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A BILL TO BE ENTITLED
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AN ACT
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relating to protection of the rights of conscience of persons from |
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providing and health care facilities from offering certain health |
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care services; providing a civil remedy; authorizing disciplinary |
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action. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. The legislature finds that: |
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(1) the public policy of this state is to respect the |
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conscience of all physicians and health care providers and the |
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right of each physician and health care provider to hold their own |
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belief about whether certain health care services are morally |
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acceptable; |
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(2) without comprehensive protections, the rights of |
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conscience of physicians, health care providers, and health care |
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facilities may be violated; and |
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(3) each physician and health care provider must be |
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protected from required participation in and each health care |
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facility must be protected from required provision of a health care |
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service the physician, provider, or facility for rights of |
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conscience has declined participation in or provision of and from |
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discriminatory adverse action resulting from the nonparticipation |
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or non-provision. |
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SECTION 2. Chapter 161, Health and Safety Code, is amended |
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by adding Subchapter Z to read as follows: |
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SUBCHAPTER Z. TEXAS HEALTH CARE CONSCIENCE PROTECTION ACT |
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Sec. 161.751. DEFINITIONS. In this subchapter: |
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(1) "Conscience" means a sincerely held set of |
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religious or philosophical moral convictions. |
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(2) "Health care facility" means a public or private |
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organization, corporation, partnership, sole proprietorship, |
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association, agency, network, joint venture, or other entity that |
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provides health care services to patients. The term includes a |
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hospital, clinic, medical center, ambulatory surgical center, |
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private physician's office, pharmacy, nursing home, laboratory or |
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diagnostic facility, infirmary, dispensary, medical school, |
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nursing school, pharmacy school, or medical training facility. |
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(3) "Health care provider" means a nurse, nurse aide, |
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medical assistant, hospital employee, allied health professional, |
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counselor, therapist, laboratory technician, clinic employee, |
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nursing home employee, pharmacist, pharmacy employee, researcher, |
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medical, pharmacy, or nursing school student, professional, |
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paraprofessional, or, without regard to whether the person holds a |
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license, any other person who furnishes or assists in the |
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furnishing of a health care service. |
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(4) "Health care service" means any phase of patient |
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medical care or treatment. The term includes: |
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(A) examination, testing, diagnosis, referral, |
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prognosis, dispensing or administering a drug or device, ancillary |
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research, instruction, therapy, treatment, and preparing for or |
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performing a surgery or procedure; |
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(B) family planning, counseling, and referrals, |
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and any other advice in connection with the use or procurement of |
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contraceptives, sterilization, or abortion; and |
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(C) record-making procedures, preparation of |
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treatment notes, and any other care or treatment rendered by a |
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physician, health care provider, or health care facility. |
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(5) "Physician" means an individual licensed to |
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practice medicine in this state. |
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Sec. 161.752. RIGHT TO DECLINE PARTICIPATION IN OR OFFER |
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HEALTH CARE SERVICE; CONSTRUCTION OF SUBCHAPTER. (a) Except as |
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provided by Subsection (b): |
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(1) a person may decline to participate in a health |
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care service for reasons of conscience; and |
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(2) a health care facility may decline to offer a |
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health care service consistent with the facility's established |
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beliefs and rights of conscience. |
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(b) A person may not decline to participate in and a health |
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care facility may not decline to offer the following services: |
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(1) emergency medical treatment required by 42 U.S.C. |
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Section 1395dd; or |
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(2) except as provided by Chapter 166, life-sustaining |
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treatment. |
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(c) Nothing in this subchapter may be construed to: |
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(1) supersede Chapter 166 governing the provision, |
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withholding, or withdrawing of life-sustaining treatment; |
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(2) apply to emergency medical treatment required by |
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42 U.S.C. Section 1395dd, life-sustaining treatment, or |
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cardiopulmonary resuscitation; or |
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(3) prevent a health care provider, health care |
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facility, or health care payer that holds itself out to the public |
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as religious, includes in its governing documents a statement of |
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its religious purpose or mission, and has internal operating |
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policies or procedures to implement its religious beliefs, from |
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making employment, staffing, contracting, or admitting privilege |
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decisions consistent with those religious beliefs. |
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(d) An exercise of the rights of conscience under this |
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section is limited to a person's right to refuse to participate in |
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or a health care facility's right to refuse to offer a specific |
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health care service. |
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Sec. 161.753. IMMUNITY OF PHYSICIANS, HEALTH CARE |
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PROVIDERS, AND HEALTH CARE FACILITIES. A physician, health care |
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provider, or health care facility may not be held civilly or |
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criminally liable because the physician or provider declines to |
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participate in or the facility declines to offer a health care |
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service wholly or partly for rights of conscience. |
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Sec. 161.754. ADVERSE ACTION. (a) A person, including a |
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health care facility, a political subdivision of this state, the |
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Texas Medical Board or another agency of this state, or a medical |
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school or other institution that conducts education or training |
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programs for health care providers violates this subchapter by |
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taking an adverse action against another person or health care |
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facility because the other person or health care facility: |
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(1) declines to participate in or offer a health care |
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service for reasons of conscience; |
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(2) testifies, assists, or participates in or is |
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preparing to testify, assist, or participate in a proceeding to |
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present information about any act or omission that the person |
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reasonably believes relates to a violation of this subchapter; or |
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(3) provides, causes to be provided, or is preparing |
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to provide or cause to be provided information about any act or |
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omission that the person reasonably believes relates to a violation |
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of this subchapter to: |
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(A) the person's employer; |
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(B) the attorney general, the Health and Human |
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Services Commission, or any state agency charged with protecting |
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health care rights of conscience; or |
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(C) the United States Department of Health and |
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Human Services, the Office of Civil Rights of the United States |
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Department of State, or any other federal agency charged with |
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protecting health care rights of conscience. |
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(b) Violations under this section include discrimination |
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against or taking an adverse action with regard to: |
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(1) licensure; |
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(2) certification; |
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(3) employment terms, benefits, seniority status, |
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promotion, or transfer; |
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(4) staff appointments or other privileges; |
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(5) denial of admission or participation in a program |
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for which the other person or facility is otherwise eligible; |
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(6) reference to rights of conscience in an |
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application form for an educational or funding program; |
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(7) questions regarding an educational or funding |
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program applicant's participation in providing a health care |
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service for rights of conscience; |
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(8) imposition of a burden in the terms or conditions |
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of employment; |
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(9) denial of aid, assistance, or benefits; |
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(10) conditional receipt of the aid, assistance, or |
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benefits; or |
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(11) coercion or disqualification of the other person |
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or facility receiving aid, assistance, or benefits. |
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Sec. 161.755. PROTOCOL FOR DECLINING PARTICIPATION IN |
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PROVISION OF HEALTH CARE SERVICE. (a) A health care facility shall |
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develop a written protocol for circumstances in which a person for |
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reasons of conscience declines to participate in providing a health |
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care service, other than emergency medical treatment under 42 |
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U.S.C. Section 1395dd or life-sustaining treatment described by |
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Chapter 166. The protocol must: |
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(1) assist the patient in accessing the requested |
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health care service by providing prompt transfer or release of |
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medical records the patient requests; and |
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(2) state the person remains responsible for providing |
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all other appropriate health care services to the patient other |
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than the specific health care service for which the person declines |
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participation for reasons of conscience. |
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(b) A person who for reasons of conscience declines |
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participation in provision of a health care service shall: |
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(1) notify the health care facility of the |
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declination; and |
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(2) comply with the applicable protocol developed |
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under this section. |
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(c) This section does not permit a protocol developed under |
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this section regarding a health care service that is contrary to the |
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conscience of a physician or health care provider to require a |
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physician, health care provider, or health care facility to counsel |
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a patient or refer the patient or facilitate the referral of the |
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patient to another physician, provider, or facility. |
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Sec. 161.756. DISCIPLINARY ACTION; COMPLAINT. (a) A |
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physician, health care provider, or health care facility that holds |
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a license issued by a licensing agency in this state is subject to |
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review and disciplinary action by the licensing agency for a |
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violation of this subchapter as if the physician, provider, or |
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facility violated the applicable licensing law. |
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(b) A person who is injured by a violation of this |
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subchapter may file a complaint with the licensing agency that |
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issued a license to the physician, health care provider, or health |
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care facility that allegedly violated this subchapter. |
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(c) A physician or health care provider may not file a |
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complaint with the appropriate licensing agency under this section |
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unless the physician or health care provider complies with the |
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health care facility's protocol developed under Section 161.755. |
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Sec. 161.757. CIVIL REMEDIES. (a) A person or health care |
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facility that is injured by a violation of this subchapter may bring |
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a civil action against another person, entity, or political |
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subdivision of this state that violates this subchapter. A person |
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or facility that brings an action under this section may obtain: |
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(1) injunctive relief; |
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(2) damages incurred by the person or facility, |
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including: |
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(A) actual damages for all psychological, |
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emotional, and physical injuries resulting from the violation of |
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this subchapter, as applicable; |
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(B) court costs; and |
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(C) reasonable attorney's fees; or |
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(3) both injunctive relief and damages. |
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(b) Governmental immunity is waived and abolished to the |
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extent of liability under this section. |
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SECTION 3. Not later than December 1, 2025, a health care |
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facility, as that term is defined by Section 161.751, Health and |
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Safety Code, as added by this Act, shall adopt protocols required by |
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Section 161.755, Health and Safety Code, as added by this Act. |
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SECTION 4. Section 161.753, Health and Safety Code, as |
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added by this Act, applies only to a cause of action that accrues on |
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or after the effective date of this Act. |
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SECTION 5. This Act takes effect September 1, 2025. |