82R5347 SJM-D
By: Zedler H.B. No. 1602
A BILL TO BE ENTITLED
AN ACT
relating to reporting requirements regarding the provision of an
abortion or treatment for complications resulting from the
provision of an abortion; creating criminal offenses; providing
penalties.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Chapter 170, Health and Safety Code, is amended
by adding Section 170.003 to read as follows:
Sec. 170.003. COERCIVE ABORTION PROHIBITED; CRIMINAL
PENALTY. (a) A physician commits an offense if the physician:
(1) intentionally performs an abortion on a woman; and
(2) knows or should reasonably believe that the woman
is seeking the abortion as the result of coercion, as that term is
defined by Section 1.07, Penal Code.
(b) An offense under this section is a Class A misdemeanor.
SECTION 2. Chapter 171, Health and Safety Code, is amended
by adding Subchapter C to read as follows:
SUBCHAPTER C. REPORTING REQUIREMENTS
Sec. 171.021. LEGISLATIVE FINDINGS AND PURPOSE. (a) The
legislature finds that:
(1) an abortion, whether surgically or chemically
induced, terminates the life of a whole, separate, unique, living
human being;
(2) this state is currently prevented from providing
adequate legal remedies to protect the life, health, and welfare of
pregnant women and unborn human life because of the lack of accurate
and relevant statistical data concerning the practice of abortion
and the women seeking abortion services in this state; and
(3) there is a need for stricter requirements
regarding the content, accuracy, and consistency of reporting by
physicians who perform abortions in this state and stricter
enforcement of the reporting requirements.
(b) The purpose of this subchapter is to further the
important and compelling state interests in:
(1) protecting the life and health of a pregnant woman
seeking an elective abortion and, to the extent constitutionally
permissible, the life of the woman's unborn child;
(2) fostering the development of standards of
professional conduct in the provision of an abortion; and
(3) maintaining accurate statistical data to aid in
providing proper maternal health assistance, regulation, and
education.
Sec. 171.022. REPORTING REQUIREMENTS. (a) Not later than
the 15th day of each month, a physician by mail shall submit to the
department the abortion reporting form required by Section 171.023
for each abortion performed by the physician in the preceding
calendar month.
(b) As soon as practicable, but not later than 48 hours
after the time of diagnosis or treatment, a physician by mail shall
submit to the department the complications form required by Section
171.024 for each illness or injury in the preceding calendar year
that:
(1) the physician determines was caused by a medical
complication resulting from an abortion for which the physician
treated a woman; or
(2) a woman suspects was caused by a medical
complication resulting from an abortion for which the physician
treated the woman.
(c) The reports submitted to the department as required by
this subchapter may not by any means identify the name of a woman on
whom an abortion is performed.
Sec. 171.023. ABORTION REPORTING FORM; PARTIAL EXCEPTION.
(a) A physician shall report to the department on the form
prescribed by the department the information required by this
section for each abortion performed by the physician.
(b) The form must include:
(1) the following information, which must be completed
by the woman before anesthesia is administered or the abortion is
performed:
(A) the woman's:
(i) age;
(ii) race or ethnicity;
(iii) marital status; and
(iv) municipality, county, state, and
nation of residence;
(B) the woman's highest level of education,
selected by checking one of the following:
(i) did not receive any high school
education;
(ii) received some high school education
but did not graduate;
(iii) is a high school graduate or
recipient of a high school equivalency certificate;
(iv) received some college education but is
not a college graduate;
(v) obtained an associate's degree;
(vi) obtained a bachelor's degree;
(vii) obtained a master's degree;
(viii) obtained a doctoral degree; or
(ix) received other education (specify):
____________;
(C) the age of the father of the unborn child at
the time of the abortion;
(D) the method or methods of contraception used
at the time the unborn child was conceived, selected by checking all
applicable methods from the following list:
(i) condoms;
(ii) spermicide;
(iii) male sterilization;
(iv) female sterilization;
(v) an injectable contraceptive;
(vi) an inter-uterine device;
(vii) mini pills;
(viii) combination pills;
(ix) a diaphragm;
(x) a cervical cap or vaginal contraceptive
ring;
(xi) a contraceptive patch;
(xii) a sponge;
(xiii) a calendar-based contraceptive
method, including rhythm method or natural family planning or
fertility awareness;
(xiv) withdrawal;
(xv) no method of contraception; or
(xvi) other method (specify): ___________;
(E) a space for the woman to indicate the
specific reason the abortion is to be performed, selected from the
following list:
(i) the woman was coerced or forced to have
the abortion;
(ii) the woman does not want any more
children;
(iii) economic reasons;
(iv) the woman's unborn child has been
diagnosed with one or more health problems that are documented in
the woman's medical records;
(v) the father of the unborn child opposes
the pregnancy;
(vi) the woman's parent opposes the
pregnancy;
(vii) the woman fears a loss of family
support;
(viii) the woman fears losing her job;
(ix) a school counselor recommends
abortion;
(x) a physician recommends abortion;
(xi) the pregnancy is the result of rape;
(xii) the pregnancy is the result of
incest;
(xiii) the woman does not prefer the gender
of the unborn child; or
(xiv) the woman does not want to complete
this section;
(F) the number of the woman's previous live
births;
(G) the number of induced abortions the woman has
previously undergone;
(H) the number of miscarriages the woman has
previously experienced;
(I) the source of the woman's referral to the
physician for the abortion, selected from the following list:
(i) a physician;
(ii) the woman herself;
(iii) a friend or family member of the
woman;
(iv) a member of the clergy;
(v) a school counselor;
(vi) a social services agency;
(vii) the department;
(viii) a family planning clinic; or
(ix) other (specify): ________________;
(J) the method of payment for the abortion,
selected from the following list:
(i) private insurance;
(ii) a public health plan;
(iii) personal payment by cash; or
(iv) personal payment by check or credit
card; and
(K) whether the woman availed herself of the
opportunity to view the printed information required under
Subchapter B and, if so, whether the woman viewed the information
described by Section 171.014 in printed form or on the department's
Internet website; and
(2) the following information, which must be completed
by the physician:
(A) the name of the facility at which the
abortion was performed, the municipality and county in which the
facility is located, and the type of facility at which the abortion
was performed, selected from the following list:
(i) an abortion facility licensed under
Chapter 245;
(ii) a private office of a licensed
physician;
(iii) a licensed hospital;
(iv) a licensed hospital satellite clinic;
or
(v) an ambulatory surgical center licensed
under Chapter 243;
(B) the license number, area of specialty, and
signature of the physician who performed the abortion;
(C) a statement that the physician screened the
woman for coercion;
(D) the type of the abortion procedure performed,
selected from the following list:
(i) chemical abortion, specifying the
chemical used;
(ii) suction and curettage;
(iii) dilation and curettage;
(iv) dilation and evacuation;
(v) dilation and extraction;
(vi) labor and induction;
(vii) hysterotomy or hysterectomy; or
(viii) other (specify): ________________;
(E) the date the abortion was performed;
(F) whether the woman survived the abortion and,
if the woman did not survive, the cause of the woman's death;
(G) the number of fetuses aborted;
(H) the number of weeks of gestation at which the
abortion was performed, based on the best medical judgment of the
attending physician performing the procedure, and the weight of the
fetus or fetuses, if determinable;
(I) the method of pregnancy verification,
selected from the following list:
(i) urine test;
(ii) clinical laboratory test;
(iii) ultrasound;
(iv) not tested; or
(v) other (specify): ________________;
(J) the total fee collected from the patient by
the physician for performing the abortion, including any services
related to the abortion;
(K) whether the abortion procedure was:
(i) covered by fee-for-service insurance;
(ii) covered by a managed care benefit
plan;
(iii) covered by another type of health
benefit plan (specify): ________________; or
(iv) not covered by insurance or a health
benefit plan;
(L) the type of anesthetic, if any, used on the
woman during the abortion;
(M) the type of anesthetic, if any, used on the
unborn child or children during the abortion;
(N) the method used to dispose of fetal tissue
and remains;
(O) complications of the abortion, including:
(i) none;
(ii) shock;
(iii) uterine perforation;
(iv) cervical laceration;
(v) hemorrhage;
(vi) aspiration or allergic response;
(vii) infection or sepsis;
(viii) infant or infants born alive;
(ix) death of woman; or
(x) other (specify): ________________;
(P) if an infant was born alive during the
abortion:
(i) whether life-sustaining measures were
provided to the infant; and
(ii) the period of time the infant
survived; and
(Q) for each abortion performed on a woman who is
younger than 18 years of age:
(i) whether:
(a) the minor's parent, managing
conservator, or legal guardian provided the written consent
required by Section 164.052(a)(19), Occupations Code;
(b) the minor obtained judicial
authorization under Section 33.003 or 33.004, Family Code, for the
minor to consent to the abortion;
(c) the woman is emancipated and
permitted under law to have the abortion without the written
consent required by Section 164.052(a)(19), Occupations Code, or
judicial authorization; or
(d) the physician concluded and
documented in writing in the patient's medical record that on the
basis of the physician's good faith clinical judgment a condition
existed that complicated the medical condition of the pregnant
minor and necessitated the immediate abortion of her pregnancy to
avert her death or to avoid a serious risk of substantial impairment
of a major bodily function and that there was insufficient time to
obtain the consent of the minor's parent, managing conservator, or
legal guardian;
(ii) if the minor's parent, managing
conservator, or legal guardian gave written consent, whether the
consent was given:
(a) in person at the time of the
abortion; or
(b) at a place other than the location
where the abortion was performed; and
(iii) if the minor obtained judicial
authorization:
(a) the process the physician or
physician's agent used to inform the minor of the availability of
judicial bypass as an alternative to the written consent required
by Section 164.052(a)(19), Occupations Code;
(b) whether court forms were provided
to the minor; and
(c) who made arrangements for the
minor for the court appearance.
(c) The information required by Subsection (b)(1) must be at
the top of the form. The information required by Subsection (b)(2)
must be at the bottom of the form.
(d) A woman is required to complete the information required
by Subsection (b)(1) unless the abortion is necessary to:
(1) prevent the woman's death or to avoid harm to the
woman, as described by Section 164.052(a)(18), Occupations Code; or
(2) avert the death of or to avoid harm to a woman who
is a minor, as described by Section 164.052(a)(19), Occupations
Code.
(e) If the woman does not complete the required information,
the physician who performs the abortion shall include in the
woman's medical file a signed written statement certifying the
nature of the medical emergency described by Subsection (d).
(f) A physician shall maintain a copy of each completed form
in the woman's medical file until the later of:
(1) the seventh anniversary of the date on which the
form was signed; or
(2) the woman's 20th birthday.
(g) A physician or the physician's agent shall provide to
each woman required to complete a form under this section a copy of
the completed form before the woman leaves the facility where the
abortion was performed.
(h) The department shall provide a copy of the abortion
reporting form:
(1) to each physician licensed to practice in this
state not later than December 1 of each year; and
(2) to each physician newly licensed to practice in
this state not later than the 30th day after the date the physician
receives that license.
(i) The form prescribed by this section must comply with the
requirements of Section 171.014(b)(1).
Sec. 171.024. COMPLICATION REPORTING FORM. (a) A
physician shall report to the department on the form prescribed by
the department the information required by this section on the
physician's treatment of an illness or injury related to a medical
complication resulting from the performance of an abortion.
(b) The form must include the following information to be
completed by the physician providing the treatment:
(1) the date of the abortion that caused or may have
caused the complication;
(2) the type of abortion that caused or may have caused
the complication, selected from the following list:
(A) chemical abortion, specifying the chemical
used;
(B) suction and curettage;
(C) dilation and curettage;
(D) dilation and evacuation;
(E) dilation and extraction;
(F) labor and induction;
(G) hysterotomy or hysterectomy; or
(H) other (specify): ________________;
(3) the name and type of the facility where the
abortion complication was diagnosed and treated, selected from the
following list:
(A) an abortion facility licensed under Chapter
245;
(B) a private office of a licensed physician;
(C) a licensed hospital;
(D) a licensed hospital satellite clinic; or
(E) an ambulatory surgical center licensed under
Chapter 243;
(4) the name and type of the facility where the
abortion was provided, if known;
(5) the license number, area of specialty, and
signature of the physician who treated the abortion complication;
(6) the date on which the abortion complication was
treated;
(7) a description of the complication or
complications, selected from the following list:
(A) none;
(B) shock;
(C) uterine perforation;
(D) cervical laceration;
(E) hemorrhage;
(F) aspiration or allergic response;
(G) infection or sepsis;
(H) infant or infants born alive;
(I) death of woman; or
(J) other (specify): ________________;
(8) the number of weeks of gestation at which the
abortion was performed, based on the best medical judgment of the
attending physician at the time of the treatment for the
complication;
(9) the number of the woman's previous live births;
(10) the number of previous induced abortions the
woman has undergone;
(11) the number of miscarriages the woman has
previously experienced;
(12) whether the treatment for the complication was
paid for by:
(A) private insurance;
(B) a public health plan;
(C) personal payment by cash; or
(D) personal payment by check or credit card;
(13) the total fee collected by the physician for
treatment of the complication;
(14) whether the treatment for the complication was:
(A) covered by fee-for-service insurance;
(B) covered by a managed care benefit plan;
(C) covered by another type of health benefit
plan (specify): ________________; or
(D) not covered by insurance or a health benefit
plan; and
(15) the type of follow-up care recommended by the
physician after the physician provides treatment for the
complication.
(c) A physician shall maintain a copy of each completed form
in the woman's medical file until the later of:
(1) the seventh anniversary of the date on which the
form was signed; or
(2) the woman's 20th birthday.
(d) A physician or the physician's agent shall provide to
each woman for whom a form is completed under this section a copy of
the completed form before the woman leaves the facility where the
treatment was received.
(e) The department shall provide a copy of the complication
form:
(1) to each physician licensed to practice in this
state not later than December 1 of each year; and
(2) to each physician newly licensed to practice in
this state not later than the 30th day after the physician receives
that license.
(f) The form prescribed by this section must comply with the
requirements of Section 171.014(b)(1).
Sec. 171.025. CONFIDENTIAL INFORMATION. (a) Except as
provided by Section 171.028 and Subsection (b), all information
received or maintained by the department under this subchapter is
confidential and is not subject to disclosure under Chapter 552,
Government Code.
(b) A department employee may disclose information
described by Subsection (a):
(1) for statistical purposes, but only if a person or
facility is not identified;
(2) to a medical professional, a state agency, or a
county or district court for purposes of enforcing this chapter or
Chapter 245; or
(3) to a state licensing board for purposes of
enforcing state licensing laws.
Sec. 171.026. PENALTIES. (a) The commissioner of state
health services may assess an administrative penalty against a
physician who fails to submit a report within the time required by
Section 171.022 in the amount of $500 for each 30-day period or
portion of a 30-day period the report remains overdue.
(b) The commissioner may bring an action against a physician
who fails to file a report required under Section 171.022 before the
first anniversary of the date the report was due to compel the
physician to submit a complete report within a time stated by the
court order or be subject to sanctions for civil contempt.
Sec. 171.027. OFFENSE; CRIMINAL PENALTY. (a) A physician
commits an offense if the physician:
(1) fails to submit a report required by this
subchapter;
(2) intentionally, knowingly, or recklessly submits
false information in a report required by this subchapter;
(3) includes in a report required by this subchapter
the name or identifying information of a woman on whom the physician
performed an abortion; or
(4) discloses confidential identifying information in
violation of Section 171.025.
(b) An offense under this section is a Class A misdemeanor.
Sec. 171.028. PUBLIC REPORT BY DEPARTMENT. (a) Not later
than April 1 of each year, the department, in a form accessible by
the public, shall issue a report that summarizes the information
reported under Section 171.022 during the preceding calendar year.
(b) Each report must include data from the reports issued
under this section in previous years, including updated or
corrected information for those reports.
(c) The department shall ensure that a report issued under
this section does not contain any information that could reasonably
lead to the identification of:
(1) a woman on whom an abortion was performed or who
received treatment for a complication resulting from an abortion;
or
(2) a physician who performed an abortion or treated a
complication resulting from an abortion.
SECTION 3. Section 245.001, Health and Safety Code, is
amended to read as follows:
Sec. 245.001. SHORT TITLE. This chapter may be cited as the
Texas Abortion Facility [Reporting and] Licensing Act.
SECTION 4. Section 245.005(e), Health and Safety Code, is
amended to read as follows:
(e) As a condition for renewal of a license, the licensee
must submit to the department the annual license renewal fee and an
annual report[, including the report required under Section
245.011].
SECTION 5. Section 248.003, Health and Safety Code, is
amended to read as follows:
Sec. 248.003. EXEMPTIONS. This chapter does not apply to:
(1) a home and community support services agency
required to be licensed under Chapter 142;
(2) a person required to be licensed under Chapter 241
(Texas Hospital Licensing Law);
(3) an institution required to be licensed under
Chapter 242;
(4) an ambulatory surgical center required to be
licensed under Chapter 243 (Texas Ambulatory Surgical Center
Licensing Act);
(5) a birthing center required to be licensed under
Chapter 244 (Texas Birthing Center Licensing Act);
(6) a facility required to be licensed under Chapter
245 (Texas Abortion Facility [Reporting and] Licensing Act);
(7) a child care institution, foster group home,
foster family home, and child-placing agency, for children in
foster care or other residential care who are under the
conservatorship of the Department of Family and Protective [and
Regulatory] Services; or
(8) a person providing medical or nursing care or
services under a license or permit issued under other state law.
SECTION 6. Effective January 1, 2012, Section 245.011,
Health and Safety Code, is repealed.
SECTION 7. (a) Not later than December 1, 2011, the
Department of State Health Services shall develop the forms
required by Sections 171.023 and 171.024, Health and Safety Code,
as added by this Act.
(b) Not later than January 1, 2012, the Department of State
Health Services shall distribute the forms required by Sections
171.023 and 171.024, Health and Safety Code, as added by this Act.
(c) Notwithstanding Section 171.022, Health and Safety
Code, as added by this Act, a physician is not required to submit a
report required by Section 171.022, Health and Safety Code, as
added by this Act, before January 1, 2012.
SECTION 8. Not later than April 1, 2013, the Department of
State Health Services shall issue the initial report required by
Section 171.028, Health and Safety Code, as added by this Act.
SECTION 9. (a) Except as otherwise provided by this Act,
this Act takes effect September 1, 2011.
(b) Sections 170.003 and 171.027, Health and Safety Code, as
added by this Act, and Sections 245.001, 245.005, and 248.003,
Health and Safety Code, as amended by this Act, take effect January
1, 2012.