By: Delco H.B. No. 1849
73R5035 CAG-F
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to regulating the practice of midwifery.
1-3 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-4 SECTION 1. SHORT TITLE; FINDINGS. (a) This Act may be
1-5 cited as the Texas Midwifery Act.
1-6 (b) The legislature recognizes that:
1-7 (1) the safe and effective care of newborns and their
1-8 mothers by midwives requires the regulation of the practice of
1-9 midwifery; and
1-10 (2) access to prenatal care and delivery services is
1-11 limited by the inadequate number and maldistribution of providers
1-12 of such services, and that the regulated practice of midwifery may
1-13 help reduce this shortage.
1-14 SECTION 2. DEFINITIONS. In this Act:
1-15 (1) "Midwife" means a person who practices midwifery
1-16 and has met the requirements of the standards of the midwifery
1-17 board.
1-18 (2) "Midwifery" means the practice by a midwife of:
1-19 (A) giving the necessary supervision, care, and
1-20 advice to a woman during normal pregnancy, labor, and the
1-21 postpartum period;
1-22 (B) conducting a normal delivery of a child; and
1-23 (C) newborn care.
1-24 (3) "Board" means the Texas Board of Health.
2-1 (4) "Certified nurse-midwife" means a person who is:
2-2 (A) a registered nurse under the laws of this
2-3 state;
2-4 (B) recognized as an advanced nurse practitioner
2-5 by the Board of Nurse Examiners; and
2-6 (C) certified by the American College of
2-7 Nurse-Midwives.
2-8 (5) "Department" means the Texas Department of Health.
2-9 (6) "Local health department" means a department of
2-10 health created by the governing body of a municipality or a county
2-11 under Section 121.031, Health and Safety Code, and its subsequent
2-12 amendments.
2-13 (7) "Local health unit" means a division of a
2-14 municipal or county government that provides limited public health
2-15 services as provided by Section 121.004, Health and Safety Code,
2-16 and its subsequent amendments.
2-17 (8) "Public health district" means a district created
2-18 under Subchapter E, Chapter 121, Health and Safety Code, and its
2-19 subsequent amendments.
2-20 SECTION 3. MIDWIFERY BOARD. (a) The Texas Board of
2-21 Health shall appoint a midwifery board that reports directly to the
2-22 Texas Board of Health. The midwifery board shall advise the board
2-23 in all matters relating to licensing and regulation of midwives.
2-24 (b) The midwifery board is composed of:
2-25 (1) three midwives licensed in this state with three
2-26 years or more of experience in the practice of midwifery, not more
2-27 than one of whom may be licensed as a health care professional in a
3-1 field other than midwifery;
3-2 (2) one certified nurse-midwife;
3-3 (3) a person licensed in this state to practice
3-4 medicine who is certified by a national professional organization
3-5 of physicians that certifies obstetricians and gynecologists;
3-6 (4) one person licensed in this state to practice
3-7 medicine who is certified by a national professional organization
3-8 of physicians that certifies pediatricians or family practitioners;
3-9 and
3-10 (5) three persons who are not practicing or trained in
3-11 a health care profession and who represent the public interest, one
3-12 of whom must be a parent with at least one child born with the
3-13 assistance of a midwife.
3-14 (c) Members of the midwifery board are appointed for
3-15 two-year terms expiring February 1 of each odd-numbered year.
3-16 (d) The midwifery board, with advice of the department,
3-17 shall develop rules regarding meetings and procedures.
3-18 SECTION 4. MIDWIFERY PROGRAM. The Texas Board of Health
3-19 shall license and regulate the practice of midwifery in Texas. The
3-20 midwifery board, with the advice of the department, shall develop
3-21 for approval by the board rules regarding:
3-22 (1) mandatory education and core competencies;
3-23 (2) licensing, licensing examinations, and the
3-24 revocation, suspension, and probation of licenses;
3-25 (3) the establishment or regulation of an apprentice
3-26 licensing procedure and rules to regulate the licensing;
3-27 (4) standards of practice of a midwife, including
4-1 defining prohibited acts and maternal infant conditions that
4-2 preclude care by a midwife;
4-3 (5) processing and disposition of complaints filed
4-4 against licensed midwives or licensed apprentices;
4-5 (6) annual reports to the board concerning the
4-6 practice of midwifery in this state; and
4-7 (7) any other aspect of the practice of midwifery.
4-8 SECTION 5. EXCEPTIONS. This Act does not apply to a
4-9 certified nurse-midwife, a physician, a health care professional
4-10 licensed by the state and operating within the scope of the
4-11 professional's license, or a person other than a midwife who
4-12 assists childbirth in an emergency.
4-13 SECTION 6. DISCLOSURE REQUIREMENT. (a) A midwife shall
4-14 disclose in oral and written form to each prospective and actual
4-15 client the limitations of the skills and practices of a midwife by
4-16 using an informed choice and disclosure statement.
4-17 (b) The midwifery board with the advice of the department
4-18 and approval of the board shall prescribe an informed choice and
4-19 disclosure statement to be used by each midwife, which must
4-20 include:
4-21 (1) documentation of the current license status of the
4-22 midwife;
4-23 (2) statistics of the midwife's experience as a
4-24 midwife;
4-25 (3) continuing education courses attended by the
4-26 midwife;
4-27 (4) medical backup arrangements;
5-1 (5) the legal requirements of midwives, including
5-2 statements concerning newborn blood screening and ophthalmia
5-3 neonatorum prevention; and
5-4 (6) procedures for filing grievances against a
5-5 midwife.
5-6 SECTION 7. VIOLATIONS. (a) A midwife commits a violation
5-7 if the midwife knowingly or intentionally fails to comply with any
5-8 requirement of this Act or commits an act prohibited by a rule
5-9 approved by the board.
5-10 (b) A person who practices midwifery without a current
5-11 license commits a violation of this Act.
5-12 SECTION 8. MINIMUM STANDARDS; EFFECT ON LOCAL ORDINANCES.
5-13 (a) This Act and the rules approved by the board constitute the
5-14 minimum standards for the practice of midwifery.
5-15 (b) This Act prohibits a municipality from adopting local
5-16 ordinances or rules to regulate the practice of midwifery within
5-17 the corporate limits of the municipality.
5-18 SECTION 9. PROVISION OF SUPPORT SERVICES. The department
5-19 and a local health department, a public health district, or a local
5-20 health unit that is owned, operated, or leased by a political
5-21 subdivision shall provide clinical and laboratory support services
5-22 to pregnant women and newborns who are clients of midwives. The
5-23 provider may charge a reasonable fee for the service, but a person
5-24 may not be denied the services because of inability to pay. In
5-25 this section, "clinical services" includes prenatal, postpartum,
5-26 child health, and family planning services.
5-27 SECTION 10. APPLICATION OF SUNSET RULE. The midwifery board
6-1 is subject to Chapter 325, Government Code (Texas Sunset Act).
6-2 Unless continued in existence as provided by that chapter, the
6-3 board is abolished and this Act expires September 1, 2001.
6-4 SECTION 11. REPEALER. Chapter 365, Acts of the 68th
6-5 Legislature, Regular Session, 1983 (Article 4512i, Vernon's Texas
6-6 Civil Statutes), is repealed.
6-7 SECTION 12. EMERGENCY. The importance of this legislation
6-8 and the crowded condition of the calendars in both houses create an
6-9 emergency and an imperative public necessity that the
6-10 constitutional rule requiring bills to be read on three several
6-11 days in each house be suspended, and this rule is hereby suspended,
6-12 and that this Act take effect and be in force from and after its
6-13 passage, and it is so enacted.