Texas 2021 - 87th Regular

Texas Senate Bill SB1173 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1	1		By: Hancock, et al. S.B. No. 1173
2		-	(Schaefer, Oliverson, Klick, et al.)
3	2
4	3
5	4		A BILL TO BE ENTITLED
6	5		AN ACT
7	6		relating to the regulation of abortion, including information
8	7		regarding perinatal palliative care and prohibiting discriminatory
9	8		abortions; authorizing disciplinary action; providing a civil
10	9		remedy; creating a criminal offense.
11	10		BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
12	11		SECTION 1. This Act may be cited as the Preborn
13	12		Nondiscrimination Act.
14	13		SECTION 2. The legislature finds that:
15	14		(1) Texas has a compelling state interest in
16	15		protecting all Texans from discrimination based on sex, race, and
17	16		disability; and
18	17		(2) Texas enforces prohibitions against
19	18		discrimination based on sex, race, and disability in various areas,
20	19		including housing, employment, education, insurance, and health
21	20		program and service provision.
22	21		SECTION 3. Chapter 161, Health and Safety Code, is amended
23	22		by adding Subchapter X to read as follows:
24	23		SUBCHAPTER X. PERINATAL PALLIATIVE CARE
25	24		Sec. 161.701. PURPOSE OF SUBCHAPTER. The purpose of this
26	25		subchapter is to ensure that a pregnant woman who receives a
27	26		diagnosis of a life-threatening disability of the woman's preborn
28	27		child is informed of the availability of perinatal palliative care.
29	28		Sec. 161.702. DEFINITION. In this subchapter, "perinatal
30	29		palliative care" means the provision of comprehensive, supportive
31	30		care to reduce the suffering of a pregnant woman, her preborn child,
32	31		and her family, from diagnosis of the preborn child's
33	32		life-threatening disability through the delivery and possible
34	33		death of the child as a result of the life-threatening disability.
35	34		The term includes medical, social, and mental health care,
36	35		including counseling and health care provided by maternal-fetal
37	36		medical specialists, obstetricians, neonatologists, anesthesia
38	37		specialists, specialty nurses, clergy, social workers, and other
39	38		individuals focused on alleviating fear and pain and ensuring the
40	39		pregnant woman, her preborn child, and her family experience a
41	40		supportive environment.
42	41		Sec. 161.703. PERINATAL PALLIATIVE CARE INFORMATIONAL
43	42		MATERIALS. (a) The commission shall develop perinatal palliative
44	43		care informational materials and post the materials on the
45	44		commission's Internet website. The materials must include:
46	45		(1) a description of the health care and other
47	46		services available through perinatal palliative care; and
48	47		(2) information about medical assistance benefits
49	48		that may be available for prenatal care, childbirth, and perinatal
50	49		palliative care.
51	50		(b) The commission shall develop, regularly update, and
52	51		publish a geographically indexed list of all perinatal palliative
53	52		care providers and programs in this state. The commission may
54	53		include perinatal palliative care providers and programs in other
55	54		states that provide care to residents of this state but may not
56	55		include an abortion provider, as defined by Section 171.002, or an
57	56		affiliate, as defined by Section 2272.001, Government Code, as
58	57		added by Chapter 501 (S.B. 22), Acts of the 86th Legislature,
59	58		Regular Session, 2019, of an abortion provider. The commission
60	59		shall post the list of perinatal palliative care providers and
61	60		programs, including contact information, on the commission's
62	61		Internet website and note the providers and programs that provide
63	62		services free of charge.
64	63		Sec. 161.704. PERINATAL PALLIATIVE CARE CERTIFICATION
65	64		FORM. The commission shall develop a form on which a pregnant woman
66	65		certifies that she has received the perinatal palliative care
67	66		informational materials and list of the perinatal palliative care
68	67		providers and programs described by Section 161.703.
69	68		Sec. 161.705. HEALTH CARE PROVIDER DUTIES ON DIAGNOSIS OF
70	69		PREBORN CHILD'S LIFE-THREATENING DISABILITY. A health care
71	70		provider who diagnoses a pregnant woman's preborn child as having a
72	71		life-threatening disability shall, at the time of the diagnosis:
73	72		(1) provide the pregnant woman with a written copy of:
74	73		(A) the perinatal palliative care informational
75	74		materials and list of the perinatal palliative care providers and
76	75		programs described by Section 161.703; and
77	76		(B) the perinatal palliative care certification
78	77		form described by Section 161.704; and
79	78		(2) obtain from the pregnant woman the signed
80	79		perinatal palliative care certification form and place the form in
81	80		the pregnant woman's medical records.
82	81		Sec. 161.706. EXCEPTION. A health care provider is not
83	82		required to provide the perinatal palliative care informational
84	83		materials or perinatal palliative care certification form under
85	84		this subchapter if the health care provider verifies the pregnant
86	85		woman's medical record contains a signed perinatal palliative care
87	86		certification form for that pregnancy as required under Section
88	87		161.705(2).
89	88		SECTION 4. Chapter 170, Health and Safety Code, is amended
90	89		by designating Sections 170.001 and 170.002 as Subchapter A and
91	90		adding a subchapter heading to read as follows:
92	91		SUBCHAPTER A. GENERAL PROVISIONS; THIRD TRIMESTER
93	92		ABORTION PROHIBITED
94	93		SECTION 5. Section 170.001, Health and Safety Code, is
95	94		amended by adding Subdivision (2-a) to read as follows:
96	95		(2-a) "Preborn child" means an unborn child as defined
97	96		by Section 171.061.
98	97		SECTION 6. Section 170.002, Health and Safety Code, is
99	98		amended to read as follows:
100	99		Sec. 170.002. PROHIBITED ACTS; EXEMPTION. (a) Except as
101	100		provided by Subsection (b), a person may not intentionally or
102	101		knowingly perform an abortion on a woman who is pregnant with a
103	102		preborn [viable unborn] child during the third trimester of the
104	103		pregnancy.
105	104		(b) Subsection (a) does not prohibit a person from
106	105		performing an abortion if at the time of the abortion the person is
107	106		a physician and concludes in good faith according to the
108	107		physician's best medical judgment that[:
109	108		[(1) the fetus is not a viable fetus and the pregnancy
110	109		is not in the third trimester;
111	110		[(2)] the abortion is necessary due to a medical
112	111		emergency, as defined by Section 171.002 [to prevent the death or a
113	112		substantial risk of serious impairment to the physical or mental
114	113		health of the woman; or
115	114		[(3) the fetus has a severe and irreversible
116	115		abnormality, identified by reliable diagnostic procedures].
117	116		(c) A physician who performs an abortion that, according to
118	117		the physician's best medical judgment at the time of the abortion,
119	118		is to abort a preborn [viable unborn] child during the third
120	119		trimester of the pregnancy shall certify in writing to the
121	120		commission, on a form prescribed by the commission, the medical
122	121		indications supporting the physician's judgment that the abortion
123	122		was authorized by Subsection (b) [(b)(2) or (3). If the physician
124	123		certifies the abortion was authorized by Subsection (b)(3), the
125	124		physician shall certify in writing on the form the fetal
126	125		abnormality identified by the physician]. The certification must
127	126		be made not later than the 30th day after the date the abortion was
128	127		performed.
129	128		SECTION 7. Chapter 170, Health and Safety Code, is amended
130	129		by adding Subchapter B to read as follows:
131	130		SUBCHAPTER B. DISCRIMINATORY ABORTION PROHIBITED
132	131		Sec. 170.051. DEFINITION. In this subchapter, "disability"
133	132		means:
134	133		(1) a physical or mental impairment that would
135	134		substantially limit one or more of an individual's major life
136	135		activities;
137	136		(2) an assessment referencing an individual's
138	137		impairment described by Subdivision (1); or
139	138		(3) a physical disfigurement, scoliosis, dwarfism,
140	139		Down syndrome, albinism, amelia, or any other type of physical,
141	140		mental, or intellectual abnormality or disease.
142	141		Sec. 170.052. DISCRIMINATORY ABORTION PROHIBITED. A person
143	142		may not:
144	143		(1) knowingly perform or attempt to perform on a
145	144		pregnant woman an abortion based on the race, ethnicity, sex, or
146	145		disability of the woman's preborn child, including a probability of
147	146		diagnosis that the child has a disability; or
148	147		(2) use force or the threat of force to intentionally
149	148		injure or intimidate a person to coerce the performance or
150	149		attempted performance of an abortion based on the race, ethnicity,
151	150		sex, or disability of the woman's preborn child, including a
152	151		probability of diagnosis that the child has a disability.
153	152		Sec. 170.053. CRIMINAL PENALTY. (a) A person who violates
154	153		Section 170.052 commits an offense. An offense under this
155	154		subsection is a Class A misdemeanor.
156	155		(b) A woman on whom an abortion is performed or attempted in
157	156		violation of Section 170.052 may not be prosecuted for a violation
158	157		of that section or for conspiracy to commit a violation of that
159	158		section.
160	159		Sec. 170.054. LICENSE SUSPENSION OR REVOCATION. A
161	160		physician who violates Section 170.052 engages in unprofessional
162	161		conduct for which the physician's license may be suspended or
163	162		revoked under Chapter 164, Occupations Code.
164	163		Sec. 170.055. CIVIL REMEDIES. (a) A civil action may be
165	164		brought against a person who violates Section 170.052 by:
166	165		(1) the woman on whom an abortion was performed or
167	166		attempted in violation of Section 170.052;
168	167		(2) the father of the preborn child for an abortion
169	168		performed or attempted on a pregnant woman in violation of Section
170	169		170.052, unless the woman's pregnancy resulted from the father's
171	170		criminal conduct; or
172	171		(3) a maternal grandparent of the preborn child for an
173	172		abortion performed or attempted in violation of Section 170.052 on
174	173		a pregnant woman who was less than 18 years of age at the time of the
175	174		violation, unless the woman's pregnancy resulted from the maternal
176	175		grandparent's criminal conduct.
177	176		(b) A person who brings an action under this section may
178	177		obtain:
179	178		(1) injunctive relief;
180	179		(2) damages incurred by the person, including:
181	180		(A) actual damages for all psychological,
182	181		emotional, and physical injuries resulting from the violation of
183	182		Section 170.052;
184	183		(B) court costs; and
185	184		(C) reasonable attorney's fees; or
186	185		(3) both injunctive relief and damages.
187	186		(c) An action for damages or injunctive relief under this
188	187		section must be filed:
189	188		(1) in a district court in the county in which the
190	189		woman on whom an abortion was performed or attempted in violation of
191	190		Section 170.052 resides; and
192	191		(2) not later than the sixth anniversary of the date
193	192		the abortion was performed or attempted in violation of Section
194	193		170.052.
195	194		(d) The damages and injunctive relief authorized by this
196	195		section are in addition to any other remedy available by law.
197	196		(e) A civil action under this section may not be brought
198	197		against a woman on whom an abortion is performed or attempted in
199	198		violation of Section 170.052.
200	199		SECTION 8. Section 171.002, Health and Safety Code, is
201	200		amended by adding Subdivision (3-a) to read as follows:
202	201		(3-a) "Preborn child" means an unborn child as defined
203	202		by Section 171.061.
204	203		SECTION 9. Section 171.012, Health and Safety Code, is
205	204		amended by amending Subsection (a) and adding Subsections (g) and
206	205		(h) to read as follows:
207	206		(a) Consent to an abortion is voluntary and informed only
208	207		if:
209	208		(1) the physician who is to perform the abortion
210	209		informs the pregnant woman on whom the abortion is to be performed
211	210		of:
212	211		(A) the physician's name;
213	212		(B) the particular medical risks associated with
214	213		the particular abortion procedure to be employed, including, when
215	214		medically accurate:
216	215		(i) the risks of infection and hemorrhage;
217	216		(ii) the potential danger to a subsequent
218	217		pregnancy and of infertility; and
219	218		(iii) the possibility of increased risk of
220	219		breast cancer following an induced abortion and the natural
221	220		protective effect of a completed pregnancy in avoiding breast
222	221		cancer;
223	222		(C) the probable gestational age of the preborn
224	223		[unborn] child at the time the abortion is to be performed; [and]
225	224		(D) the medical risks associated with carrying
226	225		the preborn child to term; and
227	226		(E) the state law prohibiting abortion of a
228	227		preborn child solely on the basis of the preborn child's race,
229	228		ethnicity, sex, or disability as defined by Section 170.051,
230	229		including a probability of diagnosis that the child has a
231	230		disability;
232	231		(2) the physician who is to perform the abortion or the
233	232		physician's agent informs the pregnant woman that:
234	233		(A) medical assistance benefits may be available
235	234		for prenatal care, childbirth, and neonatal care;
236	235		(B) the father is liable for assistance in the
237	236		support of the child without regard to whether the father has
238	237		offered to pay for the abortion; and
239	238		(C) public and private agencies provide
240	239		pregnancy prevention counseling and medical referrals for
241	240		obtaining pregnancy prevention medications or devices, including
242	241		emergency contraception for victims of rape or incest;
243	242		(3) the physician who is to perform the abortion or the
244	243		physician's agent:
245	244		(A) provides the pregnant woman with the printed
246	245		materials described by Section 171.014; and
247	246		(B) informs the pregnant woman that those
248	247		materials:
249	248		(i) have been provided by the Health and
250	249		Human Services Commission [Department of State Health Services];
251	250		(ii) are accessible on an Internet website
252	251		sponsored by the commission [department];
253	252		(iii) describe the preborn [unborn] child
254	253		and list agencies that offer alternatives to abortion; and
255	254		(iv) include a list of agencies that offer
256	255		sonogram services at no cost to the pregnant woman;
257	256		(4) before any sedative or anesthesia is administered
258	257		to the pregnant woman and at least 24 hours before the abortion or
259	258		at least two hours before the abortion if the pregnant woman waives
260	259		this requirement by certifying that she currently lives 100 miles
261	260		or more from the nearest abortion provider that is a facility
262	261		licensed under Chapter 245 or a facility that performs more than 50
263	262		abortions in any 12-month period:
264	263		(A) the physician who is to perform the abortion
265	264		or an agent of the physician who is also a sonographer certified by
266	265		a national registry of medical sonographers performs a sonogram on
267	266		the pregnant woman on whom the abortion is to be performed;
268	267		(B) the physician who is to perform the abortion
269	268		displays the sonogram images in a quality consistent with current
270	269		medical practice in a manner that the pregnant woman may view them;
271	270		(C) the physician who is to perform the abortion
272	271		provides, in a manner understandable to a layperson, a verbal
273	272		explanation of the results of the sonogram images, including a
274	273		medical description of the dimensions of the embryo or fetus, the
275	274		presence of cardiac activity, and the presence of external members
276	275		and internal organs; and
277	276		(D) the physician who is to perform the abortion
278	277		or an agent of the physician who is also a sonographer certified by
279	278		a national registry of medical sonographers makes audible the heart
280	279		auscultation for the pregnant woman to hear, if present, in a
281	280		quality consistent with current medical practice and provides, in a
282	281		manner understandable to a layperson, a simultaneous verbal
283	282		explanation of the heart auscultation;
284	283		(5) before receiving a sonogram under Subdivision
285	284		(4)(A) and before the abortion is performed and before any sedative
286	285		or anesthesia is administered, the pregnant woman completes and
287	286		certifies with her signature an election form that states as
288	287		follows:
289	288		"ABORTION AND SONOGRAM ELECTION
290	289		(1) THE INFORMATION AND PRINTED MATERIALS
291	290		DESCRIBED BY SECTIONS 171.012(a)(1)-(3), TEXAS HEALTH
292	291		AND SAFETY CODE, HAVE BEEN PROVIDED AND EXPLAINED TO
293	292		ME.
294	293		(2) I UNDERSTAND THE NATURE AND CONSEQUENCES OF
295	294		AN ABORTION.
296	295		(3) TEXAS LAW REQUIRES THAT I RECEIVE A SONOGRAM
297	296		PRIOR TO RECEIVING AN ABORTION.
298	297		(4) I UNDERSTAND THAT I HAVE THE OPTION TO VIEW
299	298		THE SONOGRAM IMAGES.
300	299		(5) I UNDERSTAND THAT I HAVE THE OPTION TO HEAR
301	300		THE HEARTBEAT.
302	301		(6) I UNDERSTAND THAT I AM REQUIRED BY LAW TO
303	302		HEAR AN EXPLANATION OF THE SONOGRAM IMAGES UNLESS I
304	303		CERTIFY IN WRITING TO ONE OF THE FOLLOWING:
305	304		___ I AM PREGNANT AS A RESULT OF A SEXUAL
306	305		ASSAULT, INCEST, OR OTHER VIOLATION OF THE TEXAS PENAL
307	306		CODE THAT HAS BEEN REPORTED TO LAW ENFORCEMENT
308	307		AUTHORITIES OR THAT HAS NOT BEEN REPORTED BECAUSE I
309	308		REASONABLY BELIEVE THAT DOING SO WOULD PUT ME AT RISK
310	309		OF RETALIATION RESULTING IN SERIOUS BODILY INJURY.
311	310		___ I AM A MINOR AND OBTAINING AN ABORTION IN
312	311		ACCORDANCE WITH JUDICIAL BYPASS PROCEDURES UNDER
313	312		CHAPTER 33, TEXAS FAMILY CODE.
314	313		[___ MY FETUS HAS AN IRREVERSIBLE MEDICAL
315	314		CONDITION OR ABNORMALITY, AS IDENTIFIED BY RELIABLE
316	315		DIAGNOSTIC PROCEDURES AND DOCUMENTED IN MY MEDICAL
317	316		FILE.]
318	317		(7) I AM MAKING THIS ELECTION OF MY OWN FREE WILL
319	318		AND WITHOUT COERCION.
320	319		(8) FOR A WOMAN WHO LIVES 100 MILES OR MORE FROM
321	320		THE NEAREST ABORTION PROVIDER THAT IS A FACILITY
322	321		LICENSED UNDER CHAPTER 245, TEXAS HEALTH AND SAFETY
323	322		CODE, OR A FACILITY THAT PERFORMS MORE THAN 50
324	323		ABORTIONS IN ANY 12-MONTH PERIOD ONLY:
325	324		I CERTIFY THAT, BECAUSE I CURRENTLY LIVE 100
326	325		MILES OR MORE FROM THE NEAREST ABORTION PROVIDER THAT
327	326		IS A FACILITY LICENSED UNDER CHAPTER 245, TEXAS HEALTH
328	327		AND SAFETY CODE, OR A FACILITY THAT PERFORMS MORE THAN
329	328		50 ABORTIONS IN ANY 12-MONTH PERIOD, I WAIVE THE
330	329		REQUIREMENT TO WAIT 24 HOURS AFTER THE SONOGRAM IS
331	330		PERFORMED BEFORE RECEIVING THE ABORTION PROCEDURE. MY
332	331		PLACE OF RESIDENCE IS:__________.
333	332		________________________________________
334	333		SIGNATURE DATE";
335	334		(6) before the abortion is performed, the physician
336	335		who is to perform the abortion receives a copy of the signed,
337	336		written certification required by Subdivision (5); and
338	337		(7) the pregnant woman is provided the name of each
339	338		person who provides or explains the information required under this
340	339		subsection.
341	340		(g) If the pregnant woman's preborn child has been diagnosed
342	341		with a life-threatening disability, the physician who is to perform
343	342		the abortion shall, at least 24 hours before the abortion or at
344	343		least two hours before the abortion if the pregnant woman waives
345	344		this requirement by certifying that she currently lives 100 miles
346	345		or more from the nearest abortion provider that is a facility
347	346		licensed under Chapter 245 or a facility in which more than 50
348	347		abortions are performed in any 12-month period:
349	348		(1) orally and in person, inform the pregnant woman of
350	349		the availability of perinatal palliative care, as that term is
351	350		defined by Section 161.702; and
352	351		(2) provide the pregnant woman with a written copy of:
353	352		(A) the perinatal palliative care informational
354	353		materials and list of the perinatal palliative care providers and
355	354		programs described by Section 161.703; and
356	355		(B) the perinatal palliative care certification
357	356		form described by Section 161.704.
358	357		(h) If a pregnant woman described by Subsection (g), after
359	358		receiving from the physician who is to perform the abortion the
360	359		perinatal palliative care informational materials and
361	360		certification form described by that subsection in the manner
362	361		required by that subsection, chooses to have an abortion instead of
363	362		continuing the pregnancy in perinatal palliative care, the
364	363		physician may perform the abortion only after:
365	364		(1) the pregnant woman signs the certification form;
366	365		and
367	366		(2) the physician places the signed certification form
368	367		in the pregnant woman's medical records.
369	368		SECTION 10. Section 171.0121, Health and Safety Code, is
370	369		amended to read as follows:
371	370		Sec. 171.0121. MEDICAL RECORD. (a) Before the abortion
372	371		begins, a copy of the signed, written certification received by the
373	372		physician under Section 171.012(a)(6) and, if applicable, under
374	373		Section 161.704 must be placed in the pregnant woman's medical
375	374		records.
376	375		(b) A copy of the signed, written certification required
377	376		under Sections 171.012(a)(5) and (6) and of any signed, written
378	377		certification required under Section 161.704 shall be retained by
379	378		the facility where the abortion is performed until:
380	379		(1) the seventh anniversary of the date the
381	380		certification [it] is signed; or
382	381		(2) if the pregnant woman is a minor, the later of:
383	382		(A) the seventh anniversary of the date the
384	383		certification [it] is signed; or
385	384		(B) the woman's 21st birthday.
386	385		SECTION 11. Section 171.0122(d), Health and Safety Code, is
387	386		amended to read as follows:
388	387		(d) A pregnant woman may choose not to receive the verbal
389	388		explanation of the results of the sonogram images under Section
390	389		171.012(a)(4)(C) if:
391	390		(1) the woman's pregnancy is a result of a sexual
392	391		assault, incest, or other violation of the Penal Code that has been
393	392		reported to law enforcement authorities or that has not been
394	393		reported because she has a reason that she declines to reveal
395	394		because she reasonably believes that to do so would put her at risk
396	395		of retaliation resulting in serious bodily injury; or
397	396		(2) the woman is a minor and obtaining an abortion in
398	397		accordance with judicial bypass procedures under Chapter 33, Family
399	398		Code[; or
400	399		[(3) the fetus has an irreversible medical condition
401	400		or abnormality, as previously identified by reliable diagnostic
402	401		procedures and documented in the woman's medical file].
403	402		SECTION 12. Section 171.014(a), Health and Safety Code, is
404	403		amended to read as follows:
405	404		(a) The department shall publish informational materials
406	405		that include:
407	406		(1) the information required to be provided under
408	407		Sections 171.012(a)(1)(B), [and] (D), and (E) and (a)(2)(A), (B),
409	408		and (C); and
410	409		(2) the materials required by Sections 161.703,
411	410		171.015, and 171.016.
412	411		SECTION 13. Section 171.042, Health and Safety Code, is
413	412		amended to read as follows:
414	413		Sec. 171.042. DEFINITION [DEFINITIONS]. In this
415	414		subchapter,[:
416	415		[(1)] "post-fertilization [Post-fertilization] age"
417	416		means the age of the preborn [unborn] child as calculated from the
418	417		fusion of a human spermatozoon with a human ovum.
419	418		[(2) "Severe fetal abnormality" has the meaning
420	419		assigned by Section 285.202.]
421	420		SECTION 14. Sections 171.043, 171.044, and 171.045, Health
422	421		and Safety Code, are amended to read as follows:
423	422		Sec. 171.043. DETERMINATION OF POST-FERTILIZATION AGE
424	423		REQUIRED. Except as otherwise provided by Section 171.046, a
425	424		physician may not perform or induce or attempt to perform or induce
426	425		an abortion without, prior to the procedure:
427	426		(1) making a determination of the probable
428	427		post-fertilization age of the preborn [unborn] child; or
429	428		(2) possessing and relying on a determination of the
430	429		probable post-fertilization age of the preborn [unborn] child made
431	430		by another physician.
432	431		Sec. 171.044. ABORTION OF PREBORN [UNBORN] CHILD OF 20 OR
433	432		MORE WEEKS POST-FERTILIZATION AGE PROHIBITED. Except as otherwise
434	433		provided by Section 171.046, a person may not perform or induce or
435	434		attempt to perform or induce an abortion on a woman if it has been
436	435		determined, by the physician performing, inducing, or attempting to
437	436		perform or induce the abortion or by another physician on whose
438	437		determination that physician relies, that the probable
439	438		post-fertilization age of the preborn [unborn] child is 20 or more
440	439		weeks.
441	440		Sec. 171.045. METHOD OF ABORTION. (a) This section applies
442	441		only to an abortion authorized under Section 171.046(a)(1) or (2)
443	442		in which:
444	443		(1) the probable post-fertilization age of the preborn
445	444		[unborn] child is 20 or more weeks; or
446	445		(2) the probable post-fertilization age of the preborn
447	446		[unborn] child has not been determined but could reasonably be 20 or
448	447		more weeks.
449	448		(b) Except as otherwise provided by Section 171.046(a)(3),
450	449		a physician performing an abortion under Subsection (a) shall
451	450		terminate the pregnancy in the manner that, in the physician's
452	451		reasonable medical judgment, provides the best opportunity for the
453	452		preborn [unborn] child to survive.
454	453		SECTION 15. Section 171.046(a), Health and Safety Code, is
455	454		amended to read as follows:
456	455		(a) The prohibitions and requirements under Sections
457	456		171.043, 171.044, and 171.045(b) do not apply to an abortion
458	457		performed if there exists a condition that, in the physician's
459	458		reasonable medical judgment, so complicates the medical condition
460	459		of the woman that, to avert the woman's death or a serious risk of
461	460		substantial and irreversible physical impairment of a major bodily
462	461		function, other than a psychological condition, it necessitates, as
463	462		applicable:
464	463		(1) the immediate abortion of her pregnancy without
465	464		the delay necessary to determine the probable post-fertilization
466	465		age of the preborn [unborn] child;
467	466		(2) the abortion of her pregnancy even though the
468	467		post-fertilization age of the preborn [unborn] child is 20 or more
469	468		weeks; or
470	469		(3) the use of a method of abortion other than a method
471	470		described by Section 171.045(b).
472	471		SECTION 16. Section 285.202(a), Health and Safety Code, is
473	472		amended to read as follows:
474	473		(a) In this section, "medical emergency" means[:
475	474		[(1)] a condition exists that, in a physician's good
476	475		faith clinical judgment, complicates the medical condition of the
477	476		pregnant woman and necessitates the immediate abortion of her
478	477		pregnancy to avert her death or to avoid a serious risk of
479	478		substantial impairment of a major bodily function[; or
480	479		[(2) the fetus has a severe fetal abnormality].
481	480		SECTION 17. Section 164.052(a), Occupations Code, is
482	481		amended to read as follows:
483	482		(a) A physician or an applicant for a license to practice
484	483		medicine commits a prohibited practice if that person:
485	484		(1) submits to the board a false or misleading
486	485		statement, document, or certificate in an application for a
487	486		license;
488	487		(2) presents to the board a license, certificate, or
489	488		diploma that was illegally or fraudulently obtained;
490	489		(3) commits fraud or deception in taking or passing an
491	490		examination;
492	491		(4) uses alcohol or drugs in an intemperate manner
493	492		that, in the board's opinion, could endanger a patient's life;
494	493		(5) commits unprofessional or dishonorable conduct
495	494		that is likely to deceive or defraud the public, as provided by
496	495		Section 164.053, or injure the public;
497	496		(6) uses an advertising statement that is false,
498	497		misleading, or deceptive;
499	498		(7) advertises professional superiority or the
500	499		performance of professional service in a superior manner if that
501	500		advertising is not readily subject to verification;
502	501		(8) purchases, sells, barters, or uses, or offers to
503	502		purchase, sell, barter, or use, a medical degree, license,
504	503		certificate, or diploma, or a transcript of a license, certificate,
505	504		or diploma in or incident to an application to the board for a
506	505		license to practice medicine;
507	506		(9) alters, with fraudulent intent, a medical license,
508	507		certificate, or diploma, or a transcript of a medical license,
509	508		certificate, or diploma;
510	509		(10) uses a medical license, certificate, or diploma,
511	510		or a transcript of a medical license, certificate, or diploma that
512	511		has been:
513	512		(A) fraudulently purchased or issued;
514	513		(B) counterfeited; or
515	514		(C) materially altered;
516	515		(11) impersonates or acts as proxy for another person
517	516		in an examination required by this subtitle for a medical license;
518	517		(12) engages in conduct that subverts or attempts to
519	518		subvert an examination process required by this subtitle for a
520	519		medical license;
521	520		(13) impersonates a physician or permits another to
522	521		use the person's license or certificate to practice medicine in
523	522		this state;
524	523		(14) directly or indirectly employs a person whose
525	524		license to practice medicine has been suspended, canceled, or
526	525		revoked;
527	526		(15) associates in the practice of medicine with a
528	527		person:
529	528		(A) whose license to practice medicine has been
530	529		suspended, canceled, or revoked; or
531	530		(B) who has been convicted of the unlawful
532	531		practice of medicine in this state or elsewhere;
533	532		(16) performs or procures a criminal abortion, aids or
534	533		abets in the procuring of a criminal abortion, attempts to perform
535	534		or procure a criminal abortion, or attempts to aid or abet the
536	535		performance or procurement of a criminal abortion;
537	536		(17) directly or indirectly aids or abets the practice
538	537		of medicine by a person, partnership, association, or corporation
539	538		that is not licensed to practice medicine by the board;
540	539		(18) performs an abortion on a woman who is pregnant
541	540		with a preborn [viable unborn] child during the third trimester of
542	541		the pregnancy unless[:
543	542		[(A)] the abortion is necessary due to a medical
544	543		emergency, as defined by Section 171.002, Health and Safety Code
545	544		[to prevent the death of the woman;
546	545		[(B) the viable unborn child has a severe,
547	546		irreversible brain impairment; or
548	547		[(C) the woman is diagnosed with a significant
549	548		likelihood of suffering imminent severe, irreversible brain damage
550	549		or imminent severe, irreversible paralysis];
551	550		(19) performs an abortion on an unemancipated minor
552	551		without the written consent of the child's parent, managing
553	552		conservator, or legal guardian or without a court order, as
554	553		provided by Section 33.003 or 33.004, Family Code, unless the
555	554		abortion is necessary due to a medical emergency, as defined by
556	555		Section 171.002, Health and Safety Code;
557	556		(20) otherwise performs an abortion on an
558	557		unemancipated minor in violation of Chapter 33, Family Code;
559	558		(21) performs or induces or attempts to perform or
560	559		induce an abortion in violation of Subchapter C, F, or G, Chapter
561	560		171, Health and Safety Code; [or]
562	561		(22) in complying with the procedures outlined in
563	562		Sections 166.045 and 166.046, Health and Safety Code, wilfully
564	563		fails to make a reasonable effort to transfer a patient to a
565	564		physician who is willing to comply with a directive; or
566	565		(23) performs or attempts to perform an abortion or
567	566		engages in other conduct in violation of Section 170.052, Health
568	567		and Safety Code.
569	568		SECTION 18. Section 164.055(b), Occupations Code, is
570	569		amended to read as follows:
571	570		(b) The sanctions provided by Subsection (a) are in addition
572	571		to any other grounds for refusal to admit persons to examination
573	572		under this subtitle or to issue a license or renew a license to
574	573		practice medicine under this subtitle. The criminal penalties
575	574		provided by Section 165.152 do not apply to a violation of Section
576	575		170.002 or 170.052, Health and Safety Code, or Subchapter C, F, or
577	576		G, Chapter 171, Health and Safety Code.
578	577		SECTION 19. The following provisions of the Health and
579	578		Safety Code are repealed:
580	579		(1) Section 171.046(c); and
581	580		(2) Sections 285.202(a-1) and (a-2).
582	581		SECTION 20. Not later than December 1, 2021:
583	582		(1) the Health and Human Services Commission shall:
584	583		(A) develop the perinatal palliative care
585	584		informational materials, list of perinatal palliative care
586	585		providers and programs, and perinatal palliative care
587	586		certification form required by Subchapter X, Chapter 161, Health
588	587		and Safety Code, as added by this Act; and
589	588		(B) update any forms and informational materials
590	589		under Subchapter B, Chapter 171, Health and Safety Code, as amended
591	590		by this Act; and
592	591		(2) the executive commissioner of the Health and Human
593	592		Services Commission shall adopt any rules necessary to implement
594	593		Subchapter X, Chapter 161, Health and Safety Code, as added by this
595	594		Act, and Subchapter B, Chapter 171, Health and Safety Code, as
596	595		amended by this Act.
597	596		SECTION 21. (a) Subchapter X, Chapter 161, Health and
598	597		Safety Code, as added by this Act, applies only to a diagnosis of a
599	598		life-threatening disability of a pregnant woman's preborn child
600	599		made on or after January 1, 2022.
601	600		(b) Chapter 170, Health and Safety Code, as amended by this
602	601		Act, Subchapters B and C, Chapter 171, Health and Safety Code, as
603	602		amended by this Act, and Chapter 164, Occupations Code, as amended
604	603		by this Act, apply only to an abortion performed, induced, or
605	604		attempted or other conduct that occurred on or after January 1,
606	605		2022. An abortion performed, induced, or attempted or other
607	606		conduct that occurred before that date is governed by the law in
608	607		effect immediately before the effective date of this Act, and that
609	608		law is continued in effect for that purpose.
610	609		SECTION 22. It is the intent of the legislature that every
611	610		provision, section, subsection, sentence, clause, phrase, or word
612	611		of this Act and every application of the provisions of this Act to
613	612		each person or entity are severable from each other. If a court for
614	613		any reason finds any application of any provision of this Act to any
615	614		person, group of persons, or circumstances to be invalid, the
616	615		remaining applications of that provision to all other persons and
617	616		circumstances shall be severed and may not be affected.
618	617		SECTION 23. This Act takes effect September 1, 2021.