Bill Text: TX HB9 | 2017 | 85th Legislature 1st Special Session | Engrossed


Bill Title: Relating to maternal health and safety, pregnancy-related deaths, and maternal morbidity, including postpartum depression.

Spectrum: Moderate Partisan Bill (Republican 86-27)

Status: (Engrossed) 2017-08-01 - Referred to Health & Human Services [HB9 Detail]

Download: Texas-2017-HB9-Engrossed.html
 
 
  By: Burkett, Davis of Harris, Morrison, H.B. No. 9
      Klick, Walle, et al.
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to maternal health and safety, pregnancy-related deaths,
  and maternal morbidity, including postpartum depression.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Section 34.004(b), Health and Safety Code, is
  amended to read as follows:
         (b)  Meetings of the task force are [closed to the public and
  are not] subject to Chapter 551, Government Code.
         SECTION 2.  Section 34.005, Health and Safety Code, is
  amended to read as follows:
         Sec. 34.005.  DUTIES OF TASK FORCE. The task force shall:
               (1)  study and review:
                     (A)  cases of pregnancy-related deaths; [and]
                     (B)  trends, rates, or disparities in
  pregnancy-related deaths and [in] severe maternal morbidity;
                     (C)  health conditions and factors that
  disproportionately affect the most at-risk population as
  determined in the joint biennial report required under Section
  34.015; and
                     (D)  best practices and programs operating in
  other states that have reduced rates of pregnancy-related deaths;
               (2)  compare rates of pregnancy-related deaths based on
  the socioeconomic status of the mother;
               (3)  determine the feasibility of the task force
  studying cases of severe maternal morbidity; and
               (4)  in consultation with the Perinatal Advisory
  Council, [(3)] make recommendations to help reduce the incidence of
  pregnancy-related deaths and severe maternal morbidity in this
  state.
         SECTION 3.  Chapter 34, Health and Safety Code, is amended by
  adding Section 34.0055 to read as follows:
         Sec. 34.0055.  SCREENING AND EDUCATIONAL MATERIALS FOR
  SUBSTANCE USE AND DOMESTIC VIOLENCE. (a) Using existing
  resources, the commission, in consultation with the task force,
  shall:
               (1)  make available to physicians and other persons
  licensed or certified to conduct a substance use and domestic
  violence screening of pregnant women information that includes:
                     (A)  guidance regarding best practices for
  verbally screening a pregnant woman for substance use and domestic
  violence using a validated screening tool; and
                     (B)  a list of substance use treatment resources
  and domestic violence prevention and intervention resources in each
  geographic region of this state; and
               (2)  review and promote the use of educational
  materials on the consequences of opioid drug use and on domestic
  violence prevention and intervention during pregnancy.
         (b)  The commission shall make available on the commission's
  Internet website the information and educational materials
  described by Subsection (a).
         SECTION 4.  Sections 34.007(a) and (b), Health and Safety
  Code, are amended to read as follows:
         (a)  The department shall determine a statistically
  significant number of cases of pregnancy-related deaths for review.  
  The department shall either randomly select cases or select all
  cases for the task force to review under this subsection to reflect
  a cross-section of pregnancy-related deaths in this state.
         (b)  The department shall statistically analyze aggregate
  data of pregnancy-related deaths and severe maternal morbidity in
  this state to identify any trends, rates, or disparities.
         SECTION 5.  Section 34.009(d), Health and Safety Code, is
  amended to read as follows:
         (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)  an abstract concerning a maternal death that does
  not include identifying information relating to a patient, the
  patient's family, or a health care provider;
               (6)  information, including the source, value, and
  purpose, related to gifts, grants, or donations to or for use by the
  task force; and
               (7)  other statistical information.
         SECTION 6.  Section 34.015, Health and Safety Code, is
  amended by amending Subsections (b) and (c) and adding Subsection
  (d) to read as follows:
         (b)  The report must include the task force's
  recommendations under Section 34.005(4) [34.005(3)].
         (c)  The report must include for each death reviewed an
  abstract that does not include information that could be used to
  identify the patient, a member of the patient's family, or a
  provider.
         (d)  The department shall disseminate the report to the state
  professional associations and organizations listed in Section
  34.006(b) and make the report publicly available in paper or
  electronic form.
         SECTION 7.  Chapter 34, Health and Safety Code, is amended by
  adding Sections 34.0155, 34.0156, and 34.0157 to read as follows:
         Sec. 34.0155.  REPORT ON PREGNANCY-RELATED DEATHS, SEVERE
  MATERNAL MORBIDITY, AND POSTPARTUM DEPRESSION. The commission
  shall: 
               (1)  evaluate options for reducing pregnancy-related
  deaths, focusing on the most prevalent causes of pregnancy-related
  deaths as identified in the joint biennial report required under
  Section 34.015, and for treating postpartum depression in
  economically disadvantaged women;
               (2)  in coordination with the department and the task
  force, identify strategies to:
                     (A)  lower costs of providing medical assistance
  under Chapter 32, Human Resources Code, related to severe maternal
  morbidity and chronic illness; and
                     (B)  improve quality outcomes related to the
  underlying causes of severe maternal morbidity and chronic illness;
  and
               (3)  not later than December 1 of each even-numbered
  year, submit to the governor, the lieutenant governor, the speaker
  of the house of representatives, the Legislative Budget Board, and
  the appropriate standing committees of the legislature a written
  report that includes:
                     (A)  a summary of the commission's and
  department's efforts to accomplish the tasks described by
  Subdivisions (1) and (2); and
                     (B)  a summary of the report required by Section
  34.0156.
         Sec. 34.0156.  MATERNAL HEALTH AND SAFETY INITIATIVE. (a)
  Using existing resources, the department, in collaboration with the
  task force, shall promote and facilitate the use among health care
  providers in this state of maternal health and safety informational
  materials, including tools and procedures related to best practices
  in maternal health and safety.
         (b)  Not later than December 1 of each even-numbered year,
  the department shall submit a report to the executive commissioner
  that includes:
               (1)  a summary of the initiative's implementation and
  outcomes; and
               (2)  recommendations for improving the effectiveness
  of the initiative.
         Sec. 34.0157.  FEASIBILITY STUDY RELATED TO MATERNAL HEALTH
  AND SAFETY INITIATIVE. (a)  Using existing resources and not later
  than December 1, 2018, the commission shall study and determine the
  feasibility of adding a provider's use of procedures included in
  the maternal health and safety initiative described by Section
  34.0156 as an indicator of quality for commission data and medical
  assistance quality-based payment purposes.
         (b)  The department shall collaborate with the commission in
  compiling available data and information needed to complete the
  feasibility study.
         (c)  The commission shall include the commission's
  determination from the feasibility study in the report required by
  Section 34.0155.
         (d)  This section expires May 1, 2019.
         SECTION 8.  Section 34.018, Health and Safety Code, is
  amended to read as follows:
         Sec. 34.018.  SUNSET PROVISION. The task force is subject to
  Chapter 325, Government Code (Texas Sunset Act). Unless continued
  in existence as provided by that chapter, the task force is
  abolished and this chapter expires September 1, 2023 [2019].
         SECTION 9.  Subchapter D, Chapter 1001, Health and Safety
  Code, is amended by adding Section 1001.0712 to read as follows:
         Sec. 1001.0712.  CAUSE OF DEATH DATA IMPROVEMENT. (a) Not
  later than December 1 of each even-numbered year, the department
  shall submit to the governor, lieutenant governor, speaker of the
  house of representatives, and appropriate standing committees of
  the legislature a report on the processes and procedures for
  collecting cause of death information, including any challenges to
  collecting accurate information relating to maternal mortality.
         (b)  In preparing the report, the department may examine:
               (1)  issues relating to the quality of the death
  information being collected, including the accuracy and
  completeness of the information;
               (2)  the role of medical certifiers in death
  information collection;
               (3)  the perceptions of the individuals collecting the
  death information regarding the information's integrity;
               (4)  the training required for the individuals
  collecting death information; and
               (5)  the structural, procedural, and technological
  issues of collecting the information.
         (c)  The department, in consultation with the Maternal
  Mortality and Morbidity Task Force, shall examine national
  standards regarding the collection of death information and may
  convene a panel of experts to advise the department and the task
  force in developing recommendations for improving the collection of
  accurate information related to cause of death.
         (d)  The report may be included as part of another report the
  department is required to submit to the legislature.
         (e)  This section expires September 1, 2021.
         SECTION 10.  Not later than June 1, 2018, the Health and
  Human Services Commission shall make available information and
  educational materials described by Section 34.0055, Health and
  Safety Code, as added by this Act.
         SECTION 11.  If before implementing any provision of this
  Act a state agency determines that an additional waiver or
  additional authorization from a federal agency is necessary for
  implementation of that provision, the agency affected by the
  provision shall request the waiver or authorization and may delay
  implementing that provision until the waiver or authorization is
  granted.
         SECTION 12.  This Act takes effect immediately if it
  receives a vote of two-thirds of all the members elected to each
  house, as provided by Section 39, Article III, Texas Constitution.  
  If this Act does not receive the vote necessary for immediate
  effect, this Act takes effect on the 91st day after the last day of
  the legislative session.
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