By: Hegar, et al. S.B. No. 5
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to the regulation of abortion procedures, providers, and
  facilities; providing penalties.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Subchapter A, Chapter 171, Health and Safety
  Code, is amended by adding Section 171.0031 to read as follows:
         Sec. 171.0031.  REQUIREMENTS OF PHYSICIAN; OFFENSE.  (a)  A
  physician performing or inducing an abortion:
               (1)  must, on the date the abortion is performed, have
  active admitting privileges at a hospital that:
                     (A)  is located not further than 30 miles from the
  location at which the abortion is performed or induced; and
                     (B)  provides obstetrical or gynecological health
  care services; and
               (2)  shall provide the pregnant woman with:
                     (A)  a telephone number by which the pregnant
  woman may reach the physician, or other health care personnel
  employed by the physician or by the facility at which the abortion
  was performed with access to the woman's relevant medical records,
  24 hours a day to request assistance for any complications that
  arise from the performance of the abortion or ask health-related
  questions regarding the abortion; and
                     (B)  the name and telephone number of the nearest
  hospital to the home of the pregnant woman at which an emergency
  arising from the abortion would be treated.
               (b)  A physician who violates Subsection (a) commits an
  offense.  An offense under this section is a Class A misdemeanor
  punishable by a fine only, not to exceed $4,000.
         SECTION 2.  Chapter 171, Health and Safety Code, is amended
  by adding Subchapter C to read as follows:
  SUBCHAPTER C.  ABORTION-INDUCING DRUGS
         Sec. 171.041.  DEFINITIONS.  In this subchapter:
               (1)  "Abortion-inducing drug" means a drug, a medicine,
  or any other substance, including a regimen of two or more drugs,
  medicines, or substances, prescribed, dispensed, or administered
  with the intent of terminating a clinically diagnosable pregnancy
  of a woman and with knowledge that the termination will, with
  reasonable likelihood, cause the death of the woman's unborn child.  
  The term includes off-label use of drugs, medicines, or other
  substances known to have abortion-inducing properties that are
  prescribed, dispensed, or administered with the intent of causing
  an abortion, including the Mifeprex regimen.  The term does not
  include a drug, medicine, or other substance that may be known to
  cause an abortion but is prescribed, dispensed, or administered for
  other medical reasons.
               (2)  "Final printed label" or "FPL" means the
  informational document approved by the United States Food and Drug
  Administration for an abortion-inducing drug that:
                     (A)  outlines the protocol authorized by that
  agency and agreed to by the drug company applying for authorization
  of the drug by that agency; and
                     (B)  delineates how a drug is to be used according
  to approval by that agency.
               (3)  "Gestational age" means the amount of time that
  has elapsed since the first day of a woman's last menstrual period.
               (4)  "Medical abortion" means the administration or use
  of an abortion-inducing drug to induce an abortion.
               (5)  "Mifeprex regimen," "RU-486 regimen," or "RU-486" 
  means the abortion-inducing drug regimen approved by the United
  States Food and Drug Administration that consists of administering
  mifepristone and misoprostal.
               (6)  "Physician" means an individual who is licensed to
  practice medicine in this state, including a medical doctor and a
  doctor of osteopathic medicine.
               (7)  "Pregnant" means the female reproductive
  condition of having an unborn child in a woman's uterus.
               (8)  "Unborn child" means an offspring of human beings
  from conception until birth.
         Sec. 171.0411.  APPLICABILITY TO MEDICAL ABORTION.  This
  subchapter does not apply to an abortion with the intent to:
               (1)  save the life or preserve the health of an unborn
  child;
               (2)  remove a dead, unborn child whose death was caused
  by spontaneous abortion;
               (3)  remove an ectopic pregnancy; or
               (4)  treat a maternal disease or illness for which a
  prescribed drug, medicine, or other substance is indicated.
         Sec. 171.042.  ENFORCEMENT BY TEXAS MEDICAL BOARD.  
  Notwithstanding Section 171.005, the Texas Medical Board shall
  enforce this subchapter.
         Sec. 171.043.  DISTRIBUTION OF ABORTION-INDUCING DRUG.  
  (a)  A person may not knowingly give, sell, dispense, administer,
  provide, or prescribe an abortion-inducing drug to a pregnant woman
  for the purpose of inducing an abortion in the pregnant woman or
  enabling another person to induce an abortion in the pregnant woman
  unless:
               (1)  the person who gives, sells, dispenses,
  administers, provides, or prescribes the abortion-inducing drug is
  a physician;
               (2)  the physician administering the abortion-inducing
  drug administers the drug to the woman while both are present at an
  abortion facility licensed under Chapter 245; and
               (3)  the provision, prescription, or administration of
  the abortion-inducing drug, except as provided by Subsection (a-1),
  satisfies the protocol tested and authorized by the United States
  Food and Drug Administration as outlined in the final printed label
  of the abortion-inducing drug.
         (a-1)  A person may provide, prescribe, or administer the
  abortion-inducing drug in the dosage amount prescribed by the
  clinical management guidelines defined by the American Congress of
  Obstetricians and Gynecologists Practice Bulletin as those
  guidelines existed on January 1, 2013.
         (b)  Before the physician gives, sells, dispenses,
  administers, provides, or prescribes an abortion-inducing drug,
  the physician must examine the pregnant woman and document, in the
  woman's medical record, the gestational age and intrauterine
  location of the pregnancy.
         (c)  The physician who gives, sells, dispenses, administers,
  provides, or prescribes an abortion-inducing drug shall provide the
  pregnant woman with:
               (1)  a copy of the final printed label of that
  abortion-inducing drug; and
               (2)  a telephone number by which the pregnant woman may
  reach the physician, or other health care personnel employed by the
  physician or by the facility at which the abortion was performed
  with access to the woman's relevant medical records, 24 hours a day
  to request assistance for any complications that arise from the
  administration or use of the drug or ask health-related questions
  regarding the administration or use of the drug.
         (d)  The physician who gives, sells, dispenses, administers,
  provides, or prescribes the abortion-inducing drug, or the
  physician's agent, must schedule a follow-up visit for the woman to
  occur not more than 14 days after the administration or use of the
  drug.  At the follow-up visit, the physician must:
               (1)  confirm that the pregnancy is completely
  terminated; and
               (2)  assess the degree of bleeding.
         (e)  The physician who gives, sells, dispenses, administers,
  provides, or prescribes the abortion-inducing drug, or the
  physician's agent, shall make a reasonable effort to ensure that
  the woman returns for the scheduled follow-up visit under
  Subsection (d).  The physician or the physician's agent shall
  document a brief description of any effort made to comply with this
  subsection, including the date, time, and name of the person making
  the effort, in the woman's medical record.
         (f)  If a physician gives, sells, dispenses, administers,
  provides, or prescribes an abortion-inducing drug to a pregnant
  woman for the purpose of inducing an abortion as authorized by this
  section and the physician knows that the woman experiences a
  serious adverse event, as defined by the MedWatch Reporting System,
  during or after the administration or use of the drug, the physician
  shall report the event to the United States Food and Drug
  Administration through the MedWatch Reporting System not later than
  the third day after the date the physician learns that the event
  occurred.
         Sec. 171.044.  ADMINISTRATIVE PENALTY.  (a)  The Texas
  Medical Board may take disciplinary action under Chapter 164,
  Occupations Code, or assess an administrative penalty under
  Subchapter A, Chapter 165, Occupations Code, against a person who
  violates Section 171.043.
         (b)  A penalty may not be assessed under this section against
  a pregnant woman who receives a medical abortion.
         SECTION 3.  Subsection (a), Section 245.010, Health and
  Safety Code, is amended to read as follows:
         (a)  The rules must contain minimum standards to protect the
  health and safety of a patient of an abortion facility and must
  contain provisions requiring compliance with the requirements of
  Subchapter B, Chapter 171.  On and after September 1, 2014, the
  minimum standards for an abortion facility must be equivalent to
  the minimum standards adopted under Section 243.010 for ambulatory
  surgical centers.
         SECTION 4.  Effective September 1, 2014, Subsection (c),
  Section 245.010, Health and Safety Code, is repealed.
         SECTION 5.  This Act may not be construed to repeal, by
  implication or otherwise, Subdivision (18), Subsection (a),
  Section 164.052, Occupations Code, Section 170.002, Health and
  Safety Code, or any other provision of Texas law regulating or
  restricting abortion not specifically addressed by this Act.  An
  abortion that complies with this Act but violates any other law is
  unlawful.  An abortion that complies with another state law but
  violates this Act is unlawful as provided in this Act.
         SECTION 6.  (a)  If some or all of the provisions of this Act
  are ever temporarily or permanently restrained or enjoined by
  judicial order, all other provisions of Texas law regulating or
  restricting abortion shall be enforced as though the restrained or
  enjoined provisions had not been adopted; provided, however, that
  whenever the temporary or permanent restraining order or injunction
  is stayed or dissolved, or otherwise ceases to have effect, the
  provisions shall have full force and effect.
         (b)  Mindful of Leavitt v. Jane L., 518 U.S. 137 (1996), in
  which in the context of determining the severability of a state
  statute regulating abortion the United States Supreme Court held
  that an explicit statement of legislative intent is controlling, it
  is the intent of the legislature that every provision, section,
  subsection, sentence, clause, phrase, or word in this Act, and
  every application of the provisions in this Act, are severable from
  each other.  If any application of any provision in this Act to any
  person, group of persons, or circumstances is found by a court to be
  invalid, the remaining applications of that provision to all other
  persons and circumstances shall be severed and 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 to impose an undue burden in a large or substantial
  fraction of relevant cases, the applications that do not present an
  undue burden shall be severed from the remaining provisions and
  shall remain in force, and shall be treated as if the legislature
  had enacted a statute limited to the persons, group of persons, or
  circumstances for which the statute's application does not present
  an undue burden.  The legislature further declares that it would
  have passed this Act, and each provision, section, subsection,
  sentence, clause, phrase, or word, and all constitutional
  applications of this Act, irrespective of the fact that any
  provision, section, subsection, sentence, clause, phrase, or word,
  or applications of this Act, were to be declared unconstitutional
  or to represent an undue burden.
         (c)  If any provision of this Act is found by any court to be
  unconstitutionally vague, then the applications of that provision
  that do not present constitutional vagueness problems shall be
  severed and remain in force.
         SECTION 7.  (a)  The executive commissioner of the Health
  and Human Services Commission shall adopt the standards required by
  Section 245.010, Health and Safety Code, as amended by this Act, not
  later than January 1, 2014.
         (b)  A facility licensed under Chapter 245, Health and Safety
  Code, is not required to comply with the standards adopted under
  Section 245.010, Health and Safety Code, as amended by this Act,
  before September 1, 2014.
         SECTION 8.  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 on the 91st day after the last day of the
  legislative session.