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A BILL TO BE ENTITLED
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AN ACT
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relating to reporting requirements regarding the provision of an |
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abortion or treatment for complications resulting from the |
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provision of an abortion; creating criminal offenses; providing |
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penalties. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Chapter 170, Health and Safety Code, is amended |
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by adding Section 170.003 to read as follows: |
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Sec. 170.003. COERCIVE ABORTION PROHIBITED; CRIMINAL |
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PENALTY. (a) A physician commits an offense if the physician: |
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(1) intentionally performs an abortion on a woman; and |
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(2) knows or should reasonably believe that the woman |
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is seeking the abortion as the result of coercion, as that term is |
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defined by Section 1.07, Penal Code. |
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(b) An offense under this section is a Class A misdemeanor. |
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SECTION 2. Chapter 171, Health and Safety Code, is amended |
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by adding Subchapter C to read as follows: |
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SUBCHAPTER C. REPORTING REQUIREMENTS |
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Sec. 171.021. LEGISLATIVE FINDINGS AND PURPOSE. (a) The |
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legislature finds that: |
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(1) an abortion, whether surgically or chemically |
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induced, terminates the life of a whole, separate, unique, living |
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human being; |
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(2) this state is currently prevented from providing |
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adequate legal remedies to protect the life, health, and welfare of |
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pregnant women and unborn human life because of the lack of accurate |
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and relevant statistical data concerning the practice of abortion |
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and the women seeking abortion services in this state; and |
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(3) there is a need for stricter requirements |
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regarding the content, accuracy, and consistency of reporting by |
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physicians who perform abortions in this state and stricter |
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enforcement of the reporting requirements. |
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(b) The purpose of this subchapter is to further the |
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important and compelling state interests in: |
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(1) protecting the life and health of a pregnant woman |
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seeking an elective abortion and, to the extent constitutionally |
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permissible, the life of the woman's unborn child; |
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(2) fostering the development of standards of |
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professional conduct in the provision of an abortion; and |
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(3) maintaining accurate statistical data to aid in |
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providing proper maternal health assistance, regulation, and |
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education. |
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Sec. 171.022. REPORTING REQUIREMENTS. (a) Not later than |
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the 15th day of each month, a physician by mail shall submit to the |
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department the abortion reporting form required by Section 171.023 |
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for each abortion performed by the physician in the preceding |
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calendar month. |
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(b) As soon as practicable, but not later than 48 hours |
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after the time of diagnosis or treatment, a physician by mail shall |
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submit to the department the complications form required by Section |
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171.024 for each illness or injury in the preceding calendar year |
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that: |
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(1) the physician determines was caused by a medical |
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complication resulting from an abortion for which the physician |
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treated a woman; or |
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(2) a woman suspects was caused by a medical |
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complication resulting from an abortion for which the physician |
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treated the woman. |
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(c) The reports submitted to the department as required by |
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this subchapter may not by any means identify the name of a woman on |
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whom an abortion is performed. |
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Sec. 171.023. ABORTION REPORTING FORM; PARTIAL EXCEPTION. |
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(a) A physician shall report to the department on the form |
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prescribed by the department the information required by this |
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section for each abortion performed by the physician. |
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(b) The form must include: |
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(1) the following information, which must be completed |
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by the woman before anesthesia is administered or the abortion is |
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performed: |
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(A) the woman's: |
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(i) age; |
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(ii) race or ethnicity; |
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(iii) marital status; and |
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(iv) municipality, county, state, and |
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nation of residence; |
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(B) the woman's highest level of education, |
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selected by checking one of the following: |
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(i) did not receive any high school |
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education; |
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(ii) received some high school education |
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but did not graduate; |
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(iii) is a high school graduate or |
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recipient of a high school equivalency certificate; |
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(iv) received some college education but is |
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not a college graduate; |
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(v) obtained an associate's degree; |
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(vi) obtained a bachelor's degree; |
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(vii) obtained a master's degree; |
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(viii) obtained a doctoral degree; or |
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(ix) received other education (specify): |
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____________; |
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(C) the age of the father of the unborn child at |
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the time of the abortion; |
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(D) the method or methods of contraception used |
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at the time the unborn child was conceived, selected by checking all |
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applicable methods from the following list: |
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(i) condoms; |
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(ii) spermicide; |
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(iii) male sterilization; |
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(iv) female sterilization; |
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(v) an injectable contraceptive; |
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(vi) an inter-uterine device; |
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(vii) mini pills; |
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(viii) combination pills; |
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(ix) a diaphragm; |
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(x) a cervical cap or vaginal contraceptive |
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ring; |
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(xi) a contraceptive patch; |
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(xii) a sponge; |
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(xiii) a calendar-based contraceptive |
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method, including rhythm method or natural family planning or |
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fertility awareness; |
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(xiv) withdrawal; |
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(xv) no method of contraception; or |
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(xvi) other method (specify): ___________; |
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(E) a space for the woman to indicate the |
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specific reason the abortion is to be performed, selected from the |
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following list: |
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(i) the woman was coerced or forced to have |
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the abortion; |
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(ii) the woman does not want any more |
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children; |
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(iii) economic reasons; |
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(iv) the woman's unborn child has been |
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diagnosed with one or more health problems that are documented in |
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the woman's medical records; |
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(v) the father of the unborn child opposes |
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the pregnancy; |
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(vi) the woman's parent opposes the |
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pregnancy; |
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(vii) the woman fears a loss of family |
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support; |
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(viii) the woman fears losing her job; |
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(ix) a school counselor recommends |
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abortion; |
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(x) a physician recommends abortion; |
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(xi) the pregnancy is the result of rape; |
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(xii) the pregnancy is the result of |
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incest; |
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(xiii) the woman does not prefer the gender |
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of the unborn child; or |
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(xiv) the woman does not want to complete |
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this section; |
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(F) the number of the woman's previous live |
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births; |
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(G) the number of induced abortions the woman has |
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previously undergone; |
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(H) the number of miscarriages the woman has |
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previously experienced; |
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(I) the source of the woman's referral to the |
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physician for the abortion, selected from the following list: |
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(i) a physician; |
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(ii) the woman herself; |
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(iii) a friend or family member of the |
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woman; |
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(iv) a member of the clergy; |
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(v) a school counselor; |
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(vi) a social services agency; |
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(vii) the department; |
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(viii) a family planning clinic; or |
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(ix) other (specify): ________________; |
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(J) the method of payment for the abortion, |
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selected from the following list: |
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(i) private insurance; |
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(ii) a public health plan; |
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(iii) personal payment by cash; or |
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(iv) personal payment by check or credit |
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card; and |
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(K) whether the woman availed herself of the |
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opportunity to view the printed information required under |
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Subchapter B and, if so, whether the woman viewed the information |
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described by Section 171.014 in printed form or on the department's |
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Internet website; and |
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(2) the following information, which must be completed |
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by the physician: |
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(A) the name of the facility at which the |
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abortion was performed, the municipality and county in which the |
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facility is located, and the type of facility at which the abortion |
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was performed, selected from the following list: |
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(i) an abortion facility licensed under |
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Chapter 245; |
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(ii) a private office of a licensed |
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physician; |
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(iii) a licensed hospital; |
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(iv) a licensed hospital satellite clinic; |
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or |
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(v) an ambulatory surgical center licensed |
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under Chapter 243; |
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(B) the license number, area of specialty, and |
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signature of the physician who performed the abortion; |
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(C) a statement that the physician screened the |
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woman for coercion; |
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(D) the type of the abortion procedure performed, |
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selected from the following list: |
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(i) chemical abortion, specifying the |
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chemical used; |
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(ii) suction and curettage; |
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(iii) dilation and curettage; |
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(iv) dilation and evacuation; |
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(v) dilation and extraction; |
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(vi) labor and induction; |
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(vii) hysterotomy or hysterectomy; or |
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(viii) other (specify): ________________; |
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(E) the date the abortion was performed; |
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(F) whether the woman survived the abortion and, |
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if the woman did not survive, the cause of the woman's death; |
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(G) the number of fetuses aborted; |
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(H) the number of weeks of gestation at which the |
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abortion was performed, based on the best medical judgment of the |
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attending physician performing the procedure, and the weight of the |
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fetus or fetuses, if determinable; |
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(I) the method of pregnancy verification, |
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selected from the following list: |
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(i) urine test; |
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(ii) clinical laboratory test; |
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(iii) ultrasound; |
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(iv) not tested; or |
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(v) other (specify): ________________; |
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(J) the total fee collected from the patient by |
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the physician for performing the abortion, including any services |
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related to the abortion; |
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(K) whether the abortion procedure was: |
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(i) covered by fee-for-service insurance; |
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(ii) covered by a managed care benefit |
|
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plan; |
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(iii) covered by another type of health |
|
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benefit plan (specify): ________________; or |
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(iv) not covered by insurance or a health |
|
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benefit plan; |
|
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(L) the type of anesthetic, if any, used on the |
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woman during the abortion; |
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(M) the type of anesthetic, if any, used on the |
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unborn child or children during the abortion; |
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(N) the method used to dispose of fetal tissue |
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and remains; |
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(O) complications of the abortion, including: |
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(i) none; |
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(ii) shock; |
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(iii) uterine perforation; |
|
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(iv) cervical laceration; |
|
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(v) hemorrhage; |
|
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(vi) aspiration or allergic response; |
|
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(vii) infection or sepsis; |
|
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(viii) infant or infants born alive; |
|
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(ix) death of woman; or |
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(x) other (specify): ________________; |
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(P) if an infant was born alive during the |
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abortion: |
|
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(i) whether life-sustaining measures were |
|
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provided to the infant; and |
|
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(ii) the period of time the infant |
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survived; and |
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(Q) for each abortion performed on a woman who is |
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younger than 18 years of age: |
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(i) whether: |
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(a) the minor's parent, managing |
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conservator, or legal guardian provided the written consent |
|
|
required by Section 164.052(a)(19), Occupations Code; |
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(b) the minor obtained judicial |
|
|
authorization under Section 33.003 or 33.004, Family Code, for the |
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minor to consent to the abortion; |
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(c) the woman is emancipated and |
|
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permitted under law to have the abortion without the written |
|
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consent required by Section 164.052(a)(19), Occupations Code, or |
|
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judicial authorization; or |
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(d) the physician concluded and |
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documented in writing in the patient's medical record that on the |
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basis of the physician's good faith clinical judgment a condition |
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existed that complicated the medical condition of the pregnant |
|
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minor and necessitated the immediate abortion of her pregnancy to |
|
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avert her death or to avoid a serious risk of substantial impairment |
|
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of a major bodily function and that there was insufficient time to |
|
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obtain the consent of the minor's parent, managing conservator, or |
|
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legal guardian; |
|
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(ii) if the minor's parent, managing |
|
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conservator, or legal guardian gave written consent, whether the |
|
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consent was given: |
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(a) in person at the time of the |
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abortion; or |
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(b) at a place other than the location |
|
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where the abortion was performed; and |
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(iii) if the minor obtained judicial |
|
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authorization: |
|
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(a) the process the physician or |
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physician's agent used to inform the minor of the availability of |
|
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judicial bypass as an alternative to the written consent required |
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by Section 164.052(a)(19), Occupations Code; |
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(b) whether court forms were provided |
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to the minor; and |
|
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(c) who made arrangements for the |
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minor for the court appearance. |
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(c) The information required by Subsection (b)(1) must be at |
|
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the top of the form. The information required by Subsection (b)(2) |
|
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must be at the bottom of the form. |
|
|
(d) A woman is required to complete the information required |
|
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by Subsection (b)(1) unless the abortion is necessary to: |
|
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(1) prevent the woman's death or to avoid harm to the |
|
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woman, as described by Section 164.052(a)(18), Occupations Code; or |
|
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(2) avert the death of or to avoid harm to a woman who |
|
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is a minor, as described by Section 164.052(a)(19), Occupations |
|
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Code. |
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(e) If the woman does not complete the required information, |
|
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the physician who performs the abortion shall include in the |
|
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woman's medical file a signed written statement certifying the |
|
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nature of the medical emergency described by Subsection (d). |
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(f) A physician shall maintain a copy of each completed form |
|
|
in the woman's medical file until the later of: |
|
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(1) the seventh anniversary of the date on which the |
|
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form was signed; or |
|
|
(2) the woman's 20th birthday. |
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|
(g) A physician or the physician's agent shall provide to |
|
|
each woman required to complete a form under this section a copy of |
|
|
the completed form before the woman leaves the facility where the |
|
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abortion was performed. |
|
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(h) The department shall provide a copy of the abortion |
|
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reporting form: |
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(1) to each physician licensed to practice in this |
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state not later than December 1 of each year; and |
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|
(2) to each physician newly licensed to practice in |
|
|
this state not later than the 30th day after the date the physician |
|
|
receives that license. |
|
|
(i) The form prescribed by this section must comply with the |
|
|
requirements of Section 171.014(b)(1). |
|
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Sec. 171.024. COMPLICATION REPORTING FORM. (a) A |
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physician shall report to the department on the form prescribed by |
|
|
the department the information required by this section on the |
|
|
physician's treatment of an illness or injury related to a medical |
|
|
complication resulting from the performance of an abortion. |
|
|
(b) The form must include the following information to be |
|
|
completed by the physician providing the treatment: |
|
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(1) the date of the abortion that caused or may have |
|
|
caused the complication; |
|
|
(2) the type of abortion that caused or may have caused |
|
|
the complication, selected from the following list: |
|
|
(A) chemical abortion, specifying the chemical |
|
|
used; |
|
|
(B) suction and curettage; |
|
|
(C) dilation and curettage; |
|
|
(D) dilation and evacuation; |
|
|
(E) dilation and extraction; |
|
|
(F) labor and induction; |
|
|
(G) hysterotomy or hysterectomy; or |
|
|
(H) other (specify): ________________; |
|
|
(3) the name and type of the facility where the |
|
|
abortion complication was diagnosed and treated, selected from the |
|
|
following list: |
|
|
(A) an abortion facility licensed under Chapter |
|
|
245; |
|
|
(B) a private office of a licensed physician; |
|
|
(C) a licensed hospital; |
|
|
(D) a licensed hospital satellite clinic; or |
|
|
(E) an ambulatory surgical center licensed under |
|
|
Chapter 243; |
|
|
(4) the name and type of the facility where the |
|
|
abortion was provided, if known; |
|
|
(5) the license number, area of specialty, and |
|
|
signature of the physician who treated the abortion complication; |
|
|
(6) the date on which the abortion complication was |
|
|
treated; |
|
|
(7) a description of the complication or |
|
|
complications, selected from the following list: |
|
|
(A) none; |
|
|
(B) shock; |
|
|
(C) uterine perforation; |
|
|
(D) cervical laceration; |
|
|
(E) hemorrhage; |
|
|
(F) aspiration or allergic response; |
|
|
(G) infection or sepsis; |
|
|
(H) infant or infants born alive; |
|
|
(I) death of woman; or |
|
|
(J) other (specify): ________________; |
|
|
(8) the number of weeks of gestation at which the |
|
|
abortion was performed, based on the best medical judgment of the |
|
|
attending physician at the time of the treatment for the |
|
|
complication; |
|
|
(9) the number of the woman's previous live births; |
|
|
(10) the number of previous induced abortions the |
|
|
woman has undergone; |
|
|
(11) the number of miscarriages the woman has |
|
|
previously experienced; |
|
|
(12) whether the treatment for the complication was |
|
|
paid for by: |
|
|
(A) private insurance; |
|
|
(B) a public health plan; |
|
|
(C) personal payment by cash; or |
|
|
(D) personal payment by check or credit card; |
|
|
(13) the total fee collected by the physician for |
|
|
treatment of the complication; |
|
|
(14) whether the treatment for the complication was: |
|
|
(A) covered by fee-for-service insurance; |
|
|
(B) covered by a managed care benefit plan; |
|
|
(C) covered by another type of health benefit |
|
|
plan (specify): ________________; or |
|
|
(D) not covered by insurance or a health benefit |
|
|
plan; and |
|
|
(15) the type of follow-up care recommended by the |
|
|
physician after the physician provides treatment for the |
|
|
complication. |
|
|
(c) A physician shall maintain a copy of each completed form |
|
|
in the woman's medical file until the later of: |
|
|
(1) the seventh anniversary of the date on which the |
|
|
form was signed; or |
|
|
(2) the woman's 20th birthday. |
|
|
(d) A physician or the physician's agent shall provide to |
|
|
each woman for whom a form is completed under this section a copy of |
|
|
the completed form before the woman leaves the facility where the |
|
|
treatment was received. |
|
|
(e) The department shall provide a copy of the complication |
|
|
form: |
|
|
(1) to each physician licensed to practice in this |
|
|
state not later than December 1 of each year; and |
|
|
(2) to each physician newly licensed to practice in |
|
|
this state not later than the 30th day after the physician receives |
|
|
that license. |
|
|
(f) The form prescribed by this section must comply with the |
|
|
requirements of Section 171.014(b)(1). |
|
|
Sec. 171.025. CONFIDENTIAL INFORMATION. (a) Except as |
|
|
provided by Section 171.028 and Subsection (b), all information |
|
|
received or maintained by the department under this subchapter is |
|
|
confidential and is not subject to disclosure under Chapter 552, |
|
|
Government Code. |
|
|
(b) A department employee may disclose information |
|
|
described by Subsection (a): |
|
|
(1) for statistical purposes, but only if a person or |
|
|
facility is not identified; |
|
|
(2) to a medical professional, a state agency, or a |
|
|
county or district court for purposes of enforcing this chapter or |
|
|
Chapter 245; or |
|
|
(3) to a state licensing board for purposes of |
|
|
enforcing state licensing laws. |
|
|
Sec. 171.026. PENALTIES. (a) The commissioner of state |
|
|
health services may assess an administrative penalty against a |
|
|
physician who fails to submit a report within the time required by |
|
|
Section 171.022 in the amount of $500 for each 30-day period or |
|
|
portion of a 30-day period the report remains overdue. |
|
|
(b) The commissioner may bring an action against a physician |
|
|
who fails to file a report required under Section 171.022 before the |
|
|
first anniversary of the date the report was due to compel the |
|
|
physician to submit a complete report within a time stated by the |
|
|
court order or be subject to sanctions for civil contempt. |
|
|
Sec. 171.027. OFFENSE; CRIMINAL PENALTY. (a) A physician |
|
|
commits an offense if the physician: |
|
|
(1) fails to submit a report required by this |
|
|
subchapter; |
|
|
(2) intentionally, knowingly, or recklessly submits |
|
|
false information in a report required by this subchapter; |
|
|
(3) includes in a report required by this subchapter |
|
|
the name or identifying information of a woman on whom the physician |
|
|
performed an abortion; or |
|
|
(4) discloses confidential identifying information in |
|
|
violation of Section 171.025. |
|
|
(b) An offense under this section is a Class A misdemeanor. |
|
|
Sec. 171.028. PUBLIC REPORT BY DEPARTMENT. (a) Not later |
|
|
than April 1 of each year, the department, in a form accessible by |
|
|
the public, shall issue a report that summarizes the information |
|
|
reported under Section 171.022 during the preceding calendar year. |
|
|
(b) Each report must include data from the reports issued |
|
|
under this section in previous years, including updated or |
|
|
corrected information for those reports. |
|
|
(c) The department shall ensure that a report issued under |
|
|
this section does not contain any information that could reasonably |
|
|
lead to the identification of: |
|
|
(1) a woman on whom an abortion was performed or who |
|
|
received treatment for a complication resulting from an abortion; |
|
|
or |
|
|
(2) a physician who performed an abortion or treated a |
|
|
complication resulting from an abortion. |
|
|
SECTION 3. Section 245.001, Health and Safety Code, is |
|
|
amended to read as follows: |
|
|
Sec. 245.001. SHORT TITLE. This chapter may be cited as the |
|
|
Texas Abortion Facility [Reporting and] Licensing Act. |
|
|
SECTION 4. Section 245.005(e), Health and Safety Code, is |
|
|
amended to read as follows: |
|
|
(e) As a condition for renewal of a license, the licensee |
|
|
must submit to the department the annual license renewal fee and an |
|
|
annual report[, including the report required under Section
|
|
|
245.011]. |
|
|
SECTION 5. Section 248.003, Health and Safety Code, is |
|
|
amended to read as follows: |
|
|
Sec. 248.003. EXEMPTIONS. This chapter does not apply to: |
|
|
(1) a home and community support services agency |
|
|
required to be licensed under Chapter 142; |
|
|
(2) a person required to be licensed under Chapter 241 |
|
|
(Texas Hospital Licensing Law); |
|
|
(3) an institution required to be licensed under |
|
|
Chapter 242; |
|
|
(4) an ambulatory surgical center required to be |
|
|
licensed under Chapter 243 (Texas Ambulatory Surgical Center |
|
|
Licensing Act); |
|
|
(5) a birthing center required to be licensed under |
|
|
Chapter 244 (Texas Birthing Center Licensing Act); |
|
|
(6) a facility required to be licensed under Chapter |
|
|
245 (Texas Abortion Facility [Reporting and] Licensing Act); |
|
|
(7) a child care institution, foster group home, |
|
|
foster family home, and child-placing agency, for children in |
|
|
foster care or other residential care who are under the |
|
|
conservatorship of the Department of Family and Protective [and
|
|
|
Regulatory] Services; or |
|
|
(8) a person providing medical or nursing care or |
|
|
services under a license or permit issued under other state law. |
|
|
SECTION 6. Effective January 1, 2012, Section 245.011, |
|
|
Health and Safety Code, is repealed. |
|
|
SECTION 7. (a) Not later than December 1, 2011, the |
|
|
Department of State Health Services shall develop the forms |
|
|
required by Sections 171.023 and 171.024, Health and Safety Code, |
|
|
as added by this Act. |
|
|
(b) Not later than January 1, 2012, the Department of State |
|
|
Health Services shall distribute the forms required by Sections |
|
|
171.023 and 171.024, Health and Safety Code, as added by this Act. |
|
|
(c) Notwithstanding Section 171.022, Health and Safety |
|
|
Code, as added by this Act, a physician is not required to submit a |
|
|
report required by Section 171.022, Health and Safety Code, as |
|
|
added by this Act, before January 1, 2012. |
|
|
SECTION 8. Not later than April 1, 2013, the Department of |
|
|
State Health Services shall issue the initial report required by |
|
|
Section 171.028, Health and Safety Code, as added by this Act. |
|
|
SECTION 9. (a) Except as otherwise provided by this Act, |
|
|
this Act takes effect September 1, 2011. |
|
|
(b) Sections 170.003 and 171.027, Health and Safety Code, as |
|
|
added by this Act, and Sections 245.001, 245.005, and 248.003, |
|
|
Health and Safety Code, as amended by this Act, take effect January |
|
|
1, 2012. |