85R21727 LED-D By: Burkett, Bailes, Laubenberg, et al. H.B. No. 200 Substitute the following for H.B. No. 200: By: Cook C.S.H.B. No. 200 A BILL TO BE ENTITLED AN ACT relating to certain prohibited abortions and the treatment and disposition of a human fetus, human fetal tissue, and embryonic and fetal tissue remains; creating a civil cause of action; imposing a civil penalty; creating criminal offenses. BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: SECTION 1. Chapter 171, Health and Safety Code, is amended by adding Subchapter F to read as follows: SUBCHAPTER F. PARTIAL-BIRTH ABORTIONS Sec. 171.101. DEFINITIONS. In this subchapter: (1) "Partial-birth abortion" means an abortion in which the person performing the abortion: (A) for the purpose of performing an overt act that the person knows will kill the partially delivered living fetus, deliberately and intentionally vaginally delivers a living fetus until: (i) for a head-first presentation, the entire fetal head is outside the body of the mother; or (ii) for a breech presentation, any part of the fetal trunk past the navel is outside the body of the mother; and (B) performs the overt act described in Paragraph (A), other than completion of delivery, that kills the partially delivered living fetus. (2) "Physician" means an individual who is licensed to practice medicine in this state, including a medical doctor and a doctor of osteopathic medicine. Sec. 171.102. PARTIAL-BIRTH ABORTIONS PROHIBITED. (a) A physician or other person may not knowingly perform a partial-birth abortion. (b) Subsection (a) does not apply to a physician who performs a partial-birth abortion that is necessary to save the life of a mother whose life is endangered by a physical disorder, physical illness, or physical injury, including a life-endangering physical condition caused by or arising from the pregnancy. Sec. 171.103. CRIMINAL PENALTY. A person who violates Section 171.102 commits an offense. An offense under this section is a state jail felony. Sec. 171.104. CIVIL LIABILITY. (a) Except as provided by Subsection (b), the father of the fetus or a parent of the mother of the fetus, if the mother is younger than 18 years of age at the time of the partial-birth abortion, may bring a civil action to obtain appropriate relief, including: (1) money damages for physical injury, mental anguish, and emotional distress; and (2) exemplary damages equal to three times the cost of the partial-birth abortion. (b) A person may not bring or maintain an action under this section if: (1) the person consented to the partial-birth abortion; or (2) the person's criminally injurious conduct resulted in the pregnancy. Sec. 171.105. HEARING. (a) A physician who is the subject of a criminal or civil action for a violation of Section 171.102 may request a hearing before the Texas Medical Board on whether the physician's conduct was necessary to save the life of a mother whose life was endangered by a physical disorder, physical illness, or physical injury, including a life-endangering physical condition caused by or arising from the pregnancy. (b) The board's findings under Subsection (a) are admissible in any court proceeding against the physician arising from that conduct. On the physician's motion, the court shall delay the beginning of a criminal or civil trial for not more than 60 days for the hearing to be held under Subsection (a). Sec. 171.106. APPLICABILITY. A woman on whom a partial-birth abortion is performed or attempted in violation of this subchapter may not be prosecuted under this subchapter or for conspiracy to commit a violation of this subchapter. SECTION 2. Subtitle H, Title 2, Health and Safety Code, is amended by adding Chapter 173 to read as follows: CHAPTER 173. DONATION OF HUMAN FETAL TISSUE Sec. 173.001. DEFINITIONS. In this chapter: (1) "Authorized facility" means: (A) a hospital licensed under Chapter 241; (B) a hospital maintained or operated by this state or an agency of this state; (C) an ambulatory surgical center licensed under Chapter 243; or (D) a birthing center licensed under Chapter 244. (2) "Human fetal tissue" means any gestational human organ, cell, or tissue from an unborn child. The term does not include supporting cells or tissue derived from a pregnancy, associated maternal tissue that is not part of the unborn child, the umbilical cord, or the placenta. Sec. 173.002. APPLICABILITY. This chapter does not apply to: (1) human fetal tissue obtained for diagnostic or pathological testing; (2) human fetal tissue obtained for a criminal investigation; (3) human fetal tissue or human tissue obtained during pregnancy or at delivery of a child, provided the tissue is obtained by an accredited public or private institution of higher education for use in research approved by an institutional review board or another appropriate board, committee, or body charged with oversight applicable to the research; or (4) cell lines derived from human fetal tissue or human tissue existing on September 1, 2017, that are used by an accredited public or private institution of higher education in research approved by an institutional review board or another appropriate board, committee, or body charged with oversight applicable to the research. Sec. 173.003. ENFORCEMENT. (a) The department shall enforce this chapter. (b) The attorney general, on request of the department or a local law enforcement agency, may assist in the investigation of a violation of this chapter. Sec. 173.004. PROHIBITED DONATION. A person may not donate human fetal tissue except as authorized by this chapter. Sec. 173.005. DONATION BY AUTHORIZED FACILITY. (a) Only an authorized facility may donate human fetal tissue. An authorized facility may donate human fetal tissue only to an accredited public or private institution of higher education for use in research approved by an institutional review board or another appropriate board, committee, or body charged with oversight applicable to the research. (b) An authorized facility may not donate human fetal tissue obtained from an elective abortion. Sec. 173.006. INFORMED CONSENT REQUIRED. An authorized facility may not donate human fetal tissue under this chapter unless the facility has obtained the written, voluntary, and informed consent of the woman from whose pregnancy the fetal tissue is obtained. The consent must be provided on a standard form prescribed by the department. Sec. 173.007. CRIMINAL PENALTY. (a) A person commits an offense if the person: (1) offers a woman monetary or other consideration to: (A) have an abortion for the purpose of donating human fetal tissue; or (B) consent to the donation of human fetal tissue; or (2) knowingly or intentionally solicits or accepts tissue from a fetus gestated solely for research purposes. (b) An offense under this section is a Class A misdemeanor punishable by a fine of not more than $10,000. (c) With the consent of the appropriate local county or district attorney, the attorney general has concurrent jurisdiction with that consenting local prosecutor to prosecute an offense under this section. Sec. 173.008. RECORD RETENTION. Unless another law requires a longer period of record retention, an authorized facility may not dispose of any medical record relating to a woman who consents to the donation of human fetal tissue before: (1) the seventh anniversary of the date consent was obtained under Section 173.006; or (2) if the woman was younger than 18 years of age on the date consent was obtained under Section 173.006, the later of: (A) the woman's 23rd birthday; or (B) the seventh anniversary of the date consent was obtained. Sec. 173.009. ANNUAL REPORT. An authorized facility that donates human fetal tissue under this chapter shall submit an annual report to the department that includes for each donation: (1) the specific type of fetal tissue donated; and (2) the accredited public or private institution of higher education that received the donation. SECTION 3. Subtitle B, Title 8, Health and Safety Code, is amended by adding Chapter 697 to read as follows: CHAPTER 697. DISPOSITION OF EMBRYONIC AND FETAL TISSUE REMAINS Sec. 697.001. PURPOSE. The purpose of this chapter is to express the state's profound respect for the life of the unborn by providing for a dignified disposition of embryonic and fetal tissue remains. Sec. 697.002. DEFINITIONS. In this chapter: (1) "Cremation" means the irreversible process of reducing remains to bone fragments through direct flame, extreme heat, and evaporation. (2) "Department" means the Department of State Health Services. (3) "Embryonic and fetal tissue remains" means an embryo, a fetus, body parts, or organs from a pregnancy that terminates in the death of the embryo or fetus and for which the issuance of a fetal death certificate is not required by state law. The term does not include the umbilical cord, placenta, gestational sac, blood, or body fluids. (4) "Executive commissioner" means the executive commissioner of the Health and Human Services Commission. (5) "Incineration" means the process of burning remains in an incinerator. (6) "Interment" means the disposition of remains by entombment, burial, or placement in a niche. (7) "Steam disinfection" means the act of subjecting remains to steam under pressure to disinfect the remains. Sec. 697.003. APPLICABILITY OF OTHER LAW. Embryonic and fetal tissue remains are not pathological waste under state law. Unless otherwise provided by this chapter, Chapters 711 and 716 of this code and Chapter 651, Occupations Code, do not apply to the disposition of embryonic and fetal tissue remains. Sec. 697.004. DISPOSITION OF EMBRYONIC AND FETAL TISSUE REMAINS. (a) Subject to Section 241.010, a health care facility in this state that provides health or medical care to a pregnant woman shall dispose of embryonic and fetal tissue remains that are passed or delivered at the facility by: (1) interment; (2) cremation; (3) incineration followed by interment; or (4) steam disinfection followed by interment. (b) The ashes resulting from the cremation or incineration of embryonic and fetal tissue remains: (1) may be interred or scattered in any manner as authorized by law for human remains; and (2) may not be placed in a landfill. (c) A health care facility responsible for disposing of embryonic and fetal tissue remains may coordinate with an entity in the registry established under Section 697.005 in an effort to offset the cost associated with burial or cremation of the embryonic and fetal tissue remains of an unborn child. (d) Notwithstanding any other law, the umbilical cord, placenta, gestational sac, blood, or body fluids from a pregnancy terminating in the death of the embryo or fetus for which the issuance of a fetal death certificate is not required by state law may be disposed of in the same manner as and with the embryonic and fetal tissue remains from that same pregnancy as authorized by this chapter. Sec. 697.005. BURIAL OR CREMATION ASSISTANCE REGISTRY. The department shall: (1) establish and maintain a registry of: (A) participating funeral homes and cemeteries willing to provide free common burial or low-cost private burial; and (B) private nonprofit organizations that register with the department to provide financial assistance for the costs associated with burial or cremation of the embryonic and fetal tissue remains of an unborn child; and (2) make the registry information available on request to a physician, health care facility, or agent of a physician or health care facility. Sec. 697.006. ETHICAL FETAL REMAINS GRANT PROGRAM. The department shall develop a grant program that uses private donations to provide financial assistance for the costs associated with disposing of embryonic and fetal tissue remains. Sec. 697.007. SUSPENSION OR REVOCATION OF LICENSE. The department may suspend or revoke the license of a health care facility that violates this chapter or a rule adopted under this chapter. Sec. 697.008. CIVIL PENALTY. (a) A person that violates this chapter or a rule adopted under this chapter is liable for a civil penalty in an amount of $1,000 for each violation. (b) The attorney general, at the request of the department, may sue to collect the civil penalty. The attorney general may recover reasonable expenses incurred in collecting the civil penalty, including court costs, reasonable attorney's fees, investigation costs, witness fees, and disposition expenses. Sec. 697.009. RULES. The executive commissioner shall adopt rules to implement this chapter. SECTION 4. 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; (19) performs an abortion on an unemancipated minor without the written consent of the child's parent, managing conservator, or legal guardian or without a court order, as provided by Section 33.003 or 33.004, Family Code, unless the abortion is necessary due to a medical emergency, as defined by Section 171.002, Health and Safety Code; (20) otherwise performs an abortion on an unemancipated minor in violation of Chapter 33, Family Code; or (21) performs or induces or attempts to perform or induce an abortion in violation of Subchapter C or F, Chapter 171, Health and Safety Code. SECTION 5. Section 164.055(b), Occupations Code, is amended to read as follows: (b) The sanctions provided by Subsection (a) are in addition to any other grounds for refusal to admit persons to examination under this subtitle or to issue a license or renew a license to practice medicine under this subtitle. The criminal penalties provided by Section 165.152 do not apply to a violation of Section 170.002, Health and Safety Code, or Subchapter C or F, Chapter 171, Health and Safety Code. SECTION 6. Section 48.02(a), Penal Code, is amended to read as follows: (a) In this section, "human ["Human] organ" means the human kidney, liver, heart, lung, pancreas, eye, bone, skin, [fetal tissue,] or any other human organ or tissue, but does not include hair or blood, blood components (including plasma), blood derivatives, or blood reagents. The term does not include human fetal tissue as defined by Section 48.03. SECTION 7. Chapter 48, Penal Code, is amended by adding Section 48.03 to read as follows: Sec. 48.03. PROHIBITION ON PURCHASE AND SALE OF HUMAN FETAL TISSUE. (a) In this section, "human fetal tissue" has the meaning assigned by Section 173.001, Health and Safety Code. (b) A person commits an offense if the person knowingly offers to buy, offers to sell, acquires, receives, sells, or otherwise transfers any human fetal tissue for economic benefit. (c) An offense under this section is a state jail felony. (d) It is a defense to prosecution under this section that the actor: (1) is an employee of or under contract with an accredited public or private institution of higher education; and (2) acquires, receives, or transfers human fetal tissue solely for the purpose of fulfilling a donation authorized by Section 173.005, Health and Safety Code. (e) This section does not apply to: (1) human fetal tissue acquired, received, or transferred solely for diagnostic or pathological testing; (2) human fetal tissue acquired, received, or transferred solely for the purposes of a criminal investigation; (3) human fetal tissue acquired, received, or transferred solely for the purpose of disposing of the tissue in accordance with state law or rules applicable to the disposition of human fetal tissue remains; (4) human fetal tissue or human tissue acquired during pregnancy or at delivery of a child, provided the tissue is acquired by an accredited public or private institution of higher education for use in research approved by an institutional review board or another appropriate board, committee, or body charged with oversight applicable to the research; or (5) cell lines derived from human fetal tissue or human tissue existing on September 1, 2017, that are used by an accredited public or private institution of higher education in research approved by an institutional review board or another appropriate board, committee, or body charged with oversight applicable to the research. (f) With the consent of the appropriate local county or district attorney, the attorney general has concurrent jurisdiction with that consenting local prosecutor to prosecute an offense under this section. SECTION 8. (a) Not later than December 1, 2017, the executive commissioner of the Health and Human Services Commission shall adopt any rules necessary to implement Chapters 173 and 697, Health and Safety Code, as added by this Act. (b) The Department of State Health Services shall: (1) not later than October 1, 2017, establish the grant program required by Section 697.006, Health and Safety Code, as added by this Act; (2) not later than December 1, 2017, prescribe the standard consent form required by Section 173.006, Health and Safety Code, as added by this Act; and (3) not later than February 1, 2018, begin to award grants under the grant program described by Subdivision (1) of this subsection. SECTION 9. (a) Subchapter F, Chapter 171, Health and Safety Code, as added by this Act, applies only to an abortion performed 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 immediately before the effective date of this Act, and that law is continued in effect for that purpose. (b) Sections 173.003, 173.004, 173.005, and 173.006, Health and Safety Code, as added by this Act, apply to a donation of human fetal tissue that occurs on or after the effective date of this Act, regardless of whether the human fetal tissue was acquired before, on, or after that date. (c) An authorized facility is not required to make an initial annual report under Section 173.009, Health and Safety Code, as added by this Act, before January 1, 2019. (d) Chapter 697, Health and Safety Code, as added by this Act, applies only to the disposition of embryonic and fetal tissue remains that occurs on or after February 1, 2018. The disposition of embryonic and fetal tissue remains that occurs before February 1, 2018, is governed by the law in effect immediately before the effective date of this Act, and the former law is continued in effect for that purpose. (e) Chapter 48, Penal Code, as amended by this Act, applies only to an offense committed on or after the effective date of this Act. An offense committed before the effective date of this Act is governed by the law in effect on the date the offense was committed, and the former law is continued in effect for that purpose. For purposes of this subsection, an offense was committed before the effective date of this Act if any element of the offense occurred before that date. SECTION 10. This Act takes effect September 1, 2017.