Bill Text: TX SB495 | 2013-2014 | 83rd Legislature | Enrolled
Bill Title: Relating to the creation of a task force to study maternal mortality and severe maternal morbidity.
Spectrum: Bipartisan Bill
Status: (Passed) 2013-06-14 - Effective on 9/1/13 [SB495 Detail]
Download: Texas-2013-SB495-Enrolled.html
S.B. No. 495 |
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relating to the creation of a task force 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 TASK FORCE | ||
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) "Health care provider" means an individual or | ||
facility licensed, certified, or otherwise authorized to | ||
administer health care, for profit or otherwise, in the ordinary | ||
course of business or professional practice, including a physician | ||
or a hospital or birthing center. | ||
(5) "Institution of higher education" has the meaning | ||
assigned by Section 61.003, Education Code. | ||
(6) "Intrapartum care" has the meaning assigned by | ||
Section 32.002. | ||
(7) "Life-threatening condition" means a condition | ||
from which the likelihood of death is probable unless the course of | ||
the condition is interrupted. | ||
(8) "Maternal morbidity" means a pregnancy-related | ||
health condition occurring during pregnancy, labor, or delivery or | ||
within one year of delivery or end of pregnancy. | ||
(9) "Patient" means the woman who while pregnant or | ||
within one year of delivery or end of pregnancy suffers death or | ||
severe maternal morbidity. | ||
(10) "Perinatal care" has the meaning assigned by | ||
Section 32.002. | ||
(11) "Physician" means a person licensed to practice | ||
medicine in this state under Subtitle B, Title 3, Occupations Code. | ||
(12) "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. | ||
(13) "Severe maternal morbidity" means maternal | ||
morbidity that constitutes a life-threatening condition. | ||
(14) "Task force" means the Maternal Mortality and | ||
Morbidity Task Force. | ||
Sec. 34.002. MATERNAL MORTALITY AND MORBIDITY TASK FORCE. | ||
(a) The Maternal Mortality and Morbidity Task Force is | ||
administered by the department. | ||
(b) The task force is a multidisciplinary advisory | ||
committee within the department and is composed of the following 15 | ||
members: | ||
(1) 13 members appointed by the commissioner as | ||
follows: | ||
(A) four physicians specializing in obstetrics, | ||
at least one of whom is a maternal fetal medicine specialist; | ||
(B) one certified nurse-midwife; | ||
(C) one registered nurse; | ||
(D) one physician specializing in family | ||
practice; | ||
(E) one physician specializing in psychiatry; | ||
(F) one physician specializing in pathology; | ||
(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. | ||
(c) In appointing members to the task force, the | ||
commissioner shall: | ||
(1) include members: | ||
(A) working in and representing communities that | ||
are diverse with regard to race, ethnicity, immigration status, and | ||
English proficiency; and | ||
(B) from differing geographic regions in the | ||
state, including both rural and urban areas; | ||
(2) endeavor to include members who are working in and | ||
representing communities that are affected by pregnancy-related | ||
deaths and severe maternal morbidity and by a lack of access to | ||
relevant perinatal and intrapartum care services; and | ||
(3) ensure that the composition of the task force | ||
reflects the racial, ethnic, and linguistic diversity of this | ||
state. | ||
(d) The commissioner shall appoint from among the task force | ||
members a presiding officer. | ||
(e) A member of the task force appointed under Subsection | ||
(b)(1) is not entitled to compensation for service on the task force | ||
or reimbursement for travel or other expenses incurred by the | ||
member while conducting the business of the task force. | ||
(f) In carrying out its duties, the task force may use | ||
technology, including teleconferencing or videoconferencing, to | ||
eliminate travel expenses. | ||
Sec. 34.003. TERMS; VACANCY. (a) Task force 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 task force member may serve more than one term. | ||
(c) A vacancy on the task force shall be filled for the | ||
unexpired term in the same manner as the original appointment. | ||
Sec. 34.004. MEETINGS. (a) The task force shall meet at | ||
least quarterly. The task force may meet at other times at the call | ||
of the commissioner. | ||
(b) Meetings of the task force are closed to the public and | ||
are not subject to Chapter 551, Government Code. | ||
Sec. 34.005. DUTIES OF TASK FORCE. The task force shall: | ||
(1) study and review: | ||
(A) cases of pregnancy-related deaths; and | ||
(B) trends in severe maternal morbidity; | ||
(2) determine the feasibility of the task force | ||
studying cases of severe maternal morbidity; and | ||
(3) make recommendations to help reduce the incidence | ||
of pregnancy-related deaths and severe maternal morbidity in this | ||
state. | ||
Sec. 34.006. CONSULTATIONS AND AGREEMENTS WITH OUTSIDE | ||
PARTIES. (a) The department and task force may consult with any | ||
relevant experts and stakeholders, including: | ||
(1) anesthesiologists; | ||
(2) intensivists or critical care physicians; | ||
(3) nutritionists; | ||
(4) substance abuse treatment specialists; | ||
(5) hospital staff or employees; | ||
(6) representatives of the state Medicaid program; | ||
(7) paramedics or other emergency medical response | ||
personnel; | ||
(8) hospital-based risk management specialists; | ||
(9) representatives of local health departments and | ||
public health districts in this state; | ||
(10) public health experts; | ||
(11) government representatives or officials; and | ||
(12) law enforcement officials. | ||
(b) In gathering information, the department and task force | ||
may consult with representatives of any relevant state professional | ||
associations and organizations, including: | ||
(1) District XI of the American Congress of | ||
Obstetricians and Gynecologists; | ||
(2) the Texas Association of Obstetricians and | ||
Gynecologists; | ||
(3) the Texas Nurses Association; | ||
(4) the Texas Section of the Association of Women's | ||
Health, Obstetric and Neonatal Nurses; | ||
(5) the Texas Academy of Family Physicians; | ||
(6) the Texas Pediatric Society; | ||
(7) the Consortium of Texas Certified Nurse-Midwives; | ||
(8) the Association of Texas Midwives; | ||
(9) the Texas Hospital Association; | ||
(10) the Texas Medical Association; and | ||
(11) the Texas Public Health Association. | ||
(c) In consulting with individuals or organizations under | ||
Subsection (a) or (b), a member of the task force or employee of the | ||
department may not disclose any identifying information of a | ||
patient or health care provider. | ||
(d) The department on behalf of the task force may enter | ||
into agreements with institutions of higher education or other | ||
organizations consistent with the duties of the department or task | ||
force under this chapter. | ||
Sec. 34.007. SELECTION AND REVIEW OF CASES. (a) The | ||
department shall determine a statistically significant number of | ||
cases of pregnancy-related deaths for review. The department shall | ||
randomly select 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 analyze aggregate data of severe | ||
maternal morbidity in this state to identify any trends. | ||
(c) If feasible, the department may select cases of severe | ||
maternal morbidity for review. In selecting cases under this | ||
subsection, the department shall randomly select cases for the task | ||
force to review to reflect trends identified under Subsection (b). | ||
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 task force to review the case. The department | ||
shall provide the information to the task force. | ||
(b) The information provided to the task force may not | ||
include identifying information of a patient or health care | ||
provider, including: | ||
(1) the name, address, or date of birth of the patient | ||
or a member of the patient's family; or | ||
(2) the name or specific location of a health care | ||
provider that treated the patient. | ||
(c) On the request of the department, a hospital, birthing | ||
center, 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, if the | ||
patient is deceased, without the authorization of the patient's | ||
family. | ||
(d) A person who provides information to the department | ||
under this section is not subject to an administrative, civil, or | ||
criminal action for damages or other relief for providing the | ||
information. | ||
Sec. 34.009. CONFIDENTIALITY; PRIVILEGE. (a) Any | ||
information pertaining to a pregnancy-related death or severe | ||
maternal morbidity is confidential for purposes of this chapter. | ||
(b) Confidential information that is acquired by the | ||
department and that includes identifying information of an | ||
individual or health care provider is privileged and may not be | ||
disclosed to any person. 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) Task force 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 task force 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 task force may publish statistical studies and | ||
research reports based on information that is confidential under | ||
this section, provided that the information: | ||
(1) is published in the aggregate; | ||
(2) does not identify a patient or the patient's | ||
family; | ||
(3) does not include any information that could be | ||
used to identify a patient or the patient's family; and | ||
(4) does not identify a health care provider. | ||
(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 task force 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. Task force 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 administrative, civil, or criminal | ||
proceeding against a patient, a member of the family of a patient, | ||
or a health care provider. | ||
Sec. 34.011. IMMUNITY. (a) A member of the task force or a | ||
person employed by or acting in an advisory capacity to the task | ||
force and who provides information, counsel, or services to the | ||
task force is not liable for damages for an action taken within the | ||
scope of the functions of the task force. | ||
(b) Subsection (a) does not apply if the person acts with | ||
malice or without the reasonable belief that the action is | ||
warranted by the facts known to the person. | ||
(c) This section does not provide immunity to a person | ||
described by Subsection (a) for a violation of a state or federal | ||
law or rule relating to the privacy of health information or 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. 34.012. 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 task force in | ||
performing functions under this chapter. | ||
(b) The information in the database may not include | ||
identifying information, including: | ||
(1) the name of a patient; or | ||
(2) the name or specific location of a health care | ||
provider that treated a patient. | ||
(c) The database may be accessed only by the department and | ||
the task force 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. The department may accept gifts and | ||
grants from any source to fund the duties of the department and the | ||
task force under this chapter. | ||
Sec. 34.015. REPORTS. (a) Not later than September 1 of | ||
each even-numbered year, the task force and the department shall | ||
submit a joint report on the findings of the task force 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 task force's | ||
recommendations under Section 34.005(3). | ||
(c) 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. | ||
Sec. 34.016. RULES. The executive commissioner may adopt | ||
rules to implement this chapter. | ||
Sec. 34.017. DEPARTMENT ACCESS TO INFORMATION. | ||
(a) Notwithstanding Chapter 108 or any other law, the department | ||
may have access to the following information that may include the | ||
identity of a patient to fulfill its duties under this chapter: | ||
(1) birth records; | ||
(2) fetal death records; | ||
(3) maternal death records; and | ||
(4) hospital and birthing center discharge data. | ||
(b) The department may not disclose the information | ||
described by Subsection (a) to the task force or any other person. | ||
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, 2019. | ||
SECTION 2. (a) Not later than September 1, 2014, 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 Task Force 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 Task Force 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, 2016. | ||
(c) Not later than December 1, 2013, the commissioner of | ||
state health services shall appoint the members of the Maternal | ||
Mortality and Morbidity Task Force in accordance with Subdivision | ||
(1), Subsection (b), Section 34.002, 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, 2015, four members to serve terms expiring February 1, | ||
2017, and four members to serve terms expiring February 1, 2019. | ||
SECTION 3. This Act takes effect September 1, 2013. | ||
______________________________ | ______________________________ | |
President of the Senate | Speaker of the House | |
I hereby certify that S.B. No. 495 passed the Senate on | ||
May 2, 2013, by the following vote: Yeas 31, Nays 0; and that the | ||
Senate concurred in House amendments on May 21, 2013, by the | ||
following vote: Yeas 31, Nays 0. | ||
______________________________ | ||
Secretary of the Senate | ||
I hereby certify that S.B. No. 495 passed the House, with | ||
amendments, on May 17, 2013, by the following vote: Yeas 129, | ||
Nays 11, two present not voting. | ||
______________________________ | ||
Chief Clerk of the House | ||
Approved: | ||
______________________________ | ||
Date | ||
______________________________ | ||
Governor |