Bill Text: TX HB15 | 2011-2012 | 82nd Legislature | Enrolled

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Bill Title: Relating to informed consent to an abortion.

Sponsorship: Partisan Bill (Republican 86-2)

Status: (Passed) 2011-05-19 - Effective on 9/1/11 [HB15 Detail]

Download: Texas-2011-HB15-Enrolled.html

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H.B. No. 15

AN ACT
relating to informed consent to an abortion.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 171.002, Health and Safety Code, is
amended to read as follows:
Sec. 171.002. DEFINITIONS [DEFINITION]. In this chapter:
(1) "Abortion" [, "abortion"] means the use of any
means to terminate the pregnancy of a female known by the attending
physician to be pregnant with the intention that the termination of
the pregnancy by those means will, with reasonable likelihood,
cause the death of the fetus.
(2) "Abortion provider" means a facility where an
abortion is performed, including the office of a physician and a
facility licensed under Chapter 245.
(3) "Medical emergency" means a life-threatening
physical condition aggravated by, caused by, or arising from a
pregnancy that, as certified by a physician, places the woman in
danger of death or a serious risk of substantial impairment of a
major bodily function unless an abortion is performed.
(4) "Sonogram" means the use of ultrasonic waves for
diagnostic or therapeutic purposes, specifically to monitor an
unborn child.
SECTION 2. Section 171.012, Health and Safety Code, is
amended by amending Subsections (a), (b), and (c) and adding
Subsection (a-1) to read as follows:
(a) Consent [Except in the case of a medical emergency,
consent] to an abortion is voluntary and informed only if:
(1) the physician who is to perform the abortion [or
the referring physician] informs the pregnant woman on whom the
abortion is to be performed of:
(A) the physician's name [of the physician who
will perform the abortion];
(B) the particular medical risks associated with
the particular abortion procedure to be employed, including, when
medically accurate:
(i) the risks of infection and hemorrhage;
(ii) the potential danger to a subsequent
pregnancy and of infertility; and
(iii) the possibility of increased risk of
breast cancer following an induced abortion and the natural
protective effect of a completed pregnancy in avoiding breast
cancer;
(C) the probable gestational age of the unborn
child at the time the abortion is to be performed; and
(D) the medical risks associated with carrying
the child to term;
(2) the physician who is to perform the abortion or the
physician's agent informs the pregnant woman that:
(A) medical assistance benefits may be available
for prenatal care, childbirth, and neonatal care;
(B) the father is liable for assistance in the
support of the child without regard to whether the father has
offered to pay for the abortion; and
(C) public and private agencies provide
pregnancy prevention counseling and medical referrals for
obtaining pregnancy prevention medications or devices, including
emergency contraception for victims of rape or incest; [and]
(3) the physician who is to perform the abortion or the
physician's agent:
(A) provides [(D)] the pregnant woman with [has
the right to review] the printed materials described by Section
171.014; and
(B) informs the pregnant woman[,] that those
materials:
(i) have been provided by the [Texas]
Department of State Health Services;
(ii) [and] are accessible on an Internet
website sponsored by the department;
(iii) [, and that the materials] describe
the unborn child and list agencies that offer alternatives to
abortion; and
(iv) include a list of agencies that offer
sonogram services at no cost to the pregnant woman;
(4) before any sedative or anesthesia is administered
to the pregnant woman and at least 24 hours before the abortion or
at least two hours before the abortion if the pregnant woman waives
this requirement by certifying that she currently lives 100 miles
or more from the nearest abortion provider that is a facility
licensed under Chapter 245 or a facility that performs more than 50
abortions in any 12-month period:
(A) the physician who is to perform the abortion
or an agent of the physician who is also a sonographer certified by
a national registry of medical sonographers performs a sonogram on
the pregnant woman on whom the abortion is to be performed;
(B) the physician who is to perform the abortion
displays the sonogram images in a quality consistent with current
medical practice in a manner that the pregnant woman may view them;
(C) the physician who is to perform the abortion
provides, in a manner understandable to a layperson, a verbal
explanation of the results of the sonogram images, including a
medical description of the dimensions of the embryo or fetus, the
presence of cardiac activity, and the presence of external members
and internal organs; and
(D) the physician who is to perform the abortion
or an agent of the physician who is also a sonographer certified by
a national registry of medical sonographers makes audible the heart
auscultation for the pregnant woman to hear, if present, in a
quality consistent with current medical practice and provides, in a
manner understandable to a layperson, a simultaneous verbal
explanation of the heart auscultation;
(5) before receiving a sonogram under Subdivision
(4)(A) and [(3) the woman certifies in writing] before the abortion
is performed and before any sedative or anesthesia is administered,
the pregnant woman completes and certifies with her signature an
election form that states as follows:
"ABORTION AND SONOGRAM ELECTION
(1) THE INFORMATION AND PRINTED MATERIALS
DESCRIBED BY SECTIONS 171.012(a)(1)-(3), TEXAS HEALTH
AND SAFETY CODE, HAVE BEEN PROVIDED AND EXPLAINED TO
ME.
(2) I UNDERSTAND THE NATURE AND CONSEQUENCES OF
AN ABORTION.
(3) TEXAS LAW REQUIRES THAT I RECEIVE A SONOGRAM
PRIOR TO RECEIVING AN ABORTION.
(4) I UNDERSTAND THAT I HAVE THE OPTION TO VIEW
THE SONOGRAM IMAGES.
(5) I UNDERSTAND THAT I HAVE THE OPTION TO HEAR
THE HEARTBEAT.
(6) I UNDERSTAND THAT I AM REQUIRED BY LAW TO
HEAR AN EXPLANATION OF THE SONOGRAM IMAGES UNLESS I
CERTIFY IN WRITING TO ONE OF THE FOLLOWING:
___ I AM PREGNANT AS A RESULT OF A SEXUAL ASSAULT,
INCEST, OR OTHER VIOLATION OF THE TEXAS PENAL CODE THAT
HAS BEEN REPORTED TO LAW ENFORCEMENT AUTHORITIES OR
THAT HAS NOT BEEN REPORTED BECAUSE I REASONABLY
BELIEVE THAT DOING SO WOULD PUT ME AT RISK OF
RETALIATION RESULTING IN SERIOUS BODILY INJURY.
___ I AM A MINOR AND OBTAINING AN ABORTION IN
ACCORDANCE WITH JUDICIAL BYPASS PROCEDURES UNDER
CHAPTER 33, TEXAS FAMILY CODE.
___ MY FETUS HAS AN IRREVERSIBLE MEDICAL
CONDITION OR ABNORMALITY, AS IDENTIFIED BY RELIABLE
DIAGNOSTIC PROCEDURES AND DOCUMENTED IN MY MEDICAL
FILE.
(7) I AM MAKING THIS ELECTION OF MY OWN FREE WILL
AND WITHOUT COERCION.
(8) FOR A WOMAN WHO LIVES 100 MILES OR MORE FROM
THE NEAREST ABORTION PROVIDER THAT IS A FACILITY
LICENSED UNDER CHAPTER 245 OR A FACILITY THAT PERFORMS
MORE THAN 50 ABORTIONS IN ANY 12-MONTH PERIOD ONLY:
I CERTIFY THAT, BECAUSE I CURRENTLY LIVE 100
MILES OR MORE FROM THE NEAREST ABORTION PROVIDER THAT
IS A FACILITY LICENSED UNDER CHAPTER 245 OR A FACILITY
THAT PERFORMS MORE THAN 50 ABORTIONS IN ANY 12-MONTH
PERIOD, I WAIVE THE REQUIREMENT TO WAIT 24 HOURS AFTER
THE SONOGRAM IS PERFORMED BEFORE RECEIVING THE
ABORTION PROCEDURE. MY PLACE OF RESIDENCE
IS:__________.
________________________________________
SIGNATURE DATE"
[that the information described by Subdivisions (1) and (2) has
been provided to her and that she has been informed of her
opportunity to review the information described by Section
171.014]; [and]
(6) [(4)] before the abortion is performed, the
physician who is to perform the abortion receives a copy of the
signed, written certification required by Subdivision (5); and
(7) the pregnant woman is provided the name of each
person who provides or explains the information required under this
subsection [(3)].
(a-1) During a visit made to a facility to fulfill the
requirements of Subsection (a), the facility and any person at the
facility may not accept any form of payment, deposit, or exchange or
make any financial agreement for an abortion or abortion-related
services other than for payment of a service required by Subsection
(a). The amount charged for a service required by Subsection (a)
may not exceed the reimbursement rate established for the service
by the Health and Human Services Commission for statewide medical
reimbursement programs.
(b) The information required to be provided under
Subsections (a)(1) and (2) may not be provided by audio or video
recording and must be provided at least 24 hours before the abortion
is to be performed:
(1) orally and [by telephone or] in person in a private
and confidential setting if the pregnant woman currently lives less
than 100 miles from the nearest abortion provider that is a facility
licensed under Chapter 245 or a facility that performs more than 50
abortions in any 12-month period; or [and]
(2) orally by telephone or in person in a private and
confidential setting if the pregnant woman certifies that the woman
currently lives 100 miles or more from the nearest abortion
provider that is a facility licensed under Chapter 245 or a facility
that performs more than 50 abortions in any 12-month period [at
least 24 hours before the abortion is to be performed].
(c) When providing the information under Subsection (a)(3)
[(a)(2)(D)], the physician or the physician's agent must provide
the pregnant woman with the address of the Internet website on which
the printed materials described by Section 171.014 may be viewed as
required by Section 171.014(e).
SECTION 3. Subchapter B, Chapter 171, Health and Safety
Code, is amended by adding Sections 171.0121, 171.0122, 171.0123,
and 171.0124 to read as follows:
Sec. 171.0121. MEDICAL RECORD. (a) Before the abortion
begins, a copy of the signed, written certification received by the
physician under Section 171.012(a)(6) must be placed in the
pregnant woman's medical records.
(b) A copy of the signed, written certification required
under Sections 171.012(a)(5) and (6) shall be retained by the
facility where the abortion is performed until:
(1) the seventh anniversary of the date it is signed;
or
(2) if the pregnant woman is a minor, the later of:
(A) the seventh anniversary of the date it is
signed; or
(B) the woman's 21st birthday.
Sec. 171.0122. VIEWING PRINTED MATERIALS AND SONOGRAM
IMAGE; HEARING HEART AUSCULTATION OR VERBAL EXPLANATION. (a) A
pregnant woman may choose not to view the printed materials
provided under Section 171.012(a)(3) after she has been provided
the materials.
(b) A pregnant woman may choose not to view the sonogram
images required to be provided to and reviewed with the pregnant
woman under Section 171.012(a)(4).
(c) A pregnant woman may choose not to hear the heart
auscultation required to be provided to and reviewed with the
pregnant woman under Section 171.012(a)(4).
(d) A pregnant woman may choose not to receive the verbal
explanation of the results of the sonogram images under Section
171.012(a)(4)(C) if:
(1) the woman's pregnancy is a result of a sexual
assault, incest, or other violation of the Penal Code that has been
reported to law enforcement authorities or that has not been
reported because she has a reason that she declines to reveal
because she reasonably believes that to do so would put her at risk
of retaliation resulting in serious bodily injury;
(2) the woman is a minor and obtaining an abortion in
accordance with judicial bypass procedures under Chapter 33, Family
Code; or
(3) the fetus has an irreversible medical condition or
abnormality, as previously identified by reliable diagnostic
procedures and documented in the woman's medical file.
(e) The physician and the pregnant woman are not subject to
a penalty under this chapter solely because the pregnant woman
chooses not to view the printed materials or the sonogram images,
hear the heart auscultation, or receive the verbal explanation, if
waived as provided by this section.
Sec. 171.0123. PATERNITY AND CHILD SUPPORT INFORMATION.
If, after being provided with a sonogram and the information
required under this subchapter, the pregnant woman chooses not to
have an abortion, the physician or an agent of the physician shall
provide the pregnant woman with a publication developed by the
Title IV-D agency that provides information about paternity
establishment and child support, including:
(1) the steps necessary for unmarried parents to
establish legal paternity;
(2) the benefits of paternity establishment for
children;
(3) the steps necessary to obtain a child support
order;
(4) the benefits of establishing a legal parenting
order; and
(5) financial and legal responsibilities of
parenting.
Sec. 171.0124. EXCEPTION FOR MEDICAL EMERGENCY. A
physician may perform an abortion without obtaining informed
consent under this subchapter in a medical emergency. A physician
who performs an abortion in a medical emergency shall:
(1) include in the patient's medical records a
statement signed by the physician certifying the nature of the
medical emergency; and
(2) not later than the 30th day after the date the
abortion is performed, certify to the Department of State Health
Services the specific medical condition that constituted the
emergency.
SECTION 4. Section 171.013(a), Health and Safety Code, is
amended to read as follows:
(a) The [If the woman chooses to view the materials
described by Section 171.014, the] physician or the physician's
agent shall furnish copies of the materials described by Section
171.014 to the pregnant woman [her] at least 24 hours before the
abortion is to be performed and shall direct the pregnant woman to
the Internet website required to be published under Section
171.014(e). The [A] physician or the physician's agent may furnish
the materials to the pregnant woman by mail if the materials are
mailed, restricted delivery to addressee, at least 72 hours before
the abortion is to be performed.
SECTION 5. Section 171.015, Health and Safety Code, is
amended to read as follows:
Sec. 171.015. INFORMATION RELATING TO PUBLIC AND PRIVATE
AGENCIES. The informational materials must include [either]:
(1) geographically indexed materials designed to
inform the pregnant woman of public and private agencies and
services that:
(A) are available to assist a woman through
pregnancy, childbirth, and the child's dependency, including:
(i) a comprehensive list of adoption
agencies;
(ii) a description of the services the
adoption agencies offer; [and]
(iii) a description of the manner,
including telephone numbers, in which an adoption agency may be
contacted; and
(iv) a comprehensive list of agencies and
organizations that offer sonogram services at no cost to the
pregnant woman;
(B) do not provide abortions or abortion-related
services or make referrals to abortion providers; and
(C) are not affiliated with organizations that
provide abortions or abortion-related services or make referrals to
abortion providers; and [or]
(2) a toll-free, 24-hour telephone number that may be
called to obtain an oral list and description of agencies described
by Subdivision (1) that are located near the caller and of the
services the agencies offer.
SECTION 6. Subchapter A, Chapter 241, Health and Safety
Code, is amended by adding Section 241.007 to read as follows:
Sec. 241.007. COMPLIANCE WITH CERTAIN REQUIREMENTS
REGARDING SONOGRAM BEFORE ABORTION. A hospital shall comply with
Subchapter B, Chapter 171.
SECTION 7. Subchapter A, Chapter 243, Health and Safety
Code, is amended by adding Section 243.017 to read as follows:
Sec. 243.017. COMPLIANCE WITH CERTAIN REQUIREMENTS
REGARDING SONOGRAM BEFORE ABORTION. An ambulatory surgical center
shall comply with Subchapter B, Chapter 171.
SECTION 8. Section 245.006(a), Health and Safety Code, is
amended to read as follows:
(a) The department shall [may] inspect an abortion facility
at random, unannounced, and reasonable times as necessary to ensure
compliance with this chapter and Subchapter B, Chapter 171.
SECTION 9. Chapter 245, Health and Safety Code, is amended
by adding Section 245.024 to read as follows:
Sec. 245.024. COMPLIANCE WITH CERTAIN REQUIREMENTS
REGARDING SONOGRAM BEFORE ABORTION. An abortion facility shall
comply with Subchapter B, Chapter 171.
SECTION 10. Section 164.055(a), Occupations Code, is
amended to read as follows:
(a) The board shall [may] take an appropriate disciplinary
action against a physician who violates Section 170.002 or Chapter
171, Health and Safety Code. The board shall [may] refuse to admit
to examination or refuse to issue a license or renewal license to a
person who violates that section or chapter.
SECTION 11. Subchapter B, Chapter 164, Occupations Code, is
amended by adding Section 164.0551 to read as follows:
Sec. 164.0551. COMPLIANCE WITH CERTAIN REQUIREMENTS
REGARDING SONOGRAM BEFORE ABORTION. A physician shall comply with
Subchapter B, Chapter 171, Health and Safety Code.
SECTION 12. The purposes of this Act include, but are not
limited to:
(1) protecting the physical and psychological health
and well-being of pregnant women;
(2) providing pregnant women access to information
that would allow her to consider the impact an abortion would have
on her unborn child; and
(3) protecting the integrity and ethical standards of
the medical profession.
SECTION 13. The change in law made by this Act applies only
to an abortion performed on or after the 30th day after the
effective date of this Act. An abortion performed before the 30th
day after the effective date of this Act is governed by the law in
effect on the date the abortion was performed, and the former law is
continued in effect for that purpose.
SECTION 14. The Title IV-D agency shall publish the
information required by Section 171.0123, Health and Safety Code,
as added by this Act, not later than the 30th day after the
effective date of this Act.
SECTION 15. Every provision in this Act and every
application of the provisions in this Act are severable from each
other. If any application of any provision in this Act to any
person or group of persons or circumstances is found by a court to
be invalid, the remainder of this Act and the application of the
Act's provisions to all other persons and circumstances may not be
affected. All constitutionally valid applications of this Act
shall be severed from any applications that a court finds to be
invalid, leaving the valid applications in force, because it is the
legislature's intent and priority that the valid applications be
allowed to stand alone. Even if a reviewing court finds a provision
of this Act invalid in a large or substantial fraction of relevant
cases, the remaining valid applications shall be severed and
allowed to remain in force.
SECTION 16. This Act takes effect immediately if it
receives a vote of two-thirds of all the members elected to each
house, as provided by Section 39, Article III, Texas Constitution.
If this Act does not receive the vote necessary for immediate
effect, this Act takes effect September 1, 2011.
______________________________ ______________________________
President of the Senate Speaker of the House
I certify that H.B. No. 15 was passed by the House on March 7,
2011, by the following vote: Yeas 107, Nays 42, 1 present, not
voting; and that the House concurred in Senate amendments to H.B.
No. 15 on May 5, 2011, by the following vote: Yeas 94, Nays 41, 1
present, not voting.
______________________________
Chief Clerk of the House
I certify that H.B. No. 15 was passed by the Senate, with
amendments, on May 3, 2011, by the following vote: Yeas 21, Nays
10.
______________________________
Secretary of the Senate
APPROVED: __________________
Date
__________________
Governor