  designate a SAFE program described by Subsection (a) as a
  SAFE-ready facility under Section 323.0015 if the program notifies
  the commission that the program employs or contracts with a sexual
  assault forensic examiner or uses a telemedicine system of sexual
  assault forensic examiners to provide consultation during a sexual
  assault forensic medical examination to a nurse or physician
  licensed to practice in this state.
         Sec. 323.053.  MINIMUM STANDARDS FOR SAFE PROGRAMS. A SAFE
  program must:
               (1)  operate under the active oversight of a medical
  director who is a physician licensed by and in good standing with
  the Texas Medical Board;
               (2)  provide medical treatment under a physician's
  order, standing medical order, standing delegation order, or other
  order or protocol as defined by Texas Medical Board rules;
               (3)  employ or contract with a sexual assault examiner
  or a sexual assault nurse examiner;
               (4)  provide access to a sexual assault program
  advocate, as required by Subchapter H, Chapter 56A, Code of
  Criminal Procedure;
               (5)  ensure a sexual assault survivor has access to a
  private treatment room;
               (6)  if indicated by a survivor's history or on a
  survivor's request, provide:
                     (A)  HIV testing and prophylactic medication to
  the survivor or a referral for the testing and medication; and
                     (B)  counseling and prophylactic medications for
  exposure to sexually transmitted infections and pregnancy;
               (7)  provide to survivors the name and telephone number
  of a nearby sexual assault program that provides to survivors the
  minimum services described by Subchapter A, Chapter 420, Government
  Code;
               (8)  provide to survivors the information form required
  by Section 323.005, 323.0051, or 323.0052, as applicable, and
  orally communicate the information regarding crime victims
  compensation under Section 323.005(a)(4);
               (9)  collaborate with any sexual assault program, as
  defined by Section 420.003, Government Code, that provides services
  to survivors in the county;
               (10)  engage in efforts to improve the quality of the
  program;
               (11)  maintain capacity for appropriate triage or have
  agreements with other health facilities to assure that a survivor
  receives the appropriate level of care indicated for the survivor's
  medical and mental health needs;
               (12)  prioritize the safety and well-being of
  survivors;
               (13)  provide a trauma-informed approach in the
  forensic medical care provided to survivors; and
               (14)  collaborate with:
                     (A)  law enforcement agencies and attorneys
  representing the state with jurisdiction in the county;
                     (B)  any available local sexual assault response
  team; and
                     (C)  other interested persons in the community.
         Sec. 323.054.  FORENSIC MEDICAL EXAMINATION BY SAFE PROGRAM;
  INFORMED CONSENT.  (a)  A SAFE program shall provide to a sexual
  assault survivor under the care of the program a forensic medical
  examination in accordance with Subchapter B, Chapter 420,
  Government Code, if the examination has been requested by a law
  enforcement agency under Subchapter F, Chapter 56A, Code of
  Criminal Procedure, or if the examination is performed in
  accordance with Subchapter G, Chapter 56A, Code of Criminal
  Procedure.
         (b)  Only a sexual assault examiner or a sexual assault nurse
  examiner may perform a forensic medical examination under a SAFE
  program.
         (c)  A sexual assault examiner or sexual assault nurse
  examiner employed by or under contract with a SAFE program must
  obtain a sexual assault survivor's informed, written consent before
  performing a forensic medical examination or providing medical
  treatment to the survivor.
         (d)  A sexual assault survivor who receives a forensic
  medical examination from a sexual assault examiner or sexual
  assault nurse examiner employed by or under contract with a SAFE
  program may not be required to:
               (1)  participate in the investigation or prosecution of
  an offense as a prerequisite to receiving the forensic medical
  examination or medical treatment; or
               (2)  pay for the costs of the forensic portion of the
  forensic medical examination or for the evidence collection kit.
         SECTION 18.  Article 38.435, Code of Criminal Procedure, and
  Section 323.004(b)(8), Health and Safety Code, as added by this
  Act, apply to a forensic medical examination that occurs on or after
  the effective date of this Act. A forensic medical examination that
  occurs before that date is governed by the law in effect on the date
  the examination occurred, and the former law is continued in effect
  for that purpose.
         SECTION 19.  To the extent of any conflict, this Act prevails
  over another Act of the 87th Legislature, Regular Session, 2021,
  relating to nonsubstantive additions to and corrections in enacted
  codes.
         SECTION 20.  This Act takes effect September 1, 2021.
 
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