S.B. No. 17
AN ACT
relating to maternal health and safety, pregnancy-related deaths,
and maternal morbidity, including postpartum depression.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 34.002(b), Health and Safety Code, is
amended to read as follows:
(b) The task force is a multidisciplinary advisory
committee within the department and is composed of the following 17
[15] members:
(1) 15 [13] members appointed by the commissioner as
follows:
(A) four physicians specializing in obstetrics,
at least one of whom is a maternal fetal medicine specialist;
(B) one certified nurse-midwife;
(C) one registered nurse;
(D) one nurse specializing in labor and delivery;
(E) one physician specializing in family
practice;
(F) [(E)] one physician specializing in
psychiatry;
(G) [(F)] one physician specializing in
pathology;
(H) [(G)] one epidemiologist, biostatistician,
or researcher of pregnancy-related deaths;
(I) [(H)] one social worker or social service
provider;
(J) [(I)] one community advocate in a relevant
field; [and]
(K) [(J)] one medical examiner or coroner
responsible for recording deaths; and
(L) one physician specializing in critical care;
(2) a representative of the department's family and
community health programs; and
(3) the state epidemiologist for the department or the
epidemiologist's designee.
SECTION 2. Section 34.004, Health and Safety Code, is
amended by amending Subsection (b) and adding Subsection (c) to
read as follows:
(b) Meetings of the task force are [closed to the public and
are not] subject to Chapter 551, Government Code, except that the
task force shall conduct a closed meeting to review cases under
Section 34.007.
(c) The task force shall:
(1) allow for public comment during at least one
public meeting each year;
(2) present in open session recommendations made under
Section 34.005 to help reduce the incidence of pregnancy-related
deaths and severe maternal morbidity in this state; and
(3) post public notice for meetings conducted for the
sole purpose of reviewing cases for selection under Section 34.007.
SECTION 3. Section 34.005, Health and Safety Code, is
amended to read as follows:
Sec. 34.005. DUTIES OF TASK FORCE. The task force shall:
(1) study and review:
(A) cases of pregnancy-related deaths; [and]
(B) trends, rates, or disparities in
pregnancy-related deaths and [in] severe maternal morbidity;
(C) health conditions and factors that
disproportionately affect the most at-risk population as
determined in the joint biennial report required under Section
34.015; and
(D) best practices and programs operating in
other states that have reduced rates of pregnancy-related deaths;
(2) compare rates of pregnancy-related deaths based on
the socioeconomic status of the mother;
(3) determine the feasibility of the task force
studying cases of severe maternal morbidity; and
(4) in consultation with the Perinatal Advisory
Council, [(3)] make recommendations to help reduce the incidence of
pregnancy-related deaths and severe maternal morbidity in this
state.
SECTION 4. Chapter 34, Health and Safety Code, is amended by
adding Section 34.0055 to read as follows:
Sec. 34.0055. SCREENING AND EDUCATIONAL MATERIALS FOR
SUBSTANCE USE AND DOMESTIC VIOLENCE. (a) Using existing
resources, the commission, in consultation with the task force,
shall:
(1) make available to physicians and other persons
licensed or certified to conduct a substance use screening and
domestic violence screening of pregnant women information that
includes:
(A) guidance regarding best practices for
verbally screening a pregnant woman for substance use and verbally
screening a pregnant woman for domestic violence using a validated
screening tool; and
(B) a list of substance use treatment resources
and domestic violence prevention and intervention resources in each
geographic region of this state; and
(2) review and promote the use of educational
materials on the consequences of opioid drug use and on domestic
violence prevention and intervention during pregnancy.
(b) The commission shall make the information and
educational materials described by Subsection (a) available on the
commission's Internet website.
SECTION 5. Sections 34.007(a) and (b), Health and Safety
Code, are amended to read as follows:
(a) The department shall determine a statistically
significant number of cases of pregnancy-related deaths for review.
The department shall either randomly select cases or select all
cases for the task force to review under this subsection to reflect
a cross-section of pregnancy-related deaths in this state.
(b) The department shall statistically analyze aggregate
data of pregnancy-related deaths and severe maternal morbidity in
this state to identify any trends, rates, or disparities.
SECTION 6. Section 34.009(d), Health and Safety Code, is
amended to read as follows:
(d) Information is not confidential under this section if
the information is general information that cannot be connected
with any specific individual, case, or health care provider, such
as:
(1) total expenditures made for specified purposes;
(2) the number of families served by particular health
care providers or agencies;
(3) aggregated data on social and economic conditions;
(4) medical data and information related to health
care services that do not include any identifying information
relating to a patient or the patient's family; [and]
(5) information, including the source, value, and
purpose, related to gifts, grants, or donations to or for use by the
task force; and
(6) other statistical information.
SECTION 7. Section 34.015(b), Health and Safety Code, is
amended to read as follows:
(b) The report must include the task force's
recommendations under Section 34.005(4) [34.005(3)].
SECTION 8. Chapter 34, Health and Safety Code, is amended by
adding Sections 34.0155, 34.0156, and 34.0157 to read as follows:
Sec. 34.0155. REPORT ON PREGNANCY-RELATED DEATHS, SEVERE
MATERNAL MORBIDITY, AND POSTPARTUM DEPRESSION. The commission
shall:
(1) evaluate options for reducing pregnancy-related
deaths, focusing on the most prevalent causes of pregnancy-related
deaths as identified in the joint biennial report required under
Section 34.015, and for treating postpartum depression in
economically disadvantaged women;
(2) in coordination with the department and the task
force, identify strategies to:
(A) lower costs of providing medical assistance
under Chapter 32, Human Resources Code, related to severe maternal
morbidity and chronic illness; and
(B) improve quality outcomes related to the
underlying causes of severe maternal morbidity and chronic illness;
and
(3) not later than December 1 of each even-numbered
year, submit to the governor, the lieutenant governor, the speaker
of the house of representatives, the Legislative Budget Board, and
the appropriate standing committees of the legislature a written
report that includes:
(A) a summary of the commission's and
department's efforts to accomplish the tasks described by
Subdivisions (1) and (2); and
(B) a summary of the report required by Section
34.0156.
Sec. 34.0156. MATERNAL HEALTH AND SAFETY INITIATIVE.
(a) Using existing resources, the department, in collaboration
with the task force, shall promote and facilitate the use among
health care providers in this state of maternal health and safety
informational materials, including tools and procedures related to
best practices in maternal health and safety.
(b) Not later than December 1 of each even-numbered year,
the department shall submit a report to the executive commissioner
that includes:
(1) a summary of the initiative's implementation and
outcomes; and
(2) recommendations for improving the effectiveness
of the initiative.
Sec. 34.0157. FEASIBILITY STUDY RELATED TO MATERNAL HEALTH
AND SAFETY INITIATIVE. (a) Using existing resources and not later
than December 1, 2018, the commission shall study and determine the
feasibility of adding a provider's use of procedures included in
the maternal health and safety initiative described by Section
34.0156 as an indicator of quality for commission data and medical
assistance quality-based payment purposes.
(b) The department shall collaborate with the commission in
compiling available data and information needed to complete the
feasibility study.
(c) The commission shall include the commission's
determination from the feasibility study in the report required by
Section 34.0155.
(d) This section expires May 1, 2019.
SECTION 9. Section 34.018, Health and Safety Code, is
amended to read as follows:
Sec. 34.018. SUNSET PROVISION. The task force is subject to
Chapter 325, Government Code (Texas Sunset Act). Unless continued
in existence as provided by that chapter, the task force is
abolished and this chapter expires September 1, 2023 [2019].
SECTION 10. Subchapter D, Chapter 1001, Health and Safety
Code, is amended by adding Section 1001.0712 to read as follows:
Sec. 1001.0712. CAUSE OF DEATH DATA IMPROVEMENT. (a) Not
later than December 1 of each even-numbered year, the department
shall submit to the governor, lieutenant governor, speaker of the
house of representatives, and appropriate standing committees of
the legislature a report on the processes and procedures for
collecting cause of death information, including any challenges to
collecting accurate information relating to maternal mortality.
(b) In preparing the report, the department may examine:
(1) issues relating to the quality of the death
information being collected, including the accuracy and
completeness of the information;
(2) the role of medical certifiers in death
information collection;
(3) the perceptions of the individuals collecting the
death information regarding the information's integrity;
(4) the training required for the individuals
collecting death information; and
(5) the structural, procedural, and technological
issues of collecting the information.
(c) The department, in consultation with the Maternal
Mortality and Morbidity Task Force, shall examine national
standards regarding the collection of death information and may
convene a panel of experts to advise the department and the task
force in developing recommendations for improving the collection of
accurate information related to cause of death.
(d) The report may be included as part of another report the
department is required to submit to the legislature.
(e) This section expires September 1, 2021.
SECTION 11. Not later than June 1, 2018, the Health and
Human Services Commission shall make available the information and
educational materials described by Section 34.0055, Health and
Safety Code, as added by this Act.
SECTION 12. If before implementing any provision of this
Act a state agency determines that an additional waiver or
additional authorization from a federal agency is necessary for
implementation of that provision, the agency affected by the
provision shall request the waiver or authorization and may delay
implementing that provision until the waiver or authorization is
granted.
SECTION 13. This Act takes effect immediately if it
receives a vote of two-thirds of all the members elected to each
house, as provided by Section 39, Article III, Texas Constitution.
If this Act does not receive the vote necessary for immediate
effect, this Act takes effect on the 91st day after the last day of
the legislative session.
______________________________ ______________________________
President of the Senate Speaker of the House
I hereby certify that S.B. No. 17 passed the Senate on
July 25, 2017, by the following vote: Yeas 31, Nays 0; and that the
Senate concurred in House amendments on August 15, 2017, by the
following vote: Yeas 31, Nays 0.
______________________________
Secretary of the Senate
I hereby certify that S.B. No. 17 passed the House, with
amendments, on August 14, 2017, by the following vote: Yeas 146,
Nays 0, two present not voting.
______________________________
Chief Clerk of the House
Approved:
______________________________
Date
______________________________
Governor