83S20100 SCL-D
By: Rodriguez of Travis H.B. No. 51
A BILL TO BE ENTITLED
AN ACT
relating to human sexuality and health, including the regulation of
abortion; providing a civil penalty.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 28.004, Education Code, is amended by
amending Subsections (e) and (i) and adding Subsection (o) to read
as follows:
(e) Any course materials and instruction relating to human
sexuality, sexually transmitted diseases, or human
immunodeficiency virus or acquired immune deficiency syndrome
shall be selected by the board of trustees with the advice of the
local school health advisory council and [must]:
(1) must present abstinence from sexual activity as
the preferred choice of behavior in relationship to all sexual
activity for [unmarried] persons of school age;
(2) must devote sufficient [more] attention to
abstinence from sexual activity to emphasize the importance of
abstinence from sexual activity [than to any other behavior];
(3) must emphasize that abstinence from sexual
activity, if used consistently and correctly, is the only method
that is 100 percent effective in preventing pregnancy, sexually
transmitted infections [diseases], sexually transmitted infection
with human immunodeficiency virus, [or] acquired immune deficiency
syndrome resulting from sexual activity, and the emotional distress
that may be [trauma] associated with adolescent sexual activity
that results in a sexually transmitted infection or an unintended
pregnancy;
(4) must direct adolescents to a standard of behavior
in which abstinence from sexual activity [before marriage] is the
most effective way to prevent pregnancy, sexually transmitted
infections [diseases], sexually transmitted [and] infection with
human immunodeficiency virus, and [or] acquired immune deficiency
syndrome resulting from sexual activity; [and]
(5) must present age-appropriate information;
(6) must be evidence-based;
(7) must provide information about the effectiveness
of methods approved by the United States Food and Drug
Administration for reducing the risk of contracting sexually
transmitted infections, including human immunodeficiency virus,
and preventing pregnancy;
(8) must include strategies to promote effective
communication between adolescents and their parents and other
family members about values and healthy relationships;
(9) must encourage students to develop healthy life
skills, including goal setting, responsible decision making,
refusal and negotiation, and effective communication;
(10) must teach skills for making responsible
decisions about sexual activity, including how to avoid unwanted
verbal or physical sexual advances and how to avoid making unwanted
verbal or physical sexual advances; and
(11) may not promote bias against:
(A) students of any race, gender, sexual
orientation, or ethnic or cultural background;
(B) sexually active students; or
(C) children with disabilities [teach
contraception and condom use in terms of human use reality rates
instead of theoretical laboratory rates, if instruction on
contraception and condoms is included in curriculum content].
(i) Before each school year, a school district shall provide
written notice to a parent of each student enrolled in the district
of the board of trustees' decision regarding whether the district
will provide human sexuality instruction to district students. If
instruction will be provided, the notice must include:
(1) a summary of the basic content of the district's
human sexuality instruction to be provided to the student,
including a statement informing the parent that the instruction is
required by [of the instructional requirements under] state law to:
(A) present abstinence from sexual activity as
the preferred choice of behavior in relationship to all sexual
activity for persons of school age; and
(B) devote sufficient attention to abstinence
from sexual activity to emphasize the importance of abstinence from
sexual activity;
(2) a statement of whether the instruction is
considered by the district to be abstinence-only instruction or
comprehensive instruction, including an explanation of the
difference between those types of instruction and a specific
statement regarding whether the student will receive information on
contraception and condom use;
(3) [(2)] a statement of the parent's right to:
(A) review curriculum materials as provided by
Subsection (j); and
(B) remove the student from any part of the
district's human sexuality instruction without subjecting the
student to any disciplinary action, academic penalty, or other
sanction imposed by the district or the student's school; and
(4) [(3)] information describing the opportunities
for parental involvement in the development of the curriculum to be
used in human sexuality instruction, including information
regarding the local school health advisory council established
under Subsection (a).
(o) In this section:
(1) "Abstinence-only instruction" means instruction
that does not include information about preventing pregnancy,
sexually transmitted infections, infection with human
immunodeficiency virus, or acquired immune deficiency syndrome
through any means other than total abstinence from sexual activity.
(2) "Age-appropriate information" means information,
including topics, messages, and teaching methods, that is suitable
for the particular ages or age groups of children and adolescents to
whom the information is to be presented based on the developing
cognitive, emotional, and behavioral capacity of children or
adolescents of that age or age group.
(3) "Evidence-based" means:
(A) verified or supported by research that is:
(i) in compliance with accepted scientific
methods;
(ii) published in peer-reviewed journals,
if appropriate; and
(iii) recognized as medically accurate,
objective, and complete by mainstream professional organizations
and agencies with expertise in the relevant field, including the
Centers for Disease Control and Prevention and the United States
Department of Health and Human Services' Office of Adolescent
Health; and
(B) proven, through rigorous scientific
evaluation, to achieve positive outcomes concerning sexually risky
behavior or negative health consequences of sexually risky
behavior.
SECTION 2. Section 32.003(a), Family Code, is amended to
read as follows:
(a) A child may consent to medical, dental, psychological,
and surgical treatment for the child by a licensed physician or
dentist if the child:
(1) is on active duty with the armed services of the
United States of America;
(2) is:
(A) 16 years of age or older and resides separate
and apart from the child's parents, managing conservator, or
guardian, with or without the consent of the parents, managing
conservator, or guardian and regardless of the duration of the
residence; and
(B) managing the child's own financial affairs,
regardless of the source of the income;
(3) consents to the diagnosis and treatment of an
infectious, contagious, or communicable disease that is required by
law or a rule to be reported by the licensed physician or dentist to
a local health officer or the [Texas] Department of State Health
Services, including all diseases within the scope of Section
81.041, Health and Safety Code;
(4) is unmarried and pregnant and consents to
hospital, medical, or surgical treatment, other than abortion,
related to the pregnancy;
(5) consents to examination and treatment for drug or
chemical addiction, drug or chemical dependency, or any other
condition directly related to drug or chemical use;
(6) is unmarried, is the parent of a child, and has
actual custody of his or her child and consents to medical, dental,
psychological, or surgical treatment for the child; [or]
(7) is serving a term of confinement in a facility
operated by or under contract with the Texas Department of Criminal
Justice, unless the treatment would constitute a prohibited
practice under Section 164.052(a)(19), Occupations Code; or
(8) is 16 years of age or older, has given birth to a
child, and consents to an examination or medical treatment, other
than abortion or emergency contraception, related to
contraception.
SECTION 3. Section 33.002(a), Family Code, is amended to
read as follows:
(a) A physician may not perform an abortion on a pregnant
unemancipated minor unless:
(1) the physician performing the abortion gives at
least 48 hours actual notice, in person or by telephone, of the
physician's intent to perform the abortion to:
(A) a parent of the minor, if the minor has no
managing conservator or guardian; or
(B) a court-appointed managing conservator or
guardian;
(2) the judge of a court having probate jurisdiction,
the judge of a county court at law, the judge of a district court,
including a family district court, or a court of appellate
jurisdiction issues an order authorizing the minor to consent to
the abortion as provided by Section 33.003 or 33.004;
(3) a probate court, county court at law, district
court, including a family district court, or court of appeals, by
its inaction, constructively authorizes the minor to consent to the
abortion as provided by Section 33.003 or 33.004;
(3-a) a medical professional described by Section
33.0045 constructively authorizes the minor to consent to the
abortion as provided by Section 33.0045; or
(4) the physician performing the abortion:
(A) concludes that on the basis of the
physician's good faith clinical judgment, a condition exists that
complicates the medical condition of the pregnant minor and
necessitates the immediate abortion of her pregnancy to avert her
death or to avoid a serious risk of substantial and irreversible
impairment of a major bodily function; and
(B) certifies in writing to the [Texas]
Department of State Health Services and in the patient's medical
record the medical indications supporting the physician's judgment
that the circumstances described by Paragraph (A) exist.
SECTION 4. Chapter 33, Family Code, is amended by adding
Section 33.0045 to read as follows:
Sec. 33.0045. COUNSELOR APPROVAL. (a) In this section,
"medical professional" means a physician, physician assistant,
nurse, or psychologist licensed in this state to provide medical,
health, or mental health services.
(b) A pregnant minor who wants to have an abortion without
the written consent of and notification to one of her parents, her
managing conservator, or her guardian may obtain counseling from a
medical professional.
(c) A medical professional conducting counseling under this
section shall inform the minor of alternatives to abortion and
advise the minor on the option of involving the minor's parents,
managing conservator, or guardian in her decision to have an
abortion.
(d) A medical professional conducting counseling under this
section may not notify a parent, managing conservator, or guardian
that the minor is pregnant or that the minor wants to have an
abortion. Counseling between the minor and the medical
professional is confidential and privileged and is not subject to
disclosure under Chapter 552, Government Code, or to discovery,
subpoena, or other legal processes.
(e) The Department of State Health Services shall develop a
standard form for purposes of certifying that the medical
professional has conducted counseling under this section.
(f) A medical professional conducting counseling shall
complete the form described by Subsection (e) on completion of
counseling. A completed form constructively authorizes the minor
to obtain an abortion without the written consent of and
notification to the minor's parents, managing conservator, or
guardian.
SECTION 5. Section 501.012, Government Code, is amended to
read as follows:
Sec. 501.012. FAMILY LIAISON OFFICER. The director of the
institutional division shall designate one employee at each
facility operated by the institutional division to serve as family
liaison officer for that facility. The family liaison officer
shall facilitate the maintenance of ties between inmates and their
families for the purpose of reducing recidivism. Each family
liaison officer shall:
(1) provide inmates' relatives with information about
the classification status, location, and health of inmates in the
facility;
(2) notify inmates about emergencies involving their
families and provide inmates with other necessary information
relating to their families; [and]
(3) assist inmates' relatives and other persons during
visits with inmates and aid those persons in resolving problems
that may affect permitted contact with inmates; and
(4) inform inmates of family planning services
available after release and assist female inmates in obtaining
those services.
SECTION 6. Subchapter A, Chapter 501, Government Code, is
amended by adding Section 501.024 to read as follows:
Sec. 501.024. MINIMUM STANDARDS FOR PREGNANT OFFENDERS.
The department shall adopt reasonable rules and procedures
establishing minimum standards for a correctional facility to:
(1) determine if an offender is pregnant; and
(2) for females confined in the facility who are known
or determined to be pregnant, ensure that the facility's health
services plan:
(A) provides pregnant offenders with
nondirective counseling and written material, in a form easily
understandable by each offender, on pregnancy options and
correctional facility policies and practices regarding care and
labor for pregnant offenders;
(B) provides prenatal and postpartum medical
care and monitoring, including nutritional and exercise
requirements; and
(C) addresses any special housing or work
assignments.
SECTION 7. Section 511.009, Government Code, is amended by
amending Subsection (a) and adding Subsection (a-1) to read as
follows:
(a) The commission shall:
(1) adopt reasonable rules and procedures
establishing minimum standards for the construction, equipment,
maintenance, and operation of county jails;
(2) adopt reasonable rules and procedures
establishing minimum standards for the custody, care, and treatment
of prisoners;
(3) adopt reasonable rules establishing minimum
standards for the number of jail supervisory personnel and for
programs and services to meet the needs of prisoners;
(4) adopt reasonable rules and procedures
establishing minimum requirements for programs of rehabilitation,
education, and recreation in county jails;
(5) revise, amend, or change rules and procedures if
necessary;
(6) provide to local government officials
consultation on and technical assistance for county jails;
(7) review and comment on plans for the construction
and major modification or renovation of county jails;
(8) require that the sheriff and commissioners of each
county submit to the commission, on a form prescribed by the
commission, an annual report on the conditions in each county jail
within their jurisdiction, including all information necessary to
determine compliance with state law, commission orders, and the
rules adopted under this chapter;
(9) review the reports submitted under Subdivision (8)
and require commission employees to inspect county jails regularly
to ensure compliance with state law, commission orders, and rules
and procedures adopted under this chapter;
(10) adopt a classification system to assist sheriffs
and judges in determining which defendants are low-risk and
consequently suitable participants in a county jail work release
program under Article 42.034, Code of Criminal Procedure;
(11) adopt rules relating to requirements for
segregation of classes of inmates and to capacities for county
jails;
(12) require that the chief jailer of each municipal
lockup submit to the commission, on a form prescribed by the
commission, an annual report of persons under 17 years of age
securely detained in the lockup, including all information
necessary to determine compliance with state law concerning secure
confinement of children in municipal lockups;
(13) at least annually determine whether each county
jail is in compliance with the rules and procedures adopted under
this chapter;
(14) require that the sheriff and commissioners court
of each county submit to the commission, on a form prescribed by the
commission, an annual report of persons under 17 years of age
securely detained in the county jail, including all information
necessary to determine compliance with state law concerning secure
confinement of children in county jails;
(15) schedule announced and unannounced inspections
of jails under the commission's jurisdiction using the risk
assessment plan established under Section 511.0085 to guide the
inspections process;
(16) adopt a policy for gathering and distributing to
jails under the commission's jurisdiction information regarding:
(A) common issues concerning jail
administration;
(B) examples of successful strategies for
maintaining compliance with state law and the rules, standards, and
procedures of the commission; and
(C) solutions to operational challenges for
jails;
(17) report to the Texas Correctional Office on
Offenders with Medical or Mental Impairments on a jail's compliance
with Article 16.22, Code of Criminal Procedure;
(18) adopt reasonable rules and procedures
establishing minimum requirements for jails to:
(A) determine if a prisoner is pregnant; and
(B) ensure that the jail's health services plan
addresses medical and mental health care, including nutritional
requirements, and any special housing or work assignment needs for
persons who are confined in the jail and are known or determined to
be pregnant; [and]
(19) provide guidelines to sheriffs regarding
contracts between a sheriff and another entity for the provision of
food services to or the operation of a commissary in a jail under
the commission's jurisdiction, including specific provisions
regarding conflicts of interest and avoiding the appearance of
impropriety; and
(20) adopt reasonable rules and procedures for
providing to female prisoners on release family planning
information and services.
(a-1) The minimum requirements adopted under Subsection
(a)(18) must meet or exceed the minimum standards adopted under
Section 501.024.
SECTION 8. Section 171.002, Health and Safety Code, is
amended to read as follows:
Sec. 171.002. DEFINITION [DEFINITIONS]. In this chapter,
"abortion"[:
[(1) "Abortion"] means the use of any means to
terminate the pregnancy of a female known by the attending
physician to be pregnant with the intention that the termination of
the pregnancy by those means will, with reasonable likelihood,
cause the death of the fetus.
[(2) "Abortion provider" means a facility where an
abortion is performed, including the office of a physician and a
facility licensed under Chapter 245.
[(3) "Medical emergency" means a life-threatening
physical condition aggravated by, caused by, or arising from a
pregnancy that, as certified by a physician, places the woman in
danger of death or a serious risk of substantial impairment of a
major bodily function unless an abortion is performed.
[(4) "Sonogram" means the use of ultrasonic waves for
diagnostic or therapeutic purposes, specifically to monitor an
unborn child.]
SECTION 9. Sections 171.012(a), (b), and (c), Health and
Safety Code, are amended to read as follows:
(a) Except in the case of a medical emergency, consent
[Consent] to an abortion is voluntary and informed only if:
(1) the physician who is to perform the abortion or the
referring physician informs the [pregnant] woman on whom the
abortion is to be performed of:
(A) the [physician's] name of the physician who
will perform the abortion;
(B) the particular medical risks associated with
the particular abortion procedure to be employed, including, when
medically accurate:
(i) the risks of infection and hemorrhage;
(ii) the potential danger to a subsequent
pregnancy and of infertility; and
(iii) the possibility of increased risk of
breast cancer following an induced abortion and the natural
protective effect of a completed pregnancy in avoiding breast
cancer;
(C) the probable gestational age of the unborn
child at the time the abortion is to be performed; and
(D) the medical risks associated with carrying
the child to term;
(2) the physician who is to perform the abortion or the
physician's agent informs the [pregnant] woman that:
(A) medical assistance benefits may be available
for prenatal care, childbirth, and neonatal care;
(B) the father is liable for assistance in the
support of the child without regard to whether the father has
offered to pay for the abortion; [and]
(C) public and private agencies provide
pregnancy prevention counseling and medical referrals for
obtaining pregnancy prevention medications or devices, including
emergency contraception for victims of rape or incest; and
(D) the woman has the right to review [(3) the
physician who is to perform the abortion or the physician's agent:
[(A) provides the pregnant woman with] the
printed materials described by Section 171.014,[; and
[(B) informs the pregnant woman] that those
materials[:
[(i)] have been provided by the Department
of State Health Services and[;
[(ii)] are accessible on an Internet
website sponsored by the department, and that the materials[;
[(iii)] describe the unborn child and list
agencies that offer alternatives to abortion[; and
[(iv) include a list of agencies that offer
sonogram services at no cost to the pregnant woman;
[(4) before any sedative or anesthesia is administered
to the pregnant woman and at least 24 hours before the abortion or
at least two hours before the abortion if the pregnant woman waives
this requirement by certifying that she currently lives 100 miles
or more from the nearest abortion provider that is a facility
licensed under Chapter 245 or a facility that performs more than 50
abortions in any 12-month period:
[(A) the physician who is to perform the abortion
or an agent of the physician who is also a sonographer certified by
a national registry of medical sonographers performs a sonogram on
the pregnant woman on whom the abortion is to be performed;
[(B) the physician who is to perform the abortion
displays the sonogram images in a quality consistent with current
medical practice in a manner that the pregnant woman may view them;
[(C) the physician who is to perform the abortion
provides, in a manner understandable to a layperson, a verbal
explanation of the results of the sonogram images, including a
medical description of the dimensions of the embryo or fetus, the
presence of cardiac activity, and the presence of external members
and internal organs; and
[(D) the physician who is to perform the abortion
or an agent of the physician who is also a sonographer certified by
a national registry of medical sonographers makes audible the heart
auscultation for the pregnant woman to hear, if present, in a
quality consistent with current medical practice and provides, in a
manner understandable to a layperson, a simultaneous verbal
explanation of the heart auscultation];
(3) the woman certifies in writing [(5) before
receiving a sonogram under Subdivision (4)(A) and] before the
abortion is performed that the information described by
Subdivisions (1) and (2) has been provided to her and that she has
been informed of her opportunity to review the information
described by Section 171.014 [and before any sedative or anesthesia
is administered, the pregnant woman completes and certifies with
her signature an election form that states as follows:
["ABORTION AND SONOGRAM ELECTION
[(1) THE INFORMATION AND PRINTED MATERIALS
DESCRIBED BY SECTIONS 171.012(a)(1)-(3), TEXAS HEALTH
AND SAFETY CODE, HAVE BEEN PROVIDED AND EXPLAINED TO
ME.
[(2) I UNDERSTAND THE NATURE AND
CONSEQUENCES OF AN ABORTION.
[(3) TEXAS LAW REQUIRES THAT I RECEIVE A
SONOGRAM PRIOR TO RECEIVING AN ABORTION.
[(4) I UNDERSTAND THAT I HAVE THE OPTION TO
VIEW THE SONOGRAM IMAGES.
[(5) I UNDERSTAND THAT I HAVE THE OPTION TO
HEAR THE HEARTBEAT.
[(6) I UNDERSTAND THAT I AM REQUIRED BY LAW
TO HEAR AN EXPLANATION OF THE SONOGRAM IMAGES UNLESS I
CERTIFY IN WRITING TO ONE OF THE FOLLOWING:
[___ I AM PREGNANT AS A RESULT OF A SEXUAL
ASSAULT, INCEST, OR OTHER VIOLATION OF THE TEXAS PENAL
CODE THAT HAS BEEN REPORTED TO LAW ENFORCEMENT
AUTHORITIES OR THAT HAS NOT BEEN REPORTED BECAUSE I
REASONABLY BELIEVE THAT DOING SO WOULD PUT ME AT RISK
OF RETALIATION RESULTING IN SERIOUS BODILY INJURY.
[___ I AM A MINOR AND OBTAINING AN ABORTION
IN ACCORDANCE WITH JUDICIAL BYPASS PROCEDURES UNDER
CHAPTER 33, TEXAS FAMILY CODE.
[___ MY FETUS HAS AN IRREVERSIBLE MEDICAL
CONDITION OR ABNORMALITY, AS IDENTIFIED BY RELIABLE
DIAGNOSTIC PROCEDURES AND DOCUMENTED IN MY MEDICAL
FILE.
[(7) I AM MAKING THIS ELECTION OF MY OWN
FREE WILL AND WITHOUT COERCION.
[(8) FOR A WOMAN WHO LIVES 100 MILES OR
MORE FROM THE NEAREST ABORTION PROVIDER THAT IS A
FACILITY LICENSED UNDER CHAPTER 245 OR A FACILITY THAT
PERFORMS MORE THAN 50 ABORTIONS IN ANY 12-MONTH PERIOD
ONLY:
[I CERTIFY THAT, BECAUSE I CURRENTLY LIVE
100 MILES OR MORE FROM THE NEAREST ABORTION PROVIDER
THAT IS A FACILITY LICENSED UNDER CHAPTER 245 OR A
FACILITY THAT PERFORMS MORE THAN 50 ABORTIONS IN ANY
12-MONTH PERIOD, I WAIVE THE REQUIREMENT TO WAIT 24
HOURS AFTER THE SONOGRAM IS PERFORMED BEFORE RECEIVING
THE ABORTION PROCEDURE. MY PLACE OF RESIDENCE
IS:__________.
____________________ ____________________
SIGNATURE DATE"]; and
(4) [(6)] before the abortion is performed, the
physician who is to perform the abortion receives a copy of the
[signed,] written certification required by Subdivision (3) [(5);
and
[(7) the pregnant woman is provided the name of each
person who provides or explains the information required under this
subsection].
(b) The information required to be provided under
Subsections (a)(1) and (2) [may not be provided by audio or video
recording and] must be provided [at least 24 hours before the
abortion is to be performed]:
(1) orally by telephone or [and] in person [in a
private and confidential setting if the pregnant woman currently
lives less than 100 miles from the nearest abortion provider that is
a facility licensed under Chapter 245 or a facility that performs
more than 50 abortions in any 12-month period]; and [or]
(2) at least 24 hours before the abortion is to be
performed [orally by telephone or in person in a private and
confidential setting if the pregnant woman certifies that the woman
currently lives 100 miles or more from the nearest abortion
provider that is a facility licensed under Chapter 245 or a facility
that performs more than 50 abortions in any 12-month period].
(c) When providing the information under Subsection
(a)(2)(D) [(a)(3)], the physician or the physician's agent must
provide the [pregnant] woman with the address of the Internet
website on which the printed materials described by Section 171.014
may be viewed as required by Section 171.014(e).
SECTION 10. Section 171.013(a), Health and Safety Code, is
amended to read as follows:
(a) If the woman chooses to view the materials described by
Section 171.014, the [The] physician or the physician's agent shall
furnish copies of the materials [described by Section 171.014] to
her [the pregnant woman] at least 24 hours before the abortion is to
be performed [and shall direct the pregnant woman to the Internet
website required to be published under Section 171.014(e)]. A
[The] physician or the physician's agent may furnish the materials
to the [pregnant] woman by mail if the materials are mailed,
restricted delivery to addressee, at least 72 hours before the
abortion is to be performed.
SECTION 11. Section 171.015, Health and Safety Code, is
amended to read as follows:
Sec. 171.015. INFORMATION RELATING TO PUBLIC AND PRIVATE
AGENCIES. The informational materials must include either:
(1) geographically indexed materials designed to
inform the [pregnant] woman of public and private agencies and
services that:
(A) are available to assist a woman through
pregnancy, childbirth, and the child's dependency, including:
(i) a comprehensive list of adoption
agencies;
(ii) a description of the services the
adoption agencies offer; and
(iii) a description of the manner,
including telephone numbers, in which an adoption agency may be
contacted[; and
[(iv) a comprehensive list of agencies and
organizations that offer sonogram services at no cost to the
pregnant woman];
(B) do not provide abortions or abortion-related
services or make referrals to abortion providers; and
(C) are not affiliated with organizations that
provide abortions or abortion-related services or make referrals to
abortion providers; or [and]
(2) a toll-free, 24-hour telephone number that may be
called to obtain an oral list and description of agencies described
by Subdivision (1) that are located near the caller and of the
services the agencies offer.
SECTION 12. Section 245.006(a), Health and Safety Code, is
amended to read as follows:
(a) The department may [shall] inspect an abortion facility
at [random, unannounced, and] reasonable times as necessary to
ensure compliance with this chapter [and Subchapter B, Chapter
171].
SECTION 13. Section 323.004(b), Health and Safety Code, as
amended by S.B. No. 1191, Acts of the 83rd Legislature, Regular
Session, 2013, is amended to read as follows:
(b) A health care facility providing care to a sexual
assault survivor shall provide the survivor with comprehensive
medical treatment and:
(1) subject to Subsection (b-1), a forensic medical
examination in accordance with Subchapter B, Chapter 420,
Government Code, if the examination has been requested by a law
enforcement agency under Article 56.06, Code of Criminal Procedure,
or is conducted under Article 56.065, Code of Criminal Procedure;
(2) a private area, if available, to wait or speak with
the appropriate medical, legal, or sexual assault crisis center
staff or volunteer until a physician, nurse, or physician assistant
is able to treat the survivor;
(3) access to a sexual assault program advocate, if
available, as provided by Article 56.045, Code of Criminal
Procedure;
(4) the information form required by Section 323.005;
(5) a private treatment room, if available;
(6) if indicated by the history of contact, access to
appropriate prophylaxis for exposure to sexually transmitted
infections; [and]
(7) the name and telephone number of the nearest
sexual assault crisis center;
(8) emergency contraceptive services described by
Section 323.0052;
(9) an assessment described by Section 323.0054;
(10) counseling and treatment described by Section
323.0055; and
(11) follow-up care information described by Section
323.0056.
SECTION 14. Chapter 323, Health and Safety Code, is amended
by adding Sections 323.0051, 323.0052, 323.0053, 323.0054,
323.0055, 323.0056, and 323.0057 to read as follows:
Sec. 323.0051. EMERGENCY CONTRACEPTIVE INFORMATION. (a)
The department shall develop a standard information form for sexual
assault survivors that includes information regarding emergency
contraception.
(b) Emergency contraception information contained in the
form must be medically and factually accurate and unbiased. The
department may use appropriate medical organizations and
associations, including the American Congress of Obstetricians and
Gynecologists, as resources in developing the form.
(c) The information form must be published in:
(1) an easily comprehensible form; and
(2) a typeface large enough to be clearly legible.
(d) The department shall annually review the information
form to determine if changes to the contents of the form are
necessary.
(e) A health care facility shall use the standard form
developed under this section.
Sec. 323.0052. EMERGENCY CONTRACEPTIVE SERVICES. In
addition to the other services and information required under this
chapter, after a sexual assault survivor arrives at a health care
facility for emergency care following an alleged sexual assault,
the facility shall promptly:
(1) provide the sexual assault survivor with the
information form required under Section 323.0051;
(2) orally communicate to the sexual assault survivor
the information regarding emergency contraception contained in the
information form provided under Subdivision (1);
(3) if indicated by the history of contact, orally
inform the sexual assault survivor that the survivor may request
and be provided with emergency contraception at the facility; and
(4) if not medically contraindicated and if the
survivor agrees to submit to a pregnancy test and that pregnancy
test produces a negative result, provide the sexual assault
survivor with emergency contraception immediately on request of the
survivor.
Sec. 323.0053. SEXUAL ASSAULT SURVIVOR ASSESSMENT
STANDARDS. (a) The department shall establish standards for
assessing sexual assault survivors for the risk of contracting a
sexually transmitted disease.
(b) In developing the standards, the department shall use as
resources appropriate:
(1) recommendations by the United States Centers for
Disease Control and Prevention;
(2) peer-reviewed clinical studies;
(3) research using in vitro and nonhuman primate
models of infection; and
(4) medical organizations and associations described
by Section 323.0051(b).
(c) The department shall annually review the standards to
determine if changes to the standards are necessary.
Sec. 323.0054. SEXUAL ASSAULT SURVIVOR ASSESSMENT. (a) A
health care facility shall promptly provide a sexual assault
survivor with an assessment of the survivor's risk of contracting a
sexually transmitted disease.
(b) An assessment described by Subsection (a) may be
conducted only by a physician, physician assistant, or advanced
practice nurse. An individual conducting the assessment shall base
the assessment on:
(1) the available information regarding the sexual
assault; and
(2) the risk assessment standards established under
Section 323.0053.
Sec. 323.0055. SEXUAL ASSAULT SURVIVOR COUNSELING AND
TREATMENT FOR SEXUALLY TRANSMITTED DISEASES. (a) After completion
of an assessment described by Section 323.0054(a), a health care
facility shall provide a sexual assault survivor with counseling on
the sexually transmitted diseases for which:
(1) the assessment described by Section 323.0054(a)
determines the sexual assault survivor may be at risk;
(2) postexposure treatment exists; and
(3) deferral of treatment would significantly reduce
the effectiveness of the treatment or pose a substantial risk to the
sexual assault survivor's health.
(b) The counseling may be conducted only by an individual
described by Section 323.0054(b) and must be provided in clear and
concise language.
(c) After providing the assessment under Section 323.0054
and the counseling described by this section, a health care
facility shall:
(1) inform the sexual assault survivor that the
survivor may request and be provided with treatment for sexually
transmitted diseases for which the survivor may be at risk as
determined by the assessment described by Section 323.0054(a); and
(2) provide the survivor with treatment for the
sexually transmitted diseases described by Subdivision (1)
immediately on request of the survivor.
Sec. 323.0056. FOLLOW-UP CARE INFORMATION. A health care
facility shall provide in clear and concise language to a sexual
assault survivor information on the physical and mental health
benefits of follow-up medical care or other health services from a
health care provider capable of providing follow-up care to
survivors of sexual assault. The information must include the
names and contact information of health care providers in the
survivor's community that are capable of providing the follow-up
care.
Sec. 323.0057. CIVIL PENALTY. (a) A health care facility
that violates Section 323.0052, 323.0054, 323.0055, or 323.0056 is
liable for a civil penalty of not less than $10,000 for each day of
violation and for each act of violation.
(b) In determining the amount of the penalty, the district
court shall consider:
(1) the health care facility's previous violations;
(2) the seriousness of the violation, including the
nature, circumstances, extent, and gravity of the violation;
(3) the demonstrated good faith of the health care
facility;
(4) the amount necessary to deter future violations;
and
(5) any other matter that should, as a matter of
justice or equity, be considered.
(c) A penalty collected under this section by the attorney
general shall be deposited to the credit of the general revenue
fund. A penalty collected under this section by a district or
county attorney shall be deposited to the credit of the general fund
in the district or county in which the suit was heard.
SECTION 15. Subchapter B, Chapter 32, Human Resources Code,
is amended by adding Section 32.0523 to read as follows:
Sec. 32.0523. WAIVER PROGRAM FOR WOMEN'S HEALTH. (a) In
this section, "Texas women's health program" means the program
operated by the Department of State Health Services that began
operating in 2013, is substantially similar to the demonstration
project operated under former Section 32.0248, and is intended to
expand access to preventive health and family planning services for
women in this state.
(b) If the Department of State Health Services ceases
operation of the Texas women's health program, the Health and Human
Services Commission shall immediately apply for a waiver under
Section 1115 of the federal Social Security Act (42 U.S.C. Section
1315) to obtain authorization for and any federal matching money
available to support a women's health program.
(c) A women's health program operated under a waiver
described by Subsection (b) must be identical to the demonstration
project formerly operated under Section 32.0248.
SECTION 16. Section 164.052(a), Occupations Code, is
amended to read as follows:
(a) A physician or an applicant for a license to practice
medicine commits a prohibited practice if that person:
(1) submits to the board a false or misleading
statement, document, or certificate in an application for a
license;
(2) presents to the board a license, certificate, or
diploma that was illegally or fraudulently obtained;
(3) commits fraud or deception in taking or passing an
examination;
(4) uses alcohol or drugs in an intemperate manner
that, in the board's opinion, could endanger a patient's life;
(5) commits unprofessional or dishonorable conduct
that is likely to deceive or defraud the public, as provided by
Section 164.053, or injure the public;
(6) uses an advertising statement that is false,
misleading, or deceptive;
(7) advertises professional superiority or the
performance of professional service in a superior manner if that
advertising is not readily subject to verification;
(8) purchases, sells, barters, or uses, or offers to
purchase, sell, barter, or use, a medical degree, license,
certificate, or diploma, or a transcript of a license, certificate,
or diploma in or incident to an application to the board for a
license to practice medicine;
(9) alters, with fraudulent intent, a medical license,
certificate, or diploma, or a transcript of a medical license,
certificate, or diploma;
(10) uses a medical license, certificate, or diploma,
or a transcript of a medical license, certificate, or diploma that
has been:
(A) fraudulently purchased or issued;
(B) counterfeited; or
(C) materially altered;
(11) impersonates or acts as proxy for another person
in an examination required by this subtitle for a medical license;
(12) engages in conduct that subverts or attempts to
subvert an examination process required by this subtitle for a
medical license;
(13) impersonates a physician or permits another to
use the person's license or certificate to practice medicine in
this state;
(14) directly or indirectly employs a person whose
license to practice medicine has been suspended, canceled, or
revoked;
(15) associates in the practice of medicine with a
person:
(A) whose license to practice medicine has been
suspended, canceled, or revoked; or
(B) who has been convicted of the unlawful
practice of medicine in this state or elsewhere;
(16) performs or procures a criminal abortion, aids or
abets in the procuring of a criminal abortion, attempts to perform
or procure a criminal abortion, or attempts to aid or abet the
performance or procurement of a criminal abortion;
(17) directly or indirectly aids or abets the practice
of medicine by a person, partnership, association, or corporation
that is not licensed to practice medicine by the board;
(18) performs an abortion on a woman who is pregnant
with a viable unborn child during the third trimester of the
pregnancy unless:
(A) the abortion is necessary to prevent the
death of the woman;
(B) the viable unborn child has a severe,
irreversible brain impairment; or
(C) the woman is diagnosed with a significant
likelihood of suffering imminent severe, irreversible brain damage
or imminent severe, irreversible paralysis; or
(19) performs an abortion on an unemancipated minor
without the written consent of the child's parent, managing
conservator, or legal guardian, without the written consent of a
medical professional, as provided by Section 33.0045, Family Code,
or without a court order, as provided by Section 33.003 or 33.004,
Family Code, authorizing the minor to consent to the abortion,
unless the physician concludes that on the basis of the physician's
good faith clinical judgment, a condition exists that complicates
the medical condition of the pregnant minor and necessitates the
immediate abortion of her pregnancy to avert her death or to avoid a
serious risk of substantial impairment of a major bodily function
and that there is insufficient time to obtain the consent of the
child's parent, managing conservator, or legal guardian.
SECTION 17. Section 164.055(a), Occupations Code, is
amended to read as follows:
(a) The board may [shall] take an appropriate disciplinary
action against a physician who violates Section 170.002 [or Chapter
171], Health and Safety Code. The board may [shall] refuse to admit
to examination or refuse to issue a license or renewal license to a
person who violates that section [or chapter].
SECTION 18. The following laws are repealed:
(1) Sections 171.012(a-1), 171.0121, 171.0122,
171.0123, 171.0124, 243.017, and 245.024, Health and Safety Code;
(2) Section 241.007, Health and Safety Code, as added
by Chapter 73 (H.B. 15), Acts of the 82nd Legislature, Regular
Session, 2011; and
(3) Section 164.0551, Occupations Code.
SECTION 19. (a) The Health and Human Services Commission
shall conduct a joint study of existing peer-reviewed scholarly
evidence regarding the age at which fetal perception of pain
occurs.
(b) The joint study shall be conducted by the Health and
Human Services Commission and:
(1) Texas A&M University System Health Science Center;
(2) Texas Tech University Health Sciences Center;
(3) the University of North Texas Health Science
Center at Fort Worth;
(4) The University of Texas Health Science Center at
Houston;
(5) The University of Texas Health Science Center at
San Antonio;
(6) The University of Texas Health Science Center at
Tyler;
(7) The University of Texas Medical Branch at
Galveston; and
(8) The University of Texas Southwestern Medical
Center.
(c) The Health and Human Services Commission shall complete
the joint study and provide copies of the study to the governor, the
lieutenant governor, the speaker of the house of representatives,
and members of the legislature not later than December 1, 2014.
SECTION 20. (a) A school district that uses instructional
materials that do not reflect the requirements prescribed by
Section 28.004(e), Education Code, as amended by this Act, shall
also use appropriate supplemental instructional materials as
necessary to comply with those requirements.
(b) A school district that permits a person not employed by
the district to present one or more components of the district's
human sexuality instruction must require the person to comply with
the requirements prescribed by Section 28.004(e), Education Code,
as amended by this Act.
(c) Section 28.004(e), Education Code, as amended by this
Act, applies beginning with the 2014-2015 school year.
(d) Section 33.002, Family Code, as amended by this Act,
Section 164.052, Occupations Code, as amended by this Act, and
Section 33.0045, Family Code, as added by this Act, apply only to an
abortion performed on an unemancipated minor on or after the
effective date of this Act. An abortion performed before the
effective date of this Act is governed by the law in effect on the
date the abortion was performed, and that law is continued in effect
for that purpose.
SECTION 21. This Act takes effect November 1, 2013.