Texas 2023 - 88th Regular

Texas House Bill HB663 Compare Versions

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1	1	By: Thierry, Oliverson, Harris of Williamson, H.B. No. 663
2	2	Collier, Howard, et al.
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 maternal
8	8	mortality information to the Department of State Health Services
9	9	and to a work group establishing a maternal mortality and morbidity
10	10	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 may receive [or] reimbursement from the
39	39	department as provided by Section 2110.004, Government Code, for
40	40	travel [or other] expenses incurred by the member while conducting
41	41	the business of the review 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) Notwithstanding any other law and for purposes of this
45	45	chapter, a health care provider, including a nurse, who during the
46	46	review of information relevant to a case of pregnancy-associated
47	47	death, pregnancy-related death, or severe maternal morbidity
48	48	obtained under this chapter learns of conduct related to the
49	49	provider's profession that is subject to a reporting requirement is
50	50	exempt from that reporting requirement for the reviewed
51	51	information.
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
154	154	within and outside this state that serve the same or a similar
155	155	purpose as a 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 a health
164	164	care provider should submit to a maternal mortality and morbidity
165	165	data registry known and available information, including
166	166	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 must include:
181	181	(1) notifiable maternal deaths, including
182	182	individualized patient data on:
183	183	(A) patients who die during pregnancy; and
184	184	(B) patients who were pregnant at any point in
185	185	the 12 months preceding their death;
186	186	(2) individualized patient information on each
187	187	pregnancy and birth;
188	188	(3) individualized patient data on the most common
189	189	high-risk conditions for maternal patients and severe cases of
190	190	maternal morbidity;
191	191	(4) nonidentifying demographic data from the
192	192	provider's patient admissions records, including age, race, and
193	193	patient health benefit coverage status; and
194	194	(5) a statistical summary based on an aggregate of
195	195	individualized patient data that includes the following:
196	196	(A) total live births;
197	197	(B) maternal age distributions;
198	198	(C) maternal race and ethnicity distributions;
199	199	(D) health benefit plan issuer distributions;
200	200	(E) incidence of diabetes, hypertension, and
201	201	hemorrhage among patients;
202	202	(F) gestational age distributions;
203	203	(G) birth weight distributions;
204	204	(H) total preterm birth rate;
205	205	(I) rate of vaginal deliveries; and
206	206	(J) rate of cesarean sections.
207	207	(h) If the department establishes a maternal mortality and
208	208	morbidity data registry, a health care provider submitting
209	209	information to the registry shall comply with all applicable
210	210	federal and state laws relating to patient confidentiality and
211	211	quality of health care information.
212	212	(i) The report and recommendations required under
213	213	Subsection (e) must outline potential uses of a maternal mortality
214	214	and morbidity data registry, including:
215	215	(1) periodic department analysis of information
216	216	submitted to the registry; and
217	217	(2) the feasibility of preparing and issuing reports,
218	218	using aggregated information, to each health care provider
219	219	participating in the registry to improve the quality of maternal
220	220	care.
221	221	(j) Not later than September 1, 2024, the department shall
222	222	prepare and submit to the governor, the lieutenant governor, the
223	223	speaker of the house of representatives, the Legislative Budget
224	224	Board, and each standing committee of the legislature having
225	225	primary jurisdiction over the department and post on the
226	226	department's Internet website the report and recommendations
227	227	required under Subsection (e).
228	228	(k) This section expires September 1, 2025.
229	229	SECTION 9. The executive commissioner of the Health and
230	230	Human Services Commission shall adopt rules as necessary to
231	231	implement Section 34.022, Health and Safety Code, as added by this
232	232	Act, not later than December 1, 2023.
233	233	SECTION 10. This Act takes effect September 1, 2023.