Texas 2013 - 83rd 1st C.S.

Texas House Bill HB60 Compare Versions

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1	1	83S10724 JSC-D
2	2	By: Laubenberg, Burkett, Harper-Brown, H.B. No. 60
3	3	Bonnen of Galveston, King of Parker,
4	4	et al.
5	5	Substitute the following for H.B.
6	6
7	7
8	8	A BILL TO BE ENTITLED
9	9	AN ACT
10	10	relating to the regulation of abortion procedures, providers, and
11	11	facilities; providing penalties.
12	12	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
13	13	SECTION 1. (a) The findings indicate that:
14	14	(1) substantial medical evidence recognizes that an
15	15	unborn child is capable of experiencing pain by not later than 20
16	16	weeks after fertilization;
17	17	(2) the state has a compelling state interest in
18	18	protecting the lives of unborn children from the stage at which
19	19	substantial medical evidence indicates that these children are
20	20	capable of feeling pain;
21	21	(3) the compelling state interest in protecting the
22	22	lives of unborn children from the stage at which substantial
23	23	medical evidence indicates that an unborn child is capable of
24	24	feeling pain is intended to be separate from and independent of the
25	25	compelling state interest in protecting the lives of unborn
26	26	children from the stage of viability, and neither state interest is
27	27	intended to replace the other; and
28	28	(4) restricting elective abortions at or later than 20
29	29	weeks post-fertilization, as provided by this Act, does not impose
30	30	an undue burden or a substantial obstacle on a woman's ability to
31	31	have an abortion because:
32	32	(A) the woman has adequate time to decide whether
33	33	to have an abortion in the first 20 weeks after fertilization; and
34	34	(B) this Act does not apply to abortions that are
35	35	necessary to avert the death or substantial and irreversible
36	36	physical impairment of a major bodily function of the pregnant
37	37	woman.
38	38	(b) The legislature intends that every application of this
39	39	statute to every individual woman shall be severable from each
40	40	other. In the unexpected event that the application of this statute
41	41	is found to impose an impermissible undue burden on any pregnant
42	42	woman or group of pregnant women, the application of the statute to
43	43	those women shall be severed from the remaining applications of the
44	44	statute that do not impose an undue burden, and those remaining
45	45	applications shall remain in force and unaffected, consistent with
46	46	Section 10 of this Act.
47	47	SECTION 2. Subchapter A, Chapter 171, Health and Safety
48	48	Code, is amended by adding Section 171.0031 to read as follows:
49	49	Sec. 171.0031. REQUIREMENTS OF PHYSICIAN; OFFENSE. (a) A
50	50	physician performing or inducing an abortion:
51	51	(1) must, on the date the abortion is performed, have
52	52	active admitting privileges at a hospital that:
53	53	(A) is located not further than 30 miles from the
54	54	location at which the abortion is performed or induced; and
55	55	(B) provides obstetrical or gynecological health
56	56	care services; and
57	57	(2) shall provide the pregnant woman with:
58	58	(A) a telephone number by which the pregnant
59	59	woman may reach the physician, or other health care personnel
60	60	employed by the physician or by the facility at which the abortion
61	61	was performed with access to the woman's relevant medical records,
62	62	24 hours a day to request assistance for any complications that
63	63	arise from the performance of the abortion or ask health-related
64	64	questions regarding the abortion; and
65	65	(B) the name and telephone number of the nearest
66	66	hospital to the home of the pregnant woman at which an emergency
67	67	arising from the abortion would be treated.
68	68	(b) A physician who violates Subsection (a) commits an
69	69	offense. An offense under this section is a Class A misdemeanor
70	70	punishable by a fine only, not to exceed $4,000.
71	71	SECTION 3. Chapter 171, Health and Safety Code, is amended
72	72	by adding Subchapters C and D to read as follows:
73	73	SUBCHAPTER C. ABORTION PROHIBITED AT OR AFTER 20 WEEKS
74	74	POST-FERTILIZATION
75	75	Sec. 171.041. SHORT TITLE. This subchapter may be cited as
76	76	the Preborn Pain Act.
77	77	Sec. 171.042. DEFINITIONS. In this subchapter:
78	78	(1) "Post-fertilization age" means the age of the
79	79	unborn child as calculated from the fusion of a human spermatozoon
80	80	with a human ovum.
81	81	(2) "Severe fetal abnormality" has the meaning
82	82	assigned by Section 285.202.
83	83	Sec. 171.043. DETERMINATION OF POST-FERTILIZATION AGE
84	84	REQUIRED. Except as otherwise provided by Section 171.046, a
85	85	physician may not perform or induce or attempt to perform or induce
86	86	an abortion without, prior to the procedure:
87	87	(1) making a determination of the probable
88	88	post-fertilization age of the unborn child; or
89	89	(2) possessing and relying on a determination of the
90	90	probable post-fertilization age of the unborn child made by another
91	91	physician.
92	92	Sec. 171.044. ABORTION OF UNBORN CHILD OF 20 OR MORE WEEKS
93	93	POST-FERTILIZATION AGE PROHIBITED. Except as otherwise provided by
94	94	Section 171.046, a person may not perform or induce or attempt to
95	95	perform or induce an abortion on a woman if it has been determined,
96	96	by the physician performing, inducing, or attempting to perform or
97	97	induce the abortion or by another physician on whose determination
98	98	that physician relies, that the probable post-fertilization age of
99	99	the unborn child is 20 or more weeks.
100	100	Sec. 171.045. METHOD OF ABORTION. (a) This section
101	101	applies only to an abortion authorized under Section 171.046(a)(1)
102	102	or (2) in which:
103	103	(1) the probable post-fertilization age of the unborn
104	104	child is 20 or more weeks; or
105	105	(2) the probable post-fertilization age of the unborn
106	106	child has not been determined but could reasonably be 20 or more
107	107	weeks.
108	108	(b) Except as otherwise provided by Section 171.046(a)(3),
109	109	a physician performing an abortion under Subsection (a) shall
110	110	terminate the pregnancy in the manner that, in the physician's
111	111	reasonable medical judgment, provides the best opportunity for the
112	112	unborn child to survive.
113	113	Sec. 171.046. EXCEPTIONS. (a) The prohibitions and
114	114	requirements under Sections 171.043, 171.044, and 171.045(b) do not
115	115	apply to an abortion performed if there exists a condition that, in
116	116	the physician's reasonable medical judgment, so complicates the
117	117	medical condition of the woman that, to avert the woman's death or a
118	118	serious risk of substantial and irreversible physical impairment of
119	119	a major bodily function, other than a psychological condition, it
120	120	necessitates, as applicable:
121	121	(1) the immediate abortion of her pregnancy without
122	122	the delay necessary to determine the probable post-fertilization
123	123	age of the unborn child;
124	124	(2) the abortion of her pregnancy even though the
125	125	post-fertilization age of the unborn child is 20 or more weeks; or
126	126	(3) the use of a method of abortion other than a method
127	127	described by Section 171.045(b).
128	128	(b) A physician may not take an action authorized under
129	129	Subsection (a) if the risk of death or a substantial and
130	130	irreversible physical impairment of a major bodily function arises
131	131	from a claim or diagnosis that the woman will engage in conduct that
132	132	may result in her death or in substantial and irreversible physical
133	133	impairment of a major bodily function.
134	134	(c) The prohibitions and requirements under Sections
135	135	171.043, 171.044, and 171.045(b) do not apply to an abortion
136	136	performed on an unborn child who has a severe fetal abnormality.
137	137	Sec. 171.047. PROTECTION OF PRIVACY IN COURT PROCEEDINGS.
138	138	(a) Except as otherwise provided by this section, in a civil or
139	139	criminal proceeding or action involving an act prohibited under
140	140	this subchapter, the identity of the woman on whom an abortion has
141	141	been performed or induced or attempted to be performed or induced is
142	142	not subject to public disclosure if the woman does not give consent
143	143	to disclosure.
144	144	(b) Unless the court makes a ruling under Subsection (c) to
145	145	allow disclosure of the woman's identity, the court shall issue
146	146	orders to the parties, witnesses, and counsel and shall direct the
147	147	sealing of the record and exclusion of individuals from courtrooms
148	148	or hearing rooms to the extent necessary to protect the woman's
149	149	identity from public disclosure.
150	150	(c) A court may order the disclosure of information that is
151	151	confidential under this section if:
152	152	(1) a motion is filed with the court requesting
153	153	release of the information and a hearing on that request;
154	154	(2) notice of the hearing is served on each interested
155	155	party; and
156	156	(3) the court determines after the hearing and an in
157	157	camera review that disclosure is essential to the administration of
158	158	justice and there is no reasonable alternative to disclosure.
159	159	Sec. 171.048. CONSTRUCTION OF SUBCHAPTER. (a) This
160	160	subchapter shall be construed, as a matter of state law, to be
161	161	enforceable up to but no further than the maximum possible extent
162	162	consistent with federal constitutional requirements, even if that
163	163	construction is not readily apparent, as such constructions are
164	164	authorized only to the extent necessary to save the subchapter from
165	165	judicial invalidation. Judicial reformation of statutory language
166	166	is explicitly authorized only to the extent necessary to save the
167	167	statutory provision from invalidity.
168	168	(b) If any court determines that a provision of this
169	169	subchapter is unconstitutionally vague, the court shall interpret
170	170	the provision, as a matter of state law, to avoid the vagueness
171	171	problem and shall enforce the provision to the maximum possible
172	172	extent. If a federal court finds any provision of this subchapter
173	173	or its application to any person, group of persons, or
174	174	circumstances to be unconstitutionally vague and declines to impose
175	175	the saving construction described by this subsection, the Supreme
176	176	Court of Texas shall provide an authoritative construction of the
177	177	objectionable statutory provisions that avoids the constitutional
178	178	problems while enforcing the statute's restrictions to the maximum
179	179	possible extent, and shall agree to answer any question certified
180	180	from a federal appellate court regarding the statute.
181	181	(c) A state executive or administrative official may not
182	182	decline to enforce this subchapter, or adopt a construction of this
183	183	subchapter in a way that narrows its applicability, based on the
184	184	official's own beliefs about what the state or federal constitution
185	185	requires, unless the official is enjoined by a state or federal
186	186	court from enforcing this subchapter.
187	187	(d) This subchapter may not be construed to authorize the
188	188	prosecution of or a cause of action to be brought against a woman on
189	189	whom an abortion is performed or induced or attempted to be
190	190	performed or induced in violation of this subchapter.
191	191	SUBCHAPTER D. ABORTION-INDUCING DRUGS
192	192	Sec. 171.061. DEFINITIONS. In this subchapter:
193	193	(1) "Abortion" means the act of using, administering,
194	194	prescribing, or otherwise providing an instrument, a drug, a
195	195	medicine, or any other substance, device, or means with the intent
196	196	to terminate a clinically diagnosable pregnancy of a woman and with
197	197	knowledge that the termination by those means will, with reasonable
198	198	likelihood, cause the death of the woman's unborn child. An act is
199	199	not an abortion if the act is done with the intent to:
200	200	(A) save the life or preserve the health of an
201	201	unborn child;
202	202	(B) remove a dead, unborn child whose death was
203	203	caused by spontaneous abortion;
204	204	(C) remove an ectopic pregnancy; or
205	205	(D) treat a maternal disease or illness for which
206	206	a prescribed drug, medicine, or other substance is indicated.
207	207	(2) "Abortion-inducing drug" means a drug, a medicine,
208	208	or any other substance, including a regimen of two or more drugs,
209	209	medicines, or substances, prescribed, dispensed, or administered
210	210	with the intent of terminating a clinically diagnosable pregnancy
211	211	of a woman and with knowledge that the termination will, with
212	212	reasonable likelihood, cause the death of the woman's unborn child.
213	213	The term includes off-label use of drugs, medicines, or other
214	214	substances known to have abortion-inducing properties that are
215	215	prescribed, dispensed, or administered with the intent of causing
216	216	an abortion, including the Mifeprex regimen. The term does not
217	217	include a drug, medicine, or other substance that may be known to
218	218	cause an abortion but is prescribed, dispensed, or administered for
219	219	other medical reasons.
220	220	(3) "Final printed label" or "FPL" means the
221	221	informational document approved by the United States Food and Drug
222	222	Administration for an abortion-inducing drug that:
223	223	(A) outlines the protocol authorized by that
224	224	agency and agreed to by the drug company applying for authorization
225	225	of the drug by that agency; and
226	226	(B) delineates how a drug is to be used according
227	227	to approval by that agency.
228	228	(4) "Gestational age" means the amount of time that
229	229	has elapsed since the first day of a woman's last menstrual period.
230	230	(5) "Medical abortion" means the administration or use
231	231	of an abortion-inducing drug to induce an abortion.
232	232	(6) "Mifeprex regimen," "RU-486 regimen," or "RU-486"
233	233	means the abortion-inducing drug regimen approved by the United
234	234	States Food and Drug Administration that consists of administering
235	235	mifepristone and misoprostol.
236	236	(7) "Physician" means an individual who is licensed to
237	237	practice medicine in this state, including a medical doctor and a
238	238	doctor of osteopathic medicine.
239	239	(8) "Pregnant" means the female reproductive
240	240	condition of having an unborn child in a woman's uterus.
241	241	(9) "Unborn child" means an offspring of human beings
242	242	from conception until birth.
243	243	Sec. 171.062. ENFORCEMENT BY TEXAS MEDICAL BOARD.
244	244	Notwithstanding Section 171.005, the Texas Medical Board shall
245	245	enforce this subchapter.
246	246	Sec. 171.063. DISTRIBUTION OF ABORTION-INDUCING DRUG.
247	247	(a) A person may not knowingly give, sell, dispense, administer,
248	248	provide, or prescribe an abortion-inducing drug to a pregnant woman
249	249	for the purpose of inducing an abortion in the pregnant woman or
250	250	enabling another person to induce an abortion in the pregnant woman
251	251	unless:
252	252	(1) the person who gives, sells, dispenses,
253	253	administers, provides, or prescribes the abortion-inducing drug is
254	254	a physician; and
255	255	(2) except as otherwise provided by Subsection (a-1),
256	256	the provision, prescription, or administration of the
257	257	abortion-inducing drug satisfies the protocol tested and
258	258	authorized by the United States Food and Drug Administration as
259	259	outlined in the final printed label of the abortion-inducing drug.
260	260	(a-1) A person may provide, prescribe, or administer the
261	261	abortion-inducing drug in the dosage amount prescribed by the
262	262	clinical management guidelines defined by the American Congress of
263	263	Obstetricians and Gynecologists Practice Bulletin as those
264	264	guidelines existed on January 1, 2013.
265	265	(b) Before the physician gives, sells, dispenses,
266	266	administers, provides, or prescribes an abortion-inducing drug,
267	267	the physician must examine the pregnant woman and document, in the
268	268	woman's medical record, the gestational age and intrauterine
269	269	location of the pregnancy.
270	270	(c) The physician who gives, sells, dispenses, administers,
271	271	provides, or prescribes an abortion-inducing drug shall provide the
272	272	pregnant woman with:
273	273	(1) a copy of the final printed label of that
274	274	abortion-inducing drug; and
275	275	(2) a telephone number by which the pregnant woman may
276	276	reach the physician, or other health care personnel employed by the
277	277	physician or by the facility at which the abortion was performed
278	278	with access to the woman's relevant medical records, 24 hours a day
279	279	to request assistance for any complications that arise from the
280	280	administration or use of the drug or ask health-related questions
281	281	regarding the administration or use of the drug.
282	282	(d) The physician who gives, sells, dispenses, administers,
283	283	provides, or prescribes the abortion-inducing drug, or the
284	284	physician's agent, must schedule a follow-up visit for the woman to
285	285	occur not more than 14 days after the administration or use of the
286	286	drug. At the follow-up visit, the physician must:
287	287	(1) confirm that the pregnancy is completely
288	288	terminated; and
289	289	(2) assess the degree of bleeding.
290	290	(e) The physician who gives, sells, dispenses, administers,
291	291	provides, or prescribes the abortion-inducing drug, or the
292	292	physician's agent, shall make a reasonable effort to ensure that
293	293	the woman returns for the scheduled follow-up visit under
294	294	Subsection (d). The physician or the physician's agent shall
295	295	document a brief description of any effort made to comply with this
296	296	subsection, including the date, time, and name of the person making
297	297	the effort, in the woman's medical record.
298	298	(f) If a physician gives, sells, dispenses, administers,
299	299	provides, or prescribes an abortion-inducing drug to a pregnant
300	300	woman for the purpose of inducing an abortion as authorized by this
301	301	section and the physician knows that the woman experiences a
302	302	serious adverse event, as defined by the MedWatch Reporting System,
303	303	during or after the administration or use of the drug, the physician
304	304	shall report the event to the United States Food and Drug
305	305	Administration through the MedWatch Reporting System not later than
306	306	the third day after the date the physician learns that the event
307	307	occurred.
308	308	Sec. 171.064. ADMINISTRATIVE PENALTY. (a) The Texas
309	309	Medical Board may take disciplinary action under Chapter 164,
310	310	Occupations Code, or assess an administrative penalty under
311	311	Subchapter A, Chapter 165, Occupations Code, against a person who
312	312	violates Section 171.063.
313	313	(b) A penalty may not be assessed under this section against
314	314	a pregnant woman who receives a medical abortion.
315	315	SECTION 4. Section 245.010(a), Health and Safety Code, is
316	316	amended to read as follows:
317	317	(a) The rules must contain minimum standards to protect the
318	318	health and safety of a patient of an abortion facility and must
319	319	contain provisions requiring compliance with the requirements of
320	320	Subchapter B, Chapter 171. On and after September 1, 2014, the
321	321	minimum standards for an abortion facility must be equivalent to
322	322	the minimum standards adopted under Section 243.010 for ambulatory
323	323	surgical centers.
324	324	SECTION 5. Section 245.011(c), Health and Safety Code, is
325	325	amended to read as follows:
326	326	(c) The report must include:
327	327	(1) whether the abortion facility at which the
328	328	abortion is performed is licensed under this chapter;
329	329	(2) the patient's year of birth, race, marital status,
330	330	and state and county of residence;
331	331	(3) the type of abortion procedure;
332	332	(4) the date the abortion was performed;
333	333	(5) whether the patient survived the abortion, and if
334	334	the patient did not survive, the cause of death;
335	335	(6) the probable post-fertilization age of the unborn
336	336	child [period of gestation] based on the best medical judgment of
337	337	the attending physician at the time of the procedure;
338	338	(7) the date, if known, of the patient's last menstrual
339	339	cycle;
340	340	(8) the number of previous live births of the patient;
341	341	and
342	342	(9) the number of previous induced abortions of the
343	343	patient.
344	344	SECTION 6. Section 164.052(a), Occupations Code, is amended
345	345	to read as follows:
346	346	(a) A physician or an applicant for a license to practice
347	347	medicine commits a prohibited practice if that person:
348	348	(1) submits to the board a false or misleading
349	349	statement, document, or certificate in an application for a
350	350	license;
351	351	(2) presents to the board a license, certificate, or
352	352	diploma that was illegally or fraudulently obtained;
353	353	(3) commits fraud or deception in taking or passing an
354	354	examination;
355	355	(4) uses alcohol or drugs in an intemperate manner
356	356	that, in the board's opinion, could endanger a patient's life;
357	357	(5) commits unprofessional or dishonorable conduct
358	358	that is likely to deceive or defraud the public, as provided by
359	359	Section 164.053, or injure the public;
360	360	(6) uses an advertising statement that is false,
361	361	misleading, or deceptive;
362	362	(7) advertises professional superiority or the
363	363	performance of professional service in a superior manner if that
364	364	advertising is not readily subject to verification;
365	365	(8) purchases, sells, barters, or uses, or offers to
366	366	purchase, sell, barter, or use, a medical degree, license,
367	367	certificate, or diploma, or a transcript of a license, certificate,
368	368	or diploma in or incident to an application to the board for a
369	369	license to practice medicine;
370	370	(9) alters, with fraudulent intent, a medical license,
371	371	certificate, or diploma, or a transcript of a medical license,
372	372	certificate, or diploma;
373	373	(10) uses a medical license, certificate, or diploma,
374	374	or a transcript of a medical license, certificate, or diploma that
375	375	has been:
376	376	(A) fraudulently purchased or issued;
377	377	(B) counterfeited; or
378	378	(C) materially altered;
379	379	(11) impersonates or acts as proxy for another person
380	380	in an examination required by this subtitle for a medical license;
381	381	(12) engages in conduct that subverts or attempts to
382	382	subvert an examination process required by this subtitle for a
383	383	medical license;
384	384	(13) impersonates a physician or permits another to
385	385	use the person's license or certificate to practice medicine in
386	386	this state;
387	387	(14) directly or indirectly employs a person whose
388	388	license to practice medicine has been suspended, canceled, or
389	389	revoked;
390	390	(15) associates in the practice of medicine with a
391	391	person:
392	392	(A) whose license to practice medicine has been
393	393	suspended, canceled, or revoked; or
394	394	(B) who has been convicted of the unlawful
395	395	practice of medicine in this state or elsewhere;
396	396	(16) performs or procures a criminal abortion, aids or
397	397	abets in the procuring of a criminal abortion, attempts to perform
398	398	or procure a criminal abortion, or attempts to aid or abet the
399	399	performance or procurement of a criminal abortion;
400	400	(17) directly or indirectly aids or abets the practice
401	401	of medicine by a person, partnership, association, or corporation
402	402	that is not licensed to practice medicine by the board;
403	403	(18) performs an abortion on a woman who is pregnant
404	404	with a viable unborn child during the third trimester of the
405	405	pregnancy unless:
406	406	(A) the abortion is necessary to prevent the
407	407	death of the woman;
408	408	(B) the viable unborn child has a severe,
409	409	irreversible brain impairment; or
410	410	(C) the woman is diagnosed with a significant
411	411	likelihood of suffering imminent severe, irreversible brain damage
412	412	or imminent severe, irreversible paralysis; [or]
413	413	(19) performs an abortion on an unemancipated minor
414	414	without the written consent of the child's parent, managing
415	415	conservator, or legal guardian or without a court order, as
416	416	provided by Section 33.003 or 33.004, Family Code, authorizing the
417	417	minor to consent to the abortion, unless the physician concludes
418	418	that on the basis of the physician's good faith clinical judgment, a
419	419	condition exists that complicates the medical condition of the
420	420	pregnant minor and necessitates the immediate abortion of her
421	421	pregnancy to avert her death or to avoid a serious risk of
422	422	substantial impairment of a major bodily function and that there is
423	423	insufficient time to obtain the consent of the child's parent,
424	424	managing conservator, or legal guardian; or
425	425	(20) performs or induces or attempts to perform or
426	426	induce an abortion in violation of Subchapter C, Chapter 171,
427	427	Health and Safety Code.
428	428	SECTION 7. Section 164.055(b), Occupations Code, is amended
429	429	to read as follows:
430	430	(b) The sanctions provided by Subsection (a) are in addition
431	431	to any other grounds for refusal to admit persons to examination
432	432	under this subtitle or to issue a license or renew a license to
433	433	practice medicine under this subtitle. The criminal penalties
434	434	provided by Section 165.152 do not apply to a violation of Section
435	435	170.002 or Subchapter C, Chapter 171, Health and Safety Code.
436	436	SECTION 8. Effective September 1, 2014, Section 245.010(c),
437	437	Health and Safety Code, is repealed.
438	438	SECTION 9. This Act may not be construed to repeal, by
439	439	implication or otherwise, Section 164.052(a)(18), Occupations
440	440	Code, Section 170.002, Health and Safety Code, or any other
441	441	provision of Texas law regulating or restricting abortion not
442	442	specifically addressed by this Act. An abortion that complies with
443	443	this Act but violates any other law is unlawful. An abortion that
444	444	complies with another state law but violates this Act is unlawful as
445	445	provided in this Act.
446	446	SECTION 10. (a) If some or all of the provisions of this
447	447	Act are ever temporarily or permanently restrained or enjoined by
448	448	judicial order, all other provisions of Texas law regulating or
449	449	restricting abortion shall be enforced as though the restrained or
450	450	enjoined provisions had not been adopted; provided, however, that
451	451	whenever the temporary or permanent restraining order or injunction
452	452	is stayed or dissolved, or otherwise ceases to have effect, the
453	453	provisions shall have full force and effect.
454	454	(b) Mindful of Leavitt v. Jane L., 518 U.S. 137 (1996), in
455	455	which in the context of determining the severability of a state
456	456	statute regulating abortion the United States Supreme Court held
457	457	that an explicit statement of legislative intent is controlling, it
458	458	is the intent of the legislature that every provision, section,
459	459	subsection, sentence, clause, phrase, or word in this Act, and
460	460	every application of the provisions in this Act, are severable from
461	461	each other. If any application of any provision in this Act to any
462	462	person, group of persons, or circumstances is found by a court to be
463	463	invalid, the remaining applications of that provision to all other
464	464	persons and circumstances shall be severed and may not be affected.
465	465	All constitutionally valid applications of this Act shall be
466	466	severed from any applications that a court finds to be invalid,
467	467	leaving the valid applications in force, because it is the
468	468	legislature's intent and priority that the valid applications be
469	469	allowed to stand alone. Even if a reviewing court finds a provision
470	470	of this Act to impose an undue burden in a large or substantial
471	471	fraction of relevant cases, the applications that do not present an
472	472	undue burden shall be severed from the remaining provisions and
473	473	shall remain in force, and shall be treated as if the legislature
474	474	had enacted a statute limited to the persons, group of persons, or
475	475	circumstances for which the statute's application does not present
476	476	an undue burden. The legislature further declares that it would
477	477	have passed this Act, and each provision, section, subsection,
478	478	sentence, clause, phrase, or word, and all constitutional
479	479	applications of this Act, irrespective of the fact that any
480	480	provision, section, subsection, sentence, clause, phrase, or word,
481	481	or applications of this Act, were to be declared unconstitutional
482	482	or to represent an undue burden.
483	483	(c) If Subchapter C, Chapter 171, Health and Safety Code, as
484	484	added by this Act, prohibiting abortions performed on an unborn
485	485	child 20 or more weeks after fertilization is found by any court to
486	486	be invalid or to impose an undue burden as applied to any person,
487	487	group of persons, or circumstances, the prohibition shall apply to
488	488	that person or group of persons or circumstances on the earliest
489	489	date on which the subchapter can be constitutionally applied.
490	490	(d) If any provision of this Act is found by any court to be
491	491	unconstitutionally vague, then the applications of that provision
492	492	that do not present constitutional vagueness problems shall be
493	493	severed and remain in force.
494	494	SECTION 11. (a) The executive commissioner of the Health
495	495	and Human Services Commission shall adopt the standards required by
496	496	Section 245.010, Health and Safety Code, as amended by this Act, not
497	497	later than January 1, 2014.
498	498	(b) A facility licensed under Chapter 245, Health and Safety
499	499	Code, is not required to comply with the standards adopted under
500	500	Section 245.010, Health and Safety Code, as amended by this Act,
501	501	before September 1, 2014.
502	502	SECTION 12. This Act takes effect immediately if it
503	503	receives a vote of two-thirds of all the members elected to each
504	504	house, as provided by Section 39, Article III, Texas Constitution.
505	505	If this Act does not receive the vote necessary for immediate
506	506	effect, this Act takes effect on the 91st day after the last day of
507	507	the legislative session.