Texas 2013 - 83rd Regular

Texas House Bill HB1085 Compare Versions

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1	1	83R16510 JSC-F
2	2	By: Walle, S. Davis of Harris H.B. No. 1085
3	3	Substitute the following for H.B. No. 1085:
4	4	By: Naishtat C.S.H.B. No. 1085
5	5
6	6
7	7	A BILL TO BE ENTITLED
8	8	AN ACT
9	9	relating to the creation of a task force to study maternal mortality
10	10	and severe maternal morbidity.
11	11	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
12	12	SECTION 1. Subtitle B, Title 2, Health and Safety Code, is
13	13	amended by adding Chapter 34 to read as follows:
14	14	CHAPTER 34. MATERNAL MORTALITY AND MORBIDITY TASK FORCE
15	15	Sec. 34.001. DEFINITIONS. In this chapter:
16	16	(1) "Commissioner" means the commissioner of state
17	17	health services.
18	18	(2) "Department" means the Department of State Health
19	19	Services.
20	20	(3) "Executive commissioner" means the executive
21	21	commissioner of the Health and Human Services Commission.
22	22	(4) "Health care provider" means an individual or
23	23	facility licensed, certified, or otherwise authorized to
24	24	administer health care, for profit or otherwise, in the ordinary
25	25	course of business or professional practice, including a physician
26	26	or a hospital or birthing center.
27	27	(5) "Institution of higher education" has the meaning
28	28	assigned by Section 61.003, Education Code.
29	29	(6) "Intrapartum care" has the meaning assigned by
30	30	Section 32.002.
31	31	(7) "Life-threatening condition" means a condition
32	32	from which the likelihood of death is probable unless the course of
33	33	the condition is interrupted.
34	34	(8) "Maternal morbidity" means a pregnancy-related
35	35	health condition occurring during pregnancy, labor, or delivery or
36	36	within one year of delivery or end of pregnancy.
37	37	(9) "Patient" means the woman who while pregnant or
38	38	within one year of delivery or end of pregnancy suffers death or
39	39	severe maternal morbidity.
40	40	(10) "Perinatal care" has the meaning assigned by
41	41	Section 32.002.
42	42	(11) "Physician" means a person licensed to practice
43	43	medicine in this state under Subtitle B, Title 3, Occupations Code.
44	44	(12) "Pregnancy-related death" means the death of a
45	45	woman while pregnant or within one year of delivery or end of
46	46	pregnancy, regardless of the duration and site of the pregnancy,
47	47	from any cause related to or aggravated by the pregnancy or its
48	48	management, but not from accidental or incidental causes.
49	49	(13) "Severe maternal morbidity" means maternal
50	50	morbidity that constitutes a life-threatening condition.
51	51	(14) "Task force" means the Maternal Mortality and
52	52	Morbidity Task Force.
53	53	Sec. 34.002. MATERNAL MORTALITY AND MORBIDITY TASK FORCE.
54	54	(a) The Maternal Mortality and Morbidity Task Force is administered
55	55	by the department.
56	56	(b) The task force is a multidisciplinary advisory
57	57	committee within the department and is composed of the following 15
58	58	members:
59	59	(1) 13 members appointed by the commissioner as
60	60	follows:
61	61	(A) four physicians specializing in obstetrics,
62	62	at least one of whom is a maternal fetal medicine specialist;
63	63	(B) one certified nurse-midwife;
64	64	(C) one registered nurse;
65	65	(D) one physician specializing in family
66	66	practice;
67	67	(E) one physician specializing in psychiatry;
68	68	(F) one physician specializing in pathology;
69	69	(G) one epidemiologist, biostatistician, or
70	70	researcher of pregnancy-related deaths;
71	71	(H) one social worker or social service provider;
72	72	(I) one community advocate in a relevant field;
73	73	and
74	74	(J) one medical examiner or coroner responsible
75	75	for recording deaths;
76	76	(2) a representative of the department's family and
77	77	community health programs; and
78	78	(3) the state epidemiologist for the department or the
79	79	epidemiologist's designee.
80	80	(c) In appointing members to the task force, the
81	81	commissioner shall:
82	82	(1) include members:
83	83	(A) working in and representing communities that
84	84	are diverse with regard to race, ethnicity, immigration status, and
85	85	English proficiency; and
86	86	(B) from differing geographic regions in the
87	87	state, including both rural and urban areas;
88	88	(2) endeavor to include members who are working in and
89	89	representing communities that are affected by pregnancy-related
90	90	deaths and severe maternal morbidity and by a lack of access to
91	91	relevant perinatal and intrapartum care services; and
92	92	(3) ensure that the composition of the task force
93	93	reflects the racial, ethnic, and linguistic diversity of this
94	94	state.
95	95	(d) The commissioner shall appoint from among the task force
96	96	members a presiding officer.
97	97	(e) A member of the task force appointed under Subsection
98	98	(b)(1) is not entitled to compensation for service on the task force
99	99	or reimbursement for travel or other expenses incurred by the
100	100	member while conducting the business of the task force.
101	101	(f) In carrying out its duties, the task force may use
102	102	technology, including teleconferencing or videoconferencing, to
103	103	eliminate travel expenses.
104	104	Sec. 34.003. TERMS; VACANCY. (a) Task force members
105	105	appointed by the commissioner serve staggered six-year terms, with
106	106	the terms of four or five members, as appropriate, expiring
107	107	February 1 of each odd-numbered year.
108	108	(b) A task force member may serve more than one term.
109	109	(c) A vacancy on the task force shall be filled for the
110	110	unexpired term in the same manner as the original appointment.
111	111	Sec. 34.004. MEETINGS. (a) The task force shall meet at
112	112	least quarterly. The task force may meet at other times at the call
113	113	of the commissioner.
114	114	(b) Meetings of the task force are closed to the public and
115	115	are not subject to Chapter 551, Government Code.
116	116	Sec. 34.005. DUTIES OF TASK FORCE. The task force shall:
117	117	(1) study and review:
118	118	(A) cases of pregnancy-related deaths; and
119	119	(B) trends in severe maternal morbidity;
120	120	(2) determine the feasibility of the task force
121	121	studying cases of severe maternal morbidity; and
122	122	(3) make recommendations to help reduce the incidence
123	123	of pregnancy-related deaths and severe maternal morbidity in this
124	124	state.
125	125	Sec. 34.006. CONSULTATIONS AND AGREEMENTS WITH OUTSIDE
126	126	PARTIES. (a) The department and task force may consult with any
127	127	relevant experts and stakeholders, including:
128	128	(1) anesthesiologists;
129	129	(2) intensivists or critical care physicians;
130	130	(3) nutritionists;
131	131	(4) substance abuse treatment specialists;
132	132	(5) hospital staff or employees;
133	133	(6) representatives of the state Medicaid program;
134	134	(7) paramedics or other emergency medical response
135	135	personnel;
136	136	(8) hospital-based risk management specialists;
137	137	(9) representatives of local health departments and
138	138	public health districts in this state;
139	139	(10) public health experts;
140	140	(11) government representatives or officials; and
141	141	(12) law enforcement officials.
142	142	(b) In gathering information, the department and task force
143	143	may consult with representatives of any relevant state professional
144	144	associations and organizations, including:
145	145	(1) District XI of the American Congress of
146	146	Obstetricians and Gynecologists;
147	147	(2) the Texas Association of Obstetricians and
148	148	Gynecologists;
149	149	(3) the Texas Nurses Association;
150	150	(4) the Texas Section of the Association of Women's
151	151	Health, Obstetric and Neonatal Nurses;
152	152	(5) the Texas Academy of Family Physicians;
153	153	(6) the Texas Pediatric Society;
154	154	(7) the Consortium of Texas Certified Nurse-Midwives;
155	155	(8) the Association of Texas Midwives;
156	156	(9) the Texas Hospital Association;
157	157	(10) the Texas Medical Association; and
158	158	(11) the Texas Public Health Association.
159	159	(c) In consulting with individuals or organizations under
160	160	Subsection (a) or (b), a member of the task force or employee of the
161	161	department may not disclose any identifying information of a
162	162	patient or health care provider.
163	163	(d) The department on behalf of the task force may enter
164	164	into agreements with institutions of higher education or other
165	165	organizations consistent with the duties of the department or task
166	166	force under this chapter.
167	167	Sec. 34.007. SELECTION AND REVIEW OF CASES. (a) The
168	168	department shall determine a statistically significant number of
169	169	cases of pregnancy-related deaths for review. The department shall
170	170	randomly select cases for the task force to review under this
171	171	subsection to reflect a cross-section of pregnancy-related deaths
172	172	in this state.
173	173	(b) The department shall analyze aggregate data of severe
174	174	maternal morbidity in this state to identify any trends.
175	175	(c) If feasible, the department may select cases of severe
176	176	maternal morbidity for review. In selecting cases under this
177	177	subsection, the department shall randomly select cases for the task
178	178	force to review to reflect trends identified under Subsection (b).
179	179	Sec. 34.008. OBTAINING DE-IDENTIFIED INFORMATION FOR
180	180	REVIEW. (a) On selecting a case of pregnancy-related death or
181	181	severe maternal morbidity for review, the department shall, in
182	182	accordance with this section, obtain information relevant to the
183	183	case to enable the task force to review the case. The department
184	184	shall provide the information to the task force.
185	185	(b) The information provided to the task force may not
186	186	include identifying information of a patient or health care
187	187	provider, including:
188	188	(1) the name, address, or date of birth of the patient
189	189	or a member of the patient's family; or
190	190	(2) the name or specific location of a health care
191	191	provider that treated the patient.
192	192	(c) On the request of the department, a hospital, birthing
193	193	center, or other custodian of the requested information shall
194	194	provide the information to the department. The information shall
195	195	be provided without the authorization of the patient or, if the
196	196	patient is deceased, without the authorization of the patient's
197	197	family.
198	198	(d) A person who provides information to the department
199	199	under this section is not subject to an administrative, civil, or
200	200	criminal action for damages or other relief for providing the
201	201	information.
202	202	Sec. 34.009. CONFIDENTIALITY; PRIVILEGE. (a) Any
203	203	information pertaining to a pregnancy-related death or severe
204	204	maternal morbidity is confidential for purposes of this chapter.
205	205	(b) Confidential information that is acquired by the
206	206	department and that includes identifying information of an
207	207	individual or health care provider is privileged and may not be
208	208	disclosed to any person. Information that may not be disclosed
209	209	under this subsection includes:
210	210	(1) the name and address of a patient or a member of
211	211	the patient's family;
212	212	(2) any service received by the patient or a member of
213	213	the patient's family;
214	214	(3) the social and economic condition of the patient
215	215	or a member of the patient's family;
216	216	(4) medical, dental, and mental health care
217	217	information related to the patient or a member of the patient's
218	218	family, including diagnoses, conditions, diseases, or disability;
219	219	and
220	220	(5) the identity of a health care provider that
221	221	provided any services to the patient or a member of the patient's
222	222	family.
223	223	(c) Task force work product or information obtained by the
224	224	department under this chapter, including information contained in
225	225	an electronic database established and maintained under Section
226	226	34.012, or any other document or record, is confidential. This
227	227	subsection does not prevent the task force or department from
228	228	releasing information described by Subsection (d) or (e) or from
229	229	submitting the report required by Section 34.015.
230	230	(d) Information is not confidential under this section if
231	231	the information is general information that cannot be connected
232	232	with any specific individual, case, or health care provider, such
233	233	as:
234	234	(1) total expenditures made for specified purposes;
235	235	(2) the number of families served by particular health
236	236	care providers or agencies;
237	237	(3) aggregated data on social and economic conditions;
238	238	(4) medical data and information related to health
239	239	care services that do not include any identifying information
240	240	relating to a patient or the patient's family; and
241	241	(5) other statistical information.
242	242	(e) The task force may publish statistical studies and
243	243	research reports based on information that is confidential under
244	244	this section, provided that the information:
245	245	(1) is published in aggregate;
246	246	(2) does not identify a patient or the patient's
247	247	family;
248	248	(3) does not include any information that could be
249	249	used to identify a patient or the patient's family; and
250	250	(4) does not identify a health care provider.
251	251	(f) The department shall adopt and implement practices and
252	252	procedures to ensure that information that is confidential under
253	253	this section is not disclosed in violation of this section.
254	254	(g) Information that is confidential under this section is
255	255	excepted from disclosure under Chapter 552, Government Code, as
256	256	provided by Section 552.101 of that chapter.
257	257	(h) The task force and the department shall comply with all
258	258	state and federal laws and rules relating to the transmission of
259	259	health information, including the Health Insurance Portability and
260	260	Accountability Act of 1996 (Pub. L. No. 104-191) and rules adopted
261	261	under that Act.
262	262	Sec. 34.010. SUBPOENA AND DISCOVERY. Task force work
263	263	product or information that is confidential under Section 34.009 is
264	264	privileged, is not subject to subpoena or discovery, and may not be
265	265	introduced into evidence in any administrative, civil, or criminal
266	266	proceeding against a patient, a member of the family of a patient,
267	267	or a health care provider.
268	268	Sec. 34.011. IMMUNITY. (a) A member of the task force or a
269	269	person employed by or acting in an advisory capacity to the task
270	270	force and who provides information, counsel, or services to the
271	271	task force is not liable for damages for an action taken within the
272	272	scope of the functions of the task force.
273	273	(b) Subsection (a) does not apply if the person acts with
274	274	malice or without the reasonable belief that the action is
275	275	warranted by the facts known to the person.
276	276	(c) This section does not provide immunity to a person
277	277	described by Subsection (a) for a violation of a state or federal
278	278	law or rule relating to the privacy of health information or the
279	279	transmission of health information, including the Health Insurance
280	280	Portability and Accountability Act of 1996 (Pub. L. No. 104-191)
281	281	and rules adopted under that Act.
282	282	Sec. 34.012. DATABASE OF DE-IDENTIFIED INFORMATION. (a)
283	283	The department may establish and maintain an electronic database to
284	284	track cases of pregnancy-related deaths and severe maternal
285	285	morbidity to assist the department and task force in performing
286	286	functions under this chapter.
287	287	(b) The information in the database may not include
288	288	identifying information, including:
289	289	(1) the name of a patient; or
290	290	(2) the name or specific location of a health care
291	291	provider that treated a patient.
292	292	(c) The database may be accessed only by the department and
293	293	the task force for the purposes described in this chapter.
294	294	Sec. 34.013. INAPPLICABILITY OF CHAPTER. This chapter does
295	295	not apply to disclosure of records pertaining to voluntary or
296	296	therapeutic termination of pregnancy, and those records may not be
297	297	collected, maintained, or disclosed under this chapter.
298	298	Sec. 34.014. FUNDING. (a) The department shall apply for
299	299	and use any available federal money to fund the duties of the
300	300	department and the task force under this chapter.
301	301	(b) The department may accept gifts and grants from any
302	302	source to fund the duties of the department and the task force under
303	303	this chapter.
304	304	Sec. 34.015. REPORTS. (a) Not later than September 1 of
305	305	each even-numbered year, the task force and the department shall
306	306	submit a joint report on the findings of the task force under this
307	307	chapter to the governor, lieutenant governor, speaker of the house
308	308	of representatives, and appropriate committees of the legislature.
309	309	(b) The report must include the task force's
310	310	recommendations under Section 34.005(a)(3).
311	311	(c) The department shall disseminate the report to the state
312	312	professional associations and organizations listed in Section
313	313	34.006(b) and make the report publicly available in paper or
314	314	electronic form.
315	315	Sec. 34.016. RULES. The executive commissioner may adopt
316	316	rules to implement this chapter.
317	317	Sec. 34.017. DEPARTMENT ACCESS TO INFORMATION. (a)
318	318	Notwithstanding Chapter 108 or any other law, the department may
319	319	have access to the following information that may include the
320	320	identity of a patient to fulfill its duties under this chapter:
321	321	(1) birth records;
322	322	(2) fetal death records;
323	323	(3) maternal death records; and
324	324	(4) hospital and birthing center discharge data.
325	325	(b) The department may not disclose the information
326	326	described by Subsection (a) to the task force or any other person.
327	327	Sec. 34.018. SUNSET PROVISION. The task force is subject to
328	328	Chapter 325, Government Code (Texas Sunset Act). Unless continued
329	329	in existence as provided by that chapter, the task force is
330	330	abolished and this chapter expires September 1, 2019.
331	331	SECTION 2. (a) Not later than September 1, 2014, the
332	332	Department of State Health Services shall submit a report to the
333	333	governor, lieutenant governor, speaker of the house of
334	334	representatives, and appropriate committees of the legislature
335	335	outlining:
336	336	(1) the department's progress in establishing the
337	337	Maternal Mortality and Morbidity Task Force required by Chapter 34,
338	338	Health and Safety Code, as added by this Act; and
339	339	(2) any recommendations for legislation to assist the
340	340	department in studying pregnancy-related deaths and severe
341	341	maternal morbidity.
342	342	(b) The Department of State Health Services and the Maternal
343	343	Mortality and Morbidity Task Force created by Chapter 34, Health
344	344	and Safety Code, as added by this Act, are not required to submit
345	345	the first report required by Section 34.015, Health and Safety
346	346	Code, as added by this Act, before September 1, 2016.
347	347	(c) Not later than December 1, 2013, the commissioner of
348	348	state health services shall appoint the members of the Maternal
349	349	Mortality and Morbidity Task Force in accordance with Section
350	350	34.002(b)(1), Health and Safety Code, as added by this Act. In
351	351	making the initial appointments, the commissioner shall designate
352	352	five members to serve terms expiring February 1, 2015, four members
353	353	to serve terms expiring February 1, 2017, and four members to serve
354	354	terms expiring February 1, 2019.
355	355	SECTION 3. This Act takes effect September 1, 2013.