Texas 2021 - 87th Regular

Texas House Bill HB136 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1	1		87R1647 EAS-F
2		-	By: Thierry~~, Oliverson~~ H.B. No. 136
	2	+	By: Thierry H.B. No. 136
3	3
4	4
5	5		A BILL TO BE ENTITLED
6	6		AN ACT
7	7		relating to the confidentiality and reporting of certain
8	8		information on maternal mortality to the Department of State Health
9	9		Services and to a work group establishing a maternal mortality and
10	10		morbidity data registry.
11	11		BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
12	12		SECTION 1. Section 34.001, Health and Safety Code, is
13	13		amended by adding Subdivision (11-a) and amending Subdivision (12)
14	14		to read as follows:
15	15		(11-a) "Pregnancy-associated death" means the death
16	16		of a woman from any cause that occurs during or within one year of
17	17		delivery or end of pregnancy, regardless of the outcome or location
18	18		of the pregnancy.
19	19		(12) "Pregnancy-related death" means the death of a
20	20		woman while pregnant or within one year of delivery or end of
21	21		pregnancy, regardless of the outcome, duration, or location [and
22	22		site] of the pregnancy, from any cause related to or aggravated by
23	23		the pregnancy or its management, but not from accidental or
24	24		incidental causes.
25	25		SECTION 2. The heading to Section 34.002, Health and Safety
26	26		Code, is amended to read as follows:
27	27		Sec. 34.002. TEXAS MATERNAL MORTALITY AND MORBIDITY REVIEW
28	28		COMMITTEE; REFERENCE IN LAW.
29	29		SECTION 3. Section 34.002, Health and Safety Code, is
30	30		amended by adding Subsection (a-1) and amending Subsection (e) to
31	31		read as follows:
32	32		(a-1) Notwithstanding any other law, a reference in this
33	33		chapter or other law to the Maternal Mortality and Morbidity Task
34	34		Force means the Texas Maternal Mortality and Morbidity Review
35	35		Committee.
36	36		(e) A member of the review committee appointed under
37	37		Subsection (b)(1) is not entitled to compensation for service on
38	38		the review committee but, subject to Section 34.014(b), may be
39	39		reimbursed [or reimbursement] for travel or other expenses incurred
40	40		by the member while conducting the business of the review
41	41		committee.
42	42		SECTION 4. Section 34.008, Health and Safety Code, is
43	43		amended by adding Subsection (e) to read as follows:
44	44		(e) For purposes of this chapter, a licensed health care
45	45		provider, including a nurse, who is involved in obtaining
46	46		information relevant to a case of pregnancy-associated death,
47	47		pregnancy-related death, or severe maternal morbidity under this
48	48		chapter and who is required under other law to report a violation
49	49		related to the provider's profession is exempt from the requirement
50	50		to report the violation for information obtained under this
51	51		chapter.
52	52		SECTION 5. Section 34.009(a), Health and Safety Code, is
53	53		amended to read as follows:
54	54		(a) Any information pertaining to a pregnancy-associated
55	55		death, a pregnancy-related death, or severe maternal morbidity is
56	56		confidential for purposes of this chapter.
57	57		SECTION 6. Section 34.014, Health and Safety Code, is
58	58		amended to read as follows:
59	59		Sec. 34.014. FUNDING. (a) The department may accept gifts
60	60		and grants from any source to fund the duties of the department and
61	61		the review committee under this chapter.
62	62		(b) The department may use only gifts, grants, or federal
63	63		funds to reimburse travel or other expenses incurred by a member of
64	64		the review committee in accordance with Section 34.002(e).
65	65		SECTION 7. Section 34.017, Health and Safety Code, is
66	66		amended by adding Subsections (c), (d), and (e) to read as follows:
67	67		(c) The department may allow voluntary and confidential
68	68		reporting to the department of pregnancy-associated deaths and
69	69		pregnancy-related deaths by health care professionals, health care
70	70		facilities, and persons who complete the medical certification for
71	71		a death certificate for deaths reviewed or analyzed by the review
72	72		committee.
73	73		(d) The department shall allow voluntary and confidential
74	74		reporting to the department of pregnancy-associated deaths and
75	75		pregnancy-related deaths by family members of or other appropriate
76	76		individuals associated with a deceased patient. The department
77	77		shall:
78	78		(1) post on the department's Internet website the
79	79		contact information of the person to whom a report may be submitted
80	80		under this subsection; and
81	81		(2) conduct outreach to local health organizations on
82	82		the availability of the review committee to review and analyze the
83	83		deaths described by this subsection.
84	84		(e) Information reported to the department under this
85	85		section is confidential in accordance with Section 34.009.
86	86		SECTION 8. Chapter 34, Health and Safety Code, is amended by
87	87		adding Section 34.022 to read as follows:
88	88		Sec. 34.022. DEVELOPMENT OF WORK GROUP ON ESTABLISHMENT OF
89	89		MATERNAL MORTALITY AND MORBIDITY DATA REGISTRY. (a) In this
90	90		section, "maternal mortality and morbidity data registry" means an
91	91		Internet website or database established to collect individualized
92	92		patient information and aggregate statistical reports on the health
93	93		status, health behaviors, and service delivery needs of maternal
94	94		patients.
95	95		(b) The department shall establish a work group to provide
96	96		advice and consultation services to the department on the report
97	97		and recommendations required by Subsection (e). The work group
98	98		consists of the following members appointed by the commissioner
99	99		unless otherwise provided:
100	100		(1) one member with appropriate expertise appointed by
101	101		the governor;
102	102		(2) two members with appropriate expertise appointed
103	103		by the lieutenant governor;
104	104		(3) two members with appropriate expertise appointed
105	105		by the speaker of the house of representatives;
106	106		(4) the chair of the Texas Hospital Association or the
107	107		chair's designee;
108	108		(5) the president of the Texas Medical Association or
109	109		the president's designee;
110	110		(6) the president of the Texas Nurses Association or
111	111		the president's designee;
112	112		(7) one member who is a physician specializing in
113	113		obstetrics and gynecology;
114	114		(8) one member who is a physician specializing in
115	115		maternal and fetal medicine;
116	116		(9) one member who is a registered nurse specializing
117	117		in labor and delivery;
118	118		(10) one member who is a representative of a hospital
119	119		located in a rural area of this state;
120	120		(11) one member who is a representative of a hospital
121	121		located in a county with a population of four million or more;
122	122		(12) one member who is a representative of a hospital
123	123		located in an urban area of this state in a county with a population
124	124		of less than four million;
125	125		(13) one member who is a representative of a public
126	126		hospital;
127	127		(14) one member who is a representative of a private
128	128		hospital;
129	129		(15) one member who is an epidemiologist;
130	130		(16) one member who is a statistician;
131	131		(17) one member who is a public health expert; and
132	132		(18) any other member with appropriate expertise as
133	133		the commissioner determines necessary.
134	134		(c) The work group shall elect from among the membership a
135	135		presiding officer.
136	136		(d) The work group shall meet periodically and at the call
137	137		of the presiding officer.
138	138		(e) With the goals of improving the quality of maternal care
139	139		and combating maternal mortality and morbidity and with the advice
140	140		of the work group established under this section, the department
141	141		shall assess and prepare a report and recommendations on the
142	142		establishment of a secure maternal mortality and morbidity data
143	143		registry to record information submitted by participating health
144	144		care providers on the health status of maternal patients over
145	145		varying periods, including the frequency and characteristics of
146	146		maternal mortality and morbidity during pregnancy and the
147	147		postpartum period.
148	148		(f) In developing the report and recommendations required
149	149		by Subsection (e), the department shall:
150	150		(1) consider individual maternal patient information
151	151		related to health status and health care received over varying
152	152		periods that should be submitted to the registry;
153	153		(2) review existing and developing registries used in
154	154		and outside this state that serve the same or a similar purpose as a
155	155		maternal mortality and morbidity data registry;
156	156		(3) review ongoing health data collection efforts and
157	157		initiatives in this state to avoid duplication and ensure
158	158		efficiency;
159	159		(4) review and consider existing laws that govern data
160	160		submission and sharing, including laws governing the
161	161		confidentiality and security of individually identifiable health
162	162		information; and
163	163		(5) evaluate the clinical period during which known
164	164		and available information should be submitted to a maternal
165	165		mortality and morbidity data registry by a health care provider,
166	166		including information:
167	167		(A) from a maternal patient's first appointment
168	168		with an obstetrician and each subsequent appointment until the date
169	169		of delivery;
170	170		(B) for the 42 days following a patient's
171	171		delivery; and
172	172		(C) until the 364th day following a patient's
173	173		delivery.
174	174		(g) If the department recommends the establishment of a
175	175		maternal mortality and morbidity data registry, the report under
176	176		Subsection (e) must include specific recommendations on the
177	177		relevant individual patient information and categories of
178	178		information to be submitted to the registry, including
179	179		recommendations on the intervals for submission of information.
180	180		The categories of individual patient information described by this
181	181		subsection must include:
182	182		(1) notifiable maternal deaths, including
183	183		individualized patient data on:
184	184		(A) patients who die during pregnancy; and
185	185		(B) patients who were pregnant at any point in
186	186		the 12 months preceding their death;
187	187		(2) individualized patient information on each
188	188		pregnancy and birth;
189	189		(3) individualized patient data on the most common
190	190		high-risk conditions for maternal patients and severe cases of
191	191		maternal morbidity;
192	192		(4) nonidentifying demographic data from the
193	193		provider's patient admissions records, including age, race, and
194	194		patient health benefit coverage status; and
195	195		(5) a statistical summary based on an aggregate of
196	196		individualized patient data that includes the following:
197	197		(A) total live births;
198	198		(B) maternal age distributions;
199	199		(C) maternal race and ethnicity distributions;
200	200		(D) health benefit plan issuer distributions;
201	201		(E) incidence of diabetes, hypertension, and
202	202		hemorrhage among patients;
203	203		(F) gestational age distributions;
204	204		(G) birth weight distributions;
205	205		(H) total preterm birth rate;
206	206		(I) rate of vaginal deliveries; and
207	207		(J) rate of cesarean sections.
208	208		(h) If the department establishes a maternal mortality and
209	209		morbidity data registry, a health care provider submitting
210	210		information to the registry shall comply with all applicable
211	211		federal and state laws relating to patient confidentiality and
212	212		quality of health care information.
213	213		(i) The report and recommendations required under
214	214		Subsection (e) must outline potential uses of a maternal mortality
215	215		and morbidity data registry, including:
216	216		(1) periodic analysis by the department of information
217	217		submitted to the registry; and
218	218		(2) the feasibility of preparing and issuing reports,
219	219		using aggregated information, to each health care provider
220	220		participating in the registry to improve the quality of maternal
221	221		care.
222	222		(j) Not later than September 1, 2022, the department shall
223	223		prepare and submit to the governor, the lieutenant governor, the
224	224		speaker of the house of representatives, the Legislative Budget
225	225		Board, and each standing committee of the legislature having
226	226		primary jurisdiction over the department and post on the
227	227		department's Internet website the report and recommendations
228	228		required under Subsection (e).
229	229		(k) This section expires September 1, 2023.
230	230		SECTION 9. The executive commissioner of the Health and
231	231		Human Services Commission shall adopt rules as necessary to
232	232		implement Section 34.022, Health and Safety Code, as added by this
233	233		Act, not later than December 1, 2021.
234	234		SECTION 10. This Act takes effect September 1, 2021.