Texas 2019 - 86th Regular

Texas Senate Bill SB750 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	S.B. No. 750
	1	+	By: Kolkhorst, et al. S.B. No. 750
	2	+	(Button)
2	3
3	4
	5	+	A BILL TO BE ENTITLED
4	6		AN ACT
5	7		relating to maternal and newborn health care and the quality of
6	8		services provided to women in this state under certain health care
7	9		programs.
8	10		BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
9	11		SECTION 1. Subchapter B, Chapter 531, Government Code, is
10	12		amended by adding Section 531.0738 to read as follows:
11	13		Sec. 531.0738. APPLICATION FOR FUNDING TO IMPLEMENT MODEL
12	14		OF CARE FOR CERTAIN MEDICAID RECIPIENTS. (a) The commission shall
13	15		apply to the Centers for Medicare and Medicaid Services to receive
14	16		any federal money available to implement a model of care that
15	17		improves the quality and accessibility of care for:
16	18		(1) pregnant women with opioid use disorder enrolled
17	19		in Medicaid during the prenatal and postpartum periods; and
18	20		(2) their children after birth.
19	21		(b) This section expires September 1, 2021.
20	22		SECTION 2. Chapter 31, Health and Safety Code, is amended by
21	23		adding Section 31.018 to read as follows:
22	24		Sec. 31.018. REFERRAL FROM HEALTHY TEXAS WOMEN PROGRAM TO
23	25		PRIMARY HEALTH CARE SERVICES PROGRAM. (a) In this section,
24	26		"Healthy Texas Women program" means a program operated by the
25	27		commission that is substantially similar to the demonstration
26	28		project operated under former Section 32.0248, Human Resources
27	29		Code, and that is intended to expand access to preventive health and
28	30		family planning services for women in this state.
29	31		(b) The executive commissioner by rule shall ensure that
30	32		women receiving services under the Healthy Texas Women program are
31	33		referred to and provided with information on the primary health
32	34		care services program.
33	35		SECTION 3. Chapter 32, Health and Safety Code, is amended by
34	36		adding Subchapters E and F to read as follows:
35	37		SUBCHAPTER E. ENHANCED PRENATAL AND POSTPARTUM CARE SERVICES
36	38		Sec. 32.101. ENHANCED PRENATAL SERVICES FOR CERTAIN WOMEN.
37	39		The commission, in collaboration with managed care organizations
38	40		that contract with the commission to provide health care services
39	41		to medical assistance recipients under Chapter 533, Government
40	42		Code, shall develop and implement cost-effective, evidence-based,
41	43		and enhanced prenatal services for high-risk pregnant women covered
42	44		under the medical assistance program.
43	45		Sec. 32.102. EVALUATION AND ENHANCEMENT OF POSTPARTUM CARE
44	46		SERVICES FOR CERTAIN WOMEN. (a) In this section, "Healthy Texas
45	47		Women program" means a program operated by the commission that is
46	48		substantially similar to the demonstration project operated under
47	49		former Section 32.0248, Human Resources Code, and that is intended
48	50		to expand access to preventive health and family planning services
49	51		for women in this state.
50	52		(b) The commission shall evaluate postpartum care services
51	53		provided to women enrolled in the Healthy Texas Women program after
52	54		the first 60 days of the postpartum period.
53	55		(c) Based on the commission's evaluation under Subsection
54	56		(b), the commission shall develop an enhanced, cost-effective, and
55	57		limited postpartum care services package for women enrolled in the
56	58		Healthy Texas Women program to be provided:
57	59		(1) after the first 60 days of the postpartum period;
58	60		and
59	61		(2) for a period of not more than 12 months after the
60	62		date of enrollment in the Healthy Texas Women program.
61	63		SUBCHAPTER F. DELIVERY AND IMPROVEMENT OF MATERNAL HEALTH CARE
62	64		SERVICES INVOLVING MANAGED CARE ORGANIZATIONS
63	65		Sec. 32.151. DEFINITIONS. In this subchapter:
64		-	(1) "High-risk population" means the population of
65		-	women most disproportionately affected by maternal morbidity and
66		-	maternal mortality, as determined in the joint biennial report
67		-	required under Section 34.015 including minority women.
68		-	(2) "Healthy Texas Women program" means a program
	66	+	(1) "Healthy Texas Women program" means a program
69	67		operated by the commission that is substantially similar to the
70	68		demonstration project operated under former Section 32.0248, Human
71	69		Resources Code, and that is intended to expand access to preventive
72	70		health and family planning services for women in this state.
73		-	(3) "Medicaid managed care organization" means a
	71	+	(2) "Medicaid managed care organization" means a
74	72		managed care organization as defined by Section 533.001, Government
75	73		Code, that contracts with the commission under Chapter 533,
76	74		Government Code, to provide health care services to medical
77	75		assistance program recipients.
78	76		Sec. 32.152. ASSESSING PROVISION OF HEALTHY TEXAS WOMEN
79	77		PROGRAM SERVICES THROUGH MANAGED CARE. (a) The commission shall
80	78		assess:
81	79		(1) the feasibility and cost-effectiveness of
82	80		contracting with Medicaid managed care organizations to provide
83	81		Healthy Texas Women program services through managed care in one or
84	82		more health care service regions in this state if the Healthy Texas
85	83		Women Section 1115 Demonstration Waiver is approved; and
86	84		(2) the potential impact of that delivery model on
87	85		women receiving services under the program.
88	86		(b) This section expires September 1, 2021.
89	87		Sec. 32.153. CONTINUITY OF CARE FOR CERTAIN WOMEN ENROLLING
90	88		IN HEALTHY TEXAS WOMEN PROGRAM. The commission shall develop and
91	89		implement strategies to ensure the continuity of care for women who
92	90		transition from the medical assistance program and enroll in the
93	91		Healthy Texas Women program. In developing and implementing
94	92		strategies under this section, the commission may collaborate with
95	93		health care providers participating in the Healthy Texas Women
96	94		program and Medicaid managed care organizations that provide health
97	95		care services to pregnant women.
98	96		Sec. 32.154. POSTPARTUM DEPRESSION TREATMENT NETWORK.
99	97		Using money from an available source designated by the commission,
100	98		the commission, in collaboration with Medicaid managed care
101	99		organizations and health care providers participating in the
102	100		Healthy Texas Women program, shall develop and implement a
103	101		postpartum depression treatment network for women enrolled in the
104	102		medical assistance or Healthy Texas Women program.
105	103		Sec. 32.155. STATEWIDE INITIATIVES TO IMPROVE QUALITY OF
106	104		MATERNAL HEALTH CARE. (a) In this section, "social determinants
107	105		of health" means the environmental conditions in which an
108	106		individual lives that affect the individual's health and quality of
109	107		life.
110	108		(b) The commission shall develop or enhance statewide
111	109		initiatives to improve the quality of maternal health care services
112	110		and outcomes for women in this state. The commission shall specify
113	111		the initiatives that each managed care organization that contracts
114	112		with the commission to provide health care services in this state
115	113		must incorporate in the organization's managed care plans. The
116	114		initiatives may address:
117	115		(1) prenatal and postpartum care rates;
118	116		(2) maternal health disparities that exist for
119	117		minority women and other high-risk populations of women in this
120	118		state;
121	119		(3) social determinants of health; or
122	120		(4) other priorities specified by the commission.
123	121		(c) A managed care organization required to incorporate the
124	122		initiatives in the organization's managed care plans under
125	123		Subsection (b) may incorporate any additional initiatives to
126	124		improve the quality of maternal health care services for women
127	125		receiving health care services through the organization.
128	126		(d) The commission shall prepare and submit to the
129	127		legislature and make available to the public an annual report that
130	128		summarizes:
131	129		(1) the commission's progress in developing or
132	130		enhancing initiatives under this section; and
133	131		(2) each managed care organization's progress in
134	132		incorporating the required initiatives in the organization's
135	133		managed care plans.
136	134		(e) The commission may submit the report required under
137	135		Subsection (d) with the report required under Section 536.008,
138	136		Government Code.
139	137		SECTION 4. The heading to Chapter 34, Health and Safety
140	138		Code, is amended to read as follows:
141	139		CHAPTER 34. TEXAS MATERNAL MORTALITY AND MORBIDITY REVIEW
142	140		COMMITTEE [TASK FORCE]
143	141		SECTION 5. Section 34.001, Health and Safety Code, is
144	142		amended by adding Subdivision (12-a) to read as follows:
145	143		(12-a) "Review committee" means the Texas Maternal
146	144		Mortality and Morbidity Review Committee.
147	145		SECTION 6. Sections 34.002, 34.003, 34.004, and 34.005,
148	146		Health and Safety Code, are amended to read as follows:
149	147		Sec. 34.002. TEXAS MATERNAL MORTALITY AND MORBIDITY REVIEW
150	148		COMMITTEE [TASK FORCE]. (a) The Texas Maternal Mortality and
151	149		Morbidity Review Committee [Task Force] is administered by the
152	150		department.
153	151		(b) The review committee [task force] is a
154	152		multidisciplinary advisory committee within the department and is
155	153		composed of the following 17 members:
156	154		(1) 15 members appointed by the commissioner as
157	155		follows:
158	156		(A) four physicians specializing in obstetrics,
159	157		at least one of whom is a maternal fetal medicine specialist;
160	158		(B) one certified nurse-midwife;
161	159		(C) one registered nurse;
162	160		(D) one nurse specializing in labor and delivery;
163	161		(E) one physician specializing in family
164	162		practice;
165	163		(F) one physician specializing in psychiatry;
166	164		(G) one physician specializing in pathology;
167	165		(H) one epidemiologist, biostatistician, or
168	166		researcher of pregnancy-related deaths;
169	167		(I) one social worker or social service provider;
170	168		(J) one community advocate in a relevant field;
171	169		(K) one medical examiner or coroner responsible
172	170		for recording deaths; and
173	171		(L) one physician specializing in critical care;
174	172		(2) a representative of the department's family and
175	173		community health programs; and
176	174		(3) the state epidemiologist for the department or the
177	175		epidemiologist's designee.
178	176		(c) In appointing members to the review committee [task
179	177		force], the commissioner shall:
180	178		(1) include members:
181	179		(A) working in and representing communities that
182	180		are diverse with regard to race, ethnicity, immigration status, and
183	181		English proficiency; and
184	182		(B) from differing geographic regions in the
185	183		state, including both rural and urban areas;
186	184		(2) endeavor to include members who are working in and
187	185		representing communities that are affected by pregnancy-related
188	186		deaths and severe maternal morbidity and by a lack of access to
189	187		relevant perinatal and intrapartum care services; and
190	188		(3) ensure that the composition of the review
191	189		committee [task force] reflects the racial, ethnic, and linguistic
192	190		diversity of this state.
193	191		(d) The commissioner shall appoint from among the review
194	192		committee [task force] members a presiding officer.
195	193		(e) A member of the review committee [task force] appointed
196	194		under Subsection (b)(1) is not entitled to compensation for service
197	195		on the review committee [task force] or reimbursement for travel or
198	196		other expenses incurred by the member while conducting the business
199	197		of the review committee [task force].
200	198		(f) In carrying out its duties, the review committee [task
201	199		force] may use technology, including teleconferencing or
202	200		videoconferencing, to eliminate travel expenses.
203	201		Sec. 34.003. TERMS; VACANCY. (a) Review committee [Task
204	202		force] members appointed by the commissioner serve staggered
205	203		six-year terms, with the terms of four or five members, as
206	204		appropriate, expiring February 1 of each odd-numbered year.
207	205		(b) A review committee [task force] member may serve more
208	206		than one term.
209	207		(c) A vacancy on the review committee [task force] shall be
210	208		filled for the unexpired term in the same manner as the original
211	209		appointment.
212	210		Sec. 34.004. MEETINGS. (a) The review committee [task
213	211		force] shall meet at least quarterly. The review committee [task
214	212		force] may meet at other times at the call of the commissioner.
215	213		(b) Meetings of the review committee [task force] are
216	214		subject to Chapter 551, Government Code, except that the review
217	215		committee [task force] shall conduct a closed meeting to review
218	216		cases under Section 34.007.
219	217		(c) The review committee [task force] shall:
220	218		(1) allow for public comment during at least one
221	219		public meeting each year;
222	220		(2) present in open session recommendations made under
223	221		Section 34.005 to help reduce the incidence of pregnancy-related
224	222		deaths and severe maternal morbidity in this state; and
225	223		(3) post public notice for meetings conducted for the
226	224		sole purpose of reviewing cases for selection under Section 34.007.
227	225		Sec. 34.005. DUTIES OF REVIEW COMMITTEE [TASK FORCE]. The
228	226		review committee [task force] shall:
229	227		(1) study and review:
230	228		(A) cases of pregnancy-related deaths;
231	229		(B) trends, rates, or disparities in
232	230		pregnancy-related deaths and severe maternal morbidity;
233	231		(C) health conditions and factors that
234	232		disproportionately affect the most at-risk population as
235	233		determined in the joint biennial report required under Section
236	234		34.015; and
237	235		(D) best practices and programs operating in
238	236		other states that have reduced rates of pregnancy-related deaths;
239	237		(2) compare rates of pregnancy-related deaths based on
240	238		the socioeconomic status of the mother;
241	239		(3) determine the feasibility of the review committee
242	240		[task force] studying cases of severe maternal morbidity; and
243	241		(4) in consultation with the Perinatal Advisory
244	242		Council, make recommendations to help reduce the incidence of
245	243		pregnancy-related deaths and severe maternal morbidity in this
246	244		state.
247	245		SECTION 7. Section 34.0055(a), Health and Safety Code, is
248	246		amended to read as follows:
249	247		(a) Using existing resources, the commission, in
250	248		consultation with the review committee [task force], shall:
251	249		(1) make available to physicians and other persons
252	250		licensed or certified to conduct a substance use screening and
253	251		domestic violence screening of pregnant women information that
254	252		includes:
255	253		(A) guidance regarding best practices for
256	254		verbally screening a pregnant woman for substance use and verbally
257	255		screening a pregnant woman for domestic violence using a validated
258	256		screening tool; and
259	257		(B) a list of substance use treatment resources
260	258		and domestic violence prevention and intervention resources in each
261	259		geographic region of this state; and
262	260		(2) review and promote the use of educational
263	261		materials on the consequences of opioid drug use and on domestic
264	262		violence prevention and intervention during pregnancy.
265	263		SECTION 8. Section 34.006, Health and Safety Code, is
266	264		amended to read as follows:
267	265		Sec. 34.006. CONSULTATIONS AND AGREEMENTS WITH OUTSIDE
268	266		PARTIES. (a) The department and review committee [task force] may
269	267		consult with any relevant experts and stakeholders, including:
270	268		(1) anesthesiologists;
271	269		(2) intensivists or critical care physicians;
272	270		(3) nutritionists;
273	271		(4) substance abuse treatment specialists;
274	272		(5) hospital staff or employees;
275	273		(6) representatives of the state Medicaid program;
276	274		(7) paramedics or other emergency medical response
277	275		personnel;
278	276		(8) hospital-based risk management specialists;
279	277		(9) representatives of local health departments and
280	278		public health districts in this state;
281	279		(10) public health experts;
282	280		(11) government representatives or officials; and
283	281		(12) law enforcement officials.
284	282		(b) In gathering information, the department and review
285	283		committee [task force] may consult with representatives of any
286	284		relevant state professional associations and organizations,
287	285		including:
288	286		(1) District XI of the American Congress of
289	287		Obstetricians and Gynecologists;
290	288		(2) the Texas Association of Obstetricians and
291	289		Gynecologists;
292	290		(3) the Texas Nurses Association;
293	291		(4) the Texas Section of the Association of Women's
294	292		Health, Obstetric and Neonatal Nurses;
295	293		(5) the Texas Academy of Family Physicians;
296	294		(6) the Texas Pediatric Society;
297	295		(7) the Consortium of Texas Certified Nurse-Midwives;
298	296		(8) the Association of Texas Midwives;
299	297		(9) the Texas Hospital Association;
300	298		(10) the Texas Medical Association; and
301	299		(11) the Texas Public Health Association.
302	300		(c) In consulting with individuals or organizations under
303	301		Subsection (a) or (b), a member of the review committee [task force]
304	302		or employee of the department may not disclose any identifying
305	303		information of a patient or health care provider.
306	304		(d) The department on behalf of the review committee [task
307	305		force] may enter into agreements with institutions of higher
308	306		education or other organizations consistent with the duties of the
309	307		department or review committee [task force] under this chapter.
310	308		SECTION 9. Sections 34.007(a) and (c), Health and Safety
311	309		Code, are amended to read as follows:
312	310		(a) The department shall determine a statistically
313	311		significant number of cases of pregnancy-related deaths for review.
314	312		The department shall either randomly select cases or select all
315	313		cases for the review committee [task force] to review under this
316	314		subsection to reflect a cross-section of pregnancy-related deaths
317	315		in this state.
318	316		(c) If feasible, the department may select cases of severe
319	317		maternal morbidity for review. In selecting cases under this
320	318		subsection, the department shall randomly select cases for the
321	319		review committee [task force] to review to reflect trends
322	320		identified under Subsection (b).
323		-	SECTION 10. Section 34.008, Health and Safety Code, is
324		-	amended by amending Subsections (a) and (b) and adding Subsection
325		-	(c-1) to read as follows:
	321	+	SECTION 10. Sections 34.008(a) and (b), Health and Safety
	322	+	Code, are amended to read as follows:
326	323		(a) On selecting a case of pregnancy-related death or severe
327	324		maternal morbidity for review, the department shall, in accordance
328	325		with this section, obtain information relevant to the case to
329	326		enable the review committee [task force] to review the case. The
330	327		department shall provide the information to the review committee
331	328		[task force].
332	329		(b) The information provided to the review committee [task
333	330		force] may not include identifying information of a patient or
334	331		health care provider, including:
335	332		(1) the name, address, or date of birth of the patient
336	333		or a member of the patient's family; or
337	334		(2) the name or specific location of a health care
338	335		provider that treated the patient.
339		-	(c-1) Not later than the 30th business day after receiving a
340		-	request from the department for records regarding a
341		-	pregnancy-related death for a specific patient, a hospital,
342		-	birthing center, or other custodian of the records shall submit the
343		-	records to the department. A request made under this subsection to
344		-	a hospital or birthing center must be limited to a patient's medical
345		-	records.
346	336		SECTION 11. Section 34.009, Health and Safety Code, is
347	337		amended by amending Subsections (b), (c), (d), (e), and (h) and
348	338		adding Subsection (b-1) to read as follows:
349	339		(b) Except as provided by Subsection (b-1), confidential
350	340		[Confidential] information that is acquired by the department and
351	341		that includes identifying information of an individual or health
352	342		care provider is privileged and may not be disclosed to any person.
353	343		Information that may not be disclosed under this subsection
354	344		includes:
355	345		(1) the name and address of a patient or a member of
356	346		the patient's family;
357	347		(2) any service received by the patient or a member of
358	348		the patient's family;
359	349		(3) the social and economic condition of the patient
360	350		or a member of the patient's family;
361	351		(4) medical, dental, and mental health care
362	352		information related to the patient or a member of the patient's
363	353		family, including diagnoses, conditions, diseases, or disability;
364	354		and
365	355		(5) the identity of a health care provider that
366	356		provided any services to the patient or a member of the patient's
367	357		family.
368	358		(b-1) Confidential information that is acquired by the
369	359		department under this section that includes identifying
370	360		information of an individual or health care provider may be
371	361		securely disclosed to an appropriate federal agency for the limited
372	362		purpose of complying with applicable requirements under the federal
373	363		Preventing Maternal Deaths Act of 2018 (Pub. L. No. 115-344).
374	364		(c) Review committee [Task force] work product or
375	365		information obtained by the department under this chapter,
376	366		including information contained in an electronic database
377	367		established and maintained under Section 34.012, or any other
378	368		document or record, is confidential. This subsection does not
379	369		prevent the review committee [task force] or department from
380	370		releasing information described by Subsection (d) or (e) or from
381	371		submitting the report required by Section 34.015.
382	372		(d) Information is not confidential under this section if
383	373		the information is general information that cannot be connected
384	374		with any specific individual, case, or health care provider, such
385	375		as:
386	376		(1) total expenditures made for specified purposes;
387	377		(2) the number of families served by particular health
388	378		care providers or agencies;
389	379		(3) aggregated data on social and economic conditions;
390	380		(4) medical data and information related to health
391	381		care services that do not include any identifying information
392	382		relating to a patient or the patient's family;
393	383		(5) information, including the source, value, and
394	384		purpose, related to gifts, grants, or donations to or for use by the
395	385		review committee [task force]; and
396	386		(6) other statistical information.
397	387		(e) The review committee [task force] may publish
398	388		statistical studies and research reports based on information that
399	389		is confidential under this section, provided that the information:
400	390		(1) is published in the aggregate;
401	391		(2) does not identify a patient or the patient's
402	392		family;
403	393		(3) does not include any information that could be
404	394		used to identify a patient or the patient's family; and
405	395		(4) does not identify a health care provider.
406	396		(h) The review committee [task force] and the department
407	397		shall comply with all state and federal laws and rules relating to
408	398		the transmission of health information, including the Health
409	399		Insurance Portability and Accountability Act of 1996 (Pub. L.
410	400		No. 104-191) and rules adopted under that Act.
411	401		SECTION 12. Section 34.010, Health and Safety Code, is
412	402		amended to read as follows:
413	403		Sec. 34.010. SUBPOENA AND DISCOVERY. Review committee
414	404		[Task force] work product or information that is confidential under
415	405		Section 34.009 is privileged, is not subject to subpoena or
416	406		discovery, and may not be introduced into evidence in any
417	407		administrative, civil, or criminal proceeding against a patient, a
418	408		member of the family of a patient, or a health care provider.
419	409		SECTION 13. Section 34.011(a), Health and Safety Code, is
420	410		amended to read as follows:
421	411		(a) A member of the review committee [task force] or a
422	412		person employed by or acting in an advisory capacity to the review
423	413		committee [task force] and who provides information, counsel, or
424	414		services to the review committee [task force] is not liable for
425	415		damages for an action taken within the scope of the functions of the
426	416		review committee [task force].
427	417		SECTION 14. Sections 34.012(a) and (c), Health and Safety
428	418		Code, are amended to read as follows:
429	419		(a) The department may establish and maintain an electronic
430	420		database to track cases of pregnancy-related deaths and severe
431	421		maternal morbidity to assist the department and review committee
432	422		[task force] in performing functions under this chapter.
433	423		(c) The database may be accessed only by the department and
434	424		the review committee [task force] for the purposes described in
435	425		this chapter.
436	426		SECTION 15. Section 34.014, Health and Safety Code, is
437	427		amended to read as follows:
438	428		Sec. 34.014. FUNDING. The department may accept gifts and
439	429		grants from any source to fund the duties of the department and the
440	430		review committee [task force] under this chapter.
441	431		SECTION 16. Sections 34.015(a) and (b), Health and Safety
442	432		Code, are amended to read as follows:
443	433		(a) Not later than September 1 of each even-numbered year,
444	434		the review committee [task force] and the department shall submit a
445	435		joint report on the findings of the review committee [task force]
446	436		under this chapter to the governor, lieutenant governor, speaker of
447	437		the house of representatives, and appropriate committees of the
448	438		legislature.
449	439		(b) The report must include the review committee's [task
450	440		force's] recommendations under Section 34.005(4).
451	441		SECTION 17. Section 34.0155, Health and Safety Code, is
452	442		amended to read as follows:
453	443		Sec. 34.0155. REPORT ON PREGNANCY-RELATED DEATHS, SEVERE
454	444		MATERNAL MORBIDITY, AND POSTPARTUM DEPRESSION. The commission
455	445		shall:
456	446		(1) evaluate options for reducing pregnancy-related
457	447		deaths, focusing on the most prevalent causes of pregnancy-related
458	448		deaths as identified in the joint biennial report required under
459	449		Section 34.015, and for treating postpartum depression in
460	450		economically disadvantaged women;
461	451		(2) in coordination with the department and the review
462	452		committee [task force], identify strategies to:
463	453		(A) lower costs of providing medical assistance
464	454		under Chapter 32, Human Resources Code, related to severe maternal
465	455		morbidity and chronic illness; and
466	456		(B) improve quality outcomes related to the
467	457		underlying causes of severe maternal morbidity and chronic illness;
468	458		and
469	459		(3) not later than December 1 of each even-numbered
470	460		year, submit to the governor, the lieutenant governor, the speaker
471	461		of the house of representatives, the Legislative Budget Board, and
472	462		the appropriate standing committees of the legislature a written
473	463		report that includes:
474	464		(A) a summary of the commission's and
475	465		department's efforts to accomplish the tasks described by
476	466		Subdivisions (1) and (2); and
477	467		(B) a summary of the report required by Section
478	468		34.0156.
479	469		SECTION 18. Section 34.0156(a), Health and Safety Code, is
480	470		amended to read as follows:
481	471		(a) Using existing resources, the department, in
482	472		collaboration with the review committee [task force], shall promote
483	473		and facilitate the use among health care providers in this state of
484	474		maternal health and safety informational materials, including
485	475		tools and procedures related to best practices in maternal health
486	476		and safety.
487	477		SECTION 19. Section 34.017(b), Health and Safety Code, is
488	478		amended to read as follows:
489	479		(b) The department may not disclose the information
490	480		described by Subsection (a) to the review committee [task force] or
491	481		any other person.
492	482		SECTION 20. Section 34.018, Health and Safety Code, is
493	483		amended to read as follows:
494	484		Sec. 34.018. SUNSET PROVISION. (a) The review committee
495	485		[task force] is subject to Chapter 325, Government Code (Texas
496	486		Sunset Act). Unless continued in existence as provided by that
497	487		chapter, the review committee [task force] is abolished and this
498	488		chapter expires September 1, 2027 [2023].
499	489		(b) The Sunset Advisory Commission shall review the review
500	490		committee during the two-year period preceding the date the
501	491		department is scheduled for abolition under Section 1001.003, but
502	492		the review committee is continued in existence until the date
503	493		provided by Subsection (a). This subsection expires September 1,
504	494		2025.
505	495		SECTION 21. Section 1001.0712(c), Health and Safety Code,
506	496		is amended to read as follows:
507	497		(c) The department, in consultation with the Texas Maternal
508	498		Mortality and Morbidity Review Committee [Task Force], shall
509	499		examine national standards regarding the collection of death
510	500		information and may convene a panel of experts to advise the
511	501		department and the review committee [task force] in developing
512	502		recommendations for improving the collection of accurate
513	503		information related to cause of death.
514	504		SECTION 22. Section 34.001(14), Health and Safety Code, is
515	505		repealed.
516	506		SECTION 23. (a) In this section, "Healthy Texas Women
517	507		program" means a program operated by the Health and Human Services
518	508		Commission that is substantially similar to the demonstration
519	509		project operated under former Section 32.0248, Human Resources
520	510		Code, and that is intended to expand access to preventive health and
521	511		family planning services for women in this state.
522	512		(b) If the Centers for Medicare and Medicaid Services
523	513		approves the waiver submitted by the executive commissioner of the
524	514		Health and Human Services Commission under Section 1115 of the
525	515		federal Social Security Act (42 U.S.C. Section 1315) for the
526	516		Healthy Texas Women Section 1115 Demonstration Waiver, the
527	517		executive commissioner shall, as soon as practicable after the
528	518		waiver is granted, seek an amendment to the waiver to provide
529	519		enhanced services under the Healthy Texas Women program.
530	520		SECTION 24. As soon as practicable after the effective date
531	521		of this Act:
532	522		(1) the executive commissioner of the Health and Human
533	523		Services Commission shall adopt rules as necessary to implement the
534	524		changes in law made by this Act; and
535	525		(2) the Health and Human Services Commission shall
536	526		apply for any federal money available to implement the model of care
537	527		described by Section 531.0738, Government Code, as added by this
538	528		Act.
539	529		SECTION 25. On the effective date of this Act:
540	530		(1) the Maternal Mortality and Morbidity Task Force is
541	531		renamed the Texas Maternal Mortality and Morbidity Review
542	532		Committee; and
543	533		(2) a reference in law to the task force means the
544	534		review committee.
545	535		SECTION 26. If before implementing any provision of this
546	536		Act a state agency determines that a waiver or authorization from a
547	537		federal agency is necessary for implementation of that provision,
548	538		the agency affected by the provision shall request the waiver or
549	539		authorization and may delay implementing that provision until the
550	540		waiver or authorization is granted.
551	541		SECTION 27. The Health and Human Services Commission is
552	542		required to implement a provision of this Act only if the
553	543		legislature appropriates money specifically for that purpose. If
554	544		the legislature does not appropriate money specifically for that
555	545		purpose, the commission may, but is not required to, implement a
556	546		provision of this Act using other appropriations available for that
557	547		purpose.
558	548		SECTION 28. This Act takes effect immediately if it
559	549		receives a vote of two-thirds of all the members elected to each
560	550		house, as provided by Section 39, Article III, Texas Constitution.
561	551		If this Act does not receive the vote necessary for immediate
562	552		effect, this Act takes effect September 1, 2019.
563		-	______________________________ ______________________________
564		-	President of the Senate Speaker of the House
565		-	I hereby certify that S.B. No. 750 passed the Senate on
566		-	April 16, 2019, by the following vote: Yeas 31, Nays 0; and that
567		-	the Senate concurred in House amendments on May 23, 2019, by the
568		-	following vote: Yeas 31, Nays 0.
569		-	______________________________
570		-	Secretary of the Senate
571		-	I hereby certify that S.B. No. 750 passed the House, with
572		-	amendments, on May 21, 2019, by the following vote: Yeas 144,
573		-	Nays 2, one present not voting.
574		-	______________________________
575		-	Chief Clerk of the House
576		-	Approved:
577		-	______________________________
578		-	Date
579		-	______________________________
580		-	Governor
	553	+	COMMITTEE AMENDMENT NO. 1
	554	+	Amend S.B. No. 750
	555	+	by adding the following appropriately
	556	+	numbered SECTIONS to the bill and renumbering subsequent SECTIONS
	557	+	of the bill accordingly:
	558	+	SECTION ____. Chapter 1061, Special District Local Laws
	559	+	Code, is amended by adding Subchapter G to read as follows:
	560	+	SUBCHAPTER G. SALES AND USE TAX
	561	+	Sec. 1061.301. TAX AUTHORIZED. (a) The district may adopt,
	562	+	change the rate of, or abolish a sales and use tax at an election
	563	+	held in the district.
	564	+	(b) The district may not adopt a tax under this subchapter
	565	+	or increase the rate of the tax if as a result of the adoption of the
	566	+	tax or the tax increase the combined rate of all sales and use taxes
	567	+	imposed by the district and all other political subdivisions of
	568	+	this state having territory in the district would exceed two
	569	+	percent in any location in the district.
	570	+	Sec. 1061.302. APPLICABILITY OF OTHER LAW. Except to the
	571	+	extent that a provision of this subchapter applies, Chapter 323,
	572	+	Tax Code, applies to a tax authorized by this subchapter in the same
	573	+	manner as that chapter applies to the tax authorized by that
	574	+	chapter.
	575	+	Sec. 1061.303. TAX RATE; CHANGE IN RATE. (a) The district
	576	+	may impose a tax authorized by this subchapter in increments of
	577	+	one-eighth of one percent, with a minimum rate of one-eighth of one
	578	+	percent and a maximum rate of two percent.
	579	+	(b) The district may increase the rate of a tax authorized
	580	+	by this subchapter to a maximum of two percent or decrease the rate
	581	+	of the tax to a minimum of one-eighth of one percent if the change is
	582	+	approved by a majority of the voters of the district at an election
	583	+	called for that purpose.
	584	+	Sec. 1061.304. ELECTION PROCEDURE. An election to adopt,
	585	+	change the rate of, or abolish a tax authorized by this subchapter
	586	+	is called by the adoption of an order of the board. The board may
	587	+	call an election on its own motion and shall call an election if a
	588	+	number of qualified voters in the district equal to at least five
	589	+	percent of the number of registered voters in the district
	590	+	petitions the board to call the election.
	591	+	Sec. 1061.305. ELECTION IN OTHER TAXING AUTHORITY. (a) In
	592	+	this section, "taxing authority" means any entity authorized to
	593	+	impose a local sales and use tax.
	594	+	(b) If the district is included within the boundaries of
	595	+	another taxing authority and the adoption or increase in the rate of
	596	+	a tax under this subchapter would result in a combined tax rate by
	597	+	the district and other political subdivisions of this state of more
	598	+	than two percent at any location in the district, an election to
	599	+	approve or increase the rate of the tax has no effect unless:
	600	+	(1) one or more of the other taxing authorities holds
	601	+	an election in accordance with the law governing that authority on
	602	+	the same date as the election under this subchapter to reduce the
	603	+	tax rate of that authority to a rate that will result in a combined
	604	+	tax rate by the district and other political subdivisions of not
	605	+	more than two percent at any location in the district; and
	606	+	(2) the combined tax rate is reduced to not more than
	607	+	two percent as a result of that election.
	608	+	(c) This section does not permit a taxing authority to
	609	+	impose taxes at differential tax rates within the territory of the
	610	+	authority.
	611	+	Sec. 1061.306. TAX EFFECTIVE DATE. (a) The adoption,
	612	+	change in the rate of, or abolition of a tax under this subchapter
	613	+	takes effect on the first day of the first calendar quarter
	614	+	occurring after the expiration of the first complete calendar
	615	+	quarter occurring after the date on which the comptroller receives
	616	+	notice of the results of an election to adopt, change the rate of,
	617	+	or abolish the tax.
	618	+	(b) If the comptroller determines that an effective date
	619	+	provided by Subsection (a) will occur before the comptroller can
	620	+	reasonably take the action required to begin collecting the tax or
	621	+	to implement the change in the rate of the tax or the abolition of
	622	+	the tax, the effective date may be extended by the comptroller until
	623	+	the first day of the next calendar quarter.
	624	+	Sec. 1061.307. USE OF TAX REVENUE. Revenue from a tax
	625	+	imposed under this subchapter may be used by the district for any
	626	+	purpose of the district authorized by law.
	627	+	SECTION ____. Section 1061.151(b), Special District Local
	628	+	Laws Code, is amended to read as follows:
	629	+	(b) The proposed budget must contain a complete financial
	630	+	statement of:
	631	+	(1) the outstanding obligations of the district;
	632	+	(2) the cash on hand in each district fund;
	633	+	(3) the money received by the district from all
	634	+	sources during the previous year;
	635	+	(4) the money available to the district from all
	636	+	sources during the ensuing year;
	637	+	(5) the balances expected at the end of the year in
	638	+	which the budget is being prepared;
	639	+	(6) the estimated revenue and balances available to
	640	+	cover the proposed budget;
	641	+	(7) the estimated ad valorem tax rate required; and
	642	+	(8) the proposed expenditures and disbursements and
	643	+	the estimated receipts and collections for the following fiscal
	644	+	year.
	645	+	SECTION ____. The heading to Subchapter F, Chapter 1061,
	646	+	Special District Local Laws Code, is amended to read as follows:
	647	+	SUBCHAPTER F. AD VALOREM TAXES
	648	+	SECTION ____. Section 26.012(1), Tax Code, is amended to
	649	+	read as follows:
	650	+	(1) "Additional sales and use tax" means an additional
	651	+	sales and use tax imposed by:
	652	+	(A) a city under Section 321.101(b);
	653	+	(B) a county under Chapter 323; or
	654	+	(C) a hospital district, other than a hospital
	655	+	district:
	656	+	(i) created on or after September 1, 2001,
	657	+	that:
	658	+	(a) [(i)] imposes the sales and use
	659	+	tax under Subchapter I, Chapter 286, Health and Safety Code; or
	660	+	(b) [(ii)] imposes the sales and use
	661	+	tax under Subchapter L, Chapter 285, Health and Safety Code; or
	662	+	(ii) that imposes the sales and use tax
	663	+	under Subchapter G, Chapter 1061, Special District Local Laws Code.
	664	+	Price