Texas 2009 - 81st Regular

Texas House Bill HB3796 Compare Versions

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11 81R31841 E
22 By: Morrison, Cook, Harless, Heflin, H.B. No. 3796
33 Kolkhorst, et al.
44 Substitute the following for H.B. No. 3796:
55 By: Solomons C.S.H.B. No. 3796
66
77
88 A BILL TO BE ENTITLED
99 AN ACT
1010 relating to informed and voluntary consent for an abortion and the
1111 collection and reporting of information related to the performance
1212 of an abortion; providing penalties.
1313 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1414 SECTION 1. The heading to Subchapter B, Chapter 171, Health
1515 and Safety Code, is amended to read as follows:
1616 SUBCHAPTER B. VOLUNTARY AND INFORMED CONSENT
1717 SECTION 2. Section 171.018, Health and Safety Code, is
1818 amended to read as follows:
1919 Sec. 171.018. OFFENSE. A physician who intentionally
2020 performs an abortion on a woman in violation of Section 171.011
2121 [this subchapter] commits an offense. An offense under this
2222 section is a misdemeanor punishable by a fine not to exceed $10,000.
2323 In this section, "intentionally" has the meaning assigned by
2424 Section 6.03(a), Penal Code.
2525 SECTION 3. Subchapter B, Chapter 171, Health and Safety
2626 Code, is amended by adding Sections 171.019, 171.020, 171.021, and
2727 171.022 to read as follows:
2828 Sec. 171.019. PREVENTION OF COERCED ABORTIONS. (a) Before
2929 performing an abortion, a physician shall:
3030 (1) verbally inform the woman on whom the abortion is
3131 to be performed that a person cannot coerce or force her to have an
3232 abortion and that the physician cannot perform the abortion unless
3333 the woman provides her voluntary and informed consent; and
3434 (2) provide the woman on whom the abortion is to be
3535 performed with the coerced abortion form described by Section
3636 171.021:
3737 (A) in both English and Spanish; and
3838 (B) in a language other than English or Spanish,
3939 if applicable, under Section 171.021(c).
4040 (b) A doctor may not perform an abortion on a woman unless,
4141 before the abortion, the woman certifies on the coerced abortion
4242 form described by Section 171.021 that she received from the
4343 physician the information and materials required by Subsection (a).
4444 (c) If the woman indicates on the coerced abortion form or
4545 on the abortion reporting form required by Section 171.051 that she
4646 is being coerced to have an abortion performed, the physician:
4747 (1) shall report abuse or neglect under Chapter 261,
4848 Family Code, if applicable;
4949 (2) shall provide the referral required by Section
5050 171.020(2);
5151 (3) shall provide the woman with access to a telephone
5252 in a private room; and
5353 (4) may not perform the abortion until the woman
5454 provides her voluntary and informed consent that the woman states
5555 is not a result of coercion.
5656 Sec. 171.020. REFERRAL TO DOMESTIC VIOLENCE ASSISTANCE.
5757 The department shall require each physician who performs an
5858 abortion to:
5959 (1) maintain a list of domestic violence shelters and
6060 assistance programs that do not provide or refer for abortions; and
6161 (2) provide a referral to a domestic violence shelter
6262 or assistance program that does not provide or refer for abortions
6363 if the woman seeking an abortion communicates to the facility, the
6464 physician, or an agent of the physician who is performing the
6565 abortion that the woman is being abused or is being coerced to have
6666 the abortion.
6767 Sec. 171.021. CONTENTS OF FORM. (a) The department shall
6868 develop a coerced abortion form to be completed by each woman on
6969 whom an abortion is performed in this state. The form must include:
7070 (1) the following title centered on the page in
7171 boldfaced capital letters in 18-point font or larger: "NOTICE";
7272 (2) the following statement printed in 14-point font
7373 or larger: "It is against the law for a person, regardless of that
7474 person's relationship to you, to coerce or force you to have an
7575 abortion. By law, a physician cannot perform an abortion, including
7676 inducing, prescribing for, or otherwise providing the means for an
7777 abortion, unless you give your voluntary and informed consent
7878 without coercion or force. It is against the law for a physician to
7979 perform an abortion against your will. You have the right to contact
8080 any local or state law enforcement agency to receive protection
8181 from any actual or threatened physical abuse or violence.";
8282 (3) the following statements printed in 14-point font
8383 or larger followed by spaces for the woman to initial:
8484 (A) "I have been informed in person that no one
8585 can coerce or force me to have an abortion and that an abortion
8686 cannot be provided to me unless I provide my voluntary and informed
8787 consent."; and
8888 (B) "I have read the above notice and understand
8989 that I have legal protection against being coerced or forced to have
9090 an abortion.";
9191 (4) spaces for the signature of the woman on whom an
9292 abortion is to be performed and the date the form was completed; and
9393 (5) spaces for the license number, area of specialty,
9494 and signature of the physician who performed the abortion.
9595 (b) The department shall provide the form required by
9696 Subsection (a) in both English and Spanish.
9797 (c) If the department determines that a substantial number
9898 of residents in this state speak a primary language other than
9999 English or Spanish, the department shall provide the form required
100100 by Subsection (a) in that language. The department shall instruct a
101101 facility that provides abortions to provide the coerced abortion
102102 form in a language other than English or Spanish if the department
103103 determines that a substantial number of residents in the area speak
104104 a primary language other than English or Spanish.
105105 Sec. 171.022. PROVISION AND RETENTION OF COERCED ABORTION
106106 FORM. (a) The department shall provide a copy of this section and
107107 Sections 171.019-171.021 and the coerced abortion form required by
108108 Section 171.019 to:
109109 (1) a physician who becomes newly licensed to practice
110110 in this state, not later than the 30th day after the date the
111111 physician receives the license; and
112112 (2) all physicians licensed to practice in this state,
113113 not later than December 1 of each year.
114114 (b) A copy of the coerced abortion form certified by the
115115 woman shall be placed in the woman's medical file and kept until at
116116 least the seventh anniversary of the date on which the form was
117117 signed or, if the woman is a minor, at least until the date the woman
118118 reaches 20 years of age, whichever is later.
119119 (c) The woman on whom an abortion is performed shall be
120120 given a copy of the completed coerced abortion form in person before
121121 the woman leaves the facility where the abortion is performed.
122122 SECTION 4. Chapter 171, Health and Safety Code, is amended
123123 by adding Subchapter C to read as follows:
124124 SUBCHAPTER C. ABORTION REPORTING
125125 Sec. 171.051. ABORTION REPORTING FORM. (a) A physician who
126126 performs an abortion must submit a report by mail to the department
127127 on each abortion the physician performs. The report must be
128128 submitted on a form provided by the department.
129129 (b) The report may not identify the name of the patient by
130130 any means.
131131 (c) The abortion reporting form for each abortion must
132132 include the following information to be completed by the patient:
133133 (1) the patient's age, race or ethnicity, and marital
134134 status and municipality, county, state, and nation of residence;
135135 (2) the age of the father of the unborn child at the
136136 time of the abortion;
137137 (3) a space for the patient to indicate the specific
138138 reason the abortion was performed, including:
139139 (A) the mother feels coerced or forced to have
140140 the abortion;
141141 (B) the mother has all the children she wants;
142142 (C) the mother cannot afford the child;
143143 (D) the child has been diagnosed with one or more
144144 health problems that are documented in the medical records of the
145145 mother;
146146 (E) the father of the child opposes the
147147 pregnancy;
148148 (F) a parent of the mother of the unborn child
149149 opposes the pregnancy;
150150 (G) the mother fears a loss of family support;
151151 (H) the mother fears losing her job;
152152 (I) a school counselor recommends abortion;
153153 (J) a physician recommends abortion;
154154 (K) the pregnancy was a result of rape;
155155 (L) the pregnancy was a result of incest; or
156156 (M) the mother does not wish to complete this
157157 section;
158158 (4) the number of previous live births of the patient;
159159 (5) the number of previous induced abortions of the
160160 patient;
161161 (6) the number of previous miscarriages or spontaneous
162162 abortions of the patient;
163163 (7) the source of referral for the abortion,
164164 including:
165165 (A) a physician;
166166 (B) self;
167167 (C) a friend or family member;
168168 (D) a member of the clergy;
169169 (E) a school counselor;
170170 (F) a social services agency;
171171 (G) the Department of State Health Services;
172172 (H) a family planning agency; or
173173 (I) other (specify): ___________________; and
174174 (8) whether or not the woman availed herself of the
175175 opportunity to view the printed information required by Subchapter
176176 B, and, if so, whether the woman viewed the information described in
177177 Section 171.014, through the Internet or by booklet.
178178 (d) The abortion reporting form for each abortion must
179179 include the following information to be completed by the physician:
180180 (1) the name of the abortion facility at which the
181181 abortion was performed, the municipality and county in which the
182182 facility is located, and whether the facility:
183183 (A) is licensed as an abortion facility under
184184 Chapter 245;
185185 (B) is operating as the private office of a
186186 licensed physician;
187187 (C) is a licensed hospital;
188188 (D) is a licensed hospital satellite clinic; or
189189 (E) is a licensed ambulatory surgical center;
190190 (2) the license number, area of specialty, and
191191 signature of the physician who performed or induced the abortion;
192192 (3) a statement that the physician screened the
193193 patient for coercion in compliance with Section 171.019;
194194 (4) the type of abortion procedure, including:
195195 (A) nonsurgical abortion, specifying the
196196 medication or chemical used;
197197 (B) suction and curettage;
198198 (C) dilation and curettage;
199199 (D) dilation and evacuation;
200200 (E) labor and induction;
201201 (F) dilation and extraction;
202202 (G) hysterotomy or hysterectomy; or
203203 (H) other (specify): ________;
204204 (5) the date the abortion was performed;
205205 (6) whether the patient survived the abortion, and if
206206 the patient did not survive, the cause of death;
207207 (7) the number of fetuses the patient was carrying;
208208 (8) the number of weeks of gestation based on the best
209209 medical judgment of the attending physician at the time of the
210210 procedure and the weight of the fetus or fetuses, if determinable;
211211 (9) the method of pregnancy verification, including:
212212 (A) urine test;
213213 (B) clinical lab test;
214214 (C) ultrasound;
215215 (D) not tested; or
216216 (E) other (specify): ____________________;
217217 (10) whether the abortion was paid for by:
218218 (A) private insurance;
219219 (B) a public health plan; or
220220 (C) personal payment by patient;
221221 (11) whether there was no insurance coverage or
222222 insurance coverage was provided by:
223223 (A) a fee-for-service insurance company;
224224 (B) a managed care company; or
225225 (C) another source (specify): ________________;
226226 (12) the total fee collected for performing the
227227 abortion, including any services related to the abortion;
228228 (13) the type of anesthetic, if any, used for each
229229 abortion performed, and whether anesthetic was used for the woman,
230230 the unborn child or children, or both;
231231 (14) the method used to dispose of the fetal tissue and
232232 remains;
233233 (15) complications for each abortion, including:
234234 (A) none;
235235 (B) shock;
236236 (C) uterine perforation;
237237 (D) cervical laceration;
238238 (E) hemorrhage;
239239 (F) aspiration or allergic response;
240240 (G) infection or sepsis;
241241 (H) infant or infants born alive;
242242 (I) death of mother; or
243243 (J) other (specify): __________; and
244244 (16) if the infant or infants were born alive:
245245 (A) whether life-sustaining measures were
246246 provided to the infant or infants; and
247247 (B) the period of time the infant or infants
248248 survived.
249249 (e) If the patient is a minor, the report on each abortion
250250 must include:
251251 (1) whether the minor's parent, managing conservator,
252252 or legal guardian provided the written consent required by Section
253253 164.052(a)(19), Occupations Code, and, if so, whether the consent
254254 was given:
255255 (A) in person at the time of the abortion; or
256256 (B) at a place other than the location at which
257257 the abortion is performed or induced;
258258 (2) whether the physician concluded and documented in
259259 writing in the patient's medical record that on the basis of the
260260 physician's good faith clinical judgment a condition existed that
261261 complicated the medical condition of the pregnant minor and
262262 necessitated the immediate abortion of her pregnancy to avert her
263263 death or to avoid a serious risk of substantial impairment of a
264264 major bodily function and that there was insufficient time to
265265 obtain the consent of the minor's parent, managing conservator, or
266266 legal guardian;
267267 (3) whether the minor was emancipated and permitted to
268268 have the abortion without the written consent required by Section
269269 164.052(a)(19), Occupations Code;
270270 (4) whether judicial authorization was received,
271271 waiving the written consent required by Section 164.052(a)(19),
272272 Occupations Code; and
273273 (5) if judicial authorization was received, the
274274 process the physician or the physician's agent used to inform the
275275 minor of the judicial bypass, whether court forms were provided to
276276 her, and what entity made the court arrangement for the minor.
277277 (f) The patient must fill out sections of the form under
278278 Subsection (c). Sections to be filled out by the patient must be at
279279 the top of the form. The bottom portion of the reporting form must
280280 be completed by the physician performing the abortion. The
281281 requirement that the patient fill out the patient's portion of the
282282 form may be waived only if the abortion is performed to prevent the
283283 death of the mother or to avoid harm to a mother described by
284284 Section 164.052(a)(18), Occupations Code, or harm to a mother who
285285 is a minor described by Section 164.052(a)(19), Occupations Code.
286286 If the requirement that the patient fill out the patient's portion
287287 of the form is waived under this subsection, the physician
288288 performing the abortion shall include in the patient's medical
289289 records a signed written statement certifying the nature of the
290290 medical emergency.
291291 (g) A copy of the abortion reporting form must be maintained
292292 in the patient's medical file at least until the seventh
293293 anniversary of the date of the abortion. The patient must be given
294294 a copy of the completed abortion reporting form in person after the
295295 physician and patient complete the form.
296296 (h) The department shall provide the abortion reporting
297297 form required by this section, together with a copy of this section
298298 to:
299299 (1) a physician who becomes newly licensed to practice
300300 in this state, not later than the 30th day after the date the
301301 physician receives the license; and
302302 (2) all physicians licensed to practice in this state,
303303 not later than December 1 of each year.
304304 Sec. 171.052. ABORTION COMPLICATION REPORT. (a) A
305305 physician practicing in the state who treats an illness or injury
306306 related to complications from an abortion shall complete and submit
307307 an abortion complication report to the department. The report must
308308 be submitted by mail on the form provided by the department.
309309 (b) The department shall prepare an abortion complication
310310 report form for all physicians licensed and practicing in this
311311 state. A copy of this section must be attached to the form. The
312312 form must include:
313313 (1) the date and type of the original abortion,
314314 including:
315315 (A) nonsurgical abortion, specifying the
316316 medication or chemical used;
317317 (B) suction and curettage;
318318 (C) dilation and curettage;
319319 (D) dilation and evacuation;
320320 (E) labor and induction;
321321 (F) dilation and extraction;
322322 (G) hysterotomy or hysterectomy; or
323323 (H) other (specify): ______________;
324324 (2) the name and type of facility where the abortion
325325 complication was diagnosed and treated, including:
326326 (A) an abortion facility licensed under Chapter
327327 245;
328328 (B) a private office of a licensed physician;
329329 (C) a licensed hospital;
330330 (D) a licensed hospital satellite clinic; or
331331 (E) a licensed ambulatory surgical center;
332332 (3) the name and type of facility where the abortion
333333 was performed, if known;
334334 (4) the license number, area of specialty, and
335335 signature of the physician who treated the abortion complication;
336336 (5) the date on which the abortion complication was
337337 diagnosed and treated;
338338 (6) a description of the abortion complication,
339339 including:
340340 (A) none;
341341 (B) shock;
342342 (C) uterine perforation;
343343 (D) cervical laceration;
344344 (E) hemorrhage;
345345 (F) aspiration or allergic response;
346346 (G) infection or sepsis;
347347 (H) infant or infants born alive;
348348 (I) death of mother; or
349349 (J) other (specify): ________________;
350350 (7) the patient's age, race or ethnicity, and marital
351351 status and municipality, county, state, and nation of residence;
352352 (8) the number of weeks of gestation at which the
353353 abortion was performed based on the best medical judgment of the
354354 attending physician at the time of treatment for the abortion
355355 complication;
356356 (9) the number of previous live births of the patient;
357357 (10) the number of previous induced abortions for the
358358 patient;
359359 (11) the number of previous miscarriages or
360360 spontaneous abortions of the patient;
361361 (12) whether treatment for the abortion complication
362362 was paid for by:
363363 (A) private insurance;
364364 (B) a public health plan; or
365365 (C) personal payment by the patient;
366366 (13) the total fee collected for treatment for the
367367 abortion complication;
368368 (14) whether there was no insurance coverage or
369369 insurance coverage was provided by:
370370 (A) a fee-for-service insurance company;
371371 (B) a managed care company; or
372372 (C) another provider; and
373373 (15) the type of follow-up care recommended.
374374 (c) The department shall provide the abortion complication
375375 form required by this section, together with a copy of this section,
376376 to:
377377 (1) a physician who becomes newly licensed to practice
378378 in this state, not later than the 30th day after the date the
379379 physician receives the license; and
380380 (2) all physicians licensed to practice in this state,
381381 not later than December 1 of each year.
382382 (d) A copy of the abortion complication report form must be
383383 maintained in the patient's medical file until the seventh
384384 anniversary of the date the abortion complication was diagnosed and
385385 treated. The patient must receive a copy of the completed form in
386386 person before the patient leaves the facility.
387387 SECTION 5. Chapter 171, Health and Safety Code, is amended
388388 by adding Subchapter D to read as follows:
389389 SUBCHAPTER D. PROVISIONS RELATING TO REPORTS; PENALTIES
390390 Sec. 171.061. REPORTING REQUIREMENTS. (a) A physician
391391 performing an abortion shall complete and submit an abortion
392392 reporting form to the department for each abortion as required by
393393 Section 171.051 not later than the 15th day of each month for
394394 abortions performed in the previous calendar month.
395395 (b) A physician required to submit an abortion complication
396396 report to the department by Section 171.052 shall submit the report
397397 as soon as practicable after diagnosis or treatment of the abortion
398398 complication, but in no case more than seven days after the date of
399399 the diagnosis or treatment.
400400 (c) Not later than April 1 of each year, the department
401401 shall issue in aggregate a public report summarizing the
402402 information submitted on each individual report required by
403403 Sections 171.051 and 171.052. The public report shall cover the
404404 entire previous calendar year and shall be compiled from the data in
405405 all the abortion reporting forms and the abortion complication
406406 reports submitted to the department in accordance with Sections
407407 171.051 and 171.052. Each public report shall also provide
408408 information for all previous calendar years, adjusted to reflect
409409 any additional information from late or corrected reports. The
410410 department shall ensure that none of the information included in
411411 the public reports could reasonably lead to identification of any
412412 physician who performed an abortion or treated abortion-related
413413 complications or of any woman who has had an abortion.
414414 (d) Except as provided by Subsection (c) and Section
415415 245.023, all information and records held by the department under
416416 this subchapter and Subchapter C are confidential and are not open
417417 records for the purposes of Chapter 552, Government Code. That
418418 information may not be released or made public, except that release
419419 may be made:
420420 (1) for statistical purposes, but only if a person,
421421 patient, physician, or facility is not identified;
422422 (2) to medical personnel, appropriate state agencies,
423423 or county and district courts to enforce this chapter or Chapter
424424 245; or
425425 (3) to appropriate state licensing boards to enforce
426426 state licensing laws.
427427 (e) The department or an employee of the department may not
428428 disclose to a person or entity outside of the department the reports
429429 or contents of the reports required by this section and Sections
430430 171.051 and 171.052 in a manner or fashion that permits the person
431431 or entity to whom the form or report is disclosed to identify in any
432432 way a person who is the subject of the report.
433433 Sec. 171.062. PENALTIES. (a) A physician who does not
434434 submit a report required by Section 171.051 or 171.052 within 30
435435 days of the date the report was due is subject to a late fee of $500
436436 for each additional 30-day period or portion of a 30-day period the
437437 report is overdue.
438438 (b) A physician required to file a report by Section 171.051
439439 or 171.052 who has not submitted a complete report before the first
440440 anniversary of the date the report was due is subject to a late fee
441441 under Subsection (a) and, in an action brought by the department,
442442 may be directed by a court to submit a complete report within a
443443 period stated by court order or be subject to sanctions for civil
444444 contempt.
445445 Sec. 171.063. OFFENSE. (a) A physician commits an offense
446446 if a physician:
447447 (1) fails to submit a report required by this
448448 subchapter or Subchapter C;
449449 (2) intentionally, knowingly, or recklessly submits
450450 false information on a report required by this subchapter or
451451 Subchapter C;
452452 (3) includes the name or identifying information of
453453 the woman who had the abortion in a report required by this
454454 subchapter or Subchapter C; or
455455 (4) includes the name or identifying information of a
456456 physician in a public report required by Section 171.061(c).
457457 (b) A physician who discloses confidential identifying
458458 information in violation of Section 171.061(e) commits an offense.
459459 (c) A physician commits an offense if the physician performs
460460 an abortion and the physician reasonably believes that the abortion
461461 is the result of coercion, as defined by Section 1.07, Penal Code.
462462 (d) An offense under this section is a Class A misdemeanor.
463463 SECTION 6. Section 245.001, Health and Safety Code, is
464464 amended to read as follows:
465465 Sec. 245.001. SHORT TITLE. This chapter may be cited as the
466466 Texas Abortion Facility [Reporting and] Licensing Act.
467467 SECTION 7. Section 245.005(e), Health and Safety Code, is
468468 amended to read as follows:
469469 (e) As a condition for renewal of a license, the licensee
470470 must submit to the department the annual license renewal fee and an
471471 annual report[, including the report required under Section
472472 245.011].
473473 SECTION 8. Section 248.003, Health and Safety Code, is
474474 amended to read as follows:
475475 Sec. 248.003. EXEMPTIONS. This chapter does not apply to:
476476 (1) a home and community support services agency
477477 required to be licensed under Chapter 142;
478478 (2) a person required to be licensed under Chapter 241
479479 (Texas Hospital Licensing Law);
480480 (3) an institution required to be licensed under
481481 Chapter 242;
482482 (4) an ambulatory surgical center required to be
483483 licensed under Chapter 243 (Texas Ambulatory Surgical Center
484484 Licensing Act);
485485 (5) a birthing center required to be licensed under
486486 Chapter 244 (Texas Birthing Center Licensing Act);
487487 (6) a facility required to be licensed under Chapter
488488 245 (Texas Abortion Facility [Reporting and] Licensing Act);
489489 (7) a child care institution, foster group home,
490490 foster family home, and child-placing agency, for children in
491491 foster care or other residential care who are under the
492492 conservatorship of the Department of Protective and Regulatory
493493 Services; or
494494 (8) a person providing medical or nursing care or
495495 services under a license or permit issued under other state law.
496496 SECTION 9. Section 245.011, Health and Safety Code, is
497497 repealed.
498498 SECTION 10. (a) Not later than December 1, 2009, the
499499 Department of State Health Services shall develop and make
500500 available the forms required by Subchapter B, Chapter 171, Health
501501 and Safety Code, as amended by this Act, and Subchapter C, Chapter
502502 171, Health and Safety Code, as added by this Act, along with
503503 instructions for completing the forms.
504504 (b) Not later than January 1, 2010, the Department of State
505505 Health Services shall distribute forms as required by Sections
506506 171.022(a), 171.051(h), and 171.052(c), Health and Safety Code, as
507507 added by this Act.
508508 (c) A physician is not required to submit a report under
509509 Section 171.051 or 171.052, Health and Safety Code, as added by this
510510 Act, before January 1, 2010.
511511 (d) Section 171.063, Health and Safety Code, as added by
512512 this Act, applies only to an offense committed on or after January
513513 1, 2010. For purposes of this section, an offense is committed
514514 before January 1, 2010, if any element of the offense occurs before
515515 that date. An offense committed before January 1, 2010, is covered
516516 by the law in effect when the offense was committed, and the former
517517 law is continued in effect for that purpose.
518518 SECTION 11. (a) Except as provided by Subsection (b) of
519519 this section, this Act takes effect September 1, 2009.
520520 (b) Section 171.063, Health and Safety Code, as added by
521521 this Act, Section 245.005, Health and Safety Code, as amended by
522522 this Act, and the repeal of Section 245.011, Health and Safety Code,
523523 by this Act take effect January 1, 2010.