Texas 2021 - 87th Regular

Texas House Bill HB3218 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1	1		87R13880 SCL-F
2		-	By: Schaefer~~, Oliverson, et al.~~ H.B. No. 3218
	2	+	By: Schaefer H.B. No. 3218
3	3
4	4
5	5		A BILL TO BE ENTITLED
6	6		AN ACT
7	7		relating to the regulation of abortion, including information
8	8		regarding perinatal palliative care and prohibiting discriminatory
9	9		abortions; authorizing disciplinary action; providing a civil
10	10		remedy; creating a criminal offense.
11	11		BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
12	12		SECTION 1. This Act may be cited as the Preborn
13	13		Nondiscrimination Act.
14	14		SECTION 2. The legislature finds that:
15	15		(1) Texas has a compelling state interest in
16	16		protecting all Texans from discrimination based on sex, race, and
17	17		disability; and
18	18		(2) Texas enforces prohibitions against
19	19		discrimination based on sex, race, and disability in various areas,
20	20		including housing, employment, education, insurance, and health
21	21		program and service provision.
22	22		SECTION 3. Chapter 161, Health and Safety Code, is amended
23	23		by adding Subchapter X to read as follows:
24	24		SUBCHAPTER X. PERINATAL PALLIATIVE CARE
25	25		Sec. 161.701. PURPOSE OF SUBCHAPTER. The purpose of this
26	26		subchapter is to ensure that a pregnant woman who receives a
27	27		diagnosis of a life-threatening disability of the woman's preborn
28	28		child is informed of the availability of perinatal palliative care.
29	29		Sec. 161.702. DEFINITION. In this subchapter, "perinatal
30	30		palliative care" means the provision of comprehensive, supportive
31	31		care to reduce the suffering of a pregnant woman, her preborn child,
32	32		and her family, from diagnosis of the preborn child's
33	33		life-threatening disability through the delivery and possible
34	34		death of the child as a result of the life-threatening disability.
35	35		The term includes medical, social, and mental health care,
36	36		including counseling and health care provided by maternal-fetal
37	37		medical specialists, obstetricians, neonatologists, anesthesia
38	38		specialists, specialty nurses, clergy, social workers, and other
39	39		individuals focused on alleviating fear and pain and ensuring the
40	40		pregnant woman, her preborn child, and her family experience a
41	41		supportive environment.
42	42		Sec. 161.703. PERINATAL PALLIATIVE CARE INFORMATIONAL
43	43		MATERIALS. (a) The commission shall develop perinatal palliative
44	44		care informational materials and post the materials on the
45	45		commission's Internet website. The materials must include:
46	46		(1) a description of the health care and other
47	47		services available through perinatal palliative care; and
48	48		(2) information about medical assistance benefits
49	49		that may be available for prenatal care, childbirth, and perinatal
50	50		palliative care.
51	51		(b) The commission shall develop, regularly update, and
52	52		publish a geographically indexed list of all perinatal palliative
53	53		care providers and programs in this state. The commission may
54	54		include perinatal palliative care providers and programs in other
55	55		states that provide care to residents of this state but may not
56	56		include an abortion provider, as defined by Section 171.002, or an
57	57		affiliate, as defined by Section 2272.001, Government Code, as
58	58		added by Chapter 501 (S.B. 22), Acts of the 86th Legislature,
59	59		Regular Session, 2019, of an abortion provider. The commission
60	60		shall post the list of perinatal palliative care providers and
61	61		programs, including contact information, on the commission's
62	62		Internet website and note the providers and programs that provide
63	63		services free of charge.
64	64		Sec. 161.704. PERINATAL PALLIATIVE CARE CERTIFICATION
65	65		FORM. The commission shall develop a form on which a pregnant woman
66	66		certifies that she has received the perinatal palliative care
67	67		informational materials and list of the perinatal palliative care
68	68		providers and programs described by Section 161.703.
69	69		Sec. 161.705. HEALTH CARE PROVIDER DUTIES ON DIAGNOSIS OF
70	70		PREBORN CHILD'S LIFE-THREATENING DISABILITY. A health care
71	71		provider who diagnoses a pregnant woman's preborn child as having a
72	72		life-threatening disability shall, at the time of the diagnosis:
73	73		(1) provide the pregnant woman with a written copy of:
74	74		(A) the perinatal palliative care informational
75	75		materials and list of the perinatal palliative care providers and
76	76		programs described by Section 161.703; and
77	77		(B) the perinatal palliative care certification
78	78		form described by Section 161.704; and
79	79		(2) obtain from the pregnant woman the signed
80	80		perinatal palliative care certification form and place the form in
81	81		the pregnant woman's medical records.
82	82		Sec. 161.706. EXCEPTION. A health care provider is not
83	83		required to provide the perinatal palliative care informational
84	84		materials or perinatal palliative care certification form under
85	85		this subchapter if the health care provider verifies the pregnant
86	86		woman's medical record contains a signed perinatal palliative care
87	87		certification form for that pregnancy as required under Section
88	88		161.705(2).
89	89		SECTION 4. Chapter 170, Health and Safety Code, is amended
90	90		by designating Sections 170.001 and 170.002 as Subchapter A and
91	91		adding a subchapter heading to read as follows:
92	92		SUBCHAPTER A. GENERAL PROVISIONS; THIRD TRIMESTER
93	93		ABORTION PROHIBITED
94	94		SECTION 5. Section 170.001, Health and Safety Code, is
95	95		amended by adding Subdivision (2-a) to read as follows:
96	96		(2-a) "Preborn child" means an unborn child as defined
97	97		by Section 171.061.
98	98		SECTION 6. Section 170.002, Health and Safety Code, is
99	99		amended to read as follows:
100	100		Sec. 170.002. PROHIBITED ACTS; EXEMPTION. (a) Except as
101	101		provided by Subsection (b), a person may not intentionally or
102	102		knowingly perform an abortion on a woman who is pregnant with a
103	103		preborn [viable unborn] child during the third trimester of the
104	104		pregnancy.
105	105		(b) Subsection (a) does not prohibit a person from
106	106		performing an abortion if at the time of the abortion the person is
107	107		a physician and concludes in good faith according to the
108	108		physician's best medical judgment that[:
109	109		[(1) the fetus is not a viable fetus and the pregnancy
110	110		is not in the third trimester;
111	111		[(2)] the abortion is necessary due to a medical
112	112		emergency, as defined by Section 171.002 [to prevent the death or a
113	113		substantial risk of serious impairment to the physical or mental
114	114		health of the woman; or
115	115		[(3) the fetus has a severe and irreversible
116	116		abnormality, identified by reliable diagnostic procedures].
117	117		(c) A physician who performs an abortion that, according to
118	118		the physician's best medical judgment at the time of the abortion,
119	119		is to abort a preborn [viable unborn] child during the third
120	120		trimester of the pregnancy shall certify in writing to the
121	121		commission, on a form prescribed by the commission, the medical
122	122		indications supporting the physician's judgment that the abortion
123	123		was authorized by Subsection (b) [(b)(2) or (3). If the physician
124	124		certifies the abortion was authorized by Subsection (b)(3), the
125	125		physician shall certify in writing on the form the fetal
126	126		abnormality identified by the physician]. The certification must
127	127		be made not later than the 30th day after the date the abortion was
128	128		performed.
129	129		SECTION 7. Chapter 170, Health and Safety Code, is amended
130	130		by adding Subchapter B to read as follows:
131	131		SUBCHAPTER B. DISCRIMINATORY ABORTION PROHIBITED
132	132		Sec. 170.051. DEFINITION. In this subchapter, "disability"
133	133		means:
134	134		(1) a physical or mental impairment that would
135	135		substantially limit one or more of an individual's major life
136	136		activities;
137	137		(2) an assessment referencing an individual's
138	138		impairment described by Subdivision (1); or
139	139		(3) a physical disfigurement, scoliosis, dwarfism,
140	140		Down syndrome, albinism, amelia, or any other type of physical,
141	141		mental, or intellectual abnormality or disease.
142	142		Sec. 170.052. DISCRIMINATORY ABORTION PROHIBITED. A person
143	143		may not:
144	144		(1) knowingly perform or attempt to perform on a
145	145		pregnant woman an abortion based on the race, ethnicity, sex, or
146	146		disability of the woman's preborn child, including a probability of
147	147		diagnosis that the child has a disability; or
148	148		(2) use force or the threat of force to intentionally
149	149		injure or intimidate a person to coerce the performance or
150	150		attempted performance of an abortion based on the race, ethnicity,
151	151		sex, or disability of the woman's preborn child, including a
152	152		probability of diagnosis that the child has a disability.
153	153		Sec. 170.053. CRIMINAL PENALTY. (a) A person who violates
154	154		Section 170.052 commits an offense. An offense under this
155	155		subsection is a Class A misdemeanor.
156	156		(b) A woman on whom an abortion is performed or attempted in
157	157		violation of Section 170.052 may not be prosecuted for a violation
158	158		of that section or for conspiracy to commit a violation of that
159	159		section.
160	160		Sec. 170.054. LICENSE SUSPENSION OR REVOCATION. A
161	161		physician who violates Section 170.052 engages in unprofessional
162	162		conduct for which the physician's license may be suspended or
163	163		revoked under Chapter 164, Occupations Code.
164	164		Sec. 170.055. CIVIL REMEDIES. (a) A civil action may be
165	165		brought against a person who violates Section 170.052 by:
166	166		(1) the woman on whom an abortion was performed or
167	167		attempted in violation of Section 170.052;
168	168		(2) the father of the preborn child for an abortion
169	169		performed or attempted on a pregnant woman in violation of Section
170	170		170.052, unless the woman's pregnancy resulted from the father's
171	171		criminal conduct; or
172	172		(3) a maternal grandparent of the preborn child for an
173	173		abortion performed or attempted in violation of Section 170.052 on
174	174		a pregnant woman who was less than 18 years of age at the time of the
175	175		violation, unless the woman's pregnancy resulted from the maternal
176	176		grandparent's criminal conduct.
177	177		(b) A person who brings an action under this section may
178	178		obtain:
179	179		(1) injunctive relief;
180	180		(2) damages incurred by the person, including:
181	181		(A) actual damages for all psychological,
182	182		emotional, and physical injuries resulting from the violation of
183	183		Section 170.052;
184	184		(B) court costs; and
185	185		(C) reasonable attorney's fees; or
186	186		(3) both injunctive relief and damages.
187	187		(c) An action for damages or injunctive relief under this
188	188		section must be filed:
189	189		(1) in a district court in the county in which the
190	190		woman on whom an abortion was performed or attempted in violation of
191	191		Section 170.052 resides; and
192	192		(2) not later than the sixth anniversary of the date
193	193		the abortion was performed or attempted in violation of Section
194	194		170.052.
195	195		(d) The damages and injunctive relief authorized by this
196	196		section are in addition to any other remedy available by law.
197	197		(e) A civil action under this section may not be brought
198	198		against a woman on whom an abortion is performed or attempted in
199	199		violation of Section 170.052.
200	200		SECTION 8. Section 171.002, Health and Safety Code, is
201	201		amended by adding Subdivision (3-a) to read as follows:
202	202		(3-a) "Preborn child" means an unborn child as defined
203	203		by Section 171.061.
204	204		SECTION 9. Section 171.012, Health and Safety Code, is
205	205		amended by amending Subsection (a) and adding Subsections (g) and
206	206		(h) to read as follows:
207	207		(a) Consent to an abortion is voluntary and informed only
208	208		if:
209	209		(1) the physician who is to perform the abortion
210	210		informs the pregnant woman on whom the abortion is to be performed
211	211		of:
212	212		(A) the physician's name;
213	213		(B) the particular medical risks associated with
214	214		the particular abortion procedure to be employed, including, when
215	215		medically accurate:
216	216		(i) the risks of infection and hemorrhage;
217	217		(ii) the potential danger to a subsequent
218	218		pregnancy and of infertility; and
219	219		(iii) the possibility of increased risk of
220	220		breast cancer following an induced abortion and the natural
221	221		protective effect of a completed pregnancy in avoiding breast
222	222		cancer;
223	223		(C) the probable gestational age of the preborn
224	224		[unborn] child at the time the abortion is to be performed; [and]
225	225		(D) the medical risks associated with carrying
226	226		the preborn child to term; and
227	227		(E) the state law prohibiting abortion of a
228	228		preborn child solely on the basis of the preborn child's race,
229	229		ethnicity, sex, or disability as defined by Section 170.051,
230	230		including a probability of diagnosis that the child has a
231	231		disability;
232	232		(2) the physician who is to perform the abortion or the
233	233		physician's agent informs the pregnant woman that:
234	234		(A) medical assistance benefits may be available
235	235		for prenatal care, childbirth, and neonatal care;
236	236		(B) the father is liable for assistance in the
237	237		support of the child without regard to whether the father has
238	238		offered to pay for the abortion; and
239	239		(C) public and private agencies provide
240	240		pregnancy prevention counseling and medical referrals for
241	241		obtaining pregnancy prevention medications or devices, including
242	242		emergency contraception for victims of rape or incest;
243	243		(3) the physician who is to perform the abortion or the
244	244		physician's agent:
245	245		(A) provides the pregnant woman with the printed
246	246		materials described by Section 171.014; and
247	247		(B) informs the pregnant woman that those
248	248		materials:
249	249		(i) have been provided by the Health and
250	250		Human Services Commission [Department of State Health Services];
251	251		(ii) are accessible on an Internet website
252	252		sponsored by the commission [department];
253	253		(iii) describe the preborn [unborn] child
254	254		and list agencies that offer alternatives to abortion; and
255	255		(iv) include a list of agencies that offer
256	256		sonogram services at no cost to the pregnant woman;
257	257		(4) before any sedative or anesthesia is administered
258	258		to the pregnant woman and at least 24 hours before the abortion or
259	259		at least two hours before the abortion if the pregnant woman waives
260	260		this requirement by certifying that she currently lives 100 miles
261	261		or more from the nearest abortion provider that is a facility
262	262		licensed under Chapter 245 or a facility that performs more than 50
263	263		abortions in any 12-month period:
264	264		(A) the physician who is to perform the abortion
265	265		or an agent of the physician who is also a sonographer certified by
266	266		a national registry of medical sonographers performs a sonogram on
267	267		the pregnant woman on whom the abortion is to be performed;
268	268		(B) the physician who is to perform the abortion
269	269		displays the sonogram images in a quality consistent with current
270	270		medical practice in a manner that the pregnant woman may view them;
271	271		(C) the physician who is to perform the abortion
272	272		provides, in a manner understandable to a layperson, a verbal
273	273		explanation of the results of the sonogram images, including a
274	274		medical description of the dimensions of the embryo or fetus, the
275	275		presence of cardiac activity, and the presence of external members
276	276		and internal organs; and
277	277		(D) the physician who is to perform the abortion
278	278		or an agent of the physician who is also a sonographer certified by
279	279		a national registry of medical sonographers makes audible the heart
280	280		auscultation for the pregnant woman to hear, if present, in a
281	281		quality consistent with current medical practice and provides, in a
282	282		manner understandable to a layperson, a simultaneous verbal
283	283		explanation of the heart auscultation;
284	284		(5) before receiving a sonogram under Subdivision
285	285		(4)(A) and before the abortion is performed and before any sedative
286	286		or anesthesia is administered, the pregnant woman completes and
287	287		certifies with her signature an election form that states as
288	288		follows:
289	289		"ABORTION AND SONOGRAM ELECTION
290	290		(1) THE INFORMATION AND PRINTED MATERIALS
291	291		DESCRIBED BY SECTIONS 171.012(a)(1)-(3), TEXAS HEALTH
292	292		AND SAFETY CODE, HAVE BEEN PROVIDED AND EXPLAINED TO
293	293		ME.
294	294		(2) I UNDERSTAND THE NATURE AND CONSEQUENCES OF
295	295		AN ABORTION.
296	296		(3) TEXAS LAW REQUIRES THAT I RECEIVE A SONOGRAM
297	297		PRIOR TO RECEIVING AN ABORTION.
298	298		(4) I UNDERSTAND THAT I HAVE THE OPTION TO VIEW
299	299		THE SONOGRAM IMAGES.
300	300		(5) I UNDERSTAND THAT I HAVE THE OPTION TO HEAR
301	301		THE HEARTBEAT.
302	302		(6) I UNDERSTAND THAT I AM REQUIRED BY LAW TO
303	303		HEAR AN EXPLANATION OF THE SONOGRAM IMAGES UNLESS I
304	304		CERTIFY IN WRITING TO ONE OF THE FOLLOWING:
305	305		___ I AM PREGNANT AS A RESULT OF A SEXUAL
306	306		ASSAULT, INCEST, OR OTHER VIOLATION OF THE TEXAS PENAL
307	307		CODE THAT HAS BEEN REPORTED TO LAW ENFORCEMENT
308	308		AUTHORITIES OR THAT HAS NOT BEEN REPORTED BECAUSE I
309	309		REASONABLY BELIEVE THAT DOING SO WOULD PUT ME AT RISK
310	310		OF RETALIATION RESULTING IN SERIOUS BODILY INJURY.
311	311		___ I AM A MINOR AND OBTAINING AN ABORTION IN
312	312		ACCORDANCE WITH JUDICIAL BYPASS PROCEDURES UNDER
313	313		CHAPTER 33, TEXAS FAMILY CODE.
314	314		[___ MY FETUS HAS AN IRREVERSIBLE MEDICAL
315	315		CONDITION OR ABNORMALITY, AS IDENTIFIED BY RELIABLE
316	316		DIAGNOSTIC PROCEDURES AND DOCUMENTED IN MY MEDICAL
317	317		FILE.]
318	318		(7) I AM MAKING THIS ELECTION OF MY OWN FREE WILL
319	319		AND WITHOUT COERCION.
320	320		(8) FOR A WOMAN WHO LIVES 100 MILES OR MORE FROM
321	321		THE NEAREST ABORTION PROVIDER THAT IS A FACILITY
322	322		LICENSED UNDER CHAPTER 245, TEXAS HEALTH AND SAFETY
323	323		CODE, OR A FACILITY THAT PERFORMS MORE THAN 50
324	324		ABORTIONS IN ANY 12-MONTH PERIOD ONLY:
325	325		I CERTIFY THAT, BECAUSE I CURRENTLY LIVE 100
326	326		MILES OR MORE FROM THE NEAREST ABORTION PROVIDER THAT
327	327		IS A FACILITY LICENSED UNDER CHAPTER 245, TEXAS HEALTH
328	328		AND SAFETY CODE, OR A FACILITY THAT PERFORMS MORE THAN
329	329		50 ABORTIONS IN ANY 12-MONTH PERIOD, I WAIVE THE
330	330		REQUIREMENT TO WAIT 24 HOURS AFTER THE SONOGRAM IS
331	331		PERFORMED BEFORE RECEIVING THE ABORTION PROCEDURE. MY
332	332		PLACE OF RESIDENCE IS:__________.
333	333		________________________________________
334	334		SIGNATURE DATE";
335	335		(6) before the abortion is performed, the physician
336	336		who is to perform the abortion receives a copy of the signed,
337	337		written certification required by Subdivision (5); and
338	338		(7) the pregnant woman is provided the name of each
339	339		person who provides or explains the information required under this
340	340		subsection.
341	341		(g) If the pregnant woman's preborn child has been diagnosed
342	342		with a life-threatening disability, the physician who is to perform
343	343		the abortion shall, at least 24 hours before the abortion or at
344	344		least two hours before the abortion if the pregnant woman waives
345	345		this requirement by certifying that she currently lives 100 miles
346	346		or more from the nearest abortion provider that is a facility
347	347		licensed under Chapter 245 or a facility in which more than 50
348	348		abortions are performed in any 12-month period:
349	349		(1) orally and in person, inform the pregnant woman of
350	350		the availability of perinatal palliative care, as that term is
351	351		defined by Section 161.702; and
352	352		(2) provide the pregnant woman with a written copy of:
353	353		(A) the perinatal palliative care informational
354	354		materials and list of the perinatal palliative care providers and
355	355		programs described by Section 161.703; and
356	356		(B) the perinatal palliative care certification
357	357		form described by Section 161.704.
358	358		(h) If a pregnant woman described by Subsection (g), after
359	359		receiving from the physician who is to perform the abortion the
360	360		perinatal palliative care informational materials and
361	361		certification form described by that subsection in the manner
362	362		required by that subsection, chooses to have an abortion instead of
363	363		continuing the pregnancy in perinatal palliative care, the
364	364		physician may perform the abortion only after:
365	365		(1) the pregnant woman signs the certification form;
366	366		and
367	367		(2) the physician places the signed certification form
368	368		in the pregnant woman's medical records.
369	369		SECTION 10. Section 171.0121, Health and Safety Code, is
370	370		amended to read as follows:
371	371		Sec. 171.0121. MEDICAL RECORD. (a) Before the abortion
372	372		begins, a copy of the signed, written certification received by the
373	373		physician under Section 171.012(a)(6) and, if applicable, under
374	374		Section 161.704 must be placed in the pregnant woman's medical
375	375		records.
376	376		(b) A copy of the signed, written certification required
377	377		under Sections 171.012(a)(5) and (6) and of any signed, written
378	378		certification required under Section 161.704 shall be retained by
379	379		the facility where the abortion is performed until:
380	380		(1) the seventh anniversary of the date the
381	381		certification [it] is signed; or
382	382		(2) if the pregnant woman is a minor, the later of:
383	383		(A) the seventh anniversary of the date the
384	384		certification [it] is signed; or
385	385		(B) the woman's 21st birthday.
386	386		SECTION 11. Section 171.0122(d), Health and Safety Code, is
387	387		amended to read as follows:
388	388		(d) A pregnant woman may choose not to receive the verbal
389	389		explanation of the results of the sonogram images under Section
390	390		171.012(a)(4)(C) if:
391	391		(1) the woman's pregnancy is a result of a sexual
392	392		assault, incest, or other violation of the Penal Code that has been
393	393		reported to law enforcement authorities or that has not been
394	394		reported because she has a reason that she declines to reveal
395	395		because she reasonably believes that to do so would put her at risk
396	396		of retaliation resulting in serious bodily injury; or
397	397		(2) the woman is a minor and obtaining an abortion in
398	398		accordance with judicial bypass procedures under Chapter 33, Family
399	399		Code[; or
400	400		[(3) the fetus has an irreversible medical condition
401	401		or abnormality, as previously identified by reliable diagnostic
402	402		procedures and documented in the woman's medical file].
403	403		SECTION 12. Section 171.014(a), Health and Safety Code, is
404	404		amended to read as follows:
405	405		(a) The department shall publish informational materials
406	406		that include:
407	407		(1) the information required to be provided under
408	408		Sections 171.012(a)(1)(B), [and] (D), and (E) and (a)(2)(A), (B),
409	409		and (C); and
410	410		(2) the materials required by Sections 161.703,
411	411		171.015, and 171.016.
412	412		SECTION 13. Section 171.042, Health and Safety Code, is
413	413		amended to read as follows:
414	414		Sec. 171.042. DEFINITION [DEFINITIONS]. In this
415	415		subchapter, [:
416	416		[(1)] "post-fertilization [Post-fertilization] age"
417	417		means the age of the preborn [unborn] child as calculated from the
418	418		fusion of a human spermatozoon with a human ovum.
419	419		[(2) "Severe fetal abnormality" has the meaning
420	420		assigned by Section 285.202.]
421	421		SECTION 14. Sections 171.043, 171.044, and 171.045, Health
422	422		and Safety Code, are amended to read as follows:
423	423		Sec. 171.043. DETERMINATION OF POST-FERTILIZATION AGE
424	424		REQUIRED. Except as otherwise provided by Section 171.046, a
425	425		physician may not perform or induce or attempt to perform or induce
426	426		an abortion without, prior to the procedure:
427	427		(1) making a determination of the probable
428	428		post-fertilization age of the preborn [unborn] child; or
429	429		(2) possessing and relying on a determination of the
430	430		probable post-fertilization age of the preborn [unborn] child made
431	431		by another physician.
432	432		Sec. 171.044. ABORTION OF PREBORN [UNBORN] CHILD OF 20 OR
433	433		MORE WEEKS POST-FERTILIZATION AGE PROHIBITED. Except as otherwise
434	434		provided by Section 171.046, a person may not perform or induce or
435	435		attempt to perform or induce an abortion on a woman if it has been
436	436		determined, by the physician performing, inducing, or attempting to
437	437		perform or induce the abortion or by another physician on whose
438	438		determination that physician relies, that the probable
439	439		post-fertilization age of the preborn [unborn] child is 20 or more
440	440		weeks.
441	441		Sec. 171.045. METHOD OF ABORTION. (a) This section applies
442	442		only to an abortion authorized under Section 171.046(a)(1) or (2)
443	443		in which:
444	444		(1) the probable post-fertilization age of the preborn
445	445		[unborn] child is 20 or more weeks; or
446	446		(2) the probable post-fertilization age of the preborn
447	447		[unborn] child has not been determined but could reasonably be 20 or
448	448		more weeks.
449	449		(b) Except as otherwise provided by Section 171.046(a)(3),
450	450		a physician performing an abortion under Subsection (a) shall
451	451		terminate the pregnancy in the manner that, in the physician's
452	452		reasonable medical judgment, provides the best opportunity for the
453	453		preborn [unborn] child to survive.
454	454		SECTION 15. Section 171.046(a), Health and Safety Code, is
455	455		amended to read as follows:
456	456		(a) The prohibitions and requirements under Sections
457	457		171.043, 171.044, and 171.045(b) do not apply to an abortion
458	458		performed if there exists a condition that, in the physician's
459	459		reasonable medical judgment, so complicates the medical condition
460	460		of the woman that, to avert the woman's death or a serious risk of
461	461		substantial and irreversible physical impairment of a major bodily
462	462		function, other than a psychological condition, it necessitates, as
463	463		applicable:
464	464		(1) the immediate abortion of her pregnancy without
465	465		the delay necessary to determine the probable post-fertilization
466	466		age of the preborn [unborn] child;
467	467		(2) the abortion of her pregnancy even though the
468	468		post-fertilization age of the preborn [unborn] child is 20 or more
469	469		weeks; or
470	470		(3) the use of a method of abortion other than a method
471	471		described by Section 171.045(b).
472	472		SECTION 16. Section 285.202(a), Health and Safety Code, is
473	473		amended to read as follows:
474	474		(a) In this section, "medical emergency" means[:
475	475		[(1)] a condition exists that, in a physician's good
476	476		faith clinical judgment, complicates the medical condition of the
477	477		pregnant woman and necessitates the immediate abortion of her
478	478		pregnancy to avert her death or to avoid a serious risk of
479	479		substantial impairment of a major bodily function[; or
480	480		[(2) the fetus has a severe fetal abnormality].
481	481		SECTION 17. Section 164.052(a), Occupations Code, is
482	482		amended to read as follows:
483	483		(a) A physician or an applicant for a license to practice
484	484		medicine commits a prohibited practice if that person:
485	485		(1) submits to the board a false or misleading
486	486		statement, document, or certificate in an application for a
487	487		license;
488	488		(2) presents to the board a license, certificate, or
489	489		diploma that was illegally or fraudulently obtained;
490	490		(3) commits fraud or deception in taking or passing an
491	491		examination;
492	492		(4) uses alcohol or drugs in an intemperate manner
493	493		that, in the board's opinion, could endanger a patient's life;
494	494		(5) commits unprofessional or dishonorable conduct
495	495		that is likely to deceive or defraud the public, as provided by
496	496		Section 164.053, or injure the public;
497	497		(6) uses an advertising statement that is false,
498	498		misleading, or deceptive;
499	499		(7) advertises professional superiority or the
500	500		performance of professional service in a superior manner if that
501	501		advertising is not readily subject to verification;
502	502		(8) purchases, sells, barters, or uses, or offers to
503	503		purchase, sell, barter, or use, a medical degree, license,
504	504		certificate, or diploma, or a transcript of a license, certificate,
505	505		or diploma in or incident to an application to the board for a
506	506		license to practice medicine;
507	507		(9) alters, with fraudulent intent, a medical license,
508	508		certificate, or diploma, or a transcript of a medical license,
509	509		certificate, or diploma;
510	510		(10) uses a medical license, certificate, or diploma,
511	511		or a transcript of a medical license, certificate, or diploma that
512	512		has been:
513	513		(A) fraudulently purchased or issued;
514	514		(B) counterfeited; or
515	515		(C) materially altered;
516	516		(11) impersonates or acts as proxy for another person
517	517		in an examination required by this subtitle for a medical license;
518	518		(12) engages in conduct that subverts or attempts to
519	519		subvert an examination process required by this subtitle for a
520	520		medical license;
521	521		(13) impersonates a physician or permits another to
522	522		use the person's license or certificate to practice medicine in
523	523		this state;
524	524		(14) directly or indirectly employs a person whose
525	525		license to practice medicine has been suspended, canceled, or
526	526		revoked;
527	527		(15) associates in the practice of medicine with a
528	528		person:
529	529		(A) whose license to practice medicine has been
530	530		suspended, canceled, or revoked; or
531	531		(B) who has been convicted of the unlawful
532	532		practice of medicine in this state or elsewhere;
533	533		(16) performs or procures a criminal abortion, aids or
534	534		abets in the procuring of a criminal abortion, attempts to perform
535	535		or procure a criminal abortion, or attempts to aid or abet the
536	536		performance or procurement of a criminal abortion;
537	537		(17) directly or indirectly aids or abets the practice
538	538		of medicine by a person, partnership, association, or corporation
539	539		that is not licensed to practice medicine by the board;
540	540		(18) performs an abortion on a woman who is pregnant
541	541		with a preborn [viable unborn] child during the third trimester of
542	542		the pregnancy unless[:
543	543		[(A)] the abortion is necessary due to a medical
544	544		emergency, as defined by Section 171.002, Health and Safety Code
545	545		[to prevent the death of the woman;
546	546		[(B) the viable unborn child has a severe,
547	547		irreversible brain impairment; or
548	548		[(C) the woman is diagnosed with a significant
549	549		likelihood of suffering imminent severe, irreversible brain damage
550	550		or imminent severe, irreversible paralysis];
551	551		(19) performs an abortion on an unemancipated minor
552	552		without the written consent of the child's parent, managing
553	553		conservator, or legal guardian or without a court order, as
554	554		provided by Section 33.003 or 33.004, Family Code, unless the
555	555		abortion is necessary due to a medical emergency, as defined by
556	556		Section 171.002, Health and Safety Code;
557	557		(20) otherwise performs an abortion on an
558	558		unemancipated minor in violation of Chapter 33, Family Code;
559	559		(21) performs or induces or attempts to perform or
560	560		induce an abortion in violation of Subchapter C, F, or G, Chapter
561	561		171, Health and Safety Code; [or]
562	562		(22) in complying with the procedures outlined in
563	563		Sections 166.045 and 166.046, Health and Safety Code, wilfully
564	564		fails to make a reasonable effort to transfer a patient to a
565	565		physician who is willing to comply with a directive; or
566	566		(23) performs or attempts to perform an abortion or
567	567		engages in other conduct in violation of Section 170.052, Health
568	568		and Safety Code.
569	569		SECTION 18. Section 164.055(b), Occupations Code, is
570	570		amended to read as follows:
571	571		(b) The sanctions provided by Subsection (a) are in addition
572	572		to any other grounds for refusal to admit persons to examination
573	573		under this subtitle or to issue a license or renew a license to
574	574		practice medicine under this subtitle. The criminal penalties
575	575		provided by Section 165.152 do not apply to a violation of Section
576	576		170.002 or 170.052, Health and Safety Code, or Subchapter C, F, or
577	577		G, Chapter 171, Health and Safety Code.
578	578		SECTION 19. The following provisions of the Health and
579	579		Safety Code are repealed:
580	580		(1) Section 171.046(c); and
581	581		(2) Sections 285.202(a-1) and (a-2).
582	582		SECTION 20. Not later than December 1, 2021:
583	583		(1) the Health and Human Services Commission shall:
584	584		(A) develop the perinatal palliative care
585	585		informational materials, list of perinatal palliative care
586	586		providers and programs, and perinatal palliative care
587	587		certification form required by Subchapter X, Chapter 161, Health
588	588		and Safety Code, as added by this Act; and
589	589		(B) update any forms and informational materials
590	590		under Subchapter B, Chapter 171, Health and Safety Code, as amended
591	591		by this Act; and
592	592		(2) the executive commissioner of the Health and Human
593	593		Services Commission shall adopt any rules necessary to implement
594	594		Subchapter X, Chapter 161, Health and Safety Code, as added by this
595	595		Act, and Subchapter B, Chapter 171, Health and Safety Code, as
596	596		amended by this Act.
597	597		SECTION 21. (a) Subchapter X, Chapter 161, Health and
598	598		Safety Code, as added by this Act, applies only to a diagnosis of a
599	599		life-threatening disability of a pregnant woman's preborn child
600	600		made on or after January 1, 2022.
601	601		(b) Chapter 170, Health and Safety Code, as amended by this
602	602		Act, Subchapters B and C, Chapter 171, Health and Safety Code, as
603	603		amended by this Act, and Chapter 164, Occupations Code, as amended
604	604		by this Act, apply only to an abortion performed, induced, or
605	605		attempted or other conduct that occurred on or after January 1,
606	606		2022. An abortion performed, induced, or attempted or other
607	607		conduct that occurred before that date is governed by the law in
608	608		effect immediately before the effective date of this Act, and that
609	609		law is continued in effect for that purpose.
610	610		SECTION 22. It is the intent of the legislature that every
611	611		provision, section, subsection, sentence, clause, phrase, or word
612	612		of this Act and every application of the provisions of this Act to
613	613		each person or entity are severable from each other. If a court for
614	614		any reason finds any application of any provision of this Act to any
615	615		person, group of persons, or circumstances to be invalid, the
616	616		remaining applications of that provision to all other persons and
617	617		circumstances shall be severed and may not be affected.
618	618		SECTION 23. This Act takes effect September 1, 2021.