By:  Moncrief                                         S.B. No. 1433
       73R9392 JMM-F
                                 A BILL TO BE ENTITLED
    1-1                                AN ACT
    1-2  relating to the continuation and functions of the Midwifery Board
    1-3  and the regulation of the practice of midwifery.
    1-4        BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
    1-5        SECTION 1.  Section 3, Texas Midwifery Act (Article 4512i,
    1-6  Vernon's Texas Civil Statutes), is amended by amending Subsection
    1-7  (b) and adding Subsections (c) and (d) to read as follows:
    1-8        (b)  The midwifery board is composed of the following nine
    1-9  members:
   1-10              (1)  three <six> midwives with at least three years of
   1-11  experience in the practice of midwifery, not more than one <three>
   1-12  of whom may be a licensed health care professional <professionals>;
   1-13              (2)  one certified nurse-midwife;
   1-14              (3)  a person licensed to practice medicine who is
   1-15  certified by a national professional organization of physicians
   1-16  that certifies obstetricians and gynecologists;
   1-17              (4)  one person licensed to practice medicine who is
   1-18  certified by a national professional organization of physicians
   1-19  that certifies family practitioners or pediatricians; and
   1-20              (5)  three persons who are not practicing or trained in
   1-21  a health care profession and who represent the public interest, one
   1-22  of whom must be a parent with at least one child born with the
   1-23  assistance of a midwife.
   1-24        (c)  A person is not eligible for appointment as a public
    2-1  member of the midwifery board if the person or the person's spouse:
    2-2              (1)  is registered, certified, or licensed by an
    2-3  occupational regulatory agency in the field of midwifery;
    2-4              (2)  is employed by or participates in the management
    2-5  of a business entity or other organization regulated by the
    2-6  midwifery board or receiving funds from the midwifery board;
    2-7              (3)  owns or controls, directly or indirectly, more
    2-8  than 10 percent interest in a business entity or other organization
    2-9  regulated by the midwifery board or receiving funds from the
   2-10  midwifery board; or
   2-11              (4)  uses or receives a substantial amount of tangible
   2-12  goods, services, or funds from the midwifery board, other than
   2-13  compensation or reimbursement authorized by law for midwifery board
   2-14  membership, attendance, or expenses.
   2-15        (d)  Appointments to the midwifery board shall be made
   2-16  without regard to the race, color, disability, sex, religion, age,
   2-17  or national origin of the appointees.
   2-18        SECTION 2.  Section 3A, Texas Midwifery Act (Article 4512i,
   2-19  Vernon's Texas Civil Statutes), is amended to read as follows:
   2-20        Sec. 3A.  Sunset provision.  The midwifery board is subject
   2-21  to Chapter 325, Government Code (Texas Sunset Act).  Unless
   2-22  continued in existence as provided by that chapter, the midwifery
   2-23  board is abolished and this Act expires September 1, 2005 <1993>.
   2-24        SECTION 3.  The Texas Midwifery Act (Article 4512i, Vernon's
   2-25  Texas Civil Statutes) is amended by adding Section 3B to read as
   2-26  follows:
   2-27        Sec. 3B.  CONFLICT OF INTEREST RESTRICTIONS.  (a)  An
    3-1  officer, employee, or paid consultant of a Texas trade association
    3-2  in the field of midwifery may not be a member or employee of the
    3-3  midwifery board who is exempt from the state's position
    3-4  classification plan or is compensated at or above the amount
    3-5  prescribed by the General Appropriations Act for step 1, salary
    3-6  group 17, of the position classification salary schedule.
    3-7        (b)  A person who is the spouse of an officer, manager, or
    3-8  paid consultant of a Texas trade association in the field of
    3-9  midwifery may not be a midwifery board member and may not be an
   3-10  employee of the midwifery board who is exempt from the state's
   3-11  position classification plan or is compensated at or above the
   3-12  amount prescribed by the General Appropriations Act for step 1,
   3-13  salary group 17, of the position classification salary schedule.
   3-14        (c)  For the purposes of this section, a Texas trade
   3-15  association is a nonprofit, cooperative, and voluntarily joined
   3-16  association of business or professional competitors in this state
   3-17  designed to assist its members and its industry or profession in
   3-18  dealing with mutual business or professional problems and in
   3-19  promoting their common interest.
   3-20        SECTION 4.  The Texas Midwifery Act (Article 4512i, Vernon's
   3-21  Texas Civil Statutes) is amended by adding Section 3C to read as
   3-22  follows:
   3-23        Sec. 3C.  EFFECT OF LOBBYING ACTIVITY.  A person may not
   3-24  serve as a member of the midwifery board or act as the general
   3-25  counsel to the midwifery board if the person is required to
   3-26  register as a lobbyist under Chapter 305, Government Code, and its
   3-27  subsequent amendments, because of the person's activities for
    4-1  compensation on behalf of a profession related to the operation of
    4-2  the midwifery board.
    4-3        SECTION 5.  The Texas Midwifery Act (Article 4512i, Vernon's
    4-4  Texas Civil Statutes) is amended by adding Section 3D to read as
    4-5  follows:
    4-6        Sec. 3D.  GROUNDS FOR REMOVAL FROM BOARD.  (a)  It is a
    4-7  ground for removal from the midwifery board if a member:
    4-8              (1)  does not have at the time of appointment the
    4-9  qualifications required by Section 3 of this Act;
   4-10              (2)  does not maintain during service on the midwifery
   4-11  board the qualifications required by Section 3 of this Act;
   4-12              (3)  violates a prohibition established by Section
   4-13  3(c), 3B, or 3C of this Act;
   4-14              (4)  cannot discharge the member's term for a
   4-15  substantial part of the term for which the member is appointed
   4-16  because of illness or disability; or
   4-17              (5)  is absent from more than half of the regularly
   4-18  scheduled midwifery board meetings that the member is eligible to
   4-19  attend during a calendar year unless the absence is excused by
   4-20  majority vote of the midwifery board.
   4-21        (b)  The validity of an action of the midwifery board is not
   4-22  affected by the fact that it is taken when a ground for removal of
   4-23  a midwifery board member exists.
   4-24        (c)  If the program coordinator has knowledge that a
   4-25  potential ground for removal exists, the program coordinator shall
   4-26  notify the chairman of the midwifery board of the ground.  The
   4-27  board of health shall then notify the governor that a potential
    5-1  ground for removal exists.
    5-2        SECTION 6.  Section 8A, Texas Midwifery Act (Article 4512i,
    5-3  Vernon's Texas Civil Statutes), is amended by adding Subsection (d)
    5-4  to read as follows:
    5-5        (d)  Subject to the approval of the Texas Board of Health,
    5-6  the midwifery board by rule shall establish reasonable and
    5-7  necessary fees so that the fees, in the aggregate, produce
    5-8  sufficient revenue to cover the costs of administering this Act.
    5-9  The fee amounts set by the midwifery board may be adjusted so that
   5-10  the total fees collected are sufficient to cover the cost of
   5-11  administering this Act.  The midwifery board may not set a fee for
   5-12  an amount less than the amount of that fee on September 1, 1993.
   5-13        SECTION 7.  The Texas Midwifery Act (Article 4512i, Vernon's
   5-14  Texas Civil Statutes) is amended by adding Section 8C to read as
   5-15  follows:
   5-16        Sec. 8C.  ANNUAL FINANCIAL REPORT.  The department shall file
   5-17  annually with the governor and the presiding officer of each house
   5-18  of the legislature a complete and detailed written report
   5-19  accounting for all funds received and disbursed by the midwifery
   5-20  board during the preceding fiscal year.  The annual report must be
   5-21  in the form and reported in the time provided by the General
   5-22  Appropriations Act.
   5-23        SECTION 8.  The Texas Midwifery Act (Article 4512i, Vernon's
   5-24  Texas Civil Statutes) is amended by adding Section 8D to read as
   5-25  follows:
   5-26        Sec. 8D.  PUBLIC INTEREST INFORMATION.  (a)  The midwifery
   5-27  board shall prepare information of public interest describing the
    6-1  functions of the midwifery board and the midwifery board's
    6-2  procedures by which complaints are filed with and resolved by the
    6-3  midwifery board.  The midwifery board shall make the information
    6-4  available to the public and appropriate state agencies.
    6-5        (b)  The midwifery board by rule shall establish methods by
    6-6  which consumers and service recipients are notified of the name,
    6-7  mailing address, and telephone number of the midwifery board for
    6-8  the purpose of directing complaints to the midwifery board.  The
    6-9  midwifery board may provide for that notification:
   6-10              (1)  on each registration form, application, or
   6-11  disclosure and informed consent form of an individual or entity
   6-12  regulated by the midwifery board;
   6-13              (2)  on a sign prominently displayed in the place of
   6-14  business of each individual or entity regulated by the midwifery
   6-15  board; or
   6-16              (3)  in a bill for service provided by an individual or
   6-17  entity regulated by the midwifery board.
   6-18        (c)  The midwifery board shall list along with its regular
   6-19  telephone number the toll-free telephone number that may be called
   6-20  to present a complaint about a health professional if the toll-free
   6-21  number is established under other state law.
   6-22        SECTION 9.  The Texas Midwifery Act (Article 4512i, Vernon's
   6-23  Texas Civil Statutes) is amended by adding Section 8E to read as
   6-24  follows:
   6-25        Sec. 8E.  EQUAL EMPLOYMENT OPPORTUNITY POLICIES.  (a)  The
   6-26  program coordinator or the coordinator's designee shall prepare and
   6-27  maintain a written policy statement to assure implementation of a
    7-1  program of equal employment opportunity under which all personnel
    7-2  transactions are made without regard to race, color, disability,
    7-3  sex, religion, age, or national origin.  The policy statement must
    7-4  include:
    7-5              (1)  personnel policies, including policies relating to
    7-6  recruitment, evaluation, selection, application, training, and
    7-7  promotion of personnel that are in compliance with the Commission
    7-8  on Human Rights Act (Article 5221k, Vernon's Texas Civil Statutes)
    7-9  and its subsequent amendments;
   7-10              (2)  a comprehensive analysis of the midwifery board
   7-11  workforce that meets federal and state guidelines;
   7-12              (3)  procedures by which a determination can be made of
   7-13  significant underuse in the midwifery board workforce of all
   7-14  persons for whom federal or state guidelines encourage a more
   7-15  equitable balance; and
   7-16              (4)  reasonable methods to appropriately address those
   7-17  areas of underuse.
   7-18        (b)  A policy statement prepared under Subsection (a) of this
   7-19  section must cover an annual period, be updated annually, be
   7-20  reviewed by the Commission on Human Rights for compliance with
   7-21  Subsection (a)(1) of this section, and be filed with the governor's
   7-22  office.
   7-23        (c)  The governor's office shall deliver a biennial report to
   7-24  the legislature based on the information received under Subsection
   7-25  (b)  of this section.  The report may be made separately or as part
   7-26  of other biennial reports to the legislature.
   7-27        SECTION 10.  The Texas Midwifery Act (Article 4512i, Vernon's
    8-1  Texas Civil Statutes) is amended by adding Section 8F to read as
    8-2  follows:
    8-3        Sec. 8F.  PUBLIC PARTICIPATION IN MIDWIFERY BOARD HEARINGS.
    8-4  The midwifery board shall develop and implement policies that
    8-5  provide the public with a reasonable opportunity to appear before
    8-6  the midwifery board and to speak on any issue under the
    8-7  jurisdiction of the midwifery board.
    8-8        SECTION 11.  The Texas Midwifery Act (Article 4512i, Vernon's
    8-9  Texas Civil Statutes) is amended by adding Section 8G to read as
   8-10  follows:
   8-11        Sec. 8G.  DIVISION OF RESPONSIBILITY.  The midwifery board
   8-12  shall develop and implement policies that clearly define the
   8-13  respective responsibilities of the midwifery board and the staff of
   8-14  the midwifery board.
   8-15        SECTION 12.  The Texas Midwifery Act (Article 4512i, Vernon's
   8-16  Texas Civil Statutes) is amended by adding Section 8H to read as
   8-17  follows:
   8-18        Sec. 8H.  PROGRAM ACCESSIBILITY.  The midwifery board shall
   8-19  prepare and maintain a written plan that describes how a person who
   8-20  does not speak English can be provided reasonable access to the
   8-21  midwifery board's programs.  The midwifery board shall also comply
   8-22  with federal and state laws for program and facility accessibility.
   8-23        SECTION 13.  Section 10, Texas Midwifery Act (Article 4512i,
   8-24  Vernon's Texas Civil Statutes), is amended by amending Subsection
   8-25  (c) and adding Subsection (i) to read as follows:
   8-26        (c)  On renewal of the documentation, the person must provide
   8-27  the program coordinator with evidence, acceptable under the rules
    9-1  of the board, of completion of mandatory continuing education as
    9-2  prescribed by the midwifery board.  The midwifery board by rule
    9-3  shall establish a minimum number of hours of continuing education
    9-4  required to renew a documentation under this Act.  The midwifery
    9-5  board may assess the continuing education needs of documented
    9-6  midwives and may require documented midwives to attend continuing
    9-7  education courses specified by the midwifery board.  The midwifery
    9-8  board by rule shall develop a process to evaluate and approve
    9-9  continuing education courses.
   9-10        (i)  The midwifery board shall identify the key factors for
   9-11  the competent performance by a documented midwife of the documented
   9-12  midwife's professional duties.  The midwifery board shall adopt a
   9-13  procedure to assess a documented midwife's participation in
   9-14  continuing education programs.
   9-15        SECTION 14.  Section 11, Texas Midwifery Act (Article 4512i,
   9-16  Vernon's Texas Civil Statutes), is amended by adding Subsection (e)
   9-17  to read as follows:
   9-18        (e)  The midwifery board shall have the written portion of
   9-19  the examination, if any, validated by an independent testing
   9-20  professional.
   9-21        SECTION 15.  Sections 13(b), (d), and (e), Texas Midwifery
   9-22  Act (Article 4512i, Vernon's Texas Civil Statutes), are amended to
   9-23  read as follows:
   9-24        (b)  Each person who practices midwifery must apply to the
   9-25  department annually to be documented as a midwife.  The application
   9-26  must be accompanied by a nonrefundable <$50> application fee in an
   9-27  amount set by the midwifery board.  The application must include
   10-1  the information required by board rule.
   10-2        (d)  The initial documentation issued to a midwife may be
   10-3  issued at any time during the year.  The initial documentation must
   10-4  be issued before the midwife begins to practice midwifery within
   10-5  the state.  The term of the initial practice under the
   10-6  documentation begins on the date that the requirements are met and
   10-7  extends through December 31 of the initial year.  The midwifery
   10-8  board by rule may adopt a system under which documentations expire
   10-9  on various dates during the year.  For the year in which the
  10-10  documentation expiration date is changed, documentation fees
  10-11  payable on the original expiration date shall be prorated on a
  10-12  monthly basis so that each documented midwife shall pay only that
  10-13  portion of the documentation fee that is allocable to the number of
  10-14  months during which the documentation is valid.  On renewal of the
  10-15  documentation on the new expiration date, the total documentation
  10-16  renewal fee is payable <After the initial year of documentation,
  10-17  the term of the documentation begins on January 1 and ends on
  10-18  December 31 of each year.  A renewal application must be completed
  10-19  during December of the year preceding the year for which the
  10-20  renewal is requested>.
  10-21        (e)  The department may accept an application for renewal
  10-22  that is filed after the close of the documentation period during a
  10-23  grace period not to exceed 60 days after the end of the
  10-24  documentation period.  The department may charge a late filing fee
  10-25  in an amount set by the midwifery board <not to exceed $25>. The
  10-26  late filing fee must be paid in addition to the application fee.
  10-27  The board shall adopt rules to establish the duration of the grace
   11-1  period and the amount of the late filing fee.
   11-2        SECTION 16.  The Texas Midwifery Act (Article 4512i, Vernon's
   11-3  Texas Civil Statutes) is amended by adding Section 18C to read as
   11-4  follows:
   11-5        Sec. 18C.  COMPLAINT PROCEDURE IN GENERAL.  (a)  The
   11-6  midwifery board shall keep an information file about each complaint
   11-7  filed with the midwifery board.  The midwifery board's information
   11-8  file shall be kept current and contain a record for each complaint
   11-9  of:
  11-10              (1)  all persons contacted in relation to the
  11-11  complaint;
  11-12              (2)  a summary of findings made at each step of the
  11-13  complaint process; and
  11-14              (3)  other relevant information.
  11-15        (b)  The midwifery board by rule shall adopt a form to
  11-16  standardize information concerning complaints made to the midwifery
  11-17  board.  The midwifery board by rule shall prescribe information to
  11-18  be provided to a person when the person files a complaint with the
  11-19  midwifery board.
  11-20        (c)  The midwifery board shall provide reasonable assistance
  11-21  to a person who wishes to file a complaint with the midwifery
  11-22  board.
  11-23        SECTION 17.  The Texas Midwifery Act (Article 4512i, Vernon's
  11-24  Texas Civil Statutes) is amended by adding Section 18D to read as
  11-25  follows:
  11-26        Sec. 18D.  COMPLAINT INVESTIGATION AND DISPOSITION.  The
  11-27  midwifery board shall adopt rules concerning the investigation of a
   12-1  complaint filed with the midwifery board.  The rules adopted under
   12-2  this subsection shall:
   12-3              (1)  distinguish between categories of complaints; and
   12-4              (2)  ensure that the person who filed the complaint has
   12-5  an opportunity to explain the allegations made in the complaint.
   12-6        SECTION 18.  This Act takes effect September 1, 1993.
   12-7        SECTION 19.  (a)  A member of the Midwifery Board immediately
   12-8  before the effective date of this Act continues to serve as a
   12-9  member of the board on or after the effective date of this Act for
  12-10  the remainder of the member's term.  The Texas Board of Health
  12-11  shall make appointments to the board on or after the effective date
  12-12  of this Act as terms of members of the board expire and vacancies
  12-13  occur on the board to accomplish, as soon as possible, the
  12-14  membership plan for the board established by Section 3, Texas
  12-15  Midwifery Act (Article 4512i, Vernon's Texas Civil Statutes), as
  12-16  amended by this Act.
  12-17        (b)  The changes in law made by this Act to the
  12-18  qualifications of members of the Midwifery Board do not affect the
  12-19  entitlement of a member appointed before September 1, 1993, to
  12-20  continue to hold office on the board for the term for which the
  12-21  member was appointed.  The changes in the qualifications apply only
  12-22  to a member appointed on or after September 1, 1993.
  12-23        SECTION 20.  The importance of this legislation and the
  12-24  crowded condition of the calendars in both houses create an
  12-25  emergency and an imperative public necessity that the
  12-26  constitutional rule requiring bills to be read on three several
  12-27  days in each house be suspended, and this rule is hereby suspended.