85R5919 LED-F     By: Sanford H.B. No. 2878       A BILL TO BE ENTITLED   AN ACT   relating to the right of conscientious refusal of a health care   service.          BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:          SECTION 1.  (a)  This Act may be cited as the Texas Health   Care Right of Conscience Act.          (b)  The legislature finds and declares that people and   organizations hold different beliefs about whether certain health   care services and medical care are morally acceptable. It is the   public policy of this state to:                (1)  respect and protect the right of conscience of all   persons who refuse to receive, obtain, or accept, or who are engaged   in the delivery of, arrangement for, or payment of health care   services and medical care whether acting individually,   corporately, or in association with other persons;                (2)  prohibit all forms of discrimination,   disqualification, coercion, disability, or imposition of liability   on those persons or entities for refusing to act contrary to their   conscience or conscientious convictions in providing, paying for,   or arranging for the payment of health care services and medical   care; and                (3)  ensure that patients receive timely access to   information and medically appropriate care.          SECTION 2.  Chapter 161, Health and Safety Code, is amended   by adding Subchapter Y to read as follows:   SUBCHAPTER Y.  TEXAS HEALTH CARE RIGHT OF CONSCIENCE ACT          Sec. 161.751.  DEFINITIONS. In this subchapter:                (1)  "Conscience" means a sincerely held set of moral   convictions arising from:                      (A)  a belief in and relation to God; or                      (B)  a place in the life of its possessor parallel   to that filled by God among adherents to religious faiths.                (2)  "Conscientious refusal of a health care service"   means a person's refusal to receive, obtain, perform, assist in   performing, give advice regarding, suggest, recommend, refer, or   participate in a health care service that is contrary to the   person's conscience.                (3)  "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, including 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, or medical   training facility.                (4)  "Health care provider" means a nurse, nurse aide,   medical assistant, hospital employee, clinic employee, nursing   home employee, pharmacist, pharmacy employee, researcher, medical   or nursing school student, professional, paraprofessional, or any   other individual who furnishes or assists in the furnishing of   health care services.                (5)  "Health care service" means any phase of patient   medical care or treatment, including:                      (A)  testing, diagnosis, prognosis, ancillary   research, instruction, medication, and surgery;                      (B)  family planning, counseling, and referrals,   and any other advice in connection with the use or procurement of   contraceptives, sterilization, or abortion; and                      (C)  any other care or treatment rendered by a   health care facility, physician, or health care provider.                (6)  "Physician" means a person licensed to practice   medicine in this state.                (7)  "Undue delay" means an unreasonable delay that   impairs a patient's health.          Sec. 161.752.  IMMUNITY OF PHYSICIANS AND HEALTH CARE   PROVIDERS. A physician or health care provider may not be held   civilly or criminally liable solely because of the physician's or   health care provider's conscientious refusal of a health care   service.           Sec. 161.753.  DISCRIMINATION RELATED TO LICENSING. A   person violates this subchapter by discriminating against another   person because of the person's conscientious refusal of a health   care service, including discrimination with regard to:                (1)  licensing;                (2)  hiring, promoting, or transferring; and                (3)  granting of staff appointments or other   privileges.          Sec. 161.754.  DISCRIMINATION RELATED TO EMPLOYMENT. A   person, including a medical school or other institution that   conducts education or training programs for physicians or health   care providers, violates this subchapter by discriminating against   an applicant because of the applicant's conscientious refusal of a   health care service, including discrimination by:                (1)  denying employment, admission, or participation   in a program for which an applicant is eligible;                (2)  referring to conscientious refusal in an   application form;                (3)  questioning an applicant regarding the applicant's   conscientious refusal of a health care service; and                (4)  imposing a burden in the terms or conditions of   employment.          Sec. 161.755.  DISCRIMINATION RELATED TO BENEFITS. A   person, including a public official, violates this subchapter by   discriminating against a recipient entitled to any type of aid,   assistance, or benefits because of the recipient's conscientious   refusal of a health care service, including discrimination by:                (1)  denying aid, assistance, or benefits;                (2)  conditioning receipt of the aid, assistance, or   benefits; or                (3)  coercing or disqualifying the recipient.          Sec. 161.756.  CONSCIENTIOUS REFUSAL PROTOCOL. (a) A health   care facility shall develop a written conscientious refusal   protocol describing a patient's access to care and information to   ensure that a conscientious refusal of a health care service does   not impair a patient's health. The protocol must explain the   process the health care facility will implement to address a   conscientious refusal of a health care service in a timely manner to   facilitate the patient's health care service. The protocol must, at   a minimum, require a health care facility, physician, or health   care provider to:                (1)  timely inform a patient of the patient's   condition, prognosis, legal treatment options, and risks and   benefits of treatment options, consistent with accepted standards   of medical care; and                (2)  provide copies of the patient's medical records to   the patient or to another health care facility, physician, or   health care provider designated by the patient in accordance with   medical privacy laws, without undue delay, if requested by the   patient or the patient's legal representative.          (b)  This section does not require a health care facility,   physician, or health care provider to counsel a patient regarding a   health care service that is contrary to the conscience of the health   care facility, physician, or health care provider. The information   required by Subsection (a)(1) may be provided by a health care   facility, physician, or health care provider other than the health   care facility, physician, or health care provider with a   conscientious refusal of a health care service.          (c)  A health care facility, physician, or health care   provider may not recover damages under Section 161.757 unless the   health care facility, physician, or health care provider, as   applicable, complies with the applicable health care facility's   conscientious refusal protocol developed under this section.           Sec. 161.757.  VIOLATION. (a)  A person who is injured by a   violation of this subchapter may bring a civil action against a   person who violates this subchapter.          (b)  A person who brings an action under this section may   obtain:                (1)  three times the person's actual damages, including   pain and suffering, or $2,500, whichever is greater;                (2)  court costs; and                (3)  reasonable attorney's fees.          (c)  The civil damages authorized by this section are in   addition to any other remedy available by law.          Sec. 161.758.  SOVEREIGN AND GOVERNMENTAL IMMUNITY WAIVED.   Sovereign and governmental immunity to suit and from liability is   waived and abolished to the extent of liability created by Section   161.757.  A person may sue a governmental entity for damages allowed   by that section.          Sec. 161.759.  EFFECT OF PREVIOUS AGREEMENTS. This   subchapter may not be construed to exempt a person from liability   for refusal to allow or provide a particular health care service if:                (1)  the person has entered into a contract   specifically to provide that health care service; or                 (2)  the person has accepted federal or state funds   solely and specifically conditioned on allowing or providing that   health care service.          SECTION 3.  Not later than December 1, 2017, a health care   facility, as that term is defined by Section 161.751, Health and   Safety Code, as added by this Act, shall adopt a conscientious   refusal protocol required by Section 161.756, Health and Safety   Code, as added by this Act.          SECTION 4.  (a)  Section 161.752, Health and Safety Code, as   added by this Act, does not apply to a cause of action that accrued   before the effective date of this Act. A cause of action that   accrued before the effective date of this Act is governed by the law   applicable to the cause of action immediately before that date, and   that law is continued in effect for that purpose.          (b)  Section 161.757, 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. A cause of action that accrues   before the effective date of this Act is governed by the law   applicable to the cause of action immediately before that date, and   that law is continued in effect for that purpose.          SECTION 5.  This Act takes effect September 1, 2017.