89R8421 SRA-D     By: Oliverson H.B. No. 2816       A BILL TO BE ENTITLED   AN ACT   relating to protection of the rights of conscience of persons from   providing and health care facilities from offering certain health   care services; providing a civil remedy; authorizing disciplinary   action.          BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:          SECTION 1.  The legislature finds that:                (1)  the public policy of this state is to respect the   conscience of all physicians and health care providers and the   right of each physician and health care provider to hold their own   belief about whether certain health care services are morally   acceptable;                (2)  without comprehensive protections, the rights of   conscience of physicians, health care providers, and health care   facilities may be violated; and                (3)  each physician and health care provider must be   protected from required participation in and each health care   facility must be protected from required provision of a health care   service the physician, provider, or facility for rights of   conscience has declined participation in or provision of and from   discriminatory adverse action resulting from the nonparticipation   or non-provision.          SECTION 2.  Chapter 161, Health and Safety Code, is amended   by adding Subchapter Z to read as follows:   SUBCHAPTER Z.  TEXAS HEALTH CARE CONSCIENCE PROTECTION ACT          Sec. 161.751.  DEFINITIONS. In this subchapter:                (1)  "Conscience" means a sincerely held set of   religious or philosophical moral convictions.                (2)  "Health care facility" means a public or private   organization, corporation, partnership, sole proprietorship,   association, agency, network, joint venture, or other entity that   provides health care services to patients.  The term includes a   hospital, clinic, medical center, ambulatory surgical center,   private physician's office, pharmacy, nursing home, laboratory or   diagnostic facility, infirmary, dispensary, medical school,   nursing school, pharmacy school, or medical training facility.                (3)  "Health care provider" means a nurse, nurse aide,   medical assistant, hospital employee, allied health professional,   counselor, therapist, laboratory technician, clinic employee,   nursing home employee, pharmacist, pharmacy employee, researcher,   medical, pharmacy, or nursing school student, professional,   paraprofessional, or, without regard to whether the person holds a   license, any other person who furnishes or assists in the   furnishing of a health care service.                (4)  "Health care service" means any phase of patient   medical care or treatment.  The term includes:                      (A)  examination, testing, diagnosis, referral,   prognosis, dispensing or administering a drug or device, ancillary   research, instruction, therapy, treatment, and preparing for or   performing a surgery or procedure;                      (B)  family planning, counseling, and referrals,   and any other advice in connection with the use or procurement of   contraceptives, sterilization, or abortion; and                      (C)  record-making procedures, preparation of   treatment notes, and any other care or treatment rendered by a   physician, health care provider, or health care facility.                (5)  "Physician" means an individual licensed to   practice medicine in this state.          Sec. 161.752.  RIGHT TO DECLINE PARTICIPATION IN OR OFFER   HEALTH CARE SERVICE; CONSTRUCTION OF SUBCHAPTER. (a) Except as   provided by Subsection (b):                (1)  a person may decline to participate in a health   care service for reasons of conscience; and                (2)  a health care facility may decline to offer a   health care service consistent with the facility's established   beliefs and rights of conscience.          (b)  A person may not decline to participate in and a health   care facility may not decline to offer the following services:                (1)  emergency medical treatment required by 42 U.S.C.   Section 1395dd; or                (2)  except as provided by Chapter 166, life-sustaining   treatment.          (c)  Nothing in this subchapter may be construed to:                (1)  supersede Chapter 166 governing the provision,   withholding, or withdrawing of life-sustaining treatment;                (2)  apply to emergency medical treatment required by   42 U.S.C. Section 1395dd, life-sustaining treatment, or   cardiopulmonary resuscitation; or                (3)  prevent a health care provider, health care   facility, or health care payer that holds itself out to the public   as religious, includes in its governing documents a statement of   its religious purpose or mission, and has internal operating   policies or procedures to implement its religious beliefs, from   making employment, staffing, contracting, or admitting privilege   decisions consistent with those religious beliefs.          (d)  An exercise of the rights of conscience under this   section is limited to a person's right to refuse to participate in   or a health care facility's right to refuse to offer a specific   health care service.          Sec. 161.753.  IMMUNITY OF PHYSICIANS, HEALTH CARE   PROVIDERS, AND HEALTH CARE FACILITIES. A physician, health care   provider, or health care facility may not be held civilly or   criminally liable because the physician or provider declines to   participate in or the facility declines to offer a health care   service wholly or partly for rights of conscience.          Sec. 161.754.  ADVERSE ACTION. (a)  A person, including a   health care facility, a political subdivision of this state, the   Texas Medical Board or another agency of this state, or a medical   school or other institution that conducts education or training   programs for health care providers violates this subchapter by   taking an adverse action against another person or health care   facility because the other person or health care facility:                (1)  declines to participate in or offer a health care   service for reasons of conscience;                 (2)  testifies, assists, or participates in or is   preparing to testify, assist, or participate in a proceeding to   present information about any act or omission that the person   reasonably believes relates to a violation of this subchapter; or                (3)  provides, causes to be provided, or is preparing   to provide or cause to be provided information about any act or   omission that the person reasonably believes relates to a violation   of this subchapter to:                      (A)  the person's employer;                      (B)  the attorney general, the Health and Human   Services Commission, or any state agency charged with protecting   health care rights of conscience; or                      (C)  the United States Department of Health and   Human Services, the Office of Civil Rights of the United States   Department of State, or any other federal agency charged with   protecting health care rights of conscience.          (b)  Violations under this section include discrimination   against or taking an adverse action with regard to:                (1)  licensure;                (2)  certification;                (3)  employment terms, benefits, seniority status,   promotion, or transfer;                (4)  staff appointments or other privileges;                (5)  denial of admission or participation in a program   for which the other person or facility is otherwise eligible;                (6)  reference to rights of conscience in an   application form for an educational or funding program;                (7)  questions regarding an educational or funding   program applicant's participation in providing a health care   service for rights of conscience;                (8)  imposition of a burden in the terms or conditions   of employment;                (9)  denial of aid, assistance, or benefits;                (10)  conditional receipt of the aid, assistance, or   benefits; or                (11)  coercion or disqualification of the other person   or facility receiving aid, assistance, or benefits.          Sec. 161.755.  PROTOCOL FOR DECLINING PARTICIPATION IN   PROVISION OF HEALTH CARE SERVICE. (a) A health care facility shall   develop a written protocol for circumstances in which a person for   reasons of conscience declines to participate in providing a health   care service, other than emergency medical treatment under 42   U.S.C. Section 1395dd or life-sustaining treatment described by   Chapter 166. The protocol must:                (1)  assist the patient in accessing the requested   health care service by providing prompt transfer or release of   medical records the patient requests; and                (2)  state the person remains responsible for providing   all other appropriate health care services to the patient other   than the specific health care service for which the person declines   participation for reasons of conscience.          (b)  A person who for reasons of conscience declines   participation in provision of a health care service shall:                (1)  notify the health care facility of the   declination; and                (2)  comply with the applicable protocol developed   under this section.          (c)  This section does not permit a protocol developed under   this section regarding a health care service that is contrary to the   conscience of a physician or health care provider to require a   physician, health care provider, or health care facility to counsel   a patient or refer the patient or facilitate the referral of the   patient to another physician, provider, or facility.          Sec. 161.756.  DISCIPLINARY ACTION; COMPLAINT. (a) A   physician, health care provider, or health care facility that holds   a license issued by a licensing agency in this state is subject to   review and disciplinary action by the licensing agency for a   violation of this subchapter as if the physician, provider, or   facility violated the applicable licensing law.          (b)  A person who is injured by a violation of this   subchapter may file a complaint with the licensing agency that   issued a license to the physician, health care provider, or health   care facility that allegedly violated this subchapter.          (c)  A physician or health care provider may not file a   complaint with the appropriate licensing agency under this section   unless the physician or health care provider complies with the   health care facility's protocol developed under Section 161.755.          Sec. 161.757.  CIVIL REMEDIES. (a) A person or health care   facility that is injured by a violation of this subchapter may bring   a civil action against another person, entity, or political   subdivision of this state that violates this subchapter.  A person   or facility that brings an action under this section may obtain:                (1)  injunctive relief;                (2)  damages incurred by the person or facility,   including:                      (A)  actual damages for all psychological,   emotional, and physical injuries resulting from the violation of   this subchapter, as applicable;                      (B)  court costs; and                      (C)  reasonable attorney's fees; or                (3)  both injunctive relief and damages.          (b)  Governmental immunity is waived and abolished to the   extent of liability under this section.          SECTION 3.  Not later than December 1, 2025, a health care   facility, as that term is defined by Section 161.751, Health and   Safety Code, as added by this Act, shall adopt protocols required by   Section 161.755, Health and Safety Code, as added by this Act.          SECTION 4.  Section 161.753, Health and Safety Code, as   added by this Act, applies only to a cause of action that accrues on   or after the effective date of this Act.          SECTION 5.  This Act takes effect September 1, 2025.