Texas 2019 - 86th Regular

Texas House Bill HB2703 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	86R27217 JG-F
2		-	By: Thierry, et al. H.B. No. 2703
3		-	Substitute the following for H.B. No. 2703:
4		-	By: Thompson of Harris C.S.H.B. No. 2703
	1	+	86R13908 SCL-F
	2	+	By: Thierry H.B. No. 2703
5	3
6	4
7	5		A BILL TO BE ENTITLED
8	6		AN ACT
9		-	relating to ~~a work group on~~ the establishment of a maternal
10		-	~~mortality and morbidity~~ data registry.
	7	+	relating to the establishment of a maternal mortality and morbidity
	8	+	data registry.
11	9		BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
12	10		SECTION 1. Chapter 34, Health and Safety Code, is amended by
13	11		adding Section 34.019 to read as follows:
14		-	Sec. 34.019. DEVELOPMENT OF WORK GROUP ON ESTABLISHMENT OF
15		-	MATERNAL MORTALITY AND MORBIDITY DATA REGISTRY. (a) In this
16		-	section, "maternal mortality and morbidity data registry" means an
17		-	Internet website or database established to collect individualized
18		-	patient information and aggregate statistical reports on the health
19		-	status, health behaviors, and service delivery needs of maternal
20		-	patients.
21		-	(b) The department shall establish a work group to provide
22		-	advice and consultation services to the department on the report
23		-	and recommendations required by Subsection (e). The work group
24		-	consists of the following members appointed by the commissioner
25		-	unless otherwise provided:
26		-	(1) one member with appropriate expertise appointed by
27		-	the governor;
28		-	(2) two members with appropriate expertise appointed
29		-	by the lieutenant governor;
30		-	(3) two members with appropriate expertise appointed
31		-	by the speaker of the house of representatives;
32		-	(4) the chair of the Texas Hospital Association or the
33		-	chair's designee;
34		-	(5) the president of the Texas Medical Association or
35		-	the president's designee;
36		-	(6) the president of the Texas Nurses Association or
37		-	the president's designee;
38		-	(7) one member who is a physician specializing in
39		-	obstetrics and gynecology;
40		-	(8) one member who is a physician specializing in
41		-	maternal and fetal medicine;
42		-	(9) one member who is a registered nurse specializing
43		-	in labor and delivery;
44		-	(10) one member who is a representative of a hospital
45		-	located in a rural area of this state;
46		-	(11) one member who is a representative of a hospital
47		-	located in a county with a population of four million or more;
48		-	(12) one member who is a representative of a hospital
49		-	located in an urban area of this state in a county with a population
50		-	of less than four million;
51		-	(13) one member who is a representative of a public
52		-	hospital;
53		-	(14) one member who is a representative of a private
54		-	hospital;
55		-	(15) one member who is an epidemiologist;
56		-	(16) one member who is a statistician;
57		-	(17) one member who is a public health expert; and
58		-	(18) any other member with appropriate expertise as
59		-	the commissioner determines necessary.
60		-	(c) The work group shall elect from among the membership a
61		-	presiding officer.
62		-	(d) The work group shall meet periodically and at the call
63		-	of the presiding officer.
64		-	(e) With the goals of improving the quality of maternal care
65		-	and combating maternal mortality and morbidity and with the advice
66		-	of the work group established under this section, the department
67		-	shall assess and prepare a report and recommendations on the
68		-	establishment of a secure maternal mortality and morbidity data
69		-	registry to record information submitted by participating health
70		-	care providers on the health status of maternal patients over
71		-	varying periods, including the frequency and characteristics of
72		-	maternal mortality and morbidity during pregnancy and the
73		-	postpartum period.
74		-	(f) In developing the report and recommendations required
75		-	by Subsection (e), the department shall:
76		-	(1) consider individual maternal patient information
77		-	related to health status and health care received over varying
78		-	periods that should be submitted to the registry;
79		-	(2) review existing and developing registries used in
80		-	and outside this state that serve the same or a similar purpose as a
81		-	maternal mortality and morbidity data registry;
82		-	(3) review ongoing health data collection efforts and
83		-	initiatives in this state to avoid duplication and ensure
84		-	efficiency;
85		-	(4) review and consider existing laws that govern data
86		-	submission and sharing, including laws governing the
87		-	confidentiality and security of individually identifiable health
88		-	information; and
89		-	(5) evaluate the clinical period during which known
90		-	and available information should be submitted to a maternal
91		-	mortality and morbidity data registry by a health care provider,
92		-	including information:
93		-	(A) from a maternal patient's first appointment
94		-	with an obstetrician and each subsequent appointment until the date
95		-	of delivery;
96		-	(B) for the 42 days following a patient's
97		-	delivery; and
98		-	(C) until the 364th day following a patient's
99		-	delivery.
100		-	(g) If the department recommends the establishment of a
101		-	maternal mortality and morbidity data registry, the report under
102		-	Subsection (e) must include specific recommendations on the
103		-	relevant individual patient information and categories of
104		-	information to be submitted to the registry, including
105		-	recommendations on the intervals for submission of information.
106		-	The categories of individual patient information described by this
107		-	subsection must include:
108		-	(1) notifiable maternal deaths, including
109		-	individualized patient data on:
110		-	(A) patients who die during pregnancy; and
111		-	(B) patients who were pregnant at any point in
112		-	the 12 months preceding their death;
113		-	(2) individualized patient information on each
114		-	pregnancy and birth;
115		-	(3) individualized patient data on the most common
116		-	high-risk conditions for maternal patients and severe cases of
117		-	maternal morbidity;
118		-	(4) nonidentifying demographic data from the
119		-	provider's patient admissions records, including age, race, and
120		-	patient health benefit coverage status; and
121		-	(5) a statistical summary based on an aggregate of
122		-	individualized patient data that includes the following:
	12	+	Sec. 34.019. DATA REGISTRY. (a) In this section,
	13	+	"registry" means the data registry established under this section.
	14	+	(b) The task force, in collaboration with the commission and
	15	+	participating health care providers, shall establish a data
	16	+	registry on the task force's Internet website that contains data of
	17	+	participating health care providers on the frequency and
	18	+	characteristics of maternal mortality and morbidity during and
	19	+	following delivery.
	20	+	(c) A health care provider, including a public or private
	21	+	hospital, medical school, or clinic, may participate in the
	22	+	registry by:
	23	+	(1) collecting data at the time a pregnant woman is
	24	+	admitted for delivery, on the day of delivery, 42 days postpartum,
	25	+	and 364 days postpartum;
	26	+	(2) providing collected data to the registry on a
	27	+	daily basis; and
	28	+	(3) complying with all applicable federal and state
	29	+	laws relating to confidentiality and quality of health care
	30	+	information for data provided to the registry.
	31	+	(d) Data collected by a participating health care provider
	32	+	must include:
	33	+	(1) discharge data cross-referenced with birth and
	34	+	death certificates provided by the department;
	35	+	(2) clinical data on the health status of patients and
	36	+	the health care provided to those patients by a provider over time,
	37	+	including:
	38	+	(A) data on the most common high-risk conditions,
	39	+	such as hemorrhaging and pregnancy-induced hypertension; and
	40	+	(B) notifiable deaths, including stillbirths,
	41	+	infants born alive who die within 12 months of birth, and women who
	42	+	die during pregnancy or were pregnant in the 12 months preceding
	43	+	death;
	44	+	(3) demographic data from a provider's admission
	45	+	information;
	46	+	(4) data quality indicators to ensure the data is not
	47	+	missing or inconsistent; and
	48	+	(5) provider statistics, including:
123	49		(A) total live births;
124	50		(B) maternal age distributions;
125		-	(C) maternal race and ethnicity distributions;
	51	+	(C) maternal and infant race and ethnicity
	52	+	distributions;
126	53		(D) health benefit plan issuer distributions;
127	54		(E) incidence of diabetes, hypertension, and
128	55		hemorrhage among patients;
129	56		(F) gestational age distributions;
130	57		(G) birth weight distributions;
131	58		(H) total preterm birth rate;
132	59		(I) rate of vaginal deliveries; and
133	60		(J) rate of cesarean sections.
134		-	(h) If the department establishes a maternal mortality and
135		-	morbidity data registry, a health care provider submitting
136		-	information to the registry shall comply with all applicable
137		-	federal and state laws relating to patient confidentiality and
138		-	quality of health care information.
139		-	(i) The report and recommendations required under
140		-	Subsection (e) must outline potential uses of a maternal mortality
141		-	and morbidity data registry, including:
142		-	(1) periodic analysis by the department of information
143		-	submitted to the registry; and
144		-	(2) the feasibility of preparing and issuing reports,
145		-	using aggregated information, to each health care provider
146		-	participating in the registry to improve the quality of maternal
147		-	care.
148		-	(j) Not later than September 1, 2020, the department shall
149		-	prepare and submit to the governor, lieutenant governor, speaker of
150		-	the house of representatives, Legislative Budget Board, and each
151		-	standing committee of the legislature having primary jurisdiction
152		-	over the department and post on the department's Internet website
153		-	the report and recommendations required under Subsection (e).
154		-	(k) This section expires September 1, 2021.
155		-	SECTION 2. The executive commissioner of the Health and
156		-	Human Services Commission shall adopt rules as necessary to
157		-	implement Section 34.019, Health and Safety Code, as added by this
158		-	Act, not later than December 1, 2019.
	61	+	(e) The task force shall ensure the registry's data is
	62	+	updated at the time a participating provider enters data into the
	63	+	registry.
	64	+	(f) The task force shall annually analyze the data collected
	65	+	for the registry and prepare and submit a report on the analysis to
	66	+	the department and all participating health care providers. The
	67	+	task force shall publish the report on the task force's Internet
	68	+	website.
	69	+	(g) The task force shall fund the registry using existing
	70	+	resources and grants and donations provided for the registry.
	71	+	(h) The executive commissioner shall adopt rules necessary
	72	+	to implement this section.
	73	+	SECTION 2. (a) The executive commissioner of the Health and
	74	+	Human Services Commission shall adopt rules necessary to implement
	75	+	Section 34.019, Health and Safety Code, as added by this Act, not
	76	+	later than December 1, 2019.
	77	+	(b) The Maternal Mortality and Morbidity Task Force shall
	78	+	establish the data registry under Section 34.019, Health and Safety
	79	+	Code, as added by this Act, not later than December 1, 2019.
159	80		SECTION 3. This Act takes effect September 1, 2019.