reglab/statecodes huggingface dataset:
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 137 - BIRTHING CENTERS › Subchapter D - OPERATIONAL AND CLINICAL STANDARDS FOR THE PROVISION AND COORDINATION OF TREATMENT AND SERVICES › Section 137.38 - Disposition of Medical Waste

Current through Reg. 49, No. 28; July 12, 2024
A center shall meet requirements set forth by the
					 department in §§
										1.131-
					 1.137 of
					 this title (relating to Definition, Treatment, and Disposition of Special Waste
					 from Health Care-Related Facilities).
(1) All special waste including blood, body
				  fluids, placentas, sharps and biological indicators, shall be disposed of in
				  accordance with §§
										1.131-
				  1.137 of
				  this title.
(2) Placentas shall not
				  be placed in the trash or dumpster for disposal.
(3) A center may give the placenta to the
				  client at the time of discharge upon request by the client.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 137 - BIRTHING CENTERS › Subchapter D - OPERATIONAL AND CLINICAL STANDARDS FOR THE PROVISION AND COORDINATION OF TREATMENT AND SERVICES › Section 137.39 - General Requirements for the Provision and Coordination of Treatment and Services

Current through Reg. 49, No. 28; July 12, 2024
(a) A center shall
				  develop, implement, and enforce policies for the provision and coordination of
				  treatment and services.
(b) The
				  center is responsible for all care provided to center clients on its licensed
				  premises.
(c) A center and the
				  client shall have a written agreement for services. The center shall obtain an
				  acknowledgment of receipt of the agreement. The center shall comply with the
				  terms of the agreement. The written agreement shall include the following:
(1) services to be provided;
(2) who will provide the services;
				  and
(3) charges for services
				  rendered.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 137 - BIRTHING CENTERS › Subchapter D - OPERATIONAL AND CLINICAL STANDARDS FOR THE PROVISION AND COORDINATION OF TREATMENT AND SERVICES › Section 137.40 - Risk Assessments

Current through Reg. 49, No. 28; July 12, 2024
(a) Risk
				  assessment system. A center shall adopt, implement, and enforce a written risk
				  assessment system that complies with this section, conforms to accepted
				  standards of practice, and has been approved by the center's clinical director.
				  The center shall apply the risk assessment system to clients prior to
				  acceptance as a center client and throughout the pregnancy for continuation of
				  services and during the postpartum period.
(b) Admission. A birth attendant shall
				  perform the risk assessment of a potential client prior to accepting the client
				  for admission and shall only admit a client that has been assessed to have a
				  low-risk pregnancy.
(c) Change in
				  risk status, transfer, and referral. Criteria for the assessment of a client
				  who develops complications during pregnancy that would require the transfer or
				  referral of the client or newborn from the center shall be reviewed and updated
				  annually by the clinical director.
(1) The
				  center shall recognize and document in the client's clinical record when the
				  client's condition deviates from a low-risk pregnancy at any time during the
				  antepartum, intrapartum, or postpartum period. The center shall refer or
				  transfer the client to a hospital or physician consultant in accordance with
				  the written policies described in paragraph (2) of this subsection.
(2) The center shall enforce policies for the
				  transfer or referral of a client or newborn to a physician consultant or a
				  referral hospital. The written policies shall include provisions:
(A) for transfer to a hospital if emergency
				  care is required;
(B) for notifying
				  the receiving physician prior to the transfer;
(C) for notifying the receiving hospital
				  prior to the transfer;
(D) for
				  sending a copy of the clinical record to the hospital or physician consultant
				  at the time of transfer; and
(E)
				  describing the duties and responsibilities of staff during the transfer
				  procedure.
(3) The
				  center shall document the transfer or referral in the client's clinical record
				  in accordance with §
											137.53(9)(R)
				  of this title (relating to Clinical Records).
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 137 - BIRTHING CENTERS › Subchapter D - OPERATIONAL AND CLINICAL STANDARDS FOR THE PROVISION AND COORDINATION OF TREATMENT AND SERVICES › Section 137.41 - Emergency Services

Current through Reg. 49, No. 28; July 12, 2024
The center shall provide emergency services to clients when
					 a critical situation develops at the center.
(1) A center shall have an emergency call
				  system for use when there is a critical situation. The center shall have
				  available in the center personnel trained in cardiopulmonary resuscitation
				  (CPR) to be available whenever there is a client in labor or during acute
				  postpartum period.
(2) A center
				  shall provide emergency equipment and emergency medications as follows:
(A) oxygen;
(B) newborn manual breathing bags;
(C) suction equipment for newborns;
(D) a neutral thermal environment for
				  resuscitation; and
(E) other
				  medications and equipment as approved by the clinical director.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 137 - BIRTHING CENTERS › Subchapter D - OPERATIONAL AND CLINICAL STANDARDS FOR THE PROVISION AND COORDINATION OF TREATMENT AND SERVICES › Section 137.42 - Disclosure Requirements

Current through Reg. 49, No. 28; July 12, 2024
(a) At the time
				  of initial visit a center must provide the client, and if the client is a
				  minor, his or her guardian:
(1) a written
				  statement that complaints may be registered with the Manager, Health Facility
				  Compliance Group, Department of State Health Services, 1100 West 49th Street,
				  Austin, Texas 78756; telephone (888) 973-0022; (512) 834-6650; Fax (512)
				  834-6653; and
(2) a disclosure
				  statement and informed consent that explains the benefits, limitations, and
				  risks of the services available to the client, and that describes the
				  collaborative arrangements that the center has with physicians and referral
				  hospitals.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 137 - BIRTHING CENTERS › Subchapter D - OPERATIONAL AND CLINICAL STANDARDS FOR THE PROVISION AND COORDINATION OF TREATMENT AND SERVICES › Section 137.43 - Prenatal Care

Current through Reg. 49, No. 28; July 12, 2024
When prenatal care is provided, the center shall comply
					 with accepted standards of practice.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 137 - BIRTHING CENTERS › Subchapter D - OPERATIONAL AND CLINICAL STANDARDS FOR THE PROVISION AND COORDINATION OF TREATMENT AND SERVICES › Section 137.44 - Parenting and Postpartum Counseling

Current through Reg. 49, No. 28; July 12, 2024
(a) A
				  birthing center that provides prenatal care to a pregnant woman during
				  gestation or at delivery of an infant shall:
(1) provide the woman with a resource list of
				  the names, addresses, and telephone numbers of professional organizations that
				  provide postpartum counseling and assistance to parents;
(2) document in the patient's record that the
				  patient received the information described in paragraph (1) of this subsection;
				  and
(3) retain the documentation
				  for at least three years in the birthing center records.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 137 - BIRTHING CENTERS › Subchapter D - OPERATIONAL AND CLINICAL STANDARDS FOR THE PROVISION AND COORDINATION OF TREATMENT AND SERVICES › Section 137.46 - Physician Consultant Procedures

Current through Reg. 49, No. 28; July 12, 2024
(a) A
				  center shall adopt, implement, and enforce written procedures for consultation
				  with physicians for clients who develop medical complications.
(b) A physician consultant shall be a Texas
				  licensed physician, preferably who practices obstetrics and/or pediatrics, and
				  who is readily available by telephone or who is able to be present in the
				  center or hospital to deliver emergency care.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 137 - BIRTHING CENTERS › Subchapter D - OPERATIONAL AND CLINICAL STANDARDS FOR THE PROVISION AND COORDINATION OF TREATMENT AND SERVICES › Section 137.47 - Procedures for Drugs and Biologicals

Current through Reg. 49, No. 28; July 12, 2024
(a)
				  Drugs and biologicals must be handled and stored in a safe and effective manner
				  in accordance with written policies and procedures established by the center
				  and state and federal laws.
(b)
				  Drugs must be administered according to established written policies and
				  procedures and accepted standards of practice, in accordance with state and
				  federal laws.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 137 - BIRTHING CENTERS › Subchapter D - OPERATIONAL AND CLINICAL STANDARDS FOR THE PROVISION AND COORDINATION OF TREATMENT AND SERVICES › Section 137.48 - Labor and Birth Procedures

Current through Reg. 49, No. 28; July 12, 2024
(a) Labor and
				  birth shall be managed and attended by a birth attendant.
(b) The birth attendant shall be trained in
				  the use of emergency equipment.
(c)
				  A center shall ensure that its birth attendants encourage a client to seek
				  medical care if the birth attendant recognizes a sign or symptom of a
				  complication to the client's childbirth.
(d) Other clinical care provider(s) and/or a
				  birth attendant, shall be physically present in the center whenever a client is
				  in the center until the client is discharged. The clinical care provider shall
				  be capable of performing the following minimum duties:
(1) monitoring the fetal heartbeat;
(2) monitoring the mother's blood pressure,
				  pulse, and temperature;
(3)
				  performing adult and infant cardiopulmonary resuscitation, if needed;
(4) monitoring the newborn's heart rate,
				  respiratory rate and body temperature; and
(5) assessing the client's fundus and blood
				  loss.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 137 - BIRTHING CENTERS › Subchapter D - OPERATIONAL AND CLINICAL STANDARDS FOR THE PROVISION AND COORDINATION OF TREATMENT AND SERVICES › Section 137.49 - Care of the Newborn

Current through Reg. 49, No. 28; July 12, 2024
A center shall adopt, implement, and enforce written
					 policies and procedures for the care of the newborn. The clinical director
					 shall review and revise the policies as necessary to reflect current practices.
					 The policies shall include the following:
(1) resuscitation of the newborn;
(2) prophylactic treatment of the
				  eyes;
(3) documentation of a
				  physical examination of the newborn performed before discharge;
(4) referral for any abnormalities or
				  problems;
(5) the collection of
				  blood for newborn screening; and
(6) procedures for the detection of Rh and
				  ABO isoimmunization.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 137 - BIRTHING CENTERS › Subchapter D - OPERATIONAL AND CLINICAL STANDARDS FOR THE PROVISION AND COORDINATION OF TREATMENT AND SERVICES › Section 137.50 - Discharge Procedures

Current through Reg. 49, No. 28; July 12, 2024
(a) The mother
				  and newborn shall be discharged from the center when both are clinically stable
				  and have met discharge criteria established by the center.
(b) The mother and newborn shall not be
				  discharged prior to two hours from the time of placenta.
(c) If the mother or newborn remain at the
				  center for medical reasons for more than 24 hours after birth, a report shall
				  be filed with the Manager, Department of State Health Services, Health Facility
				  Compliance Group, 1100 West 49th Street, Austin, Texas 78756. The report shall
				  be filed within 48 hours after the birth describing the circumstances and
				  reasons for the extended stay.
(d)
				  A center must provide the mother with written discharge instructions. The
				  discharge instructions must include written guidelines detailing how the mother
				  may obtain emergency assistance for herself and newborn.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 137 - BIRTHING CENTERS › Subchapter D - OPERATIONAL AND CLINICAL STANDARDS FOR THE PROVISION AND COORDINATION OF TREATMENT AND SERVICES › Section 137.51 - Postpartum and Postnatal Care of the Mother and Newborn

Current through Reg. 49, No. 28; July 12, 2024
The center shall develop, implement, and enforce written
					 policies to provide follow-up postnatal and postpartum care to the newborn and
					 the mother either directly or by referral. Follow-up care may be provided in
					 the center, at the mother's residence, by telephone, or by a combination of
					 these methods in accordance with accepted standards of
					 practice.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 137 - BIRTHING CENTERS › Subchapter D - OPERATIONAL AND CLINICAL STANDARDS FOR THE PROVISION AND COORDINATION OF TREATMENT AND SERVICES › Section 137.52 - Quality Assurance

Current through Reg. 49, No. 28; July 12, 2024
(a) Quality
				  assurance program. The center shall adopt, implement, and enforce a written
				  quality assurance (QA) program that includes all health and safety aspects of
				  client care for both mother and newborn.
(1)
				  The quality assurance program shall include, but not be limited to:
(A) a review of the clinical
				  record(s);
(B) incidences of
				  morbidity and mortality of mother and newborn;
(C) postpartum infections;
(D) all cases transferred to a hospital for
				  delivery, care of newborn, or postpartum care of mother;
(E) incidents, problems and potential
				  problems identified by staff of the center, including infection
				  control;
(F) address issues of
				  unprofessional conduct by any member of the center's staff (including contract
				  staff);
(G) address the integrity
				  of surgical instruments, medical equipment, and patient supplies;
(H) address client referrals and
				  consultations;
(I) address
				  medication therapy practices, if applicable; and
(J) problems with compliance with any federal
				  and state laws and rules.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 137 - BIRTHING CENTERS › Subchapter D - OPERATIONAL AND CLINICAL STANDARDS FOR THE PROVISION AND COORDINATION OF TREATMENT AND SERVICES › Section 137.54 - Reporting and Filing Requirements

Current through Reg. 49, No. 28; July 12, 2024
(a)
				  Reportable conditions and incidents.
(1) A
				  center shall report communicable diseases required to be reported under the
				  Health and Safety Code, §
											81.042,
				  and in accordance with the department's rules under §§
											97.2-
				  97.5
				  of this title (relating to Control of Communicable Diseases).
(2) The following incidents shall be reported
				  to the department in writing, by mail, or fax within five calendar days of the
				  occurrence to the Manager of Health Facility Compliance Group, Department of
				  State Health Services, 1100 West 49th Street, Austin, Texas 78756:
(A) a death of a client, newborn, or death of
				  a fetus during the course of labor occurring in the center; and
(B) a death of a client or newborn occurring
				  within 24 hours of discharge from the center or transfer to another health care
				  facility.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 138 - DISPOSITION OF EMBRYONIC AND FETAL TISSUE REMAINS › Section 138.1 - Purpose

Current through Reg. 49, No. 28; July 12, 2024
The purpose of this chapter is to implement the Texas Health
				  and Safety Code, Chapter 697, which requires the dignified disposition of
				  embryonic and fetal tissue remains.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 138 - DISPOSITION OF EMBRYONIC AND FETAL TISSUE REMAINS › Section 138.2 - Definitions

Current through Reg. 49, No. 28; July 12, 2024
The following words and terms, when used in this chapter,
				  have the following meanings unless the context clearly indicates
				  otherwise.
(1) Burial--The act of
				depositing embryonic and fetal tissue remains in a grave, crypt, vault, or
				tomb, or at sea.
(2) Burial park--A
				tract of land that is used or intended to be used for the interment of
				embryonic and fetal tissue remains in graves.
(3) Cemetery--A tract of land that is used or
				intended to be used for the permanent interment of embryonic and fetal tissue
				remains, and includes:
(A) a burial park for
				earth interments;
(B) a mausoleum
				for crypt or vault interments;
(C)
				a columbarium for cinerary interments; or
(D) a combination of one or more of
				subparagraphs (A) - (C) of this paragraph.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 138 - DISPOSITION OF EMBRYONIC AND FETAL TISSUE REMAINS › Section 138.3 - Scope, Exemptions

Current through Reg. 49, No. 28; July 12, 2024
(a) Unless
				specifically exempted, all embryonic and fetal tissue remains from health care
				facilities must be treated as provided in this chapter.
(b) To the extent this chapter conflicts with
				Title 25, Texas Administrative Code, Chapter 1, Subchapter K, this chapter
				prevails.
(c) This chapter does not
				apply to:
(1) placentas designated for sale
				and obtained from a licensed hospital or a licensed birthing center;
(2) in vitro tissue cultures;
(3) human fetal tissue donated in accordance
				with Texas Health and Safety Code, Chapter 173;
(4) disposition of embryonic and fetal tissue
				remains of a single pregnancy, body parts, or tissue (including bulk blood),
				transferred for disposition to a licensed funeral director in accordance with
				Texas Health and Safety Code, Chapter 711, and Title 25, Texas Administrative
				Code Chapter 181 (relating to Vital Statistics), with the consent of the person
				or persons authorized to consent to the disposition of the fetal remains, body
				parts, or tissue (including bulk blood);
(5) human tissue, including embryonic and
				fetal tissue, that is expelled or removed from the human body once the person
				is outside of a health care facility;
(6) embryonic and fetal tissue required to be
				released to the parent of an unborn child pursuant to Texas Health and Safety
				Code, §
										241.010;
				and
(7) a placenta removed from a
				hospital or birthing center pursuant to Texas Health and Safety Code, Chapter
				172.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 138 - DISPOSITION OF EMBRYONIC AND FETAL TISSUE REMAINS › Section 138.4 - Application of this Chapter

Current through Reg. 49, No. 28; July 12, 2024
(a)
				This chapter may not be used to require or authorize disclosure of confidential
				information, including personally identifiable or personally sensitive
				information, not permitted to be disclosed by state or federal privacy or
				confidentiality laws.
(b) This
				chapter does not require the issuance of a birth or death certificate or a
				burial transit permit for the proper disposition of embryonic and fetal tissue
				remains from health care facilities.
(c) This chapter does not extend or modify
				requirements of Texas Health and Safety Code, Chapters 711 and 716, or Texas
				Occupations Code, Chapter 651, to disposition of embryonic and fetal tissue
				remains.
(d) This chapter applies
				to embryonic and fetal tissue remains from health care facilities.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 138 - DISPOSITION OF EMBRYONIC AND FETAL TISSUE REMAINS › Section 138.5 - Approved Methods of Treatment and Disposition

Current through Reg. 49, No. 28; July 12, 2024
(a) Embryonic and fetal tissue remains,
				regardless of the period of gestation, except as provided by § 138.3 of
				this chapter (relating to Scope, Exemptions), must be subjected to one of the
				following methods of treatment and disposal:
(1) interment;
(2) cremation;
(3) incineration followed by interment;
				or
(4) steam disinfection followed
				by interment.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 138 - DISPOSITION OF EMBRYONIC AND FETAL TISSUE REMAINS › Section 138.6 - Storage, Handling, and Transport Authorization

Current through Reg. 49, No. 28; July 12, 2024
(a) Any person or entity that is licensed,
				permitted or otherwise authorized by the Texas Funeral Services Commission to
				store, handle or transport human remains is authorized to store, handle or
				transport embryonic and fetal tissue remains in accordance with this
				chapter.
(b) Any person or entity
				that is licensed, permitted or otherwise authorized by the Texas Commission on
				Environmental Quality to store, handle or transport special waste from health
				care facilities is authorized to store, handle or transport embryonic and fetal
				tissue remains in accordance with this chapter.
(c) Any health care facility that generates
				embryonic and fetal tissue remains is authorized to store, handle, or transport
				embryonic and fetal tissue remains generated at that facility in accordance
				with this chapter.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 138 - DISPOSITION OF EMBRYONIC AND FETAL TISSUE REMAINS › Section 138.7 - Storage, Handling, and Transport Requirements

Current through Reg. 49, No. 28; July 12, 2024
(a) A container which contains untreated
				embryonic and fetal tissue remains must be placed in an outer container that is
				leak resistant, impervious to moisture, of sufficient strength to prevent
				tearing and bursting under normal conditions of use and handling, and sealed to
				prevent leakage.
(b) The outer
				container holding untreated embryonic and fetal tissue remains must be labeled
				with a warning legend in English and in Spanish, along with the international
				symbol for biohazardous material on the sides of the container. The wording of
				the warning legend must be substantially similar to the following: "CAUTION,
				contains material which may be biohazardous" and "PRECAUCIÓN, contiene
				material que pueden ser peligro biolÓgico."
(c) Untreated embryonic and fetal tissue
				remains being transported for disposition in accordance with these rules shall
				be transported using units that:
(1) have a
				fully enclosed, leak-proof remains storage area;
(2) protect the remains from mechanical
				stress or compaction;
(3) carry
				spill cleanup equipment; and
(4)
				have a compartment where remains are transported that must:
(A) be maintained in a sanitary
				condition;
(B) be locked when the
				vehicle or trailer is in motion;
(C) be locked or secured when remains are
				present in the compartment except during loading or unloading of
				remains;
(D) have a floor and sides
				made of an impervious, nonporous material;
(E) have all discharge openings securely
				closed during operation of the vehicle or trailer;
(F) maintain a temperature of 45 degrees
				Fahrenheit or less for remains transported for longer than 72 hours during
				post-collection storage period; and
(G) be disinfected before being used to
				transport any material other than remains or untreated medical waste.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 138 - DISPOSITION OF EMBRYONIC AND FETAL TISSUE REMAINS › Section 138.8 - Burial or Cremation Assistance Registry

Current through Reg. 49, No. 28; July 12, 2024
The registry is created to identify persons or entities who
				  choose to provide financial or other assistance for the transportation,
				  cremation, or burial of embryonic or fetal tissue remains.
(1) The following persons or entities may
				apply for inclusion on the registry by submitting an application on a form
				prescribed by HHSC:
(A) participating funeral
				homes and cemeteries willing to provide free common burials or free or low-cost
				private burials that certify that they will do so in compliance with applicable
				law; and
(B) private nonprofit
				organizations that will provide financial assistance for the costs associated
				with burial or cremation of embryonic and fetal tissue remains.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 139 - ABORTION FACILITY REPORTING AND LICENSING › Subchapter A - GENERAL PROVISIONS › Section 139.1 - Purpose and Scope

Current through Reg. 49, No. 28; July 12, 2024
(a) Purpose. The
				  purpose of this chapter is to implement the Texas Abortion Facility Reporting
				  and Licensing Act, Health and Safety Code, Chapter 245, which provides the
				  Department of State Health Services with the authority to establish rules
				  governing the licensing and regulation of abortion facilities and to establish
				  annual reporting requirements for each abortion performed. This chapter also
				  implements the Woman's Right to Know Act, Health and Safety Code, Chapter
				  171.
(b) Scope and applicability.
(1) Licensing requirements.
(A) A person may not establish or operate an
				  abortion facility in Texas without a license issued under this chapter unless
				  the person is exempt from licensing requirements.
(B) The following need not be licensed under
				  this chapter:
(i) a hospital licensed under
				  Health and Safety Code, Chapter 241;
(ii) an ambulatory surgical center licensed
				  under Health and Safety Code, Chapter 243; or
(iii) the office of a physician licensed by
				  the Texas Medical Board and authorized to practice medicine in the State of
				  Texas, unless the office is used for the purpose of performing more than 50
				  abortions in any 12-month period.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 139 - ABORTION FACILITY REPORTING AND LICENSING › Subchapter A - GENERAL PROVISIONS › Section 139.2 - Definitions

Current through Reg. 49, No. 28; July 12, 2024
The following words and terms, when used in this chapter,
					 shall have the following meanings, unless the context clearly indicates
					 otherwise.
(1) Abortion--The act of
				  using or prescribing an instrument, a drug, a medicine, or any other substance,
				  device, or means with the intent to cause the death of an unborn child of a
				  woman known to be pregnant. The term does not include birth control devices or
				  oral contraceptives. An act is not an abortion if the act is done with the
				  intent to save the life or preserve the health of an unborn child; remove a
				  dead, unborn child whose death was caused by spontaneous abortion; or remove an
				  ectopic pregnancy.
(2) Abortion
				  complication or adverse event--Any harmful event or adverse outcome with
				  respect to a patient related to an abortion that is performed on the patient or
				  induced and that is diagnosed or treated by a health care practitioner or at a
				  health care facility, including:
(A)
				  shock;
(B) uterine
				  perforation;
(C) cervical
				  laceration;
(D)
				  hemorrhage;
(E) aspiration or
				  allergic response;
(F)
				  infection;
(G) sepsis;
(H) death of the patient;
(I) incomplete abortion;
(J) damage to the uterus;
(K) an infant born alive after the
				  abortion;
(L) blood clots resulting
				  in pulmonary embolism or deep vein thrombosis;
(M) failure to actually terminate the
				  pregnancy;
(N) pelvic inflammatory
				  disease;
(O)
				  endometritis;
(P) missed ectopic
				  pregnancy;
(Q) cardiac
				  arrest;
(R) respiratory
				  arrest;
(S) renal
				  failure;
(T) metabolic
				  disorder;
(U) embolism;
(V) coma;
(W) placenta previa in subsequent
				  pregnancies;
(X) preterm delivery
				  in subsequent pregnancies;
(Y)
				  fluid accumulation in the abdomen;
(Z) hemolytic reaction resulting from the
				  administration of ABO-incompatible blood or blood products;
(AA) adverse reactions to anesthesia or other
				  drugs; or
(BB) any other adverse
				  event as defined by the United States Food and Drug Administration's criteria
				  provided by MedWatch Reporting System.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 139 - ABORTION FACILITY REPORTING AND LICENSING › Subchapter A - GENERAL PROVISIONS › Section 139.3 - Unlicensed Facility

Current through Reg. 49, No. 28; July 12, 2024
(a) If the
				  Department of State Health Services (department) has reason to believe that a
				  person or facility may be providing abortion services without a license as
				  required by the Act and this chapter, the department shall notify the person or
				  facility in writing by certified mail, return receipt requested. The person or
				  facility shall submit to the department the following information within 10
				  days of receipt of the notice:
(1) an
				  application for a license and the license fee; or
(2) a notarized affidavit to support
				  exemption under Health and Safety Code, §
											245.004,
				  including any and all documentation. The notarized affidavit shall attest to
				  the fact that the person or facility is exempt from licensing as specified in
				  §
											139.1(b)
				  of this title (relating to Purpose and Scope). The form of notarized affidavit
				  to support exemption shall be provided by the department.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 139 - ABORTION FACILITY REPORTING AND LICENSING › Subchapter A - GENERAL PROVISIONS › Section 139.5 - Additional Reporting Requirements

Current through Reg. 49, No. 28; July 12, 2024
In addition to the reporting required by §
										139.4
					 of this subchapter (relating to Monthly Reporting Requirements for All
					 Abortions Performed or Induced), physicians and health care facilities subject
					 to this chapter shall comply with this section when performing or inducing
					 third trimester abortions, when performing or inducing emergency abortions, and
					 when diagnosing or treating abortion complications.
(1) Reporting requirements for third
				  trimester abortions.
(A) The purpose of this
				  paragraph is to establish procedures for reporting third trimester abortions as
				  required by the Medical Practice Act, Occupations Code Chapters 151 - 160 and
				  162 - 165.
(B) A physician who
				  performs or induces a third trimester abortion of a viable fetus with a
				  biparietal diameter of 60 millimeters or greater shall certify in writing to
				  the Texas Health and Human Services Commission (HHSC) the medical indications
				  supporting the physician's judgment that the abortion is either necessary to
				  prevent the death or a substantial risk of serious impairment to the physical
				  or mental health of the woman, or the fetus has a severe and irreversible
				  abnormality, as identified through reliable diagnostic procedures.
(C) The certification shall be made on a form
				  approved by HHSC.
(D) The
				  certification form and any supporting documents shall be submitted via the
				  secure electronic reporting system established and maintained by
				  HHSC.
(E) HHSC shall retain the
				  certification form and supporting documents as a cross-reference to the annual
				  reporting requirements of the Act and this section. The certification form and
				  supporting documents retained by HHSC are confidential. Any release of the
				  documents shall be in accordance with the provisions of the Medical Practice
				  Act, Occupations Code Chapters 151 - 160 and 162 - 165.
(F) A physician performing or inducing
				  abortions at a licensed abortion facility who fails to submit the certification
				  form required under this paragraph may subject the licensed facility to denial,
				  suspension, probation, or revocation of the license in accordance with §
											139.32
				  of this chapter (relating to License Denial, Suspension, Probation, or
				  Revocation).
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 139 - ABORTION FACILITY REPORTING AND LICENSING › Subchapter A - GENERAL PROVISIONS › Section 139.6 - Public Information; Toll-Free Telephone Number

Current through Reg. 49, No. 28; July 12, 2024
(a) An abortion facility shall provide to a
				  woman, at the time the woman initially consults the facility, a written
				  statement indicating the number of the toll-free telephone number maintained
				  under subsection (d) of this section. The written statement shall be available
				  in English and Spanish.
(1) The following
				  form is an example of the statement in English.
Attached
					 Graphic
(2) The
				  following form is an example of the statement in Spanish.
Attached
					 Graphic
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 139 - ABORTION FACILITY REPORTING AND LICENSING › Subchapter A - GENERAL PROVISIONS › Section 139.7 - Unique Identifying Number; Disclosure in Advertisement

Current through Reg. 49, No. 28; July 12, 2024
(a) The department
				  shall assign to each licensed abortion facility a unique license number that
				  may not change during the period the facility is operating in this
				  state.
(b) A licensed abortion
				  facility shall include the unique license number assigned to the facility by
				  the department in any abortion advertisement directly relating to the provision
				  of abortion services at the facility. If more than one location is advertised
				  in a single advertisement, the license number(s) for each location shall be
				  included in the advertisement. The facility shall document efforts to place the
				  unique license number in advertisements within each specific deadline for each
				  advertisement.
(c) In this section,
				  "abortion advertisement" means:
(1) any
				  communication that advertises the availability of abortion services at a
				  licensed abortion facility and that is disseminated through a public medium,
				  including an advertisement in a newspaper or other publication or an
				  advertisement on television, radio, or any other electronic medium;
				  or
(2) any commercial use of the
				  name of the licensed facility as a provider of abortion services, including the
				  use of the name in a directory, listing, or pamphlet.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 139 - ABORTION FACILITY REPORTING AND LICENSING › Subchapter A - GENERAL PROVISIONS › Section 139.8 - Quality Assurance

Current through Reg. 49, No. 28; July 12, 2024
(a) Quality
				  Assurance (QA) Program. A licensed abortion facility shall maintain a QA
				  program in the facility which shall be implemented by a QA committee. The QA
				  program shall be ongoing and have a written plan of implementation. This plan
				  shall be reviewed and updated or revised at least annually by the QA Committee.
				  The QA program shall include measures for quality improvement in the
				  measurement of the facility's delivery of service. Quality assurance documents
				  pertinent to the facility shall be kept within the facility.
(b) QA committee membership. At a minimum,
				  the QA committee shall consist of at least:
(1) the medical consultant designated by the
				  facility;
(2) an advanced practice
				  registered nurse, a physician assistant, a registered nurse, or a licensed
				  vocational nurse; and
(3) at least
				  two other members of the facility's staff.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 139 - ABORTION FACILITY REPORTING AND LICENSING › Subchapter A - GENERAL PROVISIONS › Section 139.9 - Severability

Current through Reg. 49, No. 28; July 12, 2024
(a) The 83rd
				  Legislature, in enacting House Bill 2 during its Second Session (2013),
				  confirmed its intent that the provisions and the applications of the Health and
				  Safety Code relating to the licensure and operation of abortion facilities were
				  intended to be separately enforceable, if any of these separate provisions or
				  the application of those provisions was determined unconstitutional, invalid,
				  or unenforceable.
(b) Consistent
				  with the intent of the Legislature, the department intends, that with respect
				  to the application of this chapter to each woman who seeks or obtains services
				  from a facility licensed under this chapter, every provision, section,
				  subsection, sentence, clause, phrase, or word in this chapter and each
				  application of the provisions of this chapter remain severable from every other
				  provision, section, subsection, sentence, clause, phrase, word, or application
				  of this chapter.
(c) The department
				  further intends that if the application of any provision of this chapter is
				  determined by a court of competent jurisdiction to impose an impermissible or
				  undue burden on any pregnant woman or group of pregnant women, the application
				  of the chapter to those women will be severed from the remaining applications
				  of the chapter that do not impose an undue burden, and those remaining
				  applications of this chapter will remain in force and unaffected, consistent
				  with the intent of the Legislature.
(d) Accordingly, to the extent that any parts
				  or applications of this chapter or this section are enjoined, the department
				  may enforce the parts and applications of this chapter that do not violate the
				  Constitution or impose an undue burden on women seeking abortions.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 139 - ABORTION FACILITY REPORTING AND LICENSING › Subchapter B - LICENSING PROCEDURES › Section 139.21 - General Requirements for Licensure

Current through Reg. 49, No. 28; July 12, 2024
An applicant for an abortion facility license shall meet
					 the following requirements.
(1) If the
				  applicant for a license is an individual, the applicant shall be at least 18
				  years of age.
(2) An abortion
				  facility is required to apply for a separate license for each place of
				  business.
(3) An abortion facility
				  may not admit a patient for an abortion procedure until it has received an
				  initial license.
(4) The licensed
				  location shall be in Texas.
(5) The
				  licensee of the abortion facility is responsible for ensuring the facility's
				  compliance with the Act and this chapter.
(6) Renewal licenses shall expire in two
				  years.
(7) An abortion facility
				  shall prominently and conspicuously post the license issued under the Act for
				  display in a public area of the facility that is readily accessible to
				  patients, employees, and visitors.
(8) An abortion facility license shall not be
				  transferred or assigned from one person to another person or from one physical
				  location to another physical location.
(9) A licensed abortion facility shall have
				  the financial ability to carry out its functions under the Act and this
				  chapter.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 139 - ABORTION FACILITY REPORTING AND LICENSING › Subchapter B - LICENSING PROCEDURES › Section 139.22 - Fees

Current through Reg. 49, No. 28; July 12, 2024
(a) Fees for an
				  abortion facility license for all initial, change of ownership, change of
				  physical location, and renewal applications are $5,000.
(b) The commission shall not consider an
				  application as officially submitted until the applicant pays the applicable
				  licensing fee. The fee shall accompany the application form.
(c) A license fee paid to the commission is
				  not refundable.
(d) Any remittance
				  submitted to the commission in payment of a required license fee shall be in
				  the form of a certified check, money order, or personal check made payable to
				  the Texas Health and Human Services Commission .
(e) For all applications, the commission is
				  authorized to collect subscription and convenience fees, in amounts determined
				  by the TexasOnline Authority, to recover costs associated with application and
				  renewal application processing through TexasOnline, in accordance with
				  Government Code, §
										2054.111.
(f) The commission may make periodic reviews
				  of its license fee schedule to ensure that the fees imposed are in amounts
				  reasonable and necessary to defray the cost to the commission of administering
				  the Act.
(g) The commission shall
				  impose an annual assessment as follows.
(1) In
				  addition to application fees, the commission shall impose on each facility an
				  annual assessment in amounts reasonable and necessary to defray
				  costs.
(2) The annual assessment
				  shall fall into one of three categories based on the facility's three-year
				  history:
(A) Facilities for which the annual
				  average of reported abortions is less than 1,000 or facilities applying for an
				  initial license;
(B) Facilities for
				  which the annual average of reported abortions is from 1,000 to
				  2,999;
(C) Facilities for which the
				  annual average of reported abortions is 3,000 or more.
(3) Facilities identified in each category
				  shall be assessed a proportionate share of the costs.
(4) Facilities applying for an initial
				  license shall submit the assessment at the same time as the application
				  fee.
(5) The commission shall
				  notify each licensee of the amount of the annual assessment by the first day of
				  April for each year.
(6) The annual
				  assessment shall be received by the commission no later than the first day of
				  June for each year.
(7) A licensee
				  who fails to pay the annual assessment fee shall be subject to denial,
				  revocation, probation, or suspension of a license as prescribed in §
											139.32
				  of this title (relating to License Denial, Suspension, Probation, or
				  Revocation).
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 139 - ABORTION FACILITY REPORTING AND LICENSING › Subchapter B - LICENSING PROCEDURES › Section 139.23 - Application Procedures and Issuance of Licenses

Current through Reg. 49, No. 28; July 12, 2024
(a) Purpose. This section establishes the
				  application procedures that an abortion facility shall follow to obtain a
				  license to operate as a licensed abortion facility in Texas.
(b) Definitions. The following terms when
				  used in this section shall have the following meaning.
(1) Initial license--A license which is
				  issued by the commission to a first-time applicant for an abortion facility
				  license, including an unlicensed abortion facility, to a licensed facility for
				  which a change of ownership is anticipated, and to a licensed facility for
				  which a change of physical location will occur, that meets the requirements of
				  the Act and this chapter and has successfully completed the application
				  procedures for an initial license as set out in subsection (c) of this section.
				  Initial licenses shall expire in two years.
(2) Renewal license--A license issued by the
				  commission to a licensed abortion facility that meets all requirements of the
				  Act and this chapter and has completed the application procedures for obtaining
				  a renewal license as set out in subsection (d) of this section. Renewal
				  licenses shall expire in two years.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 139 - ABORTION FACILITY REPORTING AND LICENSING › Subchapter B - LICENSING PROCEDURES › Section 139.24 - Change of Ownership or Services, Change of Physical Location, and Closure of a Licensed Abortion Facility

Current through Reg. 49, No. 28; July 12, 2024
(a) The following provisions apply to change
				  of ownership of the licensed abortion facility and affect the condition of a
				  license.
(1) A licensee shall not transfer or
				  assign its license from one person to another person.
(2) The licensed abortion facility shall not
				  materially alter any license issued by the commission.
(3) A person who desires to receive a license
				  in its name for a facility licensed under the name of another person or to
				  change the ownership of any facility shall submit an initial license
				  application and the initial license fee at least 60 calendar days prior to the
				  desired date of the change of ownership. The application shall be in accordance
				  with §
											139.23(c)
				  of this title (relating to Application Procedures and Issuance of
				  Licenses).
(4) An application for a
				  change of ownership shall include a notarized affidavit signed by the previous
				  owner acknowledging agreement with the change of ownership. If the applicant is
				  a corporation, the application shall include a copy of the applicant's articles
				  of incorporation. If the applicant is a business entity other than a
				  corporation, the applicant shall include a copy of the sales
				  agreement.
(5) The commission shall
				  conduct an on-site inspection prior to the issuance of an initial license to
				  the new owner of the facility, in accordance with §
											139.23(c)
				  of this title.
(6) The previous
				  owner's license shall be void on the effective date of the change of
				  ownership.
(7) This subsection does
				  not apply if a licensee is simply revising its name as allowed by law (i.e., a
				  corporation is amending the articles of incorporation to revise its
				  name).
(8) The sale of stock of a
				  corporate licensee does not cause this subsection to apply.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 139 - ABORTION FACILITY REPORTING AND LICENSING › Subchapter B - LICENSING PROCEDURES › Section 139.25 - Time Periods for Processing and Issuing a License

Current through Reg. 49, No. 28; July 12, 2024
(a) General.
(1) The date a license application is
				  received is the date the application reaches Health Facility Licensing
				  (commission) .
(2) An application
				  for an initial license is complete when the commission has received, reviewed,
				  and found acceptable the information described in §
											139.23(c)(2)(C)
				  of this title (relating to Application Procedures and Issuance of
				  Licenses).
(3) An application for a
				  renewal license is complete when the commission has received, reviewed, and
				  found acceptable the information described in §
											139.23(d)(2)
				  of this title.
(4) An application
				  for a change of ownership or change of physical location license is complete
				  when the requirements of §
											139.24
				  of this title (relating to Change of Ownership or Services, Change of Physical
				  Location, and Closure of a Licensed Abortion Facility) have been met.