1-1 By: Moncrief S.B. No. 1433
1-2 (In the Senate - Filed April 26, 1993; April 27, 1993, read
1-3 first time and referred to Committee on Health and Human Services;
1-4 May 3, 1993, reported favorably by the following vote: Yeas 6,
1-5 Nays 0; May 3, 1993, sent to printer.)
1-6 COMMITTEE VOTE
1-7 Yea Nay PNV Absent
1-8 Zaffirini x
1-9 Ellis x
1-10 Madla x
1-11 Moncrief x
1-12 Nelson x
1-13 Patterson x
1-14 Shelley x
1-15 Truan x
1-16 Wentworth x
1-17 A BILL TO BE ENTITLED
1-18 AN ACT
1-19 relating to the continuation and functions of the midwifery board
1-20 and the regulation of the practice of midwifery.
1-21 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-22 SECTION 1. Section 3, Texas Midwifery Act (Article 4512i,
1-23 Vernon's Texas Civil Statutes), is amended by amending Subsection
1-24 (b) and adding Subsections (c) and (d) to read as follows:
1-25 (b) The midwifery board is composed of the following nine
1-26 members:
1-27 (1) three <six> midwives with at least three years of
1-28 experience in the practice of midwifery, not more than one <three>
1-29 of whom may be a licensed health care professional <professionals>;
1-30 (2) one certified nurse-midwife;
1-31 (3) a person licensed to practice medicine who is
1-32 certified by a national professional organization of physicians
1-33 that certifies obstetricians and gynecologists;
1-34 (4) one person licensed to practice medicine who is
1-35 certified by a national professional organization of physicians
1-36 that certifies family practitioners or pediatricians; and
1-37 (5) three persons who are not practicing or trained in
1-38 a health care profession and who represent the public interest, one
1-39 of whom must be a parent with at least one child born with the
1-40 assistance of a midwife.
1-41 (c) A person is not eligible for appointment as a public
1-42 member of the midwifery board if the person or the person's spouse:
1-43 (1) is registered, certified, or licensed by an
1-44 occupational regulatory agency in the field of midwifery;
1-45 (2) is employed by or participates in the management
1-46 of a business entity or other organization regulated by the
1-47 midwifery board or receiving funds from the midwifery board;
1-48 (3) owns or controls, directly or indirectly, more
1-49 than 10 percent interest in a business entity or other organization
1-50 regulated by the midwifery board or receiving funds from the
1-51 midwifery board; or
1-52 (4) uses or receives a substantial amount of tangible
1-53 goods, services, or funds from the midwifery board, other than
1-54 compensation or reimbursement authorized by law for midwifery board
1-55 membership, attendance, or expenses.
1-56 (d) Appointments to the midwifery board shall be made
1-57 without regard to the race, color, disability, sex, religion, age,
1-58 or national origin of the appointees.
1-59 SECTION 2. Section 3A, Texas Midwifery Act (Article 4512i,
1-60 Vernon's Texas Civil Statutes), is amended to read as follows:
1-61 Sec. 3A. Sunset provision. The midwifery board is subject
1-62 to Chapter 325, Government Code (Texas Sunset Act). Unless
1-63 continued in existence as provided by that chapter, the midwifery
1-64 board is abolished and this Act expires September 1, 2005 <1993>.
1-65 SECTION 3. The Texas Midwifery Act (Article 4512i, Vernon's
1-66 Texas Civil Statutes) is amended by adding Section 3B to read as
1-67 follows:
1-68 Sec. 3B. CONFLICT OF INTEREST RESTRICTIONS. (a) An
2-1 officer, employee, or paid consultant of a Texas trade association
2-2 in the field of midwifery may not be a member or employee of the
2-3 midwifery board who is exempt from the state's position
2-4 classification plan or is compensated at or above the amount
2-5 prescribed by the General Appropriations Act for step 1, salary
2-6 group 17, of the position classification salary schedule.
2-7 (b) A person who is the spouse of an officer, manager, or
2-8 paid consultant of a Texas trade association in the field of
2-9 midwifery may not be a midwifery board member and may not be an
2-10 employee of the midwifery board who is exempt from the state's
2-11 position classification plan or is compensated at or above the
2-12 amount prescribed by the General Appropriations Act for step 1,
2-13 salary group 17, of the position classification salary schedule.
2-14 (c) For the purposes of this section, a Texas trade
2-15 association is a nonprofit, cooperative, and voluntarily joined
2-16 association of business or professional competitors in this state
2-17 designed to assist its members and its industry or profession in
2-18 dealing with mutual business or professional problems and in
2-19 promoting their common interest.
2-20 SECTION 4. The Texas Midwifery Act (Article 4512i, Vernon's
2-21 Texas Civil Statutes) is amended by adding Section 3C to read as
2-22 follows:
2-23 Sec. 3C. EFFECT OF LOBBYING ACTIVITY. A person may not
2-24 serve as a member of the midwifery board or act as the general
2-25 counsel to the midwifery board if the person is required to
2-26 register as a lobbyist under Chapter 305, Government Code, and its
2-27 subsequent amendments, because of the person's activities for
2-28 compensation on behalf of a profession related to the operation of
2-29 the midwifery board.
2-30 SECTION 5. The Texas Midwifery Act (Article 4512i, Vernon's
2-31 Texas Civil Statutes) is amended by adding Section 3D to read as
2-32 follows:
2-33 Sec. 3D. GROUNDS FOR REMOVAL FROM BOARD. (a) It is a
2-34 ground for removal from the midwifery board if a member:
2-35 (1) does not have at the time of appointment the
2-36 qualifications required by Section 3 of this Act;
2-37 (2) does not maintain during service on the midwifery
2-38 board the qualifications required by Section 3 of this Act;
2-39 (3) violates a prohibition established by Section
2-40 3(c), 3B, or 3C of this Act;
2-41 (4) cannot discharge the member's duties for a
2-42 substantial part of the term for which the member is appointed
2-43 because of illness or disability; or
2-44 (5) is absent from more than half of the regularly
2-45 scheduled midwifery board meetings that the member is eligible to
2-46 attend during a calendar year unless the absence is excused by
2-47 majority vote of the midwifery board.
2-48 (b) The validity of an action of the midwifery board is not
2-49 affected by the fact that it is taken when a ground for removal of
2-50 a midwifery board member exists.
2-51 (c) If the program coordinator has knowledge that a
2-52 potential ground for removal exists, the program coordinator shall
2-53 notify the chairman of the midwifery board of the ground. The
2-54 board of health shall then notify the governor that a potential
2-55 ground for removal exists.
2-56 SECTION 6. Section 8A, Texas Midwifery Act (Article 4512i,
2-57 Vernon's Texas Civil Statutes), is amended by adding Subsection (d)
2-58 to read as follows:
2-59 (d) Subject to the approval of the Texas Board of Health,
2-60 the midwifery board by rule shall establish reasonable and
2-61 necessary fees so that the fees, in the aggregate, produce
2-62 sufficient revenue to cover the costs of administering this Act.
2-63 The fee amounts set by the midwifery board may be adjusted so that
2-64 the total fees collected are sufficient to cover the cost of
2-65 administering this Act. The midwifery board may not set a fee for
2-66 an amount less than the amount of that fee on September 1, 1993.
2-67 SECTION 7. The Texas Midwifery Act (Article 4512i, Vernon's
2-68 Texas Civil Statutes) is amended by adding Section 8C to read as
2-69 follows:
2-70 Sec. 8C. ANNUAL FINANCIAL REPORT. The department shall file
3-1 annually with the governor and the presiding officer of each house
3-2 of the legislature a complete and detailed written report
3-3 accounting for all funds received and disbursed by the midwifery
3-4 board during the preceding fiscal year. The annual report must be
3-5 in the form and reported in the time provided by the General
3-6 Appropriations Act.
3-7 SECTION 8. The Texas Midwifery Act (Article 4512i, Vernon's
3-8 Texas Civil Statutes) is amended by adding Section 8D to read as
3-9 follows:
3-10 Sec. 8D. PUBLIC INTEREST INFORMATION. (a) The midwifery
3-11 board shall prepare information of public interest describing the
3-12 functions of the midwifery board and the midwifery board's
3-13 procedures by which complaints are filed with and resolved by the
3-14 midwifery board. The midwifery board shall make the information
3-15 available to the public and appropriate state agencies.
3-16 (b) The midwifery board by rule shall establish methods by
3-17 which consumers and service recipients are notified of the name,
3-18 mailing address, and telephone number of the midwifery board for
3-19 the purpose of directing complaints to the midwifery board. The
3-20 midwifery board may provide for that notification:
3-21 (1) on each registration form, application, or
3-22 disclosure and informed consent form of an individual or entity
3-23 regulated by the midwifery board;
3-24 (2) on a sign prominently displayed in the place of
3-25 business of each individual or entity regulated by the midwifery
3-26 board; or
3-27 (3) in a bill for service provided by an individual or
3-28 entity regulated by the midwifery board.
3-29 (c) The midwifery board shall list along with its regular
3-30 telephone number the toll-free telephone number that may be called
3-31 to present a complaint about a health professional if the toll-free
3-32 number is established under other state law.
3-33 SECTION 9. The Texas Midwifery Act (Article 4512i, Vernon's
3-34 Texas Civil Statutes) is amended by adding Section 8E to read as
3-35 follows:
3-36 Sec. 8E. EQUAL EMPLOYMENT OPPORTUNITY POLICIES. (a) The
3-37 program coordinator or the coordinator's designee shall prepare and
3-38 maintain a written policy statement to assure implementation of a
3-39 program of equal employment opportunity under which all personnel
3-40 transactions are made without regard to race, color, disability,
3-41 sex, religion, age, or national origin. The policy statement must
3-42 include:
3-43 (1) personnel policies, including policies relating to
3-44 recruitment, evaluation, selection, application, training, and
3-45 promotion of personnel that are in compliance with the Commission
3-46 on Human Rights Act (Article 5221k, Vernon's Texas Civil Statutes)
3-47 and its subsequent amendments;
3-48 (2) a comprehensive analysis of the midwifery board
3-49 work force that meets federal and state guidelines;
3-50 (3) procedures by which a determination can be made of
3-51 significant underutilization in the midwifery board work force of
3-52 all persons for whom federal or state guidelines encourage a more
3-53 equitable balance; and
3-54 (4) reasonable methods to appropriately address those
3-55 areas of underutilization.
3-56 (b) A policy statement prepared under Subsection (a) of this
3-57 section must cover an annual period, be updated annually, be
3-58 reviewed by the Commission on Human Rights for compliance with
3-59 Subsection (a)(1) of this section, and be filed with the governor's
3-60 office.
3-61 (c) The governor's office shall deliver a biennial report to
3-62 the legislature based on the information received under Subsection
3-63 (b) of this section. The report may be made separately or as part
3-64 of other biennial reports to the legislature.
3-65 SECTION 10. The Texas Midwifery Act (Article 4512i, Vernon's
3-66 Texas Civil Statutes) is amended by adding Section 8F to read as
3-67 follows:
3-68 Sec. 8F. PUBLIC PARTICIPATION IN MIDWIFERY BOARD HEARINGS.
3-69 The midwifery board shall develop and implement policies that
3-70 provide the public with a reasonable opportunity to appear before
4-1 the midwifery board and to speak on any issue under the
4-2 jurisdiction of the midwifery board.
4-3 SECTION 11. The Texas Midwifery Act (Article 4512i, Vernon's
4-4 Texas Civil Statutes) is amended by adding Section 8G to read as
4-5 follows:
4-6 Sec. 8G. DIVISION OF RESPONSIBILITY. The midwifery board
4-7 shall develop and implement policies that clearly define the
4-8 respective responsibilities of the midwifery board and the staff of
4-9 the midwifery board.
4-10 SECTION 12. The Texas Midwifery Act (Article 4512i, Vernon's
4-11 Texas Civil Statutes) is amended by adding Section 8H to read as
4-12 follows:
4-13 Sec. 8H. PROGRAM ACCESSIBILITY. The midwifery board shall
4-14 prepare and maintain a written plan that describes how a person who
4-15 does not speak English can be provided reasonable access to the
4-16 midwifery board's programs. The midwifery board shall also comply
4-17 with federal and state laws for program and facility accessibility.
4-18 SECTION 13. Section 10, Texas Midwifery Act (Article 4512i,
4-19 Vernon's Texas Civil Statutes), is amended by amending Subsection
4-20 (c) and adding Subsection (i) to read as follows:
4-21 (c) On renewal of the documentation, the person must provide
4-22 the program coordinator with evidence, acceptable under the rules
4-23 of the board, of completion of mandatory continuing education as
4-24 prescribed by the midwifery board. The midwifery board by rule
4-25 shall establish a minimum number of hours of continuing education
4-26 required to renew a documentation under this Act. The midwifery
4-27 board may assess the continuing education needs of documented
4-28 midwives and may require documented midwives to attend continuing
4-29 education courses specified by the midwifery board. The midwifery
4-30 board by rule shall develop a process to evaluate and approve
4-31 continuing education courses.
4-32 (i) The midwifery board shall identify the key factors for
4-33 the competent performance by a documented midwife of the documented
4-34 midwife's professional duties. The midwifery board shall adopt a
4-35 procedure to assess a documented midwife's participation in
4-36 continuing education programs.
4-37 SECTION 14. Section 11, Texas Midwifery Act (Article 4512i,
4-38 Vernon's Texas Civil Statutes), is amended by adding Subsection (e)
4-39 to read as follows:
4-40 (e) The midwifery board shall have the written portion of
4-41 the examination, if any, validated by an independent testing
4-42 professional.
4-43 SECTION 15. Subsections (b), (d), and (e), Section 13, Texas
4-44 Midwifery Act (Article 4512i, Vernon's Texas Civil Statutes), are
4-45 amended to read as follows:
4-46 (b) Each person who practices midwifery must apply to the
4-47 department annually to be documented as a midwife. The application
4-48 must be accompanied by a nonrefundable <$50> application fee in an
4-49 amount set by the midwifery board. The application must include
4-50 the information required by board rule.
4-51 (d) The initial documentation issued to a midwife may be
4-52 issued at any time during the year. The initial documentation must
4-53 be issued before the midwife begins to practice midwifery within
4-54 the state. The term of the initial practice under the
4-55 documentation begins on the date that the requirements are met and
4-56 extends through December 31 of the initial year. The midwifery
4-57 board by rule may adopt a system under which documentations expire
4-58 on various dates during the year. For the year in which the
4-59 documentation expiration date is changed, documentation fees
4-60 payable on the original expiration date shall be prorated on a
4-61 monthly basis so that each documented midwife shall pay only that
4-62 portion of the documentation fee that is allocable to the number of
4-63 months during which the documentation is valid. On renewal of the
4-64 documentation on the new expiration date, the total documentation
4-65 renewal fee is payable <After the initial year of documentation,
4-66 the term of the documentation begins on January 1 and ends on
4-67 December 31 of each year. A renewal application must be completed
4-68 during December of the year preceding the year for which the
4-69 renewal is requested>.
4-70 (e) The department may accept an application for renewal
5-1 that is filed after the close of the documentation period during a
5-2 grace period not to exceed 60 days after the end of the
5-3 documentation period. The department may charge a late filing fee
5-4 in an amount set by the midwifery board <not to exceed $25>. The
5-5 late filing fee must be paid in addition to the application fee.
5-6 The board shall adopt rules to establish the duration of the grace
5-7 period and the amount of the late filing fee.
5-8 SECTION 16. The Texas Midwifery Act (Article 4512i, Vernon's
5-9 Texas Civil Statutes) is amended by adding Section 18C to read as
5-10 follows:
5-11 Sec. 18C. COMPLAINT PROCEDURE IN GENERAL. (a) The
5-12 midwifery board shall keep an information file about each complaint
5-13 filed with the midwifery board. The midwifery board's information
5-14 file shall be kept current and contain a record for each complaint
5-15 of:
5-16 (1) all persons contacted in relation to the
5-17 complaint;
5-18 (2) a summary of findings made at each step of the
5-19 complaint process; and
5-20 (3) other relevant information.
5-21 (b) The midwifery board by rule shall adopt a form to
5-22 standardize information concerning complaints made to the midwifery
5-23 board. The midwifery board by rule shall prescribe information to
5-24 be provided to a person when the person files a complaint with the
5-25 midwifery board.
5-26 (c) The midwifery board shall provide reasonable assistance
5-27 to a person who wishes to file a complaint with the midwifery
5-28 board.
5-29 SECTION 17. The Texas Midwifery Act (Article 4512i, Vernon's
5-30 Texas Civil Statutes) is amended by adding Section 18D to read as
5-31 follows:
5-32 Sec. 18D. COMPLAINT INVESTIGATION AND DISPOSITION. The
5-33 midwifery board shall adopt rules concerning the investigation of a
5-34 complaint filed with the midwifery board. The rules adopted under
5-35 this subsection shall:
5-36 (1) distinguish between categories of complaints; and
5-37 (2) ensure that the person who filed the complaint has
5-38 an opportunity to explain the allegations made in the complaint.
5-39 SECTION 18. This Act takes effect September 1, 1993.
5-40 SECTION 19. (a) A member of the midwifery board immediately
5-41 before the effective date of this Act continues to serve as a
5-42 member of the board on or after the effective date of this Act for
5-43 the remainder of the member's term. The Texas Board of Health
5-44 shall make appointments to the board on or after the effective date
5-45 of this Act as terms of members of the board expire and vacancies
5-46 occur on the board to accomplish, as soon as possible, the
5-47 membership plan for the board established by Section 3, Texas
5-48 Midwifery Act (Article 4512i, Vernon's Texas Civil Statutes), as
5-49 amended by this Act.
5-50 (b) The changes in law made by this Act to the
5-51 qualifications of members of the midwifery board do not affect the
5-52 entitlement of a member appointed before September 1, 1993, to
5-53 continue to hold office on the board for the term for which the
5-54 member was appointed. The changes in the qualifications apply only
5-55 to a member appointed on or after September 1, 1993.
5-56 SECTION 20. The importance of this legislation and the
5-57 crowded condition of the calendars in both houses create an
5-58 emergency and an imperative public necessity that the
5-59 constitutional rule requiring bills to be read on three several
5-60 days in each house be suspended, and this rule is hereby suspended.
5-61 * * * * *
5-62 Austin,
5-63 Texas
5-64 May 3, 1993
5-65 Hon. Bob Bullock
5-66 President of the Senate
5-67 Sir:
5-68 We, your Committee on Health and Human Services to which was
5-69 referred S.B. No. 1433, have had the same under consideration, and
5-70 I am instructed to report it back to the Senate with the
6-1 recommendation that it do pass and be printed.
6-2 Zaffirini,
6-3 Chair
6-4 * * * * *
6-5 WITNESSES
6-6 FOR AGAINST ON
6-7 ___________________________________________________________________
6-8 Name: Elizabeth Lee x
6-9 Representing: Asso of Tx Midwives
6-10 City: Austin
6-11 -------------------------------------------------------------------