HBA-AMW H.B. 17 77(R) BILL ANALYSIS Office of House Bill AnalysisH.B. 17 By: Corte State Affairs 2/23/2001 Introduced BACKGROUND AND PURPOSE Current law allows health care providers to provide information and counseling to their abortion patients, but does not require doctors to notify their patients of the potential risks or alternatives to the procedure. Many women may never receive such information or the information they receive may be incomplete. House Bill 17 requires voluntary and informed consent of the woman for an abortion to be performed. The bill sets forth the required information to be provided to women seeking an abortion, including information regarding public and private agencies that assist with pregnancy, childbirth, and adoption procedures, the development of an unborn child, and pregnancy prevention information. The bill also modifies the prerequisites for licensing a physician's office as an abortion facility and provides that an abortion procedure of a fetus age 16 weeks or more may be performed only at an ambulatory surgical center or hospital licensed to perform the procedure. H.B. 17 also prohibits new abortion facilities from being located within 1,500 feet of a church or school. RULEMAKING AUTHORITY It is the opinion of the Office of House Bill Analysis that rulemaking authority is expressly delegated to the Texas Department of Health in SECTION 1 (Section 171.014, Health and Safety Code) and the Texas Board of Health in SECTION 3 (Section 245.010, Health and Safety Code) of this bill. ANALYSIS House Bill 17 amends the Health and Safety Code to add a chapter relating to the regulation of abortion. The bill provides that an abortion must be performed by a physician licensed to practice medicine in this state and provides that an abortion of a fetus age 16 weeks or more may be performed only at an ambulatory surgical center or hospital licensed to perform the abortion (Secs. 171.002 and 171.003). Informed Consent H.B. 17 requires the voluntary and informed consent of the woman on whom an abortion is to be performed for the abortion to be performed (Sec. 171.011). The bill sets forth the conditions under which consent is considered to be voluntary and informed and provides an exception in the case of a medical emergency. Consent is considered to be voluntary and informed if the physician who is to perform the abortion or the referring physician informs the woman of the name of the physician performing the abortion, the medical risks associated with the particular abortion procedure to be employed, the probable gestational age of the unborn child at the time the abortion is to be performed, and the medical risks associated with carrying the child to term. In addition, the bill requires the physician who is to perform the abortion or the physician's agent to inform the woman that medical assistance benefits may be available for prenatal, childbirth, and neonatal care, that the father is liable for child support assistance, that public and private agencies provide pregnancy prevention counseling, and that the woman has the right to review the printed informational materials provided by the Texas Department of Health (department) (Sec. 171.012). For consent to be considered voluntary and informed, the bill requires, before the abortion is performed, that the woman certify in writing and the physician receive a copy of that certification that the aforementioned information and pregnancy prevention information have been provided to her and that she has been informed of her opportunity to review the informational materials published by the department. The bill further requires that the information required to be provided for voluntary and informed consent must be provided orally and in person and that any required or optional information that is requested must be provided at least 24 hours before the abortion is to be performed (Secs. 171.012 and 171.013). Informational Materials H.B. 17 requires the department to publish informational materials and sets forth the information to be included. The bill authorizes the physician and the physician's agent to disassociate themselves from the materials and gives them the option of whether or not to comment on the materials. The bill requires such materials to be published in an easily comprehensible and legible form in both English and Spanish. The bill requires the department to prepare and have the informational materials available for distribution by December 1, 2001, to make the materials available at no cost, to review the materials annually for changes, and to adopt the rules necessary for considering and making such changes (Secs. 171.013, 171.014, and SECTION 5). The bill requires the rules to contain provisions requiring compliance with requirements related to informed consent (Sec. 245.010). The bill provides that the informational materials relating to public and private agencies must include either: _geographically indexed materials designed to inform the woman of agencies and services available to assist a woman through pregnancy, childbirth, and the child's dependency, including a comprehensive list of adoption agencies and services and contact information, including telephone numbers, for adoption agencies; or _a toll-free, 24-hour telephone number for obtaining an oral list and description of the aforementioned agencies and services located near the caller (Sec. 171.015). The bill requires the informational materials to include materials designed to inform the woman of the probable anatomical and physiological characteristics of the unborn child at two-week gestational increments from the time when a woman can be known to be pregnant to full term, including information on the possibility of the unborn child's survival. The materials must include realistic color pictures representing the development of the child at two-week gestational increments that contain dimensions of the unborn child. Such materials must be objective, nonjudgmental, and designed to convey only accurate scientific information about the unborn child (Sec. 171.016). The bill requires that information on pregnancy prevention be designed to inform the woman of pregnancy prevention methods for females and males. The information must describe each method in detail and illustrate the proper use of each method. The pregnancy prevention information must be provided to a woman requesting an abortion by the physician or physician's agent whether or not the woman chooses to view the informational materials provided by the department (Sec. 171.017). If the woman is an unemancipated minor subject to provisions regarding notice of abortion, the bill authorizes the 24-hour periods established for providing the information required for voluntary and informed consent and the optional informational materials to run concurrently with the period during which actual or constructive notice is provided under parental notice provisions (Sec. 171.018). Exemptions from Licensing Requirement H.B. 17 requires a physician's office to be licensed as an abortion facility if it advertises that the facility performs abortions, is used to perform 10 or more abortion procedures during any month or 100 or more abortion procedures in a year, or, for a facility that operates less than 20 days in a month, performs a number of abortions that would be equivalent to 10 abortions in one month. Current law requires a physician's office to be licensed as an abortion facility if it performs more than 300 abortions in any 12month period (Sec. 245.004). Location of Abortion Facility H.B. 17 prohibits an abortion facility from being located within 1,500 feet of the property on which a church or school is located, unless the facility began operation before September 1, 2001. The bill provides that an abortion facility does not violate this prohibition if the facility is in compliance on the date the facility begins operation and a church or school subsequently is located within 1,500 feet of the facility. The bill sets forth the procedure for measuring the distance between an abortion facility and a church or school (Sec. 245.0104). EFFECTIVE DATE September 1, 2001, and applies only to an abortion that is performed on or after January 1, 2002.