reglab/statecodes huggingface dataset:
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 163 - Education Program About Sexual Conduct and Substance Abuse › Section 163.002. Instructional Elements

Sec. 163.002.  INSTRUCTIONAL ELEMENTS.  Course materials and instruction relating to sexual education or sexually transmitted diseases should include:
(1)  an emphasis on sexual abstinence as the only completely reliable method of avoiding unwanted teenage pregnancy and sexually transmitted diseases;
(2)  an emphasis on the importance of self-control, responsibility, and ethical conduct in making decisions relating to sexual behavior;
(3)  statistics, based on the latest medical information, that indicate the efficacy of the various forms of contraception;
(4)  information concerning the laws relating to the financial responsibilities associated with pregnancy, childbirth, and child rearing;
(5)  information concerning the laws prohibiting sexual abuse and the legal and counseling options available to victims of sexual abuse;
(6)  information on how to cope with and rebuff unwanted physical and verbal sexual advances, as well as the importance of avoiding the sexual exploitation of other persons;
(7)  psychologically sound methods of resisting unwanted peer pressure;  and
(8)  emphasis, provided in a factual manner and from a public health perspective, that homosexuality is not a lifestyle acceptable to the general public and that homosexual conduct is a criminal offense under Section 21.06, Penal Code.
Added by Acts 1991, 72nd Leg., ch. 14, Sec. 51, eff. Sept. 1, 1991.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 163 - Education Program About Sexual Conduct and Substance Abuse › Section 163.003. Additional Instructional Elements Regarding Human Papillomavirus

Sec. 163.003.  ADDITIONAL INSTRUCTIONAL ELEMENTS REGARDING HUMAN PAPILLOMAVIRUS.  Course materials and instruction relating to sexually transmitted diseases must be available in English and in Spanish and should include:
(1)  the following specific information on human papillomavirus:
(A)  that sexual intercourse is not required to become infected with human papillomavirus and that the avoidance of skin-to-skin contact involving the genital areas offers the best protection;
(B)  that both males and females may be infected with human papillomavirus and symptoms may not be present;
(C)  that younger women are at greater risk of human papillomavirus infection than older women; and
(D)  that human papillomavirus may be transmitted to an infant during childbirth;
(2)  information regarding the role of human papillomavirus in the development of genital warts, cervical cancer, and other diseases; and
(3)  information regarding the continuing need for women to undergo Pap smear testing, even if they have received a vaccination against human papillomavirus.
Added by Acts 2007, 80th Leg., R.S., Ch. 59 (H.B. 1379), Sec. 2, eff. September 1, 2007.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 164 - Treatment Facilities Marketing and Admission Practices › Section 164.001. Short Title

Sec. 164.001.  SHORT TITLE.  This chapter may be cited as the Treatment Facilities Marketing Practices Act.
Added by Acts 1993, 73rd Leg., ch. 705, Sec. 2.01, eff. Sept. 1, 1993.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 164 - Treatment Facilities Marketing and Admission Practices › Section 164.002. Legislative Purpose

Sec. 164.002.  LEGISLATIVE PURPOSE.  The purpose of this chapter is to safeguard the public against fraud, deceit, and misleading marketing practices and to foster and encourage competition and fair dealing by mental health facilities and chemical dependency treatment facilities by prohibiting or restricting practices by which the public has been injured in connection with the marketing and advertising of mental health services and the admission of patients.  Nothing in this chapter should be construed to prohibit a mental health facility from advertising its services in a general way or promoting its specialized services.  However, the public should be able to distinguish between the marketing activities of the facility and its clinical functions.
Added by Acts 1993, 73rd Leg., ch. 705, Sec. 2.01, eff. Sept. 1, 1993.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 164 - Treatment Facilities Marketing and Admission Practices › Section 164.003. Definitions

Sec. 164.003.  DEFINITIONS.  In this chapter:
(1)  "Advertising" or "advertise" means a solicitation or inducement, through print or electronic media, including radio, television, or direct mail, to purchase the services provided by a treatment facility.
(2)  "Chemical dependency" has the meaning assigned by Section 462.001.
(3)  "Chemical dependency facility" means a treatment facility as that term is defined by Section 462.001.
(4)  "Intervention and assessment service" means a service that offers assessment, counseling, evaluation, intervention, or referral services or makes treatment recommendations to an individual with respect to mental illness or chemical dependency.
(5)  "Mental health facility" means:
(A)  a "mental health facility" as defined by Section 571.003;
(B)  a residential treatment facility, other than a mental health facility, in which persons are treated for emotional problems or disorders in a 24-hour supervised living environment; and
(C)  a day activity and health services facility as defined by Section 103.003, Human Resources Code.
(6)  "Mental health professional" means a:
(A)  "physician" as defined by Section 571.003;
(B)  "licensed professional counselor" as defined by Section 503.002, Occupations Code;
(C)  "chemical dependency counselor" as defined by Section 504.001, Occupations Code;
(D)  "psychologist" offering "psychological services" as defined by Section 501.003, Occupations Code;
(E)  "registered nurse" licensed under Chapter 301, Occupations Code;
(F)  "vocational nurse" licensed under Chapter 301, Occupations Code;
(G)  "licensed marriage and family therapist" as defined by Section 502.002, Occupations Code;  and
(H)  "social worker" as defined by Section 505.002, Occupations Code.
(7)  "Mental health services" has the meaning assigned by Section 531.002.
(8)  "Mental illness" has the meaning assigned by Section 571.003.
(9)  "Referral source" means a person who is in a position to refer or who refers a person to a treatment facility. "Referral source" does not include a physician, an insurer, a health maintenance organization (HMO), a preferred provider arrangement (PPA), or other third party payor or discount provider organization (DPO) where the insurer, HMO, PPA, third party payor, or DPO pays in whole or in part for the treatment of mental illness or chemical dependency.
(10)  "Treatment facility" means a chemical dependency facility and a mental health facility.
Added by Acts 1993, 73rd Leg., ch. 705, Sec. 2.01, eff. Sept. 1, 1993.  Amended by Acts 2001, 77th Leg., ch. 1420, Sec. 14.784, eff. Sept. 1, 2001;  Acts 2003, 78th Leg., ch. 553, Sec. 2.010, eff. Feb. 1, 2004.
Amended by:
Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0493, eff. April 2, 2015.
Acts 2015, 84th Leg., R.S., Ch. 1231 (S.B. 1999), Sec. 3, eff. June 19, 2015.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 164 - Treatment Facilities Marketing and Admission Practices › Section 164.004. Exemptions

Sec. 164.004.  EXEMPTIONS.  This chapter does not apply to:
(1)  a treatment facility:
(A)  operated by the department, a federal agency, or a political subdivision; or
(B)  funded by the department;
(2)  a community center established under Subchapter A, Chapter 534, or a facility operated by a community center; or
(3)  a facility owned and operated by a nonprofit or not-for-profit organization offering counseling concerning family violence, help for runaway children, or rape.
Added by Acts 1993, 73rd Leg., ch. 705, Sec. 2.01, eff. Sept. 1, 1993.  Amended by Acts 2003, 78th Leg., ch. 96, Sec. 1, eff. May 20, 2003.
Amended by:
Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0494, eff. April 2, 2015.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 164 - Treatment Facilities Marketing and Admission Practices › Section 164.005. Conditioning Employee or Agent Relationships on Patient Revenue

Sec. 164.005.  CONDITIONING EMPLOYEE OR AGENT RELATIONSHIPS ON PATIENT REVENUE.  A treatment facility may not permit or provide compensation or anything of value to its employees or agents, condition employment or continued employment of its employees or agents, set its employee or agent performance standards, or condition its employee or agent evaluations, based on:
(1)  the number of patient admissions resulting from an employee's or agent's efforts;
(2)  the number or frequency of telephone calls or other contacts with referral sources or patients if the purpose of the telephone calls or contacts is to solicit patients for the treatment facility;  or
(3)  the existence of or volume of determinations made respecting the length of patient stay.
Added by Acts 1993, 73rd Leg., ch. 705, Sec. 2.01, eff. Sept. 1, 1993.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 164 - Treatment Facilities Marketing and Admission Practices › Section 164.008. Operating an Intervention and Assessment Service

Sec. 164.008.  OPERATING AN INTERVENTION AND ASSESSMENT SERVICE.  A treatment facility may not own, operate, manage, or control an intervention and assessment service that makes referrals to a treatment facility for inpatient treatment of mental illness or chemical dependency unless the intervention and assessment service:
(1)  is a qualified mental health referral service under Section 164.007;
(2)  discloses in all advertising the relationship between the treatment facility and the intervention and assessment service;  and
(3)  discloses to each person contacting the service, at the time of initial contact, the relationship between the treatment facility and the intervention and assessment service.
Added by Acts 1993, 73rd Leg., ch. 705, Sec. 2.01, eff. Sept. 1, 1993.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 164 - Treatment Facilities Marketing and Admission Practices › Section 164.009. Disclosures and Representations

Sec. 164.009.  DISCLOSURES AND REPRESENTATIONS.  (a)  A treatment facility may not admit a patient to its facilities without fully disclosing to the patient or, if the patient is a minor, the patient's parent, managing conservator, or guardian, in, if possible, the primary language of the patient, managing conservator, or guardian, as the case may be, the following information in writing before admission:
(1)  the treatment facility's estimated average daily charge for inpatient treatment with an explanation that the patient may be billed separately for services provided by mental health professionals;
(2)  the name of the attending physician, if the treatment facility is a mental health facility, or the name of the attending mental health professional, if the facility is a chemical dependency facility; and
(3)  the current "patient's bill of rights" as adopted by the executive commissioner that sets out restrictions to the patient's freedom that may be imposed on the patient during the patient's stay in a treatment facility.
(b)  A treatment facility may not misrepresent to a patient or the parent, guardian, managing conservator, or spouse of a patient, the availability or amount of insurance coverage available to the prospective patient or the amount and percentage of a charge for which the patient will be responsible.
(c)  A treatment facility may not represent to a patient who requests to leave a treatment facility against medical advice that:
(1)  the patient will be subject to an involuntary commitment proceeding or subsequent emergency detention unless that representation is made by a physician or on the written instruction of a physician who has evaluated the patient within 48 hours of the representation;  or
(2)  the patient's insurance company will refuse to pay all or any portion of the medical expenses previously incurred.
(d)  A mental health facility may not represent or recommend that a prospective patient should be admitted for inpatient treatment unless the representation is made by a licensed physician or, subsequent to evaluation by a licensed physician, by a mental health professional.
(e)  A chemical dependency facility may not represent or recommend that a prospective patient should be admitted to a facility for treatment unless and until:
(1)  the prospective patient has been evaluated, in person, by a mental health professional; and
(2)  a mental health professional determines that the patient meets the facility's admission standards.
Added by Acts 1993, 73rd Leg., ch. 705, Sec. 2.01, eff. Sept. 1, 1993.
Amended by:
Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0497, eff. April 2, 2015.
Acts 2015, 84th Leg., R.S., Ch. 1211 (S.B. 1560), Sec. 1, eff. June 19, 2015.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 164 - Treatment Facilities Marketing and Admission Practices › Section 164.010. Prohibited Acts

Sec. 164.010.  PROHIBITED ACTS.  It is a violation of this chapter, in connection with the marketing of mental health services, for a person to:
(1)  advertise, expressly or impliedly, the services of a treatment facility through the use of:
(A)  promises of cure or guarantees of treatment results that cannot be substantiated;  or
(B)  any unsubstantiated claims;
(2)  advertise, expressly or impliedly, the availability of intervention and assessment services unless and until the services are available and are provided by mental health professionals licensed or certified to provide the particular service;
(3)  fail to disclose before soliciting a referral source or prospective patient to induce a person to use the services of the treatment facility an affiliation between a treatment facility and its soliciting agents, employees, or contractors;
(4)  obtain information considered confidential by state or federal law regarding a person for the purpose of soliciting that person to use the services of a treatment facility unless and until consent is obtained from the person or, in the case of a minor, the person's parent, managing conservator, or legal guardian or another person with authority to give that authorization;  or
(5)  represent that a referral service is a qualified mental health referral service unless and until the referral service complies with Section 164.007.
Added by Acts 1993, 73rd Leg., ch. 705, Sec. 2.01, eff. Sept. 1, 1993.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 164 - Treatment Facilities Marketing and Admission Practices › Section 164.011. Injunction

Sec. 164.011.  INJUNCTION.  (a)  If it appears that a person is in violation of this chapter, the attorney general, a district attorney, or a county attorney may institute an action for injunctive relief to restrain the person from continuing the violation and for civil penalties of not less than $1,000 and not more than $25,000 per violation.
(b)  A civil action filed under this section shall be filed in a district court in Travis County or in the county in which the defendant resides.
(c)  The attorney general, a district attorney, or a county attorney may recover reasonable expenses incurred in obtaining injunctive relief, civil penalties, or both, under this section, including court costs, reasonable attorney fees, investigative costs, witness fees, and deposition expenses.
(d)  A civil penalty recovered in a suit instituted by a local government under this chapter shall be paid to that local government.
Added by Acts 1993, 73rd Leg., ch. 705, Sec. 2.01, eff. Sept. 1, 1993.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 164 - Treatment Facilities Marketing and Admission Practices › Section 164.012. Penalties

Sec. 164.012.  PENALTIES.  In addition to the penalties prescribed by this chapter, a violation of a provision of this chapter by an individual or treatment facility that is licensed by a state health care regulatory agency is subject to the same consequences as a violation of the licensing law applicable to the individual or treatment facility or of a rule adopted under that licensing law.
Added by Acts 1993, 73rd Leg., ch. 705, Sec. 2.01, eff. Sept. 1, 1993.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 164 - Treatment Facilities Marketing and Admission Practices › Section 164.013. Deceptive Trade Practices

Sec. 164.013.  DECEPTIVE TRADE PRACTICES.  A person may bring suit under Subchapter E, Chapter 17, Business & Commerce Code, for a violation of this chapter, and a public or private right or remedy prescribed by that subchapter may be used to enforce this chapter.
Added by Acts 1993, 73rd Leg., ch. 705, Sec. 2.01, eff. Sept. 1, 1993.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 164 - Treatment Facilities Marketing and Admission Practices › Section 164.014. Rule-Making Authority

Sec. 164.014.  RULE-MAKING AUTHORITY.  The executive commissioner may adopt rules interpreting the provisions of this chapter relating to the activities of a chemical dependency facility or mental health facility under the department's jurisdiction.
Added by Acts 1993, 73rd Leg., ch. 705, Sec. 2.01, eff. Sept. 1, 1993.
Amended by:
Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0498, eff. April 2, 2015.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 165 - Breast-Feeding › Subchapter A. Breast-Feeding Rights and Policies › Section 165.001. Legislative Finding

Sec. 165.001.  LEGISLATIVE FINDING.  The legislature finds that breast-feeding a baby is an important and basic act of nurture that must be encouraged in the interests of maternal and child health and family values.  In compliance with the breast-feeding promotion program established under the federal Child Nutrition Act of 1966 (42 U.S.C. Section 1771 et seq.), the legislature recognizes breast-feeding as the best method of infant nutrition.
Added by Acts 1995, 74th Leg., ch. 600, Sec. 1, eff. Aug. 28, 1995.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 165 - Breast-Feeding › Subchapter A. Breast-Feeding Rights and Policies › Section 165.002. Right to Breast-Feed or Express Breast Milk

Sec. 165.002.  RIGHT TO BREAST-FEED OR EXPRESS BREAST MILK.  A mother is entitled to breast-feed her baby or express breast milk in any location in which the mother's presence is otherwise authorized.
Added by Acts 1995, 74th Leg., ch. 600, Sec. 1, eff. Aug. 28, 1995.
Amended by:
Acts 2019, 86th Leg., R.S., Ch. 731 (H.B. 541), Sec. 1, eff. September 1, 2019.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 165 - Breast-Feeding › Subchapter A. Breast-Feeding Rights and Policies › Section 165.003. Business Designation as "Mother-Friendly"

Sec. 165.003.  BUSINESS DESIGNATION AS "MOTHER-FRIENDLY".  (a)  A business may use the designation "mother-friendly" in its promotional materials if the business develops a policy supporting the practice of worksite breast-feeding that addresses the following:
(1)  work schedule flexibility, including scheduling breaks and work patterns to provide time for expression of milk;
(2)  the provision of accessible locations allowing privacy;
(3)  access nearby to a clean, safe water source and a sink for washing hands and rinsing out any needed breast-pumping equipment;  and
(4)  access to hygienic storage alternatives in the workplace for the mother's breast milk.
(b)  The business shall submit its breast-feeding policy to the department.  The department shall maintain a list of "mother-friendly" businesses covered under this section and shall make the list available for public inspection.
Added by Acts 1995, 74th Leg., ch. 600, Sec. 1, eff. Aug. 28, 1995.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 165 - Breast-Feeding › Subchapter A. Breast-Feeding Rights and Policies › Section 165.004. Services Provided by State Agencies

Sec. 165.004.  SERVICES PROVIDED BY STATE AGENCIES.  Any state agency that administers a program providing maternal or child health services shall provide information that encourages breast-feeding to program participants who are pregnant women or mothers with infants.
Added by Acts 1995, 74th Leg., ch. 600, Sec. 1, eff. Aug. 28, 1995.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 165 - Breast-Feeding › Subchapter B. Demonstration Project › Section 165.031. Legislative Recognition

Sec. 165.031.  LEGISLATIVE RECOGNITION.  The legislature recognizes a mother's responsibility to both her job and her child when she returns to work and acknowledges that a woman's choice to breast-feed benefits the family, the employer, and society.
Added by Acts 1995, 74th Leg., ch. 600, Sec. 1, eff. Aug. 28, 1995.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 165 - Breast-Feeding › Subchapter B. Demonstration Project › Section 165.032. Demonstration Project

Sec. 165.032.  DEMONSTRATION PROJECT.  (a)  The department shall establish a demonstration project in Travis County to provide access to worksite breast-feeding for department employees who are mothers with infants.
(b)  The department shall administer the demonstration project and shall determine the benefits of, potential barriers to, and potential costs of implementing worksite breast-feeding support policies for state employees.
Added by Acts 1995, 74th Leg., ch. 600, Sec. 1, eff. Aug. 28, 1995.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 165 - Breast-Feeding › Subchapter B. Demonstration Project › Section 165.033. Breast-Feeding Policy

Sec. 165.033.  BREAST-FEEDING POLICY.  The department shall develop recommendations supporting the practice of worksite breast-feeding that address the following:
(1)  work schedule flexibility, including scheduling breaks and work patterns to provide time for expression of milk;
(2)  the provision of accessible locations allowing privacy;
(3)  access nearby to a clean, safe water source and a sink for washing hands and rinsing out any needed breast-pumping equipment;  and
(4)  access to hygienic storage alternatives in the workplace for the mother's breast milk.
Added by Acts 1995, 74th Leg., ch. 600, Sec. 1, eff. Aug. 28, 1995.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 166 - Advance Directives › Subchapter A. General Provisions › Section 166.001. Short Title

Sec. 166.001.  SHORT TITLE.  This chapter may be cited as the Advance Directives Act.
Added by Acts 1999, 76th Leg., ch. 450, Sec. 1.02, eff. Sept. 1, 1999.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 166 - Advance Directives › Subchapter A. General Provisions › Section 166.003. Witnesses

Sec. 166.003.  WITNESSES.  In any circumstance in which this chapter requires the execution of an advance directive or the issuance of a nonwritten advance directive to be witnessed:
(1)  each witness must be a competent adult; and
(2)  at least one of the witnesses must be a person who is not:
(A)  a person designated by the declarant to make a health care or treatment decision;
(B)  a person related to the declarant by blood or marriage;
(C)  a person entitled to any part of the declarant's estate after the declarant's death under a will or codicil executed by the declarant or by operation of law;
(D)  the attending physician;
(E)  an employee of the attending physician;
(F)  an employee of a health care facility in which the declarant is a patient if the employee is providing direct patient care to the declarant or is an officer, director, partner, or business office employee of the health care facility or of any parent organization of the health care facility; or
(G)  a person who, at the time the written advance directive is executed or, if the directive is a nonwritten directive issued under this chapter, at the time the nonwritten directive is issued, has a claim against any part of the declarant's estate after the declarant's death.
Added by Acts 1999, 76th Leg., ch. 450, Sec. 1.02, eff. Sept. 1, 1999.
Amended by:
Acts 2015, 84th Leg., R.S., Ch. 435 (H.B. 3074), Sec. 2, eff. September 1, 2015.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 166 - Advance Directives › Subchapter A. General Provisions › Section 166.004. Statement Relating to Advance Directive

Sec. 166.004.  STATEMENT RELATING TO ADVANCE DIRECTIVE.  (a)  In this section, "health care provider" means:
(1)  a hospital;
(2)  an institution licensed under Chapter 242, including a skilled nursing facility;
(3)  a home and community support services agency;
(4)  an assisted living facility;  and
(5)  a special care facility.
(b)  A health care provider shall maintain written policies regarding the implementation of advance directives.  The policies must include a clear and precise statement of any procedure the health care provider is unwilling or unable to provide or withhold in accordance with an advance directive.
(c)  Except as provided by Subsection (g), the health care provider shall provide written notice to an individual of the written policies described by Subsection (b).  The notice must be provided at the earlier of:
(1)  the time the individual is admitted to receive services from the health care provider;  or
(2)  the time the health care provider begins providing care to the individual.
(d)  If, at the time notice is to be provided under Subsection (c), the individual is incompetent or otherwise incapacitated and unable to receive the notice required by this section, the provider shall provide the required written notice, in the following order of preference, to:
(1)  the individual's legal guardian;
(2)  a person responsible for the health care decisions of the individual;
(3)  the individual's spouse;
(4)  the individual's adult child;
(5)  the individual's parent;  or
(6)  the person admitting the individual.
(e)  If Subsection (d) applies and except as provided by Subsection (f), if a health care provider is unable, after diligent search, to locate an individual listed by Subsection (d), the health care provider is not required to provide the notice.
(f)  If an individual who was incompetent or otherwise incapacitated and unable to receive the notice required by this section at the time notice was to be provided under Subsection (c) later becomes able to receive the notice, the health care provider shall provide the written notice at the time the individual becomes able to receive the notice.
(g)  This section does not apply to outpatient hospital services, including emergency services.
Added by Acts 1999, 76th Leg., ch. 450, Sec. 1.02, eff. Sept. 1, 1999.
Amended by:
Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0500, eff. April 2, 2015.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 166 - Advance Directives › Subchapter A. General Provisions › Section 166.005. Enforceability of Advance Directives Executed in Another Jurisdiction

Sec. 166.005.  ENFORCEABILITY OF ADVANCE DIRECTIVES EXECUTED IN ANOTHER JURISDICTION.  An advance directive or similar instrument validly executed in another state or jurisdiction shall be given the same effect as an advance directive validly executed under the law of this state.  This section does not authorize the administration, withholding, or withdrawal of health care otherwise prohibited by the laws of this state.
Added by Acts 1999, 76th Leg., ch. 450, Sec. 1.02, eff. Sept. 1, 1999.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 166 - Advance Directives › Subchapter A. General Provisions › Section 166.006. Effect of Advance Directive on Insurance Policy and Premiums

Sec. 166.006.  EFFECT OF ADVANCE DIRECTIVE ON INSURANCE POLICY AND PREMIUMS.  (a)  The fact that a person has executed or issued an advance directive does not:
(1)  restrict, inhibit, or impair in any manner the sale, procurement, or issuance of a life insurance policy to that person;  or
(2)  modify the terms of an existing life insurance policy.
(b)  Notwithstanding the terms of any life insurance policy, the fact that life-sustaining treatment is withheld or withdrawn from an insured qualified patient under this chapter does not legally impair or invalidate that person's life insurance policy and may not be a factor for the purpose of determining, under the life insurance policy, whether benefits are payable or the cause of death.
(c)  The fact that a person has executed or issued or failed to execute or issue an advance directive may not be considered in any way in establishing insurance premiums.
Added by Acts 1999, 76th Leg., ch. 450, Sec. 1.02, eff. Sept. 1, 1999.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 166 - Advance Directives › Subchapter A. General Provisions › Section 166.007. Execution of Advance Directive May Not Be Required

Sec. 166.007.  EXECUTION OF ADVANCE DIRECTIVE MAY NOT BE REQUIRED.  A physician, health facility, health care provider, insurer, or health care service plan may not require a person to execute or issue an advance directive as a condition for obtaining insurance for health care services or receiving health care services.
Added by Acts 1999, 76th Leg., ch. 450, Sec. 1.02, eff. Sept. 1, 1999.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 166 - Advance Directives › Subchapter A. General Provisions › Section 166.008. Conflict Between Advance Directives

Sec. 166.008.  CONFLICT BETWEEN ADVANCE DIRECTIVES.  To the extent that a treatment decision or an advance directive validly executed or issued under this chapter conflicts with another treatment decision or an advance directive executed or issued under this chapter, the treatment decision made or instrument executed later in time controls.
Added by Acts 1999, 76th Leg., ch. 450, Sec. 1.02, eff. Sept. 1, 1999.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 166 - Advance Directives › Subchapter A. General Provisions › Section 166.009. Certain Life-Sustaining Treatment Not Required

Sec. 166.009.  CERTAIN LIFE-SUSTAINING TREATMENT NOT REQUIRED.  This chapter may not be construed to require the provision of life-sustaining treatment that cannot be provided to a patient without denying the same treatment to another patient.
Added by Acts 1999, 76th Leg., ch. 450, Sec. 1.02, eff. Sept. 1, 1999.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 166 - Advance Directives › Subchapter A. General Provisions › Section 166.010. Applicability of Federal Law Relating to Child Abuse and Neglect

Sec. 166.010.  APPLICABILITY OF FEDERAL LAW RELATING TO CHILD ABUSE AND NEGLECT.  This chapter is subject to applicable federal law and regulations relating to child abuse and neglect to the extent applicable to the state based on its receipt of federal funds.
Added by Acts 2003, 78th Leg., ch. 1228, Sec. 2, eff. June 20, 2003.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 166 - Advance Directives › Subchapter A. General Provisions › Section 166.011. Digital or Electronic Signature

Sec. 166.011.  DIGITAL OR ELECTRONIC SIGNATURE.  (a)  For an advance directive in which a signature by a declarant, witness, or notary public is required or used, the declarant, witness, or notary public may sign the directive or a written revocation of the directive using:
(1)  a digital signature that:
(A)  uses an algorithm approved by the department;
(B)  is unique to the person using it;
(C)  is capable of verification;
(D)  is under the sole control of the person using it;
(E)  is linked to data in a manner that invalidates the digital signature if the data is changed;
(F)  persists with the document and not by association in separate files; and
(G)  is bound to a digital certificate; or
(2)  an electronic signature that:
(A)  is capable of verification;
(B)  is under the sole control of the person using it;
(C)  is linked to data in a manner that invalidates the electronic signature if the data is changed; and
(D)  persists with the document and not by association in separate files.
(b)  In approving an algorithm for purposes of Subsection (a)(1)(A), the department may consider an algorithm approved by the National Institute of Standards and Technology.
(c)  The executive commissioner by rule shall modify the advance directive forms required under this chapter as necessary to provide for the use of a digital or electronic signature that complies with the requirements of this section.
Added by Acts 2009, 81st Leg., R.S., Ch. 461 (H.B. 2585), Sec. 2, eff. September 1, 2009.
Amended by:
Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0501, eff. April 2, 2015.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 166 - Advance Directives › Subchapter B. Directive to Physicians › Section 166.031. Definitions

Sec. 166.031.  DEFINITIONS.  In this subchapter:
(1)  "Directive" means an instruction made under Section 166.032, 166.034, or 166.035 to administer, withhold, or withdraw life-sustaining treatment in the event of a terminal or irreversible condition.
(2)  "Qualified patient" means a patient with a terminal or irreversible condition that has been diagnosed and certified in writing by the attending physician.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.  Amended by Acts 1991, 72nd Leg., ch. 14, Sec. 208, eff. Sept. 1, 1991;  Acts 1993, 73rd Leg., ch. 107, Sec. 5.04, eff. Aug. 30, 1993.  Renumbered from Sec. 672.002 and amended by Acts 1999, 76th Leg., ch. 450, Sec. 1.03, eff. Sept. 1, 1999.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 166 - Advance Directives › Subchapter B. Directive to Physicians › Section 166.032. Written Directive by Competent Adult; Notice to Physician

Sec. 166.032.  WRITTEN DIRECTIVE BY COMPETENT ADULT;  NOTICE TO PHYSICIAN.  (a)  A competent adult may at any time execute a written directive.
(b)  Except as provided by Subsection (b-1), the declarant must sign the directive in the presence of two witnesses who qualify under Section 166.003, at least one of whom must be a witness who qualifies under Section 166.003(2).  The witnesses must sign the directive.
(b-1)  The declarant, in lieu of signing in the presence of witnesses, may sign the directive and have the signature acknowledged before a notary public.
(c)  A declarant may include in a directive directions other than those provided by Section 166.033 and may designate in a directive a person to make a health care or treatment decision for the declarant in the event the declarant becomes incompetent or otherwise mentally or physically incapable of communication.
(d)  A declarant shall notify the attending physician of the existence of a written directive.  If the declarant is incompetent or otherwise mentally or physically incapable of communication, another person may notify the attending physician of the existence of the written directive.  The attending physician shall make the directive a part of the declarant's medical record.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.  Amended by Acts 1991, 72nd Leg., ch. 14, Sec. 209, eff. Sept. 1, 1991;  Acts 1997, 75th Leg., ch. 291, Sec. 1, eff. Jan. 1, 1998.  Renumbered from Sec. 672.003 and amended by Acts 1999, 76th Leg., ch. 450, Sec. 1.03, eff. Sept. 1, 1999.
Amended by:
Acts 2009, 81st Leg., R.S., Ch. 461 (H.B. 2585), Sec. 3, eff. September 1, 2009.
Acts 2015, 84th Leg., R.S., Ch. 435 (H.B. 3074), Sec. 3, eff. September 1, 2015.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 166 - Advance Directives › Subchapter B. Directive to Physicians › Section 166.034. Issuance of Nonwritten Directive by Competent Adult Qualified Patient

Sec. 166.034.  ISSUANCE OF NONWRITTEN DIRECTIVE BY COMPETENT ADULT QUALIFIED PATIENT.  (a)  A competent qualified patient who is an adult may issue a directive by a nonwritten means of communication.
(b)  A declarant must issue the nonwritten directive in the presence of the attending physician and two witnesses who qualify under Section 166.003, at least one of whom must be a witness who qualifies under Section 166.003(2).
(c)  The physician shall make the fact of the existence of the directive a part of the declarant's medical record, and the names of the witnesses shall be entered in the medical record.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.  Renumbered from Sec. 672.005 and amended by Acts 1999, 76th Leg., ch. 450, Sec. 1.03, eff. Sept. 1, 1999.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 166 - Advance Directives › Subchapter B. Directive to Physicians › Section 166.035. Execution of Directive on Behalf of Patient Younger Than 18 Years of Age

Sec. 166.035.  EXECUTION OF DIRECTIVE ON BEHALF OF PATIENT YOUNGER THAN 18 YEARS OF AGE.  The following persons may execute a directive on behalf of a qualified patient who is younger than 18 years of age:
(1)  the patient's spouse, if the spouse is an adult;
(2)  the patient's parents;  or
(3)  the patient's legal guardian.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.  Renumbered from Sec. 672.006 by Acts 1999, 76th Leg., ch. 450, Sec. 1.03, eff. Sept. 1, 1999.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 166 - Advance Directives › Subchapter B. Directive to Physicians › Section 166.036. Notarized Document Not Required; Requirement of Specific Form Prohibited

Sec. 166.036.  NOTARIZED DOCUMENT NOT REQUIRED;  REQUIREMENT OF SPECIFIC FORM PROHIBITED.  (a)  Except as provided by Section 166.032(b-1), a written directive executed under Section 166.033 or 166.035 is effective without regard to whether the document has been notarized.
(b)  A physician, health care facility, or health care professional may not require that:
(1)  a directive be notarized;  or
(2)  a person use a form provided by the physician, health care facility, or health care professional.
Added by Acts 1999, 76th Leg., ch. 450, Sec. 1.03, eff. Sept. 1, 1999.
Amended by:
Acts 2009, 81st Leg., R.S., Ch. 461 (H.B. 2585), Sec. 4, eff. September 1, 2009.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 166 - Advance Directives › Subchapter B. Directive to Physicians › Section 166.037. Patient Desire Supersedes Directive

Sec. 166.037.  PATIENT DESIRE SUPERSEDES DIRECTIVE.  The desire of a qualified patient, including a qualified patient younger than 18 years of age, supersedes the effect of a directive.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.  Renumbered from Sec. 672.007 and amended by Acts 1999, 76th Leg., ch. 450, Sec. 1.03, eff. Sept. 1, 1999.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 166 - Advance Directives › Subchapter B. Directive to Physicians › Section 166.038. Procedure When Declarant Is Incompetent or Incapable of Communication

Sec. 166.038.  PROCEDURE WHEN DECLARANT IS INCOMPETENT OR INCAPABLE OF COMMUNICATION.  (a)  This section applies when an adult qualified patient has executed or issued a directive and is incompetent or otherwise mentally or physically incapable of communication.
(b)  If the adult qualified patient has designated a person to make a treatment decision as authorized by Section 166.032(c), the attending physician and the designated person may make a treatment decision in accordance with the declarant's directions.
(c)  If the adult qualified patient has not designated a person to make a treatment decision, the attending physician shall comply with the directive unless the physician believes that the directive does not reflect the patient's present desire.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.  Renumbered from 672.008 and amended by Acts 1999, 76th Leg., ch. 450, Sec. 1.03, eff. Sept. 1, 1999.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 166 - Advance Directives › Subchapter B. Directive to Physicians › Section 166.039. Procedure When Person Has Not Executed or Issued a Directive and Is Incompetent or Incapable of Communication

Sec. 166.039.  PROCEDURE WHEN PERSON HAS NOT EXECUTED OR ISSUED A DIRECTIVE AND IS INCOMPETENT OR INCAPABLE OF COMMUNICATION.  (a)  If an adult qualified patient has not executed or issued a directive and is incompetent or otherwise mentally or physically incapable of communication, the attending physician and the patient's legal guardian or an agent under a medical power of attorney may make a treatment decision that may include a decision to withhold or withdraw life-sustaining treatment from the patient.
(b)  If the patient does not have a legal guardian or an agent under a medical power of attorney, the attending physician and one person, if available, from one of the following categories, in the following priority, may make a treatment decision that may include a decision to withhold or withdraw life-sustaining treatment:
(1)  the patient's spouse;
(2)  the patient's reasonably available adult children;
(3)  the patient's parents;  or
(4)  the patient's nearest living relative.
(c)  A treatment decision made under Subsection (a) or (b) must be based on knowledge of what the patient would desire, if known.
(d)  A treatment decision made under Subsection (b) must be documented in the patient's medical record and signed by the attending physician.
(e)  If the patient does not have a legal guardian and a person listed in Subsection (b) is not available, a treatment decision made under Subsection (b) must be concurred in by another physician who is not involved in the treatment of the patient or who is a representative of an ethics or medical committee of the health care facility in which the person is a patient.
(f)  The fact that an adult qualified patient has not executed or issued a directive does not create a presumption that the patient does not want a treatment decision to be made to withhold or withdraw life-sustaining treatment.
(g)  A person listed in Subsection (b) who wishes to challenge a treatment decision made under this section must apply for temporary guardianship under Chapter 1251, Estates Code.  The court may waive applicable fees in that proceeding.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.  Amended by Acts 1997, 75th Leg., ch. 291, Sec. 3, eff. Jan. 1, 1998.  Renumbered from Sec. 672.009 and amended by Acts 1999, 76th Leg., ch. 450, Sec. 1.03, eff. Sept. 1, 1999.
Amended by:
Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0502, eff. April 2, 2015.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 166 - Advance Directives › Subchapter B. Directive to Physicians › Section 166.040. Patient Certification and Prerequisites for Complying With Directive

Sec. 166.040.  PATIENT CERTIFICATION AND PREREQUISITES FOR COMPLYING WITH DIRECTIVE.  (a)  An attending physician who has been notified of the existence of a directive shall provide for the declarant's certification as a qualified patient on diagnosis of a terminal or irreversible condition.
(b)  Before withholding or withdrawing life-sustaining treatment from a qualified patient under this subchapter, the attending physician must determine that the steps proposed to be taken are in accord with this subchapter and the patient's existing desires.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.  Amended by Acts 1991, 72nd Leg., 1st C.S., ch. 14, Sec. 6.01, eff. Nov. 12, 1991.  Renumbered from Sec. 672.010 and amended by Acts 1999, 76th Leg., ch. 450, Sec. 1.03, eff. Sept. 1, 1999.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 166 - Advance Directives › Subchapter B. Directive to Physicians › Section 166.041. Duration of Directive

Sec. 166.041.  DURATION OF DIRECTIVE.  A directive is effective until it is revoked as prescribed by Section 166.042.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.  Renumbered from Sec. 672.011 and amended by Acts 1999, 76th Leg., ch. 450, Sec. 1.03, eff. Sept. 1, 1999.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 166 - Advance Directives › Subchapter B. Directive to Physicians › Section 166.042. Revocation of Directive

Sec. 166.042.  REVOCATION OF DIRECTIVE.  (a)  A declarant may revoke a directive at any time without regard to the declarant's mental state or competency.  A directive may be revoked by:
(1)  the declarant or someone in the declarant's presence and at the declarant's direction canceling, defacing, obliterating, burning, tearing, or otherwise destroying the directive;
(2)  the declarant signing and dating a written revocation that expresses the declarant's intent to revoke the directive;  or
(3)  the declarant orally stating the declarant's intent to revoke the directive.
(b)  A written revocation executed as prescribed by Subsection (a)(2) takes effect only when the declarant or a person acting on behalf of the declarant notifies the attending physician of its existence or mails the revocation to the attending physician.  The attending physician or the physician's designee shall record in the patient's medical record the time and date when the physician received notice of the written revocation and shall enter the word "VOID" on each page of the copy of the directive in the patient's medical record.
(c)  An oral revocation issued as prescribed by Subsection (a)(3) takes effect only when the declarant or a person acting on behalf of the declarant notifies the attending physician of the revocation.  The attending physician or the physician's designee shall record in the patient's medical record the time, date, and place of the revocation, and, if different, the time, date, and place that the physician received notice of the revocation.  The attending physician or the physician's designees shall also enter the word "VOID" on each page of the copy of the directive in the patient's medical record.
(d)  Except as otherwise provided by this subchapter, a person is not civilly or criminally liable for failure to act on a revocation made under this section unless the person has actual knowledge of the revocation.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.  Renumbered from Sec. 672.012 and amended by Acts 1999, 76th Leg., ch. 450, Sec. 1.03, eff. Sept. 1, 1999.