By: King of Parker H.B. No. 4463
A BILL TO BE ENTITLED
AN ACT
relating to required counseling before an abortion is performed.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 171.012(a), Health and Safety Code, is
amended to read as follows:
(a) Consent to an abortion is voluntary and informed only
if:
(1) the physician who is to perform the abortion
informs the pregnant woman on whom the abortion is to be performed
of:
(A) the physician's name;
(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;
(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 commission
[Department of State Health Services];
(ii) are accessible on an Internet website
sponsored by the commission [department];
(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;
(5) before receiving a sonogram under Subdivision
(4)(A) and before the abortion is performed 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, TEXAS HEALTH AND SAFETY CODE, 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, TEXAS HEALTH AND SAFETY CODE, 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";
(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 (5); [and]
(7) the pregnant woman is provided the name of each
person who provides or explains the information required under this
subsection; and
(8) except during a medical emergency and before the
abortion is performed, the physician certifies using a unique
identifying number, devoid of personally identifying information
of the pregnant woman, that:
(A) the pregnant woman received pre-abortion
counseling at no cost to the pregnant woman from a counselor who:
(i) meets the qualifications established by
commission rule;
(ii) is not employed by, contracted with,
or has a pecuniary interest in a facility licensed under Chapter
245, Health Safety Code;
(iii) is authorized under a contract with
the commission to provide counseling services in accordance with
this subdivision; and
(B) the counselor provided the pregnant woman in
accordance with commission rules:
(i) medically accurate information using
the informational materials described by Section 171.014;
(ii) an assessment of and offer of
assistance in obtaining support services other than abortion that
the pregnant woman may need or be eligible for, including housing,
employment, resume development, child care, medical care, adoption
services, and health benefit plan coverage;
(iii) education on available state and
local resources to address the pregnant woman's socioeconomic
needs;
(iv) screening for domestic violence,
coercion of abortion, or human trafficking; and
(C) the counselor certified using a unique
identifying number, devoid of personally identifying information
of the pregnant woman, that the pregnant woman completed the
counseling.
(D) the counselor reported to the commission
de-identified demographic information to assist the commission in
determining the supply and demand of social services in the
pregnant woman's geographic region.
SECTION 2. Section 171.0121, Health and Safety Code, is
amended to read as follows:
Sec. 171.0121. MEDICAL RECORD. (a) Before the abortion
begins, a copy of the signed, written certification received by the
physician under Section 171.012(a)(6) and documentation of the
completed counseling required under Section 171.012(a)(8) must be
placed in the pregnant woman's medical records.
(b) A copy of the signed, written certification required
under Sections 171.012(a)(5) and (6), and documentation of the
completed counseling required under Section 171.012(a)(8) shall be
retained by the facility where the abortion is performed until:
(1) the seventh anniversary of the date it is signed;
or
(2) if the pregnant woman is a minor, the later of:
(A) the seventh anniversary of the date it is
signed; or
(B) the woman's 21st birthday.
SECTION 3. (a) Notwithstanding Sections 171.012 and
171.0121, Health and Safety Code, as amended by this Act, a
physician is not required to comply with the changes in law made by
this Act before March 1, 2020.
(b) Not later than December 1, 2020, the executive
commissioner of the Health and Human Services Commission shall
adopt rules as necessary to implement this Act.
(c) Not later than March 1, 2020, the Health and Human
Services Commission shall contract with one or more counseling
providers throughout the state to provide the services described by
Section 171.012, Health and Safety Code, as amended by this Act.
SECTION 4. The changes in law made by this Act apply only to
an abortion performed on or after March 1, 2020. An abortion
performed before March 1, 2020, is governed by the law applicable to
the abortion immediately before the effective date of this Act, and
that law is continued in effect for that purpose.
Section 5. It is the intent of the legislature that every
provision, section, subsection, sentence, clause, phrase, or word
in this Act, and every application of the provisions in this Act to
each person or entity, are severable from each other. If any
application of any provision in this Act to any person, group of
persons, or circumstances is found by a court to be invalid for any
reason, the remaining applications of that provision to all other
persons and circumstances shall be severed and may not be affected.
SECTION 6. This Act takes effect September 1, 2019.