Wednesday, July 24, 2013

Amendments of #HB2 Texas Second Special Session, 2013

Amendments to HB 2. All tabled. Most considered "not germane."

Apologies for the BAD formatting. Wanna look at the originals? Go here: http://www.legis.state.tx.us/BillLookup/Amendments.aspx?LegSess=832&Bill=HB2

AMENDMENT 1

Amend HB 2 (house committee printing) on page 5, between lines 25 and 26, by inserting the following:

(d) The prohibitions and requirements under Sections 171.043, 171.044, and 171.045(b) do not apply to an abortion performed when 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.

AMENDMENT 2

Amend HB 2 (house committee printing) as follows:

(1) Strike page 1, line 5, through page 3, line 13.

(2) On page 3, line 15, strike "Subchapters C and D" and substitute "Subchapter C".

(3) On page 5, line 8, between "condition" and ", it", insert "not described by Subsection (a-1)".

(4) On page 5, between lines 16 and 17, insert the following subsection:

(a-1) Notwithstanding Subsection (a), an abortion may be performed under Subsection (a)(1) or (2) if, in the physician's reasonable medical health judgment the medical condition caused by rape or an incestuous relationship forced on the woman that manifests after the post-fertilization age of the unborn child is 20 weeks or more presents a possibility of serious self-harm or suicide.

(5) On page 5, line 17, strike "A" and substitute "Except as provided by Subsection (a-1), a".

(6) On page 5, between lines 25 and 26, insert the following:

(d) The prohibitions and requirements under Sections 171.043, 171.044, and 171.045(b) do not apply to an abortion performed when the pregnancy is the result of rape or incest.

(7) Strike page 7, line 26, through page 12, line 23.

(8) On page 17, strike lines 1 and 2.

(9) On page 19, strike lines 5 through 12.

(10) Renumber SECTIONS of the bill accordingly.

AMENDMENT 3 (withdrawn)

Amend HB 2 (house committee printing) as follows:

(1) Strike page 2, line 16, through page 3, line 13.

(2) Add the following appropriately numbered SECTION to the bill:

SECTION ____. Section 245.006(a), Health and Safety Code, is amended to read as follows:

(a) The department shall inspect an abortion facility at random, unannounced, and reasonable times as necessary, but not fewer than two times each month,to ensure compliance with this chapter and Subchapter B, Chapter 171.

(3) Renumber SECTIONS of the bill and cross-references to those SECTIONS accordingly.

AMENDMENT 4 (tabled)

Amend HB 2 (house committee printing) as follows:

(1) On page 2, line 17, strike "Section 171.0031" and substitute "Sections 171.0031 and 171.0032".

(2) On page 3, between lines 13 and 14, insert the following new section:

Sec. 171.0032. REIMBURSEMENT. (a) The department shallprovide financial reimbursement for expenses described by Subsection (b) to a woman who receives an abortion if:

(1) the woman'spersonal residence is located more than 30 miles from a facility at which an abortion may be performed or induced;

(2) the woman received a medical referral from a physician to a facility for the performance or inducement of an abortion; and

(3) the woman submits to the department an application for reimbursement on the form and in the manner prescribed by the department.

(b) The department shall provide financial reimbursement for travel to the facility at which an abortion may be performed or induced that is closest in proximity to the woman's personal residence and related expenses as provided by this subsection. The reimbursement must be for the period relative to the performance or inducement of the abortion and include the following expenses:

(1) round-trip travel from the woman's residence to the facility;

(2) meals;

(3) lodging;

(4) facility care; and

(5) medical care, including the performance or inducement of an abortion.

(c) The department shall provide financial reimbursement for expenses described by Subsection (b) at a rate that is at least equal to the rate authorized for the travel expenses of a department employee performing authorized official state business.

(d) The executive commissioner of the Health and Human Services Commission shall adopt rules necessary to administer this section.

AMENDMENT 5 (withdrawn)

Amend HB 2 (house committee printing) as follows:

(1) On page 1, line 5, strike "(a)".

(2) On page 2, strike lines 7-15.

(3) Strike page 17, line 19, through page 18, line 20.

(4) On page 18, line 21, strike "(c)" and substitute "(b)".

(5) On page 19, strike lines 1-4.

AMENDMENT 6 (tabled)

Amend HB 2 (house committee printing) as follows:

(1) Strike page 2, line 16, through page 3, line 13.

(2) On page 3, line 15, strike "Subchapters C and D" and substitute "Subchapter C".

(3) Strike page 7, line 26, through page 12, line 23.

(4) On page 17, strike lines 1-2.

(5) On page 19, strike lines 5-12.

(6) Renumber SECTIONS of the bill, and cross-references to those SECTIONS, accordingly.

AMENDMENT 7 (tabled)

Amend HB 2 (house committee printing) as follows:

(1) On page 2, lines 3-4, strike "substantial and irreversible physical impairment of a major bodily function" and substitute "prevent serious harm to the health".

(2) On page 5, lines 6-8, strike "a serious risk of substantial and irreversible physical impairment of a major bodily function, other than a psychological condition" and substitute "to prevent serious harm to the woman's health".

(3) On page 5, lines 18-19, strike "a substantial and irreversible physical impairment of a major bodily function" and substitute "serious harm to the woman's health".

(4) On page 5, lines 21-22, strike "substantial and irreversible physical impairment of a major bodily function" and substitute "serious harm to her health".

AMENDMENT 8 (withdrawn)

Amend HB 2 (house committee printing) as follows:

(1) On page 2, line 18, strike "PHYSICIAN; OFFENSE. (a)" and substitute "PHYSICIAN.".

(2) On page 3, strike lines 11-13.

(3) On page 12, line 12, between "171.063" and the period, insert "if the board finds that the person acted intentionally or with gross negligence".

AMENDMENT 9 (tabled)

Amend HB 2 (house committee printing) on page 2, line 21, between "privileges at" and "a hospital", by inserting "or a written transfer agreement with".

AMENDMENT 10 (tabled)

Amend HB 2 (house committee printing) as follows:

(1) On page 2, line 20, between "(1)" and "must", insert "except as provided by Subsection (a-1),".

(2) On page 3, between lines 10 and 11, insert the following:

(a-1) A physician performing or inducing an abortion is not required to comply with Subsection (a)(1) if each hospital located not further than 30 miles from the location at which the abortion is performed or induced has a written policy that prohibits granting admitting privileges to a physician who performs or induces abortions outside of the hospital.

AMENDMENT 11 (tabled)

Amend HB 2 (house committee printing) as follows:

(1) On page 5, line 8, between "condition" and ", it", insert "not described by Subsection (a-1)".

(2) On page 5, between lines 16 and 17, insert the following subsection:

(a-1) Notwithstanding Subsection (a), an abortion may be performed under Subsection (a)(1) or (2) if, in the physician's reasonable medical judgment:

(1) the psychological condition is a post-traumatic stress disorder caused by rape or an incestuous relationship forced on the woman that manifests after the post-fertilization age of the unborn child is 20 weeks or more and the disorder presents a possibility of serious self-harm or suicide; or

(2) the discontinuation of psychotropic medications prescribed for a preexisting psychological condition, because of the potential side effect risks of the medications to the fetus, would have such a debilitating effect on the woman's mental state as to present a possibility of self-harm or suicide.

(3) On page 5, line 17, strike "A" and substitute "Except as provided by Subsection (a-1), a".

AMENDMENT 12 (tabled) [oh my this has a lot of stuff struck through - I'll have to figure out how to notate it. In the meantime you can refer to the original through this link:http://www.legis.state.tx.us/tlodocs/832/amendments/html/HB00002H212.HTM]

Amend HB 2 as follows:

(1) On page 5, between lines 25 and 26, insert the following:

(d) The prohibitions and requirements under Sections 171.043, 171.044, and 171.045(b) do not apply to an abortion performed on a minor if the minor or her legal representative verifies to the treating physician that she did not receive effective instruction relating to human sexuality provided in compliance with Section 28.004(e), Education Code, that was sufficient to inform her of the potential risks of pregnancy and complications that could affect her medical condition.

(2) On page 16, strike lines 5-16 and substitute the following:

(19) performs an abortion on an unemancipated minor without the written consent of the child's parent, managing conservator, or legal guardian or without a court order, as provided by Section 33.003 or 33.004, Family Code, authorizing the minor to consent to the abortion, unless:

(A) the physician concludes that on the basis of the physician's good faith clinical judgment, a condition exists that complicates the medical condition of the pregnant minor and necessitates the immediate abortion of her pregnancy to avert her death or to avoid a serious risk of substantial impairment of a major bodily function and that there is insufficient time to obtain the consent of the child's parent, managing conservator, or legal guardian; or

(B) the minor verifies to the physician that she did not receive effective instruction relating to human sexuality provided in compliance with Section 28.004(e), Education Code,that was sufficient to inform her of the potential risks of pregnancyand complications that could affect her medical condition; or

(3) Add the following appropriately numbered SECTIONS and renumber subsequent SECTIONS of the bill and any cross-references to those SECTIONS accordingly:

SECTION ____. Section 28.004, Education Code, is amended by amending Subsections (e) and (i) and adding Subsection (o) to read as follows:

(e) Any course materials and instruction relating to human sexuality, sexually transmitted infections[diseases], or human immunodeficiency virus or acquired immune deficiency syndrome shall be selected by the board of trustees with the advice of the local school health advisory council and must:

(1) present abstinence from sexual activity as the preferred choice of behavior in relationship to all sexual activity for [unmarried] persons of school age;

(2) devote sufficient [more] attention to abstinence from sexual activity to emphasize the importance of abstinence [than to any other behavior];

(3) emphasize that abstinence from sexual activity, if used consistently and correctly, is the only method that is 100 percent effective in preventing pregnancy, abortion, sexually transmittedinfections [diseases], infection with human immunodeficiency virus, [or] acquired immune deficiency syndrome, and the emotional distress that may be [trauma] associated with adolescent sexual activity that results in a sexually transmitted infection or an unintended pregnancy;

(4) direct adolescents to a standard of behavior in which abstinence from sexual activity before marriage is the most effective way to prevent pregnancy, abortion, sexually transmitted infections[diseases], [and] infection with human immunodeficiency virus, and [or] acquired immune deficiency syndrome; [and]

(5) present age-appropriate information in accordance with national standards;

(6) be evidence-based;

(7) provide age-appropriate information about the effectiveness of methods approved by the United States Food and Drug Administration for reducing the risk of contracting sexually transmitted infections, including human immunodeficiency virus, and preventing unintended pregnancy;

(8) promote healthy relationships and decision-making skills such as strategies:

(A) to promote effective communication between adolescents and their parents and other family members or their legal guardians;

(B) to develop healthy relationships; and

(C) to develop healthy life skills, including goal-setting, responsible decision making, refusal and negotiation, and effective communication; and

(9) for middle, junior high, and high school students, discuss the district's dating violence policy adopted under Section 37.0831 [teach contraception and condom use in terms of human use reality rates instead of theoretical laboratory rates, if instruction on contraception and condoms is included in curriculum content].

(i) Before each school year, a school district shall provide written notice to a parent of each student enrolled in the district of the board of trustees' decision regarding whether the district will provide human sexuality instruction to district students. If instruction will be provided, the notice must include:

(1) a summary of the basic content of the district's human sexuality instruction to be provided to the student, including a statement informing the parent that the instruction is required by [of the instructional requirements under] state law to:

(A) present abstinence from sexual activity as the preferred choice of behavior in relationship to all sexual activity for persons of school age; and

(B) devote sufficient attention to abstinence from sexual activity to emphasize the importance of abstinence;

(2) a statement of whether the instruction is considered by the district to be abstinence-only instruction or comprehensive instruction, including an explanation of the difference between those types of instruction and a specific statement regarding whether the student will receive information on contraception and condom use;

(3) [(2)] a statement of the parent's right to:

(A) review curriculum materials as provided by Subsection (j); and

(B) remove the student from any part of the district's human sexuality instruction without subjecting the student to any disciplinary action, academic penalty, or other sanction imposed by the district or the student's school; and

(4) [(3)] information describing the opportunities for parental involvement in the development of the curriculum to be used in human sexuality instruction, including information regarding the local school health advisory council established under Subsection (a).

(o) In this section:

(1) "Abstinence-only instruction" means instruction that does not include information about preventing pregnancy, abortion, sexually transmitted infections, infection with human immunodeficiency virus, or acquired immune deficiency syndrome through any means other than total abstinence from sexual activity.

(2) "Evidence-based" means information verified or supported by research that is:

(A) conducted in compliance with accepted scientific methods;

(B) published in peer-reviewed journals, if appropriate;

(C) recognized as medically accurate, objective, and complete by mainstream professional organizations and agencies with expertise in the relevant field, including the federal Centers for Disease Control and Prevention and the United States Department of Health and Human Services; and

(D) proven through rigorous, scientific evaluation to achieve positive outcomes on measures of sexual risk behavior or its health consequences.

SECTION ____. (a) A school district that uses instructional materials that do not reflect the requirements prescribed by Section 28.004(e), Education Code, as amended by this Act, shall also use appropriate supplemental instructional materials as necessary to comply with those requirements.

(b) A school district that permits a person not employed by the district to present one or more components of the district's human sexuality instruction must require the person to comply with the requirements prescribed by Section 28.004(e), Education Code, as amended by this Act.

AMENDMENT 13 (tabled)

Amend HB 2 (house committee printing) as follows:

(1) On page 10, line 8, between "physician" and the underlined semicolon, insert the following:

who:

(A) has the ability to:

(i) assess the duration of the pregnancy accurately; and

(ii) diagnose an ectopic pregnancy;

(B) is capable of providing surgical intervention in the case of an incomplete abortion or severe bleeding or has made arrangements for another qualified physician to provide the care described by this paragraph and has documented those arrangements in the woman's medical record;

(C) is able to assure patient access to a medical facility equipped to provide a blood transfusion and resuscitation; and

(D) has read and understood the prescribing information for the use of the abortion-inducing drug as provided by the drug manufacturer in accordance with the requirements of the United States Food and Drug Administration

(2) On page 10, strike lines 14-18 and substitute the following:

(b) A person may provide, prescribe, or administer the abortion-inducing drug:

(1) 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; or

(2) according to an evidence-based regimen.

(3) Strike page 10, line 24, through page 11, line 8, and substitute the following:

(d) The physician who gives, sells, dispenses, administers, provides, or prescribes an abortion-inducing drug shall:

(1) fully explain the procedure to the pregnant woman, including:

(A) explaining whether the physician is using the abortion-inducing drug:

(i) in accordance with the United States Food and Drug Administration regimen described on the final printed label;

(ii) in a dosage amount described by Subsection (b)(1); or

(iii) in accordance with an evidence-based regimen; and

(B) if using the dosage amount described by Subsection (b)(1) or an evidence-based regimen:

(i) specifying that the dosage or regimen used differs from the United States Food and Drug Administration dosage or regimen described on the final printed label; and

(ii) providing detailed information on the dosage or regimen being used;

(2) provide the pregnant woman with:

(A) the final printed label of the abortion-inducing drug;

(B) a copy of the drug manufacturer's medication guide for the abortion-inducing drug;

(C) a copy of the drug manufacturer's patient agreement; and

(D) a telephone number by which the 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 abortion-inducing drug or ask health-related questions regarding the administration or use of the abortion-inducing drug;

(3) obtain the patient's signature for and sign the patient agreement described by Subdivision (2)(C); and

(4) record the drug manufacturer's package serial number in the woman's medical record.

AMENDMENT 14 (tabled)

Amend HB 2 (house committee printing) on page 10, between lines 13 and 14, by inserting the following:

(a-1) Subsection (a) does not apply to a physician who sells, dispenses, administers, provides, or prescribes an abortion-inducing drug to a pregnant woman who is avictim of rape or incest if the probable gestational age of the unborn child is at least 49 days.

AMENDMENT 15 (tabled)

Amend HB 2 (house committee printing) as follows:

(1) On page 12, strike lines 15-23 and substitute the following:

SECTION 4. Section 245.010, Health and Safety Code, is amended by adding Subsections (a-1) and (a-2) and amending Subsection (c) to read as follows:

(a-1) Except as otherwise provided by Subsection (a-2), on or 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.

(a-2) An abortion facility located more than 50 miles from the nearest other abortion facility must meet the minimum standards adopted under Subsection (c).

(c) The standards for a facility described by Subsection (a-2) may not be more stringent than Medicare certification standards, if any, for:

(1) qualifications for professional and nonprofessional personnel;

(2) supervision of professional and nonprofessional personnel;

(3) medical treatment and medical services provided by an abortion facility and the coordination of treatment and services, including quality assurance;

(4) sanitary and hygienic conditions within an abortion facility;

(5) the equipment essential to the health and welfare of the patients;

(6) clinical records kept by an abortion facility; and

(7) management, ownership, and control of the facility.

(2) On page 17, strike lines 1-2 and renumber subsequent SECTIONS of the bill and cross-references to those SECTIONS accordingly.

AMENDMENT 16 (tabled)

Amend HB 2 (house committee printing) as follows:

(1) On page 5, between lines 25 and 26, insert the following:

(d) The Department of Family and Protective Services may waive the prohibitions and requirements under Section 171.043, 171.044, and 171.045(b) in accordance with Section 262.310, Family Code.

(2) Add the following appropriately numbered SECTIONS to the bill:

SECTION ____. (a) Subchapter D, Chapter 262, Family Code, is amended by adding Section 262.310 to read as follows:

Sec. 262.310. WAIVER FOR CERTAIN PREGNANT WOMEN. Unless the Department of Family and Protective Services provides a waiver authorizing a pregnant woman to obtain an abortion after the date the post-fertilization age of the unborn child is 20 weeks, the department shall allow a woman to voluntarily deliver a child who appears to be not more than one year old to a designated emergency infant care provider.

SECTION ____. Section 262.301(1), Family Code, is amended to read as follows:

(1) "Designated emergency infant care provider" means:

(A) an emergency medical services provider;

(B) a police station;

(C) a fire station;

(D) a hospital; or

(E)[(C)] a child-placing agency licensed by the Department of Family and Protective [and Regulatory] Services under Chapter 42, Human Resources Code, that:

(i) agrees to act as a designated emergency infant care provider under this subchapter; and

(ii) has on staff a person who is licensed as a registered nurse under Chapter 301, Occupations Code, or who provides emergency medical services under Chapter 773, Health and Safety Code, and who will examine and provide emergency medical services to a child taken into possession by the agency under this subchapter.

SECTION ____. Section 262.302(a), Family Code, is amended to read as follows:

(a) A designated emergency infant care provider shall, without a court order,take possession of a child who appears to be one year [60 days] old or younger if the child is voluntarily delivered to the provider by the child's parent and the parent did not express an intent to return for the child.

(3) Renumber SECTIONS of the bill and cross-references to those SECTIONS accordingly.

AMENDMENT 17 (tabled)

Amend HB 2 (house committee printing) as follows:

(1) On page 12, strike lines 15 through 23 and substitute the following:

SECTION 4. Section 245.010, Health and Safety Code, is amended by adding Subsections (a-1) and (a-2) and amending Subsection (c) to read as follows:

(a-1) Except as otherwise provided by Subsection (a-2), on or 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.

(a-2) An abortion facility constructed before January 1, 2014, that does not receive adequate funding from state sources to ensure compliance with the standards adopted under Subsection (a-1) must meet the minimum standards adopted under Subsection (c).

(c) The standards for a facility described by Subsection (a-2) may not be more stringent than Medicare certification standards, if any, for:

(1) qualifications for professional and nonprofessional personnel;

(2) supervision of professional and nonprofessional personnel;

(3) medical treatment and medical services provided by an abortion facility and the coordination of treatment and services, including quality assurance;

(4) sanitary and hygienic conditions within an abortion facility;

(5) the equipment essential to the health and welfare of the patients;

(6) clinical records kept by an abortion facility; and

(7) management, ownership, and control of the facility.

(2) On page 17, strike lines 1 and 2 and renumber subsequent SECTIONS of the bill and cross-references to those SECTIONS accordingly.

(3) On page 19, between lines 12 and 13, insert the following:

(c) A facility licensed under Chapter 245, Health and Safety Code, and constructed before January 1, 2014, that receives adequate funding from state sources to ensure compliance with the standards adopted under Section 245.010(a-1), Health and Safety Code, as added by this Act, shall comply with those standards not later than one year after the date the facility receives the funding.

AMENDMENT 18 (tabled)

Amend HB 2 (house committee printing) on page 12, line 23, between "centers" and the underlined period, by inserting ", except that an abortion facility may comply with 25 T.A.C. Section 139.48 instead of 25 T.A.C. Sections 135.51 and 135.52 regarding physical, environmental, and other construction standards".

AMENDMENT 19 (tabled)

Amend HB 2 (house committee printing) as follows:

(1) On page 2, line 18, strike "PHYSICIAN; OFFENSE. (a)" and substitute "PHYSICIAN.".

(2) On page 3, strike lines 11-13.

(3) On page 12, line 12, between "171.063" and the period, insert "if the board finds that the person acted intentionally or with gross negligence".

AMENDMENT 20 (tabled)

Amend HB 2 (house committee printing) by adding the following subsection, appropriately numbered, to SECTION 10 of the bill and renumbering subsequent subsections of that SECTION accordingly:

(____) If some or all of the provisions of this Act are ever temporarily or permanently restrained or enjoined by judicial order, the party challenging this Act shall recover litigation costs from this state. This state shall pay litigation costs regardless of a subsequent determination by an appellate court. A party described by this section may recover litigation costs from the state if the party prevails in a trial or appellate court.

AMENDMENT 21 (tabled)

Amend HB 2 (house committee printing) by adding the following SECTION, appropriately numbered, to the bill and renumbering subsequent SECTIONS of the bill accordingly:

SECTION ____. In addition to amounts previously appropriated to the Department of State Health Services by SB 1, Acts of the 83rd Legislature, Regular Session, 2013 (the General Appropriations Act), $6,800,000 is appropriated out of the general revenue fund to the department for the state fiscal biennium ending August 31, 2015,for the purpose of paying costs associated with entering into a contract with premier medical providers to study ways to prevent maternal and fetal deaths that result from complications during pregnancy, to prepare a report based on the study for the 84th Legislature, and to provide a copy of the report to the governor, lieutenant governor, and speaker of the house of representatives.

AMENDMENT 22 (tabled)

Amend HB 2 (house committee printing) as follows:

(1) Strike SECTION 11 of the bill (page 19, lines 5-12) and substitute the following:

SECTION 11. (a) Sections 2-10 of this Act take effect 60 days after publication in the Texas Register of a finding of fact made by the attorney general that the state has abolished the use of the death penalty as a punishment available on final conviction of a criminal offense.

(b) 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 the expiration of six months after the effective date of Sections 2-10 of this Act described in Subsection (a) of this section.

(c) 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, until the expiration of six months after the effective date of Sections 2-10 of this Act described in Subsection (a) of this section.

(2) On page 19, line 13, strike "This" and substitute "Except as provided by Section 11 of this Act, this".

AMENDMENT 23 (tabled) [ [oh my this has a lot of stuff struck through - I'll have to figure out how to notate it. In the meantime you can refer to the original through this link: at http://www.legis.state.tx.us/tlodocs/832/amendments/html/HB00002H223.HTM]

Amend HB 2 (house committee printing) by adding the following appropriately numbered SECTION to the bill and renumbering subsequent SECTIONS of the bill and cross-references to those SECTIONS accordingly:

SECTION ____. Section 171.012(a), Health and Safety Code, is amended to read as follows:

(a) Consent to an abortion is voluntary and informed only if:

(1) the physician who is to perform the abortion informs the pregnant woman on whom the abortion is to be performed of:

(A) the physician's name;

(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; and

(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;

(3) the physician who is to perform the abortion or the physician's agent:

(A) provides the pregnant woman with the printed materials described by Section 171.014; and

(B) informs the pregnant woman that those materials:

(i) have been provided by the Department of State Health Services;

(ii) are accessible on an Internet website sponsored by the department;

(iii) 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 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";

(6) 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.

AMENDMENT 24 (tabled)

Amend HB 2 (house committee printing) as follows:

(1) Add the following appropriately numbered SECTIONS to the bill and renumber subsequent SECTIONS of the bill and cross-references to those SECTIONS accordingly:

SECTION ____. (a) Subchapter B, Chapter 531, Government Code, is amended by adding Section 531.02419 to read as follows:

Sec. 531.02419. ELIGIBILITY OF CERTAIN PERSONS FOR CERTAIN BENEFIT PROGRAMS. Unless the department provides a waiver authorizing a pregnant woman to obtain an abortion after the date the post-fertilization age of the unborn child is 20 weeks, to the extent permitted under federal law and notwithstanding any other law, once a pregnant woman who is eligible for Medicaid under Section 32.02472, Human Resources Code, is at least 20 weeks pregnant, each family member of the woman who is also a member of the woman's household is eligible for benefits under the following programs:

(1) the temporary assistance for needy families program under Chapter 31, Human Resources Code;

(2) the Medicaid program under Chapter 32, Human Resources Code; and

(3) the supplemental nutrition assistance program under Chapter 33, Human Resources Code.

(b) The changes in law made by this section apply to an initial determination or redetermination of eligibility of a person for benefits under the temporary assistance for needy families program under Chapter 31, Human Resources Code, the medical assistance program under Chapter 32, Human Resources Code, or the supplemental nutrition assistance program under Chapter 33, Human Resources Code, that is made on or after the effective date of this section.

(c) This section takes effect November 1, 2013.

SECTION ____. (a) Subchapter B, Chapter 32, Human Resources Code, is amended by adding Section 32.02472 to read as follows:

Sec. 32.02472. MEDICAL ASSISTANCE FOR CERTAIN PREGNANT WOMEN TO COVER COSTS RELATED TO CHILDBIRTH. Unless the department provides a waiver authorizing a pregnant woman to obtain an abortion after the date the post-fertilization age of the unborn child is 20 weeks, the department shall provide medical assistance to cover the costs related to prenatal care and childbirth for a pregnant woman:

(1) whose income is less than or equal to 250 percent of the federal poverty level; and

(2) who attempted to obtain an abortion but was denied the abortion because at the time she sought the abortion the post-fertilization age of the unborn child was 20 weeks or more.

(b) The changes in law made by this section apply to an initial determination or redetermination of eligibility of a person for medical assistance under Chapter 32, Human Resources Code, that is made on or after the effective date of this section.

(c) This section takes effect November 1, 2013.

SECTION ____. (a) Subchapter A, Chapter 302, Labor Code, is amended by adding Section 302.0048 to read as follows:

Sec. 302.0048. ELIGIBILITY FOR CHILD CARE BENEFITS FUNDED UNDER CHILD CARE AND DEVELOPMENT BLOCK GRANT. Unless the department provides a waiver authorizing a pregnant woman to obtain an abortion after the date the post-fertilization age of the unborn child is 20 weeks, to the extent permitted under federal law and to the extent the woman is not otherwise eligible, once a pregnant woman who is eligible for Medicaid under Section 32.02472, Human Resources Code, is at least 20 weeks pregnant, the woman is eligible to receive child care funded wholly or partly from money received under the Child Care and Development Block Grant Act of 1990 (42 U.S.C. Section 9858 et seq.) for each of her dependent children for the duration of the woman's pregnancy.

(b) This section takes effect November 1, 2013.

SECTION ____. If before implementing any provision of this Act a state agency determines that a waiver or authorization from a federal agency is necessary for implementation of that provision, the agency affected by the provision shall request the waiver or authorization and may delay implementing that provision until the waiver or authorization is granted.

(2) On page 19, line 13, strike "This Act" and substitute "Except as otherwise provided by this Act, this Act".

(3) On page 19, lines 15-16, strike "Constitution. If" and substitute "Constitution, but if".

AMENDMENT 25 (tabled)

Amend HB 2 (house committee printing) as follows:(1) On page 12, strike lines 15-16 and substitute the following:SECTION 4. Section 245.010, Health and Safety Code, is amended by adding Subsection (a-1) to read as follows:(2) On page 12, between lines 23 and 24, insert the following:(a-1) An abortion facility constructed before January 1, 2014, that stops providing abortion services because it is unable to meet the minimum standards described by Subsection (a) shall receive state funds for a minimum of one year so that the facility may continue to provide services that do not include abortions. The executive commissioner of the Health and Human Services Commission shall adopt rules to implement this subsection.

AMENDMENT 26 (withdrawn)

Amend HB 2 (house committee printing) by adding the following appropriately numbered SECTIONS to the bill and renumbering subsequent SECTIONS of the bill and cross-references to those SECTIONS accordingly:

SECTION ____. Subchapter B, Chapter 531, Government Code, is amended by adding Section 531.0732 to read as follows:

Sec. 531.0732. PUBLIC EDUCATION PROGRAM REGARDING UNEXPECTED PREGNANCIES. (a) The commission shall develop a public education program regarding the impact and consequences for women and men of unexpected pregnancies.

(b) The public education program developed under Subsection (a) shall include strategies to encourage the biological fathers of children of unexpected pregnancies to support the mothers of those children in order to reduce the occurrence of abortions and the use of abortion facilities in the state.

(c) The commission may consult any state agency, council, or task force in the performance of its duties under this section. On request of the commission, a state agency, council, or task force shall assist the commission with the commission's duties under this section. The commission may establish a task force, composed of members appointed by the executive commissioner, to study the impact and consequences of unexpected pregnancies, to provide recommendations on the public education program, and to implement this section.

(d) Not later than December 1 of each even-numbered year, the commission shall report its findings and recommendations regarding the implementation of the public education program to the legislature.

(e) The commission must implement this section using existing resources, and may not accept any private donations or contract with any health care provider, facility, or advocacy group to implement this section.

SECTION ____. Subchapter B, Chapter 531, Government Code, is amended by adding Section 531.0733 to read as follows:

Sec. 531.0733. STUDY REGARDING EFFECT OF CERTAIN LEGISLATION. (a) The commission shall conduct an ongoing study to gather data regarding:

(1) the effects of HB 2 and SB 1, Acts of the 83rd Legislature, 2nd Called Session, 2013, or similar legislation of the 83rd Legislature, 2nd Called Session, on licensed abortion facilities, access to abortion services in the state, and the number of abortions performed in the state; and

(2) the administrative penalties that are assessed as a result of the legislation.

(b) Not later than December 1 of each even-numbered year, the commission shall report the results of the study, its findings, and recommendations to the legislature.

(c) The commission must implement this section using existing resources, and may not accept any private donations or contract with any health care provider, facility, or advocacy group to implement this section.

AMENDMENT 31 (tabled))

Amend HB 2 (house committee printing) by adding the following appropriately numbered SECTIONS to the bill and renumbering subsequent SECTIONS of the bill and cross-references to those SECTIONS accordingly:

SECTION ____. Section 162.301(2), Family Code, is amended to read as follows:

(2) "Child" means a child:

(A) who cannot be placed for adoption with appropriate adoptive parents without the provision of adoption assistance because of factors including ethnic background, age, membership in a minority or sibling group, the presence of a medical condition, or a physical, mental, or emotional disability; or

(B) whose mother declares in writing in accordance with rules adopted by the executive commissioner of the Health and Human Services Commission, that, because of Section 245.010(a), Health and Safety Code, or Subchapters C and D, Chapter 171, Health and Safety Code, the mother chose not to or did not have access to a facility to exercise her right to an abortion at the time the child was born.

SECTION ____. Section 162.302(b), Family Code, is amended to read as follows:

(b) The legislature intends that the program benefit children residing in foster homes at state or county expense and children described by Section 162.301(2)(B) by providing them with the stability and security of permanent homes and that the costs paid by the state and counties for foster home care for the children be reduced.

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