By: Villarreal H.B. No. 1354
A BILL TO BE ENTITLED
AN ACT
relating to preventative health care services and educational
programs to reduce unintended pregnancies, the need for abortion
and infection rates of sexually-transmitted diseases.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. SHORT TITLE. This Act may be cited as the "Texas
Prevention First Act of 2005."
SECTION 2. FUNDING FOR SERVICES TO REDUCE THE NUMBER OF
UNINTENDED PREGNANCIES AND ABORTIONS AND LOWER RATES OF SEXUALLY
TRANSMITTED DISEASES (INCLUDING HIV). The Legislative Budget Board
and the Office of the Governor are directed to take all necessary
steps to maximize the amount of money available through all Federal
and private grant programs to fund state services that provide
family planning and reproductive health services in order to reduce
the number of unintended pregnancies, the number of abortions and
lower the infection rates for sexually transmitted diseases,
including HIV.
SECTION 3. EQUITY IN PRESCRIPTION INSURANCE AND
CONTRACEPTIVE COVERAGE. Section 4, Article 3.80, Insurance Code,
is amended by adding a new Subsection (c) to read as follows:
(c) Notwithstanding any other law, any standard health
benefit plan must include coverage for contraceptives, if the plan
provides benefits for other prescription drugs, as required by
Article 21.52L of this code as added by Section 1, Chapter 1106,
Acts of the 77th Legislature, Regular Session, 2001.
SECTION 4. EMERGENCY CONTRACEPTION EDUCATION AND
INFORMATION PROGRAMS. (a) As used in this section:
(1) "department" means the Department of State Health
Services;
(2) "emergency contraception" has the meaning
assigned by Section 311.051, Health and Safety Code.
(b) The department shall develop and disseminate to the
public, directly or through arrangements with nonprofit
organizations, consumer groups, institutions of higher education,
Federal, State, or local agencies, clinics and the media,
information on emergency contraception.
(c) The information disseminated under Subsection (b) shall
include, at a minimum, a description of emergency contraception,
and an explanation of the use, safety, efficacy, and availability
of such contraception.
(d) The department shall develop and disseminate to health
care providers information on emergency contraception.
(e) The information disseminated under Subsection (d) shall
include, at a minimum:
(1) information describing the use, safety, efficacy
and availability of emergency contraception;
(2) a recommendation regarding the use of such
contraception in appropriate cases; and
(3) information explaining how to obtain copies of the
information developed under Subdivision (3), for distribution to
the patients of the providers.
SECTION 5. EMERGENCY CONTRACEPTION DRUG THERAPY BY
PHARMACISTS. (a) Section 157.101(a), Occupations Code, is amended
to read as follows:
(a) In this subchapter [section], "pharmacist" has the
meaning assigned by Section 551.003.
(b) Subchapter C, Chapter 157, Occupations Code, is amended
by adding Section 157.102 to read as follows:
Sec. 157.102. EMERGENCY CONTRACEPTION DRUG THERAPY. A
pharmacist may initiate emergency contraception drug therapy in
accordance with Sections 157.101 and 562.056.
(c) Subchapter B, Chapter 562, Occupations Code, is amended
by adding Sections 562.056 and 562.057 to read as follows:
Sec. 562.056. EMERGENCY CONTRACEPTION DRUG THERAPY. (a)
In this section and Section 562.057:
(1) "Initiate" means to provide emergency
contraception on patient request in accordance with a drug therapy
management agreement.
(2) "Patient" means an individual to whom
contraception drug therapy is dispensed and distributed as provided
by this section.
(3) "Physician" has the meaning assigned by Section
151.002.
(b) The board shall adopt rules necessary to administer this
section and Section 562.057.
(c) Subject to Section 562.057, a pharmacist may exercise
the pharmacist's professional judgment to initiate and distribute
emergency contraception drug therapy to a patient in accordance
with:
(1) this section and board rules; and
(2) standardized procedures and protocols developed
by the pharmacist and a physician with whom the pharmacist has
entered into an agreement required by Subsection (d).
(d) A pharmacist may not initiate and distribute emergency
contraception drug therapy to a patient in accordance with drug
therapy management agreement unless the pharmacist enters into an
agreement with at least one physician for purposes of the
initiation and distribution of the drug therapy. The requirement
of Section 157.101(c)(2) does not apply to drug therapy initiated
and distributed under this section.
(e) For each emergency contraception drug therapy initiated
and distributed, a pharmacist shall:
(1) provide the patient with a standardized fact sheet
developed by the board in accordance with Subsection (f);
(2) require the patient to complete a form requesting
information on possible contraindications to the drug therapy; and
(3) inform the physician with whom the pharmacist has
an agreement of the initiation and distribution of the emergency
contraception drug therapy in accordance with drug therapy
management agreement.
(f) In consultation with the Texas State Board of Medical
Examiners, the Department of State Health Services, and the
American College of Obstetricians and Gynecologists, the board
shall develop a standardized fact sheet that includes:
(1) the indications for use of the drug therapy;
(2) the appropriate method for using the drug therapy;
and
(3) the necessity and importance of medical follow-up.
(g) Subsection (f) does not preclude the use of existing
publications developed by nationally recognized medical
organizations.
Sec. 562.057. TRAINING PROGRAM ON EMERGENCY CONTRACEPTION
DRUG THERAPY INITIATION AND DISTRIBUTION. (a) A pharmacist may not
initiate or distribute emergency contraception drug therapy unless
the pharmacist has successfully completed a training program on
emergency contraception drug therapy initiation and distribution.
(b) The board and the Texas State Board of Medical Examiners
must develop and approve the training program.
(c) The training program must address:
(1) the relevant medical circumstances and
contraindications that make emergency contraception appropriate
for a patient;
(2) appropriate methods of conducting sensitive
communications related to providing the therapy;
(3) quality assurance;
(4) the availability of additional services and
procedures for making referrals to the services; and
(5) the documentation required by the board.
(d) The program provider shall issue a certificate of
completion to the pharmacist on completion of the training program.
(e) A pharmacist who initiates and distributes emergency
contraception drug therapy may display the certificate of
completion as provided by board rules.
(d) Section 483.042, Health and Safety Code, is amended by
adding Subsection (g) to read as follows:
(g) It is an exception to the application of Subsection (a)
that a dangerous drug was a contraceptive and was delivered by a
pharmacist in accordance with Section 562.056, Occupations Code.
SECTION 6. EMERGENCY CONTRACEPTION FOR VICTIMS OF SEXUAL
ASSAULT. Chapter 311, Health & Safety Code, is amended by adding
Subchapter E to read as follows:
SUBCHAPTER E. EMERGENCY CONTRACEPTION
FOR SEXUAL ASSAULT VICTIMS
Sec. 311.051. SHORT TITLE. This chapter may be cited as the
"Compassionate Assistance for Rape Emergencies Act."
Sec. 311.051. DEFINITIONS. As used in this chapter:
(1) "emergency contraception" means a drug, drug
regimen, or device that:
(A) is used post-coitally;
(B) prevents pregnancy by delaying ovulation,
preventing fertilization of an egg, or preventing implantation of
an egg in a uterus; and
(C) is approved by the Food and Drug
Administration.
(2) hospital" has the meaning assigned by Section
241.003(7);
(3) "sexual assault" has the meaning assigned by
22.001, Penal Code.
Sec. 311.052. SCOPE OF DUTY. (a) The duties imposed by
this chapter on a hospital is owed by the hospital to any woman who
presents at the hospital and:
(1) states that she is a victim of sexual assault, or
is accompanied by someone who states she is a victim of sexual
assault; or
(2) whom hospital personnel have reason to believe is
a victim of sexual assault.
Sec. 311.053. DUTY TO SURVIVORS OF SEXUAL ASSAULT TO
PROVIDE INFORMATION AND EMERGENCY CONTRACEPTIVES WITHOUT CHARGE.
(a) When a woman covered by Section 311.052 presents at the
hospital, the hospital must promptly:
(1) provide medically and factually accurate and
unbiased written and oral information about emergency
contraception, including information explaining that:
(A) emergency contraception does not cause an
abortion; and
(B) emergency contraception is effective in most
cases in preventing pregnancy after unprotected sex;
(2) offer emergency contraception to the woman;
(3) provide emergency contraception to her on her
request.
(b) The information required under Subsection (a) must be
readily comprehensible, written in clear and concise language, and
meet any conditions regarding the provision of the information in
languages other than English as the department by rule may
establish.
(c) The duties imposed by this chapter may not be avoided or
services denied because of the inability of the woman or her family
to pay for the services.
SECTION 7. TEENAGE PREGNANCY PREVENTION GRANT PROGRAM.
Subtitle H, Title 2, Health and Safety Code, is amended by adding
Chapter 172 to read as follow.
CHAPTER 172. TEENAGE PREGNANCY PREVENTION GRANTS
SUBCHAPTER A. GENERAL PROVISIONS
Sec. 172.001. SHORT TITLE. This chapter may be cited as the
"Preventing Teen Pregnancy Act."
Sec. 172.002. DEFINITION. In this chapter, "rigorous
scientific research" means research based on a program evaluation
that:
(1) measured impact on sexual or contraceptive
behavior, pregnancy or childbearing.
(2) employed an experimental or quasi-experimental
design with well-constructed and appropriate comparison groups.
(3) had a sample size large enough (at least 100 in the
combined treatment and control group) and a follow-up interval long
enough (at least six months) to draw valid conclusions about
impact.
Sec. 172.003. GRANT PROGRAM. The department shall
establish a program to award grants to public and private entities
to establish or expand teenage pregnancy prevention programs.
Sec. 172.003. ELIGIBILITY. (c) The board by rule shall
establish eligibility criteria for awarding the grants. The rules
must require the department to grant priority to those applicants
proposing to serve:
(1) communities or populations in which:
(A) teenage pregnancy or birth rates are higher
than the corresponding State average; or
(B) teenage pregnancy or birth rates are
increasing;
(2) underserved or at-risk populations such as young
males or immigrant youths; or
(3) communities or populations located in areas where
the applicant may take advantage of other available resources and
coordinate with other programs that serve youth, such as workforce
development and after school programs
(b) A new or existing teenage pregnancy prevention program
is eligible for a grant under this chapter only if the program:
(1) replicates or substantially incorporates the
elements of one or more teenage pregnancy prevention programs that
have been proven on the basis of rigorous scientific research to:
(A) delay sexual intercourse or sexual activity;
(B) increase condom or contraceptive use without
increasing sexual activity; or
(C) reduce teenage pregnancy; and
(2) incorporates one or more of the following
strategies for preventing teenage pregnancy:
(A) encouraging teenagers to delay sexual
activity;
(B) sex and HIV education;
(C) interventions for sexually active teenagers;
(D) preventive health services;
(E) youth development programs;
(F) service learning programs; or
(G) outreach or media programs.
(c) A new or existing teenage pregnancy prevention program
is not eligible for a grant under this chapter if the program is an
abstinence-only education program. Abstinence-only education
programs that receive Federal funds through the Maternal and Child
Health Block Grant, the Administration for Children and Families,
the Adolescent Family Life Program, and any other program that uses
the definition of abstinence education under Section 510(b), Social
Security Act, are ineligible for the grant program established by
this chapter.
(d) Programs receiving funds under this chapter that choose
to provide information on HIV/AIDS or contraception or both must
provide information that is complete and medically accurate.
(e) An applicant for a grant under this chapter is not
precluded from priority or other consideration on the grounds that
the applicant is:
(1) a statewide or local not-for-profit coalition
working to prevent teenage pregnancy;
(2) a State, local, or tribal agency;
(3) a public or private school;
(4) an entity that provides after-school programs; or
(5) a community or faith-based group.
(f) The department shall approve grants according to rules
adopted by the board. Except as provided by this chapter, a grant
awarded under this chapter is governed by Chapter 783, Government
Code, and rules adopted under that chapter.
Sec. 172.004. MATCHING FUNDS AND SUPPLEMENTATION OF FUNDS.
(a) The department shall not award a grant to an applicant for a
program under this chapter unless the applicant demonstrates that
it will pay, from funds derived from non-Federal sources, at least
25 percent of the cost of the program.
(b) The applicant's share of the cost of a program may be
provided in the form of cash or in-kind services.
(c) An entity that receives funds as a grant under this
chapter shall use the funds to supplement, and not supplant, funds
that would otherwise be available to the entity for teenage
pregnancy prevention.
Sec. 172.005. GRANT PROGRAM EVALUATION. (a) The
Department shall:
(1) conduct or provide for a rigorous evaluation of at
least 10 percent of programs for which a grant is awarded under this
section;
(2) collect basic data on each program for which a
grant is awarded under this section; and
(3) upon completion of the evaluations referred to in
Subdivision (1), submit to the Legislature a report that includes a
detailed statement on the effectiveness of grants under this
section.
(b) Each recipient of a grant under this chapter shall
provide to the department all information that may be required for
an evaluation under Subsection (a) and shall otherwise cooperate
with the department's data collection efforts.
SECTION 8. ACCURACY OF CONTRACEPTION INFORMATION IN HEALTH
EDUCATION INSTRUCTION. (a) This Section may be cited as the "Truth
in Contraception Act."
(b) Section 28.004(e), Education Code is amended to read as
follows:
(e) Any course materials and instruction relating to
human sexuality, sexually transmitted diseases, or human
immunodeficiency virus or acquired immune deficiency syndrome
shall be selected by the board of trustees with the advice of the
local school health advisory council and must:
(1) present abstinence from sexual activity as the
preferred choice of behavior in relationship to all sexual activity
for unmarried persons of school age;
(2) devote more attention to abstinence from sexual
activity than to any other behavior;
(3) emphasize that abstinence from sexual activity, if
used consistently and correctly, is the only method that is 100
percent effective in preventing pregnancy, sexually transmitted
diseases, infection with human immunodeficiency virus or acquired
immune deficiency syndrome, and the emotional trauma associated
with adolescent sexual activity;
(4) direct adolescents to a standard of behavior in
which abstinence from sexual activity before marriage is the most
effective way to prevent pregnancy, sexually transmitted diseases,
and infection with human immunodeficiency virus or acquired immune
deficiency syndrome; and
(5) teach contraception and condom use in a medically
accurate manner that discusses both the health benefits and [terms
of] human use reality rates (instead of theoretical laboratory
rates) of contraception and condom use, if instruction on
contraception and condoms is included in curriculum content.
SECTION 9. (a) Not later than January 1, 2006, the Texas
State Board of Pharmacy shall:
(1) adopt the rules necessary to administer Sections
562.056 and 562.057, Occupations Code, as added by this Act;
(2) in consultation with the Texas State Board of
Medical Examiners, the Department of State Health Services, and the
American College of Obstetricians and Gynecologists, develop the
standardized fact sheet required by Section 562.056, Occupations
Code, as added by this Act; and
(3) in cooperation with the Texas State Board of
Medical Examiners, develop the training program on emergency
contraception drug therapy initiation and distribution required by
Section 562.057, Occupations Code, as added by this Act.
(b) Not later than January 1, 2006, the Department of State
Health Services shall adopt the rules necessary to administer those
Sections of this Act requiring the department to adopt rules.
SECTION 10. (a) The change in law made by this Act to
Section 483.042, Health and Safety Code, applies only to an offense
committed on or after the effective date of this Act. For purposes
of this section, an offense is committed before the effective date
of this Act if any element of the offense occurs before that date.
(b) An offense committed before the effective date of this
Act is covered by the law in effect when the offense was committed,
and the former law is continued in effect for that purpose.
SECTION 11. EFFECTIVE DATE. This Act takes effect
September 1, 2005.