By: Perry, Campbell, Hall  S.B. No. 1647
         (In the Senate - Filed March 11, 2021; March 11, 2021, read
  first time and referred to Committee on State Affairs;
  March 22, 2021, reported adversely, with favorable Committee
  Substitute by the following vote:  Yeas 7, Nays 2; March 22, 2021,
  sent to printer.)
Click here to see the committee vote
 
  COMMITTEE SUBSTITUTE FOR S.B. No. 1647 By:  Campbell
 
 
A BILL TO BE ENTITLED
 
AN ACT
 
  relating to information regarding perinatal palliative care,
  regulation of abortion, and the availability of certain defenses to
  prosecution for homicide and assault offenses; providing an
  administrative penalty; creating a criminal offense.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
  ARTICLE 1.  LEGISLATIVE FINDINGS
         SECTION 1.01.  The legislature finds that:
               (1)  Texas has a compelling state interest in
  protecting all Texans from discrimination based on sex, race, and
  disability; and
               (2)  Texas enforces prohibitions against
  discrimination based on sex, race, and disability in various areas,
  including housing, employment, education, insurance, and health
  program and service provision.
  ARTICLE 2.  PROVISIONS EFFECTIVE SEPTEMBER 1, 2021
         SECTION 2.01.  Chapter 161, Health and Safety Code, is
  amended by adding Subchapter X to read as follows:
  SUBCHAPTER X.  PERINATAL PALLIATIVE CARE
         Sec. 161.701.  PURPOSE OF SUBCHAPTER. The purpose of this
  subchapter is to ensure that a pregnant woman who receives a
  diagnosis of a life-threatening disability of the woman's preborn
  child is informed of the availability of perinatal palliative care.
         Sec. 161.702.  DEFINITION. In this subchapter, "perinatal
  palliative care" means the provision of comprehensive, supportive
  care to reduce the suffering of a pregnant woman, her preborn child,
  and her family, from diagnosis of the preborn child's
  life-threatening disability through the delivery and possible
  death of the child as a result of the life-threatening disability.
  The term includes medical, social, and mental health care,
  including counseling and health care provided by maternal-fetal
  medical specialists, obstetricians, neonatologists, anesthesia
  specialists, specialty nurses, clergy, social workers, and other
  individuals focused on alleviating fear and pain and ensuring the
  pregnant woman, her preborn child, and her family experience a
  supportive environment.
         Sec. 161.703.  PERINATAL PALLIATIVE CARE INFORMATIONAL
  MATERIALS. (a) The commission shall develop perinatal palliative
  care informational materials and post the materials on the
  commission's Internet website. The materials must include:
               (1)  a description of the health care and other
  services available through perinatal palliative care; and
               (2)  information about medical assistance benefits
  that may be available for prenatal care, childbirth, and perinatal
  palliative care.
         (b)  The commission shall develop, regularly update, and
  publish a geographically indexed list of all perinatal palliative
  care providers and programs in this state. The commission may
  include perinatal palliative care providers and programs in other
  states that provide care to residents of this state but may not
  include an abortion provider, as defined by Section 171.002, or an
  affiliate, as defined by Section 2272.001, Government Code, as
  added by Chapter 501 (S.B. 22), Acts of the 86th Legislature,
  Regular Session, 2019, of an abortion provider. The commission
  shall post the list of perinatal palliative care providers and
  programs, including contact information, on the commission's
  Internet website and note the providers and programs that provide
  services free of charge.
         Sec. 161.704.  PERINATAL PALLIATIVE CARE CERTIFICATION
  FORM. The commission shall develop a form on which a pregnant woman
  certifies that she has received the perinatal palliative care
  informational materials and list of the perinatal palliative care
  providers and programs described by Section 161.703.
         Sec. 161.705.  HEALTH CARE PROVIDER DUTIES ON DIAGNOSIS OF
  PREBORN CHILD'S LIFE-THREATENING DISABILITY. A health care
  provider who diagnoses a pregnant woman's preborn child as having a
  life-threatening disability shall, at the time of the diagnosis:
               (1)  provide the pregnant woman with a written copy of:
                     (A)  the perinatal palliative care informational
  materials and list of the perinatal palliative care providers and
  programs described by Section 161.703; and
                     (B)  the perinatal palliative care certification
  form described by Section 161.704; and
               (2)  obtain from the pregnant woman the signed
  perinatal palliative care certification form and place the form in
  the pregnant woman's medical records.
         Sec. 161.706.  EXCEPTION. A health care provider is not
  required to provide the perinatal palliative care informational
  materials or perinatal palliative care certification form under
  this subchapter if the health care provider verifies the pregnant
  woman's medical record contains a signed perinatal palliative care
  certification form for that pregnancy as required under Section
  161.705(2).
         SECTION 2.02.  Chapter 170, Health and Safety Code, is
  amended by designating Sections 170.001 and 170.002 as Subchapter A
  and adding a subchapter heading to read as follows:
  SUBCHAPTER A. GENERAL PROVISIONS; POST-VIABILITY ABORTION
  PROHIBITED
         SECTION 2.03.  Section 170.001, Health and Safety Code, is
  amended by adding Subdivision (2-a) to read as follows:
               (2-a)  "Preborn child" means an unborn child as defined
  by Section 171.061.
         SECTION 2.04.  Section 170.002, Health and Safety Code, is
  amended to read as follows:
         Sec. 170.002.  PROHIBITED ACTS; EXEMPTION. (a) Except as
  provided by Subsection (b), a person may not intentionally or
  knowingly perform or induce an abortion on a woman who is pregnant
  with a preborn [viable unborn] child during the third trimester of
  the pregnancy.
         (b)  Subsection (a) does not prohibit a person from
  performing or inducing an abortion if at the time of the abortion
  the person is a physician and concludes in good faith according to
  the physician's best medical judgment that[:
               [(1)  the fetus is not a viable fetus and the pregnancy
  is not in the third trimester;
               [(2)]  the abortion is necessary due to a medical
  emergency, as defined by Section 171.002 [to prevent the death or a
  substantial risk of serious impairment to the physical or mental
  health of the woman; or
               [(3)  the fetus has a severe and irreversible
  abnormality, identified by reliable diagnostic procedures].
         (c)  A physician who performs or induces an abortion that,
  according to the physician's best medical judgment at the time of
  the abortion, is to abort a preborn [viable unborn] child during the
  third trimester of the pregnancy shall certify in writing to the
  commission, on a form prescribed by the commission, the medical
  indications supporting the physician's judgment that the abortion
  was authorized by Subsection (b) [(b)(2) or (3). If the physician
  certifies the abortion was authorized by Subsection (b)(3), the
  physician shall certify in writing on the form the fetal
  abnormality identified by the physician]. The certification must
  be made not later than the 30th day after the date the abortion was
  performed or induced.
         SECTION 2.05.  Chapter 170, Health and Safety Code, is
  amended by adding Subchapter B to read as follows:
  SUBCHAPTER B. PREBORN NONDISCRIMINATION ACT
         Sec. 170.051.  DEFINITION. In this subchapter, "disability"
  means:
               (1)  a physical or mental impairment that would
  substantially limit one or more of an individual's major life
  activities;
               (2)  an assessment referencing an individual's
  impairment described by Subdivision (1); or
               (3)  a physical disfigurement, scoliosis, dwarfism,
  Down syndrome, albinism, amelia, or any other type of physical,
  mental, or intellectual abnormality or disease.
         Sec. 170.052.  DISCRIMINATORY ABORTION PROHIBITED. A person
  may not:
               (1)  knowingly perform or induce or attempt to perform
  or induce on a pregnant woman an abortion based on the race,
  ethnicity, sex, or disability of the woman's preborn child,
  including a probability of diagnosis that the child has a
  disability; or
               (2)  use force or the threat of force to intentionally
  injure or intimidate a person to coerce the performance or
  inducement or attempted performance or inducement of an abortion
  based on the race, ethnicity, sex, or disability of the woman's
  preborn child, including a probability of diagnosis that the child
  has a disability.
         Sec. 170.053.  CRIMINAL PENALTY. (a) A person who violates
  Section 170.052 commits an offense. An offense under this
  subsection is a Class A misdemeanor.
         (b)  A woman on whom an abortion is performed or induced or
  attempted to be performed or induced in violation of Section
  170.052 may not be prosecuted for a violation of that section or for
  conspiracy to commit a violation of that section.
         Sec. 170.054.  LICENSE SUSPENSION OR REVOCATION. A
  physician who violates Section 170.052 engages in unprofessional
  conduct for which the physician's license may be suspended or
  revoked under Chapter 164, Occupations Code.
         Sec. 170.055.  CIVIL REMEDIES. (a) A civil action may be
  brought against a person who violates Section 170.052 by:
               (1)  the woman on whom an abortion was performed or
  induced or attempted to be performed or induced in violation of
  Section 170.052;
               (2)  the father of the preborn child for an abortion
  performed or induced or attempted to be performed or induced on a
  pregnant woman in violation of Section 170.052, unless the woman's
  pregnancy resulted from the father's criminal conduct; or
               (3)  a maternal grandparent of the preborn child for an
  abortion performed or induced or attempted to be performed or
  induced in violation of Section 170.052 on a pregnant woman who was
  less than 18 years of age at the time of the violation, unless the
  woman's pregnancy resulted from the maternal grandparent's criminal
  conduct.
         (b)  A person who brings an action under this section may
  obtain:
               (1)  injunctive relief;
               (2)  damages incurred by the person, including:
                     (A)  actual damages for all psychological,
  emotional, and physical injuries resulting from the violation of
  Section 170.052;
                     (B)  court costs; and
                     (C)  reasonable attorney's fees; or
               (3)  both injunctive relief and damages.
         (c)  An action for damages or injunctive relief under this
  section must be filed:
               (1)  in a district court in the county in which the
  woman on whom an abortion was performed or induced or attempted to
  be performed or induced in violation of Section 170.052 resides;
  and
               (2)  not later than the sixth anniversary of the date
  the abortion was performed or induced or attempted to be performed
  or induced in violation of Section 170.052.
         (d)  The damages and injunctive relief authorized by this
  section are in addition to any other remedy available by law.
         (e)  A civil action under this section may not be brought
  against a woman on whom an abortion is performed or induced or
  attempted to be performed or induced in violation of Section
  170.052.
         SECTION 2.06.  Section 171.002, Health and Safety Code, is
  amended by adding Subdivision (3-a) to read as follows:
               (3-a)  "Preborn child" means an unborn child as defined
  by Section 171.061.
         SECTION 2.07.  Subchapter A, Chapter 171, Health and Safety
  Code, is amended by adding Section 171.008 to read as follows:
         Sec. 171.008.  REQUIRED DOCUMENTATION. (a) If an abortion
  is performed or induced on a pregnant woman because of a medical
  emergency, the physician who performs or induces the abortion shall
  execute a written document that certifies the abortion is necessary
  due to a medical emergency and specifies the woman's medical
  condition requiring the abortion.
         (b)  A physician shall:
               (1)  place the document described by Subsection (a) in
  the pregnant woman's medical record; and
               (2)  maintain a copy of the document described by
  Subsection (a) in the physician's practice records.
         (c)  A physician who performs or induces an abortion on a
  pregnant woman shall:
               (1)  if the abortion is performed or induced to
  preserve the health of the pregnant woman, execute a written
  document that:
                     (A)  specifies the medical condition the abortion
  is asserted to address; and
                     (B)  provides the medical rationale for the
  physician's conclusion that the abortion is necessary to address
  the medical condition; or
               (2)  for an abortion other than an abortion described
  by Subdivision (1), specify in a written document that maternal
  health is not a purpose of the abortion.
         (d)  The physician shall maintain a copy of a document
  described by Subsection (c) in the physician's practice records.
         SECTION 2.08.  Section 171.012, Health and Safety Code, is
  amended by amending Subsection (a) and adding Subsections (g) and
  (h) to read as follows:
         (a)  Consent to an abortion is voluntary and informed only
  if:
               (1)  the physician who is to perform or induce the
  abortion informs the pregnant woman on whom the abortion is to be
  performed or induced of:
                     (A)  the physician's name;
                     (B)  the particular medical risks associated with
  the particular abortion procedure to be employed, including, when
  medically accurate:
                           (i)  the risks of infection and hemorrhage;
                           (ii)  the potential danger to a subsequent
  pregnancy and of infertility; and
                           (iii)  the possibility of increased risk of
  breast cancer following an induced abortion and the natural
  protective effect of a completed pregnancy in avoiding breast
  cancer;
                     (C)  the probable gestational age of the preborn
  [unborn] child at the time the abortion is to be performed or
  induced; [and]
                     (D)  the medical risks associated with carrying
  the preborn child to term; and
                     (E)  the state law prohibiting abortion of a
  preborn child solely based on the preborn child's race, ethnicity,
  sex, or disability, as defined by Section 170.051, including a
  probability of diagnosis that the child has a disability;
               (2)  the physician who is to perform or induce the
  abortion or the physician's agent informs the pregnant woman that:
                     (A)  medical assistance benefits may be available
  for prenatal care, childbirth, and neonatal care;
                     (B)  the father is liable for assistance in the
  support of the child without regard to whether the father has
  offered to pay for the abortion; and
                     (C)  public and private agencies provide
  pregnancy prevention counseling and medical referrals for
  obtaining pregnancy prevention medications or devices, including
  emergency contraception for victims of rape or incest;
               (3)  the physician who is to perform or induce the
  abortion or the physician's agent:
                     (A)  provides the pregnant woman with the printed
  materials described by Section 171.014; and
                     (B)  informs the pregnant woman that those
  materials:
                           (i)  have been provided by the commission
  [Department of State Health Services];
                           (ii)  are accessible on an Internet website
  sponsored by the commission [department];
                           (iii)  describe the preborn [unborn] child
  and list agencies that offer alternatives to abortion; and
                           (iv)  include a list of agencies that offer
  sonogram services at no cost to the pregnant woman;
               (4)  before any sedative or anesthesia is administered
  to the pregnant woman and at least 24 hours before the abortion or
  at least two hours before the abortion if the pregnant woman waives
  this requirement by certifying that she currently lives 100 miles
  or more from the nearest abortion provider that is a facility
  licensed under Chapter 245 or a facility that performs or induces
  more than 50 abortions in any 12-month period:
                     (A)  the physician who is to perform or induce the
  abortion or an agent of the physician who is also a sonographer
  certified by a national registry of medical sonographers performs a
  sonogram on the pregnant woman on whom the abortion is to be
  performed or induced;
                     (B)  the physician who is to perform or induce the
  abortion displays the sonogram images in a quality consistent with
  current medical practice in a manner that the pregnant woman may
  view them;
                     (C)  the physician who is to perform or induce the
  abortion provides, in a manner understandable to a layperson, a
  verbal explanation of the results of the sonogram images, including
  a medical description of the dimensions of the embryo or fetus, the
  presence of cardiac activity, and the presence of external members
  and internal organs; and
                     (D)  the physician who is to perform or induce the
  abortion or an agent of the physician who is also a sonographer
  certified by a national registry of medical sonographers makes
  audible the heart auscultation for the pregnant woman to hear, if
  present, in a quality consistent with current medical practice and
  provides, in a manner understandable to a layperson, a simultaneous
  verbal explanation of the heart auscultation;
               (5)  before receiving a sonogram under Subdivision
  (4)(A) and before the abortion is performed or induced and before
  any sedative or anesthesia is administered, the pregnant woman
  completes and certifies with her signature an election form that
  states as follows:
  "ABORTION AND SONOGRAM ELECTION
               (1)  THE INFORMATION AND PRINTED MATERIALS
  DESCRIBED BY SECTIONS 171.012(a)(1)-(3), TEXAS HEALTH
  AND SAFETY CODE, HAVE BEEN PROVIDED AND EXPLAINED TO
  ME.
               (2)  I UNDERSTAND THE NATURE AND CONSEQUENCES OF
  AN ABORTION.
               (3)  TEXAS LAW REQUIRES THAT I RECEIVE A SONOGRAM
  PRIOR TO RECEIVING AN ABORTION.
               (4)  I UNDERSTAND THAT I HAVE THE OPTION TO VIEW
  THE SONOGRAM IMAGES.
               (5)  I UNDERSTAND THAT I HAVE THE OPTION TO HEAR
  THE HEARTBEAT.
               (6)  I UNDERSTAND THAT I AM REQUIRED BY LAW TO
  HEAR AN EXPLANATION OF THE SONOGRAM IMAGES UNLESS I
  CERTIFY IN WRITING TO ONE OF THE FOLLOWING:
               ___  I AM PREGNANT AS A RESULT OF A SEXUAL
  ASSAULT, INCEST, OR OTHER VIOLATION OF THE TEXAS PENAL
  CODE THAT HAS BEEN REPORTED TO LAW ENFORCEMENT
  AUTHORITIES OR THAT HAS NOT BEEN REPORTED BECAUSE I
  REASONABLY BELIEVE THAT DOING SO WOULD PUT ME AT RISK
  OF RETALIATION RESULTING IN SERIOUS BODILY INJURY.
               ___  I AM A MINOR AND OBTAINING AN ABORTION IN
  ACCORDANCE WITH JUDICIAL BYPASS PROCEDURES UNDER
  CHAPTER 33, TEXAS FAMILY CODE.
               ___  MY PREBORN CHILD [FETUS] HAS AN IRREVERSIBLE
  MEDICAL CONDITION OR ABNORMALITY, AS IDENTIFIED BY
  RELIABLE DIAGNOSTIC PROCEDURES AND DOCUMENTED IN MY
  MEDICAL FILE.
               (7)  I AM MAKING THIS ELECTION OF MY OWN FREE WILL
  AND WITHOUT COERCION.
               (8)  FOR A WOMAN WHO LIVES 100 MILES OR MORE FROM
  THE NEAREST ABORTION PROVIDER THAT IS A FACILITY
  LICENSED UNDER CHAPTER 245, TEXAS HEALTH AND SAFETY
  CODE, OR A FACILITY THAT PERFORMS OR INDUCES MORE THAN
  50 ABORTIONS IN ANY 12-MONTH PERIOD ONLY:
               I CERTIFY THAT, BECAUSE I CURRENTLY LIVE 100
  MILES OR MORE FROM THE NEAREST ABORTION PROVIDER THAT
  IS A FACILITY LICENSED UNDER CHAPTER 245, TEXAS HEALTH
  AND SAFETY CODE, OR A FACILITY THAT PERFORMS OR INDUCES
  MORE THAN 50 ABORTIONS IN ANY 12-MONTH PERIOD, I WAIVE
  THE REQUIREMENT TO WAIT 24 HOURS AFTER THE SONOGRAM IS
  PERFORMED BEFORE RECEIVING THE ABORTION PROCEDURE. MY
  PLACE OF RESIDENCE IS:__________.
         ________________________________________
         SIGNATURE                        DATE";
               (6)  before the abortion is performed or induced, the
  physician who is to perform or induce the abortion receives a copy
  of the signed, written certification required by Subdivision (5);
  and
               (7)  the pregnant woman is provided the name of each
  person who provides or explains the information required under this
  subsection.
         (g)  If the pregnant woman's preborn child has been diagnosed
  with a life-threatening disability, the physician who is to perform
  or induce the abortion shall, at least 24 hours before the abortion:
               (1)  orally and in person, inform the pregnant woman of
  the availability of perinatal palliative care, as that term is
  defined by Section 161.702; and
               (2)  provide the pregnant woman with a written copy of:
                     (A)  the perinatal palliative care informational
  materials and list of the perinatal palliative care providers and
  programs described by Section 161.703; and
                     (B)  the perinatal palliative care certification
  form described by Section 161.704.
         (h)  If a pregnant woman described by Subsection (g), after
  receiving from the physician who is to perform or induce the
  abortion the perinatal palliative care informational materials and
  certification form described by that subsection in the manner
  required by that subsection, chooses to have an abortion instead of
  continuing the pregnancy in perinatal palliative care, the
  physician may perform or induce the abortion only after:
               (1)  the pregnant woman signs the certification form;
  and
               (2)  the physician places the signed certification form
  in the pregnant woman's medical records.
         SECTION 2.09.  Section 171.0121, Health and Safety Code, is
  amended to read as follows:
         Sec. 171.0121.  MEDICAL RECORD. (a) Before the abortion
  begins, a copy of the signed, written certification received by the
  physician under Section 171.012(a)(6) and, if applicable, under
  Section 161.704 must be placed in the pregnant woman's medical
  records.
         (b)  A copy of the signed, written certification required
  under Sections 171.012(a)(5) and (6) and of any signed, written
  certification required under Section 161.704 shall be retained by
  the facility where the abortion is performed or induced until:
               (1)  the seventh anniversary of the date the
  certification [it] is signed; or
               (2)  if the pregnant woman is a minor, the later of:
                     (A)  the seventh anniversary of the date the
  certification [it] is signed; or
                     (B)  the woman's 21st birthday.
         SECTION 2.10.  Section 171.014(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The department shall publish informational materials
  that include:
               (1)  the information required to be provided under
  Sections 171.012(a)(1)(B), [and] (D), and (E) and (a)(2)(A), (B),
  and (C); and
               (2)  the materials required by Sections 161.703, 
  171.015, and 171.016.
         SECTION 2.11.  The heading to Subchapter C, Chapter 171,
  Health and Safety Code, is amended to read as follows:
  SUBCHAPTER C.  ABORTION PROHIBITED AT OR AFTER 20 WEEKS PROBABLE
  GESTATIONAL AGE [POST-FERTILIZATION]
         SECTION 2.12.  Section 171.042, Health and Safety Code, is
  amended by adding Subdivision (1-a) to read as follows:
               (1-a)  "Probable gestational age" means the duration of
  a pregnancy measured by the number of weeks and days that have
  elapsed from the first day of the pregnant woman's last menstrual
  period out of an expected 40-week gestation.
         SECTION 2.13.  Sections 171.043, 171.044, and 171.045,
  Health and Safety Code, are amended to read as follows:
         Sec. 171.043.  DETERMINATION OF PROBABLE GESTATIONAL
  [POST-FERTILIZATION] AGE REQUIRED.  Except as otherwise provided by
  Section 171.046, a physician may not perform or induce or attempt to
  perform or induce an abortion without, prior to the procedure:
               (1)  making a determination of the probable gestational
  [post-fertilization] age of the preborn [unborn] child; or
               (2)  possessing and relying on a determination of the
  probable gestational [post-fertilization] age of the preborn
  [unborn] child made by another physician.
         Sec. 171.044.  ABORTION OF PREBORN [UNBORN] CHILD OF 20 OR
  MORE WEEKS PROBABLE GESTATIONAL [POST-FERTILIZATION] AGE
  PROHIBITED.  Except as otherwise provided by Section 171.046, a
  person may not perform or induce or attempt to perform or induce an
  abortion on a woman if it has been determined, by the physician
  performing, inducing, or attempting to perform or induce the
  abortion or by another physician on whose determination that
  physician relies, that the probable gestational
  [post-fertilization] age of the preborn [unborn] child is 20 or
  more weeks.
         Sec. 171.045.  METHOD OF ABORTION. (a)  This section applies
  only to an abortion authorized under Section 171.046(a)(1) or (2)
  in which:
               (1)  the probable gestational [post-fertilization] age
  of the preborn [unborn] child is 20 or more weeks; or
               (2)  the probable gestational [post-fertilization] age
  of the preborn [unborn] child has not been determined but could
  reasonably be 20 or more weeks.
         (b)  Except as otherwise provided by Section 171.046(a)(3),
  a physician performing or inducing an abortion under Subsection (a)
  shall terminate the pregnancy in the manner that, in the
  physician's reasonable medical judgment, provides the best
  opportunity for the preborn [unborn] child to survive.
         SECTION 2.14.  Section 171.046(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The prohibitions and requirements under Sections
  171.043, 171.044, and 171.045(b) do not apply to an abortion
  performed or induced if there exists a condition that, in the
  physician's reasonable medical judgment, so complicates the
  medical condition of the woman that, to avert the woman's death or a
  serious risk of substantial and irreversible physical impairment of
  a major bodily function, other than a psychological condition, it
  necessitates, as applicable:
               (1)  the immediate abortion of her pregnancy without
  the delay necessary to determine the probable gestational
  [post-fertilization] age of the preborn [unborn] child;
               (2)  the abortion of her pregnancy even though the
  probable gestational [post-fertilization] age of the preborn
  [unborn] child is 20 or more weeks; or
               (3)  the use of a method of abortion other than a method
  described by Section 171.045(b).
         SECTION 2.15.  Section 285.202(a), Health and Safety Code,
  is amended to read as follows:
         (a)  In this section, "medical emergency" means[:
               [(1)]  a condition exists that, in a physician's good
  faith clinical judgment, complicates the medical condition of the
  pregnant woman and necessitates the immediate abortion of her
  pregnancy to avert her death or to avoid a serious risk of
  substantial impairment of a major bodily function[; or
               [(2)  the fetus has a severe fetal abnormality].
         SECTION 2.16.  Section 164.052(a), Occupations Code, is
  amended to read as follows:
         (a)  A physician or an applicant for a license to practice
  medicine commits a prohibited practice if that person:
               (1)  submits to the board a false or misleading
  statement, document, or certificate in an application for a
  license;
               (2)  presents to the board a license, certificate, or
  diploma that was illegally or fraudulently obtained;
               (3)  commits fraud or deception in taking or passing an
  examination;
               (4)  uses alcohol or drugs in an intemperate manner
  that, in the board's opinion, could endanger a patient's life;
               (5)  commits unprofessional or dishonorable conduct
  that is likely to deceive or defraud the public, as provided by
  Section 164.053, or injure the public;
               (6)  uses an advertising statement that is false,
  misleading, or deceptive;
               (7)  advertises professional superiority or the
  performance of professional service in a superior manner if that
  advertising is not readily subject to verification;
               (8)  purchases, sells, barters, or uses, or offers to
  purchase, sell, barter, or use, a medical degree, license,
  certificate, or diploma, or a transcript of a license, certificate,
  or diploma in or incident to an application to the board for a
  license to practice medicine;
               (9)  alters, with fraudulent intent, a medical license,
  certificate, or diploma, or a transcript of a medical license,
  certificate, or diploma;
               (10)  uses a medical license, certificate, or diploma,
  or a transcript of a medical license, certificate, or diploma that
  has been:
                     (A)  fraudulently purchased or issued;
                     (B)  counterfeited; or
                     (C)  materially altered;
               (11)  impersonates or acts as proxy for another person
  in an examination required by this subtitle for a medical license;
               (12)  engages in conduct that subverts or attempts to
  subvert an examination process required by this subtitle for a
  medical license;
               (13)  impersonates a physician or permits another to
  use the person's license or certificate to practice medicine in
  this state;
               (14)  directly or indirectly employs a person whose
  license to practice medicine has been suspended, canceled, or
  revoked;
               (15)  associates in the practice of medicine with a
  person:
                     (A)  whose license to practice medicine has been
  suspended, canceled, or revoked; or
                     (B)  who has been convicted of the unlawful
  practice of medicine in this state or elsewhere;
               (16)  performs or procures a criminal abortion, aids or
  abets in the procuring of a criminal abortion, attempts to perform
  or procure a criminal abortion, or attempts to aid or abet the
  performance or procurement of a criminal abortion;
               (17)  directly or indirectly aids or abets the practice
  of medicine by a person, partnership, association, or corporation
  that is not licensed to practice medicine by the board;
               (18)  performs or induces or attempts to perform or
  induce an abortion on a woman who is pregnant with a preborn [viable
  unborn] child during the third trimester of the pregnancy unless[:
                     [(A)]  the abortion is necessary due to a medical
  emergency, as defined by Section 171.002, Health and Safety Code 
  [to prevent the death of the woman;
                     [(B)  the viable unborn child has a severe,
  irreversible brain impairment; or
                     [(C)  the woman is diagnosed with a significant
  likelihood of suffering imminent severe, irreversible brain damage
  or imminent severe, irreversible paralysis];
               (19)  performs or induces or attempts to perform or
  induce an abortion on an unemancipated minor without the written
  consent of the child's parent, managing conservator, or legal
  guardian or without a court order, as provided by Section 33.003 or
  33.004, Family Code, unless the abortion is necessary due to a
  medical emergency, as defined by Section 171.002, Health and Safety
  Code;
               (20)  otherwise performs or induces or attempts to
  perform or induce an abortion on an unemancipated minor in
  violation of Chapter 33, Family Code;
               (21)  performs or induces or attempts to perform or
  induce an abortion in violation of Subchapter C, F, or G, Chapter
  171, Health and Safety Code; [or]
               (22)  in complying with the procedures outlined in
  Sections 166.045 and 166.046, Health and Safety Code, wilfully
  fails to make a reasonable effort to transfer a patient to a
  physician who is willing to comply with a directive; or
               (23)  performs or induces or attempts to perform or
  induce an abortion or engages in other conduct in violation of
  Section 170.052, Health and Safety Code.
         SECTION 2.17.  Section 164.055(b), Occupations Code, is
  amended to read as follows:
         (b)  The sanctions provided by Subsection (a) are in addition
  to any other grounds for refusal to admit persons to examination
  under this subtitle or to issue a license or renew a license to
  practice medicine under this subtitle.  The criminal penalties
  provided by Section 165.152 do not apply to a violation of Section
  170.002 or 170.052, Health and Safety Code, or Subchapter C, F, or
  G, Chapter 171, Health and Safety Code.
         SECTION 2.18.  The following provisions of the Health and
  Safety Code are repealed:
               (1)  Section 170.001(3);
               (2)  Sections 171.042(1) and (2);
               (3)  Section 171.046(c); and
               (4)  Sections 285.202(a-1) and (a-2).
  ARTICLE 3.  PROVISIONS EFFECTIVE SEPTEMBER 1, 2023, OR EARLIER
         SECTION 3.01.  Chapter 171, Health and Safety Code, is
  amended by adding Subchapter H to read as follows:
  SUBCHAPTER H.  DETECTION OF FETAL HEARTBEAT
         Sec. 171.201.  DEFINITIONS. In this subchapter:
               (1)  "Fetal heartbeat" means cardiac activity or the
  steady and repetitive rhythmic contraction of the fetal heart
  within the gestational sac.
               (2)  "Gestational age" means the amount of time that
  has elapsed from the first day of a woman's last menstrual period.
               (3)  "Gestational sac" means the structure comprising
  the extraembryonic membranes that envelop the preborn child and
  that is typically visible by ultrasound after the fourth week of
  pregnancy.
               (4)  "Physician" means an individual licensed to
  practice medicine in this state, including a medical doctor and a
  doctor of osteopathic medicine.
               (5)  "Preborn child" means a human fetus or embryo in
  any stage of gestation from fertilization until birth.
               (6)  "Pregnancy" means the human female reproductive
  condition that:
                     (A)  begins with fertilization;
                     (B)  occurs when the woman is carrying the
  developing human offspring; and
                     (C)  is calculated from the first day of the
  woman's last menstrual period.
               (7)  "Standard medical practice" means the degree of
  skill, care, and diligence that an obstetrician of ordinary
  judgment, learning, and skill would employ in like circumstances.
         Sec. 171.202.  LEGISLATIVE FINDINGS. The legislature finds,
  according to contemporary medical research, that:
               (1)  fetal heartbeat has become a key medical predictor
  that a preborn child will reach live birth;
               (2)  cardiac activity begins at a biologically
  identifiable moment in time, normally when the fetal heart is
  formed in the gestational sac;
               (3)  Texas has compelling interests from the outset of
  a woman's pregnancy in protecting the health of the woman and the
  life of the preborn child; and
               (4)  to make an informed choice about whether to
  continue her pregnancy, the pregnant woman has a compelling
  interest in knowing the likelihood of her preborn child surviving
  to full-term birth based on the presence of cardiac activity.
         Sec. 171.203.  DETERMINATION OF PRESENCE OF FETAL HEARTBEAT
  REQUIRED; RECORD. (a) For the purposes of determining the presence
  of a fetal heartbeat under this section, "standard medical
  practice" includes employing the appropriate means of detecting the
  heartbeat based on the estimated gestational age of the preborn
  child and the condition of the woman and her pregnancy.
         (b)  Except as provided by Section 171.205, a physician may
  not knowingly perform or induce an abortion on a pregnant woman
  unless the physician has determined, in accordance with this
  section, whether the woman's preborn child has a detectable fetal
  heartbeat.
         (c)  In making a determination under Subsection (b), the
  physician must use a test that is:
               (1)  consistent with the physician's good faith and
  reasonable understanding of standard medical practice;
               (2)  consistent with rules adopted under this
  subchapter; and
               (3)  appropriate for the estimated gestational age of
  the preborn child and the condition of the pregnant woman and her
  pregnancy.
         (d)  A physician making a determination under Subsection (b)
  shall record in the pregnant woman's medical record:
               (1)  the estimated gestational age of the preborn
  child;
               (2)  the method used to estimate the gestational age;
  and
               (3)  the test used for detecting a fetal heartbeat,
  including the date, time, and results of the test.
         (e)  The executive commissioner may adopt rules specifying
  the appropriate tests to be used in determining the presence of a
  fetal heartbeat based on standard medical practice.
         Sec. 171.204.  PROHIBITED ABORTION OF PREBORN CHILD WITH
  DETECTABLE FETAL HEARTBEAT; EFFECT. (a) Except as provided by
  Section 171.205, a physician may not knowingly perform or induce an
  abortion on a pregnant woman if the physician detected a fetal
  heartbeat for the preborn child as required by Section 171.203 or
  failed to perform a test to detect a fetal heartbeat.
         (b)  A physician does not violate this section if the
  physician performed a test for a fetal heartbeat as required by
  Section 171.203 and did not detect a fetal heartbeat.
         (c)  This section does not affect:
               (1)  the provisions of this chapter that restrict or
  regulate an abortion by a particular method or during a particular
  stage of pregnancy; or
               (2)  any other provision of state law that regulates or
  prohibits abortion.
         Sec. 171.205.  EXCEPTION FOR MEDICAL EMERGENCY; RECORDS.
  (a) This subchapter does not apply if a physician believes a
  medical emergency exists that prevents compliance with this
  subchapter.
         (b)  A physician who performs or induces an abortion under
  circumstances described by Subsection (a) shall make written
  notations in the pregnant woman's medical record of:
               (1)  the physician's belief that a medical emergency
  necessitated the abortion; and
               (2)  the medical condition of the pregnant woman that
  prevented compliance with this subchapter.
         (c)  A physician performing or inducing an abortion under
  this section shall maintain in the physician's practice records a
  copy of the notations made under Subsection (b).
         Sec. 171.206.  CONSTRUCTION OF SUBCHAPTER; LIMITATION ON
  PUBLIC ENFORCEMENT. (a) This subchapter does not create or
  recognize a right to abortion before a fetal heartbeat is detected.
         (b)  This subchapter may not be construed to:
               (1)  authorize the initiation of a cause of action
  against or the prosecution of a woman on whom an abortion is
  performed or induced or attempted to be performed or induced in
  violation of this subchapter;
               (2)  wholly or partly repeal, either expressly or by
  implication, any other statute that regulates or prohibits
  abortion, including Chapter 6-1/2, Title 71, Revised Statutes;
               (3)  legalize the conduct prohibited by this subchapter
  or by Chapter 6-1/2, Title 71, Revised Statutes;
               (4)  restrict a political subdivision from regulating
  or prohibiting abortion in a manner that is at least as stringent as
  the laws of this state;
               (5)  limit in any way or affect the availability of a
  remedy established by Section 171.208; or
               (6)  limit the enforceability of any other laws that
  regulate or prohibit abortion.
         Sec. 171.207.  ADMINISTRATIVE PENALTY. The Texas Medical
  Board shall take disciplinary action under Chapter 164, Occupations
  Code, and shall assess an administrative penalty under Subchapter
  A, Chapter 165, Occupations Code, against any physician who
  violates this subchapter.
         Sec. 171.208.  CIVIL LIABILITY FOR VIOLATION OR AIDING OR
  ABETTING VIOLATION. (a) Any person, other than an officer or
  employee of a state or local governmental entity in this state, may
  bring a civil action against a person who violates this subchapter.
         (b)  If a claimant prevails in an action brought under this
  section, the court shall award:
               (1)  injunctive relief;
               (2)  statutory damages in an amount of not less than
  $10,000 for each violation or offense; and
               (3)  costs and attorney's fees.
         (c)  Notwithstanding Subsection (b), a court may not award
  relief under this section in response to a violation of this
  subchapter if the defendant demonstrates that the defendant
  previously paid statutory damages in a previous action for that
  particular violation or offense.
         (d)  Notwithstanding Chapter 16, Civil Practice and Remedies
  Code, a person may bring an action under this section not later than
  the sixth anniversary of the date the cause of action accrues.
         (e)  The following are not a defense to an action brought
  under this section:
               (1)  ignorance or mistake of law;
               (2)  a defendant's belief that the requirements of this
  subchapter are unconstitutional or were unconstitutional;
               (3)  a defendant's reliance on any court decision that
  has been overruled by the applicable final appellate court, even if
  that court decision had not been overruled when the defendant
  engaged in conduct that violates this subchapter; or
               (4)  the consent of the preborn child's mother to the
  abortion.
         (f)  Notwithstanding any other law, this state, a state
  official, or a district or county attorney may not intervene in an
  action brought under this section. This subsection does not
  prohibit a person described by this subsection from filing an
  amicus curiae brief in the action.
         (g)  Notwithstanding any other law, a court may not award
  costs or attorney's fees under the Texas Rules of Civil Procedure or
  any other rule adopted by the supreme court under Section 22.004,
  Government Code, to a defendant in an action brought under this
  section.
         Sec. 171.209.  CIVIL LIABILITY:  UNDUE BURDEN DEFENSE
  LIMITATIONS. (a) A defendant against whom an action is brought
  under Section 171.208 does not have standing to assert the rights of
  women seeking an abortion as a defense to liability under that
  section unless the United States Supreme Court holds that the
  courts of this state must confer standing on that defendant to
  assert the third-party rights of women seeking an abortion in state
  court as a matter of federal constitutional law.
         (b)  A defendant in an action brought under Section 171.208
  may assert an affirmative defense to liability only if:
               (1)  the defendant has standing to assert the
  third-party rights of women seeking an abortion in accordance with
  Subsection (a); and
               (2)  the defendant demonstrates that the relief sought
  by the claimant will impose an undue burden on women seeking an
  abortion.
         (c)  A court may not find an undue burden under Subsection
  (b) unless the defendant introduces evidence proving that:
               (1)  an award of relief will prevent an identifiable
  woman or an identifiable group of women from obtaining an abortion;
  or
               (2)  an award of relief will place a substantial
  obstacle in the path of an identifiable woman or an identifiable
  group of women who are seeking an abortion.
         (d)  A defendant may not establish an undue burden under this
  section by:
               (1)  merely demonstrating that an award of relief will
  prevent women from obtaining support or assistance, financial or
  otherwise, from others in their effort to obtain an abortion; or
               (2)  arguing or attempting to demonstrate that an award
  of relief against other defendants or other potential defendants
  will impose an undue burden on women seeking an abortion.
         (e)  The affirmative defense under Subsection (b) is not
  available if the United States Supreme Court overrules Roe v. Wade,
  410 U.S. 113 (1973) or Planned Parenthood v. Casey, 505 U.S. 833
  (1992), regardless of whether the conduct on which the cause of
  action is based under Section 171.208 occurred before the Supreme
  Court overruled either of those decisions.
         Sec. 171.210.  CIVIL LIABILITY:  VENUE.  Notwithstanding any
  other law, including Section 15.002, Civil Practice and Remedies
  Code, a civil action brought under Section 171.208 shall be brought
  in:
               (1)  the county in which all or a substantial part of
  the events or omissions giving rise to the claim occurred;
               (2)  the county of residence for any one of the natural
  person defendants at the time the cause of action accrued;
               (3)  the county of the principal office in this state of
  any one of the defendants that is not a natural person; or
               (4)  the county of residence for the claimant if the
  claimant is a natural person residing in this state.
         Sec. 171.211.  SOVEREIGN, GOVERNMENTAL, AND OFFICIAL
  IMMUNITY PRESERVED. (a) This section prevails over any
  conflicting law, including:
               (1)  the Uniform Declaratory Judgments Act; and
               (2)  Chapter 37, Civil Practice and Remedies Code.
         (b)  This state has sovereign immunity, a political
  subdivision has governmental immunity, and each officer and
  employee of this state or a political subdivision has official
  immunity in any action, claim, or counterclaim or any type of legal
  or equitable action that challenges the validity of any provision
  or application of this subchapter, on constitutional grounds or
  otherwise.
         (c)  A provision of state law may not be construed to waive or
  abrogate an immunity described by Subsection (b) unless it
  expressly waives immunity under this section.
         Sec. 171.212.  SEVERABILITY.  (a)  Mindful of Leavitt v. Jane
  L., 518 U.S. 137 (1996), in which in the context of determining the , 518 U.S. 137 (1996), in which in the context of determining the
  severability of a state statute regulating abortion the United
  States Supreme Court held that an explicit statement of legislative
  intent is controlling, it is the intent of the legislature that
  every provision, section, subsection, sentence, clause, phrase, or
  word in this subchapter, and every application of the provisions in
  this subchapter, are severable from each other.
         (b)  If any application of any provision in this subchapter
  to any person, group of persons, or circumstances is found by a
  court to be invalid or unconstitutional, the remaining applications
  of that provision to all other persons and circumstances shall be
  severed and may not be affected. All constitutionally valid
  applications of this subchapter shall be severed from any
  applications that a court finds to be invalid, leaving the valid
  applications in force, because it is the legislature's intent and
  priority that the valid applications be allowed to stand alone.
  Even if a reviewing court finds a provision of this subchapter to
  impose an undue burden in a large or substantial fraction of
  relevant cases, the applications that do not present an undue
  burden shall be severed from the remaining provisions and shall
  remain in force, and shall be treated as if the legislature had
  enacted a statute limited to the persons, group of persons, or
  circumstances for which the statute's application does not present
  an undue burden.
         (c)  The legislature further declares that it would have
  enacted this subchapter, and each provision, section, subsection,
  sentence, clause, phrase, or word, and all constitutional
  applications of this subchapter, irrespective of the fact that any
  provision, section, subsection, sentence, clause, phrase, or word,
  or applications of this subchapter, were to be declared
  unconstitutional or to represent an undue burden.
         (d)  If any provision of this subchapter is found by any
  court to be unconstitutionally vague, then the applications of that
  provision that do not present constitutional vagueness problems
  shall be severed and remain in force.
         (e)  No court may decline to enforce the severability
  requirements of Subsections (a), (b), (c), and (d) on the ground
  that severance would rewrite the statute or involve the court in
  legislative or lawmaking activity.  A court that declines to
  enforce or enjoins a state official from enforcing a statutory
  provision does not rewrite a statute, as the statute continues to
  contain the same words as before the court's decision.  A judicial
  injunction or declaration of unconstitutionality:
               (1)  is nothing more than an edict prohibiting
  enforcement that may subsequently be vacated by a later court if
  that court has a different understanding of the requirements of the
  Texas Constitution or United States Constitution;
               (2)  is not a formal amendment of the language in a
  statute; and
               (3)  no more rewrites a statute than a decision by the
  executive not to enforce a duly enacted statute in a limited and
  defined set of circumstances.
         (f)  If any federal or state court declares unconstitutional
  or enjoins the enforcement of a provision in this subchapter and
  fails to enforce the severability requirements of Subsections (a),
  (b), (c), (d), and (e), the executive commissioner shall:
               (1)  adopt rules that enforce the requirements
  described by this subchapter to the maximum possible extent while
  avoiding the constitutional problems or other problems identified
  by the federal or state court; and 
               (2)  issue notice of those rules, not later than the
  30th day after the date of the court ruling. 
         (g)  If the executive commissioner fails to adopt the rules
  and issue notice under Subsection (f), a person may petition for a
  writ of mandamus requiring the executive commissioner to adopt the
  rules and issue notice.
         SECTION 3.02.  Chapter 30, Civil Practice and Remedies Code,
  is amended by adding Section 30.022 to read as follows:
         Sec. 30.022.  AWARD OF ATTORNEY'S FEES IN ACTIONS
  CHALLENGING ABORTION LAWS.  (a)  Notwithstanding any other law, any
  person, including an entity, attorney, or law firm, who seeks
  declaratory or injunctive relief to prevent this state, a political
  subdivision, or any governmental entity or public official in this
  state from enforcing any statute, ordinance, rule, regulation, or
  any other type of law that regulates or restricts abortion or that
  limits taxpayer funding for individuals or entities that perform or
  promote abortions, in any state or federal court, or that
  represents any litigant seeking such relief in any state or federal
  court, is jointly and severally liable to pay the costs and
  attorney's fees of the prevailing party.
         (b)  For purposes of this section, a party is considered a
  prevailing party if a state or federal court:
               (1)  dismisses any claim or cause of action brought
  against the party that seeks the declaratory or injunctive relief
  described by Subsection (a), regardless of the reason for the
  dismissal; or 
               (2)  enters judgment in the party's favor on any such
  claim or cause of action. 
         (c)  Regardless of whether a prevailing party sought to
  recover costs or attorney's fees in the underlying action, a
  prevailing party under this section may bring a civil action to
  recover costs and attorney's fees against a person, including an
  entity, attorney, or law firm, that sought declaratory or
  injunctive relief described by Subsection (a) not later than the
  third anniversary of the date on which, as applicable:
               (1)  the dismissal or judgment described by Subsection
  (b) becomes final on the conclusion of appellate review; or
               (2)  the time for seeking appellate review expires. 
         (d)  It is not a defense to an action brought under
  Subsection (c) that:
               (1)  a prevailing party under this section failed to
  seek recovery of costs or attorney's fees in the underlying action;
  and 
               (2)  the court in the underlying action declined to
  recognize or enforce the requirements of this section.
         SECTION 3.03.  Subchapter C, Chapter 311, Government Code,
  is amended by adding Section 311.036 to read as follows:
         Sec. 311.036.  CONSTRUCTION OF ABORTION STATUTES. (a) A
  statute that regulates or prohibits abortion may not be construed
  to repeal any other statute that regulates or prohibits abortion,
  either wholly or partly, unless the repealing statute explicitly
  states that it is repealing the other statute.
         (b)  A statute that regulates or prohibits abortion may not
  be construed to restrict a political subdivision from regulating or
  prohibiting abortion in a manner that is at least as stringent as
  the laws of this state unless the statute explicitly states that
  political subdivisions are prohibited from regulating or
  prohibiting abortion in the manner described by the statute.
         (c)  Every statute that regulates or prohibits abortion is
  severable in each of its applications to every person and
  circumstance.  If any statute that regulates or prohibits abortion
  is found by any court to be unconstitutional, either on its face or
  as applied, then all applications of that statute that do not
  violate the constitutional rights of women seeking abortions shall
  be severed from the unconstitutional applications and shall remain
  enforceable, notwithstanding any other law.
         SECTION 3.04.  Section 171.012, Health and Safety Code, is
  amended by amending Subsection (a) and adding Subsection (i) to
  read as follows:
         (a)  Consent to an abortion is voluntary and informed only
  if:
               (1)  the physician who is to perform or induce the
  abortion informs the pregnant woman on whom the abortion is to be
  performed or induced of:
                     (A)  the physician's name;
                     (B)  the particular medical risks associated with
  the particular abortion procedure to be employed, including, when
  medically accurate:
                           (i)  the risks of infection and hemorrhage;
                           (ii)  the potential danger to a subsequent
  pregnancy and of infertility; and
                           (iii)  the possibility of increased risk of
  breast cancer following an induced abortion and the natural
  protective effect of a completed pregnancy in avoiding breast
  cancer;
                     (C)  the probable gestational age of the preborn
  [unborn] child at the time the abortion is to be performed or
  induced; [and]
                     (D)  the medical risks associated with carrying
  the preborn child to term; and
                     (E)  the state law prohibiting abortion of a
  preborn child solely based on the preborn child's race, ethnicity,
  sex, or disability, as defined by Section 170.051, including a
  probability of diagnosis that the child has a disability;
               (2)  the physician who is to perform or induce the
  abortion or the physician's agent informs the pregnant woman that:
                     (A)  medical assistance benefits may be available
  for prenatal care, childbirth, and neonatal care;
                     (B)  the father is liable for assistance in the
  support of the child without regard to whether the father has
  offered to pay for the abortion; and
                     (C)  public and private agencies provide
  pregnancy prevention counseling and medical referrals for
  obtaining pregnancy prevention medications or devices, including
  emergency contraception for victims of rape or incest;
               (3)  the physician who is to perform or induce the
  abortion or the physician's agent:
                     (A)  provides the pregnant woman with the printed
  materials described by Section 171.014; and
                     (B)  informs the pregnant woman that those
  materials:
                           (i)  have been provided by the commission
  [Department of State Health Services];
                           (ii)  are accessible on an Internet website
  sponsored by the commission [department];
                           (iii)  describe the preborn [unborn] child
  and list agencies that offer alternatives to abortion; and
                           (iv)  include a list of agencies that offer
  sonogram services at no cost to the pregnant woman;
               (4)  before any sedative or anesthesia is administered
  to the pregnant woman and at least 24 hours before the abortion or
  at least two hours before the abortion if the pregnant woman waives
  this requirement by certifying that she currently lives 100 miles
  or more from the nearest abortion provider that is a facility
  licensed under Chapter 245 or a facility that performs or induces
  more than 50 abortions in any 12-month period:
                     (A)  the physician who is to perform or induce the
  abortion or an agent of the physician who is also a sonographer
  certified by a national registry of medical sonographers performs a
  sonogram on the pregnant woman on whom the abortion is to be
  performed or induced;
                     (B)  the physician who is to perform or induce the
  abortion displays the sonogram images in a quality consistent with
  current medical practice in a manner that the pregnant woman may
  view them;
                     (C)  the physician who is to perform or induce the
  abortion provides, in a manner understandable to a layperson, a
  verbal explanation of the results of the sonogram images, including
  a medical description of the dimensions of the embryo or fetus, the
  presence of cardiac activity, and the presence of external members
  and internal organs; [and]
                     (D)  the physician who is to perform or induce the
  abortion or an agent of the physician who is also a sonographer
  certified by a national registry of medical sonographers makes
  audible the heart auscultation for the pregnant woman to hear, if
  present, in a quality consistent with current medical practice and
  provides, in a manner understandable to a layperson, a simultaneous
  verbal explanation of the heart auscultation; and
                     (E)  if a fetal heartbeat is detected under
  Section 171.203, the physician who is to perform or induce the
  abortion informs the woman in writing of the statistical
  probability of bringing the preborn child to term:
                           (i)  to the best of the physician's
  knowledge, based on the gestational age of the preborn child; or
                           (ii)  as provided by commission rule;
               (5)  before receiving a sonogram under Subdivision
  (4)(A) and before the abortion is performed or induced and before
  any sedative or anesthesia is administered, the pregnant woman
  completes and certifies with her signature an election form that
  states as follows:
  "ABORTION AND SONOGRAM ELECTION
               (1)  THE INFORMATION AND PRINTED MATERIALS
  DESCRIBED BY SECTIONS 171.012(a)(1)-(3), TEXAS HEALTH
  AND SAFETY CODE, HAVE BEEN PROVIDED AND EXPLAINED TO
  ME.
               (2)  I UNDERSTAND THE NATURE AND CONSEQUENCES OF
  AN ABORTION.
               (3)  TEXAS LAW REQUIRES THAT I RECEIVE A SONOGRAM
  PRIOR TO RECEIVING AN ABORTION.
               (4)  I UNDERSTAND THAT I HAVE THE OPTION TO VIEW
  THE SONOGRAM IMAGES.
               (5)  I UNDERSTAND THAT I HAVE THE OPTION TO HEAR
  THE HEARTBEAT.
               (6)  I UNDERSTAND THAT I AM REQUIRED BY LAW TO
  HEAR AN EXPLANATION OF THE SONOGRAM IMAGES UNLESS I
  CERTIFY IN WRITING TO ONE OF THE FOLLOWING:
               ___ I AM PREGNANT AS A RESULT OF A SEXUAL ASSAULT,
  INCEST, OR OTHER VIOLATION OF THE TEXAS PENAL CODE THAT
  HAS BEEN REPORTED TO LAW ENFORCEMENT AUTHORITIES OR
  THAT HAS NOT BEEN REPORTED BECAUSE I REASONABLY
  BELIEVE THAT DOING SO WOULD PUT ME AT RISK OF
  RETALIATION RESULTING IN SERIOUS BODILY INJURY.
               ___ I AM A MINOR AND OBTAINING AN ABORTION IN
  ACCORDANCE WITH JUDICIAL BYPASS PROCEDURES UNDER
  CHAPTER 33, TEXAS FAMILY CODE.
               ___ MY PREBORN CHILD [FETUS] HAS AN IRREVERSIBLE
  MEDICAL CONDITION OR ABNORMALITY, AS IDENTIFIED BY
  RELIABLE DIAGNOSTIC PROCEDURES AND DOCUMENTED IN MY
  MEDICAL FILE.
               (7)  I AM MAKING THIS ELECTION OF MY OWN FREE WILL
  AND WITHOUT COERCION.
               (8)  FOR A WOMAN WHO LIVES 100 MILES OR MORE FROM
  THE NEAREST ABORTION PROVIDER THAT IS A FACILITY
  LICENSED UNDER CHAPTER 245, TEXAS HEALTH AND SAFETY
  CODE, OR A FACILITY THAT PERFORMS OR INDUCES MORE THAN
  50 ABORTIONS IN ANY 12-MONTH PERIOD ONLY:
               I CERTIFY THAT, BECAUSE I CURRENTLY LIVE 100
  MILES OR MORE FROM THE NEAREST ABORTION PROVIDER THAT
  IS A FACILITY LICENSED UNDER CHAPTER 245, TEXAS HEALTH
  AND SAFETY CODE, OR A FACILITY THAT PERFORMS OR INDUCES
  MORE THAN 50 ABORTIONS IN ANY 12-MONTH PERIOD, I WAIVE
  THE REQUIREMENT TO WAIT 24 HOURS AFTER THE SONOGRAM IS
  PERFORMED BEFORE RECEIVING THE ABORTION PROCEDURE. MY
  PLACE OF RESIDENCE IS:__________.
         ________________________________________
         SIGNATURE                        DATE";
               (6)  before the abortion is performed or induced, the
  physician who is to perform or induce the abortion receives a copy
  of the signed, written certification required by Subdivision (5);
  and
               (7)  the pregnant woman is provided the name of each
  person who provides or explains the information required under this
  subsection.
         (i)  The executive commissioner may adopt rules that specify
  the information required under Subsection (a)(4)(E) regarding the
  statistical probability of bringing a preborn child to term based
  on the gestational age of the child. The information in the rules
  must be based on available medical evidence.
         SECTION 3.05.  Section 245.011(c), Health and Safety Code,
  is amended to read as follows:
         (c)  The report must include:
               (1)  whether the abortion facility at which the
  abortion is performed or induced is licensed under this chapter;
               (2)  the patient's year of birth, race, marital status,
  and state and county of residence;
               (3)  the type of abortion procedure;
               (4)  the date the abortion was performed or induced;
               (5)  whether the patient survived the abortion, and if
  the patient did not survive, the cause of death;
               (6)  the probable post-fertilization age of the preborn
  [unborn] child based on the best medical judgment of the attending
  physician at the time of the procedure;
               (7)  the date, if known, of the patient's last menstrual
  cycle;
               (8)  the number of previous live births of the patient;
  [and]
               (9)  the number of previous induced abortions of the
  patient;
               (10)  whether the abortion was performed or induced
  because of a medical emergency and any medical condition of the
  pregnant woman that required the abortion;
               (11)  whether the physician made a determination of the
  presence of a fetal heartbeat in accordance with Section 171.203;
  and
               (12)  whether the physician performed or induced the
  abortion under circumstances described by Section 171.205.
  ARTICLE 4. PROVISIONS EFFECTIVE SEPTEMBER 1, 2025, OR EARLIER
         SECTION 4.01.  Chapter 170, Health and Safety Code, is
  amended by adding Subchapter C to read as follows:
  SUBCHAPTER C. PROHIBITION OF ABORTION
         Sec. 170.101.  ABORTION PROHIBITED. Notwithstanding any
  other law, a person may not perform, induce, or attempt to perform
  or induce an abortion unless the abortion is performed, induced, or
  attempted to be performed or induced by a physician because of a
  medical emergency as defined by Section 171.002.
         Sec. 170.102.  CIVIL REMEDY. (a)  A civil action may be
  brought against a person who violated Section 170.101 by:
               (1)  the woman on whom an abortion was performed,
  induced, or attempted in violation of Section 170.101;
               (2)  the father of the preborn child for an abortion
  performed, induced, or attempted on a pregnant woman in violation
  of Section 170.101, unless the woman's pregnancy resulted from the
  father's criminal conduct; or
               (3)  a maternal grandparent of the preborn child for an
  abortion performed, induced, or attempted in violation of Section
  170.101 on a pregnant woman who was less than 18 years of age at the
  time of the violation, unless the woman's pregnancy resulted from
  the maternal grandparent's criminal conduct.
         (b)  A person who brings an action under this section may
  obtain:
               (1)  injunctive relief;
               (2)  damages incurred by the person, including:
                     (A)  actual damages for all psychological,
  emotional, and physical injuries resulting from the violation of
  Section 170.101;
                     (B)  court costs; and
                     (C)  reasonable attorney's fees; or
               (3)  both injunctive relief and damages.
         (c)  An action for damages or injunctive relief under this
  section must be filed:
               (1)  in a district court in the county in which the
  woman on whom an abortion was performed, induced, or attempted in
  violation of Section 170.101 resides; and
               (2)  not later than the sixth anniversary of the date
  the abortion was performed, induced, or attempted in violation of
  Section 170.101.
         (d)  The damages and injunctive relief authorized by this
  section are in addition to any other remedy available by law.
         (e)  A civil action under this section may not be brought
  against a woman on whom an abortion is performed, induced, or
  attempted in violation of Section 170.101.
         Sec. 170.103.  REVOCATION OR SUSPENSION OF LICENSE. A
  physician who violates Section 170.101 engages in unprofessional
  conduct for which the physician's license may be suspended or
  revoked under Chapter 164, Occupations Code.
         SECTION 4.02.  Section 19.06, Penal Code, is amended to read
  as follows:
         Sec. 19.06.  APPLICABILITY TO CERTAIN CONDUCT.  
  Notwithstanding any other law, this [This] chapter applies [does
  not apply] to the death of a preborn [an unborn] child unless [if]
  the conduct charged is:
               (1)  conduct committed by the mother of the preborn
  [unborn] child; or
               (2)  an abortion performed, induced, or attempted to be
  performed or induced by a physician because of a medical emergency
  as defined by Section 171.002, Health and Safety Code [a lawful
  medical procedure performed by a physician or other licensed health
  care provider with the requisite consent, if the death of the unborn
  child was the intended result of the procedure;
               [(3)  a lawful medical procedure performed by a
  physician or other licensed health care provider with the requisite
  consent as part of an assisted reproduction as defined by Section
  160.102, Family Code; or
               [(4)  the dispensation of a drug in accordance with law
  or administration of a drug prescribed in accordance with law].
         SECTION 4.03.  Section 22.12, Penal Code, is amended to read
  as follows:
         Sec. 22.12.  APPLICABILITY TO CERTAIN CONDUCT.  
  Notwithstanding any other law, this [This] chapter applies [does
  not apply] to conduct charged as having been committed against an
  individual who is a preborn [an unborn] child unless [if] the
  conduct is:
               (1)  committed by the mother of the preborn [unborn]
  child; or
               (2)  an abortion performed, induced, or attempted to be
  performed or induced by a physician because of a medical emergency
  as defined by Section 171.002, Health and Safety Code [a lawful
  medical procedure performed by a physician or other health care
  provider with the requisite consent;
               [(3)  a lawful medical procedure performed by a
  physician or other licensed health care provider with the requisite
  consent as part of an assisted reproduction as defined by Section
  160.102, Family Code; or
               [(4)  the dispensation of a drug in accordance with law
  or administration of a drug prescribed in accordance with law].
         SECTION 4.04.  The following provisions are repealed:
               (1)  Section 33.002(b), Family Code; and
               (2)  Section 171.063(b), Health and Safety Code.
         SECTION 4.05.  (a)  Subchapter C, Chapter 170, Health and
  Safety Code, as added by this article, and Sections 19.06 and 22.12,
  Penal Code, as amended by this article, shall be construed, as a
  matter of state law, to be enforceable to the maximum possible
  extent consistent with but not further than federal constitutional
  requirements, even if that construction is not readily apparent, as
  such constructions are authorized only to the extent necessary to
  save the subchapter from judicial invalidation. Judicial
  reformation of statutory language is explicitly authorized only to
  the extent necessary to save the statutory provision from
  invalidity.
         (b)  If any court determines that a provision described by
  Subsection (a) of this section is unconstitutionally vague, the
  court shall interpret the provision, as a matter of state law, to
  avoid the vagueness problem and shall enforce the provision to the
  maximum possible extent. If a federal court finds any provision
  described by Subsection (a) of this section or its application to
  any person, group of persons, or circumstances to be
  unconstitutionally vague and declines to impose the saving
  construction described by this section, the Texas Supreme Court
  shall provide an authoritative construction of the objectionable
  statutory provisions that avoids the constitutional problems while
  enforcing the statute's restrictions to the maximum possible extent
  and shall agree to answer any question certified from a federal
  appellate court regarding the statute.
         (c)  An executive or administrative state official may not
  decline to enforce a provision described by Subsection (a) of this
  section, or adopt a construction of that provision or this section
  in a way that narrows its applicability, based on the official's own
  beliefs concerning the requirements of the state or federal
  constitution, unless the official is enjoined by a state or federal
  court from enforcing that provision.
         (d)  Sections 19.06 and 22.12, Penal Code, as amended by this
  article, may not be construed to authorize the prosecution of or a
  cause of action to be brought against a woman on whom an abortion is
  performed, induced, or attempted to be performed or induced in
  violation of Section 170.101, Health and Safety Code, as added by
  this article.
  ARTICLE 5. TRANSITIONS, SEVERABILITY, PREEMPTION,
  CONSTITUTIONALITY, AND EFFECTIVE DATE
         SECTION 5.01.  Not later than December 1, 2021:
               (1)  the Health and Human Services Commission shall:
                     (A)  develop the perinatal palliative care
  informational materials, list of perinatal palliative care
  providers and programs, and perinatal palliative care
  certification form required by Subchapter X, Chapter 161, Health
  and Safety Code, as added by this Act; and
                     (B)  update any forms and informational materials
  under Subchapter B, Chapter 171, Health and Safety Code, as amended
  by this Act; and
               (2)  the executive commissioner of the Health and Human
  Services Commission shall adopt any rules necessary to implement
  Subchapter X, Chapter 161, Health and Safety Code, as added by this
  Act, and Subchapter B, Chapter 171, Health and Safety Code, as
  amended by this Act.
         SECTION 5.02.  (a) Subchapter X, Chapter 161, Health and
  Safety Code, as added by this Act, applies only to a diagnosis of a
  life-threatening disability of a pregnant woman's preborn child
  made on or after January 1, 2022.
         (b)  Subchapter B, Chapter 170, Health and Safety Code, as
  added by this Act, Subchapters B and C, Chapter 171, Health and
  Safety Code, as amended by this Act, and Chapter 164, Occupations
  Code, as amended by this Act, apply only to an abortion performed,
  induced, or attempted to be performed or induced or other conduct
  that occurred on or after January 1, 2022. An abortion performed,
  induced, or attempted to be performed or induced or other conduct
  that occurred before that date is governed by the law in effect
  immediately before the effective date of this Act, and that law is
  continued in effect for that purpose.
         (c)  Subchapter C, Chapter 170, Health and Safety Code, as
  added by this Act, applies only to an abortion that is performed,
  induced, or attempted to be performed or induced on or after the
  effective date of Article 4 of this Act.
         (d)  Subchapter H, Chapter 171, Health and Safety Code, as
  added by this Act, applies only to an abortion performed, induced,
  or attempted to be performed or induced on or after the effective
  date of Article 3 of this Act.
         (e)  Sections 19.06 and 22.12, Penal Code, as amended by this
  Act, apply only to conduct that occurs on or after the effective
  date of Article 4 of this Act.  Conduct that occurs before that date
  is governed by the law in effect on the date the conduct occurred,
  and that law is continued in effect for that purpose.
         (f)  Sections 19.06 and 22.12, Penal Code, as amended by this
  Act, apply only to an offense committed on or after the effective
  date of Article 4 of this Act.  An offense committed before that
  date is governed by the law in effect when the offense was
  committed, and the former law is continued in effect for that
  purpose.  For purposes of this subsection, an offense is committed
  before the effective date of Article 4 of this Act if any element of
  the offense occurs before that date.
         SECTION 5.03.  (a) It is the intent of the legislature that
  if a court suspends enforcement of any provision of this Act, the
  suspension is not to be regarded as repealing that provision.
         (b)  If any provision of this Act is held invalid or if the
  application of any provision to any person or circumstance is held
  invalid, the invalidity of that provision or application does not
  affect any other provision or application of this Act that can be
  given effect without the invalid provision or application, and to
  this end, the provisions of this Act are severable. It is the
  intent of the legislature that any invalidity or potential
  invalidity of a provision of this Act does not impair the immediate
  and continuing enforceability of the remaining provisions. It is
  furthermore the intent of the legislature that the provisions of
  this Act do not have the effect of repealing or limiting any other
  laws of this state.
         (c)  The legislature intends that each provision of this Act
  as applicable to each individual woman is severable from each other
  provision of this Act.  In the unexpected event that a court finds
  the application of any provision of this Act to impose an
  impermissible undue burden on any pregnant woman or group of
  pregnant women, the application of the provision to those women is
  severed from the application of the remaining provisions of this
  Act that do not impose an undue burden, and those remaining
  applications remain in force and unaffected, consistent with
  Section 5.02 of this article.
         SECTION 5.04.  (a) After the issuance of a decision by the
  United States Supreme Court overruling any prior ruling that
  prohibits states from wholly or partly prohibiting abortion, the
  issuance of any court order or judgment restoring, expanding, or
  clarifying the authority of states to wholly or partly prohibit or
  regulate abortion, or the effective date of an amendment to the
  United States Constitution restoring, expanding, or clarifying the
  authority of states to wholly or partly prohibit or regulate
  abortion, the attorney general may apply to the appropriate state
  or federal court for:
               (1)  a declaration that any one or more provisions of
  this Act are constitutional; or
               (2)  a judgment or order lifting an injunction against
  the enforcement of any one or more provisions of this Act.
         (b)  If the attorney general fails to apply for the relief
  described by Subsection (a) of this section not later than the 30th
  day after the date an event described by that subsection occurs, any
  district attorney may apply to the appropriate state or federal
  court for the relief described by that subsection.
         SECTION 5.05.  The Health and Human Services Commission is
  required to implement a provision of this Act only if the
  legislature appropriates money to the commission specifically for
  that purpose.  If the legislature does not appropriate money
  specifically for that purpose, the commission may, but is not
  required to, implement a provision of this Act using other
  appropriations that are available for that purpose.
         SECTION 5.06.  (a)  Except as otherwise provided by this
  section, this Act takes effect September 1, 2021.
         (b)  Article 3 of this Act takes effect the earlier of:
               (1)  the 91st day after the date the attorney general
  submits a report required by Section 402.003, Government Code, that
  states a court of competent jurisdiction has held the provisions in
  Article 3 of this Act to be constitutional; or
               (2)  September 1, 2023.
         (c)  Article 4 of this Act takes effect the earlier of:
               (1)  the 91st day after the date the attorney general
  submits a report required by Section 402.003, Government Code, that
  states a court of competent jurisdiction has held the provisions in
  Article 4 of this Act to be constitutional; or
               (2)  September 1, 2025.
 
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