By Wohlgemuth, Park, Denny, Mowery, Delisi H.B. No. 1334
74R3357 DLF-D
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to the protection of the rights and health of women using
1-3 or considering the use of abortion services; providing penalties.
1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-5 ARTICLE 1. REGULATION OF PROVIDERS
1-6 SECTION 1.01. Chapter 243, Health and Safety Code, is
1-7 amended to read as follows:
1-8 CHAPTER 243. AMBULATORY SURGICAL CENTERS
1-9 SUBCHAPTER A. GENERAL PROVISIONS
1-10 Sec. 243.001. SHORT TITLE. This chapter may be cited as the
1-11 Texas Ambulatory Surgical Center Licensing Act.
1-12 Sec. 243.002. DEFINITIONS. In this chapter:
1-13 (1) "Abortion" has the meaning assigned by Section
1-14 4.011(a), Medical Practice Act (Article 4495b, Vernon's Texas Civil
1-15 Statutes).
1-16 (2) "Ambulatory surgical center" means a facility that
1-17 operates primarily to provide surgical services, including abortion
1-18 services, to patients who do not require overnight hospital care.
1-19 (3) <(2)> "Board" means the Texas Board of Health.
1-20 (4) <(3)> "Department" means the Texas Department of
1-21 Health.
1-22 (5) <(4)> "Person" means an individual, firm,
1-23 partnership, corporation, or association.
1-24 (Sections 243.003-243.010 reserved for expansion
2-1 SUBCHAPTER B. LICENSING, FEES, AND INSPECTIONS
2-2 Sec. 243.011 <243.003>. LICENSE REQUIRED. (a) Except as
2-3 provided by Section 243.012 <243.004>, a person may not establish
2-4 or operate an ambulatory surgical center in this state without a
2-5 license issued under this chapter.
2-6 (b) Each ambulatory surgical center must have a separate
2-7 license.
2-8 (c) A license is not transferable or assignable.
2-9 Sec. 243.012 <243.004>. EXEMPTIONS FROM LICENSING
2-10 REQUIREMENT. The following facilities need not be licensed under
2-11 this chapter:
2-12 (1) an office or clinic of a licensed physician,
2-13 dentist, or podiatrist;
2-14 (2) a licensed nursing home; or
2-15 (3) a licensed hospital.
2-16 Sec. 243.013 <243.005>. LICENSE APPLICATION AND ISSUANCE.
2-17 (a) An applicant for an ambulatory surgical center license must
2-18 submit an application to the department on a form prescribed by the
2-19 department.
2-20 (b) Each application must be accompanied by a nonrefundable
2-21 license fee in an amount set by the board.
2-22 (c) The application must contain evidence that there is at
2-23 least one physician, dentist, or podiatrist on the staff of the
2-24 center who is licensed by the appropriate state licensing board.
2-25 (d) The department shall issue a license if, after
2-26 inspection and investigation, it finds that the applicant and the
2-27 center meet the requirements of this chapter and the standards
3-1 adopted under this chapter.
3-2 (e) The license fee must be paid annually on renewal of the
3-3 license.
3-4 (f) The department shall issue a renewal license to a center
3-5 certified under Title XVIII of the Social Security Act (42 U.S.C.
3-6 Section 1395 et seq.) when the center:
3-7 (1) remits any annual license fee; and
3-8 (2) submits the inspection results or the inspection
3-9 results report from the certification body.
3-10 Sec. 243.014 <243.006>. INSPECTIONS. (a) The department
3-11 may inspect an ambulatory surgical center at reasonable times as
3-12 necessary to assure compliance with this chapter.
3-13 (b) An ambulatory surgical center licensed by the department
3-14 and certified under Title XVIII of the Social Security Act (42
3-15 U.S.C. Section 1395 et seq.) is not subject to additional licensing
3-16 inspections under this chapter while the center maintains the
3-17 certification.
3-18 Sec. 243.015 <243.007>. FEES. The board shall set fees
3-19 imposed by this chapter in amounts reasonable and necessary to
3-20 defray the cost of administering this chapter.
3-21 Sec. 243.016 <243.008>. AMBULATORY SURGICAL CENTER LICENSING
3-22 FUND. All fees collected under this chapter shall be deposited in
3-23 the state treasury to the credit of the ambulatory surgical center
3-24 licensing fund and may be appropriated to the department only to
3-25 administer and enforce this chapter.
3-26 Sec. 243.017 <243.009>. ADOPTION OF RULES. The board shall
3-27 adopt rules necessary to implement this chapter, including
4-1 requirements for the issuance, renewal, denial, suspension, and
4-2 revocation of a license to operate an ambulatory surgical center.
4-3 Sec. 243.018 <243.010>. MINIMUM STANDARDS. (a) The rules
4-4 must contain minimum standards applicable to an ambulatory surgical
4-5 center and for:
4-6 (1) the construction and design, including plumbing,
4-7 heating, lighting, ventilation, and other design standards
4-8 necessary to ensure the health and safety of patients;
4-9 (2) the qualifications of the professional staff and
4-10 other personnel;
4-11 (3) the equipment essential to the health and welfare
4-12 of the patients;
4-13 (4) the sanitary and hygienic conditions within the
4-14 center and its surroundings; and
4-15 (5) a quality assurance program for patient care.
4-16 (b) The rules may contain minimum standards applicable to an
4-17 ambulatory surgical center that provides abortion services and for
4-18 regulation of the manner in which abortions are performed,
4-19 including:
4-20 (1) blood typing of patients before an abortion is
4-21 performed; and
4-22 (2) provision of anesthesia in connection with an
4-23 abortion.
4-24 (c) Standards set under this section may not exceed the
4-25 minimum standards for certification of ambulatory surgical centers
4-26 under Title XVIII of the Social Security Act (42 U.S.C. Section
4-27 1395 et seq.).
5-1 (d) <(c)> This section does not authorize the board to:
5-2 (1) establish the qualifications of a licensed
5-3 practitioner, except as provided by Section 243.042 or 243.043; or
5-4 (2) permit a person to provide health care services
5-5 who is not authorized to provide those services under another state
5-6 law.
5-7 Sec. 243.019. SALE OF FETAL TISSUE. An ambulatory surgical
5-8 center may not accept compensation in exchange for fetal tissue.
5-9 Sec. 243.020. INSURANCE COVERAGE FOR ABORTION PATIENTS. (a)
5-10 An ambulatory surgical center shall make available, to each patient
5-11 receiving abortion services, abortion complications insurance
5-12 issued under Article 3.80, Insurance Code.
5-13 (b) The minimum standards adopted under Section 243.018 may
5-14 specify the manner in which abortion complications insurance must
5-15 be made available.
5-16 (c) This section does not apply if the board, after a
5-17 hearing, determines that abortion complications insurance is not
5-18 available from insurance companies authorized to provide that
5-19 coverage in this state. If the board determines that abortion
5-20 complications insurance is not available, the board shall, at least
5-21 once in each two-year period, hold a hearing to reconsider that
5-22 determination.
5-23 Sec. 243.021. REPORTING REQUIREMENTS; CRIMINAL PENALTY.
5-24 (a) Each ambulatory surgical center that performs an abortion must
5-25 submit an annual report to the department on each abortion that is
5-26 performed at the ambulatory surgical center. The report must be
5-27 submitted on a form provided by the department.
6-1 (b) The report may not identify by any means the physician
6-2 performing the abortion or the patient.
6-3 (c) The report must include:
6-4 (1) the patient's year of birth, race, marital status,
6-5 and state and county of residence;
6-6 (2) the type of abortion procedure;
6-7 (3) the date the abortion was performed;
6-8 (4) whether the patient survived the abortion, and if
6-9 the patient did not survive, the cause of death;
6-10 (5) the period of gestation based on the best medical
6-11 judgment of the attending physician at the time of the procedure;
6-12 (6) the date, if known, of the patient's last
6-13 menstrual cycle;
6-14 (7) the number of previous live births of the patient;
6-15 and
6-16 (8) the number of previous induced abortions of the
6-17 patient.
6-18 (d) All information and records held by the department under
6-19 this chapter are confidential and are not open records for the
6-20 purposes of Chapter 552, Government Code. That information may not
6-21 be released or made public on subpoena or otherwise, except that
6-22 release may be made:
6-23 (1) for statistical purposes, but only if a person,
6-24 patient, or ambulatory surgical center is not identified;
6-25 (2) with the consent of each person, patient, and
6-26 ambulatory surgical center identified in the information released;
6-27 or
7-1 (3) to medical personnel, appropriate state agencies,
7-2 or county and district courts to enforce this chapter.
7-3 (e) A person commits an offense if the person violates this
7-4 section. An offense under this subsection is a Class A
7-5 misdemeanor.
7-6 Sec. 243.022. ABORTION IN UNLICENSED FACILITY TO PREVENT
7-7 DEATH OR SERIOUS IMPAIRMENT. This chapter does not remove the
7-8 responsibility or limit the ability of a physician to perform an
7-9 abortion in an unlicensed ambulatory surgical center because of the
7-10 existence of a medical emergency as described by Section 165.012.
7-11 (Sections 243.023-243.040 reserved for expansion
7-12 SUBCHAPTER C. CERTAIN FACILITIES THAT PROVIDE ABORTION SERVICES
7-13 Sec. 243.041. SCOPE OF SUBCHAPTER. This subchapter applies
7-14 only to an ambulatory surgical center that provides abortion
7-15 services for compensation.
7-16 Sec. 243.042. LICENSED PROFESSIONAL COUNSELORS. A person,
7-17 other than a physician, who is employed by or otherwise under the
7-18 supervision of an ambulatory surgical center may not provide
7-19 counseling relating to an abortion, a pregnancy, or the decision
7-20 whether to have an abortion or continue a pregnancy, unless the
7-21 person is a licensed professional counselor under the Licensed
7-22 Professional Counselor Act (Article 4512g, Vernon's Texas Civil
7-23 Statutes).
7-24 Sec. 243.043. LABORATORY SERVICES. Laboratory services,
7-25 including analysis of blood, must be performed in accordance with
7-26 the Clinical Laboratory Improvement Act of 1988 (42 U.S.C. Section
7-27 263a).
8-1 Sec. 243.044. COMPENSATION OF EMPLOYEES. (a) An ambulatory
8-2 surgical center may not compensate a person employed by the center
8-3 on the basis of:
8-4 (1) the number of abortions performed by the center;
8-5 or
8-6 (2) the number of patients whom the person served and
8-7 who underwent abortion procedures.
8-8 (b) This section does not apply to the compensation of a
8-9 physician providing abortion services at an ambulatory surgical
8-10 center.
8-11 (Sections 243.045-243.060 reserved for expansion
8-12 SUBCHAPTER D. ENFORCEMENT
8-13 Sec. 243.061 <243.011>. DENIAL, SUSPENSION, OR REVOCATION OF
8-14 LICENSE. (a) The department may deny, suspend, or revoke a
8-15 license for a violation of this chapter or a rule adopted under
8-16 this chapter.
8-17 (b) The denial, suspension, or revocation of a license by
8-18 the department and the appeal from that action are governed by the
8-19 procedures for a contested case hearing under Chapter 2001,
8-20 Government Code <the Administrative Procedure and Texas Register
8-21 Act (Article 6252-13a, Vernon's Texas Civil Statutes)>.
8-22 Sec. 243.062 <243.012>. INJUNCTION. (a) The department may
8-23 petition a district court for a temporary restraining order to
8-24 restrain a continuing violation of this chapter or the standards or
8-25 licensing requirements provided under this chapter if the
8-26 department finds that the violation creates an immediate threat to
8-27 the health and safety of the patients of an ambulatory surgical
9-1 center.
9-2 (b) A district court, on petition of the department and on a
9-3 finding by the court that a person is violating the standards or
9-4 licensing requirements provided under this chapter, may by
9-5 injunction:
9-6 (1) prohibit a person from continuing a violation of
9-7 this chapter or the standards or licensing requirements provided
9-8 under this chapter;
9-9 (2) restrain or prevent the establishment or operation
9-10 of an ambulatory surgical center without a license issued under
9-11 this chapter; or
9-12 (3) grant any other injunctive relief warranted by the
9-13 facts.
9-14 (c) The attorney general shall institute and conduct a suit
9-15 authorized by this section at the request of the department.
9-16 (d) Venue for a suit brought under this section is in the
9-17 county in which the ambulatory surgical center is located or in
9-18 Travis County.
9-19 Sec. 243.063 <243.013>. CRIMINAL PENALTY. (a) A person
9-20 commits an offense if the person violates Section 243.011(a)
9-21 <243.003(a)>.
9-22 (b) An offense under this section is a Class C misdemeanor.
9-23 (c) Each day of a continuing violation constitutes a
9-24 separate offense.
9-25 (d) It is a defense to prosecution for an offense under this
9-26 section that the violation of Section 243.011(a) was the result of
9-27 an abortion performed under Section 243.022.
10-1 Sec. 243.064 <243.014>. CIVIL PENALTY. (a) A person who
10-2 violates this chapter or who fails to comply with a rule adopted
10-3 under this chapter is liable for a civil penalty of not less than
10-4 $100 or more than $500 for each violation if the department
10-5 determines the violation threatens the health and safety of a
10-6 patient.
10-7 (b) Each day of a continuing violation constitutes a
10-8 separate ground for recovery.
10-9 SECTION 1.02. Subchapter G, Chapter 3, Insurance Code, is
10-10 amended by adding Article 3.80 to read as follows:
10-11 Art. 3.80. ABORTION COMPLICATIONS COVERAGE. (a) An insurer
10-12 authorized to issue accident and sickness insurance under this
10-13 subchapter may issue an individual policy of abortion complications
10-14 insurance under this article. The policy must provide benefits for
10-15 medical expenses arising in connection with medical complications
10-16 resulting from or in connection with the performance of an abortion
10-17 on the insured.
10-18 (b) The commissioner, by rule, may specify provisions that
10-19 must or may not be included in an abortion complications insurance
10-20 policy and may adopt rules governing rates and forms, including
10-21 rules that:
10-22 (1) establish maximum or minimum rates or require
10-23 approval of rates;
10-24 (2) require approval of forms or use of standardized
10-25 forms; or
10-26 (3) require filing of rates or forms with the
10-27 department.
11-1 (c) In this article, "abortion" has the meaning assigned by
11-2 Section 4.011(a), Medical Practice Act (Article 4495b, Vernon's
11-3 Texas Civil Statutes).
11-4 SECTION 1.03. Chapter 245, Health and Safety Code, is
11-5 repealed effective January 1, 1996.
11-6 SECTION 1.04. (a) The change in law made by this Act to
11-7 Chapter 243, Health and Safety Code, applies only to the operation
11-8 of an ambulatory surgical center that provides abortion services on
11-9 or after January 1, 1996.
11-10 (b) Notwithstanding the change in law made by this Act to
11-11 Chapter 243, Health and Safety Code, a facility licensed as an
11-12 abortion facility under Chapter 245, Health and Safety Code, before
11-13 the effective date of this Act may continue to operate as an
11-14 abortion facility until January 1, 1996. The operation of an
11-15 abortion facility before January 1, 1996, is governed by Chapter
11-16 245, Health and Safety Code.
11-17 SECTION 1.05. (a) The change in law made by the repeal of
11-18 Sections 245.011 and 245.014, Health and Safety Code, by this Act
11-19 applies only to the punishment for an offense committed on or after
11-20 January 1, 1996. For purposes of this section, an offense is
11-21 committed before January 1, 1996, if any element of the offense
11-22 occurs before that date.
11-23 (b) An offense committed before January 1, 1996, is covered
11-24 by the law in effect when the offense was committed, and the former
11-25 law is continued in effect for that purpose.
11-26 ARTICLE 2. INFORMED CONSENT
11-27 SECTION 2.01. Subtitle H, Title 2, Health and Safety Code,
12-1 is amended by adding Chapter 165 to read as follows:
12-2 CHAPTER 165. INFORMATION TO BE PROVIDED TO WOMEN CONSIDERING
12-3 ABORTION
12-4 SUBCHAPTER A. GENERAL PROVISIONS
12-5 Sec. 165.001. DEFINITIONS. In this chapter:
12-6 (1) "Abortion" has the meaning assigned by Section
12-7 4.011(a), Medical Practice Act (Article 4495b, Vernon's Texas Civil
12-8 Statutes).
12-9 (2) "Fetus" means an individual human organism in
12-10 utero.
12-11 Sec. 165.002. CONFIDENTIALITY. The name and address of an
12-12 individual who obtains information under this chapter or who
12-13 consents to an abortion under this chapter is confidential and may
12-14 be released only with the consent of the patient or as required by
12-15 court order.
12-16 (Sections 165.003-165.010 reserved for expansion
12-17 SUBCHAPTER B. DUTIES OF PHYSICIAN
12-18 Sec. 165.011. INFORMED CONSENT REQUIRED. A physician may
12-19 not perform an abortion unless:
12-20 (1) at least 24 hours before the time the abortion is
12-21 to be performed:
12-22 (A) the physician has confirmed, according to
12-23 the physician's best medical judgment, that the woman is pregnant
12-24 and has determined the probable gestational age of the fetus; and
12-25 (B) the physician has personally provided to the
12-26 woman the information required by Section 165.013; and
12-27 (2) the woman has freely executed a consent form.
13-1 Sec. 165.012. MEDICAL EMERGENCY. (a) A physician may
13-2 perform an abortion without complying with Section 165.011 if at
13-3 the time of the abortion the physician concludes in good faith
13-4 according to the physician's best medical judgment that:
13-5 (1) there is a condition that complicates the medical
13-6 status of the pregnant woman; and
13-7 (2) because of a condition described by Subdivision
13-8 (1), delay of the abortion creates a serious risk of death or of
13-9 substantial and irreversible impairment of a major bodily function.
13-10 (b) A physician shall identify in the woman's medical record
13-11 the specific medical factors on which the determination to proceed
13-12 with an abortion under this section was based.
13-13 Sec. 165.013. INFORMATION PROVIDED BY PHYSICIAN. (a) A
13-14 physician who is to perform an abortion on a pregnant woman shall
13-15 provide, orally and in person, the following information to the
13-16 woman:
13-17 (1) the name of the physician who will perform the
13-18 abortion and the fact that the physician and the facility at which
13-19 the abortion is to be performed are licensed as required by state
13-20 law;
13-21 (2) the fact that the woman may withdraw her consent
13-22 to the abortion at any time before the abortion is performed;
13-23 (3) a description of the potential medical
13-24 complications that may result from an abortion and other risks of
13-25 the procedure, after considering the woman's medical condition and
13-26 history as determined by the physician, including:
13-27 (A) the risk and consequences of perforation of
14-1 the uterus;
14-2 (B) the risk of breast cancer;
14-3 (C) the potential effect on a future pregnancy;
14-4 and
14-5 (D) potential emotional harm to the woman;
14-6 (4) information relating to what the woman should do
14-7 and whom she should contact if medical complications result from
14-8 the abortion;
14-9 (5) a description of the potential medical
14-10 complications that may result from continuing the pregnancy to
14-11 term, after considering the woman's medical condition and history
14-12 as determined by the physician;
14-13 (6) a description of the procedures the woman will
14-14 need to follow after the abortion, absent complications;
14-15 (7) a description of the drugs that the doctor
14-16 anticipates will be prescribed in connection with the abortion and
14-17 the appropriate use of the drugs;
14-18 (8) the probable gestational age of the fetus at the
14-19 time the abortion is to be performed;
14-20 (9) information relating to the availability of
14-21 pregnancy prevention information;
14-22 (10) a description of written materials relating to
14-23 abortion published by the department under this chapter, indicating
14-24 that the materials are published by the department, a statement
14-25 that the woman may choose whether to review those materials, and a
14-26 copy of those materials, including a summary of the appropriate
14-27 abortion procedure, if the woman requests it; and
15-1 (11) the fact that if injured as a result of the
15-2 abortion, the woman may have a right to bring a legal action and
15-3 that if the woman, at any time, believes that she was injured she
15-4 should consider consulting an attorney to protect her rights.
15-5 (b) The information required by this section must be
15-6 provided in language designed to be understood by the pregnant
15-7 woman, taking into account her age, level of maturity, and
15-8 intellectual capability.
15-9 (c) A physician may not provide the information required to
15-10 be provided under this section in the presence of another patient.
15-11 Sec. 165.014. KNOWLEDGE OF WELL-QUALIFIED PHYSICIAN. This
15-12 subchapter does not require a physician to disclose information
15-13 beyond the information that a well-qualified physician licensed
15-14 under the Medical Practice Act (Article 4495b, Vernon's Texas Civil
15-15 Statutes) would possess.
15-16 Sec. 165.015. MEDICAL RECORD. The physician shall retain a
15-17 copy of the consent form in the woman's medical record.
15-18 Sec. 165.016. CONSENT; PROHIBITED PROVISIONS. (a) A
15-19 consent form or other document executed by a patient in connection
15-20 with an abortion may not contain a provision limiting the liability
15-21 of the physician who performs the abortion or the facility at which
15-22 the abortion is to be performed.
15-23 (b) A provision that violates Subsection (a) is void.
15-24 Sec. 165.017. CONSENT FORM PRESUMED VALID. A written
15-25 consent form that meets the requirements of this chapter is
15-26 presumed valid. The presumption established by this subsection may
15-27 be rebutted by evidence that establishes, by a preponderance of the
16-1 evidence, that the consent was obtained through fraud, negligence,
16-2 deception, misrepresentation, coercion, or duress.
16-3 (Sections 165.018-165.030 reserved for expansion
16-4 SUBCHAPTER C. DUTIES OF DEPARTMENT
16-5 Sec. 165.031. GUIDELINES FOR PHYSICIANS. The department
16-6 shall publish guidelines to be used by physicians in providing the
16-7 information required by Section 165.013.
16-8 Sec. 165.032. WRITTEN MATERIALS RELATING TO ABORTION. The
16-9 department shall publish a package of written materials to be
16-10 provided without charge to women considering abortion. The
16-11 materials must include:
16-12 (1) a listing of services available through public
16-13 agencies:
16-14 (A) to assist the woman during pregnancy and
16-15 after the birth of a child;
16-16 (B) to assist the woman in placing the child in
16-17 an adoptive or foster home; and
16-18 (C) to assist the woman and provide counseling
16-19 if the woman experiences adverse psychological effects resulting
16-20 from the abortion;
16-21 (2) information relating to the fetus;
16-22 (3) information relating to abortion procedures
16-23 commonly used; and
16-24 (4) a pamphlet relating to prenatal care and
16-25 parenting.
16-26 Sec. 165.033. INFORMATION RELATING TO THE FETUS. (a) The
16-27 information required by Section 165.032(2) must include, for each
17-1 four-week interval from the fourth week through the 28th week of
17-2 gestation:
17-3 (1) a medically accurate depiction of the development
17-4 of a fetus that reflects the actual size of the fetus; and
17-5 (2) a nontechnical description of the probable
17-6 anatomical and physiological characteristics of the fetus at the
17-7 stage of development depicted.
17-8 (b) Each gestational stage must be summarized in a separate
17-9 document.
17-10 Sec. 165.034. INFORMATION RELATING TO ABORTION METHODS. (a)
17-11 The information required by Section 165.032(3) must include a
17-12 nontechnical summary of each abortion procedure commonly used. Each
17-13 abortion procedure must be summarized in a separate document.
17-14 (b) The summary of an abortion procedure under this section
17-15 must:
17-16 (1) describe the potential medical complications that
17-17 may result from the procedure and other risks of the procedure;
17-18 (2) state that all the risks described by Subsection
17-19 (b)(1) may not be applicable to a particular woman and that the
17-20 woman may consult with her physician for additional information;
17-21 and
17-22 (3) state that as a result of an abortion a woman may
17-23 experience depression, feelings of guilt, disturbed sleep, loss of
17-24 interest in work or sex, or anger, and that if these symptoms occur
17-25 and are intense or persistent, the woman should seek professional
17-26 assistance.
17-27 (c) In preparing or updating the information required by
18-1 Subsection (b)(1), the department shall consult with the United
18-2 States Centers for Disease Control, the American College of
18-3 Obstetricians and Gynecologists, the Texas Medical Association, and
18-4 any other source the department considers appropriate.
18-5 (d) A physician may use an alternate written summary if the
18-6 written summary:
18-7 (1) contains the information required by this section;
18-8 and
18-9 (2) is approved by the department.
18-10 Sec. 165.035. CONSENT FORM. (a) The department shall
18-11 develop a standard consent form for use in accordance with Section
18-12 165.011. The consent form must be in substantially the following
18-13 form:
18-14 "I, _____________________________________, hereby
18-15 authorize Dr.______________________ and any assistant
18-16 designated by that physician to perform upon me the
18-17 following procedure ___________________________ (insert
18-18 name of procedure).
18-19 "I understand that I am approximately ____ weeks
18-20 pregnant. I consent to the above described abortion
18-21 procedure to terminate my pregnancy. I understand that
18-22 I have the right to withdraw my consent to the abortion
18-23 procedure at any time before the procedure is
18-24 performed.
18-25 "I have received the following:
18-26 (1) a copy of a medically accurate
18-27 depiction of a fetus at the probable gestational age of
19-1 the fetus I am carrying, preceded by the explanation
19-2 that I may choose whether to review the depiction;
19-3 (2) a description of the medical procedure
19-4 that will be used to perform the abortion, preceded by
19-5 an explanation that I may choose whether to review the
19-6 description;
19-7 (3) information pertaining to the
19-8 potential medical complications and other risks
19-9 associated with abortion and with carrying a child to
19-10 term;
19-11 (4) information about what to do and whom
19-12 to contact if medical complications result from the
19-13 abortion;
19-14 (5) information pertaining to available
19-15 pregnancy-related services; and
19-16 (6) a prenatal care and parenting
19-17 information pamphlet.
19-18 "I have been given an opportunity to ask
19-19 questions about the procedure and freely and
19-20 voluntarily sign this form."
19-21 ________________________(Signature of woman)
19-22 (b) A physician may use an alternate consent form if the
19-23 consent form is:
19-24 (1) in substantially the form prescribed by Subsection
19-25 (a); and
19-26 (2) approved by the department.
19-27 Sec. 165.036. PRENATAL CARE AND PARENTING PAMPHLET. (a)
20-1 The department shall develop a prenatal care and parenting pamphlet
20-2 for distribution under this chapter.
20-3 (b) The pamphlet must be written in easily understood,
20-4 nontechnical terms.
20-5 (c) In developing the pamphlet, the department shall consult
20-6 with appropriate organizations and authorities.
20-7 (d) The department may use a prenatal care and parenting
20-8 pamphlet developed by another entity with the consent of that
20-9 entity.
20-10 Sec. 165.037. PUBLICATION OF GUIDELINES, WRITTEN MATERIALS,
20-11 CONSENT FORM, AND PAMPHLET. (a) The department shall publish the
20-12 guidelines, written materials relating to abortion, consent form,
20-13 and prenatal care and parenting pamphlet required by this chapter
20-14 in English and in Spanish. The department may publish the
20-15 guidelines, written materials, consent form, and pamphlet in
20-16 another language.
20-17 (b) The department shall make the guidelines, written
20-18 materials, consent form, and pamphlet available to:
20-19 (1) any person, on request; and
20-20 (2) physicians through the Texas State Board of
20-21 Medical Examiners and appropriate organizations of physicians.
20-22 (c) The department shall update the guidelines, written
20-23 materials, consent form, and pamphlet required by this chapter at
20-24 least once in each two-year period.
20-25 (d) The department may charge a person requesting the
20-26 guidelines, written materials, consent form, and pamphlet a
20-27 reasonable fee to defray the cost of producing the documents,
21-1 except that the department shall provide the documents to a
21-2 physician free of charge.
21-3 SECTION 2.02. Section 4.011, Medical Practice Act (Article
21-4 4495b, Vernon's Texas Civil Statutes), is amended by adding
21-5 Subsection (b-1) and amending Subsections (c) and (e) to read as
21-6 follows:
21-7 (b-1) A physician may not intentionally or knowingly perform
21-8 an abortion unless the physician has complied with the requirements
21-9 of Chapter 165, Health and Safety Code.
21-10 (c) The board may take any appropriate disciplinary action
21-11 against a practitioner of medicine who violates Subsection (b) or
21-12 (b-1) of this section. The board may refuse to admit to
21-13 examination or refuse to issue a license or renewal license to a
21-14 person who violates Subsection (b) or (b-1) of this section.
21-15 (e) The sanctions provided by Subsection (c) of this section
21-16 are in addition to any other grounds for refusal to admit persons
21-17 to examination under this Act or to issue a license or renew a
21-18 license to practice medicine under this Act. The criminal
21-19 penalties provided by Section 3.07(a) of this Act do not apply to
21-20 Subsection (b) or (b-1) of this section.
21-21 SECTION 2.03. Not later than January 1, 1996, the Texas
21-22 Department of Health shall publish the written materials,
21-23 guidelines, consent form, and pamphlet required by Chapter 165,
21-24 Health and Safety Code, as added by this Act.
21-25 ARTICLE 3. PARENTAL CONSENT
21-26 SECTION 3.01. Subtitle C, Title 2, Family Code, is amended
21-27 by adding Chapter 37 to read as follows:
22-1 CHAPTER 37. PARENTAL CONSENT TO ABORTION
22-2 SUBCHAPTER A. GENERAL PROVISIONS
22-3 Sec. 37.01. DEFINITIONS. In this chapter:
22-4 (1) "Abortion" has the meaning assigned by Section
22-5 4.011(a), Medical Practice Act (Article 4495b, Vernon's Texas Civil
22-6 Statutes).
22-7 (2) "Abuse" has the meaning assigned by Section
22-8 34.012.
22-9 (3) "Minor" has the meaning assigned by Section 11.01.
22-10 Sec. 37.02. PARENTAL CONSENT TO ABORTION. A physician may
22-11 not perform an abortion on a minor unless the minor and a parent,
22-12 managing conservator, or guardian of the minor have consented to
22-13 the abortion in accordance with Chapter 165, Health and Safety
22-14 Code.
22-15 Sec. 37.03. EXCEPTIONS. Consent of a parent, managing
22-16 conservator, or guardian under Section 37.02 is not required if:
22-17 (1) consent to the abortion is not required under
22-18 Section 165.011, Health and Safety Code, because of the existence
22-19 of a medical emergency as described by Section 165.012, Health and
22-20 Safety Code; or
22-21 (2) a parent, managing conservator, or guardian is not
22-22 available or refuses to give consent or the minor elects not to
22-23 seek the consent and a judge authorizes the abortion under
22-24 Subchapter B.
22-25 Sec. 37.04. APPLICATION TO NONRESIDENT MINOR. This chapter
22-26 applies to a minor who is located in this state, without regard to
22-27 whether the minor is a resident of this state.
23-1 (Sections 37.05-37.10 reserved for expansion
23-2 SUBCHAPTER B. JUDICIAL BYPASS PROCEDURE
23-3 Sec. 37.11. JUDICIAL APPROVAL. A pregnant minor who wishes
23-4 to have an abortion without the consent of a parent, managing
23-5 conservator, or guardian may file in a district court an
23-6 application for a court order authorizing the physician to perform
23-7 the abortion without notice to the parent, managing conservator, or
23-8 guardian.
23-9 Sec. 37.12. STANDARD FOR APPROVAL OF APPLICATION. The court
23-10 shall authorize a physician to perform the abortion without the
23-11 consent of a parent, managing conservator, or guardian if the judge
23-12 determines that:
23-13 (1) the pregnant minor is sufficiently mature and
23-14 well-informed to give informed consent under Chapter 165, Health
23-15 and Safety Code, independently of her parent, managing conservator,
23-16 or guardian; or
23-17 (2) performance of an abortion on the pregnant minor
23-18 without notice to or the consent of the parent, managing
23-19 conservator, or guardian would be in the minor's best interest.
23-20 Sec. 37.13. APPLICATION BY MINOR OR NEXT FRIEND. An
23-21 application under this subchapter may be filed by the minor or may
23-22 be filed on behalf of the minor by a next friend, except that the
23-23 application may not be filed by:
23-24 (1) a physician who performs abortions;
23-25 (2) a person who is employed by or receives financial
23-26 consideration from:
23-27 (A) a physician or ambulatory surgical center
24-1 that performs abortions; or
24-2 (B) an organization that provides abortion
24-3 services, abortion counseling, or referrals to entities that
24-4 provide abortion services; or
24-5 (3) a person who serves as a board member or volunteer
24-6 of an organization that provides abortion services, abortion
24-7 counseling, or referrals to entities that provide abortion
24-8 services.
24-9 Sec. 37.14. ATTORNEY OR GUARDIAN AD LITEM. Not later than
24-10 the 24th hour after receiving a request for an attorney or guardian
24-11 ad litem from a minor in connection with an application under this
24-12 subchapter, the court shall appoint an attorney or guardian ad
24-13 litem for the minor.
24-14 Sec. 37.15. ASSISTANCE OF COURT. (a) The clerk of the
24-15 court, or other court personnel contacted by a minor with respect
24-16 to a potential application under this subchapter, shall advise the
24-17 minor:
24-18 (1) that a proceeding on the application is
24-19 confidential and the minor may use her initials instead of her name
24-20 on the application;
24-21 (2) that the minor has the right to an appointed
24-22 attorney or guardian ad litem, as provided by this chapter; and
24-23 (3) that the minor has a right to assistance in
24-24 preparing and filing the application.
24-25 (b) On the request of the minor, the court shall provide the
24-26 minor assistance in preparing and filing the application.
24-27 Sec. 37.16. HEARING. Subject to Section 37.19, the court
25-1 shall hold a hearing on an application under this subchapter not
25-2 later than the 72nd hour after the application is filed, excluding
25-3 any Sunday or holiday that falls in that period.
25-4 Sec. 37.17. ORDER OF COURT. (a) The court shall issue a
25-5 written order granting or denying an application under this chapter
25-6 and containing specific findings of fact and conclusions of law in
25-7 support of the order. The order may confirm a ruling made on the
25-8 record during a hearing.
25-9 (b) An order issued under this section is a confidential
25-10 record under Section 37.020.
25-11 (c) Subject to Section 37.019, the court shall issue the
25-12 written order required by this section not later than the 48th hour
25-13 after the hearing is held, excluding any Sunday or holiday that
25-14 falls in that period.
25-15 Sec. 37.18. APPEAL. A minor whose application is denied
25-16 under this subchapter may appeal the denial to the court of
25-17 appeals. The notice of appeal must be filed not later than the
25-18 24th hour after the issuance of the order denying the application.
25-19 The appeal is perfected on the 72nd hour after the time the notice
25-20 of appeal is filed, excluding any Sunday or holiday that falls in
25-21 that period.
25-22 Sec. 37.19. EXPEDITED PROCEEDINGS. A court shall reach a
25-23 decision on an application or appeal under this subchapter in
25-24 sufficient time to provide an effective opportunity for the minor
25-25 to consent to the abortion.
25-26 Sec. 37.20. PROCEEDING AND RECORDS CONFIDENTIAL. (a) A
25-27 proceeding under this subchapter is closed to the public and any
26-1 record relating to the proceeding is confidential.
26-2 (b) The minor may use initials instead of her name on the
26-3 application or notice of appeal.
26-4 (c) This section does not prevent the court from reporting
26-5 suspected abuse of a minor in accordance with Section 37.23.
26-6 Sec. 37.21. COURT FEE. A court may not assess a minor a fee
26-7 in connection with a proceeding under this subchapter.
26-8 Sec. 37.22. VENUE. Venue for an application under this
26-9 subchapter is in the county in which the minor's residence is
26-10 located or the county in which the minor is found.
26-11 Sec. 37.23. COURT ACTION; ABUSE. If a minor making an
26-12 application under this chapter reveals to the district court that
26-13 she is the victim of abuse or that her pregnancy may be the result
26-14 of abuse, the court shall:
26-15 (1) report the abuse as required by Chapter 34; and
26-16 (2) advise the minor that there are laws to protect
26-17 her, including Chapter 17, and may take any action authorized under
26-18 Chapter 17.
26-19 (Sections 37.24-37.50 reserved for expansion
26-20 SUBCHAPTER C. ENFORCEMENT
26-21 Sec. 37.51. CRIMINAL PENALTY. (a) A physician commits an
26-22 offense if the physician intentionally performs an abortion in
26-23 violation of Section 37.02.
26-24 (b) An offense under this section is a Class C misdemeanor.
26-25 Sec. 37.52. EVIDENCE IN CIVIL PROCEEDING. The failure of a
26-26 physician to obtain the consent of a parent, managing conservator,
26-27 or guardian under Section 37.02 or a copy of an order granting an
27-1 application under Subchapter B is prima facie evidence in a civil
27-2 action relating to the abortion that the physician failed to obtain
27-3 informed consent to perform the abortion.
27-4 ARTICLE 4. ACKNOWLEDGMENT OF FEDERAL RESTRICTIONS; TRANSITION;
27-5 EMERGENCY
27-6 SECTION 4.01. In enacting this Act, the legislature
27-7 recognizes existing federal judicial doctrines restricting the
27-8 powers of the legislature in regulating abortion. This Act does
27-9 not create a right to abortion.
27-10 SECTION 4.02. This Act takes effect September 1, 1995, and
27-11 applies only to an abortion performed on or after January 1, 1996.
27-12 An abortion performed before January 1, 1996, is governed by the
27-13 law as it existed immediately before the effective date of this
27-14 Act, and that law is continued in effect for that purpose.
27-15 SECTION 4.03. The importance of this legislation and the
27-16 crowded condition of the calendars in both houses create an
27-17 emergency and an imperative public necessity that the
27-18 constitutional rule requiring bills to be read on three several
27-19 days in each house be suspended, and this rule is hereby suspended.