Bill Text: TX HB1133 | 2011-2012 | 82nd Legislature | Introduced

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Bill Title: Relating to the creation of a review board to study maternal mortality and severe maternal morbidity.

Spectrum: Partisan Bill (Democrat 2-0)

Status: (Introduced - Dead) 2011-05-06 - Failed to receive affirmative vote in comm. [HB1133 Detail]

Download: Texas-2011-HB1133-Introduced.html

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By: Walle H.B. No. 1133

A BILL TO BE ENTITLED
AN ACT
relating to the creation of a review board to study maternal
mortality and severe maternal morbidity.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subtitle B, Title 2, Health and Safety Code, is
amended by adding Chapter 34 to read as follows:
CHAPTER 34. MATERNAL MORTALITY AND MORBIDITY REVIEW BOARD
Sec. 34.001. DEFINITIONS. In this chapter:
(1) "Commissioner" means the commissioner of state
health services.
(2) "Department" means the Department of State Health
Services.
(3) "Executive commissioner" means the executive
commissioner of the Health and Human Services Commission.
(4) "Institution of higher education" has the meaning
assigned by Section 61.003, Education Code.
(5) "Intrapartum care" has the meaning assigned by
Section 32.002.
(6) "Maternal morbidity" means a pregnancy-related
health condition occurring during pregnancy, labor, or delivery or
within one year of delivery or end of pregnancy.
(7) "Patient" means the woman who while pregnant or
within one year of delivery or end of pregnancy suffers death or
maternal morbidity.
(8) "Perinatal care" has the meaning assigned by
Section 32.002.
(9) "Pregnancy-related death" means the death of a
woman while pregnant or within one year of delivery or end of
pregnancy, regardless of the duration and site of the pregnancy,
from any cause related to or aggravated by the pregnancy or its
management, but not from accidental or incidental causes.
(10) "Review board" means the Maternal Mortality and
Morbidity Review Board.
(11) "Severe maternal morbidity" means maternal
morbidity that constituted a life-threatening condition.
Sec. 34.002. MATERNAL MORTALITY AND MORBIDITY REVIEW BOARD.
(a) The review board is a multidisciplinary advisory committee
composed of the following 15 members:
(1) 13 members appointed by the commissioner as
follows:
(A) four obstetricians, at least one of whom is a
maternal fetal medicine specialist;
(B) one midwife;
(C) one registered nurse;
(D) one physician specializing in family
practice;
(E) one mental health professional;
(F) one pathologist;
(G) one epidemiologist, biostatistician, or
researcher of pregnancy-related deaths;
(H) one social worker or social service provider;
(I) one community advocate in a relevant field;
and
(J) one medical examiner or coroner responsible
for recording deaths;
(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.
(b) In appointing members to the review board, the
commissioner shall:
(1) include members:
(A) working in and representing communities
that:
(i) are diverse with regard to race,
ethnicity, immigration status, and English proficiency; and
(ii) are severely affected by
pregnancy-related deaths and severe maternal morbidity and by a
lack of access to relevant perinatal and intrapartum care services;
and
(B) from differing geographic regions in the
state, including both rural and urban areas; and
(2) ensure that the composition of the board reflects
the racial, ethnic, and linguistic diversity of this state.
(c) The commissioner shall appoint from among the review
board members a presiding officer.
(d) A member of the review board is not entitled to
compensation but is entitled to reimbursement for travel or other
expenses incurred by the member while conducting the business of
the review board, as provided by the General Appropriations Act.
Reimbursement for a review board member's travel or other expenses
shall be paid from funds appropriated to the department.
Sec. 34.003. TERMS; VACANCY. (a) Review board members
appointed by the commissioner serve staggered six-year terms, with
the terms of four or five members, as appropriate, expiring
February 1 of each odd-numbered year.
(b) A review board member may serve more than one term.
(c) A vacancy on the review board shall be filled for the
unexpired term in the same manner as the original appointment.
Sec. 34.004. MEETINGS. (a) The review board shall meet at
least quarterly. The review board may meet at other times at the
call of the commissioner.
(b) Meetings of the review board are closed to the public
and are not subject to Chapter 551, Government Code.
Sec. 34.005. DUTIES OF REVIEW BOARD. (a) The review board
shall:
(1) study and review pregnancy-related deaths and
cases of severe maternal morbidity; and
(2) create recommendations for the prevention of
pregnancy-related deaths and severe maternal morbidity.
(b) The review board shall develop standard procedures and
criteria for the comprehensive, multidisciplinary review of
pregnancy-related deaths and cases of severe maternal morbidity.
Sec. 34.006. CONSULTATIONS AND AGREEMENTS WITH OUTSIDE
PARTIES. (a) The department and review board may consult with:
(1) anesthesiologists;
(2) intensivists or critical care physicians;
(3) nutritionists;
(4) substance abuse treatment specialists;
(5) hospital administrators;
(6) representatives of the state Medicaid program;
(7) paramedics or other emergency medical response
personnel;
(8) lawyers;
(9) risk management specialists;
(10) representatives of local health departments and
public health districts in this state;
(11) policy makers;
(12) public health experts; and
(13) government representatives or officials.
(b) In gathering information, the department and the review
board may consult with representatives of relevant state
professional associations, including:
(1) District XI of the American Congress of
Obstetricians and Gynecologists;
(2) the Texas Nurses Association;
(3) the Texas Section of the Association of Women's
Health, Obstetric and Neonatal Nurses;
(4) the Texas Academy of Family Physicians;
(5) the Consortium of Texas Certified Nurse-Midwives;
(6) the Association of Texas Midwives;
(7) the Texas Hospital Association;
(8) the Texas Medical Association; and
(9) the Texas Public Health Association.
(c) The department on behalf of the review board may enter
into agreements with institutions of higher education consistent
with the duties of the department or review board under this
chapter.
Sec. 34.007. IDENTIFICATION AND REVIEW OF CASES. The
department shall identify cases of pregnancy-related deaths and
severe maternal morbidity for review. The department shall
determine the appropriate number of cases for the review board to
review to reflect a cross-section of pregnancy-related deaths and
severe maternal morbidity cases in this state.
Sec. 34.008. OBTAINING DE-IDENTIFIED INFORMATION FOR
REVIEW. (a) On selecting a case of pregnancy-related death or
severe maternal morbidity for review, the department shall, in
accordance with this section, obtain information relevant to the
case to enable the review board to review the case. The department
shall provide the information to the review board.
(b) The information provided to the review board may not
include identifying information, including:
(1) the name, address, or date of birth of the patient
or a member of the patient's family;
(2) the name of a health care provider; or
(3) the name or specific location of a facility that
treated the patient.
(c) On the request of the department, a health care provider
or other custodian of the requested information shall provide the
information to the department. The information shall be provided
without the authorization of the patient or the patient's family if
the patient is deceased.
(d) A health care provider or other person who provides
information to the department under this section is not subject to a
civil action for damages or other relief for providing the
information. This subsection does not apply if the information
provided was false and the health care provider or other person knew
or had reason to know that the information was false.
Sec. 34.009. CONFIDENTIALITY; PRIVILEGE. (a) Information
is confidential for purposes of this chapter if the disclosure of
the information would compromise the privacy of the individual who
is the subject of the information or the individual's family.
Confidential information includes any information pertaining to
the pregnancy-related death or severe maternal morbidity.
(b) Confidential information that is acquired by the
department and that permits the identification of an individual or
health care provider is privileged and may not be disclosed to any
person except to the extent necessary to carry out the purposes of
this chapter. Information that may not be disclosed under this
subsection includes:
(1) the name and address of a patient or a member of
the patient's family;
(2) any service received by the patient or a member of
the patient's family;
(3) the social and economic condition of the patient
or a member of the patient's family;
(4) medical, dental, and mental health care
information related to the patient or a member of the patient's
family, including diagnoses, conditions, diseases, or disability;
and
(5) the identity of a health care provider that
provided any services to the patient or a member of the patient's
family.
(c) Review board work product or information obtained by the
department under this chapter, including information contained in
an electronic database established and maintained under Section
34.012, or any other document or record, is confidential. This
subsection does not prevent the review board or department from
releasing information described by Subsection (d) or (e) or from
submitting the report required by Section 34.015.
(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) other statistical information.
(e) The review board may publish statistical studies and
research reports based on information that is confidential under
this section, provided that the information:
(1) is published in aggregate;
(2) does not identify a patient or the patient's
family; and
(3) does not include any information that could be
used to identify a patient or the patient's family.
(f) The department shall adopt and implement practices and
procedures to ensure that information that is confidential under
this section is not disclosed in violation of this section.
(g) Information that is confidential under this section is
excepted from disclosure under Chapter 552, Government Code, as
provided by Section 552.101 of that chapter.
(h) The review board and the department shall comply with
all state and federal laws and rules relating to the transmission of
health information, including the Health Insurance Portability and
Accountability Act of 1996 (Pub. L. No. 104-191) and rules adopted
under that Act.
Sec. 34.010. SUBPOENA AND DISCOVERY. (a) Review board work
product or information that is confidential under Section 34.009 is
privileged, is not subject to subpoena or discovery, and may not be
introduced into evidence in any civil or criminal proceeding
against a patient, a member of the family of a patient, or a health
care provider.
(b) A document or other information that is otherwise
available from another source is not protected from subpoena,
discovery, or introduction into evidence under Subsection (a)
solely because the document or other information was presented
during a meeting of the review board or because a record of the
document or other information is maintained by the review board.
Sec. 34.012. DATABASE OF DE-IDENTIFIED INFORMATION. (a)
The department may establish and maintain an electronic database to
track cases of pregnancy-related deaths and severe maternal
morbidity to assist the department and review board in performing
functions under this chapter.
(b) The information in the database may not include
identifying information, including:
(1) the name of a patient;
(2) the name of a health care provider; or
(3) the name or specific location of a facility that
treated a patient.
(c) The database may be accessed only by the department and
the review board for the purposes described in this chapter.
Sec. 34.013. INAPPLICABILITY OF CHAPTER. This chapter does
not apply to disclosure of records pertaining to voluntary or
therapeutic termination of pregnancy, and those records may not be
collected, maintained, or disclosed under this chapter.
Sec. 34.014. FUNDING. (a) The department shall apply for
and use any available federal money to fund the duties of the
department and the review board under this chapter.
(b) The department may accept gifts and grants from any
source to fund the duties of the department and the review board
under this chapter.
Sec. 34.015. REPORTS. (a) Not later than September 1 of
each even-numbered year, the review board and the department shall
submit a joint report on the findings of the review board under this
chapter to the governor, lieutenant governor, speaker of the house
of representatives, and appropriate committees of the legislature.
(b) The report must include the review board's
recommendations to help reduce the incidence of pregnancy-related
deaths and severe maternal morbidity in this state, including:
(1) potential legislation or rules; and
(2) best practices for health care providers and
facilities that provide perinatal or intrapartum care.
(c) The department may disseminate the report to the
relevant state professional associations listed in Section
34.006(b) in paper or electronic form.
Sec. 34.016. RULES. The executive commissioner may adopt
rules to implement this chapter.
Sec. 34.017. DEPARTMENT ACCESS TO INFORMATION.
Notwithstanding Chapter 108 or any other law, the department may
have access to the following information that may reveal the
identity of a patient to fulfill its duties under this chapter:
(1) birth records; and
(2) hospital discharge data.
SECTION 2. (a) Not later than September 1, 2012, the
Department of State Health Services shall submit a report to the
governor, lieutenant governor, speaker of the house of
representatives, and appropriate committees of the legislature
outlining:
(1) the department's progress in establishing the
Maternal Mortality and Morbidity Review Board required by Chapter
34, Health and Safety Code, as added by this Act; and
(2) any recommendations for legislation to assist the
department in studying pregnancy-related deaths and severe
maternal morbidity.
(b) The Department of State Health Services and the Maternal
Mortality and Morbidity Review Board created by Chapter 34, Health
and Safety Code, as added by this Act, are not required to submit
the first report required by Section 34.015, Health and Safety
Code, as added by this Act, before September 1, 2014.
(c) Not later than December 1, 2011, the commissioner of
state health services shall appoint the members of the Maternal
Mortality and Morbidity Review Board in accordance with Section
34.002(a)(1), Health and Safety Code, as added by this Act. In
making the initial appointments, the commissioner shall designate
five members to serve terms expiring February 1, 2013, four members
to serve terms expiring February 1, 2015, and four members to serve
terms expiring February 1, 2017.
SECTION 3. This Act takes effect September 1, 2011.